Evaluate quantitative and qualitative outputs when comparing the incidence of platelet concentrates (PCs) combined with autogenous bone grafts to an autograft control group for the reconstruction of alveolar cleft defects.
Design
Systematic review and meta-analysis.
Patients/Participants
Randomized and nonrandomized controlled clinical trials where PCs were used in the reconstruction of alveolar cleft defects.
Interventions
Use of PCs in combination with autogenous bone graft in the experimental group and autogenous bone graft alone in the control group.
Main Outcome Measure(s)
Average bone formation and bone density were evaluated, mean differences were calculated and pooled by a meta-analysis technique. Additionally, clinical outcomes such as wound dehiscence, closure of the oronasal fistula, pain, swelling, discharges, infections, and bleeding were considered in the qualitative synthesis.
Results
After an evaluation of forty-nine articles, nineteen were considered for the review. The qualitative assessment of bone density, bone formation, and clinical outcomes showed no differences between groups in most of the included studies. The meta-analysis showed no statistical differences between PCs groups when compared to the control group in bone density at three months (mean difference 45.67 HU, P = .23) and six months (mean difference 48.57 HU, P = .64). Neither were statistical differences in the percentage of regenerated bone volume at six months (mean difference 6.39%, P = .15) and the volume of newly formed bone at 12 months (mean difference 0.37 mm3, P = .99).
Conclusions
There were no significant differences in terms of bone formation, bone density, and clinical outputs between groups.
JasmineSThangaveluAKrishnamoorthyRAlshatwiAA. Platelet concentrates as biomaterials in tissue engineering: A review. Regen Eng Transl Med. 2021(7):419-431. doi:10.1007/s40883-020-00165-z
2.
KhojastehAKheiriLMotamedianSRNadjmiN. Regenerative medicine in the treatment of alveolar cleft defect: A systematic review of the literature. Journal of Cranio-Maxillofacial Surgery. 2015;43(8):1608-1613. doi:10.1016/j.jcms.2015.06.041
3.
YehyaAGamaanIElMonemMA, et al.Modified platelet rich plasma (PRP) technique in repair of primary cleft palate. La Prensa Medica Argentina. 2020;106(2):1-4. doi:10.47275/0032-745x-197
4.
GiudiceGCutrignelliDALeuzziSRobustoFSportelliPNacchieroE. Autologous bone grafting with platelet-rich plasma for alveolar cleft repair in patient with cleft and palate. Ann Ital Chir. 2016;87(1):5-12.
5.
Dayashankara RaoJKBhatnagarAPandeyR, et al.A comparative evaluation of iliac crest bone graft with and without injectable and advanced platelet rich fibrin in secondary alveolar bone grafting for cleft alveolus in unilateral cleft lip and palate patients: A randomized prospective study. J Stomatol Oral Maxillofac Surg. 2021;122(3):241-247. doi:10.1016/j.jormas.2020.07.007
6.
MijiritskyEAssafHDPelegOShachamMCerroniLManganiL. Use of PRP, PRF and CGF in periodontal regeneration and facial rejuvenation—A narrative review. Biology (Basel). 2021;10(4):317. doi:10.3390/biology10040317
7.
LeeCNishiharaKOkawachiTIwashitaYMajimaHJNakamuraN. A quantitative radiological assessment of outcomes of autogenous bone graft combined with platelet-rich plasma in the alveolar cleft. Int J Oral Maxillofac Surg. 2009;38(2):117-125. doi:10.1016/j.ijom.2008.11.019
8.
MarxRECarlsonEREichstaedtRMSchimmeleSRStraussJEGeorgeffKR. Platelet-rich plasma: Growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(6):38-46. doi:10.1016/s1079-2104(98)90029-4
9.
GuptaCMehrotraDMohammadS, et al.Alveolar bone graft with platelet rich plasma in cleft alveolus. J Oral Biol Craniofac Res. 2013;3(1):3-8. doi:10.1016/j.jobcr.2013.02.002
10.
