Injectable PRF in Non-Surgical Periodontal Treatment

Patients with periodontitis will be recruited for this split-mouth randomized controlled trial. All participants will receive full-mouth supra and sub-gingival scaling and root planing (SRP). In the intervention side, i-PRF will be injected into the periodontal pockets, while the control side will receive SRP only.

Clinical measurements including Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), and Bleeding on Probing (BOP) will be recorded. Additionally, microbiological samples will be collected to assess the changes in the subgingival Porphyromonas gingivalis and Fusobacterium nucleatum . Follow-up visits are scheduled at 1 and 3 months post-intervention to assess the adjunctive benefit of i-PRF.

• Injectable Platelet-Rich Fibrin (i-PRF). (Biological), also known as Autologous Platelet Concentrate., i-PRF: Ten ml of whole blood is collected from the participant into plain tubes and immediately centrifuged. The centrifugation protocol follows the low-speed concept (e.g., 700 rpm for 3 minutes). The upper orange-colored liquid (i-PRF) is then collected and injected subgingivally into the periodontal pockets using a 25-gauge needle immediately after scaling and root planing
• Scaling and Root Planing (SRP). (Procedure), also known as Non surgical periodontal therapy, SRP, Initial periodontal therapy, Phase I periodontal therapy, Cause related periodontal therapy: Full-mouth non-surgical periodontal therapy including supra and sub-gingival scaling and root planing performed using ultrasonic devices and Gracey curettes to remove dental biofilm and calculus

Primary outcomes

• Change in Probing Pocket Depth (PPD) [Baseline, 1 month, and 3 months post-intervention]: Probing pocket depth will be measured in millimeters from the gingival margin to the base of the periodontal pocket using a standardized periodontal probe (e.g., William's probe) at six sites per tooth.

Secondary outcomes

• Clinical Attachment Level (CAL) [Baseline, 1 month, and 3 months post-intervention]: Measurement of the distance from the cemento-enamel junction (CEJ) to the base of the periodontal pocket in millimeters.
• Bleeding on Probing (BOP) [Baseline, 1 month, and 3 months post intervention]: Assessment of the presence or absence of bleeding within 30 seconds after probing, recorded as a percentage of total sites.
• Plaque Index (PI) [Baseline, 1 month, and 3 months post intervention .]: Assessment of the amount of dental plaque on the tooth surfaces to evaluate the patient's oral hygiene during the study.
• Microbiological Analysis (Bacterial Load) [Baseline, 1 month, and 3 months post intervention]: Quantification of subgingival periodontal pathogens (P. gingivalis and F. nucleatum )using Quantitative Real-time PCR (qPCR) from subgingival plaque samples.

Sex: All, ages: 30 Years to any

Inclusion Criteria:

* Adult subjects aged 30 years and above.
* No history of systemic diseases (e.g., diabetes mellitus).
* Not currently under active periodontal therapy or joining other trial in the last 3 months.
* Diagnosis with Stage II or III Periodontitis.
* presence of interdental CAL affecting ≥2 non adjacent teeth or if CAL at buccal/lingual aspects associated with PPD >4mm at ≥2 teeth.

Exclusion Criteria:

* Smokers or alcohol users.
* Patients consuming antibiotics or anticoagulants.
* Regular users of non-steroidal anti-inflammatory drugs.
* Receipt of periodontal treatment within 3 months prior to the study.
* Any bleeding or clotting disorders.
* Teeth with Grade II or Grade III furcation involvement.
* Pregnant or breastfeeding mothers.
* Patients unwilling to participate.