Titanium-prepared Platelet-rich Fibrin in Periodontal Regeneration

Platelet-Rich Fibrin Clinical Trial

Official title:

The Effect of Titanium- Platelet Rich Fibrin in Periodontal Intrabony Defects: A Randomized Controlled Split-Mouth Clinical Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05409495
• Other study ID #: B.30.2.ATA.0.01.00/93
• Status: Completed
• Phase: N/A
• Start date: April 1, 2021
• Est. completion date: February 15, 2022

Study information

• Verified date: January 2024
• Source: Ataturk University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

In this study, the possible effect of blood group distribution on the content of blood biomaterial was investigated. 64 volunteers were included in the study. Various parameters were evaluated. As a result, it was concluded that blood group distribution does not affect blood biomaterial content.

Description:

The aim of this split-mouth, randomized, and controlled study was to compare open flap debridement (OFD) alone against OFD with autogenous Titanium-prepared platelet-rich fibrin (OFD+ T-PRF) combined in treating intrabony defects (IBD). Subjects were 20 systemically healthy patients with chronic periodontitis according to 2017 World Workshop. Bilateral operation sites in patients (40 sites) were randomly selected for OFD alone or OFD+ T-PRF combined. Clinical parameters (probing depth (PD), relative attachment level (RAL), and gingival marginal level(GML)), radiographic parameters (intrabone defects (IBDs) and periodontal bone support (PBS)), and growth factors levels (GFL) in gingival crevicular fluid (GCF) (platelet-derived growth factors (PDGF-BB), fibroblast growth factors (FGF-2), relative ratio of receptor activator nuclear factor kappa-B (RANKL)/osteoprotegerin (OPG)) were analyzed. The Wilcoxon signed-rank test, the Student's t-test, the two way ANOVA, and the Tukey post hoc test were used for statistical analysis.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 20
• Est. completion date: February 15, 2022
• Est. primary completion date: February 1, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 20 Years to 60 Years

Eligibility

Inclusion Criteria:

1)Patients with bilaterally similar periodontal intrabone defects (IBDs)

Exclusion Criteria:

1. Who did not show the necessary oral hygiene during the non-surgical periodontal treatment process,

2. history of periodontal therapy in the preceding 1 year,

3. presence of devital tooth, Grade II, or higher mobility of the tooth, and less than 3 bone walls or a defect in the furcation at the site of the bone defect,

4. history of any systemic diseases that can alter the course of the periodontal disease,

5. smokers,

6. use of antibiotics,

7. pregnant/lactating women.

Related Conditions & MeSH terms

• Platelet-Rich Fibrin

Intervention

Procedure:
• periodontal surgical procedure (open flap debridement)
All surgical procedures were performed by the second periodontist. 0.12% Chlorhexidine digluconate (CHX) rinse for intraoral antisepsis and a povidone iodine solution was used for extraoral antisepsis. After local anesthesia (2% lidocaine with epinephrine 1:100,000/ Astra, Westbrough, MA) was applied, the full thickness trapezoidal flap was raised large enough to provide adequate view of the defect area. Subgingival debridement and root planning were performed with the use of area-specific curets (Gracey curets, Hu-Friedy), and granulation tissue was removed The IBD area in the control group was closed without applying any material. Then mucoperiosteal flaps were repositioned with sutured with 4/0 monoprolene sutures.
• periodontal surgical procedure (OFD +autogenous Titanium-prepared platelet-rich fibrin (OFD+ T-PRF))
All surgical procedures were performed by the second periodontist. 0.12% Chlorhexidine digluconate (CHX) rinse for intraoral antisepsis and a povidone iodine solution was used for extraoral antisepsis. After local anesthesia (2% lidocaine with epinephrine 1:100,000/ Astra, Westbrough, MA) was applied, the full thickness trapezoidal flap was raised large enough to provide adequate view of the defect area. Subgingival debridement and root planning were performed with the use of area-specific curets (Gracey curets, Hu-Friedy), and granulation tissue was removed (Figure 2a). The blood supply of the defect areas was taken into account. At the test site, IBDs were filled with T-PRF and T-PRF membranes were adapted over the defects both buccally and lingually, in addition to OFD (Figure 2b). Then mucoperiosteal flaps were repositioned with sutured with 4/0 monoprolene sutures.

