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This systematic review aims to investigate the impact of platelet-rich plasma (PRP) in conjunction with bone grafting on bone volume outcomes in secondary alveolar bone grafting (SABG) procedures among alveolar cleft patients. An exhaustive search involving PubMed, Cochrane, and Google Scholar databases yielded 20 relevant titles, ultimately leading to the inclusion of four articles meeting all specified criteria. Based on the Cochrane risk of bias in systematic reviews (ROBIS) tool, the studies showed a high risk of bias. The primary outcome, bone volume assessment, was analyzed across these articles. While the Cochrane ROBIS tool deemed the included articles to have a high risk of bias, the comparison between PRP and Non-PRP groups did not reveal a significant difference in bone volume. Radiographic data illustrated an initial three-month period of bone resorption post-graft, regardless of PRP application, followed by a six-month phase of heightened bone density, particularly discernible in the PRP groups. To sum up, our findings indicate an absence of substantial bone density increase in cleft patients undergoing SABG with PRP augmentation. Nonetheless, there was a modest trend that suggests potential incremental bone density improvement with PRP usage, underscoring the need to conduct rigorously designed, randomized controlled trials (RCTs) with low bias to validate these observations.
RESUMO
Introduction The aim of the study is to determine the effects of different vertical force vectors acting on dentoalveolar and soft tissues while applying a retraction force using various anchorage sources and their effects on these tissues. Material and methods Based on the selection criteria, a total of 35 patient case records with Angle's Class I bidental malocclusion and incompetent lips treated with four premolar extractions were included. Retraction was achieved using a NiTi coil spring with two different force vectors. The anchorage in group 1 was enhanced by a transpalatal arch (TPA) and Lower Stabilizing Arch (LSA) in the upper and lower arch, respectively, with a force vector parallel to the occlusal plane, whereas in group 2, the force vector using Temporary Anchorage Devices (TADs) was 15 - 20 degrees to the occlusal plane. The skeletal, dental, and soft tissue were obtained using 40 parameters. Intra-group comparisons between pre- and post-treatment records were conducted using a paired t-test, while inter-group comparisons were conducted using an independent t-test. Result Significant anchor loss was observed in group 1, indicated by mesial movement of molar crowns by (-2.10±0.50) in the maxillary arch and (-1.75±0.38) in the mandibular arch. Distal movement of incisors following premolar extractions with both studied force vectors resulted in an improvement in lip procumbency and incisor inclinations, without any significant skeletal changes. Molar mesial movement was observed in subjects treated with conventional anchorage. Conclusion En masse anterior retraction did lead to anchorage loss when carried out without TADs. Altering the force vector did not produce significant changes in tooth movement along the vertical plane.