Combined use of platelet-rich plasma and bone grafting with or without guided tissue regeneration in the treatment of anterior interproximal defects. Autogenous bone and platelet-rich plasma (PRP) in the treatment of intrabony defects. Effects of platelet concentrate on palatal wound healing after connective tissue graft harvesting. Effect of platelet-rich plasma on the healing of intra-bony defects treated with a natural bone mineral and a collagen membrane. Effect of platelet-rich plasma on the healing of intrabony defects treated with an anorganic bovine bone mineral and expanded polytetrafluoroethylene membranes. Effect of platelet-rich plasma on the healing of intrabony defects treated with an enamel matrix protein derivative and a natural bone mineral. Use of platelet-rich plasma in periodontal surgery—a prospective randomised double blind clinical trial Treatment of periodontal intrabony defects with demineralized freeze-dried bone allograft in combination with platelet-rich plasma: a comparative clinical trial. Platelet-rich plasma: Growth factor enhancement for bone grafts. A comparative study of root coverage with connective tissue and platelet concentrate grafts: 8-month results. Potential for osseous regeneration of platelet-rich plasma--a comparative study in mandibular third molar sockets. Reconstruction of the severely resorbed maxilla with autogenous bone, platelet-rich plasma, and implants: 1-year results of a controlled prospective 5-year study. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. Platelet-rich plasma combined with a porous hydroxyapatite graft for the treatment of intrabony periodontal defects in humans: a comparative controlled clinical study. Effect of platelet-rich plasma in the treatment of periodontal intrabony defects in humans. Influence of autologous platelet concentrate on healing in intra-bony defects following guided tissue regeneration therapy: a randomized prospective clinical split-mouth study. A reentry study on the use of bovine porous bone mineral, GTR, and platelet-rich plasma in the regenerative treatment of intrabony defects in humans. Treatment of intrabony defects with bovine-derived xenograft alone and in combination with platelet-rich plasma: a randomized clinical trial. Clinical evaluation of platelet-rich plasma and bioactive glass in the treatment of intra-bony defects. Completeness of reporting of trials published in languages other than English: implications for conduct and reporting of systematic reviews Comparison of platelet pellet and bioactive glass in periodontal regenerative therapy Language bias in randomised controlled trials published in English and German Comparison of platelet-rich plasma, bovine porous bone mineral, and guided tissue regeneration versus platelet-rich plasma and bovine porous bone mineral in the treatment of intrabony defects: a reentry study. Influence of the application of platelet-enriched plasma in oral mucosal wound healing.
BACKGROUND The aim of periodontal therapy is to prevent tissue destruction while achieving the regeneration of damaged tissues . Platelet-rich plasma ( PRP ) is used to generate new bone , periodontal ligament , and new attachment with a strategy based on the modulation and enhancement of wound healing through an autologous source for growth factors obtained from the patient 's own blood . The purpose of the present study was to evaluate the efficacy of PRP when used in combination with beta-tricalcium phosphate ( beta-TCP ) alloplastic graft material and collagen barrier membrane in the treatment of anterior interproximal intrabony defects . METHODS Thirty interproximal intrabony defects in 25 systemically healthy patients were selected for the study . Defects were distributed r and omly and equally into three groups : graft alone ( beta-TCP ) , graft + PRP , and graft + PRP + membrane . The plaque index , gingival index , periodontal probing depth , relative attachment level , transgingival probing measurement , and radiographic analyses were performed at baseline and repeated after 6 , 9 , and 12 months . RESULTS At the end of 12 months , relative attachment gain was 2.4 , 2.1 , and 2.5 mm in the three treatment groups , respectively . No statistically significant differences in clinical and radiographic measurements were observed among the groups . CONCLUSIONS All options were effective in the treatment of anterior interproximal intrabony defects . The results also suggested that PRP added no clinical benefit to beta-TCP alloplastic graft material used alone or in combination with GTR PURPOSE Obtaining an answer to the question whether autogenous bone in combination with PRP give a therapeutical effect in the form of periodontal ligament attachment regeneration . Defining the degree of elimination of a convenient environment for subgingival bacterial plaque by reduction of periodontal pocket depth and periodontitis . MATERIAL AND METHODS Twenty-six systematic ally healthy patients with diagnosed chronic and advanced periodontitis ( 24 females and 2 males ) were selected for the study . In general 72 periodontal infrabony pockets were treated . Clinical ly the following indexes were examined and measured : 1 . Plaque Index by Silness and Löe . 2 . Sulcus Bleeding Index by  Mühlemann  and Son . 3 . Clinical Attachment Level ( mm ) . 4 . Pocket Depth ( mm ) . 5 . Gingival Recession ( mm ) . 6 . Tooth mobility with the use of Periotest . 7 . Degree of alveolar bone loss with the use of Engelberger , Marthaler and Rateitschak index - EMR Index . RESULTS At 12 months after treatment the following results were noted : Mean value of attachment level regeneration 3.47 mm . Mean value of pocket depth decreased by 3.7 mm . Mean value of tooth mobility reduction by 48.3 % . Megeneration of alveolar bone by 9.24 % . CONCLUSIONS 1 . Autogenous bone with added PRP in treatment of intrabony defects caused by periodontitis have given significant clinical improvement of the periodontal tissues . 