J Periodontal Implant Sci.  2019 Dec;49(6):355-365. 10.5051/jpis.2019.49.6.355.

Platelet-rich fibrin along with a modified minimally invasive surgical technique for the treatment of intrabony defects: a randomized clinical trial

• Ahmad N
• Tewari S
• Narula SC
• Sharma RK
• Tanwar N

• KMID: 2465380
• DOI: http://doi.org/10.5051/jpis.2019.49.6.355

Abstract

PURPOSE
The modified minimally invasive surgical technique (M-MIST) has been successfully employed to achieve periodontal regeneration. Platelet-rich fibrin (PRF) is known to enhance wound healing through the release of growth factors. This study aimed to observe the outcomes of periodontal surgery when M-MIST was used with or without PRF for the treatment of isolated intrabony defects.
METHODS
This randomized clinical trial was conducted on 36 systemically healthy patients, who had chronic periodontitis associated with a single-site buccal probing pocket depth (PPD) and clinical attachment level of ≥5 mm. Patients were randomly divided into 2 groups: the test group treated with M-MIST and PRF, and the control group treated with M-MIST alone. The primary periodontal parameters analyzed were PPD, relative attachment level (RAL), and relative gingival margin level. The radiographic parameters analyzed were change in alveolar crest position (C-ACP), linear bone growth (LBG), and percentage bone fill (%BF). Patients were followed up to 6 months post-surgery.
RESULTS
Intragroup comparisons at 3 and 6 months showed consistently significant improvements in PPD and RAL in both the groups. In intergroup comparisons, the improvement in PPD reduction, gain in RAL, and the level of the gingival margin was similar in both groups at 3 and 6 months of follow-up. Furthermore, an intergroup comparison of radiographic parameters also demonstrated similar improvements in C-ACP, LBG, and %BF at 6 months of follow-up.
CONCLUSIONS
M-MIST with or without PRF yielded comparable periodontal tissue healing in terms of improvements in periodontal and radiographic parameters. Further investigation is required to confirm the beneficial effects of PRF with M-MIST. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03169920

Keyword

Chronic periodontitis; Microsurgery; Minimally invasive surgical procedures; Platelet-rich fibrin; Regeneration; Wound healing

MeSH Terms

Bone Development
Chronic Periodontitis
Fibrin*
Follow-Up Studies
Humans
Intercellular Signaling Peptides and Proteins
Microsurgery
Minimally Invasive Surgical Procedures
Regeneration
Wound Healing
Fibrin
Intercellular Signaling Peptides and Proteins

Figure

• 

  Figure 1 Procedure depicting the M-MIST. (A) Preoperative photograph showing a single-site pocket probing depth of 6 mm on the buccal surface. (B) Intraoperative photograph showing the M-MIST incision. (C) Intrabony defect after debridement. (D) Measurement of the defect depth with a UNC-15 periodontal probe. (E) A modified vertical internal mattress suture was placed. And (F) Residual pocket probing depth 6 months after surgery. M-MIST: modified minimally invasive surgical technique.

• 

  Figure 2 Flow chart of the participants in this study. PRF: platelet-rich fibrin, M-MIST: modified minimally invasive surgical technique.

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