Comparative evaluation of platelet-rich plasma + β-tricalcium phosphate and platelet-rich fibrin + β-tricalcium phosphate for healing periapical lesions, using cone beam computed tomography – an in vivo study

Background. Platelet concentrates are currently being researched for their potential to enhance bone formation. Aim. The aim of this study is to quantitatively evaluate and compare bone regeneration in periapical lesions using a combination of platelet-rich plasma (PRP) + β-tricalcium phosphate (β-TCP) and platelet-rich fibrin (PRF) + β-TCP. Methods. Ten subjects with periapical lesions measuring 10-20 mm in relation to maxillary incisors indicated for periapical surgery were selected. Pre-operative bone density values at the periapical region were measured using CBCT. Root canal treatment was completed appropriately in all cases. Under adequate local anesthesia, periapical surgery was performed. The 10 subjects were distributed into two groups of 5 subjects in each group. Group I: Periapical bone defect filled with PRP + β-TCP and Group II: Periapical bone defect filled with PRF + β-TCP. The mucoperiosteal flaps were repositioned and sutured. Bone density evaluation of the periapical region was done 6 months and 1 year after surgery using cone beam computed tomography (CBCT). The Hounsfield unit (HU) values obtained were subjected to statistical analysis by Independent samples t-test for inter-group comparison. The intra-group comparison was done by repeated measure ANOVA and Bonferroni post hoc tests. Results. In Group I and Group II, a statistically significant difference was observed at the end of 6 months and 1 year, when compared to the pre-operative values (P=0.000). There was no statistically significant difference in bone density values between the PRP + β-TCP and PRF + β-TCPgroups at both 6 months and 1-year post-operative observation periods. Conclusion. PRP + β-TCP and PRF + β-TCP were equally effective in promoting bone regeneration and can be considered valuable bioactive surgical additives for enhancement of healing in periapical bone defects.