Comparison of GTR, T-PRF and open-flap debridement in the treatment of intrabony defects with endo-perio lesions: a randomized controlled trial.

G Ustaoğlu,F Özelçi,Z Uğur Aydin

doi:10.4317/medoral.23231

Abstract

Background Titanium- prepared platelet rich fibrin (T-PRF) is an autologous hemo-component with a high concentration of platelets that also incorporates leukocytes, and growth factors into the dense fibrin matrix and can be used as a healing biomaterial. This study assesses the adjunctive use of T-PRF in intrabony defects (IBDs) with open flap debridement (OFD) in comparison with guided tissue regeneration (GTR) as a gold standard and OFD alone as a control. Material and Methods A total of 45 patients (15 per group) were randomized as either T-PRF (test group), GTR (test group), or OFD alone (control group) sites. Probing depth (PD), clinical attachment level (CAL), and IBD were recorded. The radiographic depth of IBD was also measured. Primary outcomes assessed were changes in PD, CAL, and radiographic IBD that were assessed at the beginning and nine months later. Results The PRF and GTR group showed significant improvement in clinical parameters compared with the OFD alone (control group) at nine months. While there were no significant differences in PD and CAL between test groups (T-PRF and GTR groups), the significant difference was found in radiographic IBD depth. Conclusions T-PRF may give similar successful results as GTR in the treatment of IBDs with endo-perio lesions. Key words:Flap surgery, guided tissue regeneration, intrabony defects, periodontitis, root canal therapy.

Highlights

Pulp tissue may be affected by several causes, including trauma, periodontal disease, caries, restorative procedures, restorative materials, and chemical or thermal damage
Wound healing begins with the formation of a fibrin clot, platelet adhesion, and aggregation, followed by the release of many growth factors by the alpha granules of platelets, including platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and transforming growth factor (TGF)-α and -β
No statistically significant difference was found between the Titanium- prepared platelet rich fibrin (T-Platelet-rich fibrin (PRF)) and guided tissue regeneration (GTR) groups in terms of the baseline and the 9th-month measurements of Probing depth (PD) and clinical attachment level (CAL), which were found to be significantly higher than the control group (p < 0.001)

Summary

Introduction

Pulp tissue may be affected by several causes, including trauma, periodontal disease, caries, restorative procedures, restorative materials, and chemical or thermal damage. Simon et al [3] classified endo-perio lesions into five subgroups as follows: primary endodontic diseases, primary periodontal diseases, and combined disease including primary endodontic disease with secondary periodontal involvement, a primary periodontal disease with secondary endodontic involvement and true combined disease This classification provides a valuable guide for clinicians to achieve the correct diagnosis and clinical approach. The bone graft materials form a scaffold for the resident cells of the host, promoting either osteoinductive or osteoconductive pathways [8] Another technique found to be successful in the management of IBDs is use of autologous platelet concentrate to obtain healing biomaterials. This study aimed to examine the clinical and radiographic effectiveness of the GTR and T-PRF and open flap debridement (OFD) in the treatment of IBDs with endo-perio lesions. Conclusion: T-PRF may give similar successful results as GTR in the treatment of IBDs with endo-perio lesions

Objectives

Methods

Results

Conclusion