Comparative analysis of platelet-rich fibrin, platelet-rich fibrin with hydroxyapatite and platelet-rich fibrin with alendronate in bone regeneration: A cone-beam computed tomography analysis

AIM: This clinical study was designed to evaluate the volumetric healing of periapical (PA) bone defect after PA surgery, using platelet-rich fibrin (PRF), and its combination with hydroxyapatite and alendronate. SUBJECTS AND METHODS: Twenty male patients of age between 25 and 35 years, having PA pathology (>5 mm on intraoral periapical radiograph (IOPA)) with intraoral sinus opening, were included in this study. Cone-beam computed tomography (CBCT) imaging of all patients was done. Root canal treatment with PA surgery was done. Patients were divided into four groups (5 in each group), on the basis of material placed in PA bone defect. After 1 year, CBCT imaging was done. Linear measurement of maximal dimensions in all three orthogonal planes was done in both pre- and post-CBCT image. These measurements were used to estimate the volume of the lesion healed after 1 year of surgery. STATISTICAL ANALYSIS: Analysis of variance and Post hoc Tukey's test were used for statistical analysis. RESULTS: Change in volume were significantly different between Group 1 vs Group 3; Group 2 vs Group 3 and Group 3 vs Group 4. The Group Order for change in volume 1 year post surgery Group 3> Group 4 ≈ Group 2> Group 1. CONCLUSIONS: PA bone healing after surgery is enhanced by placing combination of bone regenerative materials. PRF with hydroxyapatite provides best healing outcomes in comparison to PRF with alendronate or PRF alone.