Autologous Platelet Concentrate of 2 nd and 3 rd generations efficacy in the surgical treatment of gingival recession: an overview of systematic reviews

Background: Autologous platelet concentrate (APC)/platelet-rich fibrin (PRF) of second and third generations has increased use in periodontics to optimize wound healing. Few systematic reviews (SRs) have reported improved clinical outcomes, while other studies reported significantly better results for the connective tissue graft (CTG). There is still unclear clinical evidence about APC/PRF use to treat gingival recession (GR) defects. Then, the purpose of this SR was to evaluate the use of APC/PRF membranes (2 nd and 3 rd generations) in root coverage (RC) procedures and assess its efficacy as a substitute biomaterial. Materials and Methods: An electronic search was conducted in PubMed, Cochrane Central, Web of Science, Google Scholar, BookSC databases, and gray literature. The search strategy, without date restriction up to April 2020, included keywords as 'platelet-rich fibrin,' 'autologous platelet concentrates,' 'blood,' 'systematic review,' 'periodontics,' 'surgery,' 'tissue,' 'gingiva,' 'gingival recession,' 'connective tissue,' 'graft,' and 'root coverage.' The methodological quality was evaluated through the AMSTAR2, and a population, index test, comparator, outcome strategy was used to assess specific clinical parameters such as recession depth, clinical attachment levels, and RC outcomes. Results: Nine SRs were included. Only three articles described the technique of APC/PRF production. Three studies reported unfavorable outcomes using APC, while six reported favorable results and postoperative discomfort reduction. Articles included in this SRs that provided information about APC/PRF membranes (n = 13) showed no significant difference between APC/PRF and the control group for the parameters analyzed. Conclusions: This implies that APC/PRF may be considered a feasible substitute biomaterial for treating GR defects, although the CTG still provides superior outcomes. Further long-term and controlled studies are needed to verify this finding.