Clinical Evaluation of Platelet-Rich Plasma with Guided Tissue Regeneration

Objective: In recent years, platelet-rich plasma (PRP) has been combined with various graft materials for the purpose of periodontal regeneration. The individual role of PRP and guided tissue regeneration (GTR) in periodontal therapy is unclear and needs to be elucidated. The purpose of this study was to compare the clinical and radiological effectiveness of PRP/GTR and bioactive glass (BG)/GTR for intrabony defects in humans. Methods: Fifteen systemically healthy patients having two vertical osseous defects with pocket depths ³6mm following periodontal initial therapy were recruited for this study. Using a split mouth design, 30 intrabony defects were surgically treated with either a combination of PRP/GTR or BG/GTR. An absorbable membrane made of polylactic acid was used for GTR. The criteria for comparative study were preoperative and postoperative 6-month pocket depth (PD), clinical attachment level (CAL), and radiological alveolar bone level. Results: Both treatment modalities resulted in significant PD reduction, clinical attachment gain and radiological defect fill as compared to preoperative values (P<0.01). Initially, no difference between the two treatment modalities in any of the investigated criteria was observed. Six months after surgery, in the sites treated with PRP/GTR the mean values changed from 7.20±0.26 to 2.87±0.17 (PD), from 7.93±0.33 to 3.87±0.31 (CAL), and from 7.93±0.36 to 3.07±0.33 (radiological alveolar bone level). In the sites treated with BG/GTR the mean values changed from 7.33±0.29 to 2.93±0.12 (PD), from 8.33±0.47 to 4.27±0.40, and from 9.53±0.69 to 3.60±0.47 (radiological alveolar bone level). The differences between the two treatment modalities were not statistically significant. Conclusion: Within limits of the study, it could be concluded that both therapies led to significant improvements in the clinical and radiological parameters that were investigated. Although PRP/GTR does not seem to be more effective than BG/GTR, further experimental studies are necessary to elucidate the role of PRP in regenerative therapy.