Injectable platelet-rich fibrin improves clinical, biochemical, and microbiological outcomes in periodontitis: a 6-month split-mouth randomized controlled trial

Abstract

The study aimed to investigate the effects of scaling and root planing (SRP) in conjunction with injectable platelet-rich fibrin (i-PRF) in patients with periodontitis (Stage II–III, Grade B) 1, 3 and 6 months following the treatment. Using the “split-mouth” design, 30 patients were treated either by SRP alone or SRP + i-PRF in this randomized split-mouth clinical trial (NCT04178590). Clinical attachment level (CAL), probing pocket depth (PPD), bleeding on probing (BOP), and plaque index (PI), were recorded on both sides. Gingival crevicular fluid (GCF) was analyzed for tumor necrosis factor alpha (TNF-α), matrix metalloproteinase (MMP)-8 and alkaline phosphatase (ALP) levels using ELISA, and for total bacterial load using quantitative PCR. Clinical parameters improved significantly in SRP + i-PRF group ( p < 0.05). CAL gain was more prominent in SRP + i-PRF (0.8 mm) than in SRP group (0.4 mm) ( p < 0.01), as was the reduction in PPD (1.95 mm and 1.37 mm, respectively) ( p < 0.001) 6 months after treatment. Similarly, BOP values decreased more in the SRP + i-PRF group than in the SRP alone group (1.3 vs. 1.0, respectively, p < 0.001). Additionally, i-PRF application led to an important reduction of MMP-8 concentrations and microorganism count at 6 months follow-up ( p < 0.001), compared to SRP alone. TNF-α levels decreased significantly in both groups, with greater reductions in the i-PRF group at early follow-ups. SRP combined with i-PRF showed superior therapeutic effects in comparison to SRP alone in terms of clinical, biochemical and microbiological parameters, suggesting a promising application of i-PRF as an adjunctive periodontitis treatment. The use of combined i-PRF and SRP substantially improves the non-surgical periodontitis treatment effectiveness. ClinicalTrials.gov ID: NCT04178590.