Abstract
BackgroundThis study evaluated the long-term effects of platelet-rich plasma (PRP) on bone formation and regeneration when associated with autogenous bone graft (AB), porous biphasic calcium phosphate (pBCP), or deproteinized bovine bone (DBB) in maxillary sinus augmentation (MSA) of rabbit.MethodsIn 54 rabbits, bilateral MSA procedure was performed and randomly one sinus was filled with 200 mm3 material plus blood clot (AB/clot, DBB/clot, and pBCP/clot) and other with the same graft plus PRP (AB/PRP, DBB/PRP, and pBCP/PRP). After 30, 60, and 180 days, microtomographic were performed to analyze the three-dimensional MSA volume and histomorphometric analyses for the percentage of bone and soft tissues ingrowth. Data were compared by two-way ANOVA and the means were compared by the Tukey test, at p < 0.05.ResultsThe percentage of pBCP and DBB were nearly unchanged throughout the whole period and bone formation occurred in the spaces between particles. The MSA volume filled with DBB and pBCP agglutinated with clot and PRP maintained constant during all experimental periods (147.2 mm3 and 154.9 mm3, respectively, p = 0.7377), and no significant changes in the new formatted bone and soft tissue were observed between treatments. In AB/clot and AB/PRP, the MSA volume was similar at 30 days (140.3 mm3 and 137.9 mm3, respectively), but a higher and gradual reduction was observed until 180 days. In the AB/PRP, this reduction was significantly higher (44.2%) than AB/clot (22.5%) (p = 0.01792). Histologically, the addition of PRP to AB accelerated the new bone formation/remodeling maintaining the percentage of new bone similar to AB/clot during all experimental volume (p = 0.6406), while the AB particles showed a higher resorption in AB/PRP than AB/clot until 60 days (mean of 7.8% and 15.1%, respectively, p = 0.0396).ConclusionThe association of PRP with the autogenous graft accelerates the process of bone formation/remodeling in MSA, but not had influence on the pBCP and DBB groups.
Highlights
Alveolar bone resorption and pneumatization of the maxillary sinus after posterior tooth extraction often lead to low quality and unsuitable quantity of bone in the posterior maxilla, which makes it difficulty in the local rehabilitation with use of dental implants [1]
Material and methods Grafting materials: porous biphasic calcium phosphate: granules composed by hydroxyapatite and βtricalcium phosphate at 70:30 ratio produced by Baumer S.A., Mogi Mirim, SP, Brasil, 0.5–0.75 mm particle size
At 60 days, a higher reduction of Autogenous bone (AB) particles occurred in the AB/ platelet-rich plasma (PRP) relative to AB/clot leading a higher reduction of maxillary sinus augmentation (MSA) volume (TV of 105.8 mm3 vs. 131.9 mm3)
Summary
All animals tolerated the surgical procedures and remained healthy throughout the experimental period without the occurrence of any adversities. At 60 days, a higher reduction of AB particles occurred in the AB/ PRP relative to AB/clot leading a higher reduction of MSA volume (TV of 105.8 mm vs 131.9 mm3) In this period, both groups showed reduction on the number of trabeculae in newly formed cancellous bone and an increase in their thickness (compare the Fig. 2 A1; A4 with A2; A5). The period of 60 days was critical for observing an interaction between the type of material and the treatment (p = 0.045341) with higher NB% in AB/clot compared to the other experimental groups (Fig. 6c) In this period the sinus treated with PRP showed a higher BM% compared to the respective materials associated with the clot (p = 009966). The CT% was lower in sinus filled with AB in relation to DBB and pBCP in the periods of 30 and 60 days, but similar to that of the DBB group at 180 days
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