Regenerative potential of leucocyte‐ and platelet‐rich fibrin. Part A: intra‐bony defects, furcation defects and periodontal plastic surgery. A systematic review and meta‐analysis

Abstract

AimTo analyse the regenerative potential of leucocyte‐ and platelet‐rich fibrin (L‐PRF) during periodontal surgery.Materials and MethodsAn electronic and hand search were conducted in three databases. Only randomized clinical trials were selected and no follow‐up limitation was applied. Pocket depth (PD), clinical attachment level (CAL), bone fill, keratinized tissue width (KTW), recession reduction and root coverage (%) were considered as outcome. When possible, meta‐analysis was performed.ResultsTwenty‐four articles fulfilled the inclusion and exclusion criteria. Three subgroups were created: intra‐bony defects (IBDs), furcation defects and periodontal plastic surgery. Meta‐analysis was performed in all the subgroups. Significant PD reduction (1.1 ± 0.5 mm, p < 0.001), CAL gain (1.2 ± 0.6 mm, p < 0.001) and bone fill (1.7 ± 0.7 mm, p < 0.001) were found when comparing L‐PRF to open flap debridement (OFD) in IBDs. For furcation defects, significant PD reduction (1.9 ± 1.5 mm, p = 0.01), CAL gain (1.3 ± 0.4 mm, p < 0.001) and bone fill (1.5 ± 0.3 mm, p < 0.001) were reported when comparing L‐PRF to OFD. When L‐PRF was compared to a connective tissue graft, similar outcomes were recorded for PD reduction (0.2 ± 0.3 mm, p > 0.05), CAL gain (0.2 ± 0.5 mm, p > 0.05), KTW (0.3 ± 0.4 mm, p > 0.05) and recession reduction (0.2 ± 0.3 mm, p > 0.05).ConclusionsL‐PRF enhances periodontal wound healing.

Leucocyte‐ and platelet‐rich fibrin block for bone augmentation procedure: A proof‐of‐concept study

“…The use of a second‐generation platelet concentrate, leucocyte‐ and platelet‐rich fibrin (L‐PRF), to create a graft with high concentration of growth factors, platelets and leucocytes may enhance the development of mature lamellar bone. The clinical capacities and properties of L‐PRF have already been reported in two recent systematic reviews (Castro et al., ,b). However, its benefit in GBR has remained unclear.…”

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

“…At the same time, Castro et al. provided systematic reviews on alveolar ridge preservation, sinus floor elevation and implant therapy (Castro et al., 2017b) as well as intrabony defects, furcation defects, and periodontal plastic surgery (Castro et al., 2017a). Also, systematic reviews on mandibular third molar extractions (Al‐Hamed, Tawfik, Abdelfadil, & Al‐Saleh, 2017; Canellas, Ritto, & Medeiros, 2017) and gingival recessions (Moraschini & Barboza Edos, 2016) became available.…”

Revisión Bibliográfica

“…Gran parte de los estudios analizados en la presente revisión presentan como grupo control pacientes tratados únicamente mediante CPA, en los que se encontró una diferencia significativa en la reducción de la PS, la ganancia del NIC, la disminución de la profundidad y el porcentaje de relleno del DIO, en favor de L-PRF (9,(19)(20)(21)(22)(23)(24)(25) . Dichos resultados determinan una diferencia clínica relevante, lo que coincide con lo concluido en las 3 revisiones sistemáticas publicadas hasta la fecha (9)(10)(11) . Al comparar el tratamiento de los defectos intra-óseos mediante CPA vs. EMD o RTG, estos últimos muestran mejores resultados en la ganancia del NIC.…”

“…Estas diferencias fueron de 2,33mm, 0,95mm y 1,1mm respectivamente (9) . Panda y col. (2016) también observaron un beneficio en la ganancia del NIC, con una diferencia de 1,4 mm a favor de L-PRF vs. CPA, (10) así como Castro y col. (2017) encontraron resultados semejantes a los hallados por Shah y col. (2014) para la reducción de la PS y la ganancia del NIC aunque asociado a una reducción del DIO de 1,65mm (11) . La vasta información sobre el uso del L-PRF puede conducir a la falta de criterios de calidad objetivos que ayuden al clínico general o especialista en la toma de decisiones clínicas.…”