Eficacia de la fibrina rica en plaquetas inyectable, gel liberador de oxígeno y gel de ácido hialurónico como agentes de liberación local de fármacos en el tratamiento de la periodontitis crónica: estudio clínico-microbiológico
DOI:
https://doi.org/10.15517/dafg0q85Palabras clave:
Raspado dental; Ácido hialurónico; Bolsa periodontal; Periodontitis; Fibrina rica en plaquetas; Alisado radicular.Resumen
Este estudio evaluó clínica y microbiológicamente la eficacia del i-PRF líquido, el gel liberador de oxígeno y el gel de ácido hialurónico (HA) como agentes de liberación local de fármacos (LDD) coadyuvantes al raspado y alisado radicular (SRP) para el tratamiento de bolsas periodontales. Se realizó un ensayo clínico aleatorizado de boca dividida, en 12 pacientes con 80 bolsas periodontales (profundidad de 3-6 mm). Las bolsas se asignaron aleatoriamente a cuatro grupos: control (solo SRP), grupo experimental I (i-PRF + SRP), grupo II (gel liberador de oxígeno + SRP) y grupo III (gel de HA + SRP). Las muestras de placa se analizaron para espiroquetas mediante microscopía de campo oscuro al inicio, y a 1 y 3 meses posteriores al tratamiento. Otros indicadores primarios evaluados fueron el índice de placa (PI), índice gingival (GI), profundidad de sondaje (PPD), nivel de inserción clínica (CAL) y recesión gingival (GR), medidos con una sonda UNC-15. Las pruebas estadísticas empleadas incluyeron la prueba de Bonferroni para comparaciones intragrupo, la prueba t pareada, el análisis de varianza de medidas repetidas (ANOVA) y la prueba t no pareada para comparaciones intergrupales. El análisis intragrupo mostró mejorías significativas en PI, GI, PPD, CAL y GR en todos los grupos (p<0.05). Las comparaciones intergrupales no revelaron diferencias significativas. Desde el punto de vista microbiológico, el i-PRF redujo significativamente las espiroquetas (p < 0.05), mientras que el gel liberador de oxígeno mostró resultados clínicos superiores (p<0.05). Todos los agentes de liberación local de fármacos demostraron un potencial terapéutico significativo. El gel liberador de oxígeno destacó clínicamente, mientras que el i-PRF fue superior desde el punto de vista antimicrobiano, lo que indica su potencial terapéutico para el tratamiento de bolsas periodontales.
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Referencias
Hinrichs J.E., Kotsakis G., Naik D.G., Uppoor A. Classification of disease and conditions affecting the periodontium. In: Newman M. G.,Takie H.H., Klokkevold. P.R., Carranza F. A., editors. Carranza’s Clinical Periodontology 12th edition, Saunders Elsevier Publication, 2016.p.p.57-72.
Glickman I., Smulow J.B. Periodontal disease: Clinical, radiographic, and histopathologic features. Saunders: Philadelphia; 1974.
Graziani F., Karapetsa D., Alonso B., Herrera D. Nonsurgical and surgical treatment of periodontitis: How many options for one disease? Periodontol. 2000; 2017: 152-88. DOI: https://doi.org/10.1111/prd.12201
Teles R.P., Haffajee A.D., Socransky S.S. Microbiological goals of periodontal therapy. Periodontol. 2000;2006: 42: 180-218. DOI: https://doi.org/10.1111/j.1600-0757.2006.00192.x
Lindhe J., Westfelt E., Nyman S., Socransky S.S., Heijl L., Bratthall G. Healing following surgical/non-surgical treatment of periodontal disease. A clinical study. J Clin Periodontol 1982; 9: 115-28. DOI: https://doi.org/10.1111/j.1600-051X.1982.tb01227.x
Antczak-Bouckoms A., Joshipura K., Burdick E., Tulloch J.F. Meta-analysis of surgical versus non-surgical methods of treatment for periodontal disease. J Clin Periodontol. 1993 Apr; 20: 4: 259-68. DOI: https://doi.org/10.1111/j.1600-051X.1993.tb00355.x
Shah S.A., Vijayakar H.N., Rodrigues S.V., Mehta C.J., Mitra D.K., Shah R.A. To compare the effect of the local delivery of hyaluronan as an adjunct to scaling and root planing versus scaling and root planing alone in the treatment of chronic periodontitis. J Indian Soc Periodontol. 2016 ; 20: 549-56. DOI: https://doi.org/10.4103/0972-124X.201695
Ghanaati S., Booms P., Orlowska A., Kubesch A., Lorenz J., Rutkowski J. et al. Advanced platelet- rich fibrin: A new concept for cell-based tissue engineering by means of inflammatory cells. J Oral Implantol 2014; 40: 679-89. DOI: https://doi.org/10.1563/aaid-joi-D-14-00138
Vuckovic M., Nikolic N., Milasin J., Đorđević V., Milinkovic I., Asotic J. et al. The effect of injectable platelet rich fibrin use in the initial treatment of chronic periodontitis. Srp Arh Celok Lek. 2020; 148: 280-5. DOI: https://doi.org/10.2298/SARH190925022V
Dalton S.J., Whiting C.V., Bailey J.R., Mitchell D.C., Tarlton J.F. Mechanism of chronic skin ulceration linking lactate, transforming growth factor-beta, vascular endothelial growth factor, collagen remodeling, collagen stability, and defective angiogenesis. J Invest Dermatol. 2007; 127: 958-68 DOI: https://doi.org/10.1038/sj.jid.5700651
Mesa F.L., Aneiros J., Cabrera A. Antiproliferative effect of topical hyaluronic acid gel. Studies in gingival biopsies of patients with periodontal disease. Histol. Histopathol. 2002; 17: 747-53.
