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Meta-Analysis
. 2020 Aug;24(8):2543-2557.
doi: 10.1007/s00784-020-03400-7. Epub 2020 Jun 26.

Use of platelet-rich fibrin for the treatment of gingival recessions: a systematic review and meta-analysis

Richard J Miron  1 , Vittorio Moraschini  2 , Massimo Del Fabbro  3   4 , Adriano Piattelli  5   6   7 , Masako Fujioka-Kobayashi  8 , Yufeng Zhang  9 , Nikola Saulacic  8 , Benoit Schaller  8 , Tomoyuki Kawase  10 , Raluca Cosgarea  11   12 , Soren Jepsen  12 , Delia Tuttle  13 , Mark Bishara  14 , Luigi Canullo  15 , Meizi Eliezer  16 , Andreas Stavropoulos  17 , Yoshinori Shirakata  18 , Alexandra Stähli  16 , Reinhard Gruber  19 , Ondine Lucaciu  11 , Sofia Aroca  16 , Herbert Deppe  20 , Hom-Lay Wang  21 , Anton Sculean  16
Affiliations
Free article
Meta-Analysis

Use of platelet-rich fibrin for the treatment of gingival recessions: a systematic review and meta-analysis

Richard J Miron et al. Clin Oral Investig. 2020 Aug.
Free article

Abstract

Objectives: The aim of this systematic review and meta-analysis was to compare the use of platelet-rich fibrin (PRF) with other commonly utilized treatment modalities for root coverage procedures.

Materials and methods: The eligibility criteria comprised randomized controlled trials (RCTs) comparing the performance of PRF with that of other modalities in the treatment of Miller class I or II (Cairo RT I) gingival recessions. Studies were classified into 5 categories as follows: (1) coronally advanced flap (CAF) alone vs CAF/PRF, (2) CAF/connective tissue graft (CAF/CTG) vs CAF/PRF, (3) CAF/enamel matrix derivative (CAF/EMD) vs CAF/PRF, (4) CAF/amnion membrane (CAF/AM) vs CAF/PRF, and (5) CAF/CTG vs CAF/CTG/PRF. Studies were evaluated for percentage of relative root coverage (rRC; primary outcome), clinical attachment level (CAL), keratinized mucosa width (KMW), and probing depth (PD) (secondary outcomes).

Results: From 976 articles identified, 17 RCTs were included. The use of PRF statistically significantly increased rRC and CAL compared with CAF alone. No change in KMW or reduction in PD was reported. Compared with PRF, CTG resulted in statistically significantly better KMW and RC. No statistically significant differences were reported between the CAF/PRF and CAF/EMD groups or between the CAF/PRF and CAF/AM groups for any of the investigated parameters.

Conclusions: The use of CAF/PRF improved rRC and CAL compared with the use of CAF alone. While similar outcomes were observed between CAF/PRF and CAF/CTG for CAL and PD change, the latter group led to statistically significantly better outcomes in terms of rRC and KTW. In summary, the use of PRF in conjunction with CAF may represent a valid treatment modality for gingival recessions exhibiting adequate baseline KMW.

Clinical relevance: The data indicate that the use of PRF in conjunction with CAF statistically significantly improves rRC when compared with CAF alone but did not improve KMW. Therefore, in cases with limited baseline KMW, the use of CTG may be preferred over PRF.

Keywords: Gingival recession; L-PRF; Periodontal plastic surgery; Platelet-rich fibrin.

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