Current treatments of periodontitis have limited efficacy since they fail to suppress microorganisms satisfactorily over time. The aim of present study was to investigate whether there are differences between initial treatment of chronic periodontitis (SRP) and SRP in conjunction with injectable platelet-rich fibrin (i-PRF) application.
Current treatments of periodontitis have limited efficacy since they fail to suppress microorganisms satisfactorily over time. The aim of present study was to investigate whether there are differences between initial treatment of chronic periodontitis (SRP) and SRP in conjunction with injectable platelet-rich fibrin (i-PRF) application. Thirty patients with chronic periodontitis who had at least two sites with perriodontal pocket depth (PPD) ≥ 4 mm on contralateral side will be involved in the study. Using a split-mouth design, patients will be treated with SRP + I-PRF -(test group) or SRP only-(control group). Gingival crevicular fluid (GCF) and subgingival plaque will be collected with paper points (DentsplyMaillefer, Tulsa, Oklahoma, USA) at baseline and 1, 3 and 6 months after the treatment. The presence and concentrations of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi) and Tannerella forsythia(Tf) will be analyzed by real-time polymerase chain reaction (qPCR). Periodontal parameters, including bleeding on probing (BOP), probing pocket depth (PPD) and the clinical attachment level (CAL), will be recorded on both sides, as well as concentration of TNF-alpha (tumor necrosis factor alpha), ALP(alkaline phosphatase) and MMP-8 (matrix-metalloproteinase-8).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
Injectable Platelet-Rich Fibrin application as adjunct to scaling and root planing
Saline application during scaling and root planing
Department of Periodontology and Oral medicine, School of Dental Medicine, University of Belgrade
Belgrade, Serbia
Periodontal Pocket Depth-PPD
assessment of periodontal pocket depth by probing, mean value of periodontal pockets on one side of the jaw
Time frame: baseline measure (before the intervention)
Periodontal Pocket Depth-PPD - 1m
assessment of periodontal pocket depth by probing, mean value of periodontal pockets on one side of the jaw
Time frame: after 1 month
Periodontal Pocket Depth-PPD - 3m
assessment of periodontal pocket depth by probing, mean value of periodontal pockets on one side of the jaw
Time frame: after 3 months
Periodontal Pocket Depth-PPD - 6
assessment of periodontal pocket depth by probing mean value of one side of the jaw
Time frame: after 6 months
Level of Gingival Margin-LGM
assessment of level of gingival margin-LGM by probing, i.e.distance between cementoenamel junction and gingival margin (the most coronal point of the gingiva); mean value of one side of the jaw
Time frame: baseline measure (before the intervention)
Level of Gingival Margin-LGM - 1m
assessment of level of gingival margin-LGM by probing, i.e.distance between cementoenamel junction and gingival margin (the most coronal point of the gingiva); mean value of one side of the jaw
Time frame: after 1 month
Level of Gingival Margin-LGM - 3m
assessment of level of gingival margin-LGM by probing, i.e. distance between cementoenamel junction and gingival margin (the most coronal point of the gingiva); mean value of one side of the jaw
Time frame: after 3 months
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Level of Gingival Margin-LGM - 6m
assessment of level of gingival margin-LGM by probing, distance between cementoenamel junction and gingival margin (the most coronal point of the gingiva) after 6 months
Time frame: after 6 months
Clinical Attachment Level- CAL
assessment of clinical attachment level- CAL by probing
Time frame: baseline measure (before the intervention)
Clinical Attachment Level- CAL - 1m
assessment of clinical attachment level- CAL by probing, mean value of one side of the jaw
Time frame: after 1 month
Clinical Attachment Level- CAL - 3m
assessment of clinical attachment level- CAL by probing, mean value of one side of the jaw
Time frame: after 3 months
Clinical Attachment Level- CAL - 6m
assessment of clinical attachment level- CAL by probing, mean value of one side of the jaw
Time frame: after 6 months
Bleeding on Probing-BOP
assessment of bleeding on probing Mühlemann Papillary Bleeding Index , a four-grade index based on both the extent of bleeding and the time it takes for bleeding to occur after stimulation with a periodontal probe (0-the best outcome, 4-the worst outcome).
Time frame: baseline measure (before the intervention)
Bleeding on Probing-BOP - 1m
assessment of bleeding on probing Mühlemann Papillary Bleeding Index , a four-grade index based on both the extent of bleeding and the time it takes for bleeding to occur after stimulation with a periodontal probe (0-the best outcome, 4-the worst outcome).
Time frame: after 1 month
Bleeding on Probing-BOP 3m
assessment of bleeding on probing Mühlemann Papillary Bleeding Index , a four-grade index based on both the extent of bleeding and the time it takes for bleeding to occur after stimulation with a periodontal probe (0-the best outcome, 4-the worst outcome).
