Combined use of platelet-rich plasma and bone grafting with or without guided tissue regeneration in the treatment of anterior interproximal defects. Influence of autogenous platelet concentrate on combined GTR/graft therapy in intrabony defects: a 7-year follow-up of a randomized prospective clinical split-mouth study. Autogenous bone and platelet-rich plasma (PRP) in the treatment of intrabony defects. Torus mandibularis bone chips combined with platelet rich plasma gel for treatment of intrabony osseous defects: clinical and radiographic evaluation. Effect of platelet-rich plasma on the healing of intrabony defects treated with an anorganic bovine bone mineral and expanded polytetrafluoroethylene membranes. Comparative evaluation of autologous platelet-rich fibrin and platelet-rich plasma in the treatment of 3-wall intrabony defects in chronic periodontitis: a randomized controlled clinical trial. Effect of platelet-rich plasma on the healing of intrabony defects treated with an enamel matrix protein derivative and a natural bone mineral. A randomized clinical trial of autologous platelet-rich plasma in the treatment of mandibular degree II furcation defects. 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. Potential for osseous regeneration of platelet-rich plasma--a comparative study in mandibular third molar sockets. Treatment of intrabony defects with beta-tricalciumphosphate alone and in combination with platelet-rich plasma. Treatment of human periodontal infrabony defects with hydroxyapatite + β tricalcium phosphate bone graft alone and in combination with platelet rich plasma: a randomized clinical trial. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. A surgical reentry study on the influence of platelet-rich plasma in enhancing the regenerative effects of bovine porous bone mineral and 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 on the healing of intrabony defects treated with Beta tricalcium phosphate and expanded polytetrafluoroethylene membranes. Five-year results evaluating the effects of platelet-rich plasma on the healing of intrabony defects treated with enamel matrix derivative and natural bone mineral. 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. Effect of platelet-rich plasma on the healing of intrabony defects treated with an anorganic bovine bone mineral: a pilot study.
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 OBJECTIVES To investigate the influence of autogenous platelet concentrate ( APC ) on the long-term regeneration outcome 7 years after  guided tissue regeneration ( GTR ) in deep intrabony periodontal defects . MATERIAL AND METHODS In 25 patients , two deep contra-lateral intrabony defects were treated according to GTR  ( r and omized split-mouth- design ) . In the test defects , APC was additionally applied . After 7 years , healing results were assessed clinical ly by a blinded examiner and compared to baseline and 12-months results . Furthermore , a tooth survival analysis was performed . RESULTS After 7 years , 23 patients were available for survival analysis and 16 patients for split-mouth analysis ; 84 % of the test and control teeth were still in situ . In both groups , the median attachment level of 10.5 mm [ ( 25/75 % ) : test 9.0/13.0 , control 10.0/12.0 ] at baseline was significantly ( p ≤ 0.05 ) reduced to 6.0 mm [ test 4.0/6.8 , control 5.0/7.0 ] after 1 year . Six years later , it had increased again to 7.0 mm in test sites [ 5.3/10.0 ] ( p ≤ 0.05 ) and had remained stable in control sites [ 5.0/7.8 ] ( p > 0.05 ) . Bleeding on Probing ( BOP ) had increased in both groups . During the last 6 years , only 26 % of the patients received a structured supportive periodontal therapy in the clinic . CONCLUSION Within its limitations , the present study indicates that the clinical outcome of GTR therapy can be maintained over 7 years . However , the additional use of APC may even have a possibly negative influence on the long-term stability 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 The use of platelet rich plasma ( PRP ) gel in combination with torus m and ibularis offers a potentially useful treatment for periodontal osseous defects . Whether this combination enhances the outcome of periodontal regenerative therapy is not known . This study compared the effectiveness of torus m and ibularis bone chips alone and when combined with autogenous PRP gel in treating periodontal osseous defects . 