2 . The combination of PRP and autogenous bone caused the elimination of a convenient environment for subgingival bacterial plaque eliminating periodontitis BACKGROUND Platelet concentrate ( PC ) is known to contain growth factors that stimulate cellular proliferation and differentiation . In this double-blind , placebo-controlled , r and omized study , the objective was to determine whether PC accelerated connective tissue graft ( CTG ) wound healing and maintained donor site tissue thickness . METHODS Twenty healthy adult subjects with multiple bilateral gingival recessions were treated with  CTGs and PC combined with CTGs . The donor sites were treated with PC and placebo .  Clinical wound healing was observed for an average of 6 weeks . Biopsies were taken from donor sites and su bmi tted for histology and immunohistochemical analysis for type I and III collagens . Palatal tissue thickness , post-surgical complications , and pain level were evaluated . Wilcoxon , Cronbach , one- sample t , and paired- sample t tests were used to assess statistical significance at P < 0.05 . RESULTS PC-treated palatal donor sites were 1.10 mm thicker than control sites . PC-treated recipient sites showed accelerated clinical healing compared to controls . PC did not accelerate donor site clinical healing . No significant statistical differences in complication occurrence and perceived pain levels were found between control and PC-treated sites . Biopsy sample s revealed that during healing , PC-treated sites contained lower concentrations of inflammatory cells , more type I mature collagen , and less type III immature collagen than control sites . CONCLUSIONS PC may accelerate wound healing and hasten the regeneration of palatal donor tissue . PC did not influence complication occurrences or mediate pain level . PC has the potential to shorten the treatment time for patients who need multiple CTG procedures BACKGROUND Regenerative periodontal therapy with a combination of platelet-rich plasma (PRP)+a natural bone mineral (NBM)+guided tissue regeneration ( GTR ) has been shown to result in significantly higher probing depth reductions and clinical attachment-level gains compared with treatment with open flap debridement alone . However , at present , it is unknown to what extent the use of PRP may additionally enhance the clinical outcome of the therapy compared with treatment with NBM+GTR . AIM To clinical ly compare treatment of deep intra-bony defects with NBM+PRP+GTR with NBM+GTR . MATERIAL AND METHODS Thirty patients suffering from advanced periodontal disease , and each of whom displayed one advanced intra-bony defect were r and omly treated with a combination of either NBM+PRP+collagen membrane ( GTR ) or NBM+GTR . The following clinical parameters were evaluated at baseline and at 1 year after treatment : plaque index , gingival index , bleeding on probing , probing depth ( PD ) , gingival recession and clinical attachment level ( CAL ) . CAL changes were used as 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 patients . At 1 year after therapy , the sites treated with NBM+PRP+GTR showed a reduction in mean PD from 8.9+/-2.3 mm to 3.4+/-2.0 mm ( p<0.001 ) and a change in mean CAL from 10.9+/-2.2 mm to 6.4+/-1.8 mm ( p<0.001 ) . In the group treated with NBM+GTR , the mean PD was reduced from 8.9+/-2.5 mm to 3.4+/-2.3 mm ( p<0.001 ) , and the mean CAL changed from 11.1+/-2.5 mm to 6.5+/-2.3 mm ( p<0.001 ) . In both groups , all sites gained at least 3 mm of CAL . CAL gains of > or = 4 mm were measured in 80 % ( i.e. in 12 out of 15 defects ) of the cases treated with NBM+PRP+GTR and in 87 % ( i.e. in 13 out of 15 defects ) treated with NBM+GTR . No statistically significant differences in any of the investigated parameters were observed between the two groups . CONCLUSIONS Within its limits , the present study has shown that ( i ) at 1 year after regenerative surgery with both NBM+PRP+GTR and NBM+GTR , significant PD reductions and CAL gains were found , and ( ii ) the use of PRP has failed to improve the results obtained with NBM+GTR BACKGROUND Regenerative periodontal therapy with a combination of platelet-rich plasma ( PRP ) + an anorganic bovine bone mineral ( ABBM ) + guided tissue regeneration ( GTR ) has been shown to result in significantly higher probing depth reductions and clinical attachment level gains compared to treatment with open flap debridement ( OFD ) alone , ABBM alone , or GTR alone . However , there are no data evaluating to what extent the use of PRP may additionally enhance the clinical outcome of the therapy compared to treatment with ABBM + GTR . This study aim ed to clinical ly evaluate the effect of PRP on the healing of deep intrabony defects treated with ABBM and GTR by means of a non-resorbable exp and ed polytetrafluoroethylene ( ePTFE ) membrane . METHODS Twenty-four patients with advanced chronic periodontal disease and displaying one intrabony defect were r and omly treated with a combination of either PRP + ABBM + GTR or ABBM + GTR . The following clinical parameters were evaluated at baseline and at 1 year after treatment : plaque index ( PI ) , gingival index ( GI ) , bleeding on probing ( BOP ) , probing depth ( PD ) , gingival recession ( GR ) , and clinical attachment level ( CAL ) . The primary outcome variable was CAL . RESULTS No differences in any of the studied parameters were observed at baseline between the two groups . Healing was uneventful in all patients . At 1 year after therapy , the sites treated with PRP + ABBM + GTR showed a reduction in mean PD from 8.6 + /- 1.7 mm to 3.1 + /- 1.3 mm ( P < 0.001 ) and a change in mean CAL from 10.3 + /- 1.4 mm to 5.7 + /- 1.6 mm ( P < 0.001 ) . In the group treated with ABBM + GTR , mean PD was reduced from 8.8 + /- 1.7 mm to 3.1 + /- 1.0 mm ( P < 0.001 ) , and the mean CAL changed from 10.4 + /- 2.6 mm to 5.9 + /- 1.8 