Li Ang, Yang Hongjie, Zhang Jingyi, Chen Shulian, Wang Hongqiang, Gao Yanzheng
Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou.
Department of Orthopedics, China Flat Coal Shenma Medical Group General Hospital, Pingdingshan, China.
Medicine (Baltimore). 2019 Mar;98(11):e14759. doi: 10.1097/MD.0000000000014759.
This meta-analysis was performed to determine the additive effectiveness of autologous platelet-rich fibrin in the treatment of intrabony defects in chronic periodontitis patients.
Pertinent studies were identified by a search in Medline, EMBASE, the Web of Science, and the Cochrane Library. The trials searched were evaluated for eligibility. Cochrane Collaboration's Review Manager software was used to perform the meta-analyses.
Twelve eligible clinical trials were included. Pooled data found that adjunctive platelet-rich fibrin exactly yielded a significantly superior probing depth reduction compared with open flap debridement alone (weighted mean difference, 1.01; 95% confidence interval 0.95-1.08; P < .00001). The clinical attachment level (CAL) gain after treatment for 9 months was higher in patients treated with platelet-rich fibrin plus open flap debridement group than in open flap debridement-treated patients (weighted mean difference, 1.29; 95% confidence interval 0.96- 1.61; P < .00001). Similarly, the meta-analysis demonstrated that platelet-rich fibrin was superior to single open flap debridement with respect to gingival marginal level change (weighted mean difference, 0.45; 95% confidence interval 0.31-0.58; P < .00001). Regarding the hard tissue radiographic parameters, including defect depth reduction and percentage of fill defects in bone, adjunctive platelet-rich fibrin yielded significantly superior results compared with open flap debridement alone.
Adjunctive use of platelet-rich fibrin with open flap debridement significantly improves fill defects when compared to open flap debridement alone. However, additional powered studies with much larger sample sizes are needed to obtain a more concrete conclusion.
本荟萃分析旨在确定自体富血小板纤维蛋白在慢性牙周炎患者骨内缺损治疗中的附加疗效。
通过检索Medline、EMBASE、科学网和Cochrane图书馆来识别相关研究。对检索到的试验进行资格评估。使用Cochrane协作网的Review Manager软件进行荟萃分析。
纳入了12项符合条件的临床试验。汇总数据发现,与单纯翻瓣清创术相比,辅助使用富血小板纤维蛋白确实能显著降低探诊深度(加权平均差为1.01;95%置信区间为0.95 - 1.08;P<0.00001)。富血小板纤维蛋白联合翻瓣清创术治疗9个月后的临床附着水平(CAL)增益高于单纯翻瓣清创术治疗的患者(加权平均差为1.29;95%置信区间为0.96 - 1.61;P<0.00001)。同样,荟萃分析表明,在牙龈边缘水平变化方面,富血小板纤维蛋白优于单纯翻瓣清创术(加权平均差为0.45;95%置信区间为0.31 - 0.58;P<0.00001)。关于硬组织影像学参数,包括缺损深度减少和骨内填充缺损百分比,与单纯翻瓣清创术相比,辅助使用富血小板纤维蛋白产生了显著更好的结果。
与单纯翻瓣清创术相比,富血小板纤维蛋白联合翻瓣清创术在填充缺损方面有显著改善。然而,需要更多样本量更大的有足够效力的研究来得出更确切的结论。