Does zinc oxide nanoparticles potentiate the regenerative effect of platelet-rich fibrin in healing of critical bone defect in rabbits?

Abstract

Background Many encouraging studies confirmed the ability of Zinc Oxide Nanoparticles (ZnONPs) in accelerating bone growth and mineralization. The use of Platelet Rich-Fibrin (PRF) as a sole filling material for large segmental bone defects remains questionable. The objectives are to investigate the regenerative efficacy of autologous Platelet Rich-Fibrin (PRF) and Zinc Oxide Nanoparticles (ZnONPs) in repairing large segmental bone ulnar defects in a randomized controlled study in rabbits using computed tomographic interpretations. A 12 mm critical size defect was surgically induced in the ulna of 30 rabbits (n = 10/ group). In the control group, the defect was left empty. In the PRF group, the defect is filled with PRF. In the PRF/ZnONPs group, the defect is filled with PRF that was inoculated with 0.1 ml of 0.2% ZnONPs. Radiologic healing capacity was evaluated at the first, second, and third postoperative months. Results Statistical analysis showed significant differences in the radiologic healing scores between the groups (P = 0.000–0.0001) at all-time points (P = 0.000–0.047) during the study. Conclusion Rabbits in the PRF/ZnONPs group showed the highest appreciable bone quality and quantity followed by the PRF group with high quantity but low bone quality meanwhile, rabbits in the control group showed minimal quantity but medium bone quality. Interestingly, the addition of ZnONPs to PRF can accelerate the healing of ulnar critical-size defects in rabbits.

Use of platelet-rich fibrin for bone repair: a systematic review and meta-analysis of preclinical studies

“…7 Furthermore, the surgical site expedites integration, maturation, and remodeling, while increasing the bone graft density if the matched PRF permits significant postoperative protection. 53,54 Only three studies found superior results to PRF when compared to clot, and both evaluated the repair process in long bones. 8,19,26 It is widely known that the healing process in long bones requires both osteoblastic and chondroblast cells, with predominating endochondral ossification.…”

Platelet-rich fibrin as an autologous biomaterial for bone regeneration: mechanisms, applications, optimization

“…With its blood-derived fibrin as a scaffold that naturally degrades in 10–14 days, PRF not only ensures a slow and sustained release of biomolecules/growth factors ( Chen L. et al, 2021 ; Egle et al, 2021 ; Miron et al, 2021 ) but also minimizes potential foreign body reactions within the host tissue, in addition, the biomolecules/growth factors carried by PRF can promote vascular and soft and hard tissue regeneration. In bone tissue engineering, antibiotics, non-steroidal anti-inflammatory drugs, and metal nanoparticles ( Zalama et al, 2022 ) are often loaded into PRF fibrin networks to prepare drug-controlled release systems to inhibit local inflammation and infection and improve bone regeneration outcomes. Arita Dubnika et al prepared a PRF scaffold-based vancomycin (VANKA) controlled release system by first loading VANKA into liposomes or polylactic acid-glycolic acid (PLGA) particles and then loading them into the PRF scaffold.…”

Bone Tissue Engineering and Nanotechnology: A Promising Combination for Bone Regeneration

“…Zinc is involved in many physiological processes and plays a key regulatory role in osteogenesis and in bone homeostasis [197,198]. Zinc oxide NPs (ZnO NPs) are the most common type of zinc-containing nanoparticles; they have received great attention in many biological fields due to their low toxicity, good biocompatibility, high antibacterial and anticancer activities, and better osteogenic properties, being able to promote bone growth and mineralization [199][200][201]. The above properties have made ZnO NPs promising candidates in orthopedic applications.…”