Abstract
Background Platelet-rich fibrin (PRF) is a kind of autologous platelet concentrate which is easy to obtain and cheap. In recent years, it has been studied to improve the effect of periodontal regeneration. However, few studies have systematically evaluated the complementary effect of PRF in the treatment of intrabony defects. The present review is aimed at systematically assessing the effects of PRF on clinical and radiological outcomes of the surgical treatment of periodontal intrabony defects. Methods The protocol was registered at PROSPERO (International Prospective Register of Systematic Reviews) as CRD42020206056. An electronic search was conducted in MEDLINE, Cochrane, and EMBASE databases. Only randomized clinical trials were selected. Systematically healthy patients with two or three walls of intrabony defects were considered. Intrabony defect (IBD) depth reduction and bone fill (BF) % were set as primary outcomes while probing depth (PD) reduction, clinical attachment level (CAL) gain, and gingival margin level (GML) gain were considered as the secondary outcome. When possible, a meta-analysis was performed. Results Eighteen articles fulfilled the inclusion criteria, and seventeen studies were quantitatively analyzed. Of 17 studies, four were rated as high risk of bias and thirteen as the moderate risk of bias. Two comparisons were set: (1) open flap debridement (OFD) combined with PRF and OFD alone and (2) bone grafting (BG) combined with PRF and BG alone. Compared to OFD alone, OFD+PRF showed significantly greater in all primary and secondary outcomes. Compared to BG alone, BG+PRF showed significantly greater in IBD depth reduction, PD reduction, CAL gain, and GML gain. Conclusions The use of PRF was significantly effective in the treatment of periodontal intrabony defects. The benefit of OFD+PRF may be greater than BG+PRF. PRF can promote early wound healing in periodontal surgery. As all included studies were not at low risk of bias, well-designed RCTs having a high methodological quality are needed to clarify the additional effectiveness of PRF in the treatment of intrabony defects in the future.
Highlights
Periodontitis is defined as a chronic inflammatory disease caused by periodontopathic bacteria and is characterized by inflammation and the progressive destruction of toothsupporting tissues [1], which is the major cause of tooth loss in adults
The results of this meta-analysis revealed that open flap debridement (OFD) combined with Platelet-rich fibrin (PRF) is more effective than OFD procedures alone, radiographically in Intrabony defect (IBD) depth reduction by 1.81 mm (95%confidence interval (CI) = 1:53, 2.08) and vertical bone fill% by 39.56% (95%CI = 36:73, 42.38), as well as clinically in probing depth (PD) reduction by 0.52 mm (95%CI = 0:21, 0.82), clinical attachment level (CAL) gain by 1.25 mm (95%CI = 0:93, 1.57), and gingival margin level (GML) gain by 0.42 mm (95%CI = 0:32, 0.53)
bone grafting (BG) combined with PRF found to be more effective than BG procedure alone radiographically in IBD depth reduction by 0.92 mm (95%CI = 0:66, 1.18), as well as clinically in PD reduction by 0.52 mm (95%CI = 0:21, 0.82), CAL gain by 1.09 mm (95%CI = 0:77, 1.41), and GML gain by 0.69 mm (95%CI = 0:31, 1.06)
Summary
Periodontitis is defined as a chronic inflammatory disease caused by periodontopathic bacteria and is characterized by inflammation and the progressive destruction of toothsupporting tissues [1], which is the major cause of tooth loss in adults. Few studies have systematically evaluated the complementary effect of PRF in the treatment of intrabony defects. The present review is aimed at systematically assessing the effects of PRF on clinical and radiological outcomes of the surgical treatment of periodontal intrabony defects. Intrabony defect (IBD) depth reduction and bone fill (BF) % were set as primary outcomes while probing depth (PD) reduction, clinical attachment level (CAL) gain, and gingival margin level (GML) gain were considered as the secondary outcome. The use of PRF was significantly effective in the treatment of periodontal intrabony defects. As all included studies were not at low risk of bias, well-designed RCTs having a high methodological quality are needed to clarify the additional effectiveness of PRF in the treatment of intrabony defects in the future
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
