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Demineralized freeze-dried bone allograft with/without i-Platelet-rich fibrin in 3 wall intrabony defects
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Keywords

Periodontitis
Allografts
Alveolar bone loss
Platelet-Rich Fibrin
Regeneration

How to Cite

1.
Mathew R, Bhatsange A. Demineralized freeze-dried bone allograft with/without i-Platelet-rich fibrin in 3 wall intrabony defects. Braz. J. Oral Sci. [Internet]. 2024 Mar. 10 [cited 2024 Jun. 16];23(00):e240338. Available from: https://periodicos.sbu.unicamp.br/ojs/index.php/bjos/article/view/8670338

Abstract

Demineralized freeze-dried bone allograft (DFDBA) contains bone morphogenetic proteins (BMPs), hence is osteoinductive. Autologous platelet concentrates exhibit a higher quantity of growth factors. Both these biomaterials aid in bone regeneration when placed in three-wall intrabony defects. However, their efficacy when used alone and in conjugation is not clear. Aim: To assess clinical and radiographic efficacy of injectable platelet-rich fibrin (i-PRF) with microsurgical access flap in the treatment of three-wall intrabony defects in chronic periodontitis patients. Methods: Thirty sites with three-wall intrabony defects were randomly assigned to control and test group by computer generated method. The test group obtained i-PRF mixed with DFDBA while the control group received only DFDBA. Clinical parameters such as site-specific Plaque index (PI), Radiographic intrabony defect depth (IBDD), modified- Sulcular bleeding index (mSBI), Clinical attachment level (CAL), and Probing pocket depth (PPD) were measured at baseline, three and six months. Results: Intragroup comparison within the control group and test group exhibited statistically highly significant variation of mean PI, mSBI, PPD, CAL, and IBDD score from baseline to 3 months and from 3-6 months (p<0.001). However, intergroup comparison demonstrated no statistically significant variation of mean IBDD at all 3 intervals (p>0.05). Conclusion: i-PRF combined with DFDBA enhanced the radiographic and clinical parameters as opposed to DFDBA alone. The role of i-PRF is promising in its capacity for easy obtainability and increased potential to aid in regeneration. 

https://doi.org/10.20396/bjos.v23i00.8670338
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References

Brunsvold MA, Mellonig JT. Bone grafts and periodontal regeneration. Periodontol 2000. 1993 Feb;1:80-91.

Zhou S, Sun C, Huang S, Wu X, Zhao Y, Pan C, et al. Efficacy of adjunctive bioactive materials in the treatment of periodontal intrabony defects: a systematic review and meta-analysis. Biomed Res Int. 2018 May;2018:8670832. doi: 10.1155/2018/8670832.

Panda S, Ramamoorthi S, Jayakumar ND, Sankari M, Varghese SS. Platelet rich fibrin and alloplast in the treatment of intrabony defect. J Pharm Bioallied Sci. 2014 Apr;6(2):127-31. doi: 10.4103/0975-7406.129178.

Prichard JF. The etiology, diagnosis and treatment of the intrabony defect. J Periodontol. 1967 Nov-Dec;38(6):455-65. doi: 10.1902/jop.1967.38.6_part1.455.

Agarwal P, Chatterjee A, Gokhale S, Singh HP, Kandwal A. Evaluation of platelet-rich plasma alone or in combination with demineralized freeze dried bone allograft in treatment of periodontal infrabony defects: A comparative clinical trial. J Indian Soc Periodontol. 2016 Jan-Feb;20(1):42-7. doi: 10.4103/0972-124X.170811.

Jethwa J, Ireland RS, Chan D. Does a combination of platelet-rich plasma and decalcified freeze-dried bone allograft offer advantages over decalcified freeze-dried bone allograft alone when using pocket depth and clinical attachment level as markers for periodontal healing? A literature review. J Investig Clin Dent. 2019 May;10(2):e12397. doi: 10.1111/jicd.12397.

Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):e45-50. doi: 10.1016/j.tripleo.2005.07.009.

Pradeep AR, Bajaj P, Rao NS, Agarwal E, Naik SB. Platelet-rich fibrin combined with a porous hydroxyapatite graft for the treatment of 3-wall intrabony defects in chronic periodontitis: a randomized controlled clinical trial. J Periodontol. 2017 Dec;88(12):1288-96. doi: 10.1902/jop.2012.110722.

Miron RJ, Fujioka-Kobayashi M, Hernandez M, Kandalam U, Zhang Y, Ghanaati S, et al. Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry? Clin Oral Investig. 2017 Nov;21(8):2619-27. doi: 10.1007/s00784-017-2063-9.

