# Five-year results evaluating the healing of intrabony defects following treatment with A-PRF+ or EMD: a randomized controlled trial

**Authors:** Boróka Klára Csifó-Nagy, Bálint Czufor, Eleonóra Sólyom, Ferenc Dőri

PMC · DOI: 10.1007/s00784-026-06806-x · 2026-03-23

## TL;DR

This study found that A-PRF+ and EMD both effectively treat intrabony periodontal defects, with similar long-term results over five years.

## Contribution

A-PRF+ is shown as a reliable autologous alternative to EMD for periodontal regeneration with stable outcomes.

## Key findings

- Both A-PRF+ and EMD resulted in significant PD reductions and CAL gains after six months.
- Clinical outcomes remained stable over five years with no significant differences between the two treatments.
- A-PRF+ offers a viable autologous alternative for periodontal regeneration.

## Abstract

The aim of the study was to clinically evaluate the long-term healing of intrabony periodontal defects treated with a new-generation platelet-rich fibrin (A-PRF+) compared with enamel matrix derivative (EMD).

Thirty intrabony defects in 18 patients were randomly assigned to treatment with A-PRF+ (test, n = 15) or EMD (control, n = 15). Clinical parameters were assessed at baseline, 6 months, 1 year, and 5 years post-surgery. Clinical attachment level (CAL) was the primary outcome variable. Following full-thickness flap elevation, defect debridement, scaling, and root planning were performed. Defects were filled with A-PRF + or EMD according to group allocation and stabilized with sutures. At the 5-year follow-up, 26 defects in 14 patients were available for evaluation.

Both treatment methods resulted in statistically significant PD reductions, respectively CAL gains after 6 months, and the results were maintained 5 years post-operatively. At 5 years no statistically significant differences were found between the two groups as the mean CAL gain was 2.92 ± 1.65 mm in the test group, and 3.84 ± 1.81 mm in the control group, respectively (p < 0.05).

Within the limitations of this study, A-PRF+ demonstrated clinical outcomes comparable to EMD in the surgical treatment of intrabony periodontal defects, with stable long-term results.

A-PRF + may represent a reliable autologous alternative for periodontal regeneration, offering favorable and stable clinical outcomes over a five-year period.

## Full-text entities

- **Genes:** AGXT (alanine--glyoxylate aminotransferase) [NCBI Gene 189] {aka AGT, AGT1, AGXT1, PH1, SPAT, SPT}, STAT3 (signal transducer and activator of transcription 3) [NCBI Gene 6774] {aka ADMIO, ADMIO1, APRF, HIES}, VEGFA (vascular endothelial growth factor A) [NCBI Gene 7422] {aka L-VEGF, MVCD1, VEGF, VPF}
- **Diseases:** diabetes mellitus (MESH:D003920), Plaque (MESH:D003773), attachment loss (MESH:D017622), PD (MESH:D007222), Periodontal disease (MESH:D010510), DBBM (MESH:D002418), EMD (MESH:C536408), FMBS (MESH:D009059), Bleeding (MESH:D006470), systemic diseases (MESH:D034721), Defects (MESH:D000013), inflammation (MESH:D007249), GR (MESH:D005889), osteoporosis (MESH:D010024), Periodontal osseous defects (MESH:D010518), CAL (MESH:D019962), NBM (MESH:D012080), ES (MESH:D012512)
- **Chemicals:** hyaluronic acid (MESH:D006820), Augmentin (MESH:D019980), EDTA (MESH:D004492), chlorhexidine (MESH:D002710), amoxicillin (MESH:D000658), Curasept ADS (-), clavulanic acid (MESH:D019818)
- **Species:** Homo sapiens (human, species) [taxon 9606], Bos taurus (bovine, species) [taxon 9913], Mus musculus (house mouse, species) [taxon 10090]

## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13008997/full.md

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Source: https://tomesphere.com/paper/PMC13008997