Randomized Split-Mouth Clinical Study

Background: This study evaluates contributions of platelet-rich fibrin (PRF) combined with conventional flap surgery on growth factor levels in gingival crevicular fluid (GCF) and periodontal healing.Methods: Twenty-six patients (52 sites) with chronic periodontitis were treated either with autologous PRF with open flap debridement (OFD+PRF) or OFD alone. Growth factor levels in GCF at baseline and 2, 4, and 6 weeks after surgery were analyzed, and clinical parameters such as probing depth (PD), relative clinical attachment level (rCAL), and gingival margin level (GML) at baseline and 9 months after surgery were measured.Results: Mean PD reduction and rCAL gain were significantly greater in OFD+ PRF sites than in OFD sites. Mean GML change was -0.38 + 0.10 mm in OFD sites and 0.11 + 0.08 mm in the test group; difference between the two groups was statistically significant (P < 0.05). Both groups demonstrated increased expression levels of fibroblast growth factor-2, transforming growth factor-b1, and platelet-derived growth factor-BB at 2 weeks compared with baseline, followed by reductions at 4 and 6 weeks. The OFD+ PRF group showed significantly higher growth factor levels compared with the OFD group at 2 and 4 weeks.Conclusion: PRF membrane combined with OFD provides significantly higher GCF concentrations of angiogenic biomarkers for approximate to 2 to 4 weeks and better periodontal healing in terms of conventional flap sites