The adjunctive effect of autologous platelet concentrates on orthodontic tooth movement: A systematic review and meta-analysis of current randomized controlled trials

Abstract

To evaluate the effectiveness of autologous platelet concentrates (APCs) as adjuncts on accelerating orthodontic tooth movement (OTM) of the human subjects undergoing orthodontic treatment and to critically appraise the available literature. Five electronic databases (PubMed, Scopus, Web of Science, Embase, and Cochrane Central Register of Controlled Trials) were searched from 2000 up to May 2021 to retrieve eligible randomized controlled trials (RCTs) investigating patients who underwent orthodontic treatment that involved OTM of maxillary and mandibular incisors and canines. All the enrolled cases were treated with APCs and had no local or systemic interfering factors. The quality of the included studies was assessed using the modified JADAD scale. The effect sizes were assessed using mean difference (MD). The heterogeneity analysis was conducted using (I2) statistic at α=0.10. Finally, seven RCTs were included in the qualitative, and two RCTs were included in the quantitative analysis. The meta-analysis was performed regarding the effect of injectable platelet-rich fibrin (I-PRF) on the rate of canine tooth movement in millimeters at different intervals of the 1st, 2nd, and 3rd months. In the 1st month, I-PRF (WMD:0.12mm, CI95% -5.01 to 5.24, I2=90%) did not significantly affect OTM. In the 2nd month, I-PRF (WMD:0.66mm, CI95% 0.60 to 0.73, I2=10%) significantly increased the OTM. However, in the 3rd month, I-PRF did not significantly increase the OTM (WMD:0.54mm, CI95% -1.38 to 2.47, I2=67%). According to the low certainty of evidence about this topic, providing a definite conclusion is not possible. However, applying I-PRF seems to be efficient in accelerating the OTM of the canines. Further high-quality studies with larger sample sizes will be indispensable to validate this conclusion.