Dual-action platelet-rich fibrin in periodontal therapy: Assessing the efficacy of injectable versus metronidazole-enhanced platelet-rich fibrin in non-surgical periodontal treatment – A clinical study

TL;DR

This clinical study compares two types of platelet-rich fibrin used in periodontal treatment and finds that one with metronidazole performs better in improving gum health.

Contribution

The study introduces metronidazole-infused PRF gel as a more effective adjunct to non-surgical periodontal therapy compared to injectable PRF.

Findings

Both i-PRF and metronidazole-infused PRF gel improved periodontal pocket depth and clinical attachment level significantly.

Metronidazole-infused PRF gel showed better reduction in gingival inflammation and bleeding on probing compared to i-PRF.

Improvements in oral hygiene index were observed but not statistically significant in either group.

Abstract

Adjunctive therapies play a crucial role in enhancing the efficacy of non-surgical periodontal therapy (NSPT) by addressing the multifactorial nature of periodontal disease. Injectable platelet-rich fibrin (i-PRF) and metronidazole-infused PRF gel have emerged as potential biomaterials that promote periodontal regeneration and antibacterial effects, respectively.

To evaluate and compare the clinical efficacy of i-PRF and metronidazole-infused PRF gel as adjuncts to NSPT in patients with periodontitis.

ology: A randomized controlled trial was conducted on 20 periodontal sites in patients with Stage II-III periodontitis. Sites were divided into two groups (n = 10 each), receiving either i-PRF or metronidazole-infused PRF gel following NSPT. Clinical parameters, including Oral Hygiene Index (OHI), Gingival Index (GI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL), were assessed at baseline, 4 weeks, and 3 months. Statistical analyses included the Mann-Whitney U test for intergroup comparisons and the Friedman test for intragroup comparisons.

Both groups showed significant improvement in PPD and CAL over the study period (p < 0.001). The metronidazole-infused PRF gel group demonstrated a more pronounced reduction in GI and BOP compared to the i-PRF group (p = 0.01 and p = 0.66, respectively). Improvements in OHI were observed in both groups but were not statistically significant.

The study highlights the potential of metronidazole-infused PRF gel as a superior adjunct to NSPT due to its enhanced antimicrobial effects and periodontal tissue healing properties. Personalized therapeutic strategies incorporating bioactive materials can optimize periodontal treatment outcomes.

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