Piroxicam gel versus injectable platelet rich fibrin in the treatment of stage III periodontitis

Abstract

Background In view of the importance and prevalence of chronic periodontitis, there is still an urgent need to search for an effective therapy that is less expensive, easy to use, and readily available with no side effects. Injectable platelet rich fibrin (i-PRF) and piroxicam were considered as possible treatment options of periodontitis. Aim To evaluate the efficacy of piroxicam gel versus i-PRF in treatment of stage III periodontitis. Materials and method The current study was carried out as a randomized clinical trial. The participants diagnosed as having stage III, grade B periodontitis were selected from the patients attending Department of Periodontology and Oral Medicine, Faculty of Dentistry, Tanta University. The selected individuals randomly assigned into two groups (by means of a sealed envelope via masked supervisor): group I and group II. Forty sites (the deepest periodontal pockets) were selected. Twenty sites from GI was treated by piroxicam gel and 20 sites in GII were treated by i-PRF. The application was done 2 weeks after scaling and root planing and applied for five times one application every 2 weeks over 10 weeks. The comparison was assessed clinically and immunologically. Clinically, via recorded: probing pocket depth, clinical attachment loss, and bleeding on probing. Immunologically, via measuring: the levels of matrix metalloproteinases-8 in gingival cervical fluid samples. Clinical and immunological were recorded at baseline (before scaling and root planing), 4 weeks (2 weeks after first application), 8 weeks (at fourth application), and 12 weeks (2 weeks after the last application). Results Both groups showed significant improvement in all clinical and immunological parameters. Comparing GI and GII at each follow-up time point, there was significant amelioration in all assessed parameters in favor to GII. Conclusion The use of i-PRF is preferred over the use of piroxicam gel in the treatment of stage III chronic periodontitis, as it gives better clinical and immunological results.