Effect of platelet-rich plasma on bone regeneration in dentistry: a systematic review (original) (raw)
Related papers
Journal of Cranio-Maxillofacial Surgery, 2013
Platelet-rich plasma (PRP) is rich in growth factors, target-specific polypeptides that play a role in cell proliferation and differentiation and can thus encourage wound repair. This study sought to assess the effects of PRP on new bone formation in a sample of 25 patients with clinical indications for extraction of all four impacted third molars with similar orientation, depth, and root morphology. Immediately after extraction, sockets on one side received PRP, whereas those on the other side (control) did not. Patients underwent 6 months of clinical and radiographic follow-up. Periapical radiographs were scanned and bone repair was assessed by image histogram analysis. The radiographic densities of the extraction sockets were compared to the densities of the distal surfaces of the adjacent teeth, with the difference between both serving to distinguish the PRP and control sides. Results showed that healing of PRPtreated sockets was significantly different from that of control sockets at 1-, 3-, and 6-month followup, in mandibular and maxillary sockets alike. The results of this sample suggest that PRP provides a safe and effective means of speeding alveolar bone repair.
Platelet-rich plasma (PRP) is an autologous product that contains highly concentrated number of platelets in a small volume of plasma, derived from whole blood by gradient density centrifugation. It has been speculated that local growth factors in human platelets (insulin-like growth factor, IGF; transforming growth factor, TGF-b; platelet derived growth factor, PDGF) would enhance healing of grafts and also counteract resorption. The aim of this study was to evaluate efficacy of PRP on early healing after autogenous bone grafting. Of the twenty patients selected ten were treated with autogenous bone graft and PRP (PRP group) and other ten with autogenous bone graft alone (non-PRP group). PRP group consisted of two benign tumor of mandible, one post surgical defect, two unilateral alveolar cleft, one bilateral alveolar cleft with skeletal class III malocclusion, one maxillary hypoplasia, one oronasal fistula, one recurrent tumor of mandible, one multiple impacted mandibular teeth. Non-PRP group consisted of seven benign tumor of jaw, one keratocyst odontogenic tumor, one orbital blow out fracture, one residual traumatic defect. Biopsies were taken in the native bone, PRP treated grafted bone, grafted bone without PRP at 3 months to assess the maturity of bone. Radiographic imaging was performed by panoramic radiography at 3 and 6 months to evaluate bone opacity of grafted bone on comparison with native bone and computerized tomography at 6 months to evaluate grafted bone morphologically and to measure bone density in Hounsfield units. Microscopic results showed that significantly more matured bone was formed at PRP treated sites as that of native bone and immature bone in controls after 3 months of healing. Bone opacity of PRP treated bone grafts was close to that of native bone than that of non-PRP treated bone grafts on panoramic radiograph at 3 and 6 months. There was graft loss in three cases and graft resorption in one case of non-PRP treated bone grafts at 6 months. In PRP group the compact bone was clearly differentiated from cancellous bone as in native bone and thick in five cases, thin in five cases. In non-PRP group the compact bone was thin as a whole. Comparing native bone group and PRP group the CT value of PRP treated bone graft was more or less close to native bone group and comparing native bone group and non-PRP group CT value was low in non-PRP treated bone graft. Whereas when comparing PRP and non-PRP group CT value was higher in PRP group. Autologous PRP was a safe, biocompatible, effective, source for growth factors and carries no risk of transmissible diseases. It enhances and accelerates bone regeneration of autogenous bone grafts.