mm ( P < 0.001 ) . In both groups , all sites gained > or =3 mm of CAL . CAL gains > or = 4 mm were measured in 83 % ( i.e. , in 10 of 12 defects ) of the cases treated with PRP + ABBM + GTR and in 92 % ( i.e. , in 11 of 12 defects ) treated with ABBM + GTR . No statistically significant differences in any of the studied parameters were observed between the two groups at 1-year reevaluation . CONCLUSION Within its limits , the present study has shown that , at 1 year after regenerative therapy in periodontal intrabony defects , optimal clinical results were obtained with ABBM + GTR with a non-resorbable barrier , with or without the addition of PRP BACKGROUND Regenerative periodontal surgery utilizing a combination of an enamel matrix protein derivative ( EMD ) and a natural bone mineral ( NBM ) and platelet-rich plasma ( PRP ) has been shown to enhance the outcomes of regenerative surgery significantly . At present , it is unknown whether root conditioning with EMD , followed by defect fill with a combination of NBM+PRP may additionally enhance the clinical results obtained with EMD+NBM . AIM To compare clinical ly the treatment of deep intrabony defects with either EMD+NBM+PRP or EMD+NBM . MATERIAL AND METHODS Twenty-six patients suffering from advanced chronic periodontitis , and each of whom displayed one advanced intrabony defect were r and omly treated with either EMD+NBM+PRP ( test ) or EMD+NBM ( control ) . The following clinical parameters were evaluated at baseline and at 1 year after treatment : plaque index ( PI ) , gingival index ( GI ) , bleeding on probing ( BOP ) , probing depth ( PD ) , gingival recession ( GR ) and clinical attachment level ( CAL ) . The primary outcome variable was CAL . RESULTS Healing was uneventful in all patients . At 1 year after therapy , the test sites showed a reduction in mean PD from 8.8+/-1.9 mm to 3.1+/-0.9 mm ( p<0.001 ) and a change in mean CAL from 10.8+/-2.0 mm to 6.0+/-1.5 mm ( p<0.001 ) . In the control group the mean PD was reduced from 8.8+/-2.0 mm to 2.8+/-1.6 mm ( p<0.001 ) and the mean CAL changed from 10.5+/-1.6 mm to 5.5+/-1.4 mm ( p<0.001 ) . CAL gains of > or = 4 mm were measured in 77 % ( i.e. in 10 out of 13 defects ) of the cases treated with EMD+NBM+PRP and in 100 % ( i.e. in all 13 defects ) treated with EMD+NBM . No statistically significant differences in any of the investigated parameters were observed between the two groups . CONCLUSIONS Within its limits , the present study has shown that ( i ) 1 year after regenerative surgery , both treatments result ed in statistically significant PD reductions and CAL gains and ( ii ) the use of PRP failed to enhance the results obtained with EMD+NBM The aim of this prospect i ve controlled r and omized clinical trial was to evaluate the additional effect of platelet-rich plasma ( PRP ) in attachment gain . Twenty-two patients showing contralateral intrabony defects were included . Defects were r and omized to β-TCP ( Cerasorb ® ) in combination with PRP ( test ) or alone ( control )  . Probing pocket depth ( PPD ) , clinical attachment level ( CAL ) , and relative AL ( RAL ) were assessed at the first , initial , re-evaluation ( or basis examinations ) and 6 months after surgery . Defect dimensions were recorded at baseline surgery ( day 0 ) and during re-entry surgery ( after 6 months ) , with vertical depth of the defect as primary outcome variable . An early healing index ( EHI ) was assessed 3 days , 1 , 2 and 4 weeks after surgery . Both treatments led to clinical improvements . The median reduction of open vertical depth was 1.9 mm ( interquartile intervals , 0.75 and 2.5 mm ) at test sites , compared with 2.6 mm ( 1.8 and 3.5 mm ) at control sites ( p = 0.19 , Wilcoxon ) . The median reductions of PPD and CAL at the four sites in close proximity to the defect in the interproximal area at test sites were 0.8 and 0.28 mm , and at control sites 0.4 and 0.13 mm , respectively . The EHI showed a reduction from grade 3 after 3 days to grade 1 after 4 weeks . PRP did not improve the results achieved with β-TCP in the treatment of intrabony defects BACKGROUND The aim of the present r and omized , double-masked , clinical trial was to compare platelet-rich plasma ( PRP ) combined with a demineralized freeze-dried bone allograft ( DFDBA ) to DFDBA mixed with a saline solution in the treatment of human intrabony defects . METHODS Sixty interproximal intrabony osseous defects in 60 healthy , non-smoking subjects diagnosed with chronic periodontitis were treated in this study . Thirty subjects each were r and omly assigned to the test group ( PRP + DFDBA ) or the control group ( DFDBA + saline ) . Clinical and radiographic measurements were made at baseline and at the 12-month evaluation . RESULTS Compared to baseline , the 12-month results indicated that both treatment modalities result ed in significant changes in all clinical parameters ( gingival index , bleeding on probing , probing depth , clinical attachment level , and gingival recession ; P < 0.001 ) and radiographic parameters ( hard tissue fill and bone depth reduction ; P < 0.001 ) . However , the test group exhibited statistically significantly greater changes compared to the control group in probing depth reduction ( 4.3 + /- 1.7 mm versus 2.6 + /- 2.2 mm ; P < 0.05 ) and clinical attachment gain ( 3.5 + /- 2.1 mm versus 2.3 + /- 2.4 mm ; P < 0.001 ) . CONCLUSIONS Treatment with a combination of PRP and DFDBA led to a significantly greater clinical improvement in intrabony periodontal defects compared to DFDBA with saline . No statistically significant differences were observed in the hard tissue response between the two treatment groups , which confirmed that PRP had no effect on hard tissue fill or gain in new hard tissue formation Platelet-rich plasma is an autologous source of platelet-derived growth factor and transforming growth factor beta that is obtained by sequestering and