Evaluation of clinical effectiveness of Platelet Rich Fibrin in the treatment of Endo-Perio Lesion when compared with Open Flap Debridement. A Narrative review

Abstract

Purpose: Endo-Perio Lesion (EPL) is a periodontal disease that affects both endodontic and periodontal soft and hard tissues. Due to the intricacy of the condition, difficulties arise when treating EPL. This narrative review aims to evaluate Platelet-Rich Fibrin (PRF) effect on EPL for soft tissue healing and bone fill. Thereby, treatment using PRF will be compared with Open-Flap Debridement (OFD) in EPL.

Methods The literature search was conducted in PubMed, and Cochrane Central Register of Controlled Trials (CENTRAL) to answer the research question “What is the clinical effectiveness of endo-perio lesions treated with platelet-rich fibrin when compared with lesions treated with open flap debridement?” Yielded articles from the search were screened in three stages. Furthermore, a manual search was performed, and articles meeting inclusion criteria were included. The screening process is presented using the PRISMA flow chart. Quality assessment of the included articles was conducted using the Jadad, CASP, and Cochrane risk of bias tool.

Results Four articles were included in the study. The baseline for a 9-month study, Titanium Platelet-Rich Fibrin (T-PRF) for intrabony depth (IBD) was 5.93mm, Guided Tissue Regeneration (GTR) IBD 6.76mm, OFD had 6.49mm. At 9-months T-PRF reported IBD 2.95mm, GTR had IBD 2.90mm, and OFD IBD 5.59mm, statistical significance was found between the intervention and control group regarding PD and CAL (p<0.001). No statistical difference found between T-PRF and GTR. Moreover, a 12-month trial reported Bone Defect Fill (BDF) for PRF 4.13mm, GTR 3.97mm, and OFD 2.23mm. Between the groups, PRF had the highest BDF, then GTR, then OFD having the lowest fill at 12-months. conclusion In conclusion, the results from the reviewed trials suggest that PRF is a promising treatment modality. However, due to limitations in the existing studies, further research in the area should be conducted.