Effect of Bone Graft and Platelet Rich Fibrin With and Without Alendronate in the Management of Intrabony Periodontal Defect: A Randomized Clinical study

Abstract

BACKGROUND: Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, and loss of connective tissue attachment and alveolar bone around the affected teeth. The ultimate goal of periodontal therapy is to regenerate the lost periodontal tissues, including cementum, periodontal ligament and alveolar bone. The aim of periodontal therapy is to protect and maintain the patient’s natural dentition over his or her lifetime for optimal comfort, function and esthetic appearance. The regenerative therapy includes various treatment modalities such as use of bone grafts, GTR etc. Various bone grafts and bone replacement graft materials have been used, and growth factors have been incorporated in the bone grafts to stimulate the progenitor cells to form new tissues. Hence, the aim of the present study is to evaluate the effect of bone graft and platelet rich fibrin with and without alendronate in the management of intrabony periodontal defect. MATERIALS AND METHOD: The study sample included 20 patients, 9 male and 11 females, between 25 - 50 years with 20 intra bony defects with probing pocket depth of ≥ 5mm requiring periodontal flap surgery. Sites were randomly divided and treated with one of the following: Group-A open flap debridement followed by placement of platelet rich fibrin (PRF) and bone graft (Perioglas). Group-B open flap debridement followed by placement of platelet rich fibrin (PRF), alendronate and bone graft (Perioglas). Clinical parameters recorded were plaque index, gingival index, pocket depth, relative attachment level, radiographic defect fill were recorded at baseline and 6 months. Statistical analysis was done using SPSS software. RESULTS: The results of present study demonstrate that in all the sites there was a significant improvement in clinical and radiographic parameters, thereby improving periodontal status. CONCLUSION: • Perioglas, PRF and ALN were all shown to be safe to use, without causing any immunologic or antigenic reactions in any of the treated patients. • Perioglas appears to be a suitable vehicle to administer biologic substances like PRF and growth factors to induce new bone regeneration. • A combination therapy with Perioglas + PRF is also found to be effective. • The present study found that adding a single titrated dose of host modulating agent like ALN marginally improved the predictability of bone formation