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Antimicrobials have been used as adjuncts to non-surgical periodontal therapy. However, systemic antibiotics often require large dosages to achieve suitable concentrations at the disease site. Leukocyte platelet-rich fibrin (L-PRF) is a promising bio-material, with antimicrobial, anti-inflammatory, and wound-healing enhancement effects. This study aimed to evaluate the efficacy of L-PRF as a locally sustained released device for metronidazole antimicrobial.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Twenty-four patients with eighty periodontal pockets had moderate periodontitis with attachment loss of 3\u20134\u00a0mm, and probing depth\u2009\u2264\u20095, which was equally divided into two groups: Group (I) underwent scaling and root planing with intra-pocket application of L-PRF loaded with Metronidazole, while Group (II) was treated by scaling and root planing with intra-pocket application of L-PRF alone. Microbiological measurements were taken at baseline and after one month to analyze the relative count of <jats:italic>Porphyromonas gingivalis (P. gingivalis)<\/jats:italic> using real time PCR. Clinical parameters were measured at baseline and after 1, 3, and 6 months. These parameters included probing depth (PD), clinical attachment loss (CAL), plaque index (PI), modified gingival index (MGI), and bleeding index (BI).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Microbiological and clinical findings revealed that both treatment methods resulted in a reduction in <jats:italic>P. gingivalis<\/jats:italic> counts, in addition to improvements in the clinical parameters: PD reduction, CAL gain, PI reduction, BI decrease and MGI reduction compared to baseline. However, L-PRF-metronidazole group showed superior results in the studied parameters over the study period. Nonetheless, there was no statistically significant improvement. (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The intra-pocket application of both L-PRF loaded with Metronidazole and L-PRF alone contributed to the successful treatment of moderate periodontitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>NCT06153706 (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinical-trials.gov\/\">http:\/\/www.clinical-trials.gov\/<\/jats:ext-link>); 1\/12\/2023, retrospective registration.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12903-024-05254-x","type":"journal-article","created":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T04:37:20Z","timestamp":1734755840000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Evaluation of leukocyte-platelet rich fibrin as an antibiotic slow-release biological device in the treatment of moderate periodontitis: a randomized controlled clinical trial"],"prefix":"10.1186","volume":"24","author":[{"given":"Yasmeen K.","family":"Omar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohy A. 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