Non-Cochrane · intervention · PM42886327
Effectiveness of different autologous platelet concentrates for orthodontic canine retraction following premolar extraction: a systematic review and meta-analysis.
Wang Xiaoya, Li Yuzhen, Shao Jiawen, et al. · Progress in orthodontics · 2026 · PubMed · doi:10.1186/s40510-026-00648-9
Findings
Population Orthodontic patients undergoing maxillary canine retraction following premolar extraction
15 findings
| PRP | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 3–4 months | MD 0.11 [0.01, 0.2] Low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 69 participants |
| PRP | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 2–3 months | MD 0.25 [0.02, 0.48] Low Downgraded: risk of bias, inconsistency 5 studies · 100 participants |
| PRP | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 0–1 month | MD 0.38 [0.26, 0.5] Moderate Downgraded: risk of bias 6 studies · 110 participants |
| PRP | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 1–2 months · Sensitivity analysis excluding Le 2023 | MD 0.09 [0.01, 0.17] GRADE not reported 5 studies |
| PRP | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 1–2 months | MD 0.26 [-0.12, 0.63] Very low Downgraded: risk of bias, imprecision, inconsistency 6 studies · 110 participants |
| i-PRF | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 0–1 month | MD 0.26 [0.09, 0.44] Low Downgraded: inconsistency 4 studies · 94 participants |
| i-PRF | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 1–2 months | MD 0.4 [0.18, 0.61] Very low Downgraded: risk of bias, inconsistency 5 studies · 114 participants |
| i-PRF | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 3–4 months | MD 0.17 [0.01, 0.34] Low Downgraded: imprecision, inconsistency, indirectness 4 studies · 94 participants |
| i-PRF | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 2–3 months | MD 0.35 [0.1, 0.61] Very low Downgraded: risk of bias, inconsistency 5 studies · 114 participants |
| L-PRF | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 1–2 weeks | MD 0.12 [0.09, 0.14] Low Downgraded: risk of bias, imprecision 3 studies · 45 participants |
| L-PRF | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 3–4 months | MD -0.02 [-0.17, 0.13] Very low Downgraded: risk of bias, imprecision 2 studies · 27 participants |
| L-PRF | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 2–3 months | MD 0.07 [0.03, 0.11] Low Downgraded: risk of bias, imprecision 4 studies · 63 participants |
| L-PRF | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 0–1 month | MD 0.54 [0.32, 0.76] Very low Downgraded: risk of bias, imprecision, inconsistency 5 studies · 77 participants |
| L-PRF | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 1–2 months | MD 0.33 [0.05, 0.62] Very low Downgraded: risk of bias, imprecision, inconsistency 7 studies · 108 participants |
| L-PRF | Conventional orthodontic treatment without APC, with or without placebo or sham | Rate of canine retraction 0–1 week | MD 0.04 [0.01, 0.07] Low Downgraded: risk of bias, imprecision 3 studies · 45 participants |
Included primary studies 31
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| El-Timamy 2020 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Pham 2025 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Reyes Pacheco 2020 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Alomar 2025 Evaluating the efficacy of platelet-rich fibrin in accelerating canine retraction following upper first premolar extraction: a split-mouth… PMID:41180777 | 2025 | this review only | Rate of canine retraction | not extracted yet |
| Ammar 2024 Evaluation of the effectiveness of the platelet-rich plasma compared to the injectable platelet-rich fibrin on the rate of maxillary… PMID:37796117 | 2024 | this review only | Rate of canine retraction | not extracted yet |
| Angel 2022 Effects of submucosally administered platelet-rich plasma on the rate of tooth movement. PMID:34491291 | 2022 | this review only | Rate of canine retraction | not extracted yet |