concentrating platelets by gradient density centrifugation . This technique produced a concentration of human platelets of 338 % and identified platelet-derived growth factor and transforming growth factor beta within them . Monoclonal antibody assessment of cancellous cellular marrow grafts demonstrated cells that were capable of responding to the growth factors by bearing cell membrane receptors . The additional amounts of these growth factors obtained by adding platelet-rich plasma to grafts evidence d a radiographic maturation rate 1.62 to 2.16 times that of grafts without platelet-rich plasma . As assessed by histomorphometry , there was also a greater bone density in grafts in which platelet-rich plasma was added ( 74.0 % + /- 11 % ) than in grafts in which platelet-rich plasma was not added ( 55.1 % + /- 8 % ; p = 0.005 ) BACKGROUND Gingival recession presents destruction of both soft and hard tissues . The objectives of this r and omized clinical trial were to assess the clinical efficacy of platelet concentrate grafts ( PCG ) in the treatment of Miller Class I or II buccal gingival defects and to compare their soft tissue healing with those of subepithelial connective tissue grafts ( SCTG ) . METHODS Seventeen arches in 15 patients with bilateral gingival recessions were treated with SCTG and PCG covered by coronally advanced flaps . Vertical recession depth ( VRD ) , clinical attachment level ( CAL ) , clinical probing depth ( PD ) , and width of keratinized tissue ( KTW ) were measured preoperatively and 8 months postsurgery . Surveys on post-surgical discomfort level ( PSDL ) and manual platelet count were also performed . Esthetic outcomes were also evaluated . Paired t test , repeated measures analysis of variance ( ANOVA ) , and chi-square and signed-rank tests were used to access statistical significance ( alpha = 0.05 ) . RESULTS Mean VRD statistically significantly decreased from 2.43 mm presurgery to 0.48 mm with PCG ( 80 % root coverage ) and from 2.48 mm to 0.17 mm with SCTG ( 95 % root coverage ) . No statistically significant differences between the treatments were found for VRD , CAL , and KTW , while mean PD was significantly shallower in the PCG group ( 1.05 mm ) than that in the SCTG group ( 1.79 mm ) . Complete coverage was achieved in 60 % of the PCG group and in 65.5 % of the SCTG group . PSDL was significantly lower in the PCG group 1 month post-surgery . Platelet counts demonstrated a five-fold increase in PC . Soft tissue in the PCG group demonstrated superior contour and texture matching when compared to the SCTG group . CONCLUSIONS The platelet concentrate graft may be an alternative graft material for treating gingival recession . Treatment with this graft may result in better esthetic appearance Platelet-rich plasma ( PRP ) , the concentrate of platelets in plasma contains various growth factors that enhance osseous regeneration . This study utilized homologous platelet-rich plasma in the treatment of third molar extraction sockets in a total of fourteen human subjects , who were r and omly assigned into one control and one test group , each comprising of seven members . Clinical parameters like pain on palpation , number of analgesic tablets consumed , swelling , degree of mouth opening , and condition of mucosa overlying the surgical site were assessed at intervals of 1,3,5,7,9,12 , and 16 weeks post operatively . The margins between the socket and surrounding bone , radiopacity of bone filling the socket , and presence oftrabecular bone formation were evaluated simultaneously . Soft tissue healing differed significantly between the two groups , with the test group exhibiting better results . Radiographic evidence of bone formation was visible as early as I week in test subjects . It was concluded that PRP contributed to better healing of soft tissues and bone and is a viable means of growth factor delivery BACKGROUND Prosthetic treatment of the edentulous maxilla may require bone augmentation to enable placement and integration of dental implants . This constitutes a complex healing situation , and resorption of the grafted bone and failure of the implants often occur . The application of autogenous platelet-rich plasma ( PRP ) has been suggested to improve incorporation and preservation of bone grafts . PURPOSE The aim of this controlled clinical study was to evaluate whether PRP in conjunction with grafting of particulated autogenous bone to the maxilla could improve the integration and clinical function of dental implants . An additional aim was to compare block bone grafts without PRP with PRP-treated particulated bone . MATERIAL AND METHODS Nineteen consecutive patients were included in the study and treated with iliac bone grafts and dental implants in the maxilla according to a split-mouth design . In the anterior maxilla , particulated bone mixed with PRP ( test ) was compared with onlay block grafts without additional PRP ( control ) . In the posterior maxilla , particulated bone grafts with ( test ) or without ( control ) PRP were placed as sinus inlay grafts . After 6 months of healing , 152 implants ( 8 implants/patient ) ( TiOblast , Astra Tech AB , Mölndal , Sweden ) were placed . Test ( PRP ; 76 implants ) and non-PRP ( 76 implants ) sides were evaluated and compared by implant survival rate , marginal bone level , and implant stability using resonance frequency analysis ( RFA ) during 1 year in function . RESULTS Two control implants in control sites in two patients were lost at abutment connection . After 1 year in function , no further implants were lost , giving an overall survival rate of 98.7 % . The marginal bone level measurements showed no significant differences , although there was a tendency toward less resorption on PRP sides . RFA measurements showed statistically significantly higher implant stability quotient values for PRP sites at abutment connection in the anterior but not in the