Histological comparison of DBBM and platelet rich fibrin for guided bone regeneration in a rabbit model

Abstract

To histologically evaluate the use of bovine derived deproteinized xenograft (DBBM), leukocyte and platelet rich fibrin (L-PRF) and the combination of both in Guided Bone Regeneration (GBR) performed in noncritical size defects in rabbit. Methods: A prospective experimental study was performed. Four bone defects in the tibiae of 12 rabbits were made and each of them was filled with DBBM, L-PRF, a combination of DBBM + L-PRF or was left to heal as control site. All defects were covered with a collagen membrane. Rabbits were randomly distributed in three groups and euthanatized at 3, 6 or 9 weeks. Samples were obtained and histologically analyzed to determine vital bone, connective tissue and remaining graft particles percentage. Analysis of variance, Kruskal Wallis and non-paired t-test where used to evaluate the significance of the results. Results: At 3 weeks of healing, DBBM showed significantly more vital bone percentage than L-PRF (p = 0,05) and DBBM + L-PRF showed significantly less connective tissue than control (p < 0,05). All other groups showed no statistical difference between them. At 6 weeks of healing, DBBM showed significantly more vital bone percentage than L-PRF (p < 0,05), DBBM + L-PRF (p < 0,05) and control (p < 0,05) and there wasn't any other significant difference regarding to connective tissue or remaining particle percentage between groups. At t 9 weeks healing period, there weren't any significant differences between groups. Conclusions: DBBM seems to enhance vital bone formation at early healing stages. The use of L-PRF alone or combined with DBBM, didn't show any histological improvement regarding to vital bone formation. The use of DBBM, alone or in conjunction with L-PRF showed a trend to reduce connective tissue percentage. The use of L-PRF combined with DBBM didn't affect the remaining particle percentage.

The Adjunctive Use of Leucocyte- and Platelet-Rich Fibrin in Periodontal Endosseous and Furcation Defects: A Systematic Review and Meta-Analysis

“…We assume that the radiographic defect fill achieved with PRF alone is bone fill, though it remains to be histologically proved. Histologic data on PRF exist for other types of osseous defects, such as experimental [ 74 , 75 ] and human alveolar ridge [ 76 , 77 , 78 , 79 , 80 , 81 , 82 ] defects. The combined PRF/β-TCP graft achieved more new bone formation at twelve weeks than PRF or β-TCP alone, as histologically assessed in experimental tibial defects in pigs [ 74 ].…”

“…The combined PRF/β-TCP graft achieved more new bone formation at twelve weeks than PRF or β-TCP alone, as histologically assessed in experimental tibial defects in pigs [ 74 ]. L-PRF, bovine derived deproteinized xenograft (DBBM) and combined L-PRF/DBBM covered with collagen membranes had similar outcomes at nine weeks regarding percentage vital bone, percentage connective tissue and percentage remaining graft particles, as histologically assessed in experimental tibial defects in rabbits [ 75 ]. Regarding lateral two-stage sinus augmentation, the predominant human histologic data on the combined PRF/osseous graft, as compared with osseous graft alone, show that the amount of new bone formed is not affected and the bone formation process is accelerated leading to mature bone earlier [ 83 ].…”

Role of Autologous Platelet Gel (APG) in Bone Healing: A Rabbit Study

“…While Knapen et al observed that L-PRF did not provide any additional effect on the quantity and quality of bone during guided bone healing over a period of 12 weeks [30]. Frequently, platelet concentrates have been used mixed with bone graft to promote bone regeneration [31]. The growth factors present in APG have been shown to induce bone formation and enhance fibroblast proliferation when mixed with hydroxyapatite [32].…”

Effect of Applying 1% Metformin on Guided Bone Regeneration Processes with Bovine-Derived Xenografts

“…In addition to certain physical properties meant to maintain space throughout healing and achieve better bone neoformation, grafts in GBR should ideally have as many of the following three biological properties as possible: osteogenicity, osteoinductivity, and osteoconductivity [4]. Xenografts and, more specifically, deproteinized bovine bone minerals, are some of the most widely used types of grafts today because of the successful results they have shown in GBR procedures [5]; they are a good alternative to the gold standard but are primarily and only osteoconductive [6]. This is because, although the organic part is removed to reduce the risk of infection, the inorganic phase-mainly consisting of hydroxyapatite-and its porous architecture are preserved [7].…”