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Title Platelet Rich Plasma Does Not Improve Bone Engraftment Rates Over Bone Grafting Alone In The Sinus
Clinical Question In a patient with bone defects, does platelet rich plasma and bone grafting improve engraftment rates in the sinus compared to bone grafting alone?
Clinical Bottom Line Based on a recent RCT, platelet rich plasma does not improve engraftment rates in the sinus compared to bone grafting alone. However, further studies should be performed.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19563329Torres / 2009144 adult humansRandomized Controlled Trial
Key resultsEngraftment survival was similar between patients treated with platelet rich plasma and bone graft (98.6%) and those treated only with bone grafts (96.2%)in the sinus. The Authors reported no significant difference, though p values and confidence intervals were not reported for this specific comparison. Histomorphometrical analysis suggests that bone augmentation was significantly greater when bone graft was used in conjunction with PRP.
Evidence Search ("Bone Transplantation"[Mesh]) AND "Platelet-Rich Plasma"[Mesh] AND bone defects
Comments on
The Evidence
The RCT was double blinded, with adequate follow-up, minimal dropout rate along with adequate compliance, however, the groups had some dissimilarities. Furthermore, there were 144 patients in the study, which is a large number. There were no power calculations done for an expected treatment effect. Histomorphometrical analysis was done on 5 patients in split-mouth design.
Applicability This evident can be applied to middle aged to elderly patients without severe comorbidities (ASA Class III) or chronic sinusitis undergoing bone graftment in sinus augmentation.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics)
Keywords Platelet Rich Plasma, Bone Transplantation
ID# 2104
Date of submission: 09/16/2011spacer
E-mail MaldonadoAlf@livemail.uthscsa.edu
Author Katherine Maldonado Alfandari
Co-author(s) e-mail
Faculty mentor/Co-author Yong-Hee Patricia Chun, DDS, MS, PhD
Faculty mentor/Co-author e-mail ChunY@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by William Gillum (SAN ANTONIO,TX) on 11/30/2017
A PubMed search conducted on November 23, 2017 found further evidence of the highest level of research in supporting the 2009 study cited originally. A systematic review and meta-analysis (PMID 26775635) found implant survival was not significantly different when using Platelet Rich Plasma (PRP) in conjunction with bone grafting.The second systematic review (PMID 26987695) also found implant survival to have no significant change in implant survival with Platelet Rich Plasma PRP as an adjunctive therapy in sinus lift procedures.

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