Treatment of periodontal endosseous defects with platelet-rich plasma alone or in combination with demineralized freeze-dried bone allograft: a comparative clinical trial.
BACKGROUND
Platelet-rich plasma (PRP) alone or combined with other regenerative materials was previously studied in human periodontal endosseous defects. There are no sufficient data evaluating to what extent the addition of demineralized freeze-dried bone allograft (DFDBA) to PRP may enhance the effectiveness of PRP. The aim of this randomized, double-masked, controlled clinical trial was to compare the effectiveness of autologous PRP alone to PRP + DFDBA in periodontal endosseous defects.


METHODS
Twenty-four proximal endosseous defects in 24 patients with severe chronic periodontitis were randomly treated with PRP alone or in combination with DFDBA. The final evaluation at 6 months was based on clinical and radiographic parameters. Subtraction radiography was used. The primary outcome variable was clinical attachment level (CAL).


RESULTS
The two treatment groups were initially comparable (mean CAL: 8.67 +/- 2.19 mm for PRP + DFDBA and 8.25 +/- 1.96 mm for PRP). Both treatments achieved statistically significant and similar CAL gain (3.08 +/- 1.17 mm for PRP + DFDBA and 3.08 +/- 0.95 mm for PRP), probing depth, defect depth, and area surface reduction. The percentage of defect fill did not significantly differ between the two treatments. There was a non-significant trend to greater defect fill (45.42% versus 41.29%), defect depth (54.05% versus 49.52%), and area surface (58.43% versus 52.16%) reduction with the graft. In both groups, 66.66% of the defects gained > or =3 mm of CAL.


CONCLUSIONS
Within its limits, this study demonstrates that both PRP and PRP combined with DFDBA resulted in significant clinical and radiographic improvement in human periodontal endosseous defects at 6 months, and the addition of DFDBA to PRP did not significantly enhance the treatment outcome.
Markou
Nikolaos
N
Department of Periodontology, School of Dentistry, University of Athens, Athens, Greece. perionarm@gmail.com
Pepelassi
Eudoxie
E
Vavouraki
Helen
H
Stamatakis
Harry C
HC
Nikolopoulos
Georgios
G
Vrotsos
Ioannis
I
Tsiklakis
Kostas
K
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000601:surgery*; D000543:Alveoloplasty; D016025:Bone Transplantation / Q000379:methods*; D055113:Chronic Periodontitis / Q000601:surgery*; D015925:Cryopreservation; D003648:Decalcification Technique; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005612:Freeze Drying; D005889:Gingival Recession / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D053657:Platelet-Rich Plasma; D013382:Subtraction Technique; D014021:Tissue Preservation; D014184:Transplantation, Homologous; D016896:Treatment Outcome