Comparative Evaluation of Ofloxacin Incorporated T-PRF vs Metronidazole Incorporated T-PRF as an Adjunct to Non Surgical Periodontal Therapy: A Randomized Controlled Clinical Trial

Abstract

Introduction: Non-surgical periodontal therapy (NSPT) remains the cornerstone in the management of periodontitis; however, complete elimination of subgingival pathogens through mechanical debridement alone is often limited. Local drug delivery systems combined with biologically active scaffolds may enhance therapeutic outcomes. Titanium-prepared platelet-rich fibrin (T-PRF), owing to its dense fibrin architecture and sustained release of growth factors, has emerged as a promising autologous biomaterial. Incorporation of antimicrobial agents such as ofloxacin and metronidazole into T-PRF may provide combined antimicrobial and regenerative benefits. Aim: To evaluate and compare the clinical efficacy of ofloxacin-incorporated T-PRF and metronidazole-incorporated T-PRF as adjuncts to scaling and root planing (SRP) in the treatment of periodontitis. Methodology: This randomized controlled clinical trial included thirty systemically healthy patients diagnosed with periodontitis were randomly allocated into three groups (n=10): Group I—SRP alone; Group II—SRP with ofloxacin-loaded T-PRF; and Group III—SRP with metronidazole-loaded T-PRF. Antimicrobial-loaded T-PRF membranes were placed sub-gingivally following SRP. Clinical parameters including plaque index, bleeding index, probing depth, and clinical attachment level were recorded at baseline, one month, and three months. Results: All groups demonstrated significant improvement in clinical parameters over time with no adverse events reported. Both antimicrobial-loaded T-PRF groups showed greater reductions in probing depth and gains in clinical attachment compared to SRP alone. Ofloxacin-incorporated T-PRF demonstrated marginally superior outcomes compared to metronidazole-incorporated T-PRF at three months. Conclusion: Antimicrobial-loaded T-PRF serves as an effective adjunct to NSPT, with ofloxacin-incorporated T-PRF showing enhanced clinical benefits in managing periodontitis.