Recombinant Human Platelet–Derived Growth Factor: A Systematic Review of Clinical Findings in Oral Regenerative Procedures

Abstract

Aim: The use of recombinant human platelet-derived growth factor–BB (rhPDGF) has received Food and Drug Administration approval for the treatment of periodontal and orthopedic bone defects and dermal wound healing. Many studies have investigated its regenerative potential in a variety of other oral clinical indications. The aim of this systematic review was to assess the efficacy, safety, and clinical benefit of recombinant human platelet-derived growth factor (rhPDGF) use for alveolar bone and/or soft tissue regeneration. Material and Methods: Comprehensive electronic and manual literature searches according to the PRISMA guidelines were performed to identify interventional and observational studies evaluating the regenerative applications of rhPDGF-BB. The primary outcomes were the safety, efficacy, and overall clinical benefit of rhPDGF use in oral regenerative procedures. Results: Sixty-three human clinical studies (mean ± SD follow-up period of 10.7 ± 3.3 mo) were included in the qualitative analysis. No serious adverse effects were reported in any of the 63 studies, aside from the postoperative complications routinely associated with surgical therapy. Use of rhPDGF was shown to be beneficial when combined with allografts, xenografts, and alloplasts (the latter tricalcium phosphate [β-TCP]) for the treatment of periodontal defects and gingival recession. The use of rhPDGF also led to favorable clinical outcomes when combined with allografts or xenografts for guided bone regeneration (GBR) and alveolar ridge preservation. While favorable clinical results support the use of the combination of rhPDGF plus allograft or xenograft for GBR, ARP, and sinus floor augmentation, current data support the use of rhPDGF and alloplasts (e.g., β-TCP) only in periodontal defects and gingival recession. Conclusions: Based on the clinical evidence, rhPDGF is safe and provides clinical benefits when used in combination with bone allografts, xenograft, or β-TCP for the treatment of intrabony and furcation periodontal defects and gingival recession or when used with allografts or xenograft for GBR and ARP (PROSPERO CRD42020142446). Knowledge Transfer Statement: Clinicians should be aware that rhPDGF is a safe and effective approach for the treatment of intrabony and furcation periodontal defects and gingival recession or when used with allografts or xenograft for bone regeneration and alveolar ridge preservation. With consideration of cost and patient preference, this result could lead to more appropriate therapeutic decisions.

Does Platelet-Rich Fibrin Enhance the Early Angiogenetic Potential of Different Bone Substitute Materials? An In Vitro and In Vivo Analysis

“…In general, with recent adjustments in regulatory requirements by the Food and Drug Administration, the application of growth factors related to bone substitute materials, such as recombinant human bone morphogenetic proteins (rhBMPs) [ 25 ], platelet-derived growth factor-BB (rhPDGF) [ 26 ], and fibroblast growth factor-2 (rhFGF-2) [ 27 ], has emerged as a new frontier in the field of reconstructive surgery. Currently, there is an ongoing debate on appropriate concentrations and indications [ 28 ].…”

Platelet-Rich Fibrin in Single and Multiple Coronally Advanced Flap for Type 1 Recession: An Updated Systematic Review and Meta-Analysis

“…It has been advocated that the biologic agents may improve both soft tissue healing and the outcomes of the CAF [19,20]. Among them, platelets concentrates have gained increased interest.…”

Alveolar Bone Ridge Augmentation Using Polymeric Membranes: A Systematic Review and Meta-Analysis

“…The study quality and designs were evaluated according to: (i) An adapted version of the Newcastle–Ottawa scale [ 15 ] for interventional and observational researches. Studies were considered as having a high, medium, or low methodological quality and (ii) The Joanna Briggs Institute Critical Appraisal tool for case series.…”

“…Studies were considered as having a high, medium, or low methodological quality and (ii) The Joanna Briggs Institute Critical Appraisal tool for case series. Studies were considered as having a high, medium, or low risk of bias [ 15 ].…”