Treatment of intrabony defects with bovine-derived xenograft alone and in combination with platelet-rich plasma: a randomized clinical trial

BACKGROUND: In the treatment of periodontal intrabony defects, the benefits of adding platelet-rich plasma (PRP) to a bone replacement grafting material have not been tested. The purpose of this study was to compare the clinical outcomes obtained by the combination of PRP and a bovine derived xenograft (BDX) to those obtained from the use of the bone replacement graft alone. METHODS: Thirteen patients were enrolled in a randomized, split mouth, double-masked clinical trial. Bilateral defects were matched according to their intrasurgical measurements. Qualifying defects had loss of attachment of > or = 6 mm, a radiographically detectable defect of > or = 4 mm, at least two remaining osseous walls, and not primarily related to a furcation involvement. After the hygienic phase, at the baseline examination, probing depth (PD), clinical attachment level (CAL), and recession (REC) were measured. During open flap debridement, the defects were randomly assigned to receive either BDX mixed with PRP or BDX alone. Baseline osseous intrasurgical measurements were obtained. Post-surgical follow-up and maintenance were performed and PD, CAL, and REC were remeasured at 6 months. The mean baseline and 6-month PD, CAL, and REC of the deepest buccal and lingual measurements related to the defect for each group were computed. The change from baseline to 6 months for each parameter measured was calculated. Pre- and postoperative comparisons were made between treatment groups at 6 months. RESULTS: Randomization of the defects resulted in comparable groups (P > or = 0.05). At 6 months, paired t test comparisons within groups showed statistically significant benefits with both treatment modalities (P < or = 0.05). The mean changes (delta) at 6 months for the test and the control groups at the deepest sites were: PD reduction: 3.54 and 2.53 mm; CAL gain: 3.15 and 2.31 mm; and REC: -0.38 and -0.23 mm, respectively. Paired t test comparisons yielded significant differences between treatments for PD and CAL (P < or = 0.05). CONCLUSION: In this 6-month clinical trial, the addition of a high concentration of autologous platelets to a bovine derived xenograft to treat intrabony defects significantly improved their clinical periodontal response.     

Regenerative treatment with platelet-rich plasma combined with a bovine-derived xenograft in smokers and non-smokers: 12-month clinical and radiographic results

Aim: The purpose of this study was to assess the healing response of intrabony defects following regenerative treatment with platelet-rich plasma (PRP) combined with a bovine-derived xenograft (BDX) in smokers and non-smokers.
Materials and Methods: A total of 24 advanced chronic periodontitis patients, 12 smokers and 12 non-smokers, with 113 intrabony defects with an intrabony component of 3 mm were included in this study. Defects were surgically treated with PRP/BDX. At baseline and 12 months after surgery, the following parameters were recorded: plaque and sulcus bleeding indices, probing depth (PD), relative attachment level, marginal recession, probing and radiographic bone levels.
Results: Considering the soft tissue measurements, smokers and non-smokers presented a mean PD reduction of 3.97 ± 0.76 and 4.63 ± 0.52 mm, recession of 0.76 ± 0.44 and 0.50 ± 0.12 mm and attachment gain of 3.26 ± 0.42 and 4.06 ± 0.40 mm, respectively. Evaluation of the hard tissue findings revealed that the mean clinical and radiographic bone gains in smokers and non-smokers were 2.83 ± 0.47 and 3.63 ± 0.38 mm, 2.98 ± 0.38 and 3.67 ± 0.48 mm, respectively. Inter-group differences for PD reduction ( p <0.05), attachment ( p <0.001), clinical ( p <0.001) and radiographic bone gains ( p <0.001) were found to be significant between smokers and non-smokers.
Conclusions: Within the limits of this study, the results indicate that treatment outcome following PRP/BDX application in intrabony defects is impaired with smoking.     

Treatment of intrabony periodontal defects with platelet-rich plasma versus platelet-poor plasma combined with a bovine-derived xenograft: a controlled clinical trial

Background: The purpose of this study is to assess the healing outcomes of intrabony defects after treatment with platelet‐rich plasma (PRP) versus platelet‐poor plasma (PPP) combined with bovine‐derived xenograft (BDX). Methods: Using a split‐mouth design, a total of 79 intrabony defects with an intrabony component of ≥3 mm in 20 patients were treated either with PRP/BDX (group 1) or PPP/BDX (group 2). At baseline and 12 months after surgery, plaque and sulcus bleeding indices, probing depth (PD), relative attachment level, recession, and probing and radiographic bone levels were recorded. Results: After 12 months, groups 1 and 2 presented a mean PD reduction of 3.87 ± 0.86 and 3.76 ± 0.80 mm, recession of 1.35 ± 0.68 and 1.58 ± 0.54 mm, attachment gain of 2.51 ± 0.97 and 2.18 ± 0.87 mm, clinical bone gain of 2.18 ± 0.86 and 2.09 ± 0.89 mm, and radiographic bone gain of 2.11 ± 0.87 and 2.19 ± 0.96 mm, respectively. Intergroup differences were found to be insignificant. Conclusions: Within its limits, these results suggest that the outcomes of the treatment after PRP/BDX and PPP/BDX applications in intrabony defects are similar. When the platelet counts are taken into consideration, PPP seems to demonstrate similar clinical efficacy as the PRP.     

Use of platelet-rich plasma in the treatment of bisphosphonate-related osteonecrosis of the jaw

Platelet-rich plasma is a concentrate of growth factors and osteoconductive proteins, which can play a major role in bone biology by accelerating and enhancing bone repair and regeneration. This paper describes the results of using platelet-rich plasma in the management of bisphosphonate-associated necrosis of the jaw. Eight patients with a diagnosis of bisphosphonate-associated necrosis of the jaw were surgically treated for debridement and removal of necrotic bone, followed by application of autologous platelet concentrate enriched with growth factors and primary suture of the wound. Patients underwent periodic clinical and radiological follow-up examinations. All patients showed clinical improvement and oral lesions resolved 2–4 weeks after treatment. After an average 14-month follow up period, patients remained asymptomatic. Although not conclusive, the combination of necrotic-bone curettage and platelet-rich-plasma to treat refractory osteonecrosis of the jaw yielded promising results.     

富血小板血浆在颌骨再生方面的应用

富血小板血浆(platelet-rich plasma,PRP)是全血经过密度梯度离心分离产生的血小板浓缩物,富含多种自源性生长因子,不仅具有促进组织愈合和骨再生的作用,而且还避免了免疫原性和疾病传播等缺点。迄今为止,国内外学者对PRP已进行了大量的基础和临床研究,该文就其生物学特性、在颌骨再生和其他方面的应用研究作一综述。     

Treatment of periapical inflammatory lesion with the combination of platelet-rich plasma and tricalcium phosphate: a case report

Periapical surgery is an important treatment alternative in the presence of a periapical inflammatory lesion. To achieve optimal healing and regeneration of the bone, different bone substitutes or barrier membranes can be used after degranulation of the lesion. Tricalcium phosphate (TCP) graft material is one of these substitutes. Platelet Rich Plasma (PRP) preparation is a new biotechnology and can be used in many different surgical procedures. It consists of thrombocyte concentrates and high amounts of growth factors (GFs), especially platelet derived growth factor (PDGF), insulin-like growth factor (IGF-I) and transforming growth factor (TGF-beta), which are important in wound healing and regeneration. In this case report, use of platelet gel in conjunction with TCP in the treatment of periapical inflammatory lesion and the results of 12 months has been reported.     

Clinical comparison of an enamel matrix derivative used alone or in combination with a bovine-derived xenograft for the treatment of periodontal osseous defects in humans

