Clinical Efficacy of Platelet Derivatives in Periodontal Tissue Regeneration: An Umbrella Review

Table 1

Features of the reviews and meta-analyses evaluated.

Authors	Review type	Number of papers included	Type of periodontal regeneration	Types of platelet derivative	Main results
Miron et al. [17]	Systematic review	22	Intrabony defects and periodontal plastic surgery	PRF	Intrabony defect: additional use of PRF resulted in reduced PD and CAL gain compared to OFD ().; Periodontal plastic surgery: CTG produced greater width in the keratinized tissue compared to PRF.
Miron et al. [18]	Systematic review and meta-analysis	27	Intrabony defects	PRF and L-PRF	Intrabony defect: higher overall CAL with PRF (0.84 (95% CI: 0.57–1.11) greater radiographic bone fill with PRF (0.99, 95% CI: 0.64–1.34).
Castro et al. [19]	Systematic review and meta-analysis	24	Intrabony defects and periodontal plastic surgery	PRF-L	Intrabony defect: PRF-L application led to reduced PD (mean difference: 1.1 mm, , CI: 0.6–1.6), and CAL gain (mean difference: 1, 2 mm, , CI: 0.5–1.9).; Amount of bone fill in mm (mean difference: 1.7 mm, , CI: 1.0–2.3) and bone fill % (mean difference: 46.0%, 95% CI: 33.2–58.7).; Periodontal plastic surgery: PRF-L produced a reduction in recession depth (mean difference: 0.6 mm, , CI: 0.2–1.1).
Panda et al. [20]	Systematic review and meta-analysis	15	Intrabony defects	PRF and PRP	Intrabony defect: bone fill %: PRF and PRP significantly higher than OFD alone.; PRP + bone grafting caused significant improvement in CAL.
Zhou et al. [21]	Systematic review and meta-analysis	6	Intrabony defects	PRP and PRF	Intrabony defect: PD reduction: PRP and PRF presented statistically significant differences compared to DFDBA alone.; PRP: mean deviation of (0.47; 95% CI: 0.14–0.80) and PRF: 0.88 (95% CI: 0.41–1.34); CAL gain: PRF statistically significant difference compared to DFDBA alone, mean deviation 0.77 (95% CI: 0.31–1.22). Greater with PRF than amniotic membrane.; Bone fill %: PRP statistically significant difference compared to DFDBA alone; mean deviation 0.71 (95% CI: 0.13–1.29).
Moraschini and Barboza [24]	Systematic review and meta-analysis	7	Periodontal plastic surgery	PRF	Periodontal plastic surgery: improvement in healing and healing parameters. Postoperative comfort especially in the donor site.
Najeeb et al. [22]	Systematic review	13	Intrabony defects	PRF	Intraosseous defect: it was not reported a statistically significant additional benefit in clinical parameters with the use of PRF.
Tavelli et al. [23]	Systematic review and network meta-analysis	55	Intrabony defects	PRP, PRF, and L-PRF	Intraosseous defect: PD reduction: PRP (−0.41; 95% CI: −0.66 to − 0.16).; PRF (−0.57; 95% CI: −0.76, −0.38); CAL gain: PRP (−0.58; 95% CI: −0.91 to − 0.26); PRF (−0.82; 95% CI: −1.08, −0.56).; Bone fill %: PRP (17.32; 95% CI: 6.12–28.51).; PRF (29.61; 95% CI: 23.28–35.93).; EMD (19.71; 95% CI: 12.78, 26.64).

PD, probing depth; CAL, clinical attachment level; PRF, platelet-rich fibrin; PRP, platelet-rich plasma; L-PRF, leucocyte- and platelet-rich fibrin; OFD, surgical or open field therapy; DFDBA, demineralized bone matrix; CTG, connective tissue graft; EMD, emdogain.