Regenerative potential of leucocyte- and platelet-rich fibrin. Part A: intra-bony defects, furcation defects and periodontal plastic surgery. A systematic review and meta-analysis

AimTo analyse the regenerative potential of leucocyte- and platelet-rich fibrin (L-PRF) during periodontal surgery. Materials and MethodsAn electronic and hand search were conducted in three databases. Only randomized clinical trials were selected and no follow-up limitation was applied. Pocket depth (PD), clinical attachment level (CAL), bone fill, keratinized tissue width (KTW), recession reduction and root coverage (%) were considered as outcome. When possible, meta-analysis was performed. ResultsTwenty-four articles fulfilled the inclusion and exclusion criteria. Three subgroups were created: intra-bony defects (IBDs), furcation defects and periodontal plastic surgery. Meta-analysis was performed in all the subgroups. Significant PD reduction (1.10.5mm, p<0.001), CAL gain (1.2 +/- 0.6mm, p<0.001) and bone fill (1.7 +/- 0.7mm, p<0.001) were found when comparing L-PRF to open flap debridement (OFD) in IBDs. For furcation defects, significant PD reduction (1.9 +/- 1.5mm, p=0.01), CAL gain (1.3 +/- 0.4mm, p<0.001) and bone fill (1.5 +/- 0.3mm, p<0.001) were reported when comparing L-PRF to OFD. When L-PRF was compared to a connective tissue graft, similar outcomes were recorded for PD reduction (0.2 +/- 0.3mm, p>0.05), CAL gain (0.2 +/- 0.5mm, p>0.05), KTW (0.3 +/- 0.4mm, p>0.05) and recession reduction (0.2 +/- 0.3mm, p>0.05). ConclusionsL-PRF enhances periodontal wound healing.