Laxman V.K., Khatri M., Devaraj C.G. Evaluation of new furcation stent as a fixed reference point for class II furcation measurements. J Contem Dent Pra.c 2009; 10: 1-11. DOI: https://doi.org/10.5005/jcdp-10-2-18
Silness J., Loe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta odontol Scand 1964; 21: 533-51
Loe H., Silness J Periodontal diseases in pregnancy. I. Prevalence and severity Acta odontol Scand 1963; 21: 533-51 DOI: https://doi.org/10.3109/00016356309011240
Roman -Torres C.V.G., Bryington M.S., Kussaba S.T., Pimentel A.C., Jimbo R., Cortelli J.R. et al. Comparison Of Full-Mouth Scaling and Quadrant-Wise Scaling in the Treatment of Adult Chronic Periodontitis. Braz Dent J. 2018; 29: 296-300. DOI: https://doi.org/10.1590/0103-6440201801715
Soni R., Priya A., Yadav H., Mishra N., Kumar L. Bone augmentation with sticky boneand platelet- rich fibrin by ridge- split technique and nasal floor engagement for immediate loading of dental implant after extracting impacted. Natl J Maxillofac Surg 2019; 10: 98-101. DOI: https://doi.org/10.4103/njms.NJMS_37_18
Fotani S., Shiggaon L.B., Waghmare A., Kulkarni G., Agrawal A., Tekwani R. Effect of injectable platelet rich fibrin (i-PRF) on thin gingival biotype: A clinical trial Journal of Appl. Dent Med Sci.2019; 5: 9-16.
Cunha E.J., Auersvald C.M., Deliberador T.M., Gonzaga C.C., Esteban Florez F.L., Correr G.M., Storrer C.L.M. Effects of Active Oxygen Toothpaste in Supragingival Biofilm Reduction: A Randomized Controlled Clinical Trial. Int J Dent. 2019 Jul 1; 2019: 3938214. DOI: https://doi.org/10.1155/2019/3938214
Koul A., Kabra R., Chopra R., Sharma N., Sekhar V. Comparative evaluation of oxygen releasing formula (blue m® gel) and chlorhexidine as an adjunct with scaling and root planing in the management of patients with chronic periodontitis- A clinicmicrobiological study. J Dent Specialities. 2019; 7: 111-7. DOI: https://doi.org/10.18231/j.jds.2019.026
Asha A., Prabhuji M.L.V., Rashmi P., Roja Y., Bhavikatti S.K. Pocket reduction with high concentrated oxygen oral gel: A Preliminary Case Report Research Journal of pharmacy and technology2022; 15 (10): 4367-1. DOI: https://doi.org/10.52711/0974-360X.2022.00732
Johannsen A., Tellefsen M., Wikesjö U., Johannsen G. Local delivery of hyaluronan as an adjunct to scaling and root planing in the treatment of chronic periodontitis. J Periodontol. 2009 Sep; 80 (9): 1493-7. DOI: https://doi.org/10.1902/jop.2009.090128
Lang N.P. Focus on intrabony defects-conservative therapy. Periodontol 2000 2000; 22: 51-8. DOI: https://doi.org/10.1034/j.1600-0757.2000.2220105.x
Lindhe, J., Nyman, S., & Karring, T. (1982). Scaling and root planing in shallow pockets. Journal of Clinical Periodontology, 9 (5), 415-418. DOI: https://doi.org/10.1111/j.1600-051X.1982.tb02054.x
Badersten A., Nilveus R., Egelberg J. Effect of nonsurgical periodontal therapy. III. Single versus repeated instrumentation. J Clin Periodontol. 1984; 11: 114-24. DOI: https://doi.org/10.1111/j.1600-051X.1984.tb00839.x
Miron R.J., Zhang Y., Ghanaati S., Choukroun J., Hernandez M., Kandalam U. et al. Injectable platelet rich fibrin (i-PRF): Oppurtunities in regenerative dentistry. Clin Oral Investig 2017, 21: 2619-27. DOI: https://doi.org/10.1007/s00784-017-2063-9
Pullishery F., Hussein Alattas M., Roshdy Abdelrasoul M., Fouad Hassan A., Abdelhamid Ahmed Derbala D., Hashir S. Effectiveness of i-PRF in periodontal regeneration - A systematic review and meta-analysis. Saudi Dent J. 2024 Feb; 36 (2): 214-221. DOI: https://doi.org/10.1016/j.sdentj.2023.10.017
