Research Article
Volume 20 Issue 5 - 2021
Evaluation of Effect of T-PRF Over L-PRF as an Adjunct to the Bone Graft (DFDBA) in the Treatment of Intra Bony Defects - A Randomized Controlled Clinical and Radiographic Trial
Palaparthy Raja Babu1, Raghaveena Ingle2, Suryakanth Malgikar3*, Vidya Sagar S1, Juliet Josephin J3 and Abhinav Atchuta3
1Professor, Department of Periodontology, Kaloji Narayana Rao University of Health Sciences, Telangana, India
2Consultant Periodontist, Bengaluru, India
3Reader, Department of Periodontology, Kaloji Narayana Rao University of Health Sciences, Telangana, India
*Corresponding Author: Suryakanth Malgikar, Reader, Department of Periodontology, Kaloji Narayana Rao University of Health Sciences, Telangana, India.
Received: February 23, 2021; Published: April 30, 2021


Background: Periodontal regenerative therapy is rapidly evolving, with a major shift from bio compatible material to human derived biomaterials. Demineralized Freeze Dried Bone Allograft (DFDBA), has both osteoinductive and osteoconductive property, hence is utilized in periodontal bone defects. To enhance the regenerative outcomes, various additives viz commercial growth factors, PRP, PRF etc. are adjunctively used along with bone grafts. Titanium-prepared, Platelet Rich Fibrin (T-PRF) is one such new concentrate used in regenerative surgery.

Aim of the Study: The aim of the present trial was to evaluate clinically and radiographically the efficacy of autologous L-PRF (Leukocyte Platelet Rich Fibrin) and T-PRF as an adjunct to DFDBA in the treatment of intrabony defects in chronic periodontitis patients.

Materials and Methods: 30 intrabony sites were randomly assigned into two treatment groups as group I (Control): DFDBA + L-PRF and group II (Test): DFDBA + T-PRF. Venous blood samples were collected and PRF obtained after centrifugation was used in combination with bone graft (DFDBA) in intra bony defects. Clinical parameters PPD and RAL and radiographic defect depth of randomly selected sites in group I and group II were recorded at baseline, 3rd, 6th and 9th months after therapy.

Results: Within each group, significant improvements (P < 0.05) were found for all variables in 9-month follow-up compared with baseline. Greatest reduction in the PPD of 60.66% and RAL gain of 1.6 mm was found in group II and radiographic bone gain of 3.07 mm (21.64%) at the end of 9th month in group II. Percentage changes of radiographic defect depth in both the groups were found to be significant from baseline to 9th month, greatest reduction of 3.07 (21.64%) was found in group II at 9th month interval whereas in group I it was 2.14 (14.53%).

Conclusion: Significant improvements in clinical and radiographic parameters indicate success of regenerative therapy using T- PRF over L-PRF with DFDBA.


Keywords: Chronic Periodontitis; Periodontal Regeneration; Intrabony Defects; Platelet Rich Fibrin; Titanium - Platelet Rich Fibrin; Allograft; DFDBA


  1. Giannobile WV. “The potential role of growth and differentiation factors in periodontal regeneration”. Journal of Periodontology 67 (1996): 545e53.  
  2. Froum SJ., et al. “Current concepts of periodontal regeneration. A review of the literature”. The New York State Dental Journal 68 (2002):14-22.
  3. Trombelli L. “Which reconstructive procedures are effective for treating the periodontal intraosseous defect?” Periodontology 2000 37 (2005): 88-105.
  4. Bartold PM., et al. “Stem cells and periodontal regeneration”. Periodontology 2000 40 (2006):164-172.
  5. McClain PK and Schallhorn RG. “Long-term assessment of combined osseous composite grafting, root conditioning, and guided tissue regeneration”. International Journal of Periodontics and Restorative Dentistry 13 (1993): 9-27.
  6. Guillemin MR., et al. “Healing in periodontal defects treated by decalcified freeze-dried bone allografts in combination with ePTFE membranes (I). Clinical and scanning electron microscope analysis”. Journal of Clinical Periodontology 20 (1993): 528-536.
  7. Jayakumar ND., et al. “Platelet rich fibrin and xenograft in the treatment of intrabony defects”. Contemporary Clinical Dentistry 5 (2014): 550-554.
  8. Choukroun J., et al. “Une opportunite´ en paro-implantologie: Le PRF”. Implantodontie 42 (2001): 55-62.
  9. Tunali M., et al. “In vivo evaluation of titanium-prepared platelet rich fibrin (T-PRF): a new platelet concentration”. British Journal of Oral and Maxillofacial Surgery 51 (2013): 438-443.
  10. Everett FG and Fixott HC. “Use of an incorporated grid in the diagnosis of oral roentgenograms”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 16 (1963): 1061-64.
  11. Dohan DM., et al. “Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 101 (2006): E37-44.
  12. Ozdemir H., et al. “A novel platelet concentration: Titanium-Prepared Platelet-Rich Fibrin”. BioMed Research International (2014).
  13. Rummelhart JM., et al. “Comparision of Freeze-dried bone allograft and Demineralized Freeze Dried Bone Allograft”. Journal of Periodontology 60 (1989): 655-663.
  14. Chang IC., et al. “Platelet-rich fibrin modulates the expression of extracellular signal-regulated protein kinase and osteoprotegerin in human osteoblasts”. Journal of Biomedical Materials Research Part A 95 (2010): 327-332.
  15. Huang FM., et al. “Platelet-rich fibrin increases proliferation and differentiation of human dental pulp cells”. Journal of Endodontics 36 (2010): 1628-1632.
  16. Mazor Z., et al. “Sinus floor augmentation with simultaneous implant placement using Choukroun’s platelet rich fibrin as the sole grafting material: a radiologic and histologic study at 6 months”. Journal of Periodontology 80 (2009): 2056-2064.
  17. Tsai CH., et al. “Platelet-rich fibrin modulates cell proliferation of human periodontally related cells in vitro”. The Journal of Dental Sciences 4 (2009): 130-135.
  18. Wu CL., et al. “Platelet rich fibrin increases cell attachment, proliferation and collagen related protein expression of human osteoblasts”. The Australian Dental Journal 2 (2012): 207-212.
  19. Chang YC and Zhao JH. “Effect of Platelet rich fibrin on human periodontal ligament fibroblasts and application for periodontal infrabony defects”. The Australian Dental Journal 4 (2011): 365-371.
  20. Takemoto S., et al. “Platelet adhesion on titanium oxide gels: effect of surface oxidation”. Biomaterials 25 (2004): 3485-3492.
Citation: Suryakanth Malgikar., et al. “Evaluation of Effect of T-PRF Over L-PRF as an Adjunct to the Bone Graft (DFDBA) in the Treatment of Intra Bony Defects - A Randomized Controlled Clinical and Radiographic Trial”. EC Dental Science 20.5 (2021): 164-175.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

January Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before February 13, 2023.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.