Meta-analysis of the effect of platelet-rich fibrin in alveolar ridge preservation

doi:10.12016/j.issn.2096-1456.2021.02.005

Abstract

Abstract:

Objective To evaluate the effect of platelet-rich fibrin (PRF) on alveolar ridge preservation after tooth extraction. Methods Randomized controlled trials (RCTs) published before August 25, 2020 about the use of PRF after tooth extraction were searched through the PubMed, Embase, Cochrane Library, HowNet, Wanfang, CBM databases and clinical trial registration centers in China and the United States. Outcome indicators included in the studies included dry socket occurrence, alveolar bone resorption in the horizontal and vertical directions, and the percentage of new bone. Meta-analysis was conducted with Review Manager Version 5.3 software. Results A total of 706 studies were retrieved. After screening, 8 studies were analyzed quantitatively. Meta-analysis results showed that PRF could reduce the absorption of alveolar bone after tooth extraction, which reduced the horizontal bone mass (WMD=-0.71, 95% CI=-1.11 to -0.32, P < 0.05) and buccal (WMD=-1.38, 95% CI =-1.87 to -0.88, P < 0.05) and lingual sides (WMD=-0.49, 95% CI=-0.92 to -0.06, P < 0.05) and increased the percentage of new bone (SMD=1.24, 95% CI =0.25 to 2.23, P < 0.05). However, there was no significant difference in preventing the occurrence of dry socket (RD < 0.01, 95% CI=-0.05 to 0.04, P=0.95) and reducing bone absorption in the vertical direction of mesial (WMD=-0.11, 95% CI=-1.17 to 0.95, P=0.84) and distal (WMD=-0.66, 95% CI=-1.93 to 0.60, P=0.30) alveolar ridge after tooth extraction. Conclusion Using PRF alone after tooth extraction can effectively preserve bone mass in the horizontal direction of the alveolar ridge and the vertical direction of the buccal and lingual sides.

Key words: platelet-rich fibrin, platelet-concentrate, tooth socket, alveolar bone absorption, socket preservation, alveolar ridge preservation, randomized controlled trials, meta-analysis

摘要：

目的评价拔牙后使用富血小板纤维蛋白（platelet-rich fibrin,PRF）在位点保存中的效果。方法检索Pubmed、Embase、Cochrane library、知网、万方、CBM数据库及中国、美国临床试验注册中心2020年8月25日前发表的有关拔牙后使用PRF的随机对照临床试验（randomized controlled trials,RCTs）,纳入研究的结局指标包括干槽症、水平和垂直方向牙槽骨吸收、新生骨百分比,应用Review Manager 5.3版软件进行meta分析。结果共检索到文献706篇,经筛选后纳入11篇研究,其中8篇定量分析,meta分析结果显示拔牙后使用PRF能减少牙槽骨的吸收,其中减少水平骨量（WMD=-0.71,95%CI=-1.11~-0.32,P < 0.05）,颊侧垂直骨量（WMD=-1.38,95%CI =-1.87~-0.88,P < 0.05）、舌侧垂直骨量（WMD=-0.49,95% CI=-0.92~-0.06,P < 0.05）的吸收,而且提高了新生骨百分比（SMD=1.24,95% CI=0.25~2.23,P < 0.05）,但在预防术后干槽症发生（RD < 0.01,95%CI=-0.05~0.04,P=0.95）及减少牙槽窝近中（WMD=-0.11,95% CI =-1.17~0.95,P=0.84）、远中（WMD=-0.66,95% CI=-1.93~0.60,P=0.30）垂直方向骨吸收上差异无统计学意义。结论拔牙后单纯使用PRF,可有效保存牙槽嵴水平方向及颊舌侧垂直方向的骨量。

关键词: 富血小板纤维蛋白, 浓缩血小板, 牙槽窝, 牙槽骨吸收, 位点保存, 牙槽嵴保存, 临床随机对照试验, meta分析

CLC Number:

R782

DONG Jingbo,LI Zhenzhen,LIU Chenxi,SHI Peikai. Meta-analysis of the effect of platelet-rich fibrin in alveolar ridge preservation[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(2): 99-105.

董静博,李珍珍,刘晨曦,石培凯. 富血小板纤维蛋白在位点保存中使用效果的meta分析[J]. 口腔疾病防治, 2021, 29(2): 99-105.

Figures/Tables 8

References 33

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Study	Year	Study type	Sex （female/male）	Age （mean）	Patients （teeth）	Test （number）	Control （number）	Duration （weeks）	Outcome indicator
Hauser^[8]	2013	RCT	7/10	47	17（17）	PRF（9）	N（8）	8	①②③
Temmerman^[9]	2016	RCT	7/15	54	22（44）	L-PRF（19）	N（21）	12	②③
Suttapreyasri^[10]	2013	RCT	5/3	23	8（20）	PRF（10）	N（10）	8	②③
Canellas^[11]	2019	RCT	27/21	45	48（48）	L-PRF （24）	N（24）	12	②③④
Clark^[12]	2018	RCT	22/18	58	20（20）	A-PRF（10）	N（10）	15	②③④
Liu^[13]	2016	RCT	NR	54	34（34）	PRF（17）	N（17）	9	②③
Girish^[2]	2018	RCT	NR	43	30（60）	PRF（30）	N（30）	24	②③
Alzahrani^[14]	2017	RCT	15/9	38	24（24）	PRF（14）	N（14）	8	②
Ivanova^[15]	2019	RCT	NR	42	35（35）	A-PRF（23）	N（12）	16	②③④
Ning^[16]	2018	RCT	8/12	19	20（40）	PRF（20）	N（20）	2	①
Marenzi^[17]	2015	RCT	9/17	54	26（108）	PRF（54）	N（54）	3	①

Study	Year	Study type	Sex （female/male）	Age （mean）	Patients （teeth）	Test （number）	Control （number）	Duration （weeks）	Outcome indicator
Hauser^[8]	2013	RCT	7/10	47	17（17）	PRF（9）	N（8）	8	①②③
Temmerman^[9]	2016	RCT	7/15	54	22（44）	L-PRF（19）	N（21）	12	②③
Suttapreyasri^[10]	2013	RCT	5/3	23	8（20）	PRF（10）	N（10）	8	②③
Canellas^[11]	2019	RCT	27/21	45	48（48）	L-PRF （24）	N（24）	12	②③④
Clark^[12]	2018	RCT	22/18	58	20（20）	A-PRF（10）	N（10）	15	②③④
Liu^[13]	2016	RCT	NR	54	34（34）	PRF（17）	N（17）	9	②③
Girish^[2]	2018	RCT	NR	43	30（60）	PRF（30）	N（30）	24	②③
Alzahrani^[14]	2017	RCT	15/9	38	24（24）	PRF（14）	N（14）	8	②
Ivanova^[15]	2019	RCT	NR	42	35（35）	A-PRF（23）	N（12）	16	②③④
Ning^[16]	2018	RCT	8/12	19	20（40）	PRF（20）	N（20）	2	①
Marenzi^[17]	2015	RCT	9/17	54	26（108）	PRF（54）	N（54）	3	①