Niveda R. and Kaarthikeyan G. Effect of oxygen releasing oral gel compared to chlorhexidine gel in the Treatment of Periodontitis. Int. J. Pharm. Res. 2020; 32: 75-82. DOI: https://doi.org/10.9734/jpri/2020/v32i1930711
Deliberador T.M., Weiss S.G., Rychuv F., Cordeiro G., Cate M.C.L.T., Leonardi L. et al. Comparative analysisin vitro of the application of blue M® oral gel versus chlorhexidine on porphyromonas gingivalis. A Pilot Study Advances in Microbiology 2020; 10: 194-201. DOI: https://doi.org/10.4236/aim.2020.104015
Agarwal R., Kamble P.S., Mangalekar S.B., Nayak Y., Sawant P., Chatterjee A. A comparative evaluation of efficacy of oxygen releasing formula gel, chlorhexidine gel and scaling and root planing alone in the management of chronic periodontitis– A clinico-microbiological study. Eur. Chem. Bull. 2023; 12: 4520-4536.
Dohan D.M., Choukroun J., Diss A. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part II: Platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2006; 101: 45-50. DOI: https://doi.org/10.1016/j.tripleo.2005.07.009
Serafini G., Lopreiato M., Lollobrigida M., Lamazza L., Mazzucchi G., Fortunato L. et al. Platelet Rich Fibrin (PRF) and Its Related Products: Biomolecular Characterization of the Liquid Fibrinogen. J Clin. Med. 2020; 9: 1099. DOI: https://doi.org/10.3390/jcm9041099
Zhou X., Wang J., Liu W., Huang, X., Song, Y., Wang, Z.et al..Periodontal Status and Microbiologic Pathogens in Patients with Chronic Obstructive Pulmonary Disease and Periodontitis: A Case-Control Study. Int J Chron Obstruct Pulmon Dis. 2020; 15: 2071-2079. DOI: https://doi.org/10.2147/COPD.S266612
Choukroun J., Ghanaati S. Reduction of relative centrifugation force within injectable platelet- rich-fibrin (PRF) concentrates advances patients' own inflammatory cells, platelets and growth factors: The first introduction to the low speed centrifugation concept. Eur J Trauma EmergSurg 2018; 44: 87-95. DOI: https://doi.org/10.1007/s00068-017-0767-9
Karde P.A., Sethi K.S., Mahale S.A., Khedkar S.U., Patil A.G., Joshi C.P. Comparative evaluation of platelet count and antimicrobial efficacy of injectable platelet-rich fibrin with other platelet concentrates: An in vitro study. J Indian Soc Periodontal 2017; 21: 97-101. DOI: https://doi.org/10.4103/jisp.jisp_201_17
Xu, Y., Höfling, K., Fimmers, R., Frentzen, M., & Jervøe-Storm, P. M. Clinical and Microbiological Effects of Topical Subgingival Application of Hyaluronic Acid Gel Adjunctive to Scaling and Root Planing in the Treatment of Chronic Periodontitis. Journal of Periodontology, 2004; 75 (8): 1114-1118. DOI: https://doi.org/10.1902/jop.2004.75.8.1114
Gontiya, G.; Galgali, S.R. Effect of hyaluronan on periodontitis: A clinical and histological study. J. Indian Soc. Periodontol. 2012, 16: 184-192. DOI: https://doi.org/10.4103/0972-124X.99260
Eick S., Renatus A., Heinicke M., Pfister W., Stratul S.I., Jentsch H. Hyaluronic Acid as an adjunct after scaling and root planing: a prospective randomized clinical trial. J Periodontol 2013 Jul; 84 (7): 941-949. DOI: https://doi.org/10.1902/jop.2012.120269
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Derechos de autor 2026 Mansi Bansal, Manish Khatri, Deepali Mathur, Pratiksha Tripathi, Nisha Parveen, Nutan Tyagi.
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