Effectiveness of platelet rich fibrin alone or in combination with bone grafts in the treatment of infrabony defects: Systematic review and metanalysis

This systematic review aimed to investigate the effectiveness of PRF alone or in combination with bone grafts in enhancement of tissue/bone formation in infrabony defects. A search was performed in electronic databases (i.e. Pubmed/MEDLINE, EMBASE, Cochrane, Clinical trials.org) in order to identify Randomized Control Trials (RCTs). The last electronic search was run on 24 August 2021. From the search, 21 articles fulfilled the inclusion criteria and were quantitatively analyzed. In total, there were 13 articles with low risk of bias, 4 with some concerns and 4 with high risk. The meta-analysis showed that there was a statistically significant benefit from the use of PRF alone or in combination with bone graft after 6 months follow up in clinical attachment level (CAL), periodontal probing depth (PPD) and bone fill (BF). However, there was not a significant difference in CAL and PPD after 9 months. In summary the use of PRF was effective in the treatment of periodontal infrabony defects especially in CAL and BF after 6 months follow up. From the interpretation of the results, we indicate that the combination of PRF with grafting materials may accelerate the bone healing process in the treatment of intrabony defects.