Non-Cochrane · intervention · PM41634685
A network meta-analysis of randomized controlled trials evaluating the evidence of pharmacological agents and growth factors in the regeneration of bony defects in chronic periodontitis.
Koli Shivani, Rathod Surekha, Kolte Abhay, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-07742-8
Findings
Population Patients with chronic periodontitis with intrabony or grade II furcation defects
30 findings
| Alendronate (ALN) plus platelet-rich fibrin (PRF) | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, direct evidence estimate | SMD 2.45 GRADE not reported Studies not reported |
| Alendronate (ALN) plus platelet-rich fibrin (PRF) | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, indirect evidence estimate | SMD 2.32 GRADE not reported Studies not reported |
| Alendronate (ALN) plus platelet-rich fibrin (PRF) | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Network meta-analysis, consistency model | SMD 2.45 [2.34, 2.56] GRADE not reported 3 studies |
| Alendronate (ALN) plus platelet-rich fibrin (PRF) | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, direct evidence estimate | SMD 1.89 GRADE not reported Studies not reported |
| Alendronate (ALN) plus platelet-rich fibrin (PRF) | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Network meta-analysis, consistency model | SMD 1.89 [1.57, 2.21] GRADE not reported 3 studies |
| Alendronate (ALN) plus platelet-rich fibrin (PRF) | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, indirect evidence estimate | SMD 0.99 GRADE not reported Studies not reported |
| Rosuvastatin (RSV) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, direct evidence estimate | SMD 2.32 GRADE not reported Studies not reported |
| Rosuvastatin (RSV) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, indirect evidence estimate | SMD 0.99 GRADE not reported Studies not reported |
| Rosuvastatin (RSV) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Network meta-analysis, consistency model | SMD 1.55 [1.17, 1.94] GRADE not reported 1 study |
| Rosuvastatin (RSV) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Network meta-analysis, consistency model | SMD 2.32 [1.99, 2.65] GRADE not reported 1 study |
| Rosuvastatin (RSV) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, indirect evidence estimate | SMD 2.24 GRADE not reported Studies not reported |
| Rosuvastatin (RSV) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, direct evidence estimate | SMD 1.55 GRADE not reported Studies not reported |
| Atorvastatin (ATV) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, indirect evidence estimate | SMD 0.99 GRADE not reported Studies not reported |
| Atorvastatin (ATV) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Network meta-analysis, consistency model | SMD 1.20 [0.72, 1.69] GRADE not reported 1 study |
| Atorvastatin (ATV) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, indirect evidence estimate | SMD 2.29 GRADE not reported Studies not reported |
| Atorvastatin (ATV) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, direct evidence estimate | SMD 2.24 GRADE not reported Studies not reported |
| Atorvastatin (ATV) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, direct evidence estimate | SMD 1.20 GRADE not reported Studies not reported |
| Atorvastatin (ATV) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Network meta-analysis, consistency model | SMD 2.24 [2.11, 2.38] GRADE not reported 1 study |
| Metformin (MF) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, direct evidence estimate | SMD 2.29 GRADE not reported Studies not reported |
| Metformin (MF) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, direct evidence estimate | SMD 1.91 GRADE not reported Studies not reported |
| Metformin (MF) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Network meta-analysis, consistency model | SMD 1.91 [1.37, 2.46] GRADE not reported 4 studies |
| Metformin (MF) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, indirect evidence estimate | SMD 0.99 GRADE not reported Studies not reported |
| Metformin (MF) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Network meta-analysis, consistency model | SMD 2.29 [2.15, 2.44] GRADE not reported 4 studies |
| Metformin (MF) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, indirect evidence estimate | SMD 2.07 GRADE not reported Studies not reported |
| Melatonin (ML) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Network meta-analysis, consistency model | SMD 2.07 [1.98, 2.15] GRADE not reported 1 study |
