Abstract

Bisphosphonates are frequently used for the antiresorptive treatment in bone metastasis diseases or for osteoporosis. A side effect of this therapy is osteonecrosis of the jaw. This inhibits osteoclast function, but osteoblasts and fibroblasts are also negatively affected in terms of impaired proliferation. Additive local treatment with platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) promotes adhesion, proliferation and migration of cells due to high concentrations of growth factors like PDGF, TGF and IGF. The aim of the study was to investigate the effect of PRP or PRF on proliferation, migration and viability of osteoblasts and oral fibroblasts, treated with zoledronic acid (ZA). ZA treated fibroblasts and osteoblasts were exposed to PRP/PRF. Cell proliferation, migration and viability were measured using the real-time cell-analyzer assay (RTCA), the scratch assay and the MTT assay. There was a significant increase in closure of the scratch area by PRP/PRF treated osteoblasts (PRP = 40.6%, PRF = 100.0%, NC = 0.0%) as well as fibroblasts (PRP = 100.0%, PRF = 100.0%, NC = 12.7%) in comparison to the group of negative control (all p ≤ 0.05). Furthermore, the negative effect of ZA on cell migration was generally reduced in both cell lines using PRP/PRF. The viability and proliferation of cells decreased after exposure to ZA, whereas we observed an enhancement of cell viability within 24 hours by application of PRP/PRF in ZA treated cells. The negative effect of ZA on cell proliferation was especially reduced when using PRF. The use of PRF/PRP improves the behavior of ZA-treated cells, but PRF appears to have an advantage in comparison to PRP. This study demonstrates that treatment with PRF/PRP may have positive effects in the therapy of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ).

Highlights

  • Bisphosphonates are widely used for the treatment of abnormal bone metabolism frequently found in bone metastasis or in osteoporosis

  • Various studies have shown that both platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) promote settlement, adhesion, proliferation and migration of osteoblasts due to high concentrations of growth factors like PDGF, TGF and IGF leading to improved wound healing[15,16]

  • Concerning PRF, the concentration of 5% PRF showed significant increase in proliferation of fibroblasts compared to 2.5%, 10%, 25% and 50% (p ≤ 0.05, each)

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Summary

Introduction

Bisphosphonates are widely used for the treatment of abnormal bone metabolism frequently found in bone metastasis or in osteoporosis. In order to improve wound healing and reduce the rate of recurrence, local therapeutic measures are becoming increasingly popular These are based on faster adhesion of soft tissue to the affected bone areas, e.g. surgical debridement combined with local application of platelet-rich blood products[14]. Various studies have shown that both platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) promote settlement, adhesion, proliferation and migration of osteoblasts due to high concentrations of growth factors like PDGF, TGF and IGF leading to improved wound healing[15,16]. The aim of this study was to investigate the impact of PRP or PRF on proliferation, migration and viability of bisphosphonate-treated osteoblasts and oral fibroblasts in an effect to enhance local treatment of BRONJ

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