To evaluate and compare the synergetic effect of Cranberry extract with PRF versus the use of PRF alone in the treatment of Chronic Periodontitis: A Clinical and a Radiological study
Main Article Content
Keywords
Cranberry extract, Platelet rich fibrin, Intrabony defect, Chronic Periodontitis
Abstract
Background: Among the several types of periodontitis, chronic periodontitis is the utmost common form of periodontal disease which can progress with a slow rate but may have a sudden rapid rate of progression along with a remarkable bone loss. In terms of adequacy in sufficient periodontal regeneration, periodontal flap surgeries lack the potential and takes often a back seat. Several other regenerative methods have been promoted among which platelet rich fibrin (PRF) is seen to be most extensively used. It is an old and successful trend to either add PRF or to infuse it along with other drugs at the wound site to enhance periodontal regeneration. Several herbal products were used as an infusion with PRF in the past for the antimicrobial effect but no herbal products were used in the form of a synergetic agent with PRF for enhancing periodontal regeneration. Cranberry fruit, its origin is from North America has been much popular because of its essential ingredients for a good health. It has got a significant therapeutic potential as an antimicrobial agent and as an antioxidant agent, but been never used for enhancing periodontal regeneration. Hence, the current study’s goal is to assess and compare the synergetic effect of Cranberry extract with PRF versus the use of PRF alone in the treatment of chronic periodontitis.
Materials and Method: A double blinded randomized clinical trial (RCT) was done with twenty subjects which included patients based on the selection criteria in the age group of 35 to 55 years having periodontal intrabony defects. The Control Group A received PRF alone and the Test Group B received PRF+CRN at the site of intrabony defects.Subjects in each group were assessed for their clinical parameters such as probing pocket depth (PPD), relative attachment level (RAL), gingival index (GI), plaque index (PI) and radiographical parameters such as defect depth (DD), defect area (DA) and defect fill % (DF %) at baseline. The follow up period was decided according to the the previous studies at three, six and nine months respectively.
Results: There was a statistically significant enhancement in the clinical and radiographic parameters from baseline to three, six and nine months in each group. However, the treated group showed statistically significant than the control group. Conclusion: Within the limitations of the given study, use of PRF+CRN was efficacious in comparison to the use of PRF alone in the treatment of intrabony defect.
References
2. S. Vadiraj, Rashmita Nayak, Gopal Krishna Choudhary etal. Periodontal Pathogens and respiratory diseases-evaluating their potential association: a clinical and microbiological study.The Journal Of contemporary Dental Practice. 2012: 03: 14.
3. Rashmita Nayak, Saurav Panda etal; Minced Platelet Rich Fibrin with Hydroxyapatite in surgical treatment of Apico-Marginal Periodontal Defect; Utkal University Journal Of Dental Sciences; 2014;2;2.
4. Saurav Panda, Rashmita Nayak etal. Plasma Rich In Growth Factors (PRGF) in non-surgical periodontal therapy: A randomized clinical trial: Brazilian Oral Research: 2020: 34.
5. Eid Abdelmagyd HA, Ram Shetty DS, Musa Musleh Al-Ahmari DM. Herbal medicine as adjunct in periodontal therapies- A review of clinical trials in past decade. J Oral Biol Craniofac Res. 2019;9(3):212-7.
6. Rashmita Nayak, Gopal Krishna Choudhary, Sandeep Prakash etal: The role of plasma female sex hormones on gingivitis in pregnancy: a clinicobiochemical study: Journal Of Contemporary Dental Practice: 13:6:2012
7. Sharmistha Das, Prachi Khuntia, Rashmita Nayak etal; Cranberry-A Boon in Periodontal Therapy; Indian Journal Of Forensic Medicine & Toxicology;2020; 14;4.
8. Rashmita Nayak, Prachi Khuntia etal; Platelet-Rich Fibrin: An Update; Indian Journal Of Forensic Medicine & Toxicology;2020; 14;4.
9. Feghali K, Feldman M, La VD, Santos J, Grenier D. Cranberry proanthocyanidins: natural weapons against periodontal diseases. J Agric Food Chem. 2012;60(23):5728-35.
10. Labrecque J, Bodet C, Chandad F, Grenier D. Effects of a high-molecular-weight cranberry fraction on growth, biofilm formation and adherence of Porphyromonas gingivalis. J Antimicrob Chemother. 2006;58(2):439-43.
