The Evidence-based Effect of Platelet-rich Fibrin in Osteogenesis: A Systematic Review and Meta-analysis

Abstract

ABSTRACT Background: Platelet Rich Fibrin (PRF) is a growth factor concentration functioning as an initiator of wound healing and bone regeneration, and it is mainly reported in dentistry rehabilitation and rejuvenation. Objective: summarize and analyze the evidence based on the effect of PRF on the bone osteogenesis Methods: A comprehensive search was conducted on the bibliographic databases or Medical Subject Headings in the PubMed. The search was conducted among articles that were published between 2010 and 2021.  Required article information was extracted from each article by abstract and full paper availability that focuses on the Platelet-Rich Fibrin (PRF) And Osteogenesis. We recruited studies with the design was employed clinical trials with in vitro and in vivo approaches. The only study that provided osteogenesis outcome proceeded to the quantitative analysis. Results: Regarding literature search and screening processes, it yielded 24 studies for qualitative assessment and eleven studies for quantitative analysis. Most of the studies performed a combination of PRF with other materials such as Mg ring, BMSCs, Gold nanoparticles, and PDLSCs. It showed that PRF combined with other materials enhanced the osteogenic ability. The assessment of PRF only showed the various result in multiple outcome markers. For the ALP, the mean difference is 1.40 [1.14-1.67] p-value 0.001. It indicates there is a significant effect of PRF application with the increase of ALP. For the RUNX2, there is a significant effect of PRF application with the increase of RUNX2 1.10 [0.93, 1.26]. For OCN, the mean difference of PRF in OCN is 0.77 [0.43, 1.12] p=0.001. It showed a significant effect of PRF application with the increase of OCN. There is also a significant effect of PRF application for TRAP with the declining number of TRAP is -1.59 [-2.96, -0.22] p=0.001. Conclusion: PRF combined with other materials showed more promising results rather than PRF only. Moreover, in the assessment of PRF only, it was found that PRF has a significant effect in accelerating bone osteogenesis. Keywords: PRF, Platelet-Rich Fibrin, Osteogenesis