Comparison between Antimicrobial Photodynamic Therapy and Injectable Platelet Rich Fibrin as an adjunct to Non-Surgical Periodontal Treatment (A Randomized Controlled Clinical Trial with Microbiological Assessment)

Abstract

Non-surgical periodontal therapy is considered the gold standard of periodontal treatment and its clinical efficacy is well documented. Meanwhile to improve its results, novel techniques had been proposed to be an adjunct to mechanical debridement, two of the recent techniques to be used is the use of injectable platelet rich fibrin as an intra pocket medication and the other method is antimicrobial photodynamic therapy. The objective of the present study was to compare between injectable platelet rich fibrin and anti-microbial photodynamic therapy on clinical parameters and bactericidal effect on Pg as an adjunct to non-surgical periodontal therapy in the treatment of generalized stage III grade B periodontitis.. The present study entailed a thirty-nine patients diagnosed with generalized stage III grade B periodontitis. Patients were divided into 3 groups; group I included 13 patients treated with non-surgical periodontal treatment (NSPT) followed by intra pocket injection of i-PRF. Group II included 13 patients treated with non-surgical periodontal treatment (NSPT) followed by aPDT. Group III included 13 patients treated with non-surgical periodontal treatment (NSPT) only. Clinical parameters including plaque index, gingival index, pocket depth and clinical attachment level were recorded at baseline and three months postoperatively. Moreover, GCF samples were collected with paper point for microbiological assessment. It was done at baseline, one week and one month postoperatively. Results showed no statistical significant difference between the 3 different groups regarding plaque index. Regarding gingival index, there was a statistical significant reduction in each group. In all groups, there was a statistical significant reduction in probing depth and by comparing the mean percentage change between the three groups, results revealed statistical significant difference between i-PRF and aPDT when compared to control group. By comparing mean percentage change of CAL after three months between groups there was a statistical significant attachment gain in aPDT when compared to the other two groups. Moreover, i-PRF group showed a statistical significant gain in attachment level when compared to control group. Regarding microbiological analysis, there was a statistical significant decrease in the mean percentage change of microbiological load in all groups. The i-PRF showed a significant reduction in microbiological load when compared to the other two groups at the end of the study.