posterior regions . CONCLUSIONS The present clinical study showed that a high implant survival rate and stable marginal bone conditions can be achieved after 1 year of loading in the maxilla following autogenous bone grafting whether or not PRP is used . RFA measurements revealed differences at abutment connection , which could be explained by the type of graft rather than as an effect of PRP . Although no obvious positive effects of PRP on bone graft healing could be demonstrated , the h and ling of the particulated bone grafts was improved BACKGROUND A combination of platelet-rich plasma ( PRP ) , bovine porous bone mineral ( BPBM ) and guided tissue regeneration ( GTR ) has been shown to be effective in promoting clinical signs of periodontal regeneration in intrabony defects . As an initial attempt to clarify the role played by each of the three treatment components , this study was performed to compare the clinical effectiveness of two regenerative techniques for intrabony defects in humans : a combination of PRP/BPBM/GTR vs. GTR . MATERIAL AND METHODS Eighteen patients participated in the study . Using a split-mouth design , interproximal bony defects were surgically treated with either an absorbable membrane made of polylactic acid for GTR or a combination of PRP/BPBM/GTR . Changes in pocket depth , attachment level and defect fill as revealed by 6-month reentry surgeries were evaluated . RESULTS Both treatment modalities result ed in significant pocket depth reduction and clinical attachment gain as compared to baseline values . Pocket depth reduction was 4.98 + /- 0.96 mm on buccal and 4.93 + /- 0.92 mm on lingual sites of the PRP/BPBM/GTR group and 3.62 + /- 0.81 mm on buccal and 3.54 + /- 0.88 mm on lingual sites of the GTR group . The gain in clinical attachment observed was 4.37 + /- 1.31 mm on buccal and 4.28 + /- 1.33 mm on lingual sites of the PRP/BPBM/GTR group and 2.62 + /- 1.23 mm on buccal and 2.44 + /- 1.21 mm on lingual sites of the GTR group . The amount of defect fill observed was 4.78 + /- 1.26 mm on buccal and 4.66 + /- 1.32 mm on lingual sites of the PRP/BPBM/GTR group and 2.31 + /- 0.76 mm on buccal and 2.26 + /- 0.81 mm on lingual sites of the GTR group . All differences between the two groups were statistically significant in favor of the PRP/BPBM/GTR group . CONCLUSIONS The results of this study suggest that PRP and BPBM provide an added regenerative effect to GTR in promoting the clinical resolution of intrabony defects on patients with severe periodontitis BACKGROUND The aim of the present controlled clinical study was to compare platelet-rich plasma ( PRP ) combined with a biodegradable ceramic , porous hydroxyapatite ( HA ) with a mixture of HA and saline in the treatment of human intrabony defects . METHODS Seventy interproximal intrabony osseous defects in 70 healthy , non-smoking subjects diagnosed with chronic periodontitis were included in this study . Thirty-five subjects each were r and omly assigned to either the test group ( PRP and HA ) or control group ( HA with saline ) . Clinical and radiographic measurements were determined at baseline and the 12-month evaluation . RESULTS When compared to baseline , the 12-month results indicated that , while both treatment modalities result ed in significant changes in all clinical parameters ( gingival index , bleeding on probing , probing depth , clinical attachment level , and intrabony defect fill ; P < 0.001 ) , the test group exhibited statistically significant changes compared to the control sites in probing depth reduction : 4.7 + /- 1.6 mm versus 3.7 + /- 2.0 mm ( P < 0.05 ) ; clinical attachment gain : 3.4 + /- 1.7 mm versus 2.0 + /- 1.2 mm ( P < 0.001 ) ; and vertical relative attachment gain : 70.3 % + /- 23.4 % versus 45.5 % + /- 29.4 % ( P < 0.001 ) . CONCLUSION Treatment with a combination of PRP and HA compared to HA with saline led to a significantly more favorable clinical improvement in intrabony periodontal defects BACKGROUND Platelet-rich plasma ( PRP ) is a kind of natural source of autologous growth factors , and has been used successfully in medical community . However , the effect of PRP in periodontal regeneration is not clear yet . This study was design ed to evaluate the effectiveness of PRP as an adjunct to bovine porous bone mineral ( BPBM ) graft in the treatment of human intrabony defects . METHODS Seventeen intrabony defects in 10 periodontitis patients were r and omly treated either with PRP and BPBM ( test group , n = 9 ) or with BPBM alone ( control group , n = 8) . Clinical parameters were evaluated including changes in probing depth , relative attachment level ( measured by Florida Probe and a stent ) , and bone probing level between baseline and 1 year postoperatively . St and ardized periapical radiographs of each defect were taken at baseline , 2 weeks , and 1 year postoperatively , and analyzed by digital subtraction radiography ( DSR ) . RESULTS Both treatment modalities result ed in significant attachment gain , reduction of probing depth , and bone probing level at 1-year post-surgery compared to baseline . The test group exhibited statistically significant improvement compared to the control sites in probing depth reduction : ( 4.78 + /- 0.95 ) mm versus ( 3.48 + /- 0.41 ) mm ( P < 0.01 ) ; clinical attachment gain : ( 4.52 + /- 1.14 ) mm versus ( 2.85 + /- 0.80 ) mm ( P < 0.01 ) ; bone probing reduction : ( 4.56 + /- 1.04 ) mm versus ( 2.88 + /- 0.79 ) mm ( P < 0.01 ) ; and defect bone fill : ( 73.41 + /- 14.78)% versus ( 47.32 + /- 11.47)% ( P < 0.01 ) . DSR analysis of baseline and 1 year postoperatively also showed greater radiographic gains in alveolar bone mass in the test group than in the control group : gray increase ( 580 + /- 50 ) grays versus ( 220 + /- 32 ) grays ( P = 0.0001 ) ; area with increased gray were ( 5.21 + /- 1.25 ) mm(2 ) versus ( 3.02 + /- 1.22 ) mm(2 ) ( P = 0.0001 ) . CONCLUSIONS The treatment with a