Cochrane · intervention · CD011423
Autologous platelet concentrates for treating periodontal infrabony defects
Del Fabbro, M, Karanxha, L, Panda, S, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
34
current version
GRADE rated
11
No studies
5
Included studies
38
as reported
No studies 5 · 14.7%Ungraded 18 · 52.9%Very low 11 · 32.4%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients affected by infrabony defects requiring surgical treatment, regardless of their age or gender | Patients affected by infrabony defects requiring surgical treatment regardless of age or gender; age range 17 to 74 years; 35 studies included both men and women (different proportions), 3 studies did not report this; most studies did not include smokers |
| Intervention | Autologous platelet concentrates (APCs) (irrespective of type: platelet-rich plasma (PRP), plasma-rich growth factors (PRGF), or platelet-rich fibrin (PRF)) used in conjunction with a specific surgical technique: OFD; OFD + bone graft (BG); guided tissue regeneration (GTR); enamel matrix derivative (EMD) | Autologous platelet concentrates (APCs) (PRP, PRGF, or PRF) used in conjunction with a specific surgical technique: APC + open flap debridement (OFD) (n=12); APC + OFD + bone graft (BG) (n=17); APC + guided tissue regeneration (GTR) (n=7); APC + enamel matrix derivative (EMD) (n=2) |
| Comparison | The same surgical techniques when used alone (without the adjunct of APCs) | The same surgical techniques used alone (without APC): OFD alone (n=12); OFD + BG (n=17); GTR (n=7); EMD (n=2) |
| Outcomes | Primary outcomes: change in probing depth (PD); change in clinical attachment level (CAL); change in radiographic bone defect filling (RBF). Secondary outcomes: tooth survival; pocket closure; oral health-related quality of life | Change in probing depth (n=38); Change in clinical attachment level (n=38); Change in radiographic bone defect filling (n=31); Tooth survival (n=38); Pocket closure (n=38); Oral health-related quality of life (n=0) |
| Study designs | Randomised controlled trials of both parallel and split-mouth design | Randomised controlled trials of both parallel (n=16) and split-mouth (n=22) design |
| Timing | Not reported | Follow-up between 3 and 6 months; Follow-up between 9 and 12 months |
Search date: 27 February 2018. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid; LILACS BIREME Virtual Health Library
Questions and results
Current version onlyAutologous platelet concentrates (APC) + open flap debridement (OFD) vs OFD (open flap debridement) alone
Population: Patients affected by infrabony defects requiring surgical treatment, regardless of their age or gender
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in probing depth (PD) (mm) 9 to 12 months | MD 1.29 [1.00, 1.58] 1.29 [1.00, 1.58] mm | 12 studies · 510 participants | Very low Downgraded: risk of bias, inconsistency |
Tooth survival | All studies in all groups reported a survival rate of 100% for the treated teeth (no comparative estimate; not GRADE-rated). | 12 studies | Ungraded |
Change in radiographic bone defect filling (RBF) (%) 9 to 12 months | MD 34.26 [30.07, 38.46] 34.26 [30.07, 38.46] % | 9 studies · 401 participants | Very low Downgraded: risk of bias, inconsistency |
Oral health-related quality of life | No quantitative analysis regarding patients' quality of life was possible (no data). | 0 studies | No studies |
Change in clinical attachment level (CAL) (mm) 9 to 12 months | MD 1.47 [1.11, 1.82] 1.47 [1.11, 1.82] mm | 12 studies · 510 participants | Very low Downgraded: risk of bias, inconsistency |
Pocket closure (complete pocket closure) | No complete pocket closure was reported (outcome addressed across included studies; no usable comparative estimate). | NR | Ungraded |
Autologous platelet concentrates (APC) + open flap debridement (OFD) + bone graft (BG) vs OFD + BG (open flap debridement + bone graft)
Population: Patients affected by infrabony defects requiring surgical treatment, regardless of their age or gender
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in probing depth (PD) (mm) 3 to 6 months | MD 0.62 [0.30, 0.94] | 11 studies · 272 participants | Ungraded |
Change in radiographic bone defect filling (RBF) (%) All follow-ups | MD 8.10 [5.26, 10.94] 8.10 [5.26, 10.94] % | 11 studies · 420 participants | Very low Downgraded: risk of bias, inconsistency |
Change in clinical attachment level (CAL) (mm) 3 to 6 months | MD 0.47 [0.11, 0.84] | 11 studies · 272 participants | Ungraded |
Pocket closure (complete pocket closure) | No complete pocket closure was reported (outcome addressed across included studies; no usable comparative estimate). | NR | Ungraded |
Change in radiographic bone defect filling (RBF) (%) 9 to 12 months | MD 9.99 [6.44, 13.55] | 6 studies · 282 participants | Ungraded |
Change in probing depth (PD) (mm) 9 to 12 months | MD 0.50 [0.31, 0.69] | 10 studies · 381 participants | Ungraded |
Change in radiographic bone defect filling (RBF) (%) 3 to 6 months | MD 4.76 [1.27, 8.25] | 6 studies · 162 participants | Ungraded |
Change in clinical attachment level (CAL) (mm) All follow-ups | MD 0.72 [0.43, 1.00] 0.72 [0.43, 1.00] mm | 17 studies · 569 participants | Very low Downgraded: risk of bias, inconsistency |
Change in probing depth (PD) (mm) All follow-ups | MD 0.54 [0.33, 0.75] 0.54 [0.33, 0.75] mm | 17 studies · 569 participants | Very low Downgraded: risk of bias, inconsistency |