Time frame: after 3 months
Bleeding on Probing-BOP - 6m
assessment of bleeding on probing Mühlemann Papillary Bleeding Index , a four-grade index based on both the extent of bleeding and the time it takes for bleeding to occur after stimulation with a periodontal probe (0-the best outcome, 4-the worst outcome).
Time frame: after 6 months
Plaque Index- PI
visual assessment of plaque index-PI and by probing Plaque Index (Silness and Löe), 0-the best outcome, 3-the worst outcome
Time frame: baseline measure (before the intervention)
Plaque Index- PI -1m
visual assessment of plaque index-PI and by probing Plaque Index (Silness and Löe), 0-the best outcome, 3-the worst outcome
Time frame: after 1 month
Plaque Index- PI -3m
visual assessment of plaque index-PI and by probing Plaque Index (Silness and Löe), 0-the best outcome, 3-the worst outcome
Time frame: after 3 months
Plaque Index- PI - 6m
visual assessment of plaque index-PI and by probing
Time frame: after 6 months
Number of Periodontal Pockets With Presence/Absence of Aggregatibacter Actinomycetemcomitans (Aa) in Gingival Crevicular Fluid (GCF)
Number of periodontal pockets with presence/absence of Aggregatibacter actinomycetemcomitans in gingival crevicular fluid (GCF) at baseline
Time frame: baseline measure (before the intervention)
Number of Periodontal Pockets With Presence/Absence of Aggregatibacter Actinomycetemcomitans (Aa) in Gingival Crevicular Fluid (GCF) -1m
Number of periodontal pockets with presence/absence of Aggregatibacter actinomycetemcomitans in gingival crevicular fluid (GCF) after 1 month
Time frame: after 1 month
Number of Periodontal Pockets With Presence/Absence of Aggregatibacter Actinomycetemcomitans (Aa) in Gingival Crevicular Fluid (GCF) - 3m
Number of periodontal pockets with presence/absence of Aggregatibacter Actinomycetemcomitans (Aa) in Gingival Crevicular Fluid (GCF) after 3 months
Time frame: after 3 months
Number of Periodontal Pockets With Presence/Absence of Aggregatibacter Actinomycetemcomitans (Aa) in Gingival Crevicular Fluid (GCF) - 6m
Number of periodontal pockets with presence/absence of Aggregatibacter actinomycetemcomitans in gingival crevicular fluid (GCF) after 6 months
Time frame: after 6 months
Number of Periodontal Pockets With Presence/Absence of Porphyromonas Gingivalis (Pg) in Gingival Crevicular Fluid (GCF)
Number of periodontal pockets with presence/absence of Porphyromonas gingivalis - Pg in gingival crevicular fluid (GCF) at baseline
Time frame: baseline measure (before the intervention)
Number of Periodontal Pockets With Presence/Absence of Porphyromonas Gingivalis (Pg) in Gingival Crevicular Fluid (GCF) - 1m
Number of periodontal pockets with presence/absence of Porphyromonas gingivalis - Pg in gingival crevicular fluid (GCF) after 1 month
Time frame: after 1 month
Number of Periodontal Pockets With Presence/Absence of Porphyromonas Gingivalis (Pg) in Gingival Crevicular Fluid (GCF) - 3m
Number of periodontal pockets with presence/absence of Porphyromonas gingivalis - Pg in gingival crevicular fluid after 3 months.
Time frame: after 3 months
Number of Periodontal Pockets With Presence/Absence of Porphyromonas Gingivalis (Pg) in Gingival Crevicular Fluid (GCF) - 6m
Number of periodontal pockets with presence/absence of Porphyromonas gingivalis - Pg in gingival crevicular fluid after 6 months.
Time frame: after 6 months
Number of Periodontal Pockets With Presence/Absence of Prevotella Intermedia (Pi) in Gingival Crevicular Fluid (GCF)
Number of periodontal pockets with presence/absence of Prevotella intermedia-Pi in gingival crevicular fluid (GCF) at baseline
Time frame: baseline measure (before the intervention)
Number of Periodontal Pockets With Presence/Absence of Prevotella Intermedia (Pi) in Gingival Crevicular Fluid (GCF) -1m
Number of periodontal pockets with presence/absence of Prevotella intermedia-Pi in gingival crevicular fluid (GCF) after 1 month.
Time frame: after 1 month
Number of Periodontal Pockets With Presence/Absence of Prevotella Intermedia (Pi) in Gingival Crevicular Fluid (GCF) - 3m
Number of periodontal pockets with presence/absence of Prevotella intermedia-Pi in gingival crevicular fluid (GCF) after 3 months.