Locations

Country	Name	City	State
Turkey	Atatürk University Faculty of Dentistry Department of Peirodontology	Erzurum

Sponsors (1)

Lead Sponsor	Collaborator
Ataturk University

Country where clinical trial is conducted

Turkey, 

References & Publications (23)

Arabaci T, Albayrak M. Titanium-prepared platelet-rich fibrin provides advantages on periodontal healing: A randomized split-mouth clinical study. J Periodontol. 2018 Mar;89(3):255-264. doi: 10.1002/JPER.17-0294. — View Citation

Barbalic M, Dupuis J, Dehghan A, Bis JC, Hoogeveen RC, Schnabel RB, Nambi V, Bretler M, Smith NL, Peters A, Lu C, Tracy RP, Aleksic N, Heeriga J, Keaney JF Jr, Rice K, Lip GY, Vasan RS, Glazer NL, Larson MG, Uitterlinden AG, Yamamoto J, Durda P, Haritunia — View Citation

Bussel JB, Kunicki TJ, Michelson AD. Platelets: New Understanding of Platelet Glycoproteins and Their Role in Disease. Hematology Am Soc Hematol Educ Program. 2000:222-240. doi: 10.1182/asheducation-2000.1.222. — View Citation

Chatterjee A, Pradeep AR, Garg V, Yajamanya S, Ali MM, Priya VS. Treatment of periodontal intrabony defects using autologous platelet-rich fibrin and titanium platelet-rich fibrin: a randomized, clinical, comparative study. J Investig Clin Dent. 2017 Aug; — View Citation

Choukroun J, Ghanaati S. Reduction of relative centrifugation force within injectable platelet-rich-fibrin (PRF) concentrates advances patients' own inflammatory cells, platelets and growth factors: the first introduction to the low speed centrifugation c — View Citation

Clipet F, Tricot S, Alno N, Massot M, Solhi H, Cathelineau G, Perez F, De Mello G, Pellen-Mussi P. In vitro effects of Choukroun's platelet-rich fibrin conditioned medium on 3 different cell lines implicated in dental implantology. Implant Dent. 2012 Feb; — View Citation

Cochran DL, Wozney JM. Biological mediators for periodontal regeneration. Periodontol 2000. 1999 Feb;19:40-58. doi: 10.1111/j.1600-0757.1999.tb00146.x. — View Citation

Dangaria SJ, Ito Y, Walker C, Druzinsky R, Luan X, Diekwisch TG. Extracellular matrix-mediated differentiation of periodontal progenitor cells. Differentiation. 2009 Sep-Oct;78(2-3):79-90. doi: 10.1016/j.diff.2009.03.005. Epub 2009 May 9. — View Citation

Dereka XE, Markopoulou CE, Vrotsos IA. Role of growth factors on periodontal repair. Growth Factors. 2006 Dec;24(4):260-7. doi: 10.1080/08977190601060990. — View Citation

Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):e45- — View Citation

Dohan Ehrenfest DM, Bielecki T, Jimbo R, Barbe G, Del Corso M, Inchingolo F, Sammartino G. Do the fibrin architecture and leukocyte content influence the growth factor release of platelet concentrates? An evidence-based answer comparing a pure platelet-ri — View Citation

Dohan Ehrenfest DM, Pinto NR, Pereda A, Jimenez P, Corso MD, Kang BS, Nally M, Lanata N, Wang HL, Quirynen M. The impact of the centrifuge characteristics and centrifugation protocols on the cells, growth factors, and fibrin architecture of a leukocyte- a — View Citation

Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009 Mar;27(3):158-67. doi: 10.1016/j.tibtech.2008.11.009. E — View Citation

Ghanaati S, Booms P, Orlowska A, Kubesch A, Lorenz J, Rutkowski J, Landes C, Sader R, Kirkpatrick C, Choukroun J. Advanced platelet-rich fibrin: a new concept for cell-based tissue engineering by means of inflammatory cells. J Oral Implantol. 2014 Dec;40( — View Citation