LacosteEMartineauIGagnonG. Platelet concentrates: Effects of calcium and thrombin on endothelial cell proliferation and growth factor release. J Periodontol. 2003;74(10):1498-1507. doi:10.1902/jop.2003.74.10.1498
11.
KankaraVRAnnavarapuSPathakotaKRKrishnanP. Periodontal approach in the management of alveolar cleft. J Indian Soc Periodontol. 2020;24(5):481-485. doi:10.4103/JISP.JISP_342_19
12.
SunXcZhangZbWangHLiJhMaXXiaHf. Comparison of three surgical models of bone tissue defects in cleft palate in rabbits. Int J Pediatr Otorhinolaryngol. 2019;124:164-172. doi:10.1016/j.ijporl.2019.05.002
13.
SaruhanNErtasU. Evaluating of platelet-rich fibrin in the treatment of alveolar cleft with iliac bone graft by means of volumetric analysis. Journal of Craniofacial Surgery. 2017;00(00):1-5. doi:10.1097/SCS.0000000000004125
14.
DeshpandeRSYadavAOBorleRMKalaAVJajooSNThakkarD. Comparative efficacy of autologous alveolar bone grafting with autologous platelet-rich plasma and without platelet-rich plasma in cleft alveolus patients. J Cleft Lip Palate Craniofacial Anomalies. 2017;4(1):22-25. doi:10.4103/jclpca.jclpca_38_16
15.
ChenSLiuBYinNWangYLiH. Assessment of bone formation after secondary alveolar bone grafting with and without platelet-rich plasma using computer-aided engineering techniques. J Craniofac Surg. 2020;31(2):549-552. doi:10.1097/SCS.0000000000006256
16.
NatarajanMBharath RaoK. Improving gingival zenith in a unilateral cleft patient using Platelet-Rich Fibrin (PRF). J Oral Biol Craniofac Res. Published online 2017. doi:10.1016/j.jobcr.2017.04.006
17.
ShawkyHSeifeldinSA. Does platelet-rich fibrin enhance bone quality and quantity of alveolar cleft reconstruction?Cleft Palate-Craniofacial Journal. 2016;53(5):597-606. doi:10.1597/14-290
18.
GriffinXLSmithCMCostaML. The clinical use of platelet-rich plasma in the promotion of bone healing: A systematic review. Injury. 2009;40(2):158-162. doi:10.1016/j.injury.2008.06.025
19.
GrazianiFIvanovskiSCeiSDucciFTonettiMGabrieleM. The in vitro effect of different PRP concentrations on osteoblasts and fibroblasts. Clin Oral Implants Res. 2006;17(2):212-219. doi:10.1111/j.1600-0501.2005.01203.x
20.
JanssenNGWeijsWLJKooleRRosenbergAJWPMeijerGJ. Tissue engineering strategies for alveolar cleft reconstruction: A systematic review of the literature. Clin Oral Investig. 2014;18(1):219-226. doi:10.1007/s00784-013-0947-x
21.
WhitmanDHBerryRLGreenDM. Platelet gel: An autologous alternative to fibrin glue with applications in oral and maxillofacial surgery. J Oral Maxillofac Surg.1997;55(11):1294-1299. doi:10.1016/S0278-2391(97)90187-7
22.
OyamaTNishimotoSTsugawaTShimizuF. Efficacy of platelet-rich plasma in alveolar bone grafting. Oral and Maxillofacial Surgeons J Oral Maxillofac Surg. 2004;62:555-558. doi:10.1016/j.joms.2003.08.023
23.
HigginsJPTThomasJChandlerJ, et al.Cochrane Handbook for Systematic Reviews of Interventions.; 2019. doi:10.1002/9781119536604
24.
SchreiberJJAndersonPARosasHGBuchholzALAuAG. Hounsfield units for assessing bone mineral density and strength: A tool for osteoporosis management. Journal of Bone and Joint Surgery. 2011;93(11):1057-1063.
25.
