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BMC Oral Health
Published in: BMC Oral Health 1/2016

Open Access 01-12-2016 | Research article

The effect of platelet–rich plasma on clinical outcomes of the surgical treatment of periodontal intrabony defects: A systematic review and meta–analysis

Authors: Xinshan Hou, Jingwen Yuan, Absijiang Aisaiti, Yuan Liu, Jin Zhao

Published in: BMC Oral Health | Issue 1/2016

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Abstract

Background

Studies investigating the use of platelet–rich plasma (PRP) in the treatment of intrabony defects have yielded mixed results. The aim of our study was to evaluate the efficacy of PRP by comparing clinical attachment level (CAL) and pocket depth (PD) for patients who received PRP as an adjunct to periodontal intrabony defect therapy with those for patients who did not. We also analyzed the influence of guided tissue regeneration (GTR) and different study designs (parallel and split–mouth studies) on the clinical outcomes of intrabony defects.

Methods

We performed a systematic review of articles published in any language up to June 7, 2015 by searching PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. We included only randomized controlled clinical trials (RCTs) that compared clinical outcomes between patients who received PRP as an adjunct to periodontal intrabony defect therapy and patients who did not. We combined data from randomized trials to assess clinical outcomes using a random–effects model.

Results

Of the 307 abstracts that were initially identified, 12 RCTs related to the treatment of periodontal intrabony defects were included in the final analysis. Clinically and significantly greater CAL gains and PD reductions were observed in subjects who received PRP as an adjunct to periodontal intrabony defect therapy than in subjects who did not (CAL: WMD 0.76 mm, 95 % CI = 0.34 to 1.18 mm, P = 0.0004; PD: WMD 0.53 mm, 95 % CI = 0.21 to 0.85 mm, P = 0.001). Subgroup meta-analyses of patients who underwent GTR demonstrated that this approach did not significantly affect treatment outcomes (CAL: WMD 0.08 mm, 95 % CI = −0.30 to 0.46 mm, P = 0.67), as indicated by a comparison with patients who did not undergo GTR (CAL: WMD 1.22 mm, 95 % CI = 0.88 to 1.57 mm, P < 0.00001). Univariate meta-regression analyses revealed that the use of GTR explained the heterogeneity among the included studies (P < 0.05).

