Efficacy of Platelet-Rich Fibrin After Mandibular Third Molar Extraction: A Systematic Review and Meta-Analysis

Al-Hamed, Faez Saleh; Tawfik, Mohamed A.; Abdelfadil, Ehab; Al-Saleh, M. A.

doi:10.1016/j.joms.2017.01.022

Cited by 73 publications

(61 citation statements)

References 32 publications

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“…Nevertheless, it has to be taken into account that both studies did not state whether the patients were adequately blinded. There are numerous studies assessing PRF effect on pain with mandibular third molar extraction (Al‐Hamed et al., 2017). However, only few studies used a blinded protocol (Afat, Akdogan, & Gonul, 2017; Ozgul et al., 2015).…”

Section: Discussionmentioning

confidence: 99%

The use of platelet‐rich fibrin to enhance the outcomes of implant therapy: A systematic review

Strauß

Stähli

Gruber

2018

Clinical Oral Implants Res

103

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ObjectiveTo assess the impact of platelet‐rich fibrin (PRF) on implant dentistry. The primary focused question was as follows: What are the clinical, histological, and radiographic outcomes of PRF administration for bone regeneration and implant therapy?MethodA systematic literature search comprised three databases: MEDLINE, EMBASE, and Cochrane followed by a hand search of relevant scientific journals. Human studies using PRF for bone regeneration and implant therapy were considered and articles published up to December 31, 2017 were included. Eligible studies were selected based on the inclusion criteria. Randomized controlled trials (RCT) and controlled clinical trials (CCT) were included.ResultsIn total, 5,963 titles were identified with the search terms and by hand search. A total of 12 randomized controlled trials (RCT) met the inclusion criteria and were chosen for data extraction. Included studies focused on alveolar ridge preservation after tooth extraction, osseointegration process, soft tissue management, bone augmentation, bone regeneration after sinus floor elevation and surgical peri‐implantitis treatment. Overall, the risk of bias was moderate or unclear. Nine studies showed superior outcomes for PRF for any of the evaluated variables, such as ridge dimension, bone regeneration, osseointegration process, soft tissue healing. Three studies failed to show any beneficial effects of PRF. No meta‐analysis could be performed due to the heterogeneity of study designs.ConclusionsThere is moderate evidence supporting the clinical benefit of PRF on ridge preservation and in the early phase of osseointegration. It remains unclear whether PRF can reduce pain and improve soft tissue healing. More research support is necessary to comment on the role of PRF to improve other implant therapy outcomes.

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Section: Discussionmentioning

confidence: 99%

The use of platelet‐rich fibrin to enhance the outcomes of implant therapy: A systematic review

Strauß

Stähli

Gruber

2018

Clinical Oral Implants Res

103

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“…The literature showed that PLGA can be used in a number of roles through creative manufacturing and applications. As per the additive regenerative material, L‐PRF membrane have reported efficacy in a wide variety of procedures requiring bone augmentation, including sinus floor augmentation, ridge preservation, and implant therapy (Castro et al, ; Gassling et al, ; Kumar & Shubhashini, ; Temmerman et al, ; Toffler, Holtzclaw, Del Corso, & Ehrenfest, ), with the fibrin network indicating efficacy in regeneration of bone in both in vitro and in situ studies (Al‐Hamed, Tawfik, Abdelfadil, & Al‐Saleh, ; Del Corso, Mazor, Rutkowski, & Dohan Ehrenfest, ; Kumar & Shubhashini, ; Verma, Yadav, Dixit, & Gupta, ), although no efforts have so far been directed toward studying the use of the exudate itself. Analysis of the exudate has revealed that it contains glycoproteins that favor cell adhesion, thereby offering potential to favor the cellular trafficking functions (osteoconduction) crucial to bone regeneration.…”

Section: Discussionmentioning

confidence: 99%

The effect of platelet‐rich fibrin exudate addition to porous poly(lactic‐co‐glycolic acid) scaffold in bone healing: An in vivo study

et al. 2019

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Bone grafting procedures have been widely utilized as the current state‐of‐the‐art for bone regeneration, with autogenous bone graft being the gold‐standard bone reconstructive option. However, the use of autografts may be limited by secondary donor‐site comorbidities, a finite amount of donor supply, increased operating time, and healthcare cost impact. Synthetic materials, or alloplasts, such as the polymeric material, poly(lactic‐co‐glycolic acid) (PLGA) has previously been utilized as a transient scaffold to support healing of bone defects with the potential to locally delivery osteogenic additives. In this study a novel procedure was adopted to incorporate both the dissolved contents and mechanical components of leukocyte‐ and platelet‐rich fibrin (L‐PRF) into an PLGA scaffold through a two‐step method: (a) extraction of the L‐PRF membrane transudate with subsequent immersion of the PLGA scaffold in transudate followed by (b) delivering a fibrin gel as a low‐viscosity component that subsequently polymerizes into a highly viscous, gel‐like biological material within the pores of the PLGA scaffold. Two, ~0.40 cm3, submandibular defects (n = 24) were created per side using rotary instrumentation under continuous irrigation in six sheep. Each site received a PLGA scaffold (Intra‐Lock R&D, Boca Raton, FL), with one positive control (without L‐PRF exudate addition [nL‐PRF]), and one experimental (augmented with PLGA/L‐PRF Blocks [L‐PRF]). Animals were euthanized 6 weeks postoperatively and mandibles retrieved, en bloc, for histological analysis. Histomorphometric evaluation for bone regeneration was evaluated as bone area fraction occupancy (BAFO) within the region of interest of the cortical bone (with specific image analysis software) and data presented as mean values with the corresponding 95% confidence interval values. Qualitative evaluation of nondecalcified histologic sections revealed extensive bone formation for both groups, with substantially more bone regeneration for the L‐PRF induced group relative nL‐PRF group. Quantitative BAFO within the defect as function of the effect of L‐PRF exudate on bone regeneration, demonstrated significantly (p = .018) higher values for the L‐PRF group (38.26% ± 8.5%) relative to the nL‐PRF group (~28% ± 4.0%). This in vivo study indicated that L‐PRF exudate has an impact on the regeneration of bone when incorporated with the PLGA scaffold in a large translational model. Further studies are warranted in order to evaluate the L‐PRF exudate added, as well as exploring the preparation methods, in order to facilitate bone regeneration.