BACKGROUND: The combination of bone replacement graft materials has been suggested for the treatment of periodontal osseous defects. The purpose of this study was to evaluate the effectiveness of enamel matrix derivative (EMD) combined with a bovine-derived xenograft (BDX) as compared to EMD alone in the treatment of intraosseous defects in patients with moderate to advanced periodontitis. METHODS: Sixteen adult patients with at least 2 intrabony defects were entered in this split-mouth design study. Defects were treated with EMD alone or EMD + BDX. Reentries were performed 6 to 8 months after initial surgery. The following soft and hard tissue measurements were recorded prior to initial surgery and at reentry: probing depth (PD), gingival margin location, clinical attachment level (CAL), depth of defect, and crestal bone level. Statistical analyses were performed to determine changes in PD, CAL, fill of osseous defect, and crestal resorption. Percentages of bone fill (%BF) and defect resolution (%DR) were also calculated. RESULTS: The most significant results were that gingival recession was greater for the group treated with EMD alone (0.8 +/- 0.8 mm) compared to EMD + BDX (0.3 +/- 0.6 mm) (P = 0.04) and bone fill was greater for EMD + BDX (4.0 +/- 0.8 mm) compared to EMD alone (3.1 +/- 1.0 mm) (P = 0.02). The measures for PD reduction, attachment level gain, crestal resorption, %BF, and %DR did not present a statistically significant difference (P > 0.10). CONCLUSIONS: This study evaluated the performance of EMD + BDX and EMD alone. The results demonstrated that a significant improvement in clinical parameters was observed. When comparing both modalities, a statistically significant difference was only found for gingival recession and bone fill, yielding a more favorable outcome towards the combined approach.     

A clinical comparison of a bovine-derived xenograft used alone and in combination with enamel matrix derivative for the treatment of periodontal osseous defects in humans

BACKGROUND: Enamel matrix protein derivative (EMD) and particulate anorganic cancellous bovine-derived bone xenograft (BDX) have both shown favorable clinical results in reducing intrabony periodontal defects as compared to open flap debridement alone. These materials have shown results comparable to those obtained with guided tissue regeneration. The primary aim of the present study was to evaluate the effectiveness of EMD combined with BDX as compared to BDX alone, with a secondary aim to compare the treatment outcomes of the 2 modalities. METHODS: Seventeen patients with paired intrabony defects and probing depths measuring > or = 5 mm who were being treated for chronic periodontitis were selected for this controlled, blinded, split-mouth study. Following non-surgical periodontal therapy, sites were randomly selected to receive either a combination of EMD and BDX (test group) or BDX alone (positive control group). Baseline and 6-month surgical reentry measurements were taken by a calibrated examiner blinded to the treatment. A paired Student t test was utilized to evaluate differences between baseline and post-treatment and between the treatment groups. RESULTS: Favorable clinical outcomes for both hard and soft tissue measurements were achieved for both treatment groups when compared to baseline (P < 0.001). There was no statistically significant difference for any of the measured clinical parameters. Probing depth reduction for the test group and control group was 4.2 +/- 1.1 mm and 3.9 +/- 1.3 mm, respectively (P > 0.8). Mean gain in clinical attachment levels for the test and control groups was 3.8 +/- 0.9 mm and 3.7 +/- 1.5 mm, respectively (P > 0.6). Hard tissue measurements obtained at surgical reentry were used to calculate the bone fill (BF) and percent bone fill (%BF). The BF was 3.2 +/- 1.4 mm and 3.0 +/- 1.2 mm (P > 0.6), and the %BF was 63.3 +/- 16.3% and 67.0 +/- 19.0% (P > 0.4) for the EMD + BDX and BDX groups, respectively. CONCLUSIONS: In summary, both the particulate anorganic cancellous bovine-derived bone xenograft used alone and in combination with enamel matrix derivative are effective for the treatment of human intrabony periodontal lesions.     

Human histologic evaluation of a bovine-derived bone xenograft in the treatment of periodontal osseous defects

This study evaluated a bovine-derived bone xenograft (Bio-Oss) in the treatment of human periodontal osseous defects. Four patients with at least one tooth that had been recommended for extraction because of interproximal advanced periodontal disease volunteered to participate. The surgical procedure consisted of flap reflection, soft tissue debridement, placing a notch in calculus as a histologic reference point, root planing, placement of the bovine-derived xenograft and a bioresorbable physical barrier, and flap closure. Patients were seen every 2 weeks for plaque control and any necessary adjunctive treatment. At 4 to 6 months postsurgery, 6 teeth, along with the adjacent graft site, were removed en bloc. Histologic observations demonstrated new bone, new cementum, and new periodontal ligament coronal to the reference notch in 3 of the 4 specimens. This study indicates that periodontal regeneration is possible following grafting with a bovine-derived xenograft.     

