Abstract
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 ClinicalTrials.gov 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.
Keywords
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References
- Is PRP useful in alveolar cleft reconstruction? Platelet-rich plasma in secondary alveoloplasty.Med Oral Patol Oral Cir Bucal. 2010; 15: e619-e623
- Factors contributing to delay or absence of alveolar bone grafting.Am J Orthod Dentofacial Orthop. 2022; 161: 820-828.e1
- A novel and practical protocol for three-dimensional assessment of alveolar cleft grafting procedures.Cleft Palate Craniofac J. 2022; (Online ahead of print)
- Reduction of bone resorption by the application of platelet-rich plasma (PRP) in bone grafting of the alveolar cleft.J Craniomaxillofac Surg. 2011; 39: 278-283
- De novo bone formation using bovine collagen and platelet-rich plasma.Biomaterials. 2004; 25: 5387-5393
- Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 101: 299-303
- CGF—una proposta terapeutica per la medicina rigenerativa.Odontoiatria. 2010; 1: 69-81
- Principles and methods of preparation of platelet-rich plasma: a review and author’s perspective.J Cutaneous Aesthet Surg. 2014; 7: 189-197
- Mechanical properties of human concentrated growth factor (CGF) membrane and the CGF graft with bone morphogenetic protein-2 (BMP-2) onto periosteum of the skull of nude mice.Int J Mol Sci. 2021; 2211331
- The use of platelet-rich plasma in bone reconstruction therapy.Biomaterials. 2009; 30: 4956-4966
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.Ann Intern Med. 2009; 151: 264-269
- Use of platelet-rich fibrin in the treatment of periodontal intrabony defects: a systematic review and meta-analysis.Biomed Res Int. 2021; 20216669168
- Cochrane Handbook for Systematic Reviews of Interventions. Second edition. John Wiley & Sons, Chichester2019
- A coefficient of agreement for nominal scales.Educ Psychol Meas. 1960; 20: 37-46
- Practical Statistics for Medical Research.Chapman and Hall, 1991
ReviewManager (RevMan) version 5.3. The Cochrane Collaboration. Copenhagen, Denmark: TheNordic Cochrane Centre, 2014.
- GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables.J Clin Epidemiol. 2011; 64: 383-394
- Alveolar bone graft with platelet rich plasma in cleft alveolus.J Oral Biol Craniofac Res. 2013; 3: 3-8
- Does platelet-rich fibrin enhance bone quality and quantity of alveolar cleft reconstruction?.Cleft Palate Craniofac J. 2016; 53: 597-606
- Evaluating of platelet-rich fibrin in the treatment of alveolar cleft with iliac bone graft by means of volumetric analysis.J Craniofac Surg. 2018; 29: 322-326
- Efficacy of platelet-rich fibrin combined with autogenous bone graft in the quality and quantity of maxillary alveolar cleft reconstruction.Iran J Otorhinolaryngol. 2018; 30: 329-334
- Assessment of bone formation after secondary alveolar bone grafting with and without platelet-rich plasma using computer-aided engineering techniques.J Craniofac Surg. 2020; 31: 549-552
- Efficacy of platelet-rich plasma in enhancing the osteogenic potential of bone graft in oral and maxillofacial region.J Maxillofac Oral Surg. 2021; 20: 282-295
- A three-dimensional cell-loading system using autologous plasma loaded into a porous β-tricalcium-phosphate block promotes bone formation at extraskeletal sites in rats.Mater Sci Eng C Mater Biol Appl. 2007; 27: 625-632
- Effect of platelet-rich plasma on bone grafting of alveolar clefts.J Craniofac Surg. 2017; 28: 486-488
- Effect of platelet concentration in platelet-rich plasma on peri-implant bone regeneration.Bone. 2004; 34: 665-671
- Alveolar cleft bone grafting: factors affecting case prognosis.J Korean Assoc Oral Maxillofac Surg. 2020; 46: 409-416
- Cleft size and success of secondary alveolar bone grafting—a systematic review.Cleft Palate Craniofac J. 2021; (Online ahead of print)
- Does timing of secondary alveolar bone grafting affect the need for additional bone augmentation prior to implant placement at cleft sites?.J Oral Maxillofac Surg. 2021; 79: 1927-1931
Article info
Publication history
Published online: March 14, 2023
Accepted:
January 6,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
