Clinical behavior of bone regeneration therapy with platelet-rich fibrin in cystic cavities: a systematic review.

Abstract

Background: Cysts are common pathology in the maxillofacial area. The treatment of choice consists of enucleation, regeneration of the created defect and achieving a primary closure. The platelet rich fibrin (PRF), developed by Joseph Choukroun, has been commonly use in the area of oral regeneration, thanks to its biological properties; some literature suggests the application in cystic cavities to not only avoids the collapse of tissue but also help regeneration be achieved in a shorter time, however, changes in the nature of the cells and lack of evidence in the literature continue to be a controversial issue. To analyze the current state of clinical knowledge and the potential of the use of PRF in the regeneration therapy of cystic cavities either alone or as a co-adjuvant of other biomaterials through a systematic review of the literature.

Methods: The selection of articles was carried out following the PRISMA statement for systematic reviews protocol, with selection of articles between 2006 to 2022, without discriminating in English or Spanish using a keyword algorithm "PRF jaw cyst," "Platelet rich fibrin jaw cyst," "platelet rich fibrin oral cyst," selected articles such as case reports, series of cases and comparative clinical studies were reviewed.

Results: A total of 33 articles were included in this review where 154 cystic cavities were evaluated, mostly radicular cysts, treated with PRF alone or as coadjutant of some biomaterial where a successful regeneration was evidenced in a period of 3-6 months, without any complications presented in post-surgical controls, but the lack of histopathological information was an issue in several articles.

Conclusions: Although PRF seems to be a good regenerative therapy in oral surgery and no evidence was found that contraindicated its use in this cases, its applications in cystic cavities still needs more evidence in articles with less bias and more evidence such as comparative studies with control groups.