Healing of intra-bony defects following treatment with a composite bovine-derived xenograft (Bio-Oss Collagen) in combination with a collagen membrane (Bio-Gide PERIO)

AIM: The purpose of the present study was to compare clinically the treatment of deep intra-bony defects with a combination of a composite bovine-derived xenograft (BDX Coll) and a bioresorbable collagen membrane [guided tissue regeneration (GTR)] to access flap surgery only. METHODS: Thirty-two patients, each of whom displayed one intra-bony defect, were treated either with BDX Coll+GTR (test) or with access flap surgery (control). The results were evaluated at 1 year following therapy. RESULTS: No differences in any of the investigated parameters were observed at baseline between the two groups. Healing was uneventful in all patients. At 1 year after therapy, the test group showed a reduction in the mean probing depth (PD) from 8.3+/-1.5 to 2.9+/-1.3 mm (p<0.001) and a change in the mean clinical attachment level (CAL) from 9.4+/-1.3 to 5.3+/-1.5 mm (p<0.0001). In the control group, the mean PD was reduced from 8.0+/-1.2 to 4.4+/-1.7 mm (p<0.001) and the mean CAL changed from 9.6+/-1.3 to 7.9+/-1.6 mm (p<0.01). The test treatment resulted in statistically higher PD reductions (p< or =0.05) and CAL gains (p<0.001) than the control one. In the test group, all sites (100%) gained at least 3 mm of CAL. In this group, a CAL gain of 3 or 4 mm was measured at 10 sites (62%), whereas at six sites (38%), the CAL gain was 5 or 6 mm. In the control group, no CAL gain occurred at three sites (19%), whereas at 10 sites (62%), the CAL gain was only 1 or 2 mm. A CAL gain of 3 mm was measured in three defects (19%). CONCLUSIONS: Within the limits of the present study, it can be concluded that the combination of BDX Coll+GTR resulted in significantly higher CAL gains than treatment with access flap surgery alone, and thus appears to be a suitable alternative for treating intra-bony periodontal defects.     

Healing of intrabony peri-implantitis defects following application of a nanocrystalline hydroxyapatite (Ostim) or a bovine-derived xenograft (Bio-Oss) in combination with a collagen membrane (Bio-Gide). A case series

OBJECTIVES: The aim of the present case series was to evaluate the healing of intrabony peri-implantitis defects following application of a nanocrystalline hydroxyapatite (NHA) or a bovine-derived xenograft in combination with a collagen membrane (BDX+BG). MATERIAL AND METHODS: Twenty-two patients having moderate peri-implantitis (n=22 intrabony defects) were randomly treated with (i) access flap surgery (AFS) and the application of NHA, or with AFS and the application of BDX+BG. Clinical parameters were recorded at baseline and after 6 months of non-submerged healing. RESULTS: Post-operative wound healing revealed that NHA compromized initial adhesion of the mucoperiosteal flaps in all patients. At 6 months after therapy, NHA showed a reduction in the mean PD from 7.0+/-0.6 to 4.9+/-0.6 mm and a change in the mean clinical attachment loss (CAL) from 7.5+/-0.8 to 5.7+/-1.0 mm. In the BDX+BC group, the mean PD was reduced from 7.1+/-0.8 to 4.5+/-0.7 mm and the mean CAL changed from 7.5+/-1.0 to 5.2+/-0.8 mm. CONCLUSION: Within the limits of the present case series, it can be concluded that at 6 months after surgery both therapies resulted in clinically important PD reductions and CAL gains.     

