Effect of Platelet-Rich Fibrin Coating on Secondary Stability of Dental Implants: A Systematic Review and Meta-Analysis.

A systematic review of the effect of platelet-rich fibrin (PRF) on the secondary stability of delayed dental implants is lacking. This systematic review and meta-analysis aims to evaluate if PRF's application on delayed implant placement enhances secondary stability. A comprehensive search was done on Pubmed, Cochrane Library, Embase, and Scopus databases to retrieve the records. Only randomized controlled trials (RCTs) or controlled clinical trials (CCTs) were included in the review. The outcome was secondary stability values measured in the implant stability quotient (ISQ). The meta-analysis was performed using a random effects model with 95% confidence intervals (CIs). We assessed the certainty of evidence using GRADEpro. We included 12 trials conducted worldwide involving 456 dental implants installed. Six studies showed a high risk of bias, whereas three had a low risk of bias, and three had an unclear risk of bias. One trial did not contribute to meta-analysis. Certainty of evidence was assessed for only one comparison, which reported follow-up at 12 weeks. Implant + PRF versus Implant + no PRF: the evidence for the secondary stability of implant at four weeks (Mean difference (MD) 3.34, 95% CI 2.24 to 4.43; implants = 302; studies = 8; I2 = 0%); at six weeks (MD 2.53, 95% CI 0.85 to 4.20; implants = 146; studies = 3; I2 = 0%) and at ≥12 weeks (MD 3.37, 95% CI 0.69 to 6.06; participants = 162; studies = 4; I2 = 17%) was of low certainty. There is low certainty of evidence (≥12 weeks follow-up) for implant stability by PRF coating during installation to confirm if it can be useful for the clinicians during the delayed dental implant placement. Well-planned RCTs need to be conducted with longer follow-ups of ≥12 weeks to strengthen the evidence.