Combination of Platelet-rich Fibrin (PRF) in Advanced Periodontitis Stage Treatment
Abstract
Introduction: The treatment of advanced periodontitis has been a challenge for clinicians. Platelet-rich fibrin (PRF) is a second-generation platelet concentrate that contains various growth factorss and cytokines that promote tissue regeneration. The use of PRF in combination with other regenerative materials and techniques has been shown to be effective in the treatment of intrabony defects. This case series aims to evaluate the efficacy of PRF combinations in the regenerative treatment of patients with advanced periodontitis. Case report: Two patients diagnosed with advanced periodontitis (stage III/IV grade C) were selected for this study. After the completion of periodontal initial therapy, there were still pockets with a probing depth ≥ 5 mm (5–10 mm). Therefore, surgical interventions were planned. The first case used the combination of PRF with bone graft and guided tissue regeneration (GTR), while open flap debridement (OFD) with the addition of PRF and bone graft to create sticky bone was done in the second case. Three to five months of follow-up showed favorable outcomes, as evidenced by reductions in probing depth (PD), gains in clinical attachment level, and filling of bone defects, as well as improvements in patient comfort and rapid wound healing. Conclusion: The combination of PRF with grafting material and/or GTR has been shown to be a beneficial therapeutic approach for periodontal regenerative therapy. Platelet-rich fibrin in periodontal surgery may accelerate the tissue healing process.References
Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018; 89:S159–72. doi: 10.1002/JPER. 18-0006
Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Beglundh T, et al. Treatment of stage I–III periodontitis—The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020; 47(S22):4–60. doi: 10.1111/jcpe.13290
Buffoli B, Garzetti G, Calza S, Scotti E, Borsani E, Cappa V, et al. Periodontitis Stage III–IV, Grade C and Correlated Factors: A Histomorphometric Study. Biomedicines. 2019;7(2): 43. doi: 10.3390/biomedi cines7020043
Patel GK, Gaekwad SS, Gujjari SK, S.C. VK. Platelet-Rich Fibrin in Regeneration of Intrabony Defects: A Randomized Controlled Trial. J Periodontol. 2017; 88(11):1192–9. doi: 10.1902/jop. 2017.130710
Hanna R, Trejo PM, Weltman RL. Treatment of Intrabony Defects With Bovine-Derived Xenograft Alone and in Combination With Platelet-Rich Plasma: A Randomized Clinical Trial. J Periodontol. 2004; 75(12):1668–77. doi: 10.1902/jop.2004.75.12. 1668
Camargo PM, Lekovic V, Weinlaender M, Vasilic N, Madzarevic M, Kenney EB. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. J Periodontal Res. 2002; 37(4):300–6. doi: 10.1034/j.1600-0765.2002. 01001.x
Lekovic V, Milinkovic I, Aleksic Z, Jankovic S, Stankovic P, Kenney EB, et al. Platelet-rich fibrin and bovine porous bone mineral vs. platelet-rich fibrin in the treatment of intrabony periodontal defects. J Periodontal Res. 2012; 47(4):409–17. doi: 10.1111/j.1600-0765.2011.01446.x
Choukron J, Adda F, Schoeffler C, Vervelle A. the Opportunity in perio-implantology: The PRF. Implantodontie. 2001; 42:55-62
Panda S, Ramamoorthi S, Jayakumar N, Sankari M, Varghese S. Platelet rich fibrin and alloplast in the treatment of intrabony defect. J Pharm Bioallied Sci. 2014; 6(2):127. doi: 10.4103/0975-7406.129178
Theodosaki AM, Filippou S, Kazantzidis G, Doufexi AE. Effectiveness of platelet rich fibrin alone or in combination with bone grafts in the treatment of infrabony defects: Systematic review and metanalysis. Health Sciences Review. 2022; 5:100066.
