Uso de fibrina rica em plaquetas (PRF) no reparo ósseo: revisão sistemática e meta-análise de estudos pré-clínicos

Abstract

This systematic review evaluated the potential of PRF on bone repair in animals. This systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The Protocol was registered on PROSPERO (CRD [Blinding]). It was wide search conducted in 9 databases including gray literature. All studies evaluated bone defects created in rats filled with PRF (Platelet Rich Fibrin) and clot (control). Biomaterial evaluation was also performed when present in the study. The risk of bias was assessed by the Systematic Review Center for Laboratory Animal Experimentation (SYRCLE) tool for animal studies. Meta-analysis for quantitative data was performed to estimate the effect of PRF on bone repair in rats. The heterogeneity (I2) between the studies was assessed. The search resulted in 685 studies, 10 met the eligibility criteria and 4 were included in the quantitative assessment. Analysis of the risk of bias showed that most of studies showed high bias risk at performance and detection. Meta-analysis results demonstrated divergent results between the studies and the absence of a statistically significant effect for both comparison: PRF with control (SMD = 2.54; CI 95% = -0.80, 5.89; P = 0.14); and PRF in relation to use of biomaterials (SMD = -2.61; CI 95% = -5.96, 0.73; P = 0.13). In general, heterogeneity between studies was high (I2 ≥ 75.0%). The use of PRF has demonstrated no benefit in bone defects when compared to the clot and the use of biomaterials.