Analysis and evaluation of the clinical effectiveness of chronic periodontitis treatment using stromal vascular fraction and native autologous platelet plasma: a controlled randomized clinical study

BACKGROUND: Periodontitis causes persistent oral discomfort manifested by gingival inflammation and tenderness, thereby limiting normal physiological functions. The aim of this study was to evaluate the clinical effectiveness of chronic periodontitis treatment using stromal vascular fraction (SVF) in combination with native autologous platelet plasma (APP). The findings may contribute to the optimization of periodontitis treatment methods and improve the prognosis for patients with this condition.

AIM: To evaluate the influence of the SVF in combination with native APP on periodontal tissue condition, reduction of inflammation and alveolar bone regeneration.

METHODS: 85 patients aged 36 to 65 years with chronic periodontitis and a body mass index > 30 were randomly divided into two groups according to the treatment method: group 1 — the main group (n = 43), where standard therapy was supplemented with injections of SVF and native APP into the periodontal tissues; group 2 — the control group (n = 42), where only conventional therapy was used. The analysis and evaluation of treatment effectiveness were based on clinical and instrumental diagnostic methods. Clinical parameters used to assess the effectiveness of periodontal therapy included: (1) oral hygiene index (HI) by Fedorov–Volodkina and Mühlemann bleeding index (BI), both assessed after staining; (2) probing depth (PD) measured with a periodontal probe; (3) tooth mobility assessed using the Miller mobility index with dental tweezers; (4) bone resorption evaluated using computed tomography (CT); and (5) periodontal microcirculation assessed by laser capillary blood flow analysis (LAKK-OP).

RESULTS: In group 1, the following indicators were obtained: HI, 3.500 ± 0.021; BI, 3.600 ± 0.022; PD, 5.100 ± 1.020 mm. CT revealed alveolar bone resorption up to one third of the root length. Doppler flowmetry demonstrated a blood perfusion volume of 19.010 ± 0.034 perfusion units and a perfusion rate of 1.620 ± 0.034 perfusion units. In group 2, HI was 3.400 ± 0.023, BI 3.500 ± 0.021, and PD 5.0 ± 1.030 mm. CT revealed alveolar bone resorption extending to one third of the root length, with a perfusion volume of 18.050 ± 0.033 perfusion units and a perfusion rate of 1.540 ± 0.028 perfusion units.

CONCLUSION: The use of SVF and native APP in the comprehensive treatment of chronic periodontitis has a beneficial effect on periodontal condition. A marked improvement in periodontal status was observed, manifested clinically by normalization of gingival appearance and reduction in bleeding and swelling of the marginal and papillary gingiva. Alveolar bone showed stabilization, periodontal defects regressed, progression of alveolar bone resorption was halted, and no tooth mobility was observed.