Chen L, Ding Y, Cheng G, Meng S. Use of Platelet-Rich Fibrin in the Treatment of Periodontal Intrabony Defects: A Systematic Review and Meta-Analysis. Biomed Res Int. 2021; 2021: 6669168. doi:10.1155/2021/6669168
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; 2018: 1–15. doi: 10.1155/2018/8670832
Miron RJ, Dard M, Weinreb M. Enamel matrix derivative, inflammation and soft tissue wound healing. J Periodontal Res. 2015; 50(5):555–69. doi: 10.1111/jre.12245
Pham TAV. Intrabony defect treatment with platelet-rich fibrin, guided tissue regeneration and open-flap debridement: A randomized controlled trial. Journal of Evidence Based Dental Practice. 202; 21(3):101545. doi: 10.1016/j.jebdp.2021.101545
Liu K, Huang Z, Chen Z, Han B, Ouyang X. Treatment of periodontal intrabony defects using bovine porous bone mineral and guided tissue regeneration with/without platelet‐rich fibrin: A randomized controlled clinical trial. J Periodontol. 2021; 92(11):1546–53. doi: 10.1002/JPER.20-0860
Csifó-Nagy BK, Sólyom E, Bognár VL, Nevelits A, Dőri F. Efficacy of a new-generation platelet-rich fibrin in the treatment of periodontal intrabony defects: a randomized clinical trial. BMC Oral Health. 2021; 21(1):580. doi: 10.1186/s12903-021-01925-1
Adnan K, Farrukh U, Sarwar H, Gul J, Singh SP, Khan SS, et al. Effect of PRF on extraction socket healing. Int J Health Sci (Qassim). 2023; 7(S1):974–89.
Zhang T, Wang J, Le K, Guo Y, Zhu B. Platelet-rich fibrin accelerates skin wound healing in pressure injuries: a rat model. J Wound Care. 2022; 31(9):800–4. doi: 10.12968/jowc.2022.31.9.800
Lektemur Alpan A, Torumtay Cin G. PRF improves wound healing and postoperative discomfort after harvesting subepithelial connective tissue graft from palate: a randomized controlled trial. Clin Oral Investig. 2020; 24(1):425–36. doi: 10.1007/s00784-019-02934-9
Panda S, Sankari M, Satpathy A, Jayakumar D, Mozzati M, Mortellaro C, et al. Adjunctive Effect of Autologus Platelet-Rich Fibrin to Barrier Membrane in the Treatment of Periodontal Intrabony Defects. Journal of Craniofacial Surgery. 2016; 27(3):691–6. doi: 10.1097/SCS.0000000000002524
Hägi TT, Laugisch O, Ivanovic A, Sculean A. Regenerative periodontal therapy. Quintessence Int. 2014; 45(3):185-92. doi: 10.3290/j.qi.a31203
Mancini L, Fratini A, Marchetti E. Periodontal Regeneration. Encyclopedia. 2021; 1(1):87–98. Available from: https://doi.org/10.3390/encyclopedia1010011
Kao DW, Fiorellini JP. Regenerative periodontal therapy. In Periodontal Disease. Kinane DF, Mombelli A (eds). Front Oral Biol. Basel, Karger. 2012, vol 15, pp 149–159.
Reynolds MA, Kao RT, Nares S, Camargo PM, Caton JG, Clem DS, et al. Periodontal Regeneration — Intrabony Defects: Practical Applications From the AAP Regeneration Workshop. Clin Adv Periodontics. 2015; 5(1):21–9. doi: 10.1902/cap.2015.140062
Sheikh Z, Hamdan N, Ikeda Y, Grynpas M, Ganss B, Glogauer M. Natural graft tissues and synthetic biomaterials for periodontal and alveolar bone reconstructive applications: a review. Biomater Res. 2017; 21(1):9. Doi: 10.1186/s40824-017-0095-5
Sbricoli L, Guazzo R, Annunziata M, Gobbato L, Bressan E, Nastri L. Selection of Collagen Membranes for Bone Regeneration: A Literature Review. Materials. 2020 Feb 9;13(3):786. doi: 10.3390/ma13030786
Medpark_COLLA_Brochure_ver.5_EN (cited 2023 july 5). Available from: https://medpark.net/product/ new_product.php?product_id=21
Sohn DS, Huang B, Kim J, Park WE, Park CC. Utilization of autologous concentrated growth factors (CGF) enriched bone graft matrix (Sticky bone) and CGF‑enriched fibrin membrane in implant dentistry. J Implant Adv Clin Dent 2015; 7:11-29
Rupawala T, Patel S, Shah N, Sanghvi K, Makwana S, Bhimani K. Efficacy of sticky bone as a novel autologous graft for mandibular third molar extraction socket healing - An evaluative study. Ann Maxillofac Surg. 2020;10(2):335. doi: 10.4103/ams.ams_40_20
Madi M, Elakel AM. The clinical implications of platelet-rich fibrin on periodontal regeneration: A systematic review. Saudi Dent J. 2021; 33(2):55–62. doi: 10.1016/j.sdentj.2020.12.002
Miron R, Choukroun J, Ghanaati S. Controversies related to scientific report describing g-forces from studies on platelet-rich fibrin: Necessity for standardization of relative centrifugal force values. International Journal of Growth Factors and Stem Cells in Dentistry. 2018; 1(3):80.
