The effect of leukocyte-platelet-rich fibrin in periodontal surgery on clinical parameters and patient-related outcome measures: A randomized, controlled, clinical study.

Background

This prospective study aimed to assess the clinical outcomes and patient-related outcome measures (PROMs) of open flap debridement (OFD) alone versus open flap debridement with leukocyte-platelet-rich fibrin (L-PRF).

Methods

Twenty-one patients were enrolled into a split-mouth randomized clinical trial. One side of the arch underwent OFD; the contralateral side of the same arch underwent the same OFD procedure with L-PRF placed across the alveolar bone and root surfaces underneath the buccal and lingual/palatal flap. Clinical parameters for probing depth (PD) and relative gingival recession (RGR) were recorded at six sites per tooth using a thermoplastic stent at baseline (immediately before surgery), 3 months, and 6 months. Bleeding on probing (BOP) and plaque scores were recorded at six sites per tooth throughout the study duration.

Results

The greatest reductions in PD were observed for sites ≥ 7 mm. Mean PD in the control group decreased from 7.38 mm at baseline to 3.15 mm at 3 months, with a subsequent increase to 4.00 mm at 6 months. In contrast, the test group demonstrated a sustained reduction from 7.75 mm at baseline to 3.25 mm at 3 months and 3.19 mm at 6 months. In moderate sites (4-6 mm), both groups demonstrated substantial PD reduction. Moderate subgroup mean PD decreased from 4.62 mm to 3.09 mm in the control group and from 4.76 mm to 3.19 mm in the test group at the 6-month timepoint. Relative recession and relative attachment level revealed no significant differences between the groups across all PDs. PROMs data showed that, although test group patients reported more swelling and pain early after surgery, they used less analgesics than the control group.

Conclusions

Based on the findings from this randomized clinical study, L-PRF was found to have improved, sustained PD reduction in deep periodontal pockets compared to OFD alone. L-PRF was not found to have a significant impact on PROMs or soft tissue healing compared to OFD alone. CLINICALTRIALS GOV IDENTIFIER NCT06296498 PLAIN LANGUAGE SUMMARY: In this split mouth, same arch clinical study, 21 patients were randomized into two study groups: open flap debridement (OFD) and OFD plus leukocyte-platelet-rich fibrin (L-PRF). Clinical parameters were recorded at baseline, 3 months, and 6 months after intervention, while healing and patient-reported outcome measures (PROMs) were evaluated 2 and 4 weeks after surgery. In sites ≥ 7 mm baseline PD, OFD plus L-PRF was associated with greater probing depth (PD) reduction and attachment level (AL) gain than control OFD alone, with similar gingival recession in both groups. Overall test group PD decrease was 4.44 mm, resulting in 1.05 mm more PD decrease in test sites than control. L-PRF effect was sustained with PD values in test sites reduced to 3.25 mm and 3.19 mm at 3 and 6 months, respectively (from 7.75 mm at baseline). The addition of L-PRF did not provide benefits in PROMs and soft tissue healing compared to sites treated with OFD alone.