combination of PRP and BPBM led to a significantly favorable clinical improvement in periodontal intrabony defects compared to using BPBM alone . Further studies are necessary to assess the long-term effectiveness of PRP , and a larger sample size is needed OBJECTIVES To investigate the influence of autologous platelet concentrate ( APC ) on early wound healing and regeneration outcomes following guided tissue regeneration ( GTR ) therapy . MATERIAL AND METHODS In 25 patients , two contralateral deep intra-bony defects were treated with beta-TCP and a bioresorbable GTR membrane . They were r and omly assigned to test and control procedure . In test defects , APC was additionally applied . After 3 , 6 , and 12 months , healing results were assessed by clinical parameters and quantitative digital subtraction radiography . RESULTS Post-operative membrane exposures occurred in 48 % of the test sites and 80 % of the control sites . Both groups revealed a significant clinical attachment level ( CAL ) gain of 5 mm after 12 months . Eighty-eight per cent of test and control sites showed a CAL gain of > or = 4 mm . No clinical parameter revealed significant differences between test and control sites . A significant bone density gain was found in both groups after 3 , 6 , and 12 months . Only after 6 months , the bone density gain was significantly greater in the test defects . CONCLUSION Within the limits of this study , autologous platelet concentrate did not seem to have a noticeable influence on the clinical and most of the radiographic outcomes following GTR . However , APC might reduce the occurrence of post-operative membrane exposures and accelerate bone density gain This study compared the clinical effectiveness of a combination therapy consisting of bovine porous bone mineral ( BPBM ) , guided tissue regeneration ( GTR ) , and platelet-rich plasma ( PRP ) in the regeneration of periodontal intrabony defects in humans . Twenty-eight paired intrabony defects were surgically treated using a split-mouth design . Defects were treated with BPBM , GTR , and PRP ( experimental ) , or with open-flap debridement ( control ) . Clinical parameters evaluated included changes in attachment level , pocket depth , and defect fill as revealed by reentry at 6 months . Preoperative pocket depths , attachment levels , and transoperative bone measurements were similar for the two groups . Postsurgical measurements taken at 6 months revealed that both treatment modalities significantly decreased pocket depth and increased clinical attachment and defect fill compared to baseline . The differences between the experimental and control groups were 2.22+/-0.39 mm on buccal and 2.12+/-0.34 mm on lingual sites for pocket depth , 3.05+/-0.51 mm on buccal and 2.88+/-0.46 mm on lingual sites for gain in clinical attachment , and 3.46+/-0.96 mm on buccal and 3.42+/-0.02 mm on lingual sites for defect fill . These differences between groups were statistically significant in favor of the experimental defects . The combined therapy was also clinical ly more effective than open-flap debridement . The superiority of the experimental group could not be attributed solely to the surgical intervention and was likely a result of the BPBM/GTR/ PRP application . Combining BPBM , GTR , and PRP was an effective modality of regenerative treatment for intrabony defects in patients with advanced periodontitis BACKGROUND In the treatment of periodontal intrabony defects , the benefits of adding platelet-rich plasma ( PRP ) to a bone replacement grafting material have not been tested . The purpose of this study was to compare the clinical outcomes obtained by the combination of PRP and a bovine derived xenograft ( BDX ) to those obtained from the use of the bone replacement graft alone . METHODS Thirteen patients were enrolled in a r and omized , split mouth , double-masked clinical trial . Bilateral defects were matched according to their intrasurgical measurements . Qualifying defects had loss of attachment of > or = 6 mm , a radiographically detectable defect of > or = 4 mm , at least two remaining osseous walls , and not primarily related to a furcation involvement . After the hygienic phase , at the baseline examination , probing depth ( PD ) , clinical attachment level ( CAL ) , and recession ( REC ) were measured . During open flap debridement , the defects were r and omly assigned to receive either BDX mixed with PRP or BDX alone . Baseline osseous intrasurgical measurements were obtained . Post-surgical follow-up and maintenance were performed and PD , CAL , and REC were remeasured at 6 months . The mean baseline and 6-month PD , CAL , and REC of the deepest buccal and lingual measurements related to the defect for each group were computed . The change from baseline to 6 months for each parameter measured was calculated . Pre- and postoperative comparisons were made between treatment groups at 6 months . RESULTS R and omization of the defects result ed in comparable groups ( P > or = 0.05 ) . At 6 months , paired t test comparisons within groups showed statistically significant benefits with both treatment modalities ( P < or = 0.05 ) . The mean changes ( delta ) at 6 months for the test and the control groups at the deepest sites were : PD reduction : 3.54 and 2.53 mm ; CAL gain : 3.15 and 2.31 mm ; and REC : -0.38 and -0.23 mm , respectively . Paired t test comparisons yielded significant differences between treatments for PD and CAL ( P < or = 0.05 ) . CONCLUSION In this 6-month clinical trial , the addition of a high concentration of autologous platelets to a bovine derived xenograft to treat intrabony defects significantly improved their clinical periodontal response BACKGROUND There are limited numbers of studies focused on the using of platelet-rich plasma ( PRP ) combined with different types of bone substitutes in intra-bony defects . AIM The purpose of this study was to evaluate the effect