富血小板纤维蛋白在牙周内骨缺损治疗中的应用：系统评价和荟萃分析。

Use of Platelet-Rich Fibrin in the Treatment of Periodontal Intrabony Defects: A Systematic Review and Meta-Analysis.

机构信息

National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.

State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan 610041, China.

出版信息

Biomed Res Int. 2021 Feb 4;2021:6669168. doi: 10.1155/2021/6669168. eCollection 2021.

DOI:10.1155/2021/6669168

PMID:33614786

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7878074/

Abstract

BACKGROUND

Platelet-rich fibrin (PRF) is a kind of autologous platelet concentrate which is easy to obtain and cheap. In recent years, it has been studied to improve the effect of periodontal regeneration. However, few studies have systematically evaluated the complementary effect of PRF in the treatment of intrabony defects. The present review is aimed at systematically assessing the effects of PRF on clinical and radiological outcomes of the surgical treatment of periodontal intrabony defects.

METHODS

The protocol was registered at PROSPERO (International Prospective Register of Systematic Reviews) as CRD42020206056. An electronic search was conducted in MEDLINE, Cochrane, and EMBASE databases. Only randomized clinical trials were selected. Systematically healthy patients with two or three walls of intrabony defects were considered. Intrabony defect (IBD) depth reduction and bone fill (BF) % were set as primary outcomes while probing depth (PD) reduction, clinical attachment level (CAL) gain, and gingival margin level (GML) gain were considered as the secondary outcome. When possible, a meta-analysis was performed.

RESULTS

Eighteen articles fulfilled the inclusion criteria, and seventeen studies were quantitatively analyzed. Of 17 studies, four were rated as high risk of bias and thirteen as the moderate risk of bias. Two comparisons were set: (1) open flap debridement (OFD) combined with PRF and OFD alone and (2) bone grafting (BG) combined with PRF and BG alone. Compared to OFD alone, OFD+PRF showed significantly greater in all primary and secondary outcomes. Compared to BG alone, BG+PRF showed significantly greater in IBD depth reduction, PD reduction, CAL gain, and GML gain.

CONCLUSIONS

The use of PRF was significantly effective in the treatment of periodontal intrabony defects. The benefit of OFD+PRF may be greater than BG+PRF. PRF can promote early wound healing in periodontal surgery. As all included studies were not at low risk of bias, well-designed RCTs having a high methodological quality are needed to clarify the additional effectiveness of PRF in the treatment of intrabony defects in the future.

摘要

背景

富血小板纤维蛋白（PRF）是一种自体血小板浓缩物，易于获取且价格低廉。近年来，它被研究用于改善牙周再生效果。然而，很少有研究系统评估 PRF 在治疗牙周骨内缺损中的补充作用。本综述旨在系统评估 PRF 对牙周骨内缺损手术治疗的临床和影像学结果的影响。

方法

该方案在 PROSPERO（国际前瞻性系统评价注册库）中进行了注册，注册号为 CRD42020206056。在 MEDLINE、Cochrane 和 EMBASE 数据库中进行了电子检索。仅选择随机临床试验。系统性健康的患者有两个或三个骨内缺损壁。骨内缺损（IBD）深度减少和骨填充（BF）%为主要结果，而探诊深度（PD）减少、临床附着水平（CAL）增加和牙龈边缘水平（GML）增加则作为次要结果。在可能的情况下进行了荟萃分析。

结果

符合纳入标准的文章有 18 篇，其中 17 篇进行了定量分析。在这 17 项研究中，有 4 项被评为高偏倚风险，13 项为中偏倚风险。设置了两个比较：（1）翻瓣清创术（OFD）联合 PRF 与 OFD 单独比较，（2）骨移植（BG）联合 PRF 与 BG 单独比较。与 OFD 单独相比，OFD+PRF 在所有主要和次要结果上均有显著更大的改善。与 BG 单独相比，BG+PRF 在 IBD 深度减少、PD 减少、CAL 增加和 GML 增加方面有显著更大的改善。