Abstract
Introduction
Bone grafts are frequently used for the treatment of bone defects, but can cause postoperative complications, and sometimes a sufficient quantity of bone is not available. Hence, synthetic biomaterials have been used as an alternative to autogenous bone grafts. Recent clinical reports suggest that application of autologous blood plasma enriched with platelets can enhance the formation of new bone. There are very few in vitro or in vivo studies published on the efficiency of platelet-rich plasma (PRP). The objective of this study was to evaluate the alloplastic bone substitute for its osteogenic potential with or without PRP.
Materials and Methods
Twenty-three patients with periapical bony defects were selected for this study. Clinical parameters such as pain visual analog scale (VAS), swelling, infection, graft migration, rejection, radiographical interpretations at regular interval and scintigraphic evaluation were done to evaluate osteogenic potential of alloplastic bone substitute with or without PRP.
Results
The highest acceleration in bone formation was observed in groups where alloplastic bone substitute was used with PRP. There were no statistically significant differences between the two groups regarding other outcome variables throughout the postoperative period.
Conclusion
Addition of PRP significantly accelerates vascularization of the graft, improves soft tissue healing, reduces postoperative morbidity and enhances bone regeneration.
Key Words: Bone graft, osseous defects, platelet-rich plasma
Full Text
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References
- 1.Saikia KC, Bhattacharya TD, Bhuyan SK, Talukdar DJ, Saikia SP, Jitesh P. Calcium phosphate ceramics as bone graft substitutes in filling bone tumor defects. Indian J Orthop. 2008;42:169–172. doi: 10.4103/0019-5413.39588. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Chandrashekar KT, Saxena Chavi, Biograft HT. As a bone graft material in the treatment of periodontal vertical defects and its clinical and radiological evaluation: clinical study. J Ind Soc Periodontol. 2009;13:138–144. doi: 10.4103/0972-124X.60226. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Kenny EG, Lekovie V, Han T, Carranga FA, Domitri JB. The use of porous hydroxyapatite implant in periodontal defects. J Periodontol. 1985;50:82–88. doi: 10.1902/jop.1985.56.2.82. [DOI] [PubMed] [Google Scholar]
- 4.Choi BH, Im CJ, Huh JY, Suh JY, Lee SH. Effect of platelet-rich plasma on bone regeneration in autogenous bone graft. Int J Oral Maxillofac Surg. 2004;33:56–59. doi: 10.1054/ijom.2003.0466. [DOI] [PubMed] [Google Scholar]
- 5.Manson PN. Facial bone healing and bone grafts: a review of clinical physiology. Clinic Plastic Surg. 1994;21:331–348. [PubMed] [Google Scholar]
- 6.Sergio A, Bruno K, Marcia R. Alveolar ridge sockets preservation with bone grafting-review. Annal Acad Medic. 2008;54:70–81. [PubMed] [Google Scholar]
- 7.Thorn JJ, Sorensen H, Weis-Fogh U, Andersen M. Autologous fibrin glue with growth factors in reconstructive maxillofacial surgery. Int J Oral Maxillofac Surg. 2004;33:95–100. doi: 10.1054/ijom.2003.0461. [DOI] [PubMed] [Google Scholar]
- 8.Christie RJ, Carrington L, Alving B. Postoperative bleeding induced by topical bovine thromb. In report of two cases. Surgery. 1997;121:708. doi: 10.1016/s0039-6060(97)90061-1. [DOI] [PubMed] [Google Scholar]
- 9.Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgef KR. Platelet rich plasma. Growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85:638–646. doi: 10.1016/s1079-2104(98)90029-4. [DOI] [PubMed] [Google Scholar]
- 10.Weibrich G, Kless WK, Hapner G, Hrizler WE. Growth factor levels in platelet-rich plasma and correlation with donor age, sex and platelet count. J Craniomaxillofac Surg. 2002;30:97–102. doi: 10.1054/jcms.2002.0285. [DOI] [PubMed] [Google Scholar]
- 11.Boyapati L, Wang HL. The role of platelet-rich plasma in sinus augmentation: a critical review. Implant Dent. 2006;15:160–170. doi: 10.1097/01.id.0000217791.74343.60. [DOI] [PubMed] [Google Scholar]
- 12.Nikolidakis D, van den Dolder J, Wolke JGC, Jansen JA. The effect of platelet-rich plasma on the early bone formation around Ca-P-coated and non-coated oral implants in cortical bone. Clin Oral Impl Res. 2008;19:207–213. doi: 10.1111/j.1600-0501.2007.01456.x. [DOI] [PubMed] [Google Scholar]
- 13.Consolo U, Zaffe D, Bertoldi C, Coccherelli G. Platelet rich plasma activity on maxillary sinus floor augmentation by autologous bone. Clin Oral Impl Res. 2007;18:252–262. doi: 10.1111/j.1600-0501.2006.01330.x. [DOI] [PubMed] [Google Scholar]
- 14.Marx RE. The biology of platelet-rich plasma. J Oral Maxillofac Surg. 2001;59:1119–1121. doi: 10.1053/joms.2001.26801. [DOI] [PubMed] [Google Scholar]
- 15.Green David M, Klink B. Platelet gel as an intraoperatively procured platelet-based alternative to fibrin glue. Plast Reconstr Surg. 1997;101:1161–1162. doi: 10.1097/00006534-199804040-00067. [DOI] [PubMed] [Google Scholar]
- 16.Messora MR, Nagata MJH, Nagata RC. Bone healing with platelet-rich plasma: a histologie and histometric study in rat calvaria. J Periodont Res. 2008;43:217–223. doi: 10.1111/j.1600-0765.2007.01017.x. [DOI] [PubMed] [Google Scholar]
- 17.Shanaman R, Filstein MR. Danesh Meyer Ml Localised ridge augmentation using GBR are platelet rich plasma case reports. Int J Periodontic Restor Dent. 2001;21:345–355. [PubMed] [Google Scholar]
- 18.Arpornmaeklong P, Kochel M, Depprich R, Kubler NR, Wuzler KK. Influence of platelet rich plasma on osteogenic differentiation of rat bone marrow stromal cells. An in vitro study. Int J Oral Maxillofac Surg. 2004;33:60–70. doi: 10.1054/ijom.2003.0492. [DOI] [PubMed] [Google Scholar]
- 19.De Vasconelos GBC, Goncalves F, Pimentel SP. Platelet-rich plasma may not provide any additional effect when associated with guided bone regeneration around dental implants in dogs. Clin Oral Impl Res. 2007;18:649–654. doi: 10.1111/j.1600-0501.2007.01383.x. [DOI] [PubMed] [Google Scholar]
- 20.Harris D, Farrell B, Block MS. Zygomatic arch defects grafted with mineralized bone with PRP or PPP in dogs. J Oral Maxillofac Surg. 2003;61:42–43. [Google Scholar]
