Non-Cochrane · intervention · PM42378866
Effects of platelet-rich fibrin combined with hydroxyapatite in the treatment of patients with periodontal intrabony defects: a meta-analysis.
Li Luyue, Liu Tian, Yan Ziqin, et al. · Clinics (Sao Paulo, Brazil) · 2026 · PubMed · doi:10.1016/j.clinsp.2026.101035
Findings
Population Patients with periodontal intrabony defects
19 findings
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Probing depth (PD) change Overall (all time points) | MD 0.74 [0.32, 1.17] GRADE not reported 11 studies |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Gingival index (GI) change 9 months | MD 0.16 [-0.15, 0.47] GRADE not reported 3 studies · 118 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Gingival index (GI) change Overall (all time points) | MD 0.13 [0.01, 0.25] GRADE not reported 5 studies |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Probing depth (PD) change 6 months | MD 0.84 [0.03, 1.64] GRADE not reported 7 studies · 194 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Plaque index (PI) change 6 months | MD 0.03 [-0.08, 0.15] GRADE not reported 3 studies · 72 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Plaque index (PI) change Overall (all time points) | MD 0.05 [0.00, 0.10] GRADE not reported 6 studies |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Clinical attachment loss (CAL) change 6 months | MD 0.90 [-0.02, 1.82] GRADE not reported 7 studies · 194 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Gingival index (GI) change 6 months | MD 0.11 [-0.03, 0.25] GRADE not reported 3 studies · 72 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Clinical attachment loss (CAL) change Overall (all time points) | MD 0.75 [0.32, 1.19] GRADE not reported 11 studies |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Probing depth (PD) change 3 months | MD 0.40 [-0.89, 1.69] GRADE not reported 3 studies · 74 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Clinical attachment loss (CAL) change 9 months | MD 0.63 [0.14, 1.11] GRADE not reported 4 studies · 157 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Plaque index (PI) change 9 months | MD 0.07 [0.01, 0.14] GRADE not reported 3 studies · 118 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Probing depth (PD) change 9 months | MD 0.62 [0.23, 1.02] GRADE not reported 4 studies · 157 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Gingival index (GI) change 3 months | MD 0.13 [-0.06, 0.32] GRADE not reported 1 study · 24 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Plaque index (PI) change 12 months | MD 0.00 [-0.10, 0.10] GRADE not reported 1 study · 24 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Plaque index (PI) change 3 months | MD 0.13 [-0.07, 0.34] GRADE not reported 1 study · 24 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Probing depth (PD) change 12 months | MD 1.50 [1.09, 1.91] GRADE not reported 1 study · 24 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Clinical attachment loss (CAL) change 3 months | MD 0.52 [-0.79, 1.82] GRADE not reported 3 studies · 74 participants |
| Platelet-rich fibrin (PRF) combined with hydroxyapatite (HA), with or without other biocompatible bone substitutes | Same bone substitute(s) alone without PRF (HA alone; two trials list PRF as control in Table 1) | Clinical attachment loss (CAL) change 12 months | MD 1.00 [0.50, 1.50] GRADE not reported 1 study · 24 participants |
Included primary studies 11
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Bahammam 2021 Expression of Vascular Endothelial Growth Factor Using Platelet Rich Fibrin (PRF) and Nanohydroxyapatite (nano-HA) in Treatment of… PMID:33424378 | 2021 | 3 other reviews | not stated | not extracted yet |
| Mallappa 2022 Clinicoradiographic evaluation of advanced-platelet rich fibrin block (A PRF + i PRF + nanohydroxyapatite) compared to nanohydroxyapatite… PMID:35959304 | 2022 | 1 other review | not stated | not extracted yet |
| Pradeep 2017 Platelet-Rich Fibrin Combined With a Porous Hydroxyapatite Graft for the Treatment of 3-Wall Intrabony Defects in Chronic Periodontitis: A… PMID:29314065 | 2017 | 1 other review | not stated | not extracted yet |
| Shah 2023 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Baghele 2023 Clinical and radiographic evaluation of platelet-rich fibrin and bone graft material (β-tricalcium phosphate + hydroxyapatite) in the… PMID:36825719 | 2023 | this review only | not stated | not extracted yet |
| Chaudhary 2023 Injectable platelet-rich fibrin polymerized with hydroxyapatite bone graft for the treatment of three-wall intrabony defects: A randomized… PMID:37152456 | 2023 | this review only | not stated | not extracted yet |
| Dambhare 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Elgendy 2015 Clinical and radiographic evaluation of nanocrystalline hydroxyapatite with or without platelet-rich fibrin membrane in the treatment of… PMID:25810595 | 2015 | this review only | not stated | not extracted yet |
| Nair 2022 Effect of Injectable Platelet-Rich Fibrin with a Nano-Hydroxyapatite Bone Graft on the Treatment of a Grade II Furcation Defect. PMID:36354513 | 2022 | this review only | not stated | not extracted yet |
| Qian 2014 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Thetay 2021 A randomized comparative study of platelet-rich fibrin along with hydroxyapatite graft for the treatment of 3-walled defects in chronic… PMID:36105500 | 2021 | this review only | not stated | 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 periodontal intrabony defects, no restriction on age or nationality | Patients with periodontal intrabony defects (11 RCTs, 351 patients in Table 1) |
| Intervention | Platelet-rich fibrin combined with hydroxyapatite, with or without additional biocompatible bone substitutes | PRF with hydroxyapatite (n=11) |
| Comparison | The same bone substitute material(s) used alone without PRF | Hydroxyapatite alone (n=9); PRF alone (n=2) |
| Outcomes | Probing depth, clinical attachment loss, plaque index, gingival index | Probing depth (n=11); clinical attachment loss (n=11); gingival index (n=5); plaque index (n=6) |
| Study designs | Randomized controlled trials | RCTs (n=11) |
| Timing | Not specified | 3, 6, 9 and 12 months post-surgery |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: N/A | NRSI: N/A · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | No | no |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |