The application of platelet rich fibrin in patients presenting with osteonecrosis of the jaw: A systematic literature review

The aim of this systematic literature review was to summarise the available evidence regarding the administration of platelet rich fibrin (PRF) in patients diagnosed with osteonecrosis of the jaw (ONJ). A PRISMA-conform systematic literature review was conducted using a PICO-defined search strategy. MEDLINE was accessed and hits published before February 2020 were reviewed. All studies reporting on intraoperative administration of PRF into an osseous defect in patients presenting with ONJ were included. Eligibility of the studies was assessed by two independent reviewers according to prespecified criteria. Sixteen studies described the application of PRF for treatment of ONJ in 166 patients. Follow-up periods ranged from 30 to 1560 days. There was large heterogeneity regarding patient details and perioperative management. The only randomised controlled study (RCT) included suggested modest superiority in early recovery, infection rate and reported pain. No adverse events related to PRF were reported in any of the studies. The evidence regarding relative merits of PRF application versus standard of care in patients with ONJ is low. Current evidence is limited by small, non-consecutive patient samples and lack of a randomised control group. Because some observational reports and one RCT suggested improvements of early recovery, further studies are needed.