Effects of Platelet-Rich Fibrin on Hard Tissue Healing: A Histomorphometric Crossover Trial in Sheep

Abstract

Bone defects lead to aesthetic and functional losses, causing dental rehabilitation to be more difficult. The objective of this work is to histologically assess the hard tissue healing of bone defects filled with platelet-rich fibrin (PRF) alone or as an adjuvant for mixing with and covering anorganic bovine bone (ABB), compared to ABB covered with a resorbable collagen membrane (CM). This study was designed as a crossover animal study. Four 5-mm tibia defects, 5 mm apart from each other, were surgically created on the tibias of 6 sheep. The defects were randomly filled with ABB + CM; PRF alone; ABB+PRF; or were left empty. The animals were euthanized on days 10, 20, and 40 post-operatively. No group showed any signs of bone necrosis. Inflammation was observed in 2 control and 3 test defects with no statistically significant difference between groups at each time point. The ABB + CM and ABB + PRF groups experienced the highest bone regeneration ratios. No differences between the empty-defect and PRF groups were observed in regard to bone regeneration. No statistical difference was observed between the ABB+PRF and ABB + CM groups in regard to bone regeneration and the amount of residual graft material at each time point. The use of PRF should be preferred due to its autogenous origin, low cost, and ease of use.

Platelet-rich fibrin (PRF) membrane isolated and injectable-PRF-mixed particulate bovine bone graft in rattibiae non-critical defects healing

“…In addition, To, Su, Hidaka, Okudera and Matsuo [37] also showed superior bone formation in dogs sockets lled with A-PRF membrane (200g for 8 min) in comparison to the blood clot. However, other pre-clinical studies reported no additional effect of standard membrane PRF in critical defects bone formation [36,38,39,41].…”

“…The addition of bioactive materials has been extensively proposed to improve the osteoinductive properties of the DBBM graft [35, 36, 38-41, 51, 52]. Studies evaluating the DBBM graft mixed with PRF membrane obtained by standard protocol showed superior bone formation in comparison to DBBM or PRF alone in calvaria [35], tibia [39], and femur [52] bone defects. However, other studies in calvaria [36,40,41,51] or tibia [38] defects reported that DBBM mixed with PRF did not provide any additional effect on bone formation in comparison to DBBM alone.…”

“…In addition, the use of PRF includes clinical advantages such as low cost when compared to bone substitute materials, as well as the facility of obtention and lack of biochemical handling of blood that makes this preparation strictly autologous [8]. However, as the results from this study demonstrated, the potential of PRF membranes, as a lling material, remains controversial [35][36][37][38][39][40][41].…”

May Autogenous Grafts Increase the Effectiveness of Hyalonect Membranes in Intraosseous Defects: An Experimental In Vivo Study

“…Histomorphometry is well suited for preclinical animal models that can provide substantial histological information and evaluate standardized groups [ 21 ]. In this study, sheep were used as experimental animals due to them being frequently used models in dental studies to evaluate bone healing, having a bone structure and remodeling that are similar to those of human beings, and having proper structure for wide defects [ 22 , 23 , 24 ]. Using the sheep’s right ilium as the control group and left ilium as the experimental group made it possible to host both groups on the same animal.…”