Kang YH, Jeon SH, Park JY, Chung JH, Choung YH, Choung HW, Kim ES, Choung PH. Platelet-rich fibrin is a Bioscaffold and reservoir of growth factors for tissue regeneration. Tissue Eng Part A. 2011 Feb;17(3-4):349-59. doi: 10.1089/ten.TEA.2010.0327. Epub 2 — View Citation

Kim TH, Kim SH, Sandor GK, Kim YD. Comparison of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factor (CGF) in rabbit-skull defect healing. Arch Oral Biol. 2014 May;59(5):550-8. doi: 10.1016/j.archoralbio.2014.02.004. Epu — View Citation

Kobayashi E, Fluckiger L, Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, Miron RJ. Comparative release of growth factors from PRP, PRF, and advanced-PRF. Clin Oral Investig. 2016 Dec;20(9):2353-2360. doi: 10.1007/s00784-016-1719-1. Epub 2016 Jan 25 — View Citation

Kumar RV, Shubhashini N. Platelet rich fibrin: a new paradigm in periodontal regeneration. Cell Tissue Bank. 2013 Sep;14(3):453-63. doi: 10.1007/s10561-012-9349-6. Epub 2012 Nov 11. — View Citation

Masuki H, Okudera T, Watanebe T, Suzuki M, Nishiyama K, Okudera H, Nakata K, Uematsu K, Su CY, Kawase T. Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advanced platelet-rich fibri — View Citation

Mohanty D, Ghosh K, Marwaha N, Kaur S, Chauhan AP, Das KC. Major blood group antigens--a determinant of factor VIII levels in blood? Thromb Haemost. 1984 Jul 29;51(3):414. No abstract available. — View Citation

Selezneva IA, Gilmiyarova FN, Borodina IA, Ereshchenko AA, Gilmiyarov EM, Kartashov VV. [capital ES, Cyrilliclinicmolecular indicators of inflammatory destructive damage of the oral cavity in periodontitis in persons with various group accessories of bloo — View Citation

Su CY, Kuo YP, Tseng YH, Su CH, Burnouf T. In vitro release of growth factors from platelet-rich fibrin (PRF): a proposal to optimize the clinical applications of PRF. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Jul;108(1):56-61. doi: 10.1016/j — View Citation

Whitman DH, Berry RL, Green DM. Platelet gel: an autologous alternative to fibrin glue with applications in oral and maxillofacial surgery. J Oral Maxillofac Surg. 1997 Nov;55(11):1294-9. doi: 10.1016/s0278-2391(97)90187-7. — View Citation

* Note: There are 23 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	While examining the radiographic intraosseous defect, the distance between the alveolar bone crest and the base of the defect was taken into account. This distance (IBD) was evaluated using computer aided software.	Radiographic Measurements; Measurements were made on radiographic images in order to evaluate the healing of the patient's bone tissue.	9 month
Other	Also while measuring periodontal bone support (PBS) using radiographic images used Image Tool v.3.0 (UTHSCSA).	Radiographic Measurements; Measurements were made on radiographic images in order to evaluate the healing of the patient's bone tissue.	9 month
Primary	site-specific plaque index (PI) (Silness & Loe)	measurement of plaque accumulated on the tooth surface	9 month
Primary	modified sulcus bleeding index (mSBI)	assessment of bleeding gums	9 month
Primary	probing depth from the gingival margin (PD)	evaluated from the gingival margin to the base of the pocket	9 month
Primary	gingival marginal level (GML)	measured from the apical most end of the stent to the crest of the gingival margin	9 month
Primary	relative attachment level (RAL)	evaluated from the cementoenamel junction to the base of the pocket and gingival marginal level	9 month
Secondary	fibroblast growth factors (FGF-2)	growth factor affecting periodontal regeneration	12 weeks
Secondary	platelet-derived growth factors (PDGF-BB)	growth factor affecting periodontal regeneration	12 weeks
Secondary	Gingival Crevicular Fluid Collection; The gingival crevicular fluid (GCF) sample was collected to biochemically evaluate the patient's periodontal tissue healing.	relative ratio of receptor activator nuclear factor kappa-B (RANKL)/osteoprotegerin (OPG))	12 weeks