Effectiveness of platelet-rich concentrates on the rate of orthodontic tooth movement: a systematic review and meta-analysis

Abstract

Summary Background Autologous platelet-rich concentrates (PRCs) are recently used as a local biological substance in orthodontics to accelerate the rate of tooth movement. Objectives This systematic review aimed to evaluate the effects of PRCs on the rate of orthodontic tooth movement (OTM). Search methods Unrestricted search of five electronic databases supplemented by the manual and gray literature search were undertaken in March 2022. Selection criteria Randomized controlled trials (RCTs) evaluating the effect of PRCs on the rate of OTM with their side effect were included in this systematic review. Data collection and analysis Data items were extracted by two authors using a pre-piloted extraction form. Similar outcomes within a comparable time frame were synthesized in a meta-analysis. Results Fourteen studies were deemed eligible for inclusion and seven RCTs were pooled in a meta-analysis. Canine retraction rate was higher in the side of PRCs injection than the control side by 0.28 mm/month (95% CI: 0.16–0.40, I2 = 95.6 per cent, P < 0.001, 345 patients) in the first 4 months after PRCs injection. There was no statistically significant difference between the PRCs side and the control side regarding molar anchorage loss (MAL) (MD = 0.03 mm, 95% CI: −0.18 to 0.24, I2 = 46.3 per cent, P = 0.78, 44 patients), canine rotation (MD = −0.19o, 95% CI: −1.95 to 1.57, I2 = 45.4 per cent, P = 0.96, 48 patients), or en-masse retraction. Likewise, there was no difference between both groups in terms of the duration of de-crowding. The mandibular canine retraction was statistically higher on the PRCs side than on the control side by 0.17 mm/month (P < 0.001, one trial). Regarding root resorption, there was no statistically significant difference between the experimental and control sides within the follow-up time. Mild pain scores were reported by the patients in the first 24 hours after injections. Conclusions Low-level evidence indicates that the effect of PRCs on OTM is minor and clinically insignificant. The findings should be interpreted with caution due to the inherent limitations in the included RCTs. Registration PROSPERO (CRD42022300026).