Shanelec DA. Periodontal microsurgery. J Esthet Restor Dent. 2003;15(7):402-7; discussion 408. doi: 10.1111/j.1708-8240.2003.tb00965.x.

Cortellini P, Tonetti MS. Microsurgical approach to periodontal regeneration. Initial evaluation in a case cohort. J Periodontol. 2001 Apr;72(4):559-69. doi: 10.1902/jop.2001.72.4.559.

Jain R, Kudva P, Kumar R, Nagar S. Periodontal microsurgery-magnifying facts, maximizing results. J Adv Med Dent Sci Res. 2014;2(3):24-34.

Silness J, Loe H. Periodontol disease in pregnancy. Il. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964 Feb;22:121-35. doi: 10.3109/00016356408993968.

Mombelli A, van Oosten MA, Schurch E Jr, Land NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol. 1987 Dec;2(4):145-51. doi: 10.1111/j.1399-302x.1987.tb00298.x.

Mourão CF, Valiense H, Melo ER, Mourão NB, Maia MD. Obtention of injectable platelets rich-fibrin (i-PRF) and its polymerization with bone graft: technical note. Rev Col Bras Cir. 2015 Nov-Dec;42(6):421-3. doi: 10.1590/0100-69912015006013.

Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple IL, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015 Jun;68(1):182-216. doi: 10.1111/prd.12086.

Bowers G, Felton F, Middleton C, Glynn D, Sharp S, Mellonig J, et al. Histologic comparison of regeneration in human intrabony defects when osteogenin is combined with demineralized freeze-dried bone allograft and with purified bovine collagen. J Periodontol. 1991 Nov;62(11):690-702. doi: 10.1902/jop.1991.62.11.690.

Najeeb S, Khurshid Z, Agwan MAS, Ansari SA, Zafar MS, Matinlinna JP. Regenerative Potential of Platelet Rich Fibrin (PRF) for curing intrabony periodontal defects: a systematic review of clinical studies. Tissue Eng Regen Med. 2017 Sep;14(6):735-42. doi: 10.1007/s13770-017-0079-5.

Shah R, Gowda TM, Thomas R, Kumar T, Mehta DS. Biological activation of bone grafts using injectable platelet-rich fibrin. J Prosthet Dent. 2019 Mar;121(3):391-3. doi: 10.1016/j.prosdent.2018.03.027.

Elgendy EA, Abo Shady TE. Clinical and radiographic evaluation of nanocrystalline hydroxyapatite with or without platelet-rich fibrin membrane in the treatment of periodontal intrabony defects. J Indian Soc Periodontol. 2015 Jan-Feb;19(1):61-5. doi: 10.4103/0972-124X.148639.

Wang X, Zhang Y, Choukroun J, Ghanaati S, Miron RJ. Effects of an injectable platelet-rich fibrin on osteoblast behavior and bone tissue formation in comparison to platelet-rich plasma. Platelets. 2018 Jan;29(1):48-55. doi: 10.1080/09537104.2017.1293807.

Sharma A, Pradeep AR. Treatment of 3-wall intrabony defects in patients with chronic periodontitis with autologous platelet-rich fibrin: a randomized controlled clinical trial. J Periodontol. 2011 Dec;82(12):1705-12. doi: 10.1902/jop.2011.110075.

Zhang J, Yin C, Zhao Q, Zhao Z, Wang J, Miron RJ, et al. Anti-inflammation effects of injectable platelet-rich fibrin via macrophages and dendritic cells. J Biomed Mater Res A. 2020 Jan;108(1):61-8. doi: 10.1002/jbm.a.36792.

Khosropanah H, Shahidi S, Basri A, Houshyar M. Treatment of intrabony defects by DFDBA alone or in combination with PRP: a split-mouth randomized clinical and three-dimensional radiographic trial. J Dent (Tehran). 2015 Oct;12(10):764-73.

Caton JG, Greenstein G. Factors related to periodontal regeneration. Periodontol 2000. 1993 Feb;1(1):9-15.

Kao RT, Nares S, Reynolds MA. Periodontal regeneration - intrabony defects: a systematic review from the AAP Regeneration Workshop. J Periodontol. 2015 Feb;86(2 Suppl):S77-104. doi: 10.1902/jop.2015.130685.

Wachtel H, Schenk G, Böhm S, Weng D, Zuhr O, Hürzeler MB. Microsurgical access flap and enamel matrix derivative for the treatment of periodontal intrabony defects: a controlled clinical study. J Clin Periodontol. 2003 Jun;30(6):496-504. doi: 10.1034/j.1600-051x.2003.00013.x.

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Copyright (c) 2024 Rinnu Mathew, Anuradha Bhatsange

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