Platelet-Rich Fibrin as a New Approach in Treating Gingival Recession: Systematic Review and Meta-Analysis

Abstract

The purpose was to systematically review the effect of platelet rich fibrin (PRF) in the treatment of Miller class I and II recession defects in comparison to conventional surgical procedures. Three electronic databases were searched, and hand search was performed for relevant articles, up to October 2015. All relevant articles were independently screened to specific inclusion criteria. Primary outcomes were Recession Depth (RD), Keratinized Tissue Width (KTW), and Percentage of Root Coverage (%RC). Secondary outcomes were Clinical Attachment Level (CAL), Probing Depth (PD), Healing Index (HI), and Pain. Ten randomized clinical trials met the inclusion criteria and seven were included in the meta-analysis. No statistically significant difference was found in %RC between Coronally Advanced Flap (CAF) and CAF + PRF or between CAF + Connective Tissue Graft (CAF + CTG) and CAF + PRF (p = 0.17 and p = 0.56) respectively. A borderline statistical difference was observed between CAF and CAF + PRF (p = 0.05), and no statistically significance difference between CAF + CTG and CAF + PRF (p = 0.23) in KTW. In regards to pain and healing, a significant reduction in pain during the first 5-7 days and faster healing observed in the PRF intervention when compared to the use of CTG or Enamel Matrix Derivative (EMD). In conclusion, there was no statistical or clinical difference present between PRF and CAF, CAF + CTG, or CAF + EMD for RD, %RC and KTW when treating Miller class I and II gingival recession. Significant improvement of postoperative pain and healing can be achieved, which may indicate PRF use as an alternative to conventional surgical approaches.