Time frame: after 3 months
Number of Periodontal Pockets With Presence/Absence of Prevotella Intermedia (Pi) in Gingival Crevicular Fluid (GCF) -6m
Number of periodontal pockets with presence/absence of Prevotella intermedia-Pi in gingival crevicular fluid (GCF) after 6 months.
Time frame: after 6 months
Number of Periodontal Pockets With Presence/Absence of Tannerella Forsythia (Tf) in Gingival Crevicular Fluid (GCF)
Number of periodontal pockets with presence/absence of Tannerella forsythia-Tf in gingival crevicular fluid (GCF) at baseline
Time frame: baseline measure (before the intervention)
Number of Periodontal Pockets With Presence/Absence of Tannerella Forsythia (Tf) in Gingival Crevicular Fluid (GCF) - 1m
Number of periodontal pockets with presence/absence of Tannerella forsythia-Tf in gingival crevicular fluid (GCF) after 1 month.
Time frame: after 1 month
Number of Periodontal Pockets With Presence/Absence of Tannerella Forsythia (Tf) in Gingival Crevicular Fluid (GCF) - 3m
Number of periodontal pockets with presence/absence of Tannerella forsythia-Tf in gingival crevicular fluid (GCF) after 3 months.
Time frame: after 3 months
Number of Periodontal Pockets With Presence/Absence of Tannerella Forsythia (Tf) in Gingival Crevicular Fluid (GCF) - 6m
Number of periodontal pockets with presence/absence of Tannerella forsythia-Tf in gingival crevicular fluid (GCF) after 6 months.
Time frame: after 6 months
Periodontal Pocket Microorganisms
The concentration of periodontal pocket microorganisms determined in gingival crevicular fluid (GCF) by qPCR-real time.
Time frame: baseline measure (before the intervention)
Periodontal Pocket Microorganisms -1m
The concentration of periodontal pocket microorganisms determined in gingival crevicular fluid (GCF) by qPCR-real time after 1 month.
Time frame: after 1 month
Periodontal Pocket Microorganisms - 3m
The concentration of periodontal pocket microorganisms determined in gingival crevicular fluid (GCF) by qPCR-real time after 3 months.
Time frame: after 3 months
Periodontal Pocket Microorganisms - 6m
The concentration of periodontal pocket microorganisms determined in gingival crevicular fluid (GCF) by qPCR-real time after 6 months.
Time frame: after 6 months
Tumor Necrosis Factor Alpha-TNF-α
concentration of Tumor necrosis factor alpha-TNF-α in GCF using ELISA Kit
Time frame: baseline measure (before the intervention)
Tumor Necrosis Factor Alpha-TNF-α -1m
The concentration of Tumor necrosis factor alpha-TNF-α in GCF using ELISA Kit
Time frame: after 1 month
Tumor Necrosis Factor Alpha-TNF-α - 3m
The concentration of Tumor necrosis factor alpha-TNF-α using ELISA Kit after 3 months.
Time frame: after 3 months
Tumor Necrosis Factor Alpha-TNF-α -6m
The concentration of Tumor necrosis factor alpha-TNF-α using ELISA Kit after 6 months.
Time frame: after 6 months
Matrix Metalloproteinase 8 - MMP-8
The concentration of Matrix metalloproteinase 8 - MMP-8 in GCF using ELISA Kit
Time frame: baseline measure (before the intervention)
Matrix Metalloproteinase 8 - MMP-8 -1m
The concentration of Matrix metalloproteinase 8 - MMP-8 in GCF using ELISA Kit after 1 month.
Time frame: after 1 month
Matrix Metalloproteinase 8 - MMP-8 - 3m
The concentration of Matrix metalloproteinase 8 - MMP-8 using ELISA Kit after 3 months.
Time frame: after 3 months
Matrix Metalloproteinase 8 - MMP-8 - 6m
The concentration of Matrix metalloproteinase 8 - MMP-8 using ELISA Kit after 6 months.
Time frame: after 6 months
Alkaline Phosphatase - ALP
The concentration of Alkaline phosphatase - ALP in GCF using ELISA Kit
Time frame: baseline measure (before the intervention)
Alkaline Phosphatase - ALP -1m
The concentration of Alkaline phosphatase - ALP in GCF using ELISA Kit after 1 month.
Time frame: after 1 month
Alkaline Phosphatase - ALP -3m
The concentration of Alkaline phosphatase - ALP using ELISA Kitafter 3 months.
Time frame: after 3 months
Alkaline Phosphatase - ALP -6m
The concentration of Alkaline phosphatase - ALP using ELISA Kit after 6 months.
Time frame: after 6 months