Conclusions

Within its limitations, this review suggests that PRP may be beneficial as an adjunct to graft materials for the treatment of periodontal intrabony defects, except in cases involving the use of GTR.
Literature
1.
2.
Sander L, Karring T. Healing of periodontal lesions in monkeys following the guided tissue regeneration procedure. A histological study. J Clin Periodontol. 1995;22:332–7.CrossRefPubMed
3.
Cochran DL, Wozney JM. Biological mediators for periodontal regeneration. Periodontol. 1999;10:40–58.CrossRef
4.
Bae JH, Kim YK, Myung SK. Effects of platelet-rich plasma on sinus bone graft: Meta-Analysis. J Periodontol. 2011;82:660–7.CrossRefPubMed
5.
Babbush CA, Kevy SV, Jacobson MS. An in vitro and in vivo evaluation of autologous platelet concentrate in oral reconstruction. Implant Dent. 2003;12:24–34.CrossRefPubMed
6.
Anitua E. Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants. 1999;14(4):529–35.PubMed
7.
De Obarrio JJ, Arauz-Dutari JI, Chamberlain TM, Croston A. The use of autologous growth factors in periodontal surgical therapy: platelet gel biotechnology--case reports. Int J Periodontics Restorative Dent. 2000;20(5):486–97.PubMed
8.
Kassolis JD, Reynolds MA. Evaluation of the adjunctive benefits of platelet-rich plasma in subantral sinus augmentation. J Craniofac Surg. 2005;16:280–7.CrossRefPubMed
9.
Camargo PM, Lekovic V, Weinlaender M, Vasilic N, Madzarevic M, Kenney EB. A reentry study on the use of bovine porous bone mineral, GTR, and platelet-rich plasma in the regenerative treatment of intrabony defects in humans. Int J Periodontics Restorative Dent. 2005;25(1):49–59.PubMed
10.
Lekovic V, Camargo PM, Weinlaender M, Vasilic N, Kenney EB. Comparison of platelet-rich plasma, bovine porous bone mineral, and guided tissue regeneration versus platelet-rich plasma and bovine porous bone mineral in the treatment of intrabony defects: a reentry study. J Periodontol. 2002;73:198–205.CrossRefPubMed
11.
Okuda K, Tai H, Tanabe K, Suzuki H, Sato T, Kawase T, Saito Y, Wolff LF, Yoshiex H. Platelet-rich plasma combined with a porous hydroxyapatite graft for the treatment of intrabony periodontal defects in humans: a comparative controlled clinical study. J Periodontol. 2005;76:890–8.CrossRefPubMed
12.
Roselló-Camps A, Monje A, Lin GH, Khoshkam V, Chávez-Gatty M, Wang HL. Platelet-rich plasma for periodontal regeneration in the treatment of intrabony defects: a meta-analysis on prospective clinical trials. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2015;120:562–74.CrossRef
13.
Panda S, Doraiswamy J, Malaiappan S, Varghese SS, Del Fabbro M. Additive effect of autologous platelet concentrates in treatment of intrabony defects: a systematic review and meta-analysis. J Investig Clin Dent. 2016;7(1):13–26.CrossRefPubMed
14.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62:1006–12.CrossRefPubMed
15.
Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, 2011. www.cochrane-handbook.org. Accessed 11 Sep 2015.
16.
17.
Fabbro M, Bortolin M, Taschieri S, Weinstein R. Is platelet concentrate advantageous for the surgical treatment of periodontal diseases? A Systematic Review and Meta-Analysis. J Periodontol. 2011;82:1100–11.CrossRefPubMed
18.
Lesaffre E, Philstrom B, Needleman I, Worthington H. The design and analysis of split-mouth studies: what statisticians and clinicians should know. Stat Med. 2009;28:3470–82.CrossRefPubMed
19.
Van Houwelingen HC, Arends LR, Stijnen T. Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med. 2002;21:589–624.CrossRefPubMed
20.
Thompson SG, Sharp SJ. Explaining heterogeneity in meta-analysis: a comparison of methods. Stat Med. 1999;18:2693–708.CrossRefPubMed
21.
Rodrigues SV, Acharya AB, Thakur SL. An evaluation of platelet-rich plasma without thrombin activation with or without anorganic bone mineral in the treatment of human periodontal intrabony defects. Platelets. 2011;22:353–60.CrossRefPubMed
22.
Yilmaz S, Kabadayi C, Ipci SD, Cakar G, Kuru B. Treatment of intrabony periodontal defects with platelet-rich plasma versus platelet-poor plasma combined with a bovine-derived xenograft: a controlled clinical trial. J Periodontol. 2011;82:837–44.CrossRefPubMed
