Effectiveness Of Autologous Platelet-rich Fibrin Research Articles

Additive effectiveness of autologous platelet-rich fibrin in the treatment of intrabony defects: A PRISMA-compliant meta-analysis.

Background:This meta-analysis was performed to determine the additive effectiveness of autologous platelet-rich fibrin in the treatment of intrabony defects in chronic periodontitis patients.Methods:Pertinent studies were identified by a search in Medline, EMBASE, the Web of Science, and the Cochrane Library. The trials searched were evaluated for eligibility. Cochrane Collaboration's Review Manager software was used to perform the meta-analyses.Results:Twelve eligible clinical trials were included. Pooled data found that adjunctive platelet-rich fibrin exactly yielded a significantly superior probing depth reduction compared with open flap debridement alone (weighted mean difference, 1.01; 95% confidence interval 0.95–1.08; P < .00001). The clinical attachment level (CAL) gain after treatment for 9 months was higher in patients treated with platelet-rich fibrin plus open flap debridement group than in open flap debridement-treated patients (weighted mean difference, 1.29; 95% confidence interval 0.96– 1.61; P < .00001). Similarly, the meta-analysis demonstrated that platelet-rich fibrin was superior to single open flap debridement with respect to gingival marginal level change (weighted mean difference, 0.45; 95% confidence interval 0.31–0.58; P < .00001). Regarding the hard tissue radiographic parameters, including defect depth reduction and percentage of fill defects in bone, adjunctive platelet-rich fibrin yielded significantly superior results compared with open flap debridement alone.Conclusion:Adjunctive use of platelet-rich fibrin with open flap debridement significantly improves fill defects when compared to open flap debridement alone. However, additional powered studies with much larger sample sizes are needed to obtain a more concrete conclusion.

Adjunctive Effect of Autologous Platelet-Rich Fibrin in the Treatment of Intrabony Defects in Localized Aggressive Periodontitis Patients: A Randomized Controlled Split-Mouth Clinical Trial.

The aim of this study was to investigate the clinical and radiologic efficacy of autologous platelet-rich fibrin (PRF) in the treatment of intrabony defects associated with localized aggressive periodontitis (LAP). A total of 30 sites, 2 sites per individual in 15 LAP patients, were treated with modified flap operation (MFO; Kirkland flap) alone or combined with autologous PRF. The study variables included plaque index, sulcus bleeding index, probing depth (PD), clinical attachment level (CAL), and gingival marginal level at baseline and 12 months postoperatively. The radiographic bone fill (RBF) on standardized radiographs was assessed after a year using image analysis software. The improvements in PD, CAL, and RBF in test sites compared to control sites were statistically significant (P < .05). Mean CAL gain and bone fill in the test sites were 4.0 ± 0.63 mm and 3.09 mm, respectively. Almost 80% of the PRF-treated sites showed ≥ 50% bone fill with minimal marginal tissue recession. Use of PRF significantly enhances the clinical and radiographic outcomes of open flap debridement in the treatment of periodontal intraosseous defects in patients affected by LAP.

Effectiveness of autologous platelet-rich fibrin in the treatment of intra-bony defects: A systematic review and meta-analysis.

The aim of the present meta-analysis is to determine the clinical and radiographic outcomes of using platelet-rich fibrin (PRF) for the treatment of periodontal intra-bony defect (IBD) compared with open flap debridement (OFD). MEDLINE/PubMed, EBSCO and Cochrane database were used to identify studies in English language published from January 1, 2005 to January 31, 2013. An additional hand search of the relevant journals and of the bibliographies of the paper identified was also performed. Articles retrieved were screened using specific inclusion criteria by five independent reviewers: Studies investigating the effect of platelet concentrate in surgical procedure for the treatment of periodontal intra osseous defects compared with the control group in which platelet concentrate was not used were included. Five relevant articles were selected for the meta-analysis of which 3 articles were retrieved after electronic search and two articles were included after hand search. The number of patients in studies ranged from 15 to 62 (32-90 sites) with mean age ranging from 29.47 to 39.7. A total of 298 sites were treated using PRF either in combination with graft or as a monotherapy in comparison to traditional OFD procedure. The meta-analysis showed a standard mean difference of 0.95 mm; 95% confidence interval (CI): 0.20-1.71 in clinical attachment level (CAL) and 2.33 mm; 95% CI: 1.43-3.23 in IBD after treatment of IBD with PRF compared with OFD. The meta-analysis showed clinically significant improvements in periodontal parameters such as CAL, IBD, and reduction in probing depth when IBDs were treated with PRF alone when compared to OFD.

