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Purpose: To investigate the use of platelet-rich fibrin for alveolar ridge preservation compared to natural healing, bone graft material and platelet-rich fibrin in combination with bone graft material. Materials and methods: The present systematic review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The review examined randomised controlled trials comparing the clinical outcomes of platelet-rich fibrin with those of other modalities for alveolar ridge preservation. Studies of third molar extraction site healing were excluded. The studies were classified into three categories: natural wound healing vs platelet-rich fibrin; bone graft material vs platelet-rich fibrin; and bone graft material vs bone graft material and platelet-rich fibrin. Results: From 179 articles identified, 16 randomised controlled trials were included. Owing to the heterogeneity of the investigated parameters, it was not possible to perform a meta-analysis. In total, 10 randomised controlled trials compared platelet-rich fibrin to natural wound healing, with seven of these demonstrating favourable outcomes to either limit postextraction dimensional changes or improve new bone formation in the platelet-rich fibrin group. Three of four studies comparing healing with bone graft material to platelet-rich fibrin found that the latter led to significantly greater horizontal or vertical bone resorption, and the bone graft material was more able to maintain the ridge dimensions. Two out of three randomised controlled trials investigating healing with both bone graft material and platelet-rich fibrin reported better outcomes using this combined approach than with bone graft material alone. All studies investigating soft tissue healing with platelet-rich fibrin demonstrated better outcomes in the platelet-rich fibrin group. Conclusions: The majority of studies comparing healing with platelet-rich fibrin to natural healing concluded that the former more successfully limits postextraction dimensional changes than the latter. However, 75% of studies investigating platelet-rich fibrin vs bone graft material reported better results in the bone graft group with respect to its ability to maintain postextraction dimensional changes. The addition of platelet-rich fibrin to bone graft material may improve clinical outcomes, although data are limited. [ABSTRACT FROM AUTHOR]

Aim To analyse the effect of leucocyte- and platelet-rich fibrin (L-PRF) on bone regeneration procedures and osseointegration. Materials and Methods An electronic and hand search was conducted in three databases (MEDLINE, EMBASE and Cochrane). Only randomized clinical trials, written in English where L-PRF was applied in bone regeneration and implant procedures, were selected. No follow-up restrictions were applied. Results A total of 14 articles were included and processed. Three subgroups were created depending on the application: sinus floor elevation (SFE), alveolar ridge preservation and implant therapy. In SFE, for a lateral window as well as for the trans-alveolar technique, histologically faster bone healing was reported when L-PRF was added to most common xenografts. L-PRF alone improved the preservation of the alveolar width, resulting in less buccal bone resorption compared to natural healing. In implant therapy, better implant stability over time and less marginal bone loss were observed when L-PRF was applied. Meta-analyses could not be performed due to the heterogeneity of the data. Conclusions Despite the lack of strong evidence found in this systematic review, L-PRF might have a positive effect on bone regeneration and osseointegration. [ABSTRACT FROM AUTHOR]