Cleft lip and palate Meta-Analysis|Articles in Press

The effectiveness of using platelet-rich concentrate with iliac bone graft in the repair of alveolar cleft: a meta-analysis of randomized controlled trials

  • T. Li
    Medical College of Nanchang University, Nanchang, Jiangxi Province, China

    Department of Plastic Surgery, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
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  • Y.Y. Wang
    Medical College of Nanchang University, Nanchang, Jiangxi Province, China

    Department of Plastic Surgery, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China
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  • C. Liu
    Correspondence to: Department of Plastic Surgery, Jiangxi Provincial People’s Hospital, Nanchang 330006, Jiangxi Province, China.
    Department of Plastic Surgery, Jiangxi Provincial People’s Hospital, Nanchang, Jiangxi Province, China

    The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
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Published:March 14, 2023DOI:


      The purpose of this study was to review the existing evidence from randomized controlled trials (RCTs) on the effect of autogenous bone grafts combined with a platelet-rich concentrate on alveolar clefts. An electronic search was conducted in the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Embase, and databases for studies published between January 2000 and April 2022. This study included six RCTs to evaluate bone quantity (bone formation ratio, %) and quality (bone density in Hounsfield units, HU), as well as complications as a way to assess the safety of the technique. Two independent reviewers assessed the risk of bias. There was no statistically significant difference in bone formation ratio at 6 months of follow-up between the use of autologous bone alone for alveolar bone grafting or adding platelet-rich plasma (PRP) (mean difference (MD) 14.33%, 95% confidence interval (CI) − 7.19% to 35.85%; P = 0.196) or platelet-rich fibrin (PRF) (MD 9.38%, 95% CI −2.36% to 21.12%; P = 0.123) to autologous bone. The MD for the change in bone density at 6 months was in favour of PRP added to autologous bone graft (MD 155.69 HU, 95% CI 99.29–212.09 HU; P < 0.001); however, this result was based on only two studies, one of which had a high risk of bias. Patients who received autologous bone graft with PRP were significantly less likely to experience complications (odds ratio (OR) 0.21, 95% CI 0.05–0.92; P = 0.038), but this was no longer statistically significant after a sensitivity test (OR 0.24, 95% CI 0.04–1.56; P = 0.138). In conclusion, this systematic review and meta-analysis appears to show no benefit to using a platelet-rich concentrate combined with autologous bone for alveolar cleft grafting in terms of bone volume, bone density, or complications.


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