11. Patel GK, Gaekwad SS, Gujjari SK, S CV. Platelet-Rich Fibrin in Regeneration of Intrabony Defects: A Randomized Controlled Trial. J Periodontol. 2017;88(11):1192-9.
12. Anuroopa Mahapatra, Rashmita Nayak, Anurag Satapathy, BK Patil, Rinkee Mohanty, Gatha Mohanty: Maternal Periodontal Status, oral inflammatory load, and systemic inflammation are associated with low infant birth weight; Journal Of Periodontology: 92: 8: 1107-1116: 2021
13. Löe HJTJoP. The gingival index, the plaque index and the retention index systems. 1967;38(6):610-6.
14. Naina Pattnaik, Rinkee Mohanty, Anurag Satapathy, Rashmita Nayak etal: Aloe vera mouthwashes can be a natural alternative to chemically formulated ones-A randomized -controlled trial: Journal Of Taibah University Medical Sciences; 17;03; 2022
15. Rohina Shamim, Anurag Satapathy, Rashmita Nayak etal; Efficacy of fresh Aloe vera extract in postoperative healing following periodontal surgery in patients with chronic periodontitis: A randomized clinical trial; Journal Of Dental And Allied Sciences;2016;02;05
16. Ajwani H, Shetty S, Gopalakrishnan D, Kathariya R, Kulloli A, Dolas RS, et al. Comparative evaluation of platelet-rich fibrin biomaterial and open flap debridement in the treatment of two and three wall intrabony defects. J Int Oral Health. 2015;7(4):32-7.
17. Thorat M, Pradeep AR, Pallavi B. Clinical effect of autologous platelet-rich fibrin in the treatment of intra-bony defects: a controlled clinical trial. J Clin Periodontol. 2011;38(10):925-32.
18. Chatterjee A, Pradeep AR, Garg V, Yajamanya S, Ali MM, Priya VS. Treatment of periodontal intrabony defects using autologous platelet-rich fibrin and titanium platelet-rich fibrin: a randomized, clinical, comparative study. J Investig Clin Dent. 2017;8(3).
19. Martande SS, Kumari M, Pradeep AR, Singh SP, Suke DK, Guruprasad CN. Platelet-Rich Fibrin Combined With 1.2% Atorvastatin for Treatment of Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial. J Periodontol. 2016;87(9):1039-46.
20. Sharma A, Pradeep AR. Autologous platelet-rich fibrin in the treatment of mandibular degree II furcation defects: a randomized clinical trial. J Periodontol. 2011;82(10):1396-403.
21. Chadwick JK, Mills MP, Mealey BL. Clinical and Radiographic Evaluation of Demineralized Freeze-Dried Bone Allograft Versus Platelet-Rich Fibrin for the Treatment of Periodontal Intrabony Defects in Humans. J Periodontol. 2016;87(11):1253-60.
22. Bajaj P, Agarwal E, Rao NS, Naik SB, Pradeep AR, Kalra N, et al. Autologous Platelet-Rich Fibrin in the Treatment of 3-Wall Intrabony Defects in Aggressive Periodontitis: A Randomized Controlled Clinical Trial. J Periodontol. 2017;88(11):1186-91.
23. Plasma rich in growth factors(PRGF) in non-surgical periodontal therapy: a randomized clinical trial: Brazilian Oral Research.34.2020.
24. Yamanaka A, Kouchi T, Kasai K, Kato T, Ishihara K, Okuda K. Inhibitory effect of cranberry polyphenol on biofilm formation and cysteine proteases of Porphyromonas gingivalis. 2007;42(6):589-92.
25. Weiss EI, Houri-Haddad Y, Greenbaum E, Hochman N, Ofek I, Zakay-Rones Z. Cranberry juice constituents affect influenza virus adhesion and infectivity. Antiviral Res. 2005;66(1):9-12.
26. Bodet C, Chandad F, Grenier DJEJOS. Cranberry components inhibit IL-6, IL-8 and PGE2 production by lipopolysaccharide-activated gingival fibroblasts. 2007;115:64-70.
27. Kinane DF. Regulators of tissue destruction and homeostasis as diagnostic aids in periodontology. 2000;24(1):215-25.
28. Bodet C, Chandad F, Grenier D. Inhibition of host extracellular matrix destructive enzyme production and activity by a high-molecular-weight cranberry fraction. J Periodontal Res. 2007;42(2):159-68.