The Adjunctive Use of Leucocyte- and Platelet-Rich Fibrin in Periodontal Endosseous and Furcation Defects: A Systematic Review and Meta-Analysis

Abstract

The aim of this systematic review of randomized controlled trials was to evaluate the adjunctive use of leucocyte- and platelet-rich fibrin (L-PRF) in periodontal endosseous and furcation defects, as compared without L-PRF. The endosseous defect group was subclassified into: L-PRF/open flap debridement (L-PRF/OFD) versus OFD, L-PRF/osseous graft (L-PRF/OG) versus OG, L-PRF/Emdogain (L-PRF/EMD) versus EMD, and L-PRF/guided tissue regeneration (L-PRF/GTR) versus GTR. The furcation defect group was subclassified into L-PRF/OFD versus OFD, and L-PRF/OG versus OG. Mean difference, 95% confidence intervals and forest plots were calculated for probing pocket depth (PPD), clinical attachment level (CAL) and radiographic defect depth (DD). Nineteen studies concerning systemically healthy non-smokers were included. The results of this systematic review and meta-analysis showed in two- and/or three-wall endosseous defects that the adjunctive use of L-PRF to OFD or OG was significantly beneficial for PPD reduction, CAL gain and DD reduction, as compared without L-PRF. Furthermore, the data showed that for two- and/or three-wall endosseous defects, the adjunctive use of L-PRF to GTR was significantly beneficial for CAL and DD improvement, whereas adding L-PRF to EMD had no significant effect, and that for class II furcation defects, the addition of L-PRF to OFD was significantly beneficial for PPD, CAL and DD improvement, whereas the addition of L-PRF to OG was significantly clinically beneficial. In conclusion, this systematic review and meta-analysis found that there was significant clinical and radiographic additive effectiveness of L-PRF to OFD and to OG in two- and/or three-wall periodontal endosseous defects of systemically healthy non-smokers, as compared without L-PRF.

Clinical benefits of autologous platelet concentrate in periodontal intrabony defects: A network meta‐analysis of randomized controlled trials

“…Recently, new forms of platelet‐rich fibrin have been devised. Under the low‐speed centrifugation concept, platelet‐rich fibrin can be obtained as advanced platelet‐rich fibrin, injectable platelet‐rich fibrin, and liquid platelet‐rich fibrin [109]. Considered an important innovation, advanced platelet‐rich fibrin has more cells and is characterized by sustained cell content release, which has been confirmed by in vitro studies [92].…”

Application of Fibrin Associated with Photobiomodulation as a Promising Strategy to Improve Regeneration in Tissue Engineering: A Systematic Review

“…The three-dimensional structure of fibrin allows for a series of cellular interactions and provides a temporary matrix in which cells can proliferate, organize, and perform their functions, especially at injured or inflamed sites. Thus, fibrin has been used with the aim of accelerating healing and regeneration in several surgical procedures, especially in medicine in the areas of orthopedics [ 5 , 6 ], neurology [ 7 , 8 , 9 ], and plastic surgery [ 10 , 11 ], as well as in dentistry in the areas of periodontics [ 12 , 13 ], implantology [ 14 , 15 ], and oral and maxillofacial surgery [ 16 , 17 ].…”