Effectiveness of Platelet-Rich Fibrin as an Adjunctive Material to Bone Graft in Maxillary Sinus Augmentation: A Meta-Analysis of Randomized Controlled Trails

PURPOSE: To date, it remains unknown whether the addition of platelet-rich fibrin (PRF) to bone grafts actually improves the effectiveness of maxillary sinus augmentation. This study aimed to perform a meta-analysis to evaluate the efficacy of PRF in sinus lift. MATERIALS AND METHODS: PubMed, Embase, and the Cochrane Library were searched. Randomized controlled studies were identified. The risk of bias was evaluated using the Cochrane Collaboration tool. RESULTS: Five RCTs were included in our meta-analysis. Clinical, radiographic, and histomorphometric outcomes were considered. No implant failure or graft failure was detected in all included studies within the follow-up period. The percentage of contact length between newly formed bone substitute and bone in the PRF group was lower but lacked statistical significance (3.90%, 95% CI, -2.91% to 10.71%). The percentages of new bone formation (-1.59%, 95% CI, -5.36% to 2.18%) and soft-tissue area (-3.73%, 95% CI, -10.11% to 2.66%) were higher in the PRF group but were not significantly different. The percentage of residual bone graft was not significant in either group (4.57%, 95% CI, 0% to 9.14%). CONCLUSIONS: Within the limitations of this review, it was concluded that there were no statistical differences in survival rate, new bone formation, contact between newly formed bone and bone substitute, percentage of residual bone graft (BSV/TV), and soft-tissue area between the non-PRF and PRF groups. Current evidence supporting the necessity of adding PRF to bone graft in sinus augmentation is limited.