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评估先进的富血小板纤维蛋白在治疗牙龈退缩中的效果:系统评价和荟萃分析。

Assessing the effectiveness of advanced platelet rich fibrin in treating gingival recession: a systematic review and meta-analysis.

机构信息

Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, 33516, Egypt.

Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Horus University, Horus, Egypt.

出版信息

BMC Oral Health. 2024 Nov 19;24(1):1400. doi: 10.1186/s12903-024-05115-7.

Abstract

OBJECTIVES

The literature lacks comprehensive evidence on the efficacy of advanced platelet rich fibrin(A-PRF) in treating gingival recession. Therefore, this systematic review and meta-analysis aimed to evaluate the effectiveness of A-PRF in the treatment of gingival recession.

MATERIALS AND METHODS

We adhered to the guidelines of PRISMA in searching the following databases: PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus to include all the eligible studies according to the prespecified inclusion and exclusion criteria. We conducted our search up to February 28, 2024. We conducted a meta-analysis of the primary and secondary clinical outcomes to measure the changes from baseline to 6 months after surgery.

RESULTS

Our review included 10 randomized clinical trials in which 146 participants with 457 recession defects were included. We found that combination of A-PRF with various surgical techniques, such as coronally advanced flap (CAF) connective tissue graft (CTG), VISTA, tunneling, and pinhole surgical technique, demonstrated promising outcomes but varied by comparison group. We observed that CTG with CAF showed a higher reduction in recession depth in comparison to A-PRF with CAF. This review indicated no statistical or clinical differences in recession width, width of keratinized gingiva, probing depth, and clinical attachment level between the study and control groups.

CONCLUSIONS

Due to the less invasive nature of A-PRF, it provides a better clinical option to improve the outcomes of treating gingival recession. However, more well-designed RCTs with standardized approaches are needed to confirm these results.

摘要

目的

文献中缺乏关于先进富血小板纤维蛋白(A-PRF)治疗牙龈退缩疗效的综合证据。因此,本系统评价和荟萃分析旨在评估 A-PRF 在治疗牙龈退缩方面的有效性。

材料与方法

我们遵循 PRISMA 指南,在以下数据库中进行搜索:PubMed/MEDLINE、Embase、Cochrane 图书馆、Web of Science 和 Scopus,根据预先设定的纳入和排除标准纳入所有符合条件的研究。我们的搜索截止日期为 2024 年 2 月 28 日。我们对主要和次要临床结果进行了荟萃分析,以衡量手术 6 个月后从基线的变化。

结果

我们的综述纳入了 10 项随机临床试验,其中包括 146 名参与者的 457 个退缩缺陷。我们发现,A-PRF 与各种手术技术(如冠向推进瓣(CAF)结缔组织移植(CTG)、VISTA、隧道和微孔手术技术)相结合,显示出有前途的结果,但与对照组不同。我们观察到,与 A-PRF 联合 CAF 相比,CTG 联合 CAF 可更有效地降低牙龈退缩深度。本综述表明,研究组和对照组在牙龈退缩宽度、角化龈宽度、探诊深度和临床附着水平方面没有统计学或临床差异。

结论

由于 A-PRF 的微创性质,它为改善治疗牙龈退缩的结果提供了更好的临床选择。然而,需要更多设计良好的 RCT 采用标准化方法来证实这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2068/11575048/6bd33c4f8ac9/12903_2024_5115_Fig1_HTML.jpg

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