Abstract
A human‐cultured alveolar bone‐derived periosteal (hCP) sheet is an osteogenic grafting material used clinically in periodontal regenerative therapy, while platelet‐rich fibrin (PRF), a platelet concentrate with fibrin clot, is considered to augment the wound healing process. Therefore, whether the combined use of hCP‐PRF complex could facilitate bone regeneration synergistically was evaluated in animal models. Human periosteal segments (1 × 1 mm) were cultured initially on plastic dishes and formed an hCP sheet. The hCP sheet was implanted with freshly prepared human PRF into subcutaneous tissue (hCP: n = 4, hCP + PRF: n = 4) and 4 mm diameter calvarial bone defect models (hCP: n = 4, hCP + PRF: n = 4, control [defect‐only]: n = 4) that prepared in nude mice. At 4 weeks postimplantation, new bone formation was evaluated by using μCT. Cell growth and neovascularization were evaluated by histochemical and immunohistological methods. In the subcutaneous tissue, mineral deposit formation, collagen deposition, and number of vessels were higher in the hCP + PRF group than in the hCP alone group. In the calvarial defect models, new bone formation was significantly higher in the hCP + PRF group than in the hCP alone group and defect‐only control group. The numbers of vessels and PCNA‐positive cells in calvarial defects were also increased in the hCP + PRF group more than in the hCP alone group. Platelet‐rich fibrin preparations support the proliferation and the growth of periosteal cells to form well‐combined active biological materials. Platelet‐rich fibrin also stimulates the local angiogenesis in the implantation site. Therefore, the combined use of hCP and PRF could be clinically applicable in bone regeneration therapy.
Highlights
Periodontal and alveolar bone regenerative therapies have been developed from bone grafting, guided tissue/bone regeneration, enamel matrix derivatives, and their use in combined therapies (Koop et al, 2012)
In the last few decades, cell‐based grafting materials have been applied to bone regenerative therapies by using multipotent cells such as mesenchymal stem cells (MSCs) that can differentiate into a variety of cell types (Zomorodian and Baghaban Eslaminejad, 2012)
We have previously demonstrated that human‐cultured periosteal (hCP) sheets contain MSCs with osteogenic potency and produce various growth factors and cytokines involved in bone metabolism (Kawase et al, 2010; Uematsu et al, 2013)
Summary
Periodontal and alveolar bone regenerative therapies have been developed from bone grafting, guided tissue/bone regeneration, enamel matrix derivatives, and their use in combined therapies (Koop et al, 2012). We have previously demonstrated that hCP sheets contain MSCs with osteogenic potency and produce various growth factors and cytokines involved in bone metabolism (Kawase et al, 2010; Uematsu et al, 2013). It was reported that autologous grafting of hCP sheets was one of the promising methods for treatment of alveolar bone atrophy and periodontal intrabone defects (Nagata et al, 2012; Okuda et al, 2009; Yamamiya et al, 2008). HCP sheets are considered to be effective osteogenic grafting materials for periodontal regeneration therapy. The effects of PRF on osteogenic activity of grafting periosteal cells have still been unclear in cell‐based bone regeneration therapy. The aim of the present study was to elucidate the effect of the combined use of hCP sheets and PRF on bone regeneration as an engineered bone grafting material
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