Oral health-related quality of life | No quantitative analysis regarding patients' quality of life was possible (no data). | 0 studies | No studies |
Tooth survival | All studies in all groups reported a survival rate of 100% for the treated teeth (no comparative estimate; not GRADE-rated). | 17 studies | Ungraded |
Change in clinical attachment level (CAL) (mm) 9 to 12 months · Split-mouth studies only | MD 0.84 [0.62, 1.06] | 6 studies · 192 participants | Ungraded |
Autologous platelet concentrates (APC) + guided tissue regeneration (GTR) vs GTR (guided tissue regeneration) alone
Population: Patients affected by infrabony defects requiring surgical treatment, regardless of their age or gender
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pocket closure (complete pocket closure) | No complete pocket closure was reported (outcome addressed across included studies; no usable comparative estimate). | NR | Ungraded |
Change in probing depth (PD) (mm) All follow-ups | MD 0.92 [-0.02, 1.86] 0.92 [-0.02, 1.86] mm | 7 studies · 248 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Oral health-related quality of life | No quantitative analysis regarding patients' quality of life was possible (no data). | 0 studies | No studies |
Change in clinical attachment level (CAL) (mm) All follow-ups | MD 0.42 [-0.02, 0.86] 0.42 [-0.02, 0.86] mm | 7 studies · 248 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Tooth survival | All studies in all groups reported a survival rate of 100% for the treated teeth (no comparative estimate; not GRADE-rated). | 7 studies | Ungraded |
Change in clinical attachment level (CAL) (mm) 9 to 12 months | MD 0.27 [-0.39, 0.93] | 5 studies · 164 participants | Ungraded |
Change in probing depth (PD) (mm) 3 to 6 months · Split-mouth studies only | MD 1.07 [-0.71, 2.86] | 3 studies · 134 participants | Ungraded |
Change in clinical attachment level (CAL) (mm) 3 to 6 months · Split-mouth studies only | MD 0.54 [0.18, 0.89] | 3 studies · 134 participants | Ungraded |
Change in radiographic bone defect filling (RBF) (%) All follow-ups | No RBF (radiographic bone defect filling) data were available for the APC + GTR versus GTR comparison. | 0 studies | No studies |
Change in probing depth (PD) (mm) 9 to 12 months | MD 0.68 [-0.66, 2.02] | 5 studies · 164 participants | Ungraded |
Autologous platelet concentrates (APC) + enamel matrix derivative (EMD) vs EMD (enamel matrix derivative) alone
Population: Patients affected by infrabony defects requiring surgical treatment, regardless of their age or gender
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Oral health-related quality of life | No quantitative analysis regarding patients' quality of life was possible (no data). | 0 studies | No studies |
Pocket closure (complete pocket closure) | No complete pocket closure was reported (outcome addressed across included studies; no usable comparative estimate). | NR | Ungraded |
Change in clinical attachment level (CAL) (mm) All follow-ups | MD 0.10 [-0.13, 0.32] 0.10 [-0.13, 0.32] mm | 2 studies · 75 participants | Very low Downgraded: risk of bias, imprecision |
Change in probing depth (PD) (mm) All follow-ups | MD 0.13 [-0.05, 0.30] 0.13 [-0.05, 0.30] mm | 2 studies · 75 participants | Very low Downgraded: risk of bias, imprecision |
Change in radiographic bone defect filling (RBF) (%) All follow-ups | MD -0.60 [-6.21, 5.01] -0.60 [-6.21, 5.01] % | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Tooth survival | All studies in all groups reported a survival rate of 100% for the treated teeth (no comparative estimate; not GRADE-rated). | 2 studies | Ungraded |
Autologous platelet concentrates (APC) + open flap debridement (OFD) vs OFD (open flap debridement) alone
Population: All individuals with periodontal tissue defects requiring surgical treatment, independent of age or gender
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | Protocol only (no studies assessed). Planned main comparison 1: 'APCs and OFD versus OFD alone'. | NR | No studies |
Autologous platelet concentrates (APC) + bone grafting (BG) vs BG (bone grafting) alone
Population: All individuals with periodontal tissue defects requiring surgical treatment, independent of age or gender
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | Protocol only (no studies assessed). Planned main comparison 2: 'APCs/BG versus BG alone'. | NR | No studies |
Autologous platelet concentrates (APC) + bone grafting (BG) + guided tissue regeneration (GTR) vs BG + GTR alone
Population: All individuals with periodontal tissue defects requiring surgical treatment, independent of age or gender
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | Protocol only (no studies assessed). Planned main comparison 3: 'APCs/BG/GTR versus BG/GTR alone'. Maps by meaning to the GTR comparison reported in PUB2. | NR | No studies |
Autologous platelet concentrates (APC) + enamel matrix derivative (EMD) / OFD vs EMD (enamel matrix derivative) / OFD
Population: All individuals with periodontal tissue defects requiring surgical treatment, independent of age or gender
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | Protocol only (no studies assessed). Planned main comparison 4: 'EMD/OFD versus APCs/OFD'. Maps by meaning to the EMD comparison reported in PUB2. | NR | No studies |