1. Payton King

2. By coincidence! I was running out of time to choose a topic to research for knowledge transfer, and did not have a specific clinical scenario to form a PICO question on. I was researching various methods for periodontal therapy and came across platelet-rich fibrin.

3. PICO Question: Does platelet-rich fibrin, when used as an adjunct to open flap debridement, increase the rate of bone regeneration and clinical attachment levels in patients with three wall infra-bony defects compared to open flap debridement alone?

4. Databases: EBSCOhost Google Scholar Key Phrases: “platelet-rich fibrin AND perio* AND healing” “platelet-rich fibrin AND perio*” “platelet-rich fibrin AND dental hygiene therapy” “platelet rich fibrin” “platelet-rich fibrin periodontal therapy” “platelet rich fibrin periodontal therapy AND scaling AND root planning”

6. “A simple and inexpensive procedure” 2 A sample of the patients’ blood is drawn at the time of the surgical procedure, and is placed in a centrifuge. 2 Once centrifuged, the platelet-rich fibrin clot forms between the plasma and red blood cell layers respectively. 2 This clot is quickly pulled out of the sample and is further compressed, which makes the clot elastic-like. 2

7. http://www.youtube.com/watch?v=EjhR90E707A

8. The clot is then placed into a three-wall infra-bony defect after completing open-flap debridement on the patient 2 “Contains concentrated leukocytes, platelets, and growth factors that are trapped within a fibrin matrix”. 2 http://www.regenexx.com/tag/platelets/

9. Results are collected nine months after the surgical procedure. 1,3 Clinically proven that probe depths, clinical attachment level, sulcus bleeding index, periodontal attachment level, and plaque indexes were significantly reduced in systemically healthy people that received platelet-rich fibrin along with open flap debridement. 1,3

10. Clinical attachment levels were gained in systemically healthy people that received platelet-rich fibrin therapy in adjunct with open flap debridement. 1,3 Infra-bony defects, when filled with PRF after receiving open flap debridement, where approximately 46.92% filled with new bone. 1,3 Infra-bony defects that received open flap debridement alone only filled approximately 28.66%. 1,3

11. http://www.jidonline.com/viewimage.asp?im g=JInterdiscipDentistry_2011_1_2_115_85033_ f1.jpg http://www.jidonline.com/viewimage.asp ?img=JInterdiscipDentistry_2011_1_2_115_ 85033_f4.jpg http://www.jidonline.com/viewimage.a sp?img=JInterdiscipDentistry_2011_1_2_ 115_85033_f5.jpg

12. Studies have shown that using platelet-rich fibrin as an adjunct to open flap debridement provides: clinically significant regenerative healing in infra-bony defects 1,2,3 gained clinical attachment levels 1,2,3

14. No, I cannot answer my question because more thorough research is needed, as platelet-rich fibrin is becoming a new concept to periodontal therapy. 1,2,3

15. Any Questions??

16. 1.Thorat MK, 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 Oct; 38(10): 925-932. 2.Rock L. Potential of platelet rich fibrin in regenerative periodontal therapy: literature review. Can J Dent Hygiene. 2013;47(1):33-37. 3.Sharma A, Pradeep AR. Treatment of 3-wall intrabony defects in patients with chronic periodontitis with autologous platelet-rich fibrin: a randomized controlled clinical trial. J Periodontol. 2011 December;82(12):1705-1712.