ShiraniGAbbasiAJMohebbiSZMoharramiM. Comparison between autogenous iliac bone and freeze-dried bone allograft for repair of alveolar clefts in the presence of plasma rich in growth factors: A randomized clinical trial. J Craniomaxillofac Surg.2017;45(10):1698-1703. doi:10.1016/j.jcms.2017.08.001
26.
NadonFChaputBPerisseJDe BerailALauwersFLopezR. Interest of mineralized plasmatic matrix in secondary autogenous bone graft for the treatment of alveolar clefts. Journal of Craniofacial Surgery. 2015;26(7):2148-2151. doi:10.1097/SCS.0000000000001951
27.
FindikYBaykulT. Secondary closure of alveolar clefts with mandibular symphyseal bone grafts and with platelet-rich fibrin under local anesthesia: Three case reports. Journal of Contemporary Dental Practice. 2013;14(4):751-753. doi:10.5005/jp-journals-10024-1396
28.
SolimanSMMahmoudAYElsayedAAHashishMAMohammedMFS. Evaluation of autologous platelet rich fibrin in cleft palate repair. Egypt J Hosp Med. 2019;77(5):5752-5758.
29.
HibiHYamadaYUedaMEndoY. Alveolar cleft osteoplasty using tissue-engineered osteogenic material. Int J Oral Maxillofac Surg. 2006;35(6):551-555. doi:10.1016/j.ijom.2005.12.007
30.
CorrePKhonsariRHLaureBElamraniKWeissPMercierJM. Les céramiques phosphocalciques synthétiques dans l’alvéoloplastie secondaire. Rev Stomatol Chir Maxillofac. 2012;113(2):131-135. doi:10.1016/j.stomax.2011.12.012
31.
MossaadAMAl AhmadyHHGhanemWHAbdelrahmanMAAbdelazimAFElsayedSA. The use of dual energy X-ray bone density scan in assessment of alveolar cleft grafting using bone marrow stem cells concentrate/ platelet-rich fibrin regenerative technique. Journal of Craniofacial Surgery. 2021;32(8):E780-E783. doi:10.1097/SCS.0000000000007772
32.
PadminiiEReddyGSP. The effectiveness of mineralized plasmatic matrix in the closure of alveolar clefts with volumetric assessment. Regen Med Res. 2021;9(1). doi:10.1051/rmr/210004
33.
MiuraKIYoshidaMAsahinaI. Secondary bone grafting with simultaneous auto-tooth transplantation to the alveolar cleft. J Oral Maxillofac Surg.2015;73(6):1050-1057. doi:10.1016/j.joms.2015.01.004
34.
LavagenNNokovitchLAlgrinA, et al.Efficiency of advanced-PRF usage in the treatment of alveolar cleft with iliac bone graft: A retrospective study. Journal of Cranio-Maxillofacial Surgery. 2021;49(10):923-928. doi:10.1016/j.jcms.2021.06.001
35.
ParvinAAmirkiamarzMNafisehR. Radiological assessment of using allograft in combination with platelet-rich fibrin in alveolar cleft grafting. Journal of Mazandaran University of Medical Sciences. 2016;26(142):175-185.
36.
AlchalabiNJFalihMO. The efficacy of osteon II collagen (synthetic bone graft with bovine type I collagen) with platelet rich fibrin on bone healing process in unilateral alveolar cleft. Bulletin of National Institute of Health Sciences. 2022;140(01):1097-1103.
37.
González-SánchezJGJiménez-BarragánK. Closure of recurrent cleft palate fistulas with plasma rich in growth factors. Acta Otorrinolaringologica (English Edition). 2011;62(6):448-453. doi:10.1016/j.otoeng.2011.06.001
38.
Ahmed AliAMohammad AliKAbd-AlfattahDS. The clinical use of autologous bone marrow mesenchymal stem cells in the treatment of secondary alveolar cleft. Al-Azhar Journal of Dental Science. 2022;25(2):149-156. doi:10.21608/ajdsm.2020.47542.1127
39.
El-AnwarMWNofalAAFKhalifaMQuribaAS. Use of autologous platelet-rich plasma in complete cleft palate repair. Laryngoscope. 2016;126(7):1524-1528. doi:10.1002/lary.25868
40.
