College of Dental Medicine, Department of Periodontology, Nova Southeastern University, Fort Lauderdale, FL, USA.
Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA.
Clin Oral Investig. 2017 Jul;21(6):1913-1927. doi: 10.1007/s00784-017-2133-z. Epub 2017 May 27.
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.
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.
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.
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.
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.
如今,许多医学领域的研究都指向了将再生程序与富含血小板的纤维蛋白(PRF)相结合的临床优势。本系统评价旨在收集迄今为止在牙科领域发表的大量关于 PRF 的文章,以更好地了解可能利用 PRF 增强组织/骨形成的临床程序。
系统地搜索了文献,直到 2016 年 5 月,并将其分为以下几类:骨内和分叉缺损再生、拔牙窝管理、窦提升程序、牙龈退缩治疗和引导骨再生(GBR)包括水平/垂直骨增强程序。仅纳入人类随机临床试验进行评估。
共选择了 35 篇文章并进行了相应的分类(kappa = 0.94)。总体而言,PRF 的使用在牙周病学中得到了最多的研究,用于治疗牙周骨内缺损和牙龈退缩,大多数研究表明在软组织管理和修复方面取得了良好的效果。尽管 PRF 已被证明可使第三磨牙干槽的发生率降低十倍,但很少有随机临床试验用于拔牙窝管理。几乎没有数据直接调查 PRF 对 GBR、水平/垂直骨增强程序、种植体周围炎治疗和窦提升程序中新骨形成的影响。
现在有很多研究支持 PRF 用于牙周和软组织修复。尽管如此,仍然缺乏精心设计的研究来令人信服地证明 PRF 在硬组织骨再生中的作用。因此,仍然需要进行评估 PRF 在骨形成中应用的人类随机临床试验。
PRF 被证明可以改善软组织生成并限制拔牙后体积变化,目前可用的数据很少支持其在 GBR 中的应用。