Platelet-Rich Fibrin with Minocycline versus Arestin in Non-surgical Periodontal Therapy: A Split-Mouth Randomised Controlled Clinical Trial.

Abstract

Purpose: Periodontitis is a chronic inflammatory disease and while non-surgical periodontal therapy (NSPT) remains the first choice of treatment, its capability to completely resolve inflammation may be limited. Arestin® (1 mg minocycline microsphere) is an established adjunct, whereas platelet-rich fibrin (PRF) has recently emerged as a promising local drug-delivery scaffold. This split-mouth randomised controlled clinical trial compared the clinical efficacy of adjunctive minocycline delivered via conventional Arestin® versus incorporation within a PRF scaffold for the treatment of 4-6 mm periodontal pockets after NSPT.

Methods and materials: Fifteen participants were recruited, of whom 13 completed the 6-month follow-up. Each patient contributed two interproximal sites randomly allocated to receive either adjunctive PRF + Minocycline or adjunctive Arestin® after NSPT. Periodontal parameters, such as probing depth (PD), clinical attachment level (CAL), gingival recession (GR), and bleeding on probing (BOP), were measured at baseline and 6 months.

Results: Both adjunctive approaches yielded statistically significant intra-group enhancements. Mean PD reductions were 1.13 ± 0.15 mm in the PRF + Minocycline group and 1.00 ± 0.67 mm in the Arestin® group. CAL gains were 1.02 ± 0.66 mm and 1.08 ± 0.61, respectively. Most sites in both groups showed CAL gains of 1 - 2 mm (61.5%), whereas 15.4% of sites attained a residual PD of 3 mm at 6 months. Inter-group comparisons revealed no statistically significant differences for PD (p = 0.609), GR (p = 0.096), or CAL (p = 0.789).

Conclusion: These findings suggest that PRF + Minocycline yielded comparable short-term outcomes to Arestin® as adjunctive treatments during NSPT. Therefore, treatment selection may be based on clinician preference, patient-related factors, cost, availability, and handling characteristics. Larger RCTs with longer follow-up are necessary to confirm these findings.