Platelet-Rich Fibrin-Enhanced Bone Healing Co-grafted With Either Hydroxyapatite and Beta Tricalcium Phosphate or Demineralized Freeze-Dried Bone in Small Maxillofacial Osseous Defects: A Clinical Comparison

Introduction: This study was conducted to clinically compare a commercially available combination of 70:30 nanocrystalline hydroxyapatite (HA) and beta tricalcium phosphate (βTCP) along with platelet-rich fibrin (PRF) with demineralized freeze-dried bone (DFDB) grafts along with PRF in small maxillofacial osseous defects. Materials and methods: Thirty patients with one osseous defect were randomly distributed into two groups of 15 each: Group A and Group B. Group A patients received HA+βTCP+PRF while Group B received DFDB + PRF. Postoperative pain, swelling, wound dehiscence, and the presence or absence of infection were evaluated at various intervals up to seven postop days and compared between the two groups and within either group. A technetium 99m methylene diphosphonate (MDP (99m)Tc) scan was also done for a representative patient of either group at the end of three months to evaluate the fate of the graft. Results: We found no significant difference between the two groups for any of our parameters. Significant improvements were noted for pain and swelling within either group at various intervals. The MDP (99m)Tc scan showed increased tracer uptake for the representing patient of either group. Conclusions: HA+βTCP is more inexpensive than DFDB and more readily available and has no host incompatibility or infection potential, resulting in similar clinical postoperative states as DFDB when either is used with PRF.