Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 01 Feb 2005

Bone Formation in the Maxillary Sinus by Using Platelet-rich Plasma: An Experimental Study in Sheep

DDS,
DDS,
DMD, MS,
DMD, MS, and
PhD
Page Range: 2 – 17
DOI: 10.1563/0-692.1
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Abstract

Recently, platelet-rich plasma (PRP) has been proven to be an effective regeneration adjunct when combined with autogenous bone in the reconstruction of mandibular defects. However, little is known about the effect of PRP when combined with a bone allograft in the maxillary sinus. The purpose of this study was to quantitatively evaluate the ability of PRP to enhance bone regeneration in the maxillary sinus of sheep when combined with demineralized freeze-dried bone allograft (DFDBA) and cortical cancellous freeze-dried bone allograft (CCFDBA). Ten sheep were selected for bilateral sinus augmentation DFDBA + CCFDBA + PRP (test) and DFDBA + CCFDBA (control). Five were sacrificed at 3 months and the other 5 at 6 months. Hematology tests were performed for platelet count, and histology slides were obtained for histomorphometric analysis taking 2 measures of interest: total area (square millimeters) and percentage of bone fill. Student t tests showed no significant difference between test and control groups for total area (P > .25) and percentage of bone fill (P > .80) at either 3 or 6 months. The control group showed no statistical difference for total area (P < .095) and percentage of bone fill (P < .60) between 3- and 6-month healing times. The test group, however, showed a significant increase in total area (P < .025) but not in percentage of bone fill (P < .40) for the 2 healing periods. When the treatments were compared for interactions within the animal model, no clear tendency was evident for the test group to perform in relation to the control group regarding total area (r = .766, P < .01). A moderate tendency existed between the percentages of bone filled (r = .824, P < .005). Platelet-rich plasma showed higher platelet count than did the whole blood (2 to 5 times). However, no correlation was found between the log ratio and the bone measures. Within the limitations of this study, PRP failed to enhance or accelerate bone regeneration in the maxillary sinus of sheep when combined with bone allograft.

Copyright: American Academy of Implant Dentistry


<sc>Figures</sc>
12
Figures 12

and 13. Figure 12. Clinical picture of the sinus wall after 3 months. Figure 13. Mean total tissue traced area of demineralized freeze-dried bone allograft (DFDBA) and cortical cancellous freeze-dried bone allograft (CCFDBA) vs DFDBA + CCFDBA + platelet-rich plasma



<sc>Figures</sc>
17
Figures 17

and 18. Figure 17. Dynamic histomorphometry measurements for the percentage of trabecular bone within the total tissue area. Figure 18. Percentage of tetracycline and calcein green area at 3 and 6 months for both groups


<sc>Figures</sc>
19
Figures 19

and 20. Figure 19. Correlation graph for total area. Figure 20. Correlation graph for percentage of trabecular bone fill


Contributor Notes

Edgar Grageda, DDS, is a graduate student, Jaime L. Lozada, DDS, is the director of the Advanced Education Program in Implant Dentistry, Phillip J. Boyne, DMD, MS, is a professor of Oral and Maxillofacial Surgery, Nicholas Caplanis, DMD, MS, is a professor of Implant Dentistry in the Center for Implant Dentistry, and Paul J. McMillan, PhD, is an anatomy professor, Loma Linda University, Loma Linda, Calif. Address correspondence to Dr Grageda at 7500 Callaghan, Apartment 104, San Antonio, TX 78229 (edgargrageda@hotmail.com).

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