Miron RJ, Pinto NR, Quirynen M, Ghanaati S. Standardization of relative centrifugal forces in studies related to platelet‐rich fibrin. J Periodontol. 2019; 90(8):817–20.
Bilichodmath S, K G, Nazrine S, Janardhanan N. Prediction of Gingival Recession after Flap Surgery in Patients with Chronic and Aggressive Periodontitis with Horizontal or Vertical Bone Loss. J Evol Med Dent Sci. 2022;11(1):194–8.
Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Beglundh T, et al. Treatment of stage I–III periodontitis—The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020; 47(S22):4–60. doi: 10.1111/jcpe.13290
Buffoli B, Garzetti G, Calza S, Scotti E, Borsani E, Cappa V, et al. Periodontitis Stage III–IV, Grade C and Correlated Factors: A Histomorphometric Study. Biomedicines. 2019;7(2): 43. doi: 10.3390/biomedi cines7020043
Patel GK, Gaekwad SS, Gujjari SK, S.C. VK. Platelet-Rich Fibrin in Regeneration of Intrabony Defects: A Randomized Controlled Trial. J Periodontol. 2017; 88(11):1192–9. doi: 10.1902/jop. 2017.130710
Hanna R, Trejo PM, Weltman RL. Treatment of Intrabony Defects With Bovine-Derived Xenograft Alone and in Combination With Platelet-Rich Plasma: A Randomized Clinical Trial. J Periodontol. 2004; 75(12):1668–77. doi: 10.1902/jop.2004.75.12. 1668
Camargo PM, Lekovic V, Weinlaender M, Vasilic N, Madzarevic M, Kenney EB. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. J Periodontal Res. 2002; 37(4):300–6. doi: 10.1034/j.1600-0765.2002. 01001.x
Lekovic V, Milinkovic I, Aleksic Z, Jankovic S, Stankovic P, Kenney EB, et al. Platelet-rich fibrin and bovine porous bone mineral vs. platelet-rich fibrin in the treatment of intrabony periodontal defects. J Periodontal Res. 2012; 47(4):409–17. doi: 10.1111/j.1600-0765.2011.01446.x
Choukron J, Adda F, Schoeffler C, Vervelle A. the Opportunity in perio-implantology: The PRF. Implantodontie. 2001; 42:55-62
Panda S, Ramamoorthi S, Jayakumar N, Sankari M, Varghese S. Platelet rich fibrin and alloplast in the treatment of intrabony defect. J Pharm Bioallied Sci. 2014; 6(2):127. doi: 10.4103/0975-7406.129178
Theodosaki AM, Filippou S, Kazantzidis G, Doufexi AE. Effectiveness of platelet rich fibrin alone or in combination with bone grafts in the treatment of infrabony defects: Systematic review and metanalysis. Health Sciences Review. 2022; 5:100066.
Chen L, Ding Y, Cheng G, Meng S. Use of Platelet-Rich Fibrin in the Treatment of Periodontal Intrabony Defects: A Systematic Review and Meta-Analysis. Biomed Res Int. 2021; 2021: 6669168. doi:10.1155/2021/6669168
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; 2018: 1–15. doi: 10.1155/2018/8670832
Miron RJ, Dard M, Weinreb M. Enamel matrix derivative, inflammation and soft tissue wound healing. J Periodontal Res. 2015; 50(5):555–69. doi: 10.1111/jre.12245
Pham TAV. Intrabony defect treatment with platelet-rich fibrin, guided tissue regeneration and open-flap debridement: A randomized controlled trial. Journal of Evidence Based Dental Practice. 202; 21(3):101545. doi: 10.1016/j.jebdp.2021.101545
Liu K, Huang Z, Chen Z, Han B, Ouyang X. Treatment of periodontal intrabony defects using bovine porous bone mineral and guided tissue regeneration with/without platelet‐rich fibrin: A randomized controlled clinical trial. J Periodontol. 2021; 92(11):1546–53. doi: 10.1002/JPER.20-0860
Csifó-Nagy BK, Sólyom E, Bognár VL, Nevelits A, Dőri F. Efficacy of a new-generation platelet-rich fibrin in the treatment of periodontal intrabony defects: a randomized clinical trial. BMC Oral Health. 2021; 21(1):580. doi: 10.1186/s12903-021-01925-1
Adnan K, Farrukh U, Sarwar H, Gul J, Singh SP, Khan SS, et al. Effect of PRF on extraction socket healing. Int J Health Sci (Qassim). 2023; 7(S1):974–89.
