Clinical effect of platelet rich fibrin in the treatment of periodontal intrabony defects. Systematic review and meta-analysis.

Abstract

Background: There is currently no gold standard biomaterial for the treatment of periodontal intrabony defects (PIDs). One of the current options is the use of platelet-rich fibrin (PRF). Objective: To determine the clinical effect of PRF in the treatment of PID through a systematic review and meta-analysis. Materials and Methods: A literature search was conducted up to February 2017 in the following biomedical databases: Pubmed, Embase, Scielo, Science Direct, SIGLE, LILACS and in the Cochrane Central Register of Clinical Trials. The selection criteria included: randomized clinical trials published in the last 5 years, reporting clinical effects (probing depth, clinical insertion level or gingival recession), with a follow-up time equal to or greater than 6 months, and sample size larger than or equal to 10 patients reporting the use of PRF as a treatment for PID. The methodological quality of the studies was analyzed using the Cochrane Handbook of Systematic Reviews of Interventions as a reference. Results: The search strategy yielded 20 articles. A reduction in probing depth and an increase in clinical insertion level or a reduction in gingival recession is reported, when using PRF alone or in combination with another biomaterial or substance that stimulates tissue regeneration. Conclusion: The literature suggests that the use of PRF in the treatment of PIDs has a beneficial clinical effect when compared to control treatments.

Does a combination of platelet‐rich plasma and decalcified freeze‐dried bone allograft offer advantages over decalcified freeze‐dried bone allograft alone when using pocket depth and clinical attachment level as markers for periodontal healing? A literature review

“…In a systematic review involving the adjunctive use of PRP, no significant differences were found between the two study designs . This supports a recent systematic review where a meta‐epidemiological study showed no difference between parallel and split‐mouth designs in continuous and binary data . In contrast, Hou et al stated: “different study designs are not equally effective in assessing the clinical efficacy of PRP”.…”

“…The present review was limited by the methodological detail provided in the published papers; for example, in the paper by Josephi et al, the blinding methods of the participants was unclear. Moreover, a recent systematic review reported that two the of four appraised papers had allocation concealment, whereas the methodology in the respective papers did not demonstrate this. If the information in the systematic review, which was not indexed in the CENTRAL database, was incorrect, the authors approached each researcher to further discuss their methodology.…”

Effectiveness of the use of platelet-rich fibrin associated with open flap debridement compared to open flap debridement alone for the treatment of periodontal intrabony defects: Overview of systematic reviews

“…Periodontitis is a chronic infectious disease that causes damage to periodontal tissues. [ 1 ] One of its consequences is alveolar bone resorption, which generates horizontal or vertical bone defects and supra- or intrabony defects, causing mobility and tooth loss. [ 2 ]…”

“…Several current clinical trials and systematic reviews that compare OFD plus PRF with OFD alone have indicated benefits for clinical attachment level (CAL) gain, decreased probing depth (PD), reduction, or filling of the bony defect. [ 1 , 2 , 8 - 10 , 13 - 18 ] However, this evidence is still unclear since the fast scientific progress in periodontics on regenerative treatments have led to different conclusions on the most effective treatment for patients with intrabony defects. Likewise, many periodontic specialists continue to use periodontal regenerative treatments with different biodegradable materials of synthetic and animal origin, not considering that these biomaterials have a higher risk of infection, hypersensitivity reactions, and poor biomechanical properties.…”

“…[ 2 , 6 , 9 ] However, Arbildo et al ., in 2017, and Chen et al , in 2021, mention that it is difficult to reach conclusions for this intervention due to factors such as high heterogeneity of randomized clinical trials (RCTs) and low certainty of the evidence. [ 1 , 2 ]…”