23.
Yilmaz S, Cakar G, Ipci SD, Kuru B, Yildirim B. Regenerative treatment with platelet-rich plasma combined with a bovine-derived xenograft in smokers and non-smokers: 12-month clinical and radiographic results. J Clin Periodontol. 2010;37:80–7.CrossRefPubMed
24.
Pradeep AR, Shetty SK, Garg G, Pai S. Clinical effectiveness of autologous platelet-rich plasma and Peptide-enhanced bone graft in the treatment of intrabony defects. J Periodontol. 2009;80:62–71.CrossRefPubMed
25.
Yamamiya K, Okuda K, Kawase T, Hata K, Wolff LF, Yoshie H. Tissue-engineered cultured periosteum used with platelet-rich plasma and hydroxyapatite in treating human osseous defects. J Periodontol. 2008;79:811–8.CrossRefPubMed
26.
Ilgenli T, Dündar N, Kal BI. Demineralized freeze-dried bone allograft and platelet-rich plasma vs platelet-rich plasma alone in infrabony defects: a clinical and radiographic evaluation. Clin Oral Investig. 2007;11:51–9.CrossRefPubMed
27.
Camargo PM, Lekovic V, Weinlaender M, Vasilic N, Madzarevic M, Kenney EB. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. J Periodontal Res. 2002;37:300–6.CrossRefPubMed
28.
Pradeep AR, Rao NS, Agarwal E, Bajaj P, Kumari M, Naik SB. Comparative Evaluation of Autologous Platelet-Rich Fibrin and Platelet-Rich Plasma in the Treatment of 3-Wall Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial. J Periodontol. 2012;83:1499–507.CrossRefPubMed
29.
Yilmaz S, Cakar G, Kuru B, Dirikan S, Yildirim B. Platelet-rich plasma in combination with bovine derived xenograft in the treatment of deep intrabony periodontal defects: a report of 20 consecutively treated patients. Platelets. 2009;20:432–40.CrossRefPubMed
30.
Camargo PM, Lekovic V, Weinlaender M, Divnic-Resnik T, Pavlovic M, Kenney EB. A surgical reentry study on the influence of platelet-rich plasma in enhancing the regenerative effects of bovine porous bone mineral and guided tissue regeneration in the treatment of intrabony defects in humans. J Periodontol. 2009;80:915–23.CrossRefPubMed
31.
Czuryszkiewicz-Cyrana J, Banach J. Autogenous bone and platelet-rich plasma (PRP) in the treatment of intrabony defects. Adv Med Sci. 2006;51 Suppl 1:26–30.PubMed
32.
Dori F, Nikolidakis D, Huszar T, Arweiler NB, Gera I, Sculean A. Effect of platelet-rich plasma on the healing of intrabony defects treated with an enamel matrix protein derivative and a natural bone mineral. J Clin Periodontol. 2008;35(1):44–50.PubMed
33.
Döri F, Arweiler N, Húszár T, Gera I, Miron RJ, Sculean A. Five-year results evaluating the effects of platelet-rich plasma on the healing of intrabony defects treated with enamel matrix derivative and natural bone mineral. J Periodontol. 2013;84:1546–55.CrossRefPubMed
34.
Gupta G. Clinical and radiographic evaluation of intra-bony defects in localized aggressive periodontitis patients with platelet rich plasma/hydroxyapatite graft: A comparative controlled clinical trial. Contemp Clin Dent. 2014;5:445–51.CrossRefPubMedPubMedCentral
35.
Hanna R, Trejo PM, Weltman RL. Treatment of Intrabony Defects With Bovine-Derived Xenograft Alone and in Combination With Platelet-Rich Plasma: A Randomized Clinical Trial. J Periodontol. 2004;75:1668–77.CrossRefPubMed
36.
Ouyang XY, Qiao J. Effect of platelet-rich plasma in the treatment of periodontal intrabony defects in humans. Chin Med J. 2006;119(18):1511–21.PubMed
37.
Döri F, Kovács V, Arweiler NB, Huszár T, Gera I, Nikolidakis D, Sculean A. Effect of platelet-rich plasma on the healing of intrabony defects treated with an anorganic bovine bone mineral: a pilot study. J Periodontol. 2009;80:1599–605.CrossRefPubMed
38.
Demir B, Rengu¨n D, Berberog˘lu A. Clinical evaluation of platelet-rich plasma and bioactive glass in the treatment of intra-bony defects. J Clin Periodontol. 2007;34:709–15.CrossRefPubMed
39.
Agarwal A, Gupta ND. Platelet-rich plasma combined with decalcified freeze-dried bone allograft for the treatment of noncontained human intrabony periodontal defects: a randomized controlled split-mouth study. Int J Periodontics Restorative Dent. 2014;34:705–11.CrossRefPubMed
