Additive effect of autologous platelet concentrates in treatment of intrabony defects: a systematic review and meta-analysis

Saurav Panda, Jayakumar Doraiswamy, Sankari Malaiappan, Sheeja Saji Varghese, Massimo Del Fabbro

Research output: Contribution to journalArticle

Abstract

The aim of the present review is to systematically evaluate the additive effect of autologous platelet concentrates (APCs) in treatment of intrabony defects when used along with other regenerative procedures and when used alone in terms of clinical and radiological outcomes. A search was performed in electronic databases (i.e., MEDLINE and the Cochrane Central Register of Controlled Trials) in order to identify randomized clinical trials (RCTs) assessing the additive efficacy of APCs for healing and regeneration of hard and soft tissues in patients undergoing regenerative surgical procedures for the treatment of intrabony defects, having a follow-up of at least 9 months. Included studies underwent risk of bias assessment and data extraction. The main variables evaluated for efficacy were: pocket depth (PD), clinical attachment level (CAL), radiographic bone filling, and postoperative pain. The effect of APCs adjunct was evaluated for the following procedures: open flap debridement (OFD) alone, OFD plus grafting of the defect with autogenous bone or bone substitutes, and grafting in combination with a covering membrane for guided tissue regeneration (GTR). Platelet-rich fibrin (PRF) has a significant additive effect when used along with OFD. Platelet-rich plasma (PRP) has a significant additive effect when used along with bone grafts. Conversely, PRP was found to be ineffective when used in combination with GTR procedures. No study evaluated the effect of APCs on postoperative pain. Platelet-rich plasma may be used advantageously as an adjunct to grafting materials, but not in combination with GTR, for treatment of intrabony defects. Moreover, PRF can be effective as a sole regenerative material, in combination with OFD. There is still a lack of evidence regarding the effect of PRF in combination with grafting materials and GTR, the effect of other types of APCs such as plasma rich in growth factors, and the effect of APCs on postoperative pain.

Original languageEnglish
Pages (from-to)13-26
Number of pages14
JournalJournal of investigative and clinical dentistry
Volume7
Issue number1
DOIs
Publication statusPublished - Feb 2016

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Meta-Analysis
Blood Platelets
Guided Tissue Regeneration
Debridement
Platelet-Rich Plasma
Postoperative Pain
Fibrin
Therapeutics
Bone and Bones
Bone Substitutes
Bone Transplantation
MEDLINE
Regeneration
Intercellular Signaling Peptides and Proteins
Randomized Controlled Trials
Databases
Transplants
Membranes

Keywords

  • Journal Article
  • Review

Cite this

Additive effect of autologous platelet concentrates in treatment of intrabony defects : a systematic review and meta-analysis. / Panda, Saurav; Doraiswamy, Jayakumar; Malaiappan, Sankari; Varghese, Sheeja Saji; Del Fabbro, Massimo.

In: Journal of investigative and clinical dentistry, Vol. 7, No. 1, 02.2016, p. 13-26.

Research output: Contribution to journalArticle

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AU - Del Fabbro, Massimo

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AB - The aim of the present review is to systematically evaluate the additive effect of autologous platelet concentrates (APCs) in treatment of intrabony defects when used along with other regenerative procedures and when used alone in terms of clinical and radiological outcomes. A search was performed in electronic databases (i.e., MEDLINE and the Cochrane Central Register of Controlled Trials) in order to identify randomized clinical trials (RCTs) assessing the additive efficacy of APCs for healing and regeneration of hard and soft tissues in patients undergoing regenerative surgical procedures for the treatment of intrabony defects, having a follow-up of at least 9 months. Included studies underwent risk of bias assessment and data extraction. The main variables evaluated for efficacy were: pocket depth (PD), clinical attachment level (CAL), radiographic bone filling, and postoperative pain. The effect of APCs adjunct was evaluated for the following procedures: open flap debridement (OFD) alone, OFD plus grafting of the defect with autogenous bone or bone substitutes, and grafting in combination with a covering membrane for guided tissue regeneration (GTR). Platelet-rich fibrin (PRF) has a significant additive effect when used along with OFD. Platelet-rich plasma (PRP) has a significant additive effect when used along with bone grafts. Conversely, PRP was found to be ineffective when used in combination with GTR procedures. No study evaluated the effect of APCs on postoperative pain. Platelet-rich plasma may be used advantageously as an adjunct to grafting materials, but not in combination with GTR, for treatment of intrabony defects. Moreover, PRF can be effective as a sole regenerative material, in combination with OFD. There is still a lack of evidence regarding the effect of PRF in combination with grafting materials and GTR, the effect of other types of APCs such as plasma rich in growth factors, and the effect of APCs on postoperative pain.

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