Dragonas P, Katsaros T, Avila-Ortiz G, Chambrone L, Schiavo J H, Palaiologou A
Department of Periodontics, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans, USA.
Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, USA.
Int J Oral Maxillofac Surg. 2019 Feb;48(2):250-262. doi: 10.1016/j.ijom.2018.06.003. Epub 2018 Jul 7.
This systematic review aimed to assess the effects of leukocyte-platelet-rich fibrin (L-PRF) on bone regeneration, soft tissue healing, and postoperative complications in patients undergoing ridge preservation, ridge augmentation, and maxillary sinus augmentation procedures. A comprehensive literature search was conducted by two independent reviewers. Only randomized and non-randomized controlled clinical trials were selected. Outcome data were extracted and critically analyzed. A total of 17 articles were included in the qualitative synthesis. The use of L-PRF in extraction sockets was associated with a modest beneficial effect by decreasing alveolar ridge remodeling and postoperative pain when compared to natural healing. In contrast, the use of L-PRF in maxillary sinus augmentation procedures was not associated with more favorable outcomes, and its use in ridge augmentation procedures could not be assessed adequately as it was reported in only one study. No meta-analysis could be conducted due to the heterogeneity of the selected studies. The limited evidence on the effects of L-PRF in intraoral bone grafting procedures highlights the need for further research to fully assess its clinical indications, with an emphasis on the application of standardized protocols for the preparation of this autologous product.
本系统评价旨在评估富白细胞血小板纤维蛋白(L-PRF)对接受牙槽嵴保存、牙槽嵴增量和上颌窦提升手术患者的骨再生、软组织愈合及术后并发症的影响。由两名独立评价者进行全面的文献检索。仅选择随机和非随机对照临床试验。提取结局数据并进行严格分析。定性综合分析共纳入17篇文章。与自然愈合相比,在拔牙窝中使用L-PRF通过减少牙槽嵴重塑和术后疼痛具有一定的有益作用。相比之下,在上颌窦提升手术中使用L-PRF并未带来更有利的结果,且由于仅在一项研究中报道,其在牙槽嵴增量手术中的使用无法得到充分评估。由于所选研究的异质性,无法进行荟萃分析。关于L-PRF在口腔内骨移植手术中作用的证据有限,这凸显了进一步研究以全面评估其临床适应证的必要性,重点是应用标准化方案制备这种自体产品。