The Additional Effect of Autologous Platelet Concentrates to Coronally Advanced Flap in the Treatment of Gingival Recessions: A Systematic Review and Meta-Analysis

Abstract

Background. To improve the efficacy of regenerative treatment for gingival recessions, the autologous platelet concentrates (APCs) combined with coronally advanced flap (CAF) have been investigated. However, few studies systematically assess the complementary effect of APCs in periodontal regeneration. The present study aims to evaluate the additional effect of different types of APCs to CAF in the treatment of gingival recessions. Methods. Electronic databases (EMBASE, MEDLINE, and Cochrane Central Register of Controlled Trails) and relevant journals were searched until May 15, 2019. Only randomized controlled trials (RCTs) in English were included. Outcome variables include root coverage (RC), recession depth (RD), clinical attachment level (CAL), keratinized tissue width (KTW), and gingival thickness (GT). Data were analyzed with Revman5.3. The estimate of effect sizes was expressed as the mean differences and the 95% confidence interval. Results. 8 RCTs involving 170 patients (328 sites) were included. Our meta-analysis indicated RC, RD, CAL, KTW, and GT were better improved in the CAF plus APCs groups than the CAF alone. The subgroup analyses revealed that platelet-rich fibrin (PRF) brought significant improvement in RC, RD, CAL, and GT. Concentrated growth factors (CGF) lead clinic beneficial in CAL, KTW, and GT. No significant effect of platelet-rich plasma (PRP) could be found in any clinical parameters when combined with CAF. Conclusions. PRF could exert additional effect to CAF; the preferred treatment for gingival recessions was considered. Based on the limited studies, it seemed that PRP failed to show any additional effect and it was not suggested for gingival recessions. Given the limited research and high risk of bias, it is still needed to confirm the additional effect of CGF by more high-quality studies.

Tensile strength assay comparing the resistance between two different autologous platelet concentrates (leucocyte-platelet rich fibrin versus advanced-platelet rich fibrin): a pilot study

“…In Dentistry, more specifically in periodontal surgery, questions have emerged about the use of PRF membranes with favorable results. Studies have suggested it as a possible substitute for a connective tissue graft, which is still considered the “gold standard” for soft tissue surgery [ 16 , 30 ]. In oral surgery, favorable results have been found for the insertion of membranes inside of fresh socket after extraction or using it in the treatment for bone lesions [ 31 ].…”

“…In oral surgery, favorable results have been found for the insertion of membranes inside of fresh socket after extraction or using it in the treatment for bone lesions [ 31 ]. Furthermore, the use of a PRF membrane avoids a donor site which greatly decreases the postoperative discomfort [ 30 ].…”

Additive Effect of Platelet Rich Fibrin with Coronally Advanced Flap Procedure in Root Coverage of Miller’s Class I and II Recession Defects—A PRISMA Compliant Systematic Review and Meta-Analysis

“…A subgroup analysis was carried out to address the possible differences among the outcomes of the studies regarding the selection of recession type (single or multiple adjacent recessions). This aspect has not been considered in the previous systematic reviews [ 28 , 29 ]. The results of heterogeneity among the subgroups were varied and were found to be greater than 91.3% for GT and 32.8% for WKG.…”

“…Since the comparison of CAF + L-PRF versus CAF + CTG was not significant, L-PRF was suggested as a substitute to CTG which has the potential to show a beneficial outcome on bone and keratinized tissue healing, as well as postoperative discomfort reduction. Recently, Li et al [ 29 ] evaluated the effect of autologous platelet concentrates when used with CAF. They included 5 studies to assess the effect of L-PRF and showed L-PRF could exert an additive effect to CAF.…”

Therapeutic effect of concentrated growth factor preparation on skin photoaging in a mouse model

“… 28 A recent meta-analysis showed that CGF, but not PRP, influenced therapeutic outcomes in the management of gingival recession. 29 However, research into the effect of CGF on photoaging is lacking. The current study was conducted to investigate the therapeutic effect of CGF on photoaging in a nude mouse model.…”