Effects of leukocyte–platelet-rich fibrin (L-PRF) in different intraoral bone grafting procedures: a systematic review

Dragonas, Panagiotis; Katsaros, Theodoros; Ávila‐Ortiz, Gustavo; Schiavo, Julie; Palaiologou, Archontia

doi:10.1016/j.ijom.2018.06.003

Cited by 58 publications

(68 citation statements)

References 45 publications

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“…Our results are consistent with other previous systematic reviews [40,[78][79][80] and, to our knowledge, this is the second systematic review to provide pooled analyses. The previous systematic review [40] included five RCTs, so we broadened the search and included 12 studies, from which nine were RCTs.…”

Section: Summary Of Evidencesupporting

confidence: 93%

Platelet-Rich Plasma in Maxillary Sinus Augmentation: Systematic Review

et al. 2020

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Background: Sinus augmentation can be performed with or without grafting biomaterials, and to date, there is no quality evidence regarding the augmentation of the sinus floor using only platelet concentrates, which can improve the healing period and enhance bone regeneration by stimulating angiogenesis and bone formation. The main objective of this paper was to assess the effect of the sole use of platelet concentrates in sinus augmentation in terms of newly formed bone, augmented bone height, and clinical outcomes and to assess the additional beneficial effects of platelet-rich fibrin (PRF) in combination with other grafting biomaterials. Methods: A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Pooled analyses were performed with the Review Manager software. Results: For sinus elevation only using platelet concentrates, 11 studies met the inclusion criteria and were included for qualitative synthesis. Only one study was a clinical trial, which reported improved outcomes for the allograft group compared to the titanium-PRF (T-PRF) group. A total of 12 studies where PRF was used in addition to grafting biomaterials met eligibility criteria and were included in the review. Results from meta-analyses provided no additional beneficial effects of PRF in sinus augmentation in terms of bone height and percentage of soft tissue area. There was a statistically significant lower percentage of residual bone substitute material in the PRF (+) group compared to the PRF (−) group. The percentage of newly formed bone was slightly higher in the PRF (+) group, but this was not statistically significant. Conclusion: There is no robust evidence to make firm conclusions regarding the beneficial effects of the sole use of platelet concentrates in sinus augmentation. However, studies have shown favorable outcomes regarding implant survival, bone gain, and bone height. The use of PRF with other grafting biomaterials appears to provide no additional beneficial effects in sinus lift procedures, but they may improve the healing period and bone formation. Well-conducted randomized clinical trials (RCTs) are necessary to confirm the available results to provide recommendations for the clinical practice.

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Section: Summary Of Evidencesupporting

confidence: 93%

Platelet-Rich Plasma in Maxillary Sinus Augmentation: Systematic Review

et al. 2020

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“…In a recent systematic review, there was limited evidence on the effects of Lykocite Platelet Rich Fibrin (L-PRF) in intraoral bone grafting procedures [55]. They concluded the need for further studies with special emphasis on the standardized surgical procedures [55]. Therefore, and supported by this study, a proper soft tissue healing is boosted using (A®-) PRF®.…”

Section: Discussionmentioning

confidence: 65%

“…The success of PRF may be due to the role of fibrin in initial clot stabilization [22]. PRF as a biodegradable scaffold consisting of stem cells, fibrin, platelets and leucocytes boosts microvascularization and epithelial cell migration [55,56]. This may prevent mesh exposure by using it to cover meshes as applied in this study.…”

Section: Discussionmentioning

confidence: 94%

“…This may prevent mesh exposure by using it to cover meshes as applied in this study. In a recent systematic review, there was limited evidence on the effects of Lykocite Platelet Rich Fibrin (L-PRF) in intraoral bone grafting procedures [55]. They concluded the need for further studies with special emphasis on the standardized surgical procedures [55].…”

Section: Discussionmentioning

confidence: 99%

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Minimizing risk of customized titanium mesh exposures – a retrospective analysis

Hartmann

Seiler

2020

BMC Oral Health

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Background: Recommendations for soft tissue management associated with customized bone regeneration should be developed. The aim of this study was to evaluate a new protocol for customized bone augmentation in a digital workflow. Methods: The investigators implemented a treatment of three-dimensional bone defects based on a customized titanium mesh (Yxoss CBR®, ReOSS, Filderstadt, Germany). Patients and augmentation sites were retrospectively analysed focussing on defect regions, demographic factors, healing difficulties and potential risk factors. An exposure rate was investigated concerning surgical splint application, A®-PRF and flap design. Results: In total, 98 implants could be placed. Yxoss CBR® was removed after mean time of 6.53 ± 2.7 months. Flap design was performed as full flap preparation (27.9%), full flap and periosteal incision (39.7%), periosteal incision (1.5%), poncho/split flap (27.9%) and rotation flap (2.9%). In 25% of the cases, exposures of the meshes were documented. Within this exposure rate, most of them were slight and only punctual (A = 16.2%), like one tooth width (B = 1.5%) and complete (C = 7.4%). A®-PRF provided significantly less exposures of the titanium meshes (76.5% no exposure vs. 23.5% yes, p = 0.029). Other parameters like tobacco abuse (p = 0.669), diabetes (p = 0.568) or surgical parameters (mesh size, defect region, flap design) did not influence the exposure rate. Surgical splints were not evaluated to reduce the exposure rate (p = 0.239). Gender (female) was significantly associated with less exposure rate (78,4% female vs. 21.6% male, p = 0.043). Conclusions: The results of this study suggest that the new digital protocol including patient-specific titanium meshes, resorbable membranes and bone grafting materials was proven to be a promising technique. To improve soft tissue healing, especially A®-PRF should be recommended.

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“…inflammation, healing and platelet cytokines during matrix remodeling [2][3][4][5]. It also has an osteinductive propriety that is able to stimulate cell migration and proliferation, such as osteoblast, fibroblasts and dental pulp cell which result in an improving healing and regeneration [6].…”

mentioning

confidence: 99%

L-PRF Associated With Bio-Oss® As an Optional Treatment for Radicular Cyst: Case Report

Araujo¹,

M²

2020

Res Rep Oral Maxillofac Surg

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In order to regenerate bone and soft tissue, multiples types of treatment were developed including the use of bone grafting, membranes and growth factor/cytokines/host modulating agent. Leukocyte-platelet-rich fibrin (L-PRF) is a second-generation platelet concentrate that forms a natural fibrin matrix with immune regulation node and inflammation retrocontrol proprieties, which can be useful in healing of apical defects. In the present case, bovine bone substitute graft was associated with L-PRF clot to achieve bone and soft tissue regeneration in a periapical inflammatory lesion. The case developed with a satisfactory bone healing, which suggests that the association of L-PRF and bone grafts may affect positively in the regeneration of bone in wide circumferential apical defects.

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Effects of leukocyte–platelet-rich fibrin (L-PRF) in different intraoral bone grafting procedures: a systematic review

Cited by 58 publications

References 45 publications

Platelet-Rich Plasma in Maxillary Sinus Augmentation: Systematic Review

Platelet-Rich Plasma in Maxillary Sinus Augmentation: Systematic Review

Minimizing risk of customized titanium mesh exposures – a retrospective analysis

L-PRF Associated With Bio-Oss® As an Optional Treatment for Radicular Cyst: Case Report

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