Additive effect of autologous platelet concentrates in treatment of intrabony defects: a systematic review and meta‐analysis

Abstract

The aim of the present review is to systematically evaluate the additive effect of autologous platelet concentrates (APCs) in treatment of intrabony defects when used along with other regenerative procedures and when used alone in terms of clinical and radiological outcomes. A search was performed in electronic databases (i.e., MEDLINE and the Cochrane Central Register of Controlled Trials) in order to identify randomized clinical trials (RCTs) assessing the additive efficacy of APCs for healing and regeneration of hard and soft tissues in patients undergoing regenerative surgical procedures for the treatment of intrabony defects, having a follow-up of at least 9 months. Included studies underwent risk of bias assessment and data extraction. The main variables evaluated for efficacy were: pocket depth (PD), clinical attachment level (CAL), radiographic bone filling, and postoperative pain. The effect of APCs adjunct was evaluated for the following procedures: open flap debridement (OFD) alone, OFD plus grafting of the defect with autogenous bone or bone substitutes, and grafting in combination with a covering membrane for guided tissue regeneration (GTR). Platelet-rich fibrin (PRF) has a significant additive effect when used along with OFD. Platelet-rich plasma (PRP) has a significant additive effect when used along with bone grafts. Conversely, PRP was found to be ineffective when used in combination with GTR procedures. No study evaluated the effect of APCs on postoperative pain. Platelet-rich plasma may be used advantageously as an adjunct to grafting materials, but not in combination with GTR, for treatment of intrabony defects. Moreover, PRF can be effective as a sole regenerative material, in combination with OFD. There is still a lack of evidence regarding the effect of PRF in combination with grafting materials and GTR, the effect of other types of APCs such as plasma rich in growth factors, and the effect of APCs on postoperative pain.

A Comparison of Platelet Count and Enrichment Percentages in the Platelet Rich Plasma (PRP) Obtained Following Preparation by Three Different Methods

“…A recent systematic review and meta analysis on the usefulness of autologous platelet concentrates on intrabony defect management revealed that PRP has a significant additive effect when used along with bone grafts for regeneration of intrabony defects [14]. This study was carried out to compare the percentage of platelet enrichment achieved in three PRP preparation protocols suggested by different authors.…”

Behavior of Gingival Fibroblasts on Titanium Implant Surfaces in Combination with either Injectable-PRF or PRP

“…Since PRF does not contain anti-coagulants, it forms a fibrin clot within minutes after blood collection that has since been described and utilized as a three-dimensional scaffold for tissue regeneration [23,24,25]. Despite having complete immune-biocompatibility, other advantages include faster angiogenesis of tissues, which leads to faster wound healing [26,27,28,29]. For these reasons, the use of PRF has been widespread in oral surgery and continues to grow exponentially in use [30].…”

Nanomaterials for Tissue Engineering In Dentistry

“…Regarding TE in dentistry, the introduction of new membranes able to enhance guided tissue regeneration (GTR) in periodontology [32,33,34] and of autologous platelet concentrates (PRP and PRF) with membranes for guided restoration of bone loss in oral surgery, happened in 1980–1990 [35,36,37] and can be considered the beginning of the new techniques based on three principal elements of tissue engineering: stem cells, scaffolds, and signaling molecules [38]. …”