Efficacy of Titanium-Reinforced Platelet-Rich Fibrin in Treating Intrabony Defects: A Systematic Review and Meta-Analysis

A BSTRACT Background: The systematic review and meta-analysis will present the clinical effectiveness of titanium-prepared platelet-rich fibrin (T-PRF) by demonstrating its regenerative potential and creating a foundation of evidence for clinical decision-making. Purpose: This analysis will evaluate the clinical effectiveness of T-PRF for intrabony periodontal defects, documenting attachment gain, pocket depth reduction, and bone fill compared to other therapies. Data Source: Data were taken from PubMed, Scopus, Web of Science, and Cochrane Library from inception until March 2025 with the keywords “titanium-reinforced platelet-rich fibrin,” “T-PRF,” and “intrabony defects.” Only human studies in the English language were included. Study Selection: Eligible studies were those involving humans with intra-bony or mixed defects who were treated with T-PRF and reported clinical or radiographic outcomes in randomized or controlled studies. Studies reporting on animals, case reports, reviews, and studies without control groups were excluded. Two reviewers screened the studies independently, and disagreements were resolved by consensus. Data Extraction and Synthesis: Data extraction adhered to Preferred Reporting Items for Systematic Review (PRISMA) principles. Two reviewers extracted data independently and assessed study quality using the Cochrane Risk of Bias tool. Meta-analysis was performed using a random-effects model to account for heterogeneity. Clinical attachment level (CAL) gain, probing depth (PD) reduction, and radiographic bone fill were the primary outcomes measured in millimetres. Results: Of the 15 relevant articles, 9 randomized controlled trials (RCTs) qualified. The forest plot compares the final mean pocket probing depth (PPD) change between T-PRF and open flap debridement (OFD) for four studies. The pooled mean difference (MD) was 0.92 mm (95% confidence interval (CI): −0.44, 2.28), which favored T-PRF, but the confidence interval included zero, indicating no statistically significant difference. Conclusion and Relevance: T-PRF is an exciting new option for intra-bony defects, with a thicker fibrin clot, even long resorption times, and increased cellular entrapment, resulting in increased quality cellularity and periodontal regeneration.