Effect of Diode Laser Photobiomodulation on Platelet-Rich Fibrin Architecture in Healthy and Diabetic Individuals with Periodontitis: An In Vitro Histomorphometric Study
Main Article Content
Abstract
Background
Platelet-rich fibrin (PRF) is used in periodontal regeneration because its fibrin matrix carries platelets, leukocytes and biologically active mediators involved in repair. Diabetes mellitus can modify fibrin formation and platelet function, which may affect the structure and regenerative properties of PRF. Photobiomodulation (PBM) has been reported to influence cellular activity and tissue repair, but its effect on the microscopic structure of PRF obtained from patients with diabetes and periodontitis is not well established. This study compared the histomorphometric features of PRF from systemically healthy and diabetic individuals with periodontitis before and after diode laser PBM.
Methods
Twenty-four PRF samples were studied: 12 from systemically healthy individuals with periodontitis and 12 from individuals with periodontitis and diabetes mellitus. The samples were assigned to four groups: healthy control, healthy + PBM, diabetic control, and diabetic + PBM. PRF was prepared using Choukroun’s protocol. The treatment groups were exposed to a 660 nm diode laser at 0.1 W for 60 seconds in continuous, non-contact mode. Fibrin network density, platelet entrapment, leukocyte distribution, and fibrin fiber thickness were assessed.
Results
In the healthy samples, PBM was associated with a denser fibrin network and moderate platelet and leukocyte distribution compared with untreated samples. Diabetic control samples showed a compact fibrin arrangement with relatively sparse cellular entrapment. After PBM, the diabetic samples showed better fibrin organization together with greater platelet and leukocyte distribution.
Conclusion
The PRF samples exposed to diode laser PBM showed changes in fibrin organization and cellular entrapment in both study populations, with a greater increase in measured fibrin fiber thickness in the diabetic PBM group.