Effects of local administration of platelet-rich plasma and guided tissue regeneration on bone healing in early inserted dental implants - a histomorphometric analysis

Abstract

Introduction. In order to provide the most favorable conditions for bone healing following implant loading, new techniques such as the use of growth factors to directly or indirectly regulate cell and tissue growth are becoming increasingly popular. Simplicity in producing concentrated thrombocytes derived from platelet-rich plasma has led to increasing application of growth factors derived from thrombocytes, such as PDGF, TGF-β, IGF and VEGF, in order to increase the percentage of bone-to-implant contact that provides better implant stability and possibly earlier functional loading. The aim of the study was to determine the effects of platelet-rich plasma and guided tissue regeneration on bone regeneration in the case of bone defects in early dental implant insertion. Materials and Methods. This experimental study was conducted on 10 study dogs that received 40 BCT implants, i.e., 4 implants per dog. The study included early dental implant placement in the sites of the extracted premolars. Artificial bone defects, resembling peri-implantitis defects, were made on the mesial side of each site, and the defects were filled using suitable guided tissue regeneration protocols with platelet-rich plasma derived from each experimental animal an hour before surgery. Histopathologic and histomorphometric evaluations were performed 10 months following the implantation. Results and Conclusion. The applied protocols had different effects on bone healing. According to the results obtained, the use of platelet-rich plasma combined with deproteinized bovine bone and bovine-derived resorptive membrane provided superior bone defect ossification.

Uvod. Potreba da se stvore što bolji uslovi za koštano zarastanje nakon ugradnje implantata poslednjih par godina uticala je na primenu faktora rasta koji direktno ili indirektno regulišu rast ćelija i tkiva. Jednostavnost dobijanja koncentrovanih trombocita izdvojenih iz plazme bogate trombocitima, dovela je do sve šire primene faktora rasta poreklom iz trombocita poput PDGF, TGF-β, IGF, VEGF i mnogih drugih, sa ciljem postizanja što većeg procenta kontakta površine implantata sa kosti, što obezbeđuje povećanu stabilnost implantata i brže funkcionalno opterećenje. Cilj rada bio je da se ispita uticaj plazme bogate trombocitima i vođene tkivne regeneracije tkiva u koštanim defektima kod rane ugradnje dentalnih impantata na koštanu regeneraciju. Materijal i metode. Eksperimentalna studija sprovedena je na 10 eksperimentalnih pasa kod kojih je ugrađeno 40 BCT implantata i to po četri svakom. Eksperiment se sastojao od rane ugradnje umplantate na mestima izvađenih premolara. Veštački koštani defekti, nalik periimplantatnim defektima, napravljeni su na mezijalnoj strani svake preparacije. Ti defekti su popunjeni prateći odgovarajuće postupke vodjene tkivne regeneracije, uz korišćenje plazme bogate trombocitima, dobijene iz krvi eksperimentalnih životinja sat vremena pre intervencije. Histopatološke i histomorfometrijske analize rađene su 10 meseci nakon ugradnje implantata. Rezultati i zaključak. Primenjeni protokoli različito utiču na ispunjenost koštanih defekata i koštano zarastanje. Na osnovu dobijenih rezultata došli smo do zaključka da je osifikacija koštanih defekata najveća u protokolu prema kome se primenjuje plazma bogata trombocitima u kombinaciji sa bovinom deproteinizovanom kosti i resorptivnom membranom bovinog porekla.