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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 randomised 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. This article is protected by copyright. All rights reserved.

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Objetivo: Analisar a efetividade da L–PRF (fibrina rica em plaquetas e leucócitos) na neoformação óssea em procedimentos cirúrgicos de elevação do assoalho do seio maxilar com fixação simultânea de implantes por meio da revisão sistemática da literatura e metaanálise. Materiais e Métodos: Uma pesquisa bibliográfica digital e manual, sem restrição de idioma, data ou desenho do estudo, foi realizada na PubMed/MEDLINE, Cochrane CENTRAL, Web of Science, literatura cinzenta e periódicos em linha, até janeiro de 2017. Foram selecionados estudos em humanos onde a L–PRF foi utilizada como único material de enxerto na elevação do assoalho do seio maxilar via acesso lateral com fixação simultânea de implantes. Estudo de comparação: elevação do assoalho do seio maxilar, via acesso lateral, sem enxerto. Resultados: Foi aplicada a metaanálise proporcional sobre os resultados dos estudos das técnicas com L–PRF e sem enxerto, com um intervalo de confiança (IC) de 95%. A proporção combinada da média de ganho ósseo foi de 94% (95% IC = 0,83 a 0,99) para os procedimentos realizados com L–PRF em um total de 110 medidas, e de 69% (95% IC = 0,55 a 0,82) para os procedimentos sem enxerto em um total de 342 medidas durante os 6 meses de acompanhamento. A proporção combinada da sobrevivência dos implantes foi de 99% (95% IC = 0,97 a 0,99) para os procedimentos realizados com L–PRF em um total de 110 implantes, e de 97% (95% IC = 0,96 a 0,99) para os procedimentos sem enxerto em um total de 482 implantes, durante 6 meses a 7 anos de acompanhamento. Conclusão: Os coágulos de L–PRF apresentaram um efeito estatisticamente significativo sobre a neoformação óssea na elevação do assoalho do seio maxilar via acesso lateral com a instalação simultânea de implantes, porém eles não apresentaram diferença estatisticamente significativa sobre a sobrevivência dos implantes, quando comparado aos procedimentos sem enxerto, durante os 6 meses a 7 anos de acompanhamento. Aim: Evaluate the effectiveness of leucocyte and platelet–rich fibrin (L–PRF) on new bone formation in maxillary sinus floor augmentation with immediate implant placement via a systematic review and meta-analysis. Materials and Methods: An electronic and hand search without date, language or study design restriction was conducted in PubMed/MEDLINE, Cochrane CENTRAL, Web of Science, grey literature and online journals, to January 2017. Only human studies where L-PRF was applied alone to augment the sinus floor height by lateral sinus approach with immediate implant placement were selected. Comparator studies: maxillary sinus floor augmentation by lateral sinus approach with immediate implant placement without the use of grafting material. Results: A proportional meta-analysis was performed on the outcomes from L–PRF and without grafting techniques studies with the 95% confidence intervals (CI). The pooled proportion of mean bone gain was 94% (95% CI = 0,83 to 0,99) in L–PRF therapy from a total of 110 measures, and 69% (95% CI = 0,55 to 0,82) in the technique without grafting from a total of 342 measures during the 6 months follow-up. The pooled proportion of implant survival was 99% (95% CI = 0,97 to 0,99) in L–PRF therapy from a total of 110 implants, and 97% (95% CI = 0,96 to 0,99) in the technique without grafting from a total of 482 implants, during 6 months to 7 years follow-up. Conclusion: The L–PRF clots showed a statistically significant effect on new bone formation in sinus floor elevation via lateral sinus approach with simultaneous implant placement, however they didn’t show statistically significant difference on implant survival, when compared to no grafting procedures, during 6 months to 7 years follow-up.