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Use of platelet-rich fibrin in regenerative dentistry: a systematic review

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Abstract

Objectives

Research across many fields of medicine now points towards the clinical advantages of combining regenerative procedures with platelet-rich fibrin (PRF). This systematic review aimed to gather the extensive number of articles published to date on PRF in the dental field to better understand the clinical procedures where PRF may be utilized to enhance tissue/bone formation.

Materials and methods

Manuscripts were searched systematically until May 2016 and separated into the following categories: intrabony and furcation defect regeneration, extraction socket management, sinus lifting procedures, gingival recession treatment, and guided bone regeneration (GBR) including horizontal/vertical bone augmentation procedures. Only human randomized clinical trials were included for assessment.

Results

In total, 35 articles were selected and divided accordingly (kappa = 0.94). Overall, the use of PRF has been most investigated in periodontology for the treatment of periodontal intrabony defects and gingival recessions where the majority of studies have demonstrated favorable results in soft tissue management and repair. Little to no randomized clinical trials were found for extraction socket management although PRF has been shown to significantly decrease by tenfold dry sockets of third molars. Very little to no data was available directly investigating the effects of PRF on new bone formation in GBR, horizontal/vertical bone augmentation procedures, treatment of peri-implantitis, and sinus lifting procedures.

Conclusions

Much investigation now supports the use of PRF for periodontal and soft tissue repair. Despite this, there remains a lack of well-conducted studies demonstrating convincingly the role of PRF during hard tissue bone regeneration. Future human randomized clinical studies evaluating the use of PRF on bone formation thus remain necessary.

Clinical relevance

PRF was shown to improve soft tissue generation and limit dimensional changes post-extraction, with little available data to date supporting its use in GBR.

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Authors and Affiliations

  1. College of Dental Medicine, Department of Periodontology, Nova Southeastern University, Fort Lauderdale, FL, USA

    Richard J. Miron, Maurice Salama, Masako Fujioka-Kobayashi & Maria A Hernandez

  2. Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA

    Richard J. Miron & Hom-Lay Wang

  3. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy

    Giovanni Zucchelli & Pietro Felice

  4. Pikos Institute, Tampa Bay, FL, USA

    Michael A. Pikos

  5. Department of Periodontology, Georgia University, Athens, GA, USA

    Maurice Salama

  6. Goldstein Garber & Salama, Atlanta, GA, USA

    Maurice Salama

  7. International Academy of Dental Implantology, San Diego, CA, USA

    Samuel Lee

  8. Department of Periodontology, Laval University, Quebec City, Canada

    Vincent Guillemette & Fatiha Chandad

  9. Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Masako Fujioka-Kobayashi

  10. Department of Oral Surgery, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan

    Masako Fujioka-Kobayashi

  11. West Bowmanville Dental, Bowmanville, Ontario, Canada

    Mark Bishara

  12. Department of Oral Implantology, University of Wuhan, Wuhan, China

    Yufeng Zhang

  13. Laboratory for Research of the Musculoskeletal System, KAT Hospital, School of Medicine, National and Kapodistrian, University of Athens, Athens, Greece

    Cleopatra Nacopoulos

  14. Oral Surgery Department, University Federico II Naples, Naples, Italy

    Alain Simonpieri

  15. Periodontology and Implantology, Beausoleil, France

    Alain Simonpieri

  16. Periodontology and Implantology, Marseille, France

    Alain Simonpieri

  17. Department of Advanced Periodontics, USC School of Dentistry, Los Angeles, CA, USA

    Alexandre Amir Aalam

  18. Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy

    Gilberto Sammartino

  19. FORM, Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany

    Shahram Ghanaati

  20. Pain Clinic, Nice, France

    Joseph Choukroun

Authors
  1. Richard J. Miron
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  2. Giovanni Zucchelli
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  3. Michael A. Pikos
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  4. Maurice Salama
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  5. Samuel Lee
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  6. Vincent Guillemette
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  7. Masako Fujioka-Kobayashi
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  8. Mark Bishara
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  9. Yufeng Zhang
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  10. Hom-Lay Wang
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  11. Fatiha Chandad
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  12. Cleopatra Nacopoulos
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  13. Alain Simonpieri
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  14. Alexandre Amir Aalam
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  15. Pietro Felice
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  16. Gilberto Sammartino
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  17. Shahram Ghanaati
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  18. Maria A Hernandez
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  19. Joseph Choukroun
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Corresponding author

Correspondence to Richard J. Miron.

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Conflict of interest

Joseph Choukroun is the founder of Process of PRF company and the developer and inventor of PRF protocol in Nice, France. All other authors declare no conflict of interest.

Funding

This work was fully funded by the Cell Biology Laboratory at Nova Southeastern University, College of Dental Medicine.

Ethical approval

No ethical approval was required for this study as human participants or animals were not utilized in this study.

Informed consent

Informed consent was not required as no human or animal subjects were utilized in this study.

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Miron, R.J., Zucchelli, G., Pikos, M.A. et al. Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clin Oral Invest 21, 1913–1927 (2017). https://doi.org/10.1007/s00784-017-2133-z

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  • DOI: https://doi.org/10.1007/s00784-017-2133-z

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