Healing of intrabony defects following treatment with a bovine-derived xenograft and collagen membrane. A controlled clinical study

AIM: : The purpose of the present study was to compare clinically the treatment of deep intrabony defects with a combination of a bovine-derived xenograft (BDX) and a bioresorbable collagen membrane to access flap surgery. METHODS: : Twenty-eight patients suffering from chronic periodontitis, and each of whom displayed one intrabony defect, were randomly treated with BDX + collagen membrane (test) or with access flap surgery (control). Soft tissue measurements were made at baseline and at 1 year following therapy. RESULTS: : No differences in any of the investigated parameters were observed at baseline between the two groups. Healing was uneventful in all patients. At 1 year after therapy, the test group showed a reduction in mean probing depth (PD) from 9.2+/-1.3 to 3.9+/-0.7 mm (p<0.001) and a change in mean clinical attachment level (CAL) from 10.2+/-1.5 to 6.2+/-0.5 mm (p<0.0001). In the control group, the mean PD was reduced from 9.0+/-1.2 to 5.2+/-1.8 mm (p<0.001) and the mean CAL changed from 10.5+/-1.5 to 8.4+/-2.1 mm (p<0.01). The test treatment resulted in statistically higher PD reductions (p相似文献   

Tissue-engineered cultured periosteum used with platelet-rich plasma and hydroxyapatite in treating human osseous defects

BACKGROUND: The aim of the present controlled clinical study was to compare the clinical response of human cultured periosteum (HCP) sheets in combination with platelet-rich plasma (PRP) and porous hydroxyapatite (HA) granules to a mixture of PRP and HA in the treatment of human infrabony periodontal defects. METHODS: Thirty interproximal infrabony osseous defects in 30 healthy, non-smoking subjects diagnosed with chronic periodontitis were included in this study. The subjects were randomly assigned to the test group (HCP sheets combined with PRP and HA) or the control group (PRP with HA). Clinical and radiographic measurements were made at baseline and the 12-month post-surgical evaluation. RESULTS: Compared to baseline, the 12-month results indicated that both treatment modalities resulted in statistically significant changes (P <0.01) in the gingival index, bleeding on probing, probing depth, clinical attachment level, and radiographic infrabony defect depth. Compared to the control group, the test group exhibited a statistically significantly more favorable change in clinical attachment gain (3.9 +/- 1.6 mm versus 2.7 +/- 1.3 mm; P <0.05), vertical relative attachment gain (83.5% +/- 31.7% versus 55.0% +/- 21.9%; P <0.05), and radiographic infrabony defect fill (4.9 +/- 1.2 mm versus 3.2 +/- 1.1 mm; P <0.01). CONCLUSIONS: Compared to PRP with HA, treatment with a combination of HCP sheets, PRP, and HA led to a significantly more favorable clinical improvement in infrabony periodontal defects. A factor likely contributing to these favorable clinical results is the presence of osteogenic cells in the HCP sheets, which provided greater regeneration potential.     

Polycaprolactone-20% tricalcium phosphate scaffolds in combination with platelet-rich plasma for the treatment of critical-sized defects of the mandible: a pilot study.

PURPOSE: Our group has recently fabricated 3-dimensional scaffolds of unique architecture to mediate favorable cell binding, proliferation, and differentiation. In this study, the osteoconductive and bioactive polycaprolactone-20% tricalcium phosphate (PCL-TCP) scaffolds were assessed for the treatment of critical-sized defects of the mandible, with respect to new bone formation. Platelet-rich plasma (PRP) was combined with some scaffolds to test if bone regeneration could be enhanced. MATERIALS AND METHODS: Autologous PRP was prepared from whole blood collected from 8 mongrel dogs. In each dog, 3 defects (18 x 10 x 7 mm) were created at either the left or right mandible and treated with 1 of 2 treatment modalities: 1) grafting with scaffolds alone; or 2) grafting with scaffolds loaded with PRP. The scaffolds were stabilized using 2 dental implants each to prevent rotation. Micro-CT and histologic analysis were carried out on samples after 6 and 9 months. RESULTS: Micro-CT measurements showed that PRP-treated defects had 98.3% and 58.3% more bone volume fraction than defects grafted with scaffolds alone at 6 and 9 months, respectively (P < .05). No significant difference was noted between caudal and frontal situated PRP-treated defects, but a significant difference was observed between male and female dogs. Histologic analyses verified the deposition of osteoid and new bone trabeculae throughout the section at 6 months. The defect margins were filled with mature bone trabeculae at 9 months but the middle section of the scaffolds manifested disturbed mineralization. The scaffolds experienced 33% degradation from 6 to 9 months. PRP treatment had negligible effect on the degradation of the scaffolds. CONCLUSIONS: The pilot study showed that the treatment of critical-sized defects of the mandible with PCL-TCP scaffolds may be augmented by the addition of PRP.     

