Hyperbaric Oxygen Combined with PRF on the Repair Effects of Calcined Bovine Bone to Periodontal Bone Defects, Gingival Papillae Loss and the Expression of RANKL/OPG
Objective : To investigate the effect and mechanism of Hyperbaric Oxygen Therapy (HBO) combined with Platelet-Rich Fibrin (PRF) on thetreatment of periodontal bone defects and gingival papillae loss using calcined bone (CBB).
Methods : A total of 150 patients with chronic periodontitis and bone defects were selected and divided into three groups after calcined bone grafting: the HBO-PRF group, the PRF group, and the control group, with 50 cases in each group. The Gingival Index (GI), Periodontal Pocket Depth (PD), and Clinical Attachment Loss (AL) were recorded before surgery and at 6 and 12 months post operation. Gingival papillae height (GPH) and black triangles area (BTA) were measured. and keratinized gingival width (KGW) was measured at different time points. CBCT and periapical x ray were taken to measure bone density and bone filling, and the rate of bone improvement was calculated. Enzyme-linked immunosorbent assay (ELISA) was used to determine the expression of Osteoprotegerin (OPG) and Receptor Activator of Nuclear Factor-kappa B Ligand (RANKL) in gingival crevicular fluid (GCF) before surgery and at 6 and 12 months post operation.
Results : The HBO-PRF group showed significantly reduced of the GI, PD, and AL at 6 and 12 months post operation compared to the PRF group and the control group. The reduction in KGW was significantly lower than that of the PRF group at 1, 3, 6, and 12 months post operation. HBO-PRF group showed a significant increase in GPH and a significant reduction in BTA than control group, The HBO-PRF group had a significantly higher bone density and bone fill improvement at 6 and 12 months compared to the PRF group and the control group, and the GCF OPG was significantly higher than that of other groups, while RANKL and the RANKL/OPG were significantly lower.
Tie-Lou Chen1,2*#, Hui-Jie Lu3*, Ting-Lin Zhang4 , Bing Xu5 , Dong-Sheng Xu6 , Yan-En Wang1 , An-Xin Yue7 , Yi-Yi Pang8 , Chuan-Mei Huang1 , Zhi-Zen Quan1 , Xin-Yu Yang1 , Shi-Feng Wang9#, Da-Hai Tang10# and Yi-Jun Zhou11 , Wen-Jing Chen12