title: Additive effect of autologous platelet concentrates in treatment of intrabony defects: a systematic review and meta-analysis.
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.
authors.affiliation: Department of Periodontia, Institute of Dental Sciences and SUM Hospital, Bhubaneswar, Odisha, India.
authors.forename: Saurav
authors.initials: S
authors.lastname: Panda
authors.affiliation: Department of Periodontia, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India.
authors.forename: Jayakumar
authors.initials: J
authors.lastname: Doraiswamy
authors.affiliation: Department of Periodontia, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India.
authors.forename: Sankari
authors.initials: S
authors.lastname: Malaiappan
authors.affiliation: Department of Periodontia, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India.
authors.forename: Sheeja Saji
authors.initials: SS
authors.lastname: Varghese
authors.affiliation: Department of Biomedical, Surgical and Dental Sciences, Scientific Institute for Care and Clinical Research (IRCCS) Galeazzi Orthopedic Institute, Università degli Studi di Milano, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Fabbro
mesh_terms: D016301:Alveolar Bone Loss / Q000628:therapy; D001792:Blood Platelets; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D017622:Periodontal Attachment Loss / Q000628:therapy; D053657:Platelet-Rich Plasma
keywords: intrabony defects; periodontal regeneration; platelet concentrates; platelet-rich fibrin; systematic review