Comparative clinical evaluation of demineralized freeze-dried bone allograft (DFDBA) alone versus DFDBA with platelet-rich fibrin membrane in the management of intrabony defects: A step toward enhanced periodontal regeneration

Background: Periodontal regeneration in intrabony defects remains a critical goal in periodontics. Demineralized freeze-dried bone allograft (DFDBA) and platelet-rich fibrin (PRF) have shown potential in enhancing clinical outcomes. This study compared the clinical efficacy of DFDBA alone versus DFDBA combined with PRF in the treatment of intrabony periodontal defects. Material and Method: A randomized, double-blinded, split-mouth clinical trial was conducted on patients diagnosed with Stage III or IV, Grade B or C periodontitis, each presenting with paired infrabony defects. A total of 15 defect sites were treated with DFDBA alone (control group), and 15 sites with DFDBA and PRF (test group). Clinical parameters, including probing depth (PD), clinical attachment level (CAL), plaque index (PI), and gingival index (GI), were recorded at baseline, 3 months, and 6 months postoperatively. Statistical analysis was performed using SPSS version 25, with significance set at P < 0.05. Results: Both groups showed significant intragroup improvements in all parameters ( P < 0.001). The DFDBA + PRF group demonstrated significantly greater probing pocket depth (PPD) reduction ( P = 0.01) and CAL gain ( P = 0.04) compared to DFDBA alone at 6 months, while PI and GI showed no significant intergroup differences. Conclusion: Both DFDBA alone and DFDBA combined with PRF significantly improved periodontal parameters. However, the adjunctive use of PRF yielded greater reductions in PPD and superior clinical attachment gains, indicating potential clinical advantages in terms of graft stabilization and soft-tissue healing. Further studies with extended follow-up and histologic evaluation are recommended to substantiate these findings.