Comparative evaluation of autologous platelet‐rich fibrin and platelet‐rich plasma in the treatment of mandibular degree II furcation defects: a randomized controlled clinical trial

The treatment of molar furcation defects remains a considerable challenge in clinical practice. The identification of clinical measurements influential to treatment outcomes is critical to optimize the results of surgical periodontal therapy. The present study aimed to explore the clinical and radiographical effectiveness of autologous platelet-rich fibrin (PRF) and autologous platelet-rich plasma (PRP) in the treatment of mandibular degree II furcation defects in subjects with chronic periodontitis. Seventy-two mandibular degree II furcation defects were treated with either autologous PRF with open flap debridement (OFD; 24 defects) or autologous PRP with OFD (25), or OFD alone (23). Clinical and radiological parameters such as probing depth, relative vertical clinical attachment level and horizontal clinical attachment level along with gingival marginal level were recorded at baseline and 9mo postoperatively. All clinical and radiographic parameters showed statistically significant improvement at both the test sites (PRF with OFD and PRP with OFD) compared to those with OFD alone. Relative vertical clinical attachment level gain was also greater in PRF (2.87±0.85mm) and PRP (2.71±1.04mm) sites as compared to control site (1.37±0.58mm), and relative horizontal clinical attachment level gain was statistically significantly greater in both PRF and PRP than in the control group. The use of autologous PRF or PRP were both effective in the treatment of furcation defects with uneventful healing of sites.

Comparative Evaluation of Autologous Platelet‐Rich Fibrin and Platelet‐Rich Plasma in the Treatment of 3‐Wall Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial

The topical use of platelet concentrates is recent, and its efficiency remains controversial. The present study aims to explore the clinical and radiographic effectiveness of autologous platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) in the treatment of intrabony defects in patients with chronic periodontitis. Ninety intrabony defects were treated with either autologous PRF with open-flap debridement or autologous PRP with open-flap debridement or open-flap debridement alone. Clinical and radiologic parameters, such as probing depth (PD), clinical attachment level (CAL), intrabony defect depth, and percentage defect fill, were recorded at baseline and 9 months postoperatively. Mean PD reduction and CAL gain were greater in PRF (3.77 ± 1.19 and 3.17 ± 1.29 mm) and PRP (3.77 ± 1.07 and 2.93 ± 1.08 mm) groups than the control group (2.97 ± 0.93 and 2.83 ± 0.91 mm). Furthermore, significantly greater percentage of mean bone fill was found in the PRF (55.41% ± 11.39%) and PRP (56.85% ± 14.01%) groups compared with the control (1.56% ± 15.12%) group. Within the limit of the present study, there was similar PD reduction, CAL gain, and bone fill at sites treated with PRF or PRP with conventional open-flap debridement. Because PRF is less time consuming and less technique sensitive, it may seem a better treatment option than PRP. However, long-term, multicenter randomized, controlled clinical trials will be required to know their clinical and radiographic effects on bone regeneration.

Clinical effect of autologous platelet-rich fibrin in the treatment of intra-bony defects: a controlled clinical trial

Platelet-rich fibrin (PRF) may be considered as a second-generation platelet concentrate widely used to accelerate soft and hard tissue healing because of presence of many growth factors. The present study aimed to investigate the clinical and radiological effectiveness of autologous PRF in the treatment of intra-bony defects of chronic periodontitis patients. Thirty-two intra-bony defects (one site/patient) were treated either with autologous PRF or a conventional open flap debridement alone. Clinical parameters such as plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), clinical attachment level (CAL) and gingival marginal level (GML) were recorded at baseline and 9 months post-operatively. In both the groups, by using the image analysis software intra-bony defect fill was calculated on standardized radiographs (from the baseline and 9 months). For all clinical and radiographic parameters test group was performed better than control group, and the difference was found to be statistically significant. Furthermore, images analysis revealed significantly greater bone fill in the test group compared with control (46.92%versus 28.66 %). Mean PD reduction (4.56 ± 0.37>3.56 ± 0.27) and CAL gain (3.69 ± 0.44>2.13 ± 0.43) in test group was found to be more compared with that of control group. In the test group, PD of >4 mm has highest percentage of PD reduction (68.9%) and CAL gain (61.6%). On frequency distribution analysis, there was no more difference for PD reduction in both the groups but CAL gain was much more in the test group than the control group. Within the limit of the present study, there was greater reduction in PD, more CAL gain and greater intra-bony defect fill at sites treated with PRF than the open flap debridement alone.