Maxillary sinus floor elevation using a combination of DFDBA and bovine-derived porous hydroxyapatite: a preliminary histologic and histomorphometric report

The objective of the study was to determine the osteoconductive potential of bovine-derived porous hydroxyapatite (HA) in combination with demineralized freeze-dried bone allograft (DFDBA) as an alternative to autogenous grafting in the maxillary sinus. The study involved 5 patients treated with 2-stage sinus elevation procedures using a combination of DFDBA and Osteograf/N 300 and 700. The healing time before implant placement ranged from 6 to 13 months. At the time of reentry, a bone core was harvested from each patient and processed for histologic and histomorphometric analysis. Woven and lamellar bone formation was evident in all specimens. Mean trabecular bone volume was 27.92%. The amount of newly formed bone was positively correlated with healing time. The range of new bone formation was 5.36% (6 mo) to 43.68% (12 mo). Residual HA graft particles were evident in all specimens, and the amount was inversely correlated with time. HA particles were often surrounded by an intense inflammatory infiltrate. DFDBA particles, largely present in the 6-month biopsy, were not recognizable in the 10-, 12-, and 13-month specimens, suggesting complete replacement. The combination of Osteograf/N and DFDBA appears to be osteoconductive and may be considered a valid alternative to autogenous bone grafts in sinus lift procedures. Histomorphometric and histologic evaluation may also be used to monitor the status of the future implant site.     

Leucocyte-rich and platelet-rich fibrin for the treatment of bisphosphonate-related osteonecrosis of the jaw: a prospective feasibility study

Our aim was to assess the feasibility of using leucocyte-rich and platelet-rich fibrin (L-PRF) for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a single group study. After treatment with L-PRF, the response of each patient was recorded 1 month and 4 months postoperatively. Further assessments were made of the site, stage, concentration of c-terminal crosslinked telopepide of type 1 collagen, and actinomycosis. Among the total of 34 patients, 26 (77%) showed complete resolution, 6 (18%) had delayed resolution, and 2 (6%) showed no resolution. There was a significant association between the response to treatment and the stage of BRONJ (p = 0.002) but no other significant associations were detected. This study has shown that it is feasible to use L-PRF for the treatment of BRONJ, but the effectiveness cannot be judged with this study design. Randomised prospective trials are needed to confirm this.     

Clinical evaluation of Bio-Oss®: a bovine-derived xenograft for the treatment of periodontal osseous defects in humans

The purpose of this study was to compare the bovine derived xenograft (BDX) Bio-Oss to demineralized freeze dried bone allograft (DFDBA) in human intrabony defects. 17 healthy patients with no systemic disease with moderate-severe periodontitis (7 males, 10 females; aged 34-67), were treated. Surgically, defects were included only if the intraosseous defect depth was >3.0 mm. Final selection included 30 defects. The sites were randomly assigned treatment with DFDBA or BDX. Soft tissue and osseous defect measurements were taken the day of surgery and 6 months post-operatively at re-entry. Average baseline PD, CAL, and surgical defect depth for the DFDBA group were not statistically different from the BDX group. No adverse healing response occurred. The results showed a statistically significant improvement in PD and AL for both materials at 6 months in 26 defects (4 defects did not respond to therapy). Soft tissue measurements for the DFDBA group included PD reduction of 2.0+/-1.3 mm, and AL gain of 2.6+/-1.6 mm, while the BDX group showed a PD reduction of 3.0+/-1.7 mm, and AL gain of 3.6+/-1.8 mm. Osseous measurements showed bone fill of 2.4 mm (46.8%) for the DFDBA group and 3.0 mm (55.8%) for the BDX group. Defect resolution was 59.4% for the DFDBA group and 77.6% for the BDX group. Statistical analysis revealed there was no statistical difference between the 2 materials in all measurements.     

