The Effectiveness of Platelet Rich Fibrin in Alveolar Ridge Reconstructive or Guided Bone Regenerative Procedures: A Systematic Review and Meta-Analysis.

Introduction And Objectives: Clinical studies have shown favorable outcomes following use of platelet rich fibrin (PRF), either alone or in conjunction with biomaterials for alveolar ridge reconstruction (ARR) or guided bone regeneration (GBR) . While PRF application accelerates wound healing and reduces postoperative discomfort, its effects on the alveolar bone gain, as part of ARR or GBR is less clear. Therefore, this study aims to investigate the clinical effectiveness of PRF when used in ARR or GBR, as well as postoperative discomfort following these procedures.

Sources: A systematic search using the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) method was performed to include database searches from MEDLINE (OVID interface, 1946 onwards), EMBASE (OVID interface, 1974 onwards) and Global Health (OVID interface, 1973 onwards).

Data: Of the 74 studies initially identified, 7 studies were included for the systematic review, including 6 randomized controlled trials (RCTs) and 1 cohort study. The meta-analysis showed that the incorporation of PRF as part of ARR or GBR resulted in an increase in horizontal ridge width, a reduction in the rate of resorption increase, while postoperative discomfort was the same or slightly improved. The risk of bias quality was low for only 1 out of the 6 RCTs and the Newcastle Ottawa scale assessment showed that cohort study was of high quality.

Conclusion: PRF application in ARR or GBR is associated with increased horizonal alveolar ridge width and reduce rate of graft resorption. However, the findings related to both outcome measures were based on a limited number of studies.

Clinical Significance: PRF application can be effectively used as part of ARR or GBR to increase the horizontal ridge width and reduce the rate of graft resorption.