Journal of Endodontics, 2017
Introduction: Regenerative endodontic procedures (REP) are a promising alternative for necrotic immature teeth in adolescents and children, but very little evidence is available on this alternative in long-lasting necrotic teeth with open apices in adults. REPs are designed to replace damaged structures of the pulpdentin complex, but no regeneration has been obtained in any of the cases described in necrotic immature permanent teeth with apical periodontitis with histologic results. The results are limited to periapical tissue repair with increasing root length, thickening of the root walls, and apical closure in young patients. In this series of cases, we report on the outcomes of the adjuvant use of autologous platelet-rich plasma (PRP) in endodontic therapy in adults by monitoring periapical tissue healing with periodic periapical radiographs and cone-beam computed tomographic scanning. Methods: Three teeth with apical periodontitis and open apices in 3 different patients from 21 to 35 years-old were evaluated. An REP was performed with the adjuvant use of PRP. Results: At controls, complete disappearance of the radiolucent lesions and the presence of calcified structures forming bridges occupying the pulp lumen were observed but not an ostensible thickening of root walls with a regeneration of pulp-dentin complex. Conclusions: The repair of periapical tissues with REPs of open apex teeth with apical periodontitis and in nonsurgical endodontic retreatment appears to be feasible in adults, but no regeneration was obtained in any of the present cases. The use of PRP may be a good choice as an autologous matrix because of its stability and induction; it contains growth factors and bioactive molecules like transforming growth factor beta, bone morphogenic proteins, insulinlike growth factors, and angiogenetic growth factors, which stimulate collagen production, angiogenesis, and cell differentiation. Anti-inflammatory and antibacterial properties have also been reported for this preparation, which are involved in all processes of repair.
Current Pharmaceutical Biotechnology, 2012
Platelet concentrates for surgical use are innovative tools of regenerative medicine, and were widely tested in oral and maxillofacial surgery. Unfortunately, the literature on the topic is contradictory and the published data are difficult to sort and interpret. In periodontology and dentoalveolar surgery, the literature is particularly dense about the use of the various forms of Platelet-Rich Plasma (PRP)-Pure Platelet-Rich Plasma (P-PRP) or Leukocyte-and Platelet-Rich Plasma (L-PRP)-but still limited about Platelet-Rich Fibrin (PRF) subfamilies. In this first article, we describe and discuss the current published knowledge about the use of PRP and PRF during tooth avulsion or extraction, mucogingival surgery, Guided Tissue Regeneration (GTR) or bone filling of periodontal intrabony defects, and regeneration of alveolar ridges using Guided Bone Regeneration (GBR), in a comprehensive way and in order to avoid the traps of a confusing literature and to highlight the underlying universal mechanisms of these products. Finally, we particularly insist on the perspectives in this field, through the description and illustration of the systematic use of L-PRF (Leukocyte-and Platelet-Rich Fibrin) clots and membranes during tooth avulsion, cyst exeresis or the treatment of gingival recessions by root coverage. The use of L-PRF also allowed to define new therapeutic principles: NTR (Natural Tissue Regeneration) for the treatment of periodontal intrabony lesions and Natural Bone Regeneration (NBR) for the reconstruction of the alveolar ridges. In periodontology, this field of research will soon find his golden age by the development of user-friendly platelet concentrate procedures, and the definition of new efficient concepts and clinical protocols.
Gaceta Médica de México, 2019
Background: At present, there is great interest in developing clinical applications of platelet-rich plasma (PRP) to enhance bone repair. Aim: The aim of the study was to assess bone regeneration (BR) in mandibular fractures, with the application of this adjuvant. Methods: A total of 20 patients with mandibular fractures were included in a randomized clinical trial. Patients of the experimental group (n = 10) were submitted to internal fracture reduction and administration of PRP, and patients of the control group (n = 10) were submitted to the same surgical procedure without plasma application. Radiologic assessment was made before and at 1 st and 3 rd months after surgery. X-rays were digitalized for analyze intensity and density as a reflection of BR. Results: The average age was 32 ± 11.3 years and 31.2 ± 8.48 years, respectively (p = 0.76). The radiographic intensity and density in the experimental group at the 1 st and 3 rd month were higher in contrast to the control group (p < 0.005). BR time was 3.7 ± 0.48 and 4.5 ± 0.52 weeks, respectively (p = 0.002). There was no morbidity related to the application of the PRP. Conclusion: The PRP increased the bone intensity and density in the fracture trace allowing BR and recovery in a shorter time than patients in which it was not used.
Do platelet concentrates promote bone regeneration?
