Crevicular Fluid Growth Factors Release Profile Following the Use of Platelet‐Rich Fibrin and Plasma Rich Growth Factors in Treating Periodontal Intrabony Defects: A Randomized Clinical Trial

Abstract

Background: The open, usually contaminated nature of periodontal defects could negatively affect availability and activity of platelet concentrate–suggested growth factors (GF). The aim of this study is to test this hypothesis and investigate concentrations of: 1) vascular endothelial growth factor (VEGF) and 2) platelet‐derived growth factor (PDGF‐BB) in gingival crevicular fluid (GCF) from localized intrabony defects treated with platelets rich in growth factors (PRGF) or platelet‐rich fibrin (PRF) compared with a control xenograft defect filling. Methods: Thirty non‐smoking patients suffering severe chronic periodontitis were allocated to this randomized, prospective, single‐masked trial. Each patient had one interproximal defect randomly distributed to: 1) group 1: bone‐substitute grafting control (n = 10); 2) group 2: experimental PRGF (n = 10); or 3) group 3: PRF (n = 10). Clinical parameters were measured at baseline and 6 and 9 months following therapy. GCF samples were obtained on days 1, 3, 7, 14, 21, and 30 after therapy for evaluation of VEGF and PDGF‐BB levels. Results: On days 1, 3, and 7 following surgery, mean levels of VEGF and PDGF‐BB at sites treated with PRGF and PRF were not significantly different versus the control. Levels of PDGF‐BB and VEGF were higher in the PRGF‐treated group, but differences were not significant. Growth factor levels decreased significantly in samples collected on days 14, 21, and 30 with non‐significant differences among the three groups. No significant clinical differences were reported among the three groups during the two observation periods (early period: days 1, 3, and 7; and later period: days 14, 21, and 30). Conclusions: Within the limits of the present study, it can be concluded that PRF and PRGF platelet concentrate failed to augment clinical effects achieved with the xenograft alone in treating intrabony defects. Periodontal defects could not retain extraphysiologic levels of GF suggested to be associated with platelet concentrate.