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Background and aim <p>The present trial aimed to explore whether lyophilized platelet-rich fibrin (Ly-PRF) alone or combined with nanocrystalline hydroxyapatite (n-HA) could be effective in treating the periodontal intra-bony defects (IBDs) by comparative analysis of the clinical, radiographic and biochemical outcomes.</p> Methods <p>A parallel, randomized, controlled, clinical prospective trial was chosen as a study design. This study was conducted on 36 intra-bony defects in 36 patients with stage III periodontitis who were allocated randomly to one of the following groups: Group I (<i>n</i> = 12) [control or open flap debridement (OFD) group]; Group II (<i>n</i> = 12) [test1 or OFD + Ly-PRF group]; Group III (<i>n</i> = 12) [test 2 or OFD + Ly-PRF + n-HA group]. All patients were monitored by clinical and radiographical evaluation at baseline, 3, 6 and 9 months using plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL), alveolar crest level (ACL) and percentage of defect fill (%DF). The biochemical evaluation was performed to evaluate the BMP-2 levels in gingival crevicular fluid (GCF) at baseline, 1, 4 and 12 weeks following surgery. The primary outcomes were CAL and %DF.</p> Results <p>The PI and GI did not differ significantly between the studied groups at the different intervals; however, all groups experienced statistically significant improvements in PPD and CAL, with group III reporting the highest statistically significant reduction in PPD and CAL gain. The result of the ACL found that, after 9 months, group III showed bone gain by (0.12 ± 0.13&#xa0;mm) while both group I and II showed bone loss by (-0.19 ± 0.09&#xa0;mm) and (-0.11 ± 0.06&#xa0;mm) respectively. The bone defect fill percentages in group I (20.9 ± 4.9%), group II (45.4 ± 6.1%), and group III (68.1 ± 16.6%) were observed at 9 months post-surgery. The BMP-2 levels revealed that group III showed the highest mean BMP-2 level, followed by group II, while group I showed the lowest mean BMP-2 level.</p> Conclusion <p>Lyophilized platelet-rich fibrin plus nanocrystalline hydroxyapatite appeared to be superior and promising in regenerative treatment of periodontal intra-bony defects. Bone morphogenetic protein-2 seems to be a relevant and reliable biomarker in the expression of osteogenic activity.</p>

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The Impact of Lyophilized Platelet-Rich Fibrin Combined with Nanocrystalline Hydroxyapatite in Regenerative Treatment of Periodontal Intra-Bony Defects

  • 期刊论文

  • 发表日期：

    2026年2月10日

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  • Ibraheem Mahmoud Mwafey,
  • Alaa El-Dein M. Salatein,
  • Ahmed Kassem Mohammed,
  • Helal F. Hetta

摘要

Background and aim

The present trial aimed to explore whether lyophilized platelet-rich fibrin (Ly-PRF) alone or combined with nanocrystalline hydroxyapatite (n-HA) could be effective in treating the periodontal intra-bony defects (IBDs) by comparative analysis of the clinical, radiographic and biochemical outcomes.

Methods

A parallel, randomized, controlled, clinical prospective trial was chosen as a study design. This study was conducted on 36 intra-bony defects in 36 patients with stage III periodontitis who were allocated randomly to one of the following groups: Group I (n = 12) [control or open flap debridement (OFD) group]; Group II (n = 12) [test1 or OFD + Ly-PRF group]; Group III (n = 12) [test 2 or OFD + Ly-PRF + n-HA group]. All patients were monitored by clinical and radiographical evaluation at baseline, 3, 6 and 9 months using plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL), alveolar crest level (ACL) and percentage of defect fill (%DF). The biochemical evaluation was performed to evaluate the BMP-2 levels in gingival crevicular fluid (GCF) at baseline, 1, 4 and 12 weeks following surgery. The primary outcomes were CAL and %DF.

Results

The PI and GI did not differ significantly between the studied groups at the different intervals; however, all groups experienced statistically significant improvements in PPD and CAL, with group III reporting the highest statistically significant reduction in PPD and CAL gain. The result of the ACL found that, after 9 months, group III showed bone gain by (0.12 ± 0.13 mm) while both group I and II showed bone loss by (-0.19 ± 0.09 mm) and (-0.11 ± 0.06 mm) respectively. The bone defect fill percentages in group I (20.9 ± 4.9%), group II (45.4 ± 6.1%), and group III (68.1 ± 16.6%) were observed at 9 months post-surgery. The BMP-2 levels revealed that group III showed the highest mean BMP-2 level, followed by group II, while group I showed the lowest mean BMP-2 level.

Conclusion

Lyophilized platelet-rich fibrin plus nanocrystalline hydroxyapatite appeared to be superior and promising in regenerative treatment of periodontal intra-bony defects. Bone morphogenetic protein-2 seems to be a relevant and reliable biomarker in the expression of osteogenic activity.