Platelet gel: applications in dental regenerative surgery.

Abstract

Platelet growth factors obtained from platelet-rich plasma (PRP) are used in prosthetic and periodontal regenerative therapy in dentistry. Increased microvascular proliferation in the first 20 days is followed by enhanced osteoblast activity and immature osteoid formation within 3-6 weeks, improving the quality and quantity of newly formed bone tissue. The aim of this study was to evaluate, through three-dimensional X-ray monitoring, the amount of bone obtained after bone regeneration treatment with platelet gel from autologous PRP. Patients eligible for regenerative treatment of atrophic alveolar bone of the maxilla or mandible were studied. The patients' autologous whole blood was collected at the Department of Immunology and Transfusion of San Matteo Hospital for the preparation of platelet gel. The bone at the treated sites was analysed prior to and 4 months after the treatment using the three-dimensional X-ray system Galileos. Over a period of 6 years, 133 patients were treated: 304 implants were inserted and there were five cases of failure. The regenerated bone area consisted of histologically immature osteoid tissue composed of thin trabeculae of vital bone and nuclei of osteocytes, associated with fibro-connective tissue. This co-operative trial between the Transfusion Centre, for standardised production and validation of the platelet gel, and the Dental Surgery room for its application showed that the technique appears effective and safe. Although difficulties were encountered because of the small sample size and the inability to carry out long-term histological controls, the use of small amounts of PRP (5-10%) combined with autologous bone (15-20%) and alloplastic material appears to reduce the need for bone grafting.