Use of particulate dentin-plaster of Paris combination with/without platelet-rich plasma in the treatment of bone defects around implants

PURPOSE: To evaluate the effect of particulate dentin-plaster of Paris with and without platelet-rich plasma (PRP) on bone healing and new bone formation around titanium dental implants in a canine model. Histologic sections and histomorphometric analysis of the defects were obtained at 6 and 12 weeks after surgery. MATERIALS AND METHODS: Three circular bone defects were surgically prepared in iliac crest sites in each of 10 animals. A total of 30 Avana dental implants were placed in the animals. They were self-tapping, screw-type implants, 10 mm in length and 4 mm in diameter, all made of commercially pure titanium. A titanium implant was placed centrally in each defect. In each dog, the defects were treated with 1 of the following 3 treatment modalities: (1) no treatment (control); (2) grafting with particulate dentin-plaster of Paris; (3) grafting with particulate dentin-plaster of Paris and PRP. RESULTS: Histologic analysis showed that all of the bone defects surrounding the implants that were treated with particulate dentin-plaster of Paris, with and without PRP, were filled with new bone. The defects that were not treated (control) demonstrated new bone formation only in the inferior threaded portion of the implants. DISCUSSION: Histomorphometric results revealed a higher percentage of bone contact with particulate dentin-plaster of Paris and PRP compared to the control and particulate dentin-plaster of Paris. CONCLUSIONS: These results suggested that bone defects around titanium implants can be treated successfully with particulate dentin-plaster of Paris, and that the outcome can be improved if PRP is also used.     

Evaluation of platelet-rich plasma in combination with anorganic bovine bone in the rabbit cranium: a pilot study

PURPOSE: Platelet-rich plasma (PRP) is potentially useful as an adjunct to allograft and xenograft materials in oral and maxillofacial bone and implant reconstructive surgery. This study compares bone healing and formation in 4 cranial defects in rabbits grafted with autogenous bone, xenograft, and xenograft with PRP (with a no-graft group as a control). MATERIALS AND METHODS: Fifteen New Zealand white rabbits were included in this randomized, blind, prospective pilot study. Four identical 8-mm-diameter defects were created in each rabbit cranium and immediately grafted with the above materials. Five rabbits were evaluated at 1 month, 5 at 2 months, and 5 at 4 months. Radiographs were used to evaluate bone density. RESULTS: Radiographically, sites at which Bio-Oss, autogenous bone, and Bio-Oss + PRP were grafted showed a significant increase in bone density at 1 month (P = .05 for Bio-Oss, P = .02 for autogenous bone, P = .008 for Bio-Oss + PRP) and at 4 months (P = .02 for Bio-Oss, P = .04 for autogenous bone, P = .05 for Bio-Oss + PRP). Autogenous bone sites (P < .001) and Bio-Oss + PRP sites (P < .001) also showed significant increases at 2 months. Histomorphometrically, autogenous bone sites showed a significantly greater increase than control sites (P = .08 at 1 month, P = .03 at 2 months, P = .01 at 4 months), Bio-Oss sites (P < .001 at all 3 evaluation points), or Bio-Oss + PRP sites (P = .009 at 1 month, P = .02 at 2 months, P = .01 at 4 months). Furthermore, Bio-Oss + PRP sites showed a significantly greater increase in bone area at 1, 2, and 4 months than Bio-Oss alone (P = .003 at 1 month, P = .02 at 2 months, P = .006 at 4 months). DISCUSSION: Radiographs showed significantly greater bone density at the Bio-Oss, autogenous bone, and Bio-Oss + PRP sites than at control sites at nearly every point in time evaluated; however, clinical significance is difficult to determine, since all materials appeared dense on the radiograph. Histomorphometry showed that the increase in bone area at autogenous sites was significantly greater than that seen with other grafting materials or at the control sites. CONCLUSION: This study showed a histomorphometric increase in bone formation with the addition of PRP to Bio-Oss in non-critical-sized defects in the rabbit cranium.