Injectable Platelet-Rich Fibrin With Minimally Invasive Non-Surgical Technique in Treatment of Periodontal Intrabony Defects

Periodontitis is a chronic inflammatory disease characterized by the progressive destruction of the periodontal supporting tissues, ultimately leading to tooth loss if left untreated.

Optimal periodontal regeneration within intrabony defects depends on the preservation of soft tissues and the maintenance of primary wound closure. Minimally invasive non-surgical periodontal therapy (MINST) has been introduced as a concept aiming to obtain extensive subgingival debridement with minimal tissue trauma.

Platelet-rich plasma (PRP) is an autologous blood product which is created through the centrifugation process of whole blood. It is defined as having a platelet concentration above that of normal physiological levels. The platelets present in PRP carry granules containing a significant number of active biomolecules.

Inclusion criteria

• Patients of both genders >18 years old, medically free of systemic diseases affecting periodontal regeneration.
• Diagnosis of 'periodontitis' stage III (grades B or C).
• Single-rooted and multi-rooted vital teeth in either the maxilla or the mandible.
• Presence of comparable bilateral two- or three-walled intrabony defects [probing pocket depth (PPD), > 5 mm with intrabony defect depth ≥ 3 mm, from the alveolar crest to the defect base, at screening radiograph] not in a furcation-involved tooth.

Exclusion criteria

• Patients with systemic illness known to affect the outcome of periodontal therapy, including diabetes, immune deficiencies, etc.
• Pregnant and lactating women
• Current use of any form of tobacco.
• Non-surgical periodontal treatment in the past 6 months, or surgical periodontal treatment in the past 12 months.
• Degree 2 or 3 mobility of the involved sites.6.
• Presence of periapical pathology, acute infection, or subgingival restoration which could interfere with clinical measurements.