Use of platelet-rich fibrin for the treatment of gingival recessions: a systematic review and meta-analysis

Miron, Richard J.; Moraschini, Vittório; Fabbro, Massimo Del; Piattelli, Adriano; Fujioka‐Kobayashi, Masako; Zhang, Yufeng; Saulačić, Nikola; Benoit, Sandrine; Kawase, Tomoyuki; Cosgarea, Raluca; Jepsen, Søren; Tuttle, Delia; Bishara, Mark; Canullo, Luigi; Eliezer, Meizi; Stavropoulos, Andreas; Shirakata, Yoshinori; Stähli, Alexandra; Gruber, Reinhard; Lucaciu, Ondine; Aroca, Sofia; Deppe, Herbert; Wang, Hom Lay; Sculean, Anton

doi:10.1007/s00784-020-03400-7

Cited by 71 publications

(49 citation statements)

References 59 publications

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“…Furthermore, an array of different surgical procedures utilized to treat IBDs exists. Previously, it was shown that great variability in surgical approaches was discussed when PRF was used for the treatment of gingival recessions [75]. Future research investigating more precisely various surgical difference such as flap design and surgical techniques (e.g., MIST and M-MIST) should be further evaluated in future studies to better determine optimal surgical approaches when using PRF in regenerative therapy of IBDs.…”

Section: Implications For Clinical Practice and Future Directionmentioning

confidence: 99%

Use of platelet-rich fibrin for the treatment of periodontal intrabony defects: a systematic review and meta-analysis

et al. 2021

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Objectives This study aims to compare the treatment outcomes of periodontal intrabony defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities. Materials and methods The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with that of other modalities. Studies were classified into 10 categories as follows: (1) open flap debridement (OFD) alone versus OFD/PRF; (2) OFD/bone graft (OFD/BG) versus OFD/PRF; (3) OFD/BG versus OFD/BG/PRF; (4–6) OFD/barrier membrane (BM), OFD/PRP, or OFD/enamel matrix derivative (EMD) versus OFD/PRF; (7) OFD/EMD versus OFD/EMD/PRF; (8–10) OFD/PRF versus OFD/PRF/metformin, OFD/PRF/bisphosphonates, or OFD/PRF/statins. Weighted means and forest plots were calculated for probing depth (PD), clinical attachment level (CAL), and radiographic bone fill (RBF). Results From 551 articles identified, 27 RCTs were included. The use of OFD/PRF statistically significantly reduced PD and improved CAL and RBF when compared to OFD. No clinically significant differences were reported when OFD/BG was compared to OFD/PRF. The addition of PRF to OFD/BG led to significant improvements in CAL and RBF. No differences were reported between any of the following groups (OFD/BM, OFD/PRP, and OFD/EMD) when compared to OFD/PRF. No improvements were also reported when PRF was added to OFD/EMD. The addition of all three of the following biomolecules (metformin, bisphosphonates, and statins) to OFD/PRF led to statistically significant improvements of PD, CAL, and RBF. Conclusions The use of PRF significantly improved clinical outcomes in intrabony defects when compared to OFD alone with similar levels being observed between OFD/BG and OFD/PRF. Future research geared toward better understanding potential ways to enhance the regenerative properties of PRF with various small biomolecules may prove valuable for future clinical applications. Future research investigating PRF at histological level is also needed. Clinical relevance The use of PRF in conjunction with OFD statistically significantly improved PD, CAL, and RBF values, yielding to comparable outcomes to OFD/BG. The combination of PRF with bone grafts or small biomolecules may offer certain clinical advantages, thus warranting further investigations.

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Section: Implications For Clinical Practice and Future Directionmentioning

confidence: 99%

Use of platelet-rich fibrin for the treatment of periodontal intrabony defects: a systematic review and meta-analysis

et al. 2021

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“…Solid platelet-rich fibrin (PRF), which is basically the coagulated plasma-rich fraction of blood upon centrifugation, was introduced as a local therapy to support wound healing and potentially also tissue regeneration in oral indications including treatment of gingival recessions (12), increasing the width of keratinized mucosa around implants (13), to prevent atrophic bone resorption following tooth extraction (14), and to lower the symptoms that come along with inflammation such as pain and swelling upon third molar surgery (15). Support for the beneficial clinical performance of PRF application comes from in vitro studies showing that lysates of PRF membranes are capable of reducing the LPS-induced inflammatory response of macrophages indicated by an M1-to-M2 shift of IL6 and arginase 1 expression, respectively (16,17), and also reduce the formation of osteoclasts in murine bone marrow cultures shown by histochemical staining of TRAP and the reduced expression of the respective gene and cathepsin K (18).…”