DesaiAKKumarNDikhitPKoikudeSBBhaduriS. Efficacy of platelet-rich fibrin in secondary cleft alveolar bone grafting. Craniomaxillofacial Trauma Reconstruction. 2019;1(212):e43-e50. doi:10.1055/s-0039-1678672
41.
EmaraDMakeenKAboulHassanMAdelMA. PRP Injection effect on palatal Fistula repair: A comparative study. The Egyptian Journal of Plastic and Reconstructive Surgery. 2020;42(2):337-344. doi:10.21608/ejprs.2020.79727
42.
HegabAFShumanMA. Efficacy of platelet-rich plasma in reduction of the resorption of the alveolar cleft bone graft. A comparative study. Dentistry. 2012;02(07):7-12. doi:10.4172/2161-1122.1000150
43.
El-ahmadyHHAbd ElazeemAFBellah AhmedNm, et al.Combining autologous bone marrow mononuclear cells seeded on collagen sponge with nano hydroxyapatite, and platelet-rich fibrin: Reporting a novel strategy for alveolar cleft bone regeneration. Journal of Cranio-Maxillo-Facial Surgery. Published online 2018. doi:10.1016/j.jcms.2018.05.049
44.
StankoPMracnaJStebelAUsakovaVSmrekovaMVojtassakJ. Mesenchymal stem cells- a promising perspective in the orofacial cleft surgery. Bratisl Lek Listy. 2013;114(2):50-52. doi:10.4149/BLL_2013_012
45.
MéndezRLópez-CedrúnJPatiñoB, et al.Plasma enriquecido en plaquetas en la alveoloplastia de pacientes fisurados. Cir Pediatr. 2006;19(1):23-26.
46.
KumarKAJRaoJBKumarBPMohanAPPatilKParimalaK. A prospective study involving the use of platelet rich plasma in enhancing the uptake of bone grafts in the oral and maxillofacial region. J Maxillofac Oral Surg. 2013;12(4):387-394. doi:10.1007/s12663-012-0466-3
47.
DesaiAPSahooNPalAKRoy ChowdhurySK. Efficacy of platelet-rich plasma in enhancing the osteogenic potential of bone graft in oral and maxillofacial region. J Maxillofac Oral Surg. 2020;20(2):282-295. doi:10.1007/s12663-020-01378-z
48.
AkmamHAMMustafa SalimAHassanien Ahmed HadiAJ. Evaluation of the effectiveness of using platelet rich fibrin (PRF) with bone graft in the reconstruction of alveolar cleft, A prospective study. Journal of Craniofacial Surgery. 2021;32(6):2139-2143. doi:10.1097/SCS.0000000000007486
49.
Luaces-ReyRArenaz-BúaJLópez-Cedrún-CembranosJL, et al.Is PRP useful in alveolar cleft reconstruction? Platelet-rich plasma in secondary alveoloplasty. Med Oral Patol Oral Cir Bucal. 2010;15(4):619-623. doi:10.4317/medoral.15.e619
50.
SakioRSakamotoYOgataHSakamotoTIshiiTKishiK. Effect of platelet-rich plasma on bone grafting of alveolar clefts. Journal of Craniofacial Surgery. 2017;28(2):486-488. doi:10.1097/SCS.0000000000003345
51.
Movahedian AttarBNaghdiNEtemadi ShMMehdizadehM. Chin symphysis bone, allograft, and platelet-rich fibrin: Is the combination effective in repair of alveolar cleft?J Oral Maxillofac Surg.2017;75(5):1026-1035. doi:10.1016/j.joms.2016.12.026
52.
Ferreira FortesCCarliniJLMaginiRdSGil NazarenoJZétolaAL. Allogenic bone application in association with platelet-rich plasma for alveolar bone grafting of cleft palate defects. Contemporany Clinical Dentistry. 2021;12:143-149. doi:10.4103/ccd.ccd_342_20
53.
