Lipovec Tina, Kapadia N, Antonoglou G N, Lu E M C, El-Sayed K M Fawzy, Nibali Luigi
Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
Interdisciplinary Doctoral Degree Programme Biomedicine, Clinical Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Clin Oral Investig. 2025 Jan 22;29(1):74. doi: 10.1007/s00784-024-06128-w.
To evaluate the possible additional clinical benefit from autologous platelet concentrate (APC) treatment adjunct to non-surgical periodontal therapy (NSPT).
Electronic (MEDLINE/Embase/Cochrane/MedNar/CORE) and hand searches were conducted. Following studies selection, evidence tables were formed, and meta-analyses were performed for the following outcomes: probing pocket depth (PPD) reduction, clinical attachment level (CAL) gain, and bleeding on probing (BoP) reduction. The protocol for this systematic review was registered in PROSPERO (CRD42023514388).
After de-duplication, the initial search yielded 194 citations, from which ten papers were eligible for quantitative synthesis. The APC group comprised 270 patients, while the control group included 230. The meta-analysis revealed that a single APC application resulted in a 0.6 mm greater PPD reduction (MD = -0.62; 95% CI: -1.03, -0.22) and 0.8 mm more CAL gain (MD = -0.77; 95% CI: -1.18, -0.37) at the 6-12 weeks follow-up. At six months, the APC group exhibited a 0.6 mm greater PPD reduction (MD = -0.61; 95% CI: -1.13, -0.09) and 1.1 mm more CAL gain (MD = -1.14; 95% CI: -1.94, -0.34) compared to the NSPT only group. In contrast, BoP indices did not reveal a statistically significant difference between the groups after 6-12 weeks (MD = -10.54; 95% CI: -25.21, 4.14). High heterogeneity and unclear to high risk of bias were detected.
Over six months, the adjunctive APC use appears to provide additional benefits in PPD reduction and CAL gain compared to NSPT alone.
The adjunctive use of APCs seems to promote further improvements in clinical outcomes following NSPT.
评估自体血小板浓缩物(APC)辅助非手术牙周治疗(NSPT)可能带来的额外临床益处。
进行了电子检索(MEDLINE/Embase/Cochrane/MedNar/CORE)和手工检索。在完成研究筛选后,形成了证据表,并对以下结果进行了荟萃分析:探诊深度(PPD)降低、临床附着水平(CAL)增加和探诊出血(BoP)减少。本系统评价的方案已在国际前瞻性系统评价注册库(PROSPERO,注册号:CRD42023514388)中登记。
在去除重复文献后,初步检索得到194条引文,其中10篇论文符合定量综合分析的要求。APC组包括270例患者,而对照组包括230例。荟萃分析显示,在6至12周的随访中,单次应用APC可使PPD降低幅度更大,达0.6毫米(MD = -0.62;95%置信区间:-1.03,-0.22),CAL增加幅度多0.8毫米(MD = -0.77;95%置信区间:-1.18,-0.37)。在6个月时,与仅接受NSPT的组相比,APC组的PPD降低幅度更大,达0.6毫米(MD = -0.61;95%置信区间:-1.13,-0.09),CAL增加幅度多1.1毫米(MD = -1.14;95%置信区间:-1.94,-0.34)。相比之下,在6至12周后,BoP指标在两组之间未显示出统计学上的显著差异(MD = -10.54;95%置信区间:-25.21,4.14)。检测到高异质性以及不明确至高偏倚风险。
在六个月的时间里,与单独的NSPT相比,辅助使用APC似乎在降低PPD和增加CAL方面提供了额外的益处。
APC的辅助使用似乎能促进NSPT后临床结果的进一步改善。