A comparative study of platelet-rich plasma, hydroxyapatite, demineralized bone matrix and autologous bone to promote bone regeneration after mandibular impacted third molar extraction.

Abstract

A comparative study of platelet-rich plasma, hydroxyapatite, demineralized bone matrix and autologous bone to promote bone regeneration after mandibular impacted third molar extraction AbstractObjectives: 1) to compare mandibular bone regeneration by applying autologous bone, platelet-rich plasma and two biomaterials (synthetic calcium hydroxyapatite, and demineralized bone matrix), and thus establish the potential benefits of these biomaterials in the regeneration of postextraction alveolar bone, 2) to identify wich of them accelerates more bone regeneration and 3) to determine whether there are differences in the postoperative period (pain, swelling, trismus, infection) depending on the material used. Study Design: It consists in a prospective, controlled (with a split-mouth design) and double blinded study. We use as a model an easily reproducible non-critical bone defect: the defect that remains after extraction of mandibular impacted third molar. The study design is based on the extraction of two mandibular impacted third molars in a patient during the same surgical procedure by the same surgeon. We assessed postoperative clinical data, and short, medium and long term neoformation of alveolar bone after extraction. We compared the two sockets (right and left), which had been grafted in a different way with the various elements mentioned above. In addition, we compared the postoperative inflammatory symptoms between groups. Results: The highest acceleration in bone formation was observed in groups in which we used autologous bone and demineralized bone matrix. There were no statistically significant differences between groups regarding pain, swelling, trismus and infection throughout the postoperative period. Conclusions: According to the results of our study, autologous bone persists as the gold standard material for bone regeneration. Among the assessed biomaterials, demineralized bone matrix has yielded the best results obtained. No significant differences in the postoperative (pain, swelling, trismus and infectious events) were observed, depending on the type of material used as a graft.

Platelet-rich plasma (PRP) in dental and oral surgery: from the wound healing to bone regeneration

“…The Authors observed no further acceleration in bone formation at 6 months nor did they observe statistically significant differences between the groups regarding pain, swelling, trismus and infection throughout the post-operative period. [38]. Similarly, in a study by Gurbuzer et al .…”

Platelet-Rich Plasma and Adipose-Derived Mesenchymal Stem Cells for Regenerative Medicine-Associated Treatments in Bottlenose Dolphins (Tursiops truncatus)

“…Therefore, high centrifugal forces applied to dolphin whole blood may compromise the integrity of platelets and render them inadequate for high quality PRP isolation due to loss of platelet integrity. This error in the technical step of PRP preparation and isolation may help to explain some reports indicating non-beneficial effects of PRP treatment [36]. Furthermore, our initial studies utilizing fewer revolutions (<900 rpm) were unable to concentrate the platelets to levels different than that of whole blood, i.e., lower centrifugal forces did not produce PRP in dolphin blood samples.…”

Clinical and radiographic evaluation of the efficacy of platelet-rich plasma combined with hydroxyapatite bone graft substitutes in the treatment of intra-bony defects in maxillofacial region

“…The lesion area and an adjacent bone area in each radiograph were also cropped by means of the Adobe Photoshop program. The ratio between the radiographic density of the lesion area and the adjacent bone area was obtained in each group [18].…”

“…On the contrary, Sanchez et al [17] have pointed out the lack of evidence on the efficacy of PRP in combination with bone grafts during augmentation procedures in a review. In another study by Arenaz-Bua et al [18], acceleration in bone formation has not been observed when PRP is placed in third molar extraction sites and it was concluded that PRP ease manipulation and acts as a perfect carrier when used in combination with other graft materials. In a Cochrane systematic review of randomized controlled clinical trials no reliable evidence has been found on promotion of bone healing with platelet-rich plasma, in conjunction with implant treatment [19].…”