24 sites from 12 patients were selected using a split mouth design and determined by a double-blind , r and omized , controlled clinical trial . Both sites received a full-thickness mucoperiosteal flap ; one intrabony defect was filled with torus m and ibularis bone chips alone and the other with torus m and ibularis bone chips mixed with PRP gel . There was a 57 % gain in the clinical attachment level and 60 % reduction in the probing depth for torus m and ibularis alone compared to 72 % and 68 % for sites treated with torus m and ibularis and PRP gel ( p ≤ 0.01 ) . There was a statistically significant difference in the bone dentistry and the marginal bone loss at sites with PRP gel compared to those without gel ( p ≤ 0.01 ) . The use of m and ibular tori as autogenous bone graft combined with PRP gel showed a significant improvement in the clinical outcome of periodontal therapy than m and ibular tori alone 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 The topical use of platelet concentrates is recent , and its efficiency remains controversial . The present study aims to explore the clinical and radiographic effectiveness of autologous platelet-rich fibrin ( PRF ) and platelet-rich plasma ( PRP ) in the treatment of intrabony defects in patients with chronic periodontitis . METHODS Ninety intrabony defects were treated with either autologous PRF with open-flap debridement or autologous PRP with open-flap debridement or open-flap debridement alone .  Clinical and radiologic parameters , such as probing depth ( PD ) , clinical attachment level ( CAL ) , intrabony defect depth , and percentage defect fill , were recorded at baseline and 9 months postoperatively . RESULTS Mean PD reduction and CAL gain were greater in PRF ( 3.77 ± 1.19 and 3.17 ± 1.29 mm ) and PRP ( 3.77 ± 1.07 and 2.93 ± 1.08 mm ) groups than the control group ( 2.97 ± 0.93 and 2.83 ± 0.91 mm ) . Furthermore , significantly greater percentage of mean bone fill was found in the PRF ( 55.41 % ± 11.39 % ) and PRP ( 56.85 % ± 14.01 % ) groups compared with the control ( 1.56 % ± 15.12 % ) group . CONCLUSIONS Within the limit of the present study , there was similar PD reduction , CAL gain , and bone fill at sites treated with PRF or PRP with conventional open-flap debridement . Because PRF is less time consuming and less technique sensitive , it may seem a better treatment option than PRP . However , long-term , multicenter r and omized , controlled clinical trials will be required to know their clinical and radiographic effects on bone regeneration 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 AIM A combined technique using a platelet-rich plasma (PRP)/bovine porous bone mineral/guided tissue regeneration membrane was found to be an effective modality for the treatment of m and ibular grade II furcation defects . To eluci date the role played by each component , the present r and omized , double-blind study is design ed to evaluate the effectiveness of autologous PRP alone in the treatment of m and ibular degree II furcation defects compared with open flap debridement ( OFD ) . MATERIAL AND METHODS Using a split-mouth design , 40 m and ibular degree II furcation defects were treated either with autologous PRP or OFD .  Plaque index , sulcus bleeding index , vertical probing depth , relative vertical and horizontal clinical attachment level and gingival marginal level were recorded at baseline and 6 months post-operatively . Vertical and horizontal defect depths were also recorded using spiral computed tomography . RESULTS A statistically significant difference was observed in all the clinical and radiographic parameters at the sites treated with PRP as compared with those with OFD . However , all the furcation defects retained their degree II status . CONCLUSION Despite a significant improvement , lack of complete closure of furcation defects implies a limited role of autologous PRP as a regenerative material in the treatment of furcation defects , necessitating further long-term studies 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 ( 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 The therapeutic efficacy of platelet-rich plasma ( PRP ) still remains controversial . This study aim ed to compare the efficacy of a beta-tricalcium phosphate ( β-TCP ) and PRP/β-TCP combination both clinical ly and radiographically . METHODS Fourteen chronic periodontitis patients with at least two similar three-walled defects were included in the study . Each patient was r and omly treated with both β-TCP ( n = 14 ) and PRP/β-TCP ( n = 14 ) in the same session . Baseline and 6-month evaluations of plaque index ( PI ) , gingival index ( GI ) , probing pocket depth ( PPD ) , clinical attachment level ( CAL ) , gingival recession ( GR ) , bleeding on probing , and radiographic intrabony defect depth ( RIDD ) were assessed statistically . RESULTS At 6 months , statistically significant reductions of GI , PPD , BOP , and RIDD were observed in both groups . The median values of CAL decreased from 7.0 to 6.0 mm in the β-TCP group ( p = 0.002 ) , and 7.5 to 5.0 mm in the PRP/β-TCP group ( p < 0.001 ) . No statistically significant difference was detected between the two groups for all clinical indices . CONCLUSION After a 6-month healing period , both β-TCP and PRP/β-TCP were found effective in the treatment of three-walled intrabony defects and no additional statistically significant benefits were found with PRP BACKGROUND The present study was aim ed at comparing the clinical