| Melatonin (ML) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, direct evidence estimate | SMD 2.07 GRADE not reported Studies not reported |
| Melatonin (ML) plus PRF | PRF alone (placebo-containing PRF) | Bone fill (BF) 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, indirect evidence estimate | SMD 2.45 GRADE not reported Studies not reported |
| Melatonin (ML) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, direct evidence estimate | SMD 0.99 GRADE not reported Studies not reported |
| Melatonin (ML) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Network meta-analysis, consistency model | SMD 0.99 [0.76, 1.22] GRADE not reported 1 study |
| Melatonin (ML) plus PRF | PRF alone (placebo-containing PRF) | Clinical attachment level (CAL) gain 6 and 9 months post-treatment (follow-up times combined) · Periodontal regenerative surgery for intrabony and furcation defects · Side-splitting inconsistency analysis, indirect evidence estimate | SMD 0.99 GRADE not reported Studies not reported |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Martande 2016 Platelet-Rich Fibrin Combined With 1.2% Atorvastatin for Treatment of Intrabony Defects in Chronic Periodontitis: A Randomized Controlled… PMID:27294433 | 2016 | 3 other reviews | Clinical attachment level (CAL) gain; Bone fill (BF) | not extracted yet |
| Kanoriya 2016 (intrabony) Synergistic Approach Using Platelet-Rich Fibrin and 1% Alendronate for Intrabony Defect Treatment in Chronic Periodontitis: A Randomized… PMID:27562221 | 2016 | 2 other reviews | Clinical attachment level (CAL) gain; Bone fill (BF) | not extracted yet |
| Pradeep 2016 Platelet-Rich Fibrin With 1.2% Rosuvastatin for Treatment of Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical… PMID:27452270 | 2016 | 2 other reviews | Clinical attachment level (CAL) gain; Bone fill (BF) | not extracted yet |
| Pradeep 2015 Platelet-rich fibrin with 1% metformin for the treatment of intrabony defects in chronic periodontitis: a randomized controlled clinical… PMID:25762357 | 2015 | 1 other review | Clinical attachment level (CAL) gain; Bone fill (BF) | not extracted yet |
| Dhande 2023 Clinicoradiographic comparative evaluation of 1% melatonin gel plus platelet-rich fibrin over platelet-rich fibrin alone in treatment of… PMID:37515478 | 2024 | this review only | Clinical attachment level (CAL) gain; Bone fill (BF) | not extracted yet |
| Kamel 2022 Advanced-Platelet-Rich Fibrin Combination with Metformin for Surgical Correction of Periodontal Intrabony Defects: A Randomized Double… DOI:10.21608/omx.2022.128859.1156 | 2021 | this review only | Clinical attachment level (CAL) gain; Bone fill (BF) | not extracted yet |
| Kanoriya 2016 (furcation) Mandibular Degree II Furcation Defects Treatment With Platelet-Rich Fibrin and 1% Alendronate Gel Combination: A Randomized Controlled… PMID:27712462 | 2017 | this review only | Clinical attachment level (CAL) gain; Bone fill (BF) | not extracted yet |
| Sharma 2017 A clinicoradiographic assessment of 1% metformin gel with platelet-rich fibrin in the treatment of mandibular grade II furcation defects. PMID:29456305 | 2017 | this review only | Clinical attachment level (CAL) gain; Bone fill (BF) | not extracted yet |
| Swami 2021 Clinico-radiographic comparative evaluation of 1% metformin gel plus platelet-rich fibrin over platelet-rich fibrin alone in the treatment… PMID:34533832 | 2022 | this review only | Clinical attachment level (CAL) gain; Bone fill (BF) | not extracted yet |
| Wanikar 2018 Clinico-radiographic evaluation of 1% alendronate gel as an adjunct and smart blood derivative platelet rich fibrin in grade II furcation… PMID:30007039 | 2019 | this review only | Clinical attachment level (CAL) gain; Bone fill (BF) | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with chronic periodontitis with intrabony or grade II furcation defects | Chronic periodontitis with intrabony (n=6) or interradicular/furcation (n=4) defects; 393 participants |
| Intervention | PRF combined with alendronate, rosuvastatin, atorvastatin, metformin or melatonin | PRF + alendronate (n=3); PRF + rosuvastatin (n=1); PRF + atorvastatin (n=1); PRF + metformin (n=4); PRF + melatonin (n=1) |
| Comparison | Other drug-PRF combinations and PRF alone | PRF alone (n=10) |
| Outcomes | Clinical attachment level and bone fill | Clinical attachment level; bone fill |
| Study designs | RCTs published after 2016, English, minimum 6 months follow-up | RCTs (n=10) |
| Timing | 6 to 9 months post-treatment | 6 months (n=4); 9 months (n=6) |