Clinical research on the bone graft and the use of plasma-rich fibrin: a concise systematic review

Abstract

Introduction: Bone augmentation techniques have been increasingly indicated to recreate adequate bone height and volume for dental implant sites. Maxillary sinus augmentation can be performed with or without graft biomaterials. In this sense, fibrin-rich plasma (PRF) stands out, which is a three-dimensional (3-D) autogenous biomaterial. Objective: It was carried out a systematic review of the literature on the main considerations and clinical findings of bone grafting and fibrin-rich plasma in oral and maxillofacial surgery. Methods: The present study followed a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: The total of 256 articles were found. A total of 64 articles were fully evaluated and 28 were included in this study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 134 studies that were excluded with a high risk of bias (studies with small sample size). Also, 38 studies were excluded because they did not meet the GRADE. The application of autologous platelet-rich plasma provides benefits in promoting soft tissue healing and bone regeneration in different surgical procedures, as well as being favorable for bone formation processes for dental implants, especially when combined with xenografts. In addition, it is an autologous, low-cost biomaterial that does not require the administration of additives. However, further studies with larger sample sizes and longer follow-up times are needed to provide more substantial evidence of the efficacy of platelet-rich plasma in promoting soft and hard tissue healing.