| Arora 2023 Effect of Submucosal Injection of Platelet-rich Plasma on the Rate of Canine Retraction - A Split-mouth Randomized Clinical Study. PMID:38075539 | 2023 | this review only | Rate of canine retraction | not extracted yet |
| Barhate 2022 Effects of autologous leukocyte-platelet rich fibrin (L-PRF) on the rate of maxillary canine retraction and various biomarkers in gingival… PMID:36151016 | 2022 | this review only | Rate of canine retraction | not extracted yet |
| Bulandi 2024 Comparison of various modes of acceleration of orthodontic tooth movement- A clinical study DOI:10.18231/j.jco.2024.052 | 2024 | this review only | not stated | not extracted yet |
| Cagli Karci 2021 Assessment of the effects of local platelet-rich fibrin injection and piezocision on orthodontic tooth movement during canine distalization. PMID:33962809 | 2021 | this review only | not stated | not extracted yet |
| Desai 2023 Effect of a Submucosal Injection of Platelet-Rich Plasma on the Rate of Orthodontic Tooth Movement - A Split-Mouth, Single-Blind… PMID:37250004 | 2023 | this review only | not stated | not extracted yet |
| El-Gazzar 2021 The Effect Of Submucosal Injection Of Platelet-Rich Plasma On Maxillary Canine Retraction: Split-Mouth Randomized Controlled Trial DOI:10.51847/jx4yf9wrl4 | 2021 | this review only | Rate of canine retraction | not extracted yet |
| El-Timamy 2020 Effect of platelet-rich plasma on the rate of orthodontic tooth movement. PMID:33378433 | 2020 | this review only | Rate of canine retraction | not extracted yet |
| Erdur 2021 Effect of injectable platelet-rich fibrin (i-PRF) on the rate of tooth movement. PMID:33459765 | 2021 | this review only | Rate of canine retraction | not extracted yet |
| Gupta 2022 Evaluation of injectable platelet-rich fibrin effect on the rate of canine retraction and alkaline phosphatase levels: An in-vivo study. PMID:36008239 | 2022 | this review only | not stated | not extracted yet |
| Gupta 2024 Effect of leukocyte platelet-rich fibrin on the rate of canine movement – A prospective and randomized control trial DOI:10.25259/apos_42_2023 | 2023 | this review only | Rate of canine retraction | not extracted yet |
| Gupta 2026 A split-mouth randomized controlled trial on leukocyte- and platelet-rich fibrin's role in bone density, trabecular complexity, and canine… PMID:40975630 | 2026 | this review only | not stated | not extracted yet |
| Iswariya 2025 Efficacy of leukocyte-platelet rich fibrin (L-PRF) plug in accelerating the maxillary canine retraction in young adults: A split mouth… PMID:40673283 | 2025 | this review only | Rate of canine retraction | not extracted yet |
| Joy 2021 Comparison of Mini-implant-supported Mandibular Canine Retraction with and without Submucosal Injection of Platelet-rich Plasma: A… DOI:10.5005/jp-journals-10015-1878 | 2021 | this review only | not stated | not extracted yet |
| Kamrani 2026 Efficacy of leukocyte-platelet-rich fibrin (L-PRF) and injectable platelet-rich fibrin (i-PRF) on the rate of canine retraction: a split… PMID:41881359 | 2026 | this review only | Rate of canine retraction | not extracted yet |
| Krishna 2023 Effect of leukocyte-platelet-rich fibrin (L-PRF) on the rate of orthodontic tooth movement and expression of various biomarkers in… PMID:37079155 | 2023 | this review only | Rate of canine retraction | not extracted yet |
| Le 2023 Platelet-rich plasma's (PRP) impacts on accelerated canine movement. PMID:37881667 | 2023 | this review only | Rate of canine retraction | not extracted yet |
| Minh 2025 The effect of platelet-rich fibrin (PRF) on orthodontic tooth movement: A split-mouth randomized controlled trial DOI:10.37988/1811-153x_2025_2_50 | 2025 | this review only | Rate of canine retraction | not extracted yet |
| Naji 2022 Evaluation of the efficacy of platelet-rich plasma (PRP) and injectable platelet-rich fibrin (i-PRF) in the acceleration of canine… DOI:10.4103/jioh.jioh_330_21 | 2022 | this review only | not stated | not extracted yet |
