Efficacy of injectable platelet-rich fibrin and cross-linked hyaluronic acid for augmentation of interdental papilla in terms of true and surrogate end points.

Abstract

Background: Tissue volumizers such as injectable platelet-rich fibrin (i-PRF) and hyaluronic acid (HA) have been used for nonsurgical augmentation of interdental papilla. There is sparse literature comparing the efficacy of the two tissue volumizers in terms of attainment of true endpoints. The present study compared the efficacy of i-PRF and cross-linked HA in interdental papilla augmentation.

Materials and methods: Thirty participants were allocated into Group I (i-PRF) and Group II (HA). Assessment of surrogate end points was done using Papilla Presence Index (PPI), black triangle area (BTA) (Image J Analysis), probing pocket depth, and clinical attachment level, at baseline, 3^rd month, and 6^th month. PPI and BTA were assessed at 21^st day also. True endpoints were checked using the visual analog scale (VAS) and patient satisfaction questionnaire at the 6^th month. Data were analyzed using repeated measures of ANOVA and an independent t-test.

Results: There was a significant reduction in mean BTA measured at 21 days and at the 3^rd month (P = 0.001) within the groups. However, between the groups, there was no statistically significant difference in mean BTA. Improvement in PPI scores from score 3 to score 1 in both groups was observed. The VAS score was marginally high in Group II, and patient satisfaction was relatively high in Group I.

Conclusion: i-PRF and HA are equally effective as tissue volumizers in the augmentation of interdental papilla in terms of reduction in BTA and papillary fill. Patient satisfaction favored i-PRF use.