Background: Studies investigating the use of plateletââ?¬â??rich plasma (PRP) in the treatment of intrabony defects have\nyielded mixed results. The aim of our study was to evaluate the efficacy of PRP by comparing clinical attachment\nlevel (CAL) and pocket depth (PD) for patients who received PRP as an adjunct to periodontal intrabony defect\ntherapy with those for patients who did not. We also analyzed the influence of guided tissue regeneration (GTR)\nand different study designs (parallel and splitââ?¬â??mouth studies) on the clinical outcomes of intrabony defects.\nMethods: We performed a systematic review of articles published in any language up to June 7, 2015 by searching\nPubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. We included only\nrandomized controlled clinical trials (RCTs) that compared clinical outcomes between patients who received\nPRP as an adjunct to periodontal intrabony defect therapy and patients who did not. We combined data\nfrom randomized trials to assess clinical outcomes using a randomââ?¬â??effects model.\nResults: Of the 307 abstracts that were initially identified, 12 RCTs related to the treatment of periodontal\nintrabony defects were included in the final analysis. Clinically and significantly greater CAL gains and PD\nreductions were observed in subjects who received PRP as an adjunct to periodontal intrabony defect\ntherapy than in subjects who did not (CAL: WMD 0.76 mm, 95 % CI = 0.34 to 1.18 mm, P = 0.0004; PD: WMD\n0.53 mm, 95 % CI = 0.21 to 0.85 mm, P = 0.001). Subgroup meta-analyses of patients who underwent GTR\ndemonstrated that this approach did not significantly affect treatment outcomes (CAL: WMD 0.08 mm, 95 % CI = âË?â??0.30\nto 0.46 mm, P = 0.67), as indicated by a comparison with patients who did not undergo GTR (CAL: WMD 1.\n22 mm, 95 % CI = 0.88 to 1.57 mm, P < 0.00001). Univariate meta-regression analyses revealed that the use of\nGTR explained the heterogeneity among the included studies (P < 0.05).\nConclusions: Within its limitations, this review suggests that PRP may be beneficial as an adjunct to graft\nmaterials for the treatment of periodontal intrabony defects, except in cases involving the use of GT
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