Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
Graduate Dentistry Program, Ibirapuera University, Sao Paulo, Brazil.
JDR Clin Trans Res. 2021 Apr;6(2):161-173. doi: 10.1177/2380084420921353. Epub 2020 May 11.
The use of recombinant human platelet-derived growth factor-BB (rhPDGF) has received Food and Drug Administration approval for the treatment of periodontal and orthopedic bone defects and dermal wound healing. Many studies have investigated its regenerative potential in a variety of other oral clinical indications. The aim of this systematic review was to assess the efficacy, safety, and clinical benefit of recombinant human platelet-derived growth factor (rhPDGF) use for alveolar bone and/or soft tissue regeneration.
Comprehensive electronic and manual literature searches according to the PRISMA guidelines were performed to identify interventional and observational studies evaluating the regenerative applications of rhPDGF-BB. The primary outcomes were the safety, efficacy, and overall clinical benefit of rhPDGF use in oral regenerative procedures.
Sixty-three human clinical studies (mean ± SD follow-up period of 10.7 ± 3.3 mo) were included in the qualitative analysis. No serious adverse effects were reported in any of the 63 studies, aside from the postoperative complications routinely associated with surgical therapy. Use of rhPDGF was shown to be beneficial when combined with allografts, xenografts, and alloplasts (the latter tricalcium phosphate [β-TCP]) for the treatment of periodontal defects and gingival recession. The use of rhPDGF also led to favorable clinical outcomes when combined with allografts or xenografts for guided bone regeneration (GBR) and alveolar ridge preservation. While favorable clinical results support the use of the combination of rhPDGF plus allograft or xenograft for GBR, ARP, and sinus floor augmentation, current data support the use of rhPDGF and alloplasts (e.g., β-TCP) only in periodontal defects and gingival recession.
Based on the clinical evidence, rhPDGF is safe and provides clinical benefits when used in combination with bone allografts, xenograft, or β-TCP for the treatment of intrabony and furcation periodontal defects and gingival recession or when used with allografts or xenograft for GBR and ARP (PROSPERO CRD42020142446).
Clinicians should be aware that rhPDGF is a safe and effective approach for the treatment of intrabony and furcation periodontal defects and gingival recession or when used with allografts or xenograft for bone regeneration and alveolar ridge preservation. With consideration of cost and patient preference, this result could lead to more appropriate therapeutic decisions.
重组人血小板衍生生长因子-BB(rhPDGF)已获得美国食品和药物管理局(FDA)批准,用于治疗牙周和骨科骨缺损和皮肤伤口愈合。许多研究已经调查了其在各种其他口腔临床适应症中的再生潜力。本系统评价的目的是评估 rhPDGF 用于牙槽骨和/或软组织再生的疗效、安全性和临床获益。
根据 PRISMA 指南进行全面的电子和手动文献检索,以确定评估 rhPDGF-BB 再生应用的干预性和观察性研究。主要结局是 rhPDGF 在口腔再生程序中的安全性、疗效和总体临床获益。
纳入了 63 项人体临床研究(平均随访 10.7 ± 3.3 个月)进行定性分析。除了与手术治疗常规相关的术后并发症外,在 63 项研究中均未报告任何严重不良事件。rhPDGF 与同种异体移植物、异种移植物和同种异体移植物(后者为三钙磷酸盐[β-TCP])联合使用时,可治疗牙周缺损和牙龈退缩,具有良好的治疗效果。rhPDGF 与同种异体移植物或异种移植物联合使用进行引导骨再生(GBR)和牙槽嵴保存时,也可获得良好的临床结果。虽然有利的临床结果支持 rhPDGF 联合同种异体移植物或异种移植物用于 GBR、ARP 和窦底增高,但目前的数据仅支持 rhPDGF 与同种异体移植物(例如β-TCP)联合使用治疗牙周缺损和牙龈退缩。
基于临床证据,rhPDGF 与骨同种异体移植物、异种移植物或β-TCP 联合使用治疗骨内和分叉牙周缺损和牙龈退缩,或与同种异体移植物或异种移植物联合使用进行 GBR 和 ARP 时是安全且具有临床获益的(PROSPERO CRD42020142446)。
临床医生应该意识到,rhPDGF 是一种安全有效的治疗方法,可用于治疗骨内和分叉牙周缺损和牙龈退缩,或与同种异体移植物或异种移植物联合用于骨再生和牙槽嵴保存。考虑到成本和患者偏好,这一结果可能会导致更合适的治疗决策。