Evaluation of clinical outcomes of different types of platelet concentrates alone or in combination with biomaterials for periodontal intra-bony defect treatment: A systematic review

Abstract

Background: Autologous platelet concentrates (APCs) such as PRP, PRF, A-PRF, i-PRF, and T-PRF have been extensively employed to enhance periodontal regeneration, especially in intra-bony defects. This systematic review aimed to compare clinical outcomes of various APCs used alone or with biomaterials for regenerative periodontal surgery. Methods: A systematic search was performed in PubMed, CENTRAL, Scopus, Google Scholar, and EMBASE databases up to January 31, 2024. Studies included randomized clinical trials evaluating the clinical outcomes of APCs in intra-bony defects. Primary outcomes were CAL gain, with secondary outcomes including PPD reduction and radiographic bone fill. Risk of bias was assessed using ROB2. Results: Eight randomized clinical trials involving 236 patients were included. All studies demonstrated significant improvement in CAL and PPD reduction with the use of APCs. Among platelet derivatives, T-PRF and I-PRF combined with grafts such as DFDBA or BPBM showed superior outcomes. A-PRF showed better soft tissue healing, while PRF had slightly better hard tissue regeneration compared to PRP. Conclusion: Platelet concentrates significantly enhance periodontal regeneration. Among them, newer generation concentrates (T-PRF, i-PRF, A-PRF) showed superior outcomes when combined with biomaterials. However, standardization of protocols and long-term outcomes require further research.