Evaluating the efficacy of metronidazole-loaded TPRF in open flap debridement for periodontitis management: a randomized controlled trial

The aim of this randomized clinical trial is to compare the clinical efficacy of metronidazole-loaded Titanium-Prepared Platelet-Rich Fibrin (T-PRF) and T-PRF alone as adjuncts to open flap debridement (OFD) in the surgical management of periodontal pockets. After obtaining informed consent and recording a comprehensive case history, 30 patients with moderate to severe generalized periodontitis will be enrolled and randomly allocated into two groups: a test group treated with OFD + metronidazole-loaded T-PRF and a control group treated with OFD + T-PRF alone. Following phase I periodontal therapy, patients will be clinically re-evaluated to confirm suitability for surgery. Randomization will be performed using computer-generated tables, and outcome assessment will be single-blinded to minimize bias.

All surgical procedures will be performed by a single operator using a standardized OFD protocol. Metronidazole-infused T-PRF and T-PRF membranes will be prepared from autologous blood using titanium tubes and placed into the periodontal defects following thorough debridement. Clinical parameters including Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), and Relative Clinical Attachment Level (RCAL) will be recorded at baseline, 3 months, and 6 months postoperatively to evaluate treatment outcomes.