Comparative evaluation of autologous platelet-rich fibrin and recombinant human bone morphogenetic protein-2 in the treatment of human periodontal intrabony defects: A randomized, controlled clinical and radiographic study

Background: Autologous platelet rich fibrin (PRF) and Recombinant human bone morphogenetic protein 2 (rhBMP 2) technologies have been shown to significantly support alveolar bone. The present randomized, controlled clinical trial was conducted to compare the clinical and radiographic efficacy of autologous platelet rich fibrin (PRF) and recombinant human bone morphogenetic protein 2 (rhBMP 2) in the treatment of intrabony defects (IBDs) in patients with chronic periodontitis. Methods: A randomized controlled clinical trial conducted where in the IBDs were treated with either autologous PRF with open flap debridement (OFD) or recombinant rhBMP 2 with OFD or OFD alone. Clinical and radiologic parameters including probing pocket depth, clinical attachment level (CAL), IBD depth, defect fill, and percentage of original defect resolved were recorded at baseline and 6 months postoperatively. Results: The mean pocket depth reduction was greater in PRF (1.3 ± 0.78 mm) than rhBMP 2 group (1.3 ± 0.78 mm). No significant difference was seen in CAL gain in PRF and rhBMP 2 groups (3.3 ± 0.43 mm and 1.2 ± 0.74 mm, respectively). However, the percentage of original defect resolved was significantly greater in rhBMP 2 group (41.1% ± 19.2%) compared to PRF group (26.75% ± 6.03%). Conclusions: Within the limits of the present study, results suggest that in terms of hard tissue regeneration, rhBMP 2 has shown significantly better outcome in treatment of IBDs. However, PRF encourages superior soft tissue healing compared to rhBMP 2. Furthermore, added advantages of PRF being readily available and cost effective cannot be disregarded