Background and objectives: Tissue engineering is fast gaining popularity in the field of periodontics, as periodontal disease is a complex condition, involving destruction of vital tooth supporting structures. Therefore, regeneration of these tissues lost due to disease in order to restore normal oral health and integrity is imperative. Research in this field has had far reaching consequences and conflicting reports. Although bone grafts and other regenerative options have been evolving over the last few decades, the most recent innovation in this field has been the advent of platelet rich plasma (PRP) and its derivative platelet rich fibrin (PRF). The purpose of this study was to evaluate clinically and radiographically, periodontal regeneration/alveolar bone fill with the use of synthetic alloplast (Biograft-HT) alone and with a combination of platelet rich plasma (PRP) in the treatment of human periodontal intrabony defects.
Methods: In this randomized controlled study, 15 patients (30 intrabony defects) in the age range of 25-55 years, showing bilaterally similar but not identical intrabony defects were selected. The defects were assigned randomly to Test site (PRP with Biograft-HT) and Control site (Biograft-HT alone). The clinical parameters recorded were gingival index, plaque index, probing pocket depth and relative attachment level at 0, 3, 6 and 9 months. The radiographic parameters recorded were radiographic defect depth and percentage bone fill at baseline, and at 9 months post-operatively, using standardized intra-oral periapical radiographs taken with long cone paralleling technique, which were then assessed using computer assisted image analysis software.
Results: Statistical analysis using 't' tests and Mann-Whitney tests revealed that there was a significant reduction in gingival index, plaque index, probing pocket depth and gain in clinical attachment level at the various time intervals within both the groups. Radiographic evaluation revealed statistically significant defect fill (p<0.001) at the end of 9 months within both test and control groups. However, the differences in the mean scores between the 2 groups were not statistically significant both clinically and radiographically.
Interpretation and conclusion: Both groups showed potential in enhancing periodontal regeneration; however the results with PRP with Biograft-HT were comparatively better, although not statistically significant when compared to Biograft-HT alone.
Keywords: Periodontal regeneration, platelet rich plasma, alloplasts (synthetic bone grafts), platelet rich fibrin