of bioactive glass graft material ( BG ) with and without PRP on the clinical healing of intra-bony defects . MATERIAL S AND METHODS Twenty-nine intra-bony defects were r and omly treated with either PRP/BG or BG alone . Clinical parameters were recorded at baseline and repeated 9 months after surgery and surgical reentries were also performed . RESULTS The results showed that both treatment modalities were effective . Pocket depth reduction of 3.60 + /- 0.51 mm , clinical attachment gain of 3.3 + /- 1.77 mm and defect fill of 3.47 + /- 0.53 mm were noted in the PRP/BG group , with 3.29 + /- 1.68 , 2.86 + /- 1.56 and 3.36 + /- 0.55 mm improvements , respectively , noted for the BG group . None of the differences between the two treatment modalities were statistically significant . CONCLUSIONS It is suggested that both PRP/BG combination and BG alone are effective in the treatment of intra-bony defects . The results also showed that using PRP with BG has no additional benefit in the reduction of pocket depth , clinical attachment gain and defect fill BACKGROUND Lately , the number of systematic review s published has increased substantially . Many systematic review s exclude trials published in language s other than English . However , there is little empirical evidence to support this action . We looked for differences in the completeness of reporting between trials published in other language s and those published in English , to see whether the exclusion of trials published in other language s is justified . METHODS We compared completeness of reporting , design characteristics , and analytical approaches of 133 r and omised controlled trials ( RCTs ) published in English between 1989 and 1994 and 96 published in French , German , Italian , or Spanish during the same time . RCTs were identified by h and search ing of journals ( seven in English and six in the other language s ) . FINDINGS We found no significant differences between trials published in English and other- language trials for any single item in the completeness of reporting scale ( r and omisation , double-blinding , withdrawals ) , or for the overall score ( percentage of maximum possible score 51.0 % for trials in English , 46.2 % for trials in other language s ; 95 % CI for difference -1.1 to 10.5 ) . Other- language trials were more likely than English- language trials to have adult participants , to use two or more interventions , and to compare two or more active treatments without an untreated control group . Trials in other language s were less likely to report a clearly prespecified primary outcome or any rationale for sample size estimation . INTERPRETATION These results provide evidence for inclusion of all trial reports , irrespective of the language in which they are published , in systematic review s. Their inclusion is likely to increase precision and may reduce systematic errors . We hope that our findings will prove useful to those developing guidelines and policies for the conduct of reporting of systematic review Objective . In recent years , platelet-rich plasma combined with graft material s has been used for periodontal regeneration . The individual role of blood products with guided tissue regeneration in periodontal regenerative therapy is unclear and needs to be eluci date d. The purpose of this study was to compare the clinical and radiological effectiveness of platelet pellet/guided tissue regeneration ( PP/GTR ) and bioactive glass/GTR ( BG/GTR ) treatments in patients with periodontal disease . Material and methods . Using a split mouth design , 15 chronic periodontitis patients with pocket depths ≥ 6 mm following periodontal initial therapy were r and omly assigned to treatment with a combination of PP/GTR or BG/GTR in contralateral dentition areas . An absorbable membrane of polylactic acid was used GTR . The criteria for the comparative study were preoperative and postoperative 6 months pocket depth , clinical attachment level , and radiological alveolar bone level . Results . Both treatment modalities result ed in significant pocket depth reduction and gain in clinical attachment and alveolar bone level compared to the preoperative values ( p<0.01 ) . Reduction in pocket depth , gain in clinical attachment and alveolar bone level were 4(3–6 ) , 4.1±0.7 , 4.9±1.4 mm in the PP/GTR group and 4(3–7 ) , 4.1±1.2 , 5.9±1.7 mm in the BG/GTR group , respectively . The differences between the two groups were not statistically significant ( p>0.05 ) . Conclusions . Within the limits of this study , it was concluded that PP may be effective as a bioactive glass graft material and used as a graft material for treating intrabony defects . PP thus appears to be a suitable alternative in the regenerative treatment of intrabony periodontal defects BACKGROUND Some r and omised controlled trials ( RCTs ) done in German-speaking Europe are published in international English- language journals and others in national German- language journals . We assessed whether authors are more likely to report trials with statistically significant results in English than in German . METHODS We studied pairs of RCT reports , matched for first author and time of publication , with one report published in German and the other in English . Pairs were identified from reports round in a manual search of five leading German- language journals and from reports published by the same authors in English found on Medline .  