Adjunctive Autologous Platelet Concentrates for Periodontal Regeneration in Intrabony Defects: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Periodontal intrabony defects remain a clinical challenge because conventional periodontal therapy may reduce inflammation but does not always restore lost supporting tissues. This systematic review and meta-analysis evaluated whether autologous platelet-concentrate adjuncts improve clinical and radiographic outcomes when used with regenerative periodontal therapy. Ten randomized controlled trials were included, all assessing platelet-rich fibrin or related platelet-concentrate preparations, including concentrated growth factors, injectable platelet-rich fibrin, advanced platelet-rich fibrin, and titanium-prepared platelet-rich fibrin, in the treatment of periodontal intrabony defects. The primary clinical analysis pooled clinical attachment level or relative attachment level gain and showed a significant benefit favoring platelet-concentrate adjunct regeneration (PCA) compared with regenerative therapy without platelet concentrates. A reduced sensitivity analysis also favored the platelet-concentrate group, supporting the consistency of the clinical findings. Radiographic bone-fill or defect-depth reduction outcomes also showed a favorable direction for platelet-concentrate adjuncts, although this analysis demonstrated greater variability across studies and did not reach statistical significance. Overall, the findings suggest that autologous platelet concentrates may provide a modest but clinically relevant adjunctive benefit in periodontal intrabony-defect regeneration, particularly for clinical attachment improvement. However, radiographic outcomes should be interpreted with caution because of differences in imaging methods, grafting materials, platelet-concentrate protocols, and follow-up periods. These results support the use of platelet-concentrate adjuncts as a promising component of regenerative periodontal therapy while emphasizing the need for larger, standardized randomized trials with consistent outcome reporting and longer follow-up.