effectiveness of two regenerative techniques - platelet rich plasma ( PRP ) + bone graft ( HA + β TCP ) versus bone graft ( HA + β TCP ) + normal saline in the treatment of periodontal intrabony defects . MATERIAL S AND METHODS Ten patients diagnosed with chronic periodontitis were enrolled in a r and omized split mouth clinical trial . Following phase I therapy the sites were r and omly assigned to the test group - PRP + bone graft ( HA + β TCP ) and control group - saline + bone graft ( HA + β TCP ) . Clinical parameters recorded at baseline and 6 months included plaque index , probing pocket depth , relative attachment levels , and relative gingival margin levels . Hard tissue evaluation was done using digital radiography to evaluate the image intensity and therefore the radioopacity of a desired region of interest in the intrabony defect . Pre- and postoperative comparisons were made between the treatment groups at 6 months . RESULTS Test group sites showed a significantly higher reduction in pocket depth compared to control group sites . Test group sites showed a significantly higher amount of radioopacity in the regions of interest , indicative of better graft remodeling , compared to control group sites . CONCLUSION ( HA + β TCP ) bone graft appears to be a beneficial material in the treatment of human periodontal intrabony defects . When combined with platelet-rich plasma there is a significantly higher reduction in probing pocket depth , higher gain in attachment levels and higher amount of radio-density seen in the intrabony defects 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 purpose of this study was to evaluate the additional benefits provided by the incorporation of platelet-rich plasma ( PRP ) into a regenerative protocol consisting of bovine porous bone mineral ( BPBM ) and guided tissue regeneration ( GTR ) in the treatment of intrabony defects in humans . METHODS Twenty-three paired intrabony defects were surgically treated using a split-mouth design . Defects were treated with BPBM/GTR/PRP ( experimental group ) or with BPBM/GTR ( control group ) . The clinical parameters evaluated included changes in probing depth , clinical attachment level , and defect fill as revealed by reentry surgeries at 6 months . RESULTS Preoperative probing depths , attachment levels , and transoperative bone measurements were similar for the two groups . Post-surgical measurements taken at 6 months revealed that both treatment modalities result ed in a significant decrease in probing depth , gain in clinical attachment , and bone fill of the defects compared to baseline . Postoperative differences observed between the two groups were 0.72 + /- 0.36 mm at buccal sites and 0.90 + /- 0.32 mm at lingual sites for probing depth , 0.82 + /- 0.41 mm at buccal sites and 0.78 + /- 0.38 at lingual sites for gain in clinical attachment , and 0.85 + /- 0.36 mm at buccal sites and 0.94 + /- 0.42 mm at lingual sites for defect fill , all favoring the experimental sites . However , none of the differences were statistically significant . CONCLUSION Within the limitations related to using a small sample size , PRP did not significantly augment the effects of BPBM and GTR in promoting the clinical resolution of intrabony defects 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 Regenerative periodontal therapy using platelet-rich plasma ( PRP ) and different types of bone substitutes with or without guided tissue regeneration ( GTR ) has been proposed as a modality to enhance the outcome of regenerative surgery . However , there are limited data from controlled clinical studies evaluating the effect of PRP on the healing of deep intrabony defects treated with a combination of bone substitutes and GTR . The aim of this study was to clinical ly evaluate the effect of PRP on the healing of deep intrabony defects treated with beta tricalcium phosphate ( beta-TCP ) and GTR by means of a non-bioresorbable exp and ed polytetrafluoroethylene membrane . METHODS Twenty-eight subjects with advanced chronic periodontal disease and displaying one intrabony defect were treated r and omly with a combination of PRP + beta-TCP + GTR or beta-TCP + GTR .  Plaque index , gingival index , bleeding on probing , probing depth ( PD ) , gingival recession , and clinical attachment level ( CAL ) were evaluated at baseline and at 1 year after treatment . CAL was 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 subjects . At 1 year after therapy , the sites treated with PRP + beta-TCP + GTR showed a reduction in mean PD from 9.1 + /- 0.6 mm to 3.3 + /- 0.5 mm ( P < 0.001 ) and a change in mean CAL from 10.1 + /- 1.3 mm to 5.7 + /- 1.1 mm ( P < 0.001 ) . In the group treated with beta-TCP + GTR , mean PD was reduced from 9.0 + /- 0.8 mm to 3.6 + /- 0.9 mm ( P < 0.001 ) , and the mean CAL changed from 9.9 + /- 1.0 mm to 5.9 + /- 1.2 mm ( P < 0.001 ) . In both groups , all sites gained > or =3 mm of CAL . CAL gains > or = 4 mm were noted in 86 % ( 12 