Quality of methods and reporting were assessed with two different scales by two investigators who were unaware of authors ' identities , affiliations , and other characteristics of trial reports . Main study endpoints were selected by two investigators who were unaware of trial results . Our main outcome was the number of pairs of studies in which the levels of significance ( shown by p values ) were discordant . FINDINGS 62 eligible pairs of reports were identified but 19 ( 31 % ) were excluded because they were duplicate publications . A further three pairs ( 5 % ) were excluded because no p values were given . The remaining 40 pairs were analysed . Design characteristics and quality features were similar for reports in both language s. Only 35 % of German- language articles , compared with 62 % of English- language articles , reported significant ( p < 0.05 ) differences in the main endpoint between study and control groups ( p = 0.002 by McNemar 's test ) . Logistic regression showed that the only characteristic that predicted publication in an English- language journal was a significant result . The odds ratio for publication of trials with significant results in English was 3.75 ( 95 % CI 1.25 - 11.3 ) . INTERPRETATION Authors were more likely to publish RCTs in an English- language journal if the results were statistically significant . English language bias may , therefore , be introduced in review s and meta-analyses if they include only trials reported in English . The effort of the Cochrane Collaboration to identify as many controlled trials as possible , through the manual search of many medical journals published in different language s will help to reduce such bias BACKGROUND A combination of platelet-rich plasma ( PRP ) , bovine porous bone mineral ( BPBM ) , and guided tissue regeneration ( GTR ) has been shown to be effective in promoting reduction in probing depth , gain in clinical attachment , and defect fill in intrabony periodontal lesions . The individual role played by PRP , BPBM , and GTR in this combined therapy is unclear and needs to be eluci date d. The purpose of this study was to compare the clinical effectiveness of 2 regenerative techniques for intrabony defects in humans : a combination of PRP/BPBM/GTR versus a combination of PRP/BPBM . METHODS Twenty-one patients participated in the study . Using a split-mouth design , interproximal bony defects were surgically treated with either a combination of PRP/BPBM/GTR or PRP/BPBM . The primary outcomes of the study included changes in probing depth , attachment level , and defect fill as revealed by reentry surgeries at 6 months post-treatment . RESULTS At 6 months postoperatively , clinical examination of the treated defects revealed that both treatment modalities result ed in significant probing depth reduction and clinical attachment gain compared to baseline values . Probing depth improvement was 3.98 + /- 1.02 mm on buccal and 3.94 + /- 0.94 mm on lingual sites for the PRP/BPBM group and 4.19 + /- 0.88 mm on buccal and 4.21 + /- 0.92 mm on lingual sites for the PRP/BPBM/GTR group . Gain in clinical attachment was 3.78 + /- 0.72 mm on buccal and 3.84 + /- 0.76 mm on lingual sites for the PRP/BPBM group and 4.12 + /- 0.78 mm on buccal and 4.16 + /- 0.83 mm on lingual sites for the PRP/BPBM/GTR group . Reentry surgeries revealed similar defect fill for both treatment groups ( PRP/BPBM group : 4.82 + /- 1.34 mm on buccal and 4.74 + /- 1.30 mm on lingual sites ; PRP/BPBM/GTR group : 4.96 + /- 1.28 mm on buccal and 4.78 + /- 1.32 mm on lingual sites ) . None of the differences between the 2 treatment groups was statistically significant . CONCLUSIONS The results of this study show that both combinations of PRP/BPBM/GTR and PRP/BPBM are effective in the treatment of intrabony defects present in patients with advanced chronic periodontitis . The results also suggest that GTR adds no clinical benefit to PRP/BPBM . Further studies are necessary to assess the individual role played by PRP and BPBM in the clinical outcome achieved with their combination PURPOSE The aim of this study was to describe and quantify the therapeutic value of platelet concentrate on the capillary density in oral mucosal wound healing . MATERIAL AND METHODS The subjects included 10 healthy edentulous patients who underwent bilaterally a sinus floor elevation procedure and a buccal onlay graft with autologous iliac crest bone for maxillary reconstruction . During surgery , platelet-rich plasma ( PRP ) was prepared from a blood sample taken from the patient . After r and omization in a split-mouth design , at one side PRP was administered in the wound and at the contralateral side a placebo . At baseline , microvascular capillary density was scored with the orthogonal polarization spectral ( OPS ) imaging technique and repeated measurements were performed postoperatively on a daily basis until the tenth day , after which measurements were continued weekly until the fifth postoperative week . RESULTS Ten patients , five males and five females , were included in the study with a mean age of 54.2+/-9.1 years for females and 57.6+/-6.9 years for males .  Donor platelet counts from whole blood had a mean value of 248.5+/-13.5 x 10(9)/l , while the value of platelet counts in the PRP had a mean of 975.9+/-97.9 x 10(9)/l . Wound healing was significantly accelerated in the PRP-treated mucosal wounds during the first 10 postoperative days . After the second week , no obvious differences between the PRP or placebo side could be noted . CONCLUSION PRP has a strong stimulant effect on capillary regeneration in wound healing . These effects are mainly noticeable during the early stages of wound healing
BACKGROUND AND OBJECTIVE The evidence for the efficacy of the adjunctive use of platelet-rich plasma ( PRP ) in periodontal intraosseous defects has not been systematic ally evaluated .
The objective of this review was to address the focused question , ' What is the efficacy , with respect to clinical , radiographical and patient-centred outcomes , of combinations of PRP with other therapeutic bioactive agents/ procedures , compared with the efficacy of the same agents/ procedures without the adjunctive use of PRP in the therapy of periodontal intraosseous defects in patients with chronic periodontitis and without systemic diseases that could potentially influence the outcome of periodontal therapy ? '