Effects of Autologous Bone Marrow Mesenchymal Stem Cells and Platelet-Rich Plasma on Bone Regeneration and Osseointegration of a Hydroxyapatite-Coated Titanium Implant

Abstract

Bone regeneration remains one of the major clinical needs in orthopedics, and advanced and alternative strategies involving bone substitutes, cells, and growth factors (GFs) are mandatory. The purpose of this study was to evaluate whether the association of autologous bone marrow mesenchymal stem cells (BMSC), isolated by ‘one-step surgical procedure’, and activated platelet rich plasma (PRP) improves osseointegration and bone formation of a hydroxyapatite-coated titanium (Ti-HA) implant, already in clinical use, in a rabbit cancellous defect. The GFs present in plasma, in inactivated and activated PRP were also tested. At 2 weeks, histology and histomorphometry highlighted increased bone-to-implant contact (BIC) in Ti-HA combined with BMSC and PRP in comparison to Ti-HA alone and Ti-HA + PRP. The combined effect of BMSC and PRP peaked at 4 weeks where the BIC value was higher than all other treatments. At both experimental times, newly formed bone (Trabecular Bone Volume, BV/TV) in all tested treatments showed increased values in comparison to Ti-HA alone. At 4 weeks Ti-HA + PRP + BMSC showed the highest BV/TV and the highest osteoblasts number; additionally, a higher osteoid surface and bone formation rate were found in Ti-HA + BMSC + PRP than in all other treatments. Finally, the analyses of GFs revealed higher values in the activated PRP in comparison to plasma and to non-activated PRP. The study suggests that the combination of autologous activated PRP, as a carrier for BMSCs, is a promising regenerative strategy for bone formation, osseointegration, and mineralization of bone implants.

Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: A Narrative Review

“…There are several different types of stem cells involved into the regeneration processes of dental pulp cells, including stem cells of the apical papilla (SCAPs), periodontal ligament stem cells (PDLSCs) and human dental pulp cells (hDPCs) [119,120]. It has already been proven that autologous platelet concentrate may be a carrier for bone marrow mesenchymal stem cells (BMSCs) [121] and may stimulate the processes of proliferation and differentiation of BMSCs [122]. Sequeira et al [123] used PRP as a scaffold for SCAPs and found that SCAPs induced formation of dentin-like and pulp-like tissues.…”