Use of platelet-rich fibrin in regenerative dentistry: a systematic review

Richard J Miron, Giovanni Zucchelli, Michael A Pikos, Maurice Salama, Samuel Lee, Vincent Guillemette, Masako Fujioka-Kobayashi, Mark Bishara, Yufeng Zhang, Hom-Lay Wang, Fatiha Chandad, Cleopatra Nacopoulos, Alain Simonpieri, Alexandre Amir Aalam, Pietro Felice, Gilberto Sammartino, Shahram Ghanaati, Maria A Hernandez, Joseph Choukroun, Richard J Miron, Giovanni Zucchelli, Michael A Pikos, Maurice Salama, Samuel Lee, Vincent Guillemette, Masako Fujioka-Kobayashi, Mark Bishara, Yufeng Zhang, Hom-Lay Wang, Fatiha Chandad, Cleopatra Nacopoulos, Alain Simonpieri, Alexandre Amir Aalam, Pietro Felice, Gilberto Sammartino, Shahram Ghanaati, Maria A Hernandez, Joseph Choukroun

Abstract

Objectives: Research across many fields of medicine now points towards the clinical advantages of combining regenerative procedures with platelet-rich fibrin (PRF). This systematic review aimed to gather the extensive number of articles published to date on PRF in the dental field to better understand the clinical procedures where PRF may be utilized to enhance tissue/bone formation.

Materials and methods: Manuscripts were searched systematically until May 2016 and separated into the following categories: intrabony and furcation defect regeneration, extraction socket management, sinus lifting procedures, gingival recession treatment, and guided bone regeneration (GBR) including horizontal/vertical bone augmentation procedures. Only human randomized clinical trials were included for assessment.

Results: In total, 35 articles were selected and divided accordingly (kappa = 0.94). Overall, the use of PRF has been most investigated in periodontology for the treatment of periodontal intrabony defects and gingival recessions where the majority of studies have demonstrated favorable results in soft tissue management and repair. Little to no randomized clinical trials were found for extraction socket management although PRF has been shown to significantly decrease by tenfold dry sockets of third molars. Very little to no data was available directly investigating the effects of PRF on new bone formation in GBR, horizontal/vertical bone augmentation procedures, treatment of peri-implantitis, and sinus lifting procedures.

Conclusions: Much investigation now supports the use of PRF for periodontal and soft tissue repair. Despite this, there remains a lack of well-conducted studies demonstrating convincingly the role of PRF during hard tissue bone regeneration. Future human randomized clinical studies evaluating the use of PRF on bone formation thus remain necessary.

Clinical relevance: PRF was shown to improve soft tissue generation and limit dimensional changes post-extraction, with little available data to date supporting its use in GBR.

Keywords: Bone augmentation; Platelet-rich fibrin; Soft tissue regeneration; Tissue regeneration.

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