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Effect of Autologous Platelet-Rich Plasma in Combination With Bovine Porous Bone Mineral and Bio-Guide Membrane on Bone Regeneration in Mandible Bicortical Bony Defects

Chen, Tie-Lou MD*; Lu, Hui-Jie MD; Liu, Guo-qin MD*; Tang, Da-Hai BD; Zhang, Xin-hai PhD*; Pan, Zhu-Lin PhD*; Wang, Shi-Feng MD§; Zhang, Qing-fu PhD*

Journal of Craniofacial Surgery: January 2014 - Volume 25 - Issue 1 - p 215–223
doi: 10.1097/SCS.0000000000000420
Original Articles
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Objective Growth factors contained in platelet-rich plasma (PRP) can induce osteoblast differentiation in certain studies, whereas in others, osteogenesis of PRP on mandible bone defects has not been proved clinically. The aim of the study was to investigate the effect of autologous PRP on the osteogenic potential of combining bovine porous bone mineral (BPBM) and bio-guide membrane (BGM) in promoting mandible bicortical bony defects in rabbits.

Methods One circular mandible bicortical bony defects were created in each of 54 rabbits, which were divided into 3 groups: group 1: 18 of the defects were left unfilled as a negative control; group 2: 18 of the defects were grafted with autologous PRP and BPBM/BGM; group 3: 18 of the defects were grafted with BPBM/BGM without PRP. Animals were killed at 4, 8, and 12 weeks after operation. Harvested tissue and specimens were evaluated histologically and radiographically, and metabolized observation was performed. Histological parameters associated with osteoblast activities, bone trabecula, neovascularization, newly formed mineralized bone, rudimental grafts and connective tissue formation were measured. Densities of the bones at 4, 8, and 12 weeks were studied by radiographic. The bone defect closure ratio was measured at 12 weeks. The bone metabolized parameter alkaline phosphatase was also measured and compared between 4, 8, and 12 weeks.

Results The platelet concentration of PRP is 4.19- to 4.43-fold to that of the whole blood. Histological analysis showed new bone formation at all therapeutic sites including BPBM/BGM grafts with or without PRP. A statistically significant difference in new bone formation between group PRP/BPBM/BGM and group BPBM/BGM was observed. Untreated defects of group control showed the less bone regeneration. There was significant difference of bone density between group PRP/BPBM/BGM and control, and group BPBM/BGM and control, at 4, 8, and 12 weeks postoperative. There were more bone defects filling, and the grafts were absorbed at 12 weeks of group PRP/BPBM/BGM compared with group BPBM/BGM. Defects treated with PRP/BPBM/BGM demonstrated significantly increased activity of osteoblasts, enhanced amount of mitochondria and rough endoplasmic reticulum in osteoblasts, and increased concentration of alkaline phosphatase at 4, 8, and 12 weeks compared with those treated with BPBM/BGM and control group. Complete closure ratio of bone defects treated with PRP/BPBM/BGM (50%) was significantly increased compared with that treated with BPBM/BGM (16.6%).

Conclusions The study suggested that PRP combination of BPBM and BGM had significant therapeutic effects on mandible bicortical bony defects of rabbits. The effects are associated with the high concentration of platelet in PRP and the porous configuration of BPBM. Although we cannot reveal the detailed statistical relationship of PRP on promoting BPBM/GBM osteoinductive effects, PRP demonstrated superior results of bone regeneration.

From the *Department of Periodontology, Oral Research Center of CPLA, Hospital 411 of CPLA, Shanghai; †Department of Psychology, Aerospace Engineering Medical College, Fourth Military Medical University, Xi’an; ‡Department of Clinical Medical Laboratory, Hospital 411 of CPLA, Shanghai; and §Naval Medical Research Institute, Shanghai, China.

Received June 25, 2013.

Accepted for publication August 26, 2013.

Address correspondence and reprint requests to Tie-Lou Chen, MD, Department of Periodontology, Oral Research Center of CPLA, Hospital 411 of CPLA, Shanghai, China; E-mail: chentielou2010@sina.com, xbctl@sh163.net

T.-L.C. and H.-J.L. have made equal contributions to this study, and both should be referred as first authors.

The study was supported by Nanjing Command Science & Technology Program (06MA08) and General Logistics Department Science Research Program of CPLA. The study was also supported by District Key Foundation of Science & Technology Program of Shanghai (1002-04) and also the Board of Health of Hong Kou District Foundation of Science & Technology Program of Shanghai (1203-15).

The authors report no conflicts of interest.

© 2014 by Mutaz B. Habal, MD.