The use of platelet-rich fibrin to enhance the outcomes of implant therapy: A systematic review

Franz Josef Strauss; Alexandra Stähli; Reinhard Gruber

doi:10.1111/clr.13275

The use of platelet-rich fibrin to enhance the outcomes of implant therapy: A systematic review

Clin Oral Implants Res. 2018 Oct;29 Suppl 18(Suppl Suppl 18):6-19. doi: 10.1111/clr.13275.

Authors

Franz Josef Strauss^{1

2}, Alexandra Stähli^{1

3}, Reinhard Gruber^{1

3

4}

Affiliations

¹ Department of Oral Biology, School of Dentistry, Medical University of Vienna, Vienna, Austria.
² Department of Conservative Dentistry, School of Dentistry, University of Chile, Santiago, Chile.
³ Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
⁴ Austrian Cluster for Tissue Regeneration, Vienna, Austria.

Abstract

Objective: To assess the impact of platelet-rich fibrin (PRF) on implant dentistry. The primary focused question was as follows: What are the clinical, histological, and radiographic outcomes of PRF administration for bone regeneration and implant therapy?

Method: A systematic literature search comprised three databases: MEDLINE, EMBASE, and Cochrane followed by a hand search of relevant scientific journals. Human studies using PRF for bone regeneration and implant therapy were considered and articles published up to December 31, 2017 were included. Eligible studies were selected based on the inclusion criteria. Randomized controlled trials (RCT) and controlled clinical trials (CCT) were included.

Results: In total, 5,963 titles were identified with the search terms and by hand search. A total of 12 randomized controlled trials (RCT) met the inclusion criteria and were chosen for data extraction. Included studies focused on alveolar ridge preservation after tooth extraction, osseointegration process, soft tissue management, bone augmentation, bone regeneration after sinus floor elevation and surgical peri-implantitis treatment. Overall, the risk of bias was moderate or unclear. Nine studies showed superior outcomes for PRF for any of the evaluated variables, such as ridge dimension, bone regeneration, osseointegration process, soft tissue healing. Three studies failed to show any beneficial effects of PRF. No meta-analysis could be performed due to the heterogeneity of study designs.

Conclusions: There is moderate evidence supporting the clinical benefit of PRF on ridge preservation and in the early phase of osseointegration. It remains unclear whether PRF can reduce pain and improve soft tissue healing. More research support is necessary to comment on the role of PRF to improve other implant therapy outcomes.

Keywords: alveolar ridge preservation; guided bone regeneration; implant therapy; platelet-rich fibrin; sinus floor elevation.

Publication types

Systematic Review

MeSH terms

Alveolar Process / physiology
Bone Regeneration
Dental Implantation, Endosseous* / methods
Humans
Platelet-Rich Fibrin* / physiology