Comparative Evaluation of Subgingival Irrigation with Injectable Platelet-rich Fibrin and Chlorhexidine as an Adjunct to Scaling and Root Planing in the Treatment of Periodontitis: A Randomised Split-mouth Clinical Study

Abstract Introduction: Scaling and root planing (SRP) stands as the established standard for treating periodontal conditions, despite facing limitations such as difficulty accessing deep pockets and furcations, and fully eradicating specific pathogens. To address these challenges and improve treatment outcomes, researchers have explored various local adjunctive antimicrobial agents and irrigants to complement non-surgical approaches. Recent dental research has increasingly focused on injectable platelet-rich fibrin (i-PRF) as a promising therapy to stimulate tissue regeneration. This study’s objective was to assess the effectiveness of using i-PRF and chlorhexidine (CHX) as an adjunct to promote the healing of deep periodontal pockets. Materials and Methods: This study utilised a split-mouth design wherein 140 deep periodontal pockets (≥5 mm) were randomly allocated to receive either SRP + i-PRF (intervention group) or SRP + CHX (comparison group). Clinical assessments were conducted before treatment and 3 months post-treatment, followed by statistical analysis of the collected data. Results: Clinical assessments indicated notable enhancements with both treatment approaches. The average pocket depth (PPD) reduction and clinical attachment loss (CAL) gain were notably greater in the test group compared to the control group after 3 months ( P < 0.0001). Conclusion: Using i-PRF alongside traditional SRP in a non-surgical approach could significantly enhance periodontal clinical indicators, as it contains various growth factors that facilitate tissue regeneration and stimulate fibroblast activity.