Application of autologous blood-derived platelet-rich fibrin for periodontitis treatment in dogs

Abstract

Periodontitis is one of the most prevalent inflammatory oral diseases in dog. Non-surgical managements are conventionally performed to obtain healthy oral status. With progressive periodontitis, advanced periodontal surgery and also dental extraction become warranted with major disadvantages of trauma, bleeding, prolonged anesthetic time and hospitalization, and wound healing impairment. Hence, use of platelet-rich fibrin has been studied and considered one of the novel approaches to augment in periodontitis management. This study aimed to evaluate the efficacy of autologous blood-derived platelet-rich fibrin in an aspect of periodontitis treatment in a canine models. In this study, the experiment was done at maxillary 4th premolar and mandibular 1st molar. Dogs with healthy oral status were served as a control (C group, n =5). Another 10 systemically healthy subjects presenting equally bilateral periodontitis were randomized into split mouth clinical design. Experimental groups included periodontitis group with conventional open-flap debridement (PD group, n = 20) and periodontitis group with conventional open-flap debridement and platelet-rich fibrin treatment (PD+ group, n = 20). Clinical parameters included plaque index (PI), gingival index (GI), periodontal pocket depth (PPD), and mobility index (MI) were evaluated at baseline, 7, 14, 21, and 56 days post experiment (DPE). Intra-oral radiography was undergone to assess alveolar bone at baseline, 21 and 56 DPE. Histopathological analysis concerning inflammatory and fibrosis score was evaluated at baseline and 14 DPE. Cytokine expression analysis via anti-inflammatory (TGF-β1, PDGF-B, VEGF-A, TIMP-1, COL1A1, and COL3A1) and pro-inflammatory cytokines (TNF-α and IL-1β) were evaluated at baseline, 7 and 14 DPE. The results revealed that PD+ group presented significant improvement in GI (at 14 DPE), PPD (at 21 and 56 DPE), and inflammatory reaction score (at 14 DPE) compared with PD group. Also, significant up-regulation of anti-inflammatory cytokines (except for COL1A1) together with down-regulation of pro-inflammatory cytokines were observed. In conclusion, platelet-rich fibrin might be an alternative novel approach for periodontitis treatment in dogs. (n represented surgical site)