Effect of platelet-rich plasma on the healing of intrabony defects treated with Beta tricalcium phosphate and expanded polytetrafluoroethylene membranes.
BACKGROUND
Regenerative periodontal therapy using platelet-rich plasma (PRP) and different types of bone substitutes with or without guided tissue regeneration (GTR) has been proposed as a modality to enhance the outcome of regenerative surgery. However, there are limited data from controlled clinical studies evaluating the effect of PRP on the healing of deep intrabony defects treated with a combination of bone substitutes and GTR. The aim of this study was to clinically evaluate the effect of PRP on the healing of deep intrabony defects treated with beta tricalcium phosphate (beta-TCP) and GTR by means of a non-bioresorbable expanded polytetrafluoroethylene membrane.


METHODS
Twenty-eight subjects with advanced chronic periodontal disease and displaying one intrabony defect were treated randomly with a combination of PRP + beta-TCP + GTR or beta-TCP + GTR. Plaque index, gingival index, bleeding on probing, probing depth (PD), gingival recession, and clinical attachment level (CAL) were evaluated at baseline and at 1 year after treatment. CAL was the primary outcome variable.


RESULTS
No differences in any of the investigated parameters were observed at baseline between the two groups. Healing was uneventful in all subjects. At 1 year after therapy, the sites treated with PRP + beta-TCP + GTR showed a reduction in mean PD from 9.1 +/- 0.6 mm to 3.3 +/- 0.5 mm (P <0.001) and a change in mean CAL from 10.1 +/- 1.3 mm to 5.7 +/- 1.1 mm (P <0.001). In the group treated with beta-TCP + GTR, mean PD was reduced from 9.0 +/- 0.8 mm to 3.6 +/- 0.9 mm (P <0.001), and the mean CAL changed from 9.9 +/- 1.0 mm to 5.9 +/- 1.2 mm (P <0.001). In both groups, all sites gained > or =3 mm of CAL. CAL gains > or =4 mm were noted in 86% (12 of 14 defects) of the cases treated with PRP + beta-TCP + GTR and in 79% (11 of 14 defects) of those treated with beta-TCP + GTR. No statistically significant differences in any of the investigated parameters were observed between the two groups at the 1-year reevaluation.


CONCLUSIONS
At 1 year after surgery, both therapies resulted in significant PD reductions and CAL gains.
Döri
Ferenc
F
Department of Periodontology, Semmelweis University, Budapest, Hungary.
Huszár
Tamás
T
Nikolidakis
Dimitris
D
Tihanyi
Dora
D
Horváth
Attila
A
Arweiler
Nicole B
NB
Gera
István
I
Sculean
Anton
A
D000328:Adult; D016301:Alveolar Bone Loss / Q000473:pathology / Q000601:surgery*; D000539:Alveolar Process / Q000473:pathology; D001672:Biocompatible Materials / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000473:pathology / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000473:pathology / Q000601:surgery; D010512:Periodontal Index; D053657:Platelet-Rich Plasma / Q000502:physiology; D011138:Polytetrafluoroethylene; D019237:Tooth Cervix / Q000473:pathology; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D001672:Biocompatible Materials; D018786:Bone Substitutes; D002130:Calcium Phosphates; D008567:Membranes, Artificial; C485817:beta-tricalcium phosphate; D011138:Polytetrafluoroethylene