Khattri Shivi, Kaushik Mayur, Tomar Nitin, Ahmed Sameer, Rana Nazar, Khan Mehvish, Singh Soundarya, Singh Roopse
Periodontology, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, IND.
Cureus. 2024 Dec 5;16(12):e75166. doi: 10.7759/cureus.75166. eCollection 2024 Dec.
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.
目前缺乏关于富血小板纤维蛋白（PRF）对延迟牙种植体二次稳定性影响的系统评价。本系统评价和荟萃分析旨在评估PRF应用于延迟种植体植入是否能增强二次稳定性。我们在PubMed、Cochrane图书馆、Embase和Scopus数据库进行了全面检索以获取记录。纳入评价的仅为随机对照试验（RCT）或对照临床试验（CCT）。结局指标为通过种植体稳定性商数（ISQ）测量的二次稳定性值。荟萃分析采用随机效应模型及95%置信区间（CI）进行。我们使用GRADEpro评估证据的确定性。我们纳入了全球开展的12项试验，共植入456颗牙种植体。6项研究显示存在高偏倚风险，3项为低偏倚风险，3项偏倚风险不明确。1项试验未纳入荟萃分析。仅对一项比较评估了证据的确定性，该比较报告的随访时间为12周。种植体+PRF与种植体+无PRF：种植体在4周时二次稳定性的证据（平均差值（MD）3.34，95%CI 2.24至4.43；种植体=302；研究=8；I²=0%）；6周时（MD 2.53，95%CI 0.85至4.20；种植体=146；研究=3；I²=0%）以及≥12周时（MD 3.37，95%CI 0.69至6.06；参与者=162；研究=4；I²=17%）确定性较低。对于在植入过程中使用PRF涂层提高种植体稳定性（随访≥12周），证据确定性较低，无法确定其对临床医生在延迟牙种植体植入过程中是否有用。需要开展计划完善、随访时间≥12周的RCT以强化证据。
