Autologous Platelet Concentrates in Treatment of Furcation Defects—A Systematic Review and Meta-Analysis

Abstract

Background: The aim of this review was to evaluate the adjunctive effect of autologous platelet concentrates (APCs) for the treatment of furcation defects, in terms of scientific quality of the clinical trials and regeneration parameters assessment. Methods: A systematic search was carried out in the electronic databases MEDLINE, SCOPUS, CENTRAL (Cochrane Central Register of Controlled Trials), and EMBASE, together with hand searching of relevant journals. Two independent reviewers screened the articles yielded in the initial search and retrieved the full-text version of potentially eligible studies. Relevant data and outcomes were extracted from the included studies. Risk of bias assessment was also carried out. The outcome variables, relative to baseline and post-operative defect characteristics (probing pocket depth (PPD), horizontal and vertical clinical attachment loss (HCAL, VCAL), horizontal and vertical furcation depth (HFD, VFD) were considered for meta-analysis. Results: Ten randomized trials were included in this review. Only one study was judged at high risk of bias, while seven had a low risk, testifying to the good level of the evidence of this review. The meta-analysis showed a favorable effect regarding all outcome variables, for APCs used in adjunct to open flap debridement (p < 0.001). Regarding APCs in adjunct to bone grafting, a significant advantage was found only for HCAL (p < 0.001, mean difference 0.74, 95% CI 0.54, 0.94). The sub-group analysis showed that both platelet-rich fibrin and platelet-rich plasma in adjunct with open flap debridement, yielded significantly favorable results. No meta-analysis was performed for APCs in combination with guided tissue regeneration (GTR) as only one study was found. Conclusion: For the treatment of furcation defects APCs may be beneficial as an adjunct to open flap debridement alone and bone grafting, while limited evidence of an effect of APCs when used in combination with GTR was found.

Effectiveness of Autologous Platelet Concentrates in Management of Young Immature Necrotic Permanent Teeth—A Systematic Review and Meta-Analysis

“…However, scientific data regarding the potential benefits of using APCs in regenerative therapies remains inconsistent. Some studies stated that both PRP and PRF positively affect only early healing of hard and soft tissues, with and without significant beneficial effect on final therapeutic outcomes [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. It was also reported that the use of platelet concentrates may positively affect postoperative inflammation and pain reduction [ 23 , 24 ].…”

Use of Platelet-Rich Fibrin in the Treatment of Grade 2 Furcation Defects: Systematic Review and Meta-Analysis

“…Based on these considerations, interest in the use of platelet concentrates (PCs) for the treatment of many intraoral clinical conditions, including periodontal and furcation defects, is rising [ 15 ]. The rationale behind the preparation of platelet concentrates is that concentrated platelets and autologous growth factors could be collected from a whole blood sample through centrifugation and used in a surgical site to promote local healing [ 16 , 17 , 18 ].…”

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

“…Overall, a significant improvement in GT, CAL and RD was found when treated with CAF + L-PRF. This result can be attributed to the additive regenerative potential of L-PRF [ 39 , 40 ]. L-PRF has a positive influence on cell proliferation, migration, adhesion, differentiation and inflammation, which proves its therapeutic potential in regenerative approaches [ 41 ].…”