Possible Implications for Improved Osteogenesis? The Combination of Platelet-Rich Fibrin With Different Bone Substitute Materials

Abstract

Bone substitute materials (BSM) are widely used in oral regeneration, but sufficient angiogenesis is crucial for osteogenesis. The combination of BSM with autologous thrombocyte concentrations such as platelet-rich fibrin (PRF) may represent a clinical approach to overcome this limitation. This study analyzes the early influence on osteoblast (HOB) in vitro. Here, four different BSM (allogeneic, alloplastic, and two of xenogeneic origin) were combined with PRF. After the incubation with osteoblasts for 24 h, cell viability, migration, and proliferation were assessed. Next, marker of proliferation, migration, and differentiation were evaluated on gene and protein levels in comparison to the native BSM and osteoblast alone. Addition of PRF increased viability for both the xenogeneic BSM (p = 0.0008, p = 0.032, respectively) in comparison to HOB and vs. native BSM (p = 0.008), and led to a tendency for increased cell proliferation and migration for all BSM (each p > 0.05). On gene basis, allogeneic and alloplastic BSM displayed a significantly increased RUNX2 expression (each p = 0.050). Expression of alkaline phosphatase for alloplastic (p = 0.050) and collagen-1 for xenogeneic BSM (p = 0.05) were significantly increased in combination with PRF. In addition, bone morphogenic protein was expressed significantly higher when xenogeneic material was combined with PRF in comparison to HOB alone (each p = 0.05). In summary, the combination of PRF with different BSM increases initial viability and may influence early proliferation and migration potential of osteoblast via RUNX2, alkaline phosphatase, collagen, and BMP2 especially in combination with alloplastic and xenogeneic BSM. Biofunctionalization of BSM using PRF might improve osteogenesis and extend the range of indications.

The Influence of Hyaluronic Acid Biofunctionalization of a Bovine Bone Substitute on Osteoblast Activity In Vitro

“…Recent studies analyzed combinations of BSMs with growth factors (e.g., BMP-2, VEGF) and PRF (platelet-rich fibrin). The findings of these studies illustrated that such biofunctionalized BSMs have the potency to accelerate and increase bone formation and vascularization as characteristic hallmarks of fast and sufficient bone regeneration [28][29][30][31][32][33]. As BSM modification with growth factors is technically challenging and restricted by legal requirements in most countries, further substances might be of interest for BSM biofunctionalization.…”

Non-Interventional Prospective Observational Study of Platelet Rich Fibrin as a Therapy Adjunctive in Patients with Medication-Related Osteonecrosis of the Jaw

“…The full understanding of immunological reactions leading to MRONJ and its involvement in osteogenesis and angiogenesis may represent the missing link to the comprehensive understatement of the disease. These considerations may partly explain the results obtained in this study, where the proven strong pro-angiogenic properties of the PRF, which are known to be strong [38][39][40][41][42], were demonstratively insufficient to significantly optimize soft tissue healing in MRONJ.…”

Reconstructive Peri-Implantitis Therapy by Using Bovine Bone Substitute with or without Hyaluronic Acid: A Randomized Clinical Controlled Pilot Study

“…Consequently, to overcome these issues, different bioactive materials including growth factors (e.g., BMP-2 [ 26 ]), platelet-rich fibrin [ 27 ], enamel matrix derivative (Emdogain) [ 28 ], and hyaluronic acid (HA) [ 29 ] were tested alone or combined with BBS in different regenerative surgical procedures to facilitate and increase bone formation and re-osseointegration. Recently, HA as one of the essential regulators of various cell activities (i.e., proliferation, differentiation, adhesion) has been combined with a BBS.…”