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“…The increasing interest in understanding the effects of platelet concentrate application on bone tissue is reflected in the number of recent studies that have examined this topic (Al‐Hamed et al, ; Canellas et al, ; Cortese et al, ; Isobe et al, ; Panda et al, ). Although there have been studies that have used models of bone lesions in animals to clarify the effects of these platelet concentrates at different levels (Acar et al, ; Bölükbaşı, Yeniyolm, Tekkesinm, & Altunatmaz, ; Du et al, ; Ocak et al, ), there are also clinical studies that focus on radiological (Cortese et al, ; Park et al, ) and tomographic analyses (Lim et al, ; Montanari, Callea, Yavuz, & Maglione, ; Öncü & Kaymaz, ) and its use in clinical settings (Barone et al, ; Panda et al, ; Sezgin, Uraz, Taner, & Çulhaoğlu, ), all of which seek to evaluate the effects of this therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies that used different types of analysis reinforced the controversy surrounding the positive effects of PRF on the preservation of alveolar bone. The qualitative data and the meta‐analysis of systematic review did not reveal a significant improvement in the recovery of postextracting alveoli with PRF compared to normal recovery (Al‐Hamed et al, ). PRF was unable to enhance some clinical parameter values such as improvements to the gingival index, probing depth, clinical attachment level, vertical bone loss, depth of intrabony defect, and angular defect widening in inorganic bovine bone mineral (Sezgin et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…PRF is a second‐generation platelet concentrate developed by Choukroun et al () in France. This biomaterial is autologous in clinical applications (Canellas, Ritto, & Medeiros, ; Du et al, ; Öncü & Kaymaz, ) and is produced from immediate blood centrifugation without the addition of an anticoagulant or gelling agent (Al‐Hamed, Tawfik, Abdelfadil, & Al‐Saleh, ; Canellas et al, ; Isobe et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Platelet‐rich fibrin and collagen membrane in the preservation of the alveolar bone: Feasibility of the elemental inorganic composition and scanning electron microscopy analysis

Días

Arias

Borie

et al. 2019

Microscopy Res & Technique

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The success of dental implants is related to the amount, quality, and composition of the alveolar bone. The placement of platelet-rich fibrin (PRF) clot associated with a resorbable collagen membrane (RCM) in a postextraction alveolus is a technique used for ridge preservation. This case report study analyzed the ultrastructural characteristics of cross-sectioned alveolar bone that received PRF and RCM using scanning electron microscopy and the inorganic composition using "energy dispersive X-ray spectrometry," in order to explore the feasibility of this method to clinical studies.Three alveolar bone samples from two male patients (37 and 58 years old), obtained in the procedure of placing the dental implant, were analyzed. Two bone samples previously received PRF and RCM (M37 and M58), the third sample represented a physiological bone formation without treatment (M37-control). The bone sample M37 showed irregularly shaped islets of calcified material intermingled with connective tissue. The other samples, from the 58-year-old patient with PRF and RCM (M58); and the other untreated bone sample from the same 37-year-old patient (M37-control) showed similar ultrastructural morphology with trabecular conformation without islets agglomerations. The inorganic composition analysis showed higher concentrations of calcium and phosphorus in both samples treated with PRF and RCM in comparison to the untreated bone sample. The Ca/P ratio was higher in the M37 sample compared to the others samples. The results showed morphology and inorganic composition differences among the treatments used, suggesting that this method is feasible to analyze parameters of the alveolar bone tissue.

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Efficacy of Platelet-Rich Fibrin After Mandibular Third Molar Extraction: A Systematic Review and Meta-Analysis

Cited by 73 publications

References 32 publications

The use of platelet‐rich fibrin to enhance the outcomes of implant therapy: A systematic review

The use of platelet‐rich fibrin to enhance the outcomes of implant therapy: A systematic review

The effect of platelet‐rich fibrin exudate addition to porous poly(lactic‐co‐glycolic acid) scaffold in bone healing: An in vivo study

Platelet‐rich fibrin and collagen membrane in the preservation of the alveolar bone: Feasibility of the elemental inorganic composition and scanning electron microscopy analysis

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