Effects of i-PRF on Non-surgical Periodontal Treatment
Condition: Platelet-Rich Fibrin
Study type: Observational [Patient Registry]

Summary: 
      Injectable platelet-rich fibrin, a platelet concentrate in a liquid formulation, has been
      developed to provide clinicians with ease of use alone or in combination with various
      biomaterials. The low-speed centrifugation method provides a significant advantage to the
      regeneration process with richer platelets, leukocytes, and growth factors. It also
      contributes to the wound-healing process by increasing vascularization. It is expected that
      the application of injectable platelet-rich fibrin into the gingival pocket following
      subgingival curettage in periodontitis patients will positively affect the results of
      non-surgical periodontal treatment. For this reason, in this study it was aimed to
      investigate the early effects of injectable PRF applied into the pocket for root surface
      biomodification following subgingival curettage in periodontal pockets of 6 mm and above, by
      evaluating both clinical parameters and inflammatory and healing markers in the gingival
      groove fluid
    

Detailed description: 
      The study was planned as a randomized controlled split-mouth clinical trial. A split-mouth
      design was used to better assess how the same host responded to two different treatment
      modalities. Two quadrants with contralateral deep periodontal pockets in each participant
      were selected and randomly divided into test and control groups.

      Test group: Injectable platelet-rich fibrin application into the selected deep periodontal
      pocket after scaling and root planning (SRP) procedure.

      Control group: No agent was applied to the periodontal pocket after scaling and root
      planning.

      On the first visit, clinical periodontal measurements were taken before the SRP procedure.
      Plague index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL),
      and bleeding on probing (BOP) were used as clinical periodontal parameters.

      After 1 week, the patients were called again for the SRP procedure. Injectable PRF obtained
      from the intravenous blood sample taken from the antecubital vein of the patients was
      injected into the deepened periodontal pocket subgingivally after the SRP procedure in the
      test group. Clinical periodontal measurements at 1 month and 3 months after SRP were
      repeated.

      Gingival crevicular fluid (GCF) samples were taken from selected teeth before the SRP
      procedure. On the 3rd and 7th day after the SRP, GCF samples were taken again from the same
      region.

      GCF vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-α), and
      interleukin (IL)-10 levels were evaluated by using the ELISA method and compared between
      groups.
    

Intervention name(s): non surgical periodontal treatment
Intervention type(s): Procedure
Intervention description(s): scaling and root planning were applied for non-surgical periodontal treatment i-PRF application: Intravenous blood sample taken from the antecubital vein of the patients was collected in a 10 ml tube and centrifuged at 700 rpm for 3 minutes in a PRF centrifuge device. The PRF obtained from the upper liquid layer formed in the tube was injected subgingival into the deepest point of the pocket after SRP treatment.
Clinical periodontal measurements: plaque index, gingival index, probing depth, clinical attachment level, bleeding on probing, and gingival recession were calculated.
gingival crevicular fluid: Perio papers were placed in the deepest part of the sulcus and left for 30 seconds. After 30 seconds, the paper strips were placed in the periotron device and the volume was calculated.
Other intervention name(s): i-PRF application; clinical periodontal measurement taken; gingival crevicular fluid obtained
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients with systemically healthy and stage 3 grade B periodontitis aged 18-65
      
Keywords: platelet-rich fibrin; non-surgical periodontal treatment; wound healing; growth factor; cytokine