Effect of the use of platelet concentrates on new bone formation in alveolar ridge preservation: a systematic review, meta-analysis, and trial sequential analysis

Abstract

Objectives To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized clinical trials (RCT). There is controversy whether the placement of PCs in ARP is effective in the formation of new bone. Materials and methods A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: In patients undergoing tooth extraction followed by ARP, do PCs alone in the post-extraction socket in comparison with spontaneous healing improve new vital bone formation percentage in histomorphometric analysis after more than 10 weeks? The risk of bias was assessed and a meta-analysis was conducted. Results Of 3809 results, 8 studies were considered suitable for inclusion. A total of 255 teeth were extracted in 250 patients. Regarding the PCs used, ARP was performed with platelet- and leukocyte-rich fibrin (L-PRF) in 120 sockets, and with pure platelet-rich plasma (P-PRP) in 31 sockets and 104 sockets were controlled. PCs improved new bone formation in ARP with respect to the spontaneous healing group (SMD = 1.77, 95%C.I. = 1.47–2.06, p-value < 000.1). There were no differences between the different PCs (L-PRF and P-PRP). Conclusion The results of this meta-analysis support the efficacy of the use of PCs in new bone formation in ARP. With respect to the different types of PCs studied, no differences were observed. Clinical relevance When planning implant surgery after tooth extraction, treatment with PCs should be considered for ARP. Any PC increases new bone formation compared to spontaneous healing.

Healing of Extraction Sites after Alveolar Ridge Preservation Using Advanced Platelet-Rich Fibrin: A Retrospective Study

“…Also, in other studies in which the same comparisons were made, the results were favorable for the preservation of the alveolar ridge [ 8 , 18 , 22 , 35 , 46 , 47 , 56 , 57 ]. The studies that analyzed the results of implant therapy had better outcomes for the preserved ridges than spontaneously healed alveoli [ 27 , 36 , 58 ]. In the present study, only the molar areas (first and second maxillary and mandibular molars) were included in order to homogenize the characteristics of the study sample and to minimize as much as possible the differences in size and morphology of the post-extraction alveoli on the results obtained.…”

“…In recent years, many variants of alveolar ridge preservation have been tried, one of them being the alveolar graft with a single biomaterial interposing a barrier element [ 3 ]. However, there has been no resolution regarding the best substitute material for alveolar preservation: autogenous, allogeneic, xenogeneic, or alloplastic graft [ 3 , 35 , 36 ]. The decision regarding the choice of the type of biomaterial differs depending on the case [ 3 ].…”

Advancements in alveolar bone grafting and ridge preservation: a narrative review on materials, techniques, and clinical outcomes

“…Upon examining the efficacies of diverse plasma concentrates (PCs) in ARP scenarios, it was ascertained that PCs significantly contribute to new bone formation during ARP in contrast to spontaneous healing [ 19 ]. Noteworthy is that among the analyzed PCs, no substantial differences were discerned between leukocyte- and platelet-rich fibrin (L-PRF) and pure platelet-rich plasma (P-PRP), underscoring the potential applicability of either concentrate in ARP instances [ 19 ].…”

“…Upon examining the efficacies of diverse plasma concentrates (PCs) in ARP scenarios, it was ascertained that PCs significantly contribute to new bone formation during ARP in contrast to spontaneous healing [ 19 ]. Noteworthy is that among the analyzed PCs, no substantial differences were discerned between leukocyte- and platelet-rich fibrin (L-PRF) and pure platelet-rich plasma (P-PRP), underscoring the potential applicability of either concentrate in ARP instances [ 19 ]. Furthermore, Madi et al [ 20 ] substantiated the efficacy of PRF in socket preservation through a methodical review that evaluated the impact of various grafting materials on newly formed bone, both histologically and radiographically.…”