Abstract
BACKGROUND: The elimination of the causative agent and the facilitation of tissue regeneration are the fundamental objectives of periodontal therapy. Various adjunctive agents have been investigated to optimize treatment outcomes with surgical interventions. Periostin is a matricellular protein predominantly expressed in periodontal tissues, playing a key role in tissue remodeling, inflammation, and wound healing. The human placental extract has been used in periodontal surgery and compared with open flap debridement alone, with gingival crevicular fluid (GCF) periostin levels assessed to gauge periodontal wound healing. METHODS: Sixteen systemically healthy patients diagnosed with Stage III Grade C periodontitis were enrolled in the study. Participants were randomly assigned to either the test group (n = 8) or the control group (n = 8), with a total of nine males and seven females distributed across the groups. The test group underwent open flap debridement (OFD), followed by applying human placental extract gel absorbed into a gelatin sponge, while the control group received only OFD. Clinical parameters were assessed at baseline and 3 month post-treatment. GCF periostin levels were measured at baseline, 6 weeks, and 3 months. RESULTS: The test group demonstrated a mean probing pocket depth (PPD) reduction of 4.75 ± 1.28 mm, compared to 3.12 ± 1.12 mm in the control group, with the difference being statistically significant. The relative attachment level (RAL) gain was 4.37 ± 1.18 mm in the test group and 2.75 ± 0.70 mm in the control group; however, this difference was not statistically significant. At 3 months, the mean healing index score was 4.50 ± 0.53 in the test group and 3.62 ± 0.51 in the control group, with a statistically significant intergroup difference. The Plaque Index (PI), Gingival Index (GI), and Gingival Bleeding Index (BI) showed moderate reductions at 3 months; however, intergroup differences were not statistically significant, except for BI, where the difference at 3 months was -0.180. CONCLUSIONS: The adjunctive use of placental extract gel in surgical periodontal therapy demonstrated beneficial effects on healing outcomes. In addition, periostin shows promise as a biomarker for periodontal wound healing.