Anitua Eduardo, Allende Mikel, Alkhraisat Mohammad Hamdan
Regenerative Medicine Department, BTI Biotechnology Institute, 01007 Vitoria, Spain.
Clinical Research, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), 01007 Vitoria, Spain.
Bioengineering (Basel). 2022 Sep 27;9(10):506. doi: 10.3390/bioengineering9100506.
This systematic review aims to evaluate the efficacy of the available platelet-rich plasma (PRP) products and composition to regenerate alveolar bone after tooth extraction.
PubMed, Cochrane Central Register of Controlled Trials, and EBSCO databases were searched up to 2 July 2021. Only randomized clinical trials using leukocyte-rich plasma (L-PRP) or pure-platelet rich plasma (P-PRP) for bone regeneration in alveolar ridge preservation were selected. The following outcomes were considered: (1) new bone formation (primary outcome) and (2) bone density (secondary outcome). A meta-analysis for PRP, P-PRP, and L-PRP using a fixed effect model was performed with Review Manager 5.4 software. Overall evidence was qualified using GRADE.
Six randomized clinical trials from 2639 unique articles initially identified met the inclusion criteria. The meta-analysis showed a significant effect of the P-PRP on the outcome of new bone formation (SMD, 1.44; 95% CI, 0.84 to 2.03) for P-PRP treatment. No information was retrieved for L-PRP. A statistically significant difference was also observed in the P-PRP group for bone density outcome (SMD, 1.24; 95% CI, 0.81 to 1.68). The L-PRP treated sockets also showed higher bone density (SMD, 0.88; 95% CI, 0.31 to 1.45) in comparison to control sockets. The quality of evidence was moderate for both outcomes in the P-PRP group and low for the L-PRP group.
Despite the limitations of the included studies, our data suggest that P-PRP, in comparison to unassisted healing, can improve alveolar bone regenerative potential. However, more high-quality clinical studies are needed.
本系统评价旨在评估现有富血小板血浆（PRP）产品及其成分在拔牙后牙槽骨再生中的疗效。
检索截至2021年7月2日的PubMed、Cochrane对照试验中心注册库和EBSCO数据库。仅选择使用富白细胞血浆（L-PRP）或纯富血小板血浆（P-PRP）进行牙槽嵴保存中骨再生的随机临床试验。考虑以下结果：（1）新骨形成（主要结果）和（2）骨密度（次要结果）。使用Review Manager 5.4软件对PRP、P-PRP和L-PRP进行固定效应模型的荟萃分析。使用GRADE对总体证据进行质量评估。
最初确定的2639篇独特文章中的六项随机临床试验符合纳入标准。荟萃分析显示，P-PRP治疗对新骨形成结果有显著影响（标准化均数差，1.44；95%可信区间，0.84至2.03）。未检索到L-PRP的相关信息。P-PRP组在骨密度结果方面也观察到统计学显著差异（标准化均数差，1.24；95%可信区间，0.81至1.68）。与对照牙槽窝相比，L-PRP处理的牙槽窝骨密度也更高（标准化均数差，0.88；95%可信区间，0.31至1.45）。P-PRP组两个结果的证据质量为中等，L-PRP组为低等。
尽管纳入研究存在局限性，但我们的数据表明，与无辅助愈合相比，P-PRP可提高牙槽骨再生潜力。然而，需要更多高质量的临床研究。
