Abstract
BACKGROUND: Smokers with periodontitis generally respond less favorably to nonsurgical treatments compared to nonsmokers. Injectable platelet-rich fibrin (i-PRF) is an effective autogenous material that positively influences various biological processes, including inflammation, wound healing, angiogenesis, and regeneration. This split-mouth randomized controlled study aims to investigate the effects of subgingival i-PRF application on clinical periodontal parameters as an adjunct to scaling and root planning (SRP) in smokers with periodontitis. METHODS: This study included twenty-five patients with Stage 2 to 3 Grade C periodontitis. For each patient, four contralateral deep pockets (two for each side) were randomly treated with SRP + i-PRF (test group) or SRP + saline (control group). Subgingival i-PRF/saline application was repeated on the 7th day, and clinical periodontal parameters were recorded at baseline and 1 and 3 months following the treatments. RESULTS: Compared with the baseline measurements, both groups presented significant improvements in clinical parameters. The probing depth (PD) was significantly lower in the test group than in the control group at the 1st and 3rd months (P < 0.05). The 3-month gingival index (GI) and bleeding on probing (BOP) values were significantly lower in the test group than in the control group (P < 0.05). No significant differences were observed in the Turesky modified Quigley-Hein Plaque Index (TQHPI) or clinical attachment loss (CAL) score between the groups during the follow-up visits (P > 0.05). However, greater PD reduction and clinical attachment gain were found in the test group than in the control group at the 1st and 3rd months (P < 0.05). CONCLUSIONS: Greater PD reduction and clinical attachment gain in the test group indicate that i-PRF may play a beneficial role in improving the clinical outcomes of nonsurgical periodontal treatment in smokers with periodontitis. TRIAL REGISTRATION: ID NCT06605547 ( https://clinicaltrials.gov/ ); September 23, 2024.