Evaluation of leukocyte-platelet rich fibrin as an antibiotic slow-release biological device in the treatment of moderate periodontitis: a randomized controlled clinical trial

Periodontitis is a chronic inflammatory disease caused by the accumulation of biofilm. Antimicrobials have been used as adjuncts to non-surgical periodontal therapy. However, systemic antibiotics often require large dosages to achieve suitable concentrations at the disease site. Leukocyte platelet-rich fibrin (L-PRF) is a promising bio-material, with antimicrobial, anti-inflammatory, and wound-healing enhancement effects. This study aimed to evaluate the efficacy of L-PRF as a locally sustained released device for metronidazole antimicrobial.

Twenty-four patients with eighty periodontal pockets had moderate periodontitis with attachment loss of 3–4 mm, and probing depth ≤ 5, which was equally divided into two groups: Group (I) underwent scaling and root planing with intra-pocket application of L-PRF loaded with Metronidazole, while Group (II) was treated by scaling and root planing with intra-pocket application of L-PRF alone. Microbiological measurements were taken at baseline and after one month to analyze the relative count of Porphyromonas gingivalis (P. gingivalis) using real time PCR. Clinical parameters were measured at baseline and after 1, 3, and 6 months. These parameters included probing depth (PD), clinical attachment loss (CAL), plaque index (PI), modified gingival index (MGI), and bleeding index (BI).

Microbiological and clinical findings revealed that both treatment methods resulted in a reduction in P. gingivalis counts, in addition to improvements in the clinical parameters: PD reduction, CAL gain, PI reduction, BI decrease and MGI reduction compared to baseline. However, L-PRF-metronidazole group showed superior results in the studied parameters over the study period. Nonetheless, there was no statistically significant improvement. (p < .001).

The intra-pocket application of both L-PRF loaded with Metronidazole and L-PRF alone contributed to the successful treatment of moderate periodontitis.

NCT06153706 (http://www.clinical-trials.gov/); 1/12/2023, retrospective registration.