The Efficacy of Adjunctive Platelet Concentrates in Combined Guided Tissue Regeneration and Bovine Bone Grafting for Intrabony Defects: A Systematic Review.

چکیده اصلی

OBJECTIVES: Autologous platelet concentrates (APCs) have emerged as biologically active adjuncts in guided tissue regeneration (GTR), aiming to enhance the treatment of intrabony periodontal defects through the local release of growth factors. Despite growing interest, the clinical benefits of combining APCs with bovine-derived bone grafts (BBG) in the treatment of intrabony periodontal defects remain uncertain. This systematic review aimed to evaluate the clinical efficacy of incorporating APCs alongside GTR and BBG in managing intrabony defects. MATERIALS AND METHODS: A comprehensive electronic literature search was conducted across PubMed, Ovid MEDLINE, Scopus, Cochrane, and Web of Science. Inclusion criteria included randomised control trials involving systemically healthy adults with periodontal intrabony defects > 3 mm. Studies were screened based on predefined inclusion and exclusion criteria, and the methodological quality and risk of bias were assessed using the Cochrane Risk of Bias 2.0 tool. RESULTS: The initial search identified 214 articles, from which eight full-text studies were screened for eligibility. Five randomised controlled trials met the inclusion criteria. One study reported potential clinical benefits with adjunctive APC use, while the remaining trials showed no statistically significant improvements. All included studies demonstrated concerns regarding risk of bias, primarily due to the absence of predefined protocols, and only one study provided trial outcomes beyond 12 months. Overall, the APC groups exhibited slightly greater mean gains in clinical attachment level (0.1-1.0 mm) and probing pocket depth reduction (0.1-0.8 mm) at 12 months compared with controls. CONCLUSION: The adjunctive use of APCs with bovine-derived bone grafts and guided tissue regeneration did not result in statistically significant improvements in clinical attachment level gain or probing pocket depth reduction. Future studies with standardised methodologies, larger sample sizes, and extended follow-up durations are needed to clarify the long-term efficacy of APCs in periodontal regenerative therapy.

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