Alb-PRF as an Adjunct to Regenerative Periodontal Surgery

Clinical and Radiographic Effects of Albumin Platelet-Rich Fibrin as an Adjunct to Regenerative Periodontal Surgery: A Randomized Controlled Clinical Trial

Periodontitis is characterized by the progressive destruction of tooth-supporting tissues and may lead to the formation of intrabony periodontal defects. Regenerative periodontal surgery aims to promote the reconstruction of the periodontal attachment apparatus and reduce residual defect dimensions. Albumin platelet-rich fibrin (Alb-PRF) is an autologous blood-derived biomaterial that combines an albumin-based matrix with platelet-rich fibrin components.

This randomized controlled clinical trial will evaluate the clinical and radiographic effects of Alb-PRF as an adjunct to regenerative periodontal surgery in patients with periodontitis-associated intrabony defects. Twenty-four participants will be randomly allocated to two parallel treatment groups. Both groups will undergo regenerative periodontal surgery involving defect debridement, root surface conditioning with EDTA, and placement of an allogeneic bone graft. In the experimental group, Alb-PRF will additionally be applied to the intrabony defect.

The primary outcome will be clinical attachment level gain at 6 months. Secondary outcomes will include probing depth, radiographic defect fill, early wound healing, postoperative pain, oral health-related quality of life, and adverse events. Participants will be followed for 9 months.

Inclusion Criteria:

• Adults aged 18 to 65 years.
• Diagnosis of Stage III periodontitis according to the 2017 classification of periodontal and peri-implant diseases and conditions.
• Completion of nonsurgical periodontal therapy and oral hygiene instruction before surgical treatment.
• Presence of at least one interproximal intrabony periodontal defect considered suitable for regenerative periodontal surgery.
• Residual probing depth of at least 6 mm and clinical attachment loss of at least 6 mm at the selected site following nonsurgical periodontal therapy.
• Radiographic evidence of an intrabony defect component of at least 3 mm at the selected site.
• Adequate plaque control and compliance with oral hygiene instructions.
• Ability to understand the study procedures, provide written informed consent, and attend all scheduled follow-up visits.

Exclusion Criteria:

• Current smoking or smoking cessation within the previous 6 months.
• Uncontrolled diabetes mellitus, serious cardiovascular disease, autoimmune disease, liver or kidney failure, immunodeficiency, or another systemic condition that may adversely affect periodontal healing or surgical treatment.
• Pregnancy or lactation.
• Presence of a hematologic disorder, bleeding disorder, anticoagulant therapy, or another condition that may interfere with venous blood collection or periodontal surgery.
• Use of antibiotics, systemic corticosteroids, immunosuppressive agents, bisphosphonates, antiresorptive agents, or other medications known to affect periodontal or bone healing within the previous 6 months.
• Periodontal surgical treatment at the selected site within the previous 6 months.
• Acute periodontal or endodontic infection at the selected site.
• Untreated endodontic lesions, root fractures, extensive caries, or a hopeless prognosis involving the selected tooth.
• Class II or III furcation involvement associated with the selected defect.
• Known hypersensitivity to any material used in the study.
• Inadequate oral hygiene or inability to meet the plaque-control requirements of the study protocol.
• Current orthodontic treatment.
• Inability or unwillingness to attend the scheduled follow-up visits.