Zhang T, Wang J, Le K, Guo Y, Zhu B. Platelet-rich fibrin accelerates skin wound healing in pressure injuries: a rat model. J Wound Care. 2022; 31(9):800–4. doi: 10.12968/jowc.2022.31.9.800
Lektemur Alpan A, Torumtay Cin G. PRF improves wound healing and postoperative discomfort after harvesting subepithelial connective tissue graft from palate: a randomized controlled trial. Clin Oral Investig. 2020; 24(1):425–36. doi: 10.1007/s00784-019-02934-9
Panda S, Sankari M, Satpathy A, Jayakumar D, Mozzati M, Mortellaro C, et al. Adjunctive Effect of Autologus Platelet-Rich Fibrin to Barrier Membrane in the Treatment of Periodontal Intrabony Defects. Journal of Craniofacial Surgery. 2016; 27(3):691–6. doi: 10.1097/SCS.0000000000002524
Hägi TT, Laugisch O, Ivanovic A, Sculean A. Regenerative periodontal therapy. Quintessence Int. 2014; 45(3):185-92. doi: 10.3290/j.qi.a31203
Mancini L, Fratini A, Marchetti E. Periodontal Regeneration. Encyclopedia. 2021; 1(1):87–98. Available from: https://doi.org/10.3390/encyclopedia1010011
Kao DW, Fiorellini JP. Regenerative periodontal therapy. In Periodontal Disease. Kinane DF, Mombelli A (eds). Front Oral Biol. Basel, Karger. 2012, vol 15, pp 149–159.
Reynolds MA, Kao RT, Nares S, Camargo PM, Caton JG, Clem DS, et al. Periodontal Regeneration — Intrabony Defects: Practical Applications From the AAP Regeneration Workshop. Clin Adv Periodontics. 2015; 5(1):21–9. doi: 10.1902/cap.2015.140062
Sheikh Z, Hamdan N, Ikeda Y, Grynpas M, Ganss B, Glogauer M. Natural graft tissues and synthetic biomaterials for periodontal and alveolar bone reconstructive applications: a review. Biomater Res. 2017; 21(1):9. Doi: 10.1186/s40824-017-0095-5
Sbricoli L, Guazzo R, Annunziata M, Gobbato L, Bressan E, Nastri L. Selection of Collagen Membranes for Bone Regeneration: A Literature Review. Materials. 2020 Feb 9;13(3):786. doi: 10.3390/ma13030786
Medpark_COLLA_Brochure_ver.5_EN (cited 2023 july 5). Available from: https://medpark.net/product/ new_product.php?product_id=21
Sohn DS, Huang B, Kim J, Park WE, Park CC. Utilization of autologous concentrated growth factors (CGF) enriched bone graft matrix (Sticky bone) and CGF‑enriched fibrin membrane in implant dentistry. J Implant Adv Clin Dent 2015; 7:11-29
Rupawala T, Patel S, Shah N, Sanghvi K, Makwana S, Bhimani K. Efficacy of sticky bone as a novel autologous graft for mandibular third molar extraction socket healing - An evaluative study. Ann Maxillofac Surg. 2020;10(2):335. doi: 10.4103/ams.ams_40_20
Madi M, Elakel AM. The clinical implications of platelet-rich fibrin on periodontal regeneration: A systematic review. Saudi Dent J. 2021; 33(2):55–62. doi: 10.1016/j.sdentj.2020.12.002
Miron R, Choukroun J, Ghanaati S. Controversies related to scientific report describing g-forces from studies on platelet-rich fibrin: Necessity for standardization of relative centrifugal force values. International Journal of Growth Factors and Stem Cells in Dentistry. 2018; 1(3):80.
Miron RJ, Pinto NR, Quirynen M, Ghanaati S. Standardization of relative centrifugal forces in studies related to platelet‐rich fibrin. J Periodontol. 2019; 90(8):817–20.
Bilichodmath S, K G, Nazrine S, Janardhanan N. Prediction of Gingival Recession after Flap Surgery in Patients with Chronic and Aggressive Periodontitis with Horizontal or Vertical Bone Loss. J Evol Med Dent Sci. 2022;11(1):194–8.
Published
2023-12-29
How to Cite
HARSAS, Nadhia Anindhita et al.
Combination of Platelet-rich Fibrin (PRF) in Advanced Periodontitis Stage Treatment.
Journal of Indonesian Dental Association, [S.l.], v. 6, n. 2, p. 115-123, dec. 2023.
ISSN 2621-6175.
Available at: <http://jurnal.pdgi.or.id/index.php/jida/article/view/1075>. Date accessed: 26 dec. 2024.
doi: https://doi.org/10.32793/jida.v6i3.1075.
Section
Case Report
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