| Nasef 2025 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Pham 2025 [Urinary excretion of 3beta-hydroxy-delta5-steroids in the newborn infant and the effect of ACTH administration (author's transl)]. PMID:202519 | 1977 | this review only | not stated | not extracted yet |
| Reyes Pacheco 2020 Distalization rate of maxillary canines in an alveolus filled with leukocyte-platelet-rich fibrin in adults: A randomized controlled… PMID:32591274 | 2020 | this review only | not stated | not extracted yet |
| Satapathy 2024 Effectiveness of autologous leukocyte-platelet-rich fibrin on the rate of maxillary canine retraction, rotation, pain, and soft tissue… PMID:39317704 | 2024 | this review only | Rate of canine retraction | not extracted yet |
| Zeitounlouian 2021a Effect of injectable platelet-rich fibrin (i-PRF) in accelerating orthodontic tooth movement : A randomized split-mouth-controlled trial. PMID:33481053 | 2021 | this review only | Rate of canine retraction | not extracted yet |
| Zeitounlouian 2021b Three-dimensional evaluation of the effects of injectable platelet rich fibrin (i-PRF) on alveolar bone and root length during orthodontic… PMID:33653326 | 2021 | this review only | not stated | not extracted yet |
| Zeitounlouian 2023 Does the application of autologous injectable Platelet-Rich Fibrin (i-PRF) affect the patient's daily performance during the retraction of… PMID:37978474 | 2023 | 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 | Shared studies | Jaccard |
|---|---|---|
| Bias, Study Quality, and Confounding in Temporomandibular Disorder Research Compared to General Orthodontic Studies: A Systematic Review… (2025) | 3 | 0.00 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients undergoing orthodontic treatment with premolar extraction and requiring canine retraction (human, permanent dentition; Class I/II malocclusion or bimaxillary protrusion) | 549 patients in 26 unique studies (28 articles) (n=26); mean age 16.45 to 33 years; 140 of 465 male; mainly Class I or II malocclusion, mostly maxillary arch |
| Intervention | Local administration of autologous platelet concentrates (PRP, i-PRF or L-PRF) by injection or socket placement, not combined with surgical acceleration | PRP (n=8 studies), i-PRF (n=7), L-PRF (n=8); 3 studies compared two APC subtypes; delivery submucosal (n=12), intraligamentary (n=2), both (n=3), socket (n=7), membrane (n=1) |
| Comparison | Conventional orthodontic treatment without APCs, placebo/sham injection (saline or CaCl2), or contralateral control in split-mouth studies | Untreated control side or arm, saline, CaCl2 or sham injection |
| Outcomes | Primary: rate of canine retraction (mm/month or convertible). Secondary: canine rotation, anchorage loss, pain/discomfort, root resorption, periodontal health, GCF biomarkers | Canine retraction rate pooled (16 studies in meta-analysis); narrative only: canine rotation (n=7), canine inclination (n=4), anchorage loss (n=8), GCF biomarkers (n=7), root resorption/alveolar bone/periodontal health (n=5), patient-reported outcomes (n=6), soft tissue healing and bone density (n=2) |
| Study designs | RCTs (parallel-group or split-mouth) and controlled clinical trials; at least 10 participants; English; meta-analysis restricted to RCTs of maxillary canine retraction not at high risk of bias | 25 RCTs (24 split-mouth, 1 parallel-group) and 1 split-mouth CCT (n=26); 16 RCTs in meta-analysis |
| Timing | Monthly follow-up intervals (PRP, i-PRF); early-phase weekly and monthly intervals (L-PRF) | Pooled intervals 0-1 week to 3-4 months; study follow-up 1 month to 1.5 years |
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 | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | Partial Yes | no |
| 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 | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | RCT: Yes · NRSI: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | RCT: No · NRSI: N/A | no |
| 12Impact of risk of bias on the pooled results | No | Yes | no |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |