Fibrina rica em plaquetas versus regeneração óssea guiada: uma revisão sistemática de literatura

Abstract

Graft materials and membranes are used to provide bone regeneration, in locations where the bone resorption process has occurred, both vertical and horizontal. Guided Bone Regeneration (ROG) was introduced as a therapeutic modality that seeks the neoformation of bone tissue reabsorbed using membranes, with or without bone graft. Platelet-rich fibrin (PRF) is a platelet concentrate which has been used alone as a graft material or a membrane or mixed with other graft material in various bone augmentation procedures. The main advantages of PRF are that it is autogenous and releases large amounts of growth factors. Due to the accelerating effects of these cells in soft and hard tissues, PRF can be used in areas such as alveoli preservation techniques, periodontal surgery, maxillary sinus lifting surgery and bone reconstruction procedures in dentistry. The objective of this study was to carry out a systematic review of the literature through the following guiding question: For bone regeneration, the use of PRF, associated or not with bone biomaterial, demonstrates advantages in terms of volume gain and the quality of regenerated bone when compared to the use of membranes of guided bone regeneration barriers? Two reviewers performed a bibliographic search until February 2021, through an electronic search performed in the following databases: PubMed (Medline), Web of Science, Scopus, Scielo and The Cochrane Library, using the search strategy developed for PubMed (Medline) and adapted to other databases. Articles that performed bone regeneration techniques with the use of barrier membranes for guided bone regeneration compared with the use of PRF, associated with bone biomaterial or not, were included. The risk of bias was assessed using the Cochrane Collaboration tool to assess the risk of bias. In general, studies showed a low risk of bias. One hundred and seventy potentially relevant records were identified in all databases. Of these, 4 studies met all selection criteria and were included in the qualitative analysis Two of the four studies used 6 evaluation parameters, one found significant improvement in the PRF group for 3 of the 6 evaluated parameters, and the other found improvement in 2 of the 6 parameters. While the other two studies found no significant differences in their outcomes. The available evidence suggests that the use of Platelet Rich Fibrin can be used in bone regeneration techniques, however, there is insufficient evidence to prove that its use is advantageous when compared to Guided Bone Regeneration.