1.
The Adjunctive Use of Leucocyte- and Platelet-Rich Fibrin in Periodontal Endosseous and Furcation Defects: A Systematic Review and Meta-Analysis
Pepelassi E, Deligianni M
Materials (Basel, Switzerland). 2022;15(6)
Abstract
The aim of this systematic review of randomized controlled trials was to evaluate the adjunctive use of leucocyte- and platelet-rich fibrin (L-PRF) in periodontal endosseous and furcation defects, as compared without L-PRF. The endosseous defect group was subclassified into: L-PRF/open flap debridement (L-PRF/OFD) versus OFD, L-PRF/osseous graft (L-PRF/OG) versus OG, L-PRF/Emdogain (L-PRF/EMD) versus EMD, and L-PRF/guided tissue regeneration (L-PRF/GTR) versus GTR. The furcation defect group was subclassified into L-PRF/OFD versus OFD, and L-PRF/OG versus OG. Mean difference, 95% confidence intervals and forest plots were calculated for probing pocket depth (PPD), clinical attachment level (CAL) and radiographic defect depth (DD). Nineteen studies concerning systemically healthy non-smokers were included. The results of this systematic review and meta-analysis showed in two- and/or three-wall endosseous defects that the adjunctive use of L-PRF to OFD or OG was significantly beneficial for PPD reduction, CAL gain and DD reduction, as compared without L-PRF. Furthermore, the data showed that for two- and/or three-wall endosseous defects, the adjunctive use of L-PRF to GTR was significantly beneficial for CAL and DD improvement, whereas adding L-PRF to EMD had no significant effect, and that for class II furcation defects, the addition of L-PRF to OFD was significantly beneficial for PPD, CAL and DD improvement, whereas the addition of L-PRF to OG was significantly clinically beneficial. In conclusion, this systematic review and meta-analysis found that there was significant clinical and radiographic additive effectiveness of L-PRF to OFD and to OG in two- and/or three-wall periodontal endosseous defects of systemically healthy non-smokers, as compared without L-PRF.
2.
The adjunctive use of platelet-rich plasma in the therapy of periodontal intraosseous defects: a systematic review
Kotsovilis S, Markou N, Pepelassi E, Nikolidakis D
Journal of Periodontal Research. 2010;45((3):):428-43.
Abstract
BACKGROUND AND OBJECTIVE The evidence for the efficacy of the adjunctive use of platelet-rich plasma (PRP) in periodontal intraosseous defects has not been systematically evaluated. The objective of this review was to address the focused question, 'What is the efficacy, with respect to clinical, radiographical and patient-centred outcomes, of combinations of PRP with other therapeutic bioactive agents/procedures, compared with the efficacy of the same agents/procedures without the adjunctive use of PRP in the therapy of periodontal intraosseous defects in patients with chronic periodontitis and without systemic diseases that could potentially influence the outcome of periodontal therapy?' by performing a systematic review of randomized controlled clinical trials (RCTs) published in the dental literature in any language, up to and including September 2008. MATERIAL AND METHODS Data sources principally included electronic databases, manually searched journals and contact with experts. In the first phase of study selection, the titles and abstracts, and in the second phase, full papers were screened independently and in duplicate by two reviewers. RESULTS In the first phase, 6124 potentially relevant titles and abstracts were examined. In the second phase, the full text of 20 publications was thoroughly evaluated. Eventually, 10 RCTs were selected. CONCLUSION Diverse outcomes (positive and negative) have been reported for the efficacy of PRP combined with various therapeutic bioactive agents/procedures, reflecting the limited and heterogeneous data available and possibly suggesting that the specific selection of agents/procedures combined with PRP could be important. Additional research on the efficacy of each specific combination of PRP is necessary.
3.
Treatment of periodontal endosseous defects with platelet-rich plasma alone or in combination with demineralized freeze-dried bone allograft: a comparative clinical trial
Markou N, Pepelassi E, Vavouraki H, Stamatakis HC, Nikolopoulos G, Vrotsos I, Tsiklakis K
Journal of Periodontology. 2009;80((12):):1911-9.
Abstract
BACKGROUND Platelet-rich plasma (PRP) alone or combined with other regenerative materials was previously studied in human periodontal endosseous defects. There are no sufficient data evaluating to what extent the addition of demineralized freeze-dried bone allograft (DFDBA) to PRP may enhance the effectiveness of PRP. The aim of this randomized, double-masked, controlled clinical trial was to compare the effectiveness of autologous PRP alone to PRP + DFDBA in periodontal endosseous defects. METHODS Twenty-four proximal endosseous defects in 24 patients with severe chronic periodontitis were randomly treated with PRP alone or in combination with DFDBA. The final evaluation at 6 months was based on clinical and radiographic parameters. Subtraction radiography was used. The primary outcome variable was clinical attachment level (CAL). RESULTS The two treatment groups were initially comparable (mean CAL: 8. 67 +/- 2. 19 mm for PRP + DFDBA and 8. 25 +/- 1. 96 mm for PRP). Both treatments achieved statistically significant and similar CAL gain (3. 08 +/- 1. 17 mm for PRP + DFDBA and 3. 08 +/- 0. 95 mm for PRP), probing depth, defect depth, and area surface reduction. The percentage of defect fill did not significantly differ between the two treatments. There was a non-significant trend to greater defect fill (45. 42% versus 41. 29%), defect depth (54. 05% versus 49. 52%), and area surface (58. 43% versus 52. 16%) reduction with the graft. In both groups, 66. 66% of the defects gained > or =3 mm of CAL. CONCLUSION Within its limits, this study demonstrates that both PRP and PRP combined with DFDBA resulted in significant clinical and radiographic improvement in human periodontal endosseous defects at 6 months, and the addition of DFDBA to PRP did not significantly enhance the treatment outcome.