of 14 defects ) of the cases treated with PRP + beta-TCP + GTR  and in 79 % ( 11 of 14 defects ) of those treated with beta-TCP + GTR . No statistically significant differences in any of the investigated parameters were observed between the two groups at the 1-year reevaluation . CONCLUSION At 1 year after surgery , both therapies result ed in significant PD reductions and CAL gains BACKGROUND Regenerative periodontal surgery using the combination of enamel matrix derivative ( EMD ) and natural bone mineral ( NBM ) with and without addition of platelet-rich plasma ( PRP ) has been shown to result in substantial clinical improvements , but the long-term effects of this combination are unknown . METHODS The goal of this study was to evaluate the long-term ( 5-year ) outcomes after regenerative surgery of deep intrabony defects with either EMD + NBM + PRP or EMD + NBM .  Twenty-four patients were included . In each patient , one intrabony defect was r and omly treated with either EMD + NBM + PRP or EMD + NBM .  Clinical parameters were evaluated at baseline and 1 and 5 years after treatment . The primary outcome variable was clinical attachment level ( CAL ) . RESULTS The sites treated with EMD + NBM + PRP demonstrated a mean CAL change from 10.5 ± 1.6 to 6.0 ± 1.7 mm ( P < 0.001 ) at 1 year and 6.2 ± 1.5 mm ( P < 0.001 ) at 5 years . EMD + NBM-treated defects showed a mean CAL change from 10.6 ± 1.7 to 6.1 ± 1.5 mm ( P < 0.001 ) at 1 year and 6.3 ± 1.4 mm ( P < 0.001 ) at 5 years . At 1 year , a CAL gain of ≥4 mm was measured in 83 % ( 10 of 12 ) of the defects treated with EMD + NBM + PRP and in 100 % ( all 12 ) of the defects treated with EMD + NBM . Compared to baseline , in both groups at 5 years , a CAL gain of ≥4 mm was measured in 75 % ( nine of 12 in each group ) of the defects . Four sites in the EMD + PRP + NBM group lost 1 mm of the CAL gained at 1 year . In the EMD + NBM group , one defect lost 2 mm and four other defects lost 1 mm of the CAL gained at 1 year . No statistically significant differences in any of the investigated parameters were observed between the two groups . CONCLUSIONS Within their limits , the present results indicate that : 1 ) the clinical outcomes obtained with both treatments can be maintained up to a period of 5 years ; and 2 ) the use of PRP does not appear to improve the results obtained with EMD + NBM 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 Periodontal therapy using the combination of platelet-rich plasma ( PRP ) and different grafting material s has been suggested as a modality to enhance the outcome of regenerative surgery . In most clinical studies , a barrier membrane was used to cover the defects , and thus , the effects of PRP may have been masked by the effects of the barrier . The data from controlled clinical studies evaluating the effect of regenerative therapy using various grafting material s with or without PRP are still limited . The purpose of this study was to clinical ly compare the healing of intrabony defects treated with either a combination of an anorganic bovine bone mineral ( ABBM ) and PRP to those obtained with ABBM alone . METHODS Thirty patients with advanced chronic periodontal disease and displaying one intrabony defect were r and omly treated with PRP + ABBM or ABBM alone . The following clinical parameters were evaluated at baseline and 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 statistical significant differences in any of the investigated parameters between the two groups were observed at baseline . Healing was uneventful in all patients . In the PRP + ABBM group , mean PD decreased from 8.6 + /- 1.8 mm to 3.4 + /- 1.4 mm ( P < 0.001 ) and mean CAL changed from 9.9 + /- 1.7 mm to 5.3 + /- 1.8 mm ( P < 0.001 ) . In the ABBM group , mean PD decreased from 8.5 + /- 2.0 mm to 3.2 + /- 1.3 mm ( P < 0.001 ) and mean CAL changed from 9.6 + /- 1.9 mm to 4.9 + /- 1.5 mm ( P < 0.001 ) . CAL gains > or=3 mm were measured in 80 % ( 12 of 15 defects ) of cases treated with PRP + ABBM and in 87 % ( 13 of 15 defects ) of cases treated with ABBM alone . No statistically significant differences in any of the investigated parameters were observed between the two groups at the 1-year reevaluation . CONCLUSIONS Within the limits of the present study , it can be concluded that 1 ) at 1 year after regenerative surgery with PRP + ABBM and ABBM alone , significant PD reductions and CAL gains were found , and 2 ) the use of PRP failed to improve the results obtained with ABBM alone
Background and Objective The purpose of this study was to highlight the clinical performance of platelet-rich plasma ( PRP ) used as an adjunctive tool for regeneration in infrabony periodontal defects using different bio material s or performing different surgical flap approaches .
Comparative evaluation of main clinical outcomes as probing pocket depth reduction , clinical attachment gain , and recession reduction with and without the use of PRP has been analysed .