Panda Saurav, Satpathy Anurag, Chandra Das Abhaya, Kumar Manoj, Mishra Lora, Gupta Swati, Srivastava Gunjan, Lukomska-Szymanska Monika, Taschieri Silvio, Del Fabbro Massimo
Department of Periodontics and Oral Implantology, Siksha 'O' Anusandhan University, Bhubaneswar 751003, India.
Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milano, Italy.
Materials (Basel). 2020 Sep 27;13(19):4314. doi: 10.3390/ma13194314.
This systematic review and meta-analysis aims to assess the additive effect of leukocyte and platelet-rich fibrin (L-PRF) on coronally advanced flap (CAF) procedures in root coverage of Miller's class I and II gingival recession defects. Review methodology: A comprehensive search in MEDLINE (PubMed), Scopus and CENTRAL (the Cochrane Central Register of Controlled Trials), along with an additional hand search, provided eight randomized clinical trials to be included in this review. A total of 167 patients with 470 gingival recession defects were analyzed. A meta-analysis was carried out to assess the change in gingival thickness (GT), width of keratinized gingiva (WKG), root coverage percentage (%RC), clinical attachment level (CAL) and recession depth (RD) at all follow-ups between CAF alone and CAF + L-PRF groups for all included studies. A subgroup analysis was carried out based on recession type (single/multiple).
Overall, a significant improvement in GT, CAL and RD was found when treated with CAF + L-PRF. There was a trend for a positive effect in terms of an increase in WKG when using L-PRF, especially in the treatment of single recession, though significance was not achieved ( = 0.08 overall). The results of heterogeneity among the subgroups were varied and were found to be greater than 91.3% for GT and 32.8% for WKG.
L-PRF when used in addition to CAF showed favorable results for the treatment of class I and II gingival recession defects.
本系统评价和荟萃分析旨在评估富含白细胞和血小板的纤维蛋白（L-PRF）对米勒I类和II类牙龈退缩缺损根面覆盖的冠向推进瓣（CAF）手术的附加效果。
在MEDLINE（PubMed）、Scopus和CENTRAL（Cochrane对照试验中央注册库）中进行全面检索，并额外进行手工检索，共纳入8项随机临床试验。对167例患者的470处牙龈退缩缺损进行了分析。对所有纳入研究中单独使用CAF组和CAF + L-PRF组在所有随访时的牙龈厚度（GT）、角化龈宽度（WKG）、根面覆盖百分比（%RC）、临床附着水平（CAL）和退缩深度（RD）的变化进行荟萃分析。根据退缩类型（单个/多个）进行亚组分析。
总体而言，CAF + L-PRF治疗时，GT、CAL和RD有显著改善。使用L-PRF时，WKG增加有积极作用趋势，尤其是在治疗单个退缩时，尽管未达到显著性（总体P = 0.08）。亚组间异质性结果各不相同，GT的异质性大于91.3%，WKG的异质性为32.8%。
CAF联合使用L-PRF治疗I类和II类牙龈退缩缺损效果良好。