Musculoskeletal regeneration, 2015
Platelet concentrates have been used in various applications within Oral and Maxillofacial Surgery and Implantology with the aim of promote tissue repair. The first generation of platelet concentrates is Platelet-Rich Plasma (PRP) and recent studies question its actual effectiveness on tissue healing because of the rapid release of growth factors. The second generation of platelet concentrates, the Platelet-Rich Fibrin (PRF), shows peculiar features in the release of growth factors, which occurs slowly and gradually and thus seems to promote a more promising effect over the tissues under repair in comparison with PRP, especially regarding to bone. However, the literature data are different and better results seem to be obtained when the PRF is mainly used in combination with other graft materials. Additional well-designed studies are needed to better clarify this matter.
Effect of Platelet Rich Plasma (PRP) to Autogenous Bone Graft
Folia Medica Indonesiana
Bone graft use in maxillofacial surgery is currently developing, though some problems still persist. One of promising solutions to the problems is application of platelet rich plasma which may accelerate soft tissue healing and bone formation. This study aims to provide basic understanding to the development of PRP application in bone healing where bone graft is applied on human maxillae. Bone defects were made on maxillae of albino rabbits, with an application of bone graft in control group and bone graft plus PRP in treatment group. Histopathological analysis was performed in both groups to assess osteoblast density and collagen tissue area. On day 21st, more osteoblast density and collagen area in treatment group are significantly observed (p<0.05, 95% confidence interval). Observations were made on hard callus formation. In conclusions, platelet rich plasma may increase density of osteoblast in rabbit maxillary bone graft.
From Coagulation to Oral Surgery Application: Platelets in Bone Regeneration
2018
The complexity of the treatment of tissue lesions, particularly bone lesions, in regenerative medicine depends on the origin of the substance loss (traumatic, tumoral, infectious, etc.), its size and mechanical requirements. In the field of dental surgery, the need to ensure rapid regeneration of injured bone tissue for periodontal, post-extractional or pre-implant corrective surgery leads dental surgeons to have a large number of biomaterials in their therapeutic arsenal. The mineral materials are most often used because of their chemical composition which is close to bone’s mineral phase. They also present a resorption time in agreement with the time of formation of new bone.However their benefits are inconstant and the need of new bioactive structures, well accepted by the host, and favoring tissue healing has grown. Here is the place for platelet concentrates such as Platelet Rich Plasma (PRP) and Platelet Rich Fibrin (PRF) which are rich in growth factors, cytokines and others ...
Platelet rich plasma in oral and maxillofacial surgery from the perspective of composition
Platelets, 2020
The application of platelet-rich plasma (PRP) in oral and maxillofacial surgery has been thoroughly studied in the last two decades. Currently, different types of PRP are applied in the clinical practice, being the presence or absence of leukocytes one of the classification criteria. However, there is poor evidence assessing the influence of the PRP composition in their efficacy. In this context, the aim of this narrative review is to compile the existing evidence covering the efficacy of PRP in oral and maxillofacial surgery, starting from a systematic literature search and to qualitatively describe the efficacy outcomes from the composition perspective. According to the results of this review, the application of PRP in oral and maxillofacial surgery is a potential strategy to improve soft-and hard-tissue regeneration, observing differences in the efficacy of PRP depending on its composition and the studied application. P-PRP (the absence of leukocytes) has been more consistent in achieving beneficial effects in alveolar ridge preservation, management of post-extraction complications, bone augmentation and temporomandibular joint disorders. For that, the composition and methodology used to prepare the PRP should be a critical point when evaluating the efficacy of PRP.
Autogenous Platelet Rich Plasma in Healing of Bone Defects
JMS SKIMS
Purpose: To evaluate the efficacy of PRP in regeneration of bone in defects of the oral and maxillofacial region. Methods: A comparative nonrandomized study including 40 patients with bony defects of cystic origin in the maxillofacial region was carried out in the Department of Oral and Maxillofacial Surgery. Patients were divided into two groups: group A received PRP and in group B PRP was not used. Postoperatively, the patients were monitored regularly by radiographs to evaluate new bone growth at 1st ,3rd and 6th month clinically and radiographically. Results: Faster bone healing in was observed in the patients in whom PRP was used at every follow up. Conclusion: Defects filled with PRP showed comparatively earlier and faster bone regeneration. JMS 2013;16(2):90-94