Invited Review Paper
Osteobiology
Is autologous platelet concentrate beneficial for post-extraction socket healing? A systematic review

https://doi.org/10.1016/j.ijom.2011.04.009Get rights and content

Abstract

The aim of this systematic review was to assess if the use of autologous platelet concentrates may be beneficial to the healing of extraction sockets. Medline, Embase and Cochrane Central Register of Controlled Trials were searched using a combination of specific search terms. Hand searching of the relevant journals and of the bibliographies of reviews was also performed. Prospective comparative studies evaluating the effect of a platelet concentrate on fresh extraction sockets were included. Outcome variables related to hard and soft tissue healing, aesthetics and postoperative discomfort were considered. A methodological study quality assessment was made. The initial search yielded 425 articles, eight were finally included. 207 tooth extractions (104 tests and 103 controls) in 115 patients were evaluated. The articles provided a broad range of variable outcomes to assess the regenerative potential of platelet concentrate and its possible benefits to the treatment. Favourable effects on hard and soft tissue healing and postoperative discomfort reduction were often reported. A large heterogeneity was found regarding study design, sample size, surgical techniques and methods for preparing platelet concentrates. Standardization of experimental design is needed in order to detect the true effect of platelet concentrates in regenerative procedures of extraction sockets.

Section snippets

Materials and methods

A literature search was carried out on electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials), using the following search terms, alone and in combination by means of Boolean operators: ‘platelet-rich plasma’, ‘autologous platelet concentrates’, ‘platelet growth factors’ and ‘platelet-rich fibrin’. The search was limited to studies involving human subjects. No language or time restriction was applied. The last electronic search was performed on October 2010.

A

Results

The electronic search provided 424 articles. One additional article71 was identified by hand searching. Figure 1 illustrates the selection process. After screening the titles and abstracts, 11 articles, reporting on 12 comparative studies assessing the effect of platelet concentrates on the treatment of extraction sockets were identified. After review of the full text, one article62 was excluded because platelet concentrate was used in both treatment groups, another article7 was excluded

Discussion

The response of living tissues to all forms of injury is inflammation, which involves humoral and cellular reactions at the site of injury and prepares the site for healing. The latter is a complex and prolonged process based on a cascade of biological events controlled by a number of biologically active growth and differentiation factors and cytokines.

A recent strategy to promote the wound-healing cascade is to prepare an autologous platelet concentrate suspended in a small plasma volume, and

Funding

None.

Conflict of interest

None declared.

Ethical approval

Not required.

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