The Effect of Using Platelet-Rich Fibrin With an Iliac Crest Bone Graft on Alveolar Bone Formation: A Systematic Review
Shankargouda Patil, Sonia Sabu, Shilpa Bhandi, Samuel Thomas, Aayushi Shah, Hayden Dehoyos, Frank W Licari, Charles MillerObjective
Alveolar bone grafting in individuals with cleft lip and/or palate is typically performed using the iliac crest as the donor site. Platelet-rich fibrin is a concentrate rich in growth factors that can promote bone formation. This review evaluates the effect of using this concentrate along with alveolar bone grafts on bone formation in people with cleft lip and/or palate.
Design
This systematic review was conducted following the PRISMA guidelines, and PubMed (MEDLINE), Scopus, Embase, and Web of Science were searched with appropriate search terms. Data were exported to EndNote Online, and duplicates were removed. After screening, full-text articles were retrieved, and only those meeting the inclusion criteria were further assessed. Data were extracted, and the methodological quality of the articles was appraised using the Cochrane Risk of Bias tool.
Setting
Not applicable.
Patients
Individuals with cleft lip and/or palate.
Interventions
Alveolar bone grafting using the iliac crest.
Main outcome measure
Details on volume, percentage of newly formed bone, density, height, and width of the bone over time in the cleft lip and/or palate.
Results
Of 116 articles retrieved from the databases, 5 were included in the review. All studies indicated better outcomes when using platelet-rich fibrin with the graft, although the results were not always statistically significant. Methodological concerns were noted across all studies.
Conclusion
Platelet-rich fibrin may enhance bone formation at the alveolar cleft site when used with iliac crest grafts. However, more rigorous long-term studies and clinical trials are needed to obtain definitive evidence.