The Influence of PRP on Early Bone Formation in Membrane Protected Defects. A Histological and Histomorphometric Study in the Rabbit Calvaria

Abstract

Platelet rich plasma (PRP) has been proposed to be a useful adjunct to bone grafting. The aim of the present study was to assess new bone formation in bone regeneration procedures using platelet rich plasma (PRP) alone or in combination with autogenous bone. Four surgically created, monocortical defects 5 mm in diameter in the calvariae of 15 New Zealand rabbits were grafted with a coagulum-filled control, PRP, particulated autogenous bone alone (A), or combined with PRP (A-PRP). Mean platelet concentration of 1,761,930 ± 680,200/µl was achieved (5.30 ± 2.63 × fold of baseline). Animals were sacrificed 1, 2, and 4 weeks later. Histomorphometric analysis showed no statistical difference for total new bone formation at any time point, however, a detailed analysis revealed a statistically significant higher percentage of lamellar bone than woven bone for the autogenous bone group at 2 weeks; all other groups demonstrated equal percentages of either bone type. At 4 weeks, all groups revealed a statistically greater component of lamellar bone over woven bone. Graft resorption rate was similar for both A and A-PRP. PRP platelet concentration was significantly positively correlated with TGF-beta1 but not with PDGF-AB. Within the limits of the chosen animal model, this study demonstrated that PRP during early healing, whether alone or mixed with autogenous bone, did not lead to greater bone remodelling, as compared to coagulum. In contrast, autogenous bone alone demonstrated accelerated bone remodelling at 2 weeks.