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Periodontal regeneration by leukocyte and platelet-rich fibrin with autogenous bone graft versus enamel matrix derivative with autogenous bone graft in the treatment of periodontal intrabony defects. a randomized non-inferiority trial.

BACKGROUND
Aim of the present study was to ascertain if a combination of leukocyte and platelet-rich fibrin (L-PRF) + autogenous bone graft (ABG) may be a clinically "non-inferior" treatment modality as compared with the association of Enamel Matrix Derivative (EMD) with ABG in the management of intrabony defects (IBDs).


METHODS
Forty-four patients, exhibiting at least one unfavourable intraosseous defect, were treated by L-PRF associated with ABG (22 patients; test group) or EMD+ABG (control group) in each defect. At baseline and 12 months, a complete clinical and radiographic examination was done. Pre- and post-therapy clinical (probing pocket depth [PPD], clinical attachment level [CAL], gingival recession [GR]) and radiographic (defect Bone level [(DBL)] parameters for the different treatments were compared. To guarantee the test treatment's efficacy 1mm was chosen as non-inferiority margin; for clinical relevance, a second non-inferiority margin = 0.5mm was set.


RESULTS
Clinical and radiographic parameters significantly improved 12 months after surgery in both test and control sites, without inter-groups differences for each measurement. The control group - test group differences for the parameters CAL gain -0.248mm (-0.618 to 0.122), PPD Reduction -0.397mm (-0.810 to 0.015), GR Change 0.059mm (-0.300 to 0.418), DBL Gain -0.250mm (-0.746 to 0.246) were all within the non-inferiority margin of 0.5 mm.


CONCLUSION
Our results suggest that the L-PRF+ABG combined treatment of non-contained intrabony defects produces non-inferior results in terms of CAL gain, PPD reduction, GR increase and DBL gain in comparison with the EMD+ABG combination. This article is protected by copyright. All rights reserved.