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Meta-Analysis
. 2019 Mar 17;20(6):1347.
doi: 10.3390/ijms20061347.

Autologous Platelet Concentrates in Treatment of Furcation Defects-A Systematic Review and Meta-Analysis

Sourav Panda  1   2 , Lorena Karanxha  3 , Funda Goker  4 , Anurag Satpathy  5 , Silvio Taschieri  6   7 , Luca Francetti  8   9 , Abhaya Chandra Das  10 , Manoj Kumar  11 , Sital Panda  12 , Massimo Del Fabbro  13   14
Affiliations
Meta-Analysis

Autologous Platelet Concentrates in Treatment of Furcation Defects-A Systematic Review and Meta-Analysis

Sourav Panda et al. Int J Mol Sci. .

Abstract

Background: The aim of this review was to evaluate the adjunctive effect of autologous platelet concentrates (APCs) for the treatment of furcation defects, in terms of scientific quality of the clinical trials and regeneration parameters assessment.

Methods: A systematic search was carried out in the electronic databases MEDLINE, SCOPUS, CENTRAL (Cochrane Central Register of Controlled Trials), and EMBASE, together with hand searching of relevant journals. Two independent reviewers screened the articles yielded in the initial search and retrieved the full-text version of potentially eligible studies. Relevant data and outcomes were extracted from the included studies. Risk of bias assessment was also carried out. The outcome variables, relative to baseline and post-operative defect characteristics (probing pocket depth (PPD), horizontal and vertical clinical attachment loss (HCAL, VCAL), horizontal and vertical furcation depth (HFD, VFD) were considered for meta-analysis.

Results: Ten randomized trials were included in this review. Only one study was judged at high risk of bias, while seven had a low risk, testifying to the good level of the evidence of this review. The meta-analysis showed a favorable effect regarding all outcome variables, for APCs used in adjunct to open flap debridement (p < 0.001). Regarding APCs in adjunct to bone grafting, a significant advantage was found only for HCAL (p < 0.001, mean difference 0.74, 95% CI 0.54, 0.94). The sub-group analysis showed that both platelet-rich fibrin and platelet-rich plasma in adjunct with open flap debridement, yielded significantly favorable results. No meta-analysis was performed for APCs in combination with guided tissue regeneration (GTR) as only one study was found.

Conclusion: For the treatment of furcation defects APCs may be beneficial as an adjunct to open flap debridement alone and bone grafting, while limited evidence of an effect of APCs when used in combination with GTR was found.

Keywords: autologous platelet concentrates; bone defects; bone grafting; bone regeneration; furcation defects; periodontal defects; periodontal regeneration; periodontal surgery; plasma rich in growth factors; platelet-rich fibrin; platelet-rich plasma; tissue healing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart depicting study selection process.
Figure 2
Figure 2
Risk of bias (RoB) assessment.
Figure 3
Figure 3
Forest plot showing the effect on probing pocket depth for comparison of APC + OFD versus OFD alone at end of all-follow-up (6–12 m).
Figure 4
Figure 4
Forest plot showing the effect on probing pocket depth for comparison of APC + BG versus BG alone at end of all-follow-up (6–12 m).
Figure 5
Figure 5
Forest plot showing the effect on vertical clinical attachment level for comparison of APC + OFD versus OFD alone at end of all-follow-up (6–12 m).
Figure 6
Figure 6
Forest plot showing the effect on vertical clinical attachment level for comparison of APC + BG versus BG alone at end of all-follow-up (6–12 m).
Figure 7
Figure 7
Forest plot showing the effect on horizontal clinical attachment level for comparison of APC + OFD versus OFD alone at end of all-follow-up (6–12 m).
Figure 8
Figure 8
Forest plot showing the effect on horizontal clinical attachment level for comparison of APC + BG versus BG alone at end of all-follow-up (6–12 m).
Figure 9
Figure 9
Forest plot showing the effect on vertical furcation depth for comparison of APC + OFD versus OFD alone at end of all-follow-up (6–12 m).
Figure 10
Figure 10
Forest plot showing the effect on vertical furcation depth for comparison of APC + BG versus BG alone at end of all-follow-up (6–12 m).
Figure 11
Figure 11
Forest plot showing the effect on horizontal furcation length for comparison of APC + OFD versus OFD alone at end of all-follow-up (6–12 m).
Figure 12
Figure 12
Forest plot showing the effect on horizontal furcation length for comparison of APC + BG versus BG alone at end of all-follow-up (6–12 m).
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