Synergistic Application of Platelet-Rich Fibrin and 1% Alendronate in Periodontal Bone Regeneration: A Meta-Analysis

Abstract

Periodontal bone regeneration relies on coupled and cooperative bone formation and resorption. Accordingly a novel strategy on concurrent use of platelet-rich fibrin (PRF) (anabolic agent) and 1% alendronate (ALN) (anticatabolic agent) was proposed recently in regenerative periodontal treatment. It was supposed to enhance bone formation and reduce bone resorption simultaneously. However, there is a lack of evidence-based studies to answer whether this concurrent application was superior to single application until now. Besides, concerns on ALN lead to some reservation on this synergistic way. ALN may impair new bone formation and necrotize jaws. Thus, in order to compare the clinical efficacy between PRF plus 1%ALN and PRF alone on periodontal bone regeneration, we performed present systematic review and meta-analysis. Because it is the prerequisite for measuring the combined efficacy of PRF plus 1%ALN, firstly we evaluated the effectiveness of 1%ALN. Our data indicated that adjunctive 1%ALN was effective in promoting periodontal bone repair. Further, PRF plus 1%ALN showed a greater capacity for periodontal regeneration than PRF alone with statistical significance. The findings of this study revealed the promising prospects on synergistic application of bone anabolic agents (PRF) and antiresorption medications (1%ALN) in regenerative periodontal treatment.

Use of Platelet-Rich Fibrin in the Treatment of Periodontal Intrabony Defects: A Systematic Review and Meta-Analysis

“…It was indicated that OFD+PRF is more effective than OFD alone, which is in accordance with our results. A meta-analysis [38] showed that OFD +1% alendronate+PRF was even better than OFD+PRF. However, GML and BF% changes were not assessed in the study of Castro et al Interestingly, our study revealed that PRF has certain benefits for GML gain in both OFD and .53] Total (95% Cl) Heterogeneity: tau 2 = 0.01; chi 2 = 119.59, df = 9 (P < 0.00001); I 2 = 92% Test for overall effect: Z = 8.13 (P < 0.00001) GML -1 -0.5 Favors OFD Favours OFD+PRF 0 0.5 1 Figure 4: Forest plots for PD reduction, CAL gain, and GML gain in the group OFD+PRF vs. OFD alone.…”

“…In the quantitative analysis of the effect of PRF on periodontal surgery, the heterogeneity among the studies was as high as the meta-analysis of Castro et al [17], Tarallo et al [39], Panda et al [42], Li et al [38], and Li et al [41]. Heterogeneity may come from different clinical research methodology and implementation processes.…”

Effects of alendronate in bone repair: A study in rat femur fractures treated with plates and screws

“…This study did not analyze blood biochemistry, which is an important indicator of possible future systemic complications. Li, F et al and Srisubut et al had also studied the effects of local delivery of ALN and suggest that the drug have increased bone formation (29,30). Wang, YH et al linked PLGA (lactic-coglycolic acid) to ALN for slow and local application and found an excellent graft potential (31).…”

Comparative analysis of platelet.rich fibrin, platelet-rich fibrin with hydroxyapatite and platelet-rich fibrin with alendronate in bone regeneration: A cone-beam computed tomography analysis

“…The promising results of the periodontal studies promoted us to use it for enhancing healing in PA bone defects. [ 23 24 ] Reddy et al . and Gupta et al .…”