40.
Piemontese M, Aspriello SD, Rubini C, Ferrante L, Procaccini M. Treatment of Periodontal Intrabony Defects with Demineralized Freeze-Dried Bone Allograft in Combination With Platelet-Rich Plasma: A Comparative Clinical Trial. J Periodontol. 2008;79:802–10.CrossRefPubMed
41.
Harnack L, Boedeker RH, Kurtulus I, Boehm S, Gonzales J, Meyle J. Use of platelet-rich plasma in periodontal surgery—a prospective randomized double blind clinical trial. Clin Oral Invest. 2009;13:179–87.CrossRef
42.
Özdemir B, Ökte E. Treatment of intrabony defects with beta-tricalciumphosphate alone and in combination with platelet-rich plasma. J Biomed Mater Res B Appl Biomater. 2012;100:976–83.CrossRefPubMed
43.
Kaushick BT, Jayakumar ND, Padmalatha O, Varghese S. Treatment of human periodontal infrabony defects with hydroxyapatite + β-tricalcium phosphate bone graft alone and in combination with platelet rich plasma: A randomized clinical trial. Indian J Dent Res. 2011;22:505–10.CrossRefPubMed
44.
Christgau M, Moder D, Wagner J, Glässl M, Hiller KA, Wenzel A, Schmalz G. Influence of autologous platelet concentrate on healing in intrabony defects following guided tissue regeneration therapy: a randomized prospective clinical split-mouth study. J Clin Periodontol. 2006;33:908–21.CrossRefPubMed
45.
Döri F, Huszár T, Nikolidakis D, Arweiler NB, Gera I, Sculean A. Effect of Platelet-Rich Plasma on the Healing of Intrabony Defects Treated With an Anorganic Bovine Bone Mineral and Expanded Polytetrafluoroethylene Membranes. J Periodontol. 2007;78:983–90.CrossRefPubMed
46.
Döri F, Huszár T, Nikolidakis D, Arweiler NB, Gera I, Sculean A. Effect of platelet rich plasma on the healing of intra-bony defects treated with a natural bone mineral and a collagen membrane. J Clin Periodontal. 2007;34:254–61.CrossRef
47.
Döri F, Huszár T, Nikolidakis D, Tihanyi D, Horváth A, Arweiler NB, Gera I, Sculean A. Effect of Platelet-Rich Plasma on the Healing of Intrabony Defects Treated With Beta Tricalcium Phosphate and Expanded Polytetrafluoroethylene Membranes. J Periodontol. 2008;79:660–9.CrossRefPubMed
48.
Okuda K, Kawase T, Momose M, Murata M, Saito Y, Suzuki H, Wolff LF, Yoshie H. Platelet-rich plasma contains high levels of platelet-derived growth factor and transforming growth factor-beta and modulates the proliferation of periodontally related cells in vitro. J Periodontol. 2003;74:849–57.CrossRefPubMed
49.
Appel TR, Potzsch B, Muller J, Von Lindern JJ, Berge SJ, Reich RH. Comparison of three different preparations of platelet concentrates for growth factor enrichment. Clin Oral Implants Res. 2002;13:522–8.CrossRefPubMed
50.
Lesaffre E, Garcia Zattera MJ, Redmond C, Huber H, Needleman I. Reported methodological quality of split-mouth studies. J Clin Periodontol. 2007;34:756–61.CrossRefPubMed
51.
Smaïl F, et al. Comparison of intervention effects in split-mouth and parallel-arm randomized controlled trials: a meta-epidemiological study. BMC Med Res Methodol. 2014;14:64.CrossRef
52.
Weibrich G, Kleis WK, Hafner G. Growth factor levels in the platelet-rich plasma produced by 2 different methods: curasan-type PRP kit versus PCCS PRP system. Int J Oral Maxillofac Implants. 2002;17(2):184–90.PubMed
53.
Weibrich G, Kleis WK, Buch R, Hitzler WE, Hafner G. The Harvest Smart PRePTM system versus the Friadent- Schu¨tze platelet-rich plasma kit. Clin Oral Implants Res. 2003;14:233–9.CrossRefPubMed
54.
55.
Hopewell S, Clarke M, Lefebvre C, Scherer R. Handsearching versus electronic searching to identify reports of randomized trials. Cochrane Database Syst Rev. 2007;2:Mr000001.PubMed
Metadata
Title
The effect of platelet–rich plasma on clinical outcomes of the surgical treatment of periodontal intrabony defects: A systematic review and meta–analysis
Authors
Xinshan Hou
Jingwen Yuan
Absijiang Aisaiti
Yuan Liu
Jin Zhao
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2016
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-016-0261-5

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