Section: Introductionmentioning

confidence: 99%

Liquid PRF Reduces the Inflammatory Response and Osteoclastogenesis in Murine Macrophages

et al. 2021

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Macrophage activation and osteoclastogenesis are hallmarks of inflammatory osteolysis and may be targeted by the local application of liquid platelet-rich fibrin (PRF). Liquid PRF is produced by a hard spin of blood in the absence of clot activators and anticoagulants, thereby generating an upper platelet-poor plasma (PPP) layer, a cell-rich buffy coat layer (BC; termed concentrated-PRF or C-PRF), and the remaining red clot (RC) layer. Heating PPP has been shown to generate an albumin gel (Alb-gel) that when mixed back with C-PRF generates Alb-PRF having extended working properties when implanted in vivo. Evidence has demonstrated that traditional solid PRF holds a potent anti-inflammatory capacity and reduces osteoclastogenesis. Whether liquid PRF is capable of also suppressing an inflammatory response and the formation of osteoclasts remains open. In the present study, RAW 264.7 and primary macrophages were exposed to lipopolysaccharides (LPS), lactoferrin, and agonists of Toll-like receptors (TLR3 and TLR7) in the presence or absence of lysates prepared by freeze-thawing of liquid PPP, BC, Alb-gel, and RC. For osteoclastogenesis, primary macrophages were exposed to receptor activator of nuclear factor kappa B ligand (RANKL), macrophage colony-stimulating factor (M-CSF), and human transforming growth factor-β1 (TGF-β1) in the presence or absence of PPP, BC, Alb-gel, RC lysates and hemoglobin. We show here that it is mainly the lysates prepared from PPP and BC that consistently reduced the agonist-induced expression of interleukin 6 (IL6) and cyclooxygenase-2 (COX2) in macrophages, as determined by RT-PCR and immunoassay. With respect to osteoclastogenesis, lysates from PPP and BC but also from RC, similar to hemoglobin, reduced the expression of osteoclast marker genes tartrate-resistant acid phosphatase (TRAP) and cathepsin K, as well as TRAP histochemical staining. These findings suggest that liquid PRF holds a potent in vitro heat-sensitive anti-inflammatory activity in macrophages that goes along with an inhibition of osteoclastogenesis.

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“…underlined the fact that the use of PRF appeared to improve patient-related outcomes such as postsurgical discomfort and pain. 8 …”

Section: Discussionmentioning

confidence: 99%

Platelet rich fibrin as a gingival tissue regeneration enhancer

Petrescu

Mirica

Miron

et al. 2021

Journal of Dental Sciences

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Tissue regenerative procedures aim to enhance regeneration of altered tissue. Extensive research has been carried out in this area and all proposed procedures present limitations. In this context the area of platelet-rich fibrin (PRF) research has gained tremendous awareness in the latest years. PRF is a low-cost regenerative modality that facilitates soft tissue regeneration derived from 100% autologous sources. It forms a fibrin mesh that liberates growth factors in a slow and prolonged manner and also contains supra-physiological concentrations of leukocytes. Reports from the literature have suggested that these leukocyte-rich blood-preparations are capable of improving wound healing, diminishing post-operative pain, and additionally minimizing the risk of infection. In our article we present the first clinical case where PRF was used as a wound healing accelerator of gingival lesions in a chemical soft tissue burn after teeth whitening.

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Use of platelet-rich fibrin for the treatment of gingival recessions: a systematic review and meta-analysis

Cited by 71 publications

References 59 publications

Use of platelet-rich fibrin for the treatment of periodontal intrabony defects: a systematic review and meta-analysis

Use of platelet-rich fibrin for the treatment of periodontal intrabony defects: a systematic review and meta-analysis

Liquid PRF Reduces the Inflammatory Response and Osteoclastogenesis in Murine Macrophages

Platelet rich fibrin as a gingival tissue regeneration enhancer

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