Use of platelet-rich fibrin for the treatment of gingival recessions: a systematic review and meta-analysis

Objectives The aim of this systematic review and meta-analysis was to compare the use of platelet-rich fibrin (PRF) with othercommonly utilized treatment modalities for root coverage procedures.Materials and methods The eligibility criteria comprised randomized controlled trials (RCTs) comparing the performance ofPRF with that of other modalities in the treatment of Miller class I or II (Cairo RT I) gingival recessions. Studies were classifiedinto 5 categories as follows: (1) coronally advanced flap (CAF) alone vs CAF/PRF, (2) CAF/connective tissue graft (CAF/CTG)vs CAF/PRF, (3) CAF/enamel matrix derivative (CAF/EMD) vs CAF/PRF, (4) CAF/amnion membrane (CAF/AM) vs CAF/PRF, and (5) CAF/CTG vs CAF/CTG/PRF. Studies were evaluated for percentage of relative root coverage (rRC; primaryoutcome), clinical attachment level (CAL), keratinized mucosa width (KMW), and probing depth (PD) (secondary outcomes).Results From 976 articles identified, 17 RCTs were included. The use of PRF statistically significantly increased rRC and CALcompared with CAF alone. No change in KMW or reduction in PD was reported. Compared with PRF, CTG resulted instatistically significantly better KMW and RC. No statistically significant differences were reported between the CAF/PRFand CAF/EMD groups or between the CAF/PRF and CAF/AM groups for any of the investigated parameters.Conclusions The use of CAF/PRF improved rRC and CAL compared with the use of CAF alone. While similar outcomes wereobserved between CAF/PRF and CAF/CTG for CAL and PD change, the latter group led to statistically significantly betteroutcomes in terms of rRC and KTW. In summary, the use of PRF in conjunction with CAF may represent a valid treatmentmodality for gingival recessions exhibiting adequate baseline KMW.Clinical relevance The data indicate that the use of PRF in conjunction with CAF statistically significantly improves rRC whencompared with CAF alone but did not improve KMW. Therefore, in cases with limited baseline KMW, the use of CTG may bepreferred over PRF.