Autologous Platelet Concentrates to improve post extraction outcomes

Area of Science:

• Regenerative Medicine
• Oral and Maxillofacial Surgery
• Biomaterials

Background:

• Autologous protein concentrates (APCs), including platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and plasma rich in growth factors (PRGF), are increasingly utilized in dental procedures.
• Their application post-tooth extraction aims to leverage growth factors for enhanced healing and reduced complications.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of APCs in improving outcomes following tooth extraction.
• To assess the impact of APCs on soft tissue healing, bone healing, probing depth, and postoperative complications.

Main Methods:

• A comprehensive electronic search of Medline, Embase, Scopus, and CENTRAL was conducted, supplemented by manual searches.
• Randomized and controlled clinical trials with at least five patients per group were included.
• Meta-analysis was performed for studies reporting comparable outcome measurements, with risk ratios and mean differences calculated.

Main Results:

• APCs significantly improved soft tissue healing at seven days (MD 1.01) and reduced probing depth at three months (MD -1.63).
• Bone density was statistically improved in the APC group (MD 5.06), while new bone percentage and metabolism showed no significant difference.
• No statistical differences were observed for alveolar osteitis, acute inflammation, or alveolar infection; however, qualitative analysis suggested reduced swelling and trismus.

Conclusions:

• APCs show promise in enhancing soft tissue healing, reducing probing depth, and improving bone density after tooth extraction.
• Their benefits extend to reducing swelling and trismus, but evidence does not support their use for reducing pain, alveolar osteitis, inflammation, or infection.
• Further research is needed to investigate the effect of APCs on pain reduction due to study heterogeneity.