Bezerra TorresBPinho AndradeJNFigueiredo DinizFEBrandao Barreto Carvalho MoraesJRAyres GuerzetLCFerreira da SilvaLC. Autogenous bone graft versus bovine bone graft in association with platelet-rich plasma for the reconstruction of alveolar clefts: A pilot study. Cleft Palate Craniofac J.2019;56(1):134-140. doi:10.1177/1055665618770194
54.
Abd El AzeemAAl-AhmadyHAbdul RahmanM. Evaluation of 3D computer-assisted patient’s specific scaffold seeded with autogenous stem cells and platelet-rich fibrin in alveolar cleft repair. Al-Azhar Dental Journal for Girls. 2021;8(2):261-270. doi:10.21608/adjg.2021.22943.1225
55.
OmidkhodaMJahnabinAKhoshandamF, et al.Efficacy of platelet-rich fibrin combined with autogenous bone graft in the quality and quantity of maxillary alveolar cleft reconstruction. Iran J Otorhinolaryngol. 2018;30(6):329-334.
56.
Segura-CastilloJLAguirre-CamachoHGonzález-OjedaAMichel-PerezJ. Reduction of bone resorption by the application of fibrin glue in the reconstruction of the alveolar cleft. Journal of Craniofacial Surgery. 2005;16(1):105-112. doi:10.1097/00001665-200501000-00020
57.
MarukawaEOshinaHIinoGMoritaKOmuraK. Reduction of bone resorption by the application of platelet-rich plasma (PRP) in bone grafting of the alveolar cleft. Journal of Cranio-Maxillofacial Surgery. 2011;39(4):278-283. doi:10.1016/j.jcms.2010.04.017
58.
OsmanOAMKamelIHElshereifAMohamedAMMagdyA. Effect of platelet rich plasma (PRP) on bone graft in alveolar cleft repair. The Egyptian Journal of Plastic and Reconstructive Surgery. 2020;43(3):417-424. doi:10.21608/ejprs.2020.68177
59.
AlnajjarAAlkhouryIBurhanASAlkhouliM. The efficacy of xenograft polymerized with platelet rich fibrin versus autogenous graft during the secondary alveolar bone grafting of alveolar clefts: A randomized controlled clinical trial. Int J Dent Oral Sci. 2020;7(11):886-891. doi:10.19070/2377-8075-20000196
60.
ThanasutASilkosessakOSubbalekhaK. Platelet-rich fibrin did not affect autologous bone graft in repairing alveolar clefts. J Oral Maxillofac Surg Med Pathol. 2021;33(4):402-407. doi:10.1016/j.ajoms.2021.01.011
61.
AldaghirOMNajeARGhadhbanATAl atabiHhAldaghirOM. Effectiveness of maxillary cortical bone graft chips harvested by bone scraper, covered with platelet-rich fibrin (PRF), in reconstruction of alveolar clefts: Comparative study. Oral Maxillofac Surg. Published online 2022:1-12. doi:10.1007/s10006-022-01128-0
62.
WuCPanWFengC, et al.Grafting materials for alveolar cleft reconstruction : A systematic review and best- evidence synthesis. Int J Oral Maxillofac Surg. 2017;47(3):345-356. doi:10.1016/j.ijom.2017.08.003
63.
SeifeldinSA. Seifeldin2016.pdf. Saudi Dent J. 2016;28(1):3-11. doi:10.1016/j.sdentj.2015.01.006
64.
KamalMZiyabAHBartellaA, et al.Volumetric comparison of autogenous bone and tissue-engineered bone replacement materials in alveolar cleft repair: A systematic review and meta-analysis. British Journal of Oral and Maxillofacial Surgery. 2018;56(6):453-462. doi:10.1016/j.bjoms.2018.05.007
65.
Osorio ColoradoCEscobarLMGonzálezMCGamboaLFChambroneL. Evaluation of density, volume, height and rate of bone resorption of substitutes of autologous bone grafts for the repair of alveolar clefts in humans: A systematic review. Heliyon. 2020;6(9). doi:10.1016/j.heliyon.2020.e04646
