APPENDIX 5
Bibliographical literature review examines histological, radiological and clinical parameters in the bone with different biomaterial techniques PRGF, PRF,PRP
with alloplast, alografts, heterologous, autogenous bone for regeneration.
P
R
P
Periodontal
defects
(test-control in
vivo and vitro)
- Rigeneration with
1.beta TCP(beta
tricalcium
phosphate)+PRP+
GTR
(non
bioreasorbable
expanded
polytetrafluoroet
hylene
membrane)
2. Beta-TCP+GTR
(Dori et al 2008)
vivo
Regeneration
1.PRP
2.PRP+ABM(
bovine anorganic
bone mineral)
vivo
(Rodriques et al
2011)
Regeneration
1.autogenous
mandibular bone
2.FHA alone
3.PRP-FHA
4.MSCs-PRP-FHA
Study in vitro (Piri
et al 2009)
After 1 year radiological and clinical control
Group:
PRP+Beta-TCP+GTR
PD
CAL
Beta-TCP+GTR
9.1+-0.6mm to
3.3+-0.5mm
P<0.001
10.1+-1.3mm to
5.7+-1.1mm
p<0.001
9.0+-0.8mm to
3.6+-0.9mm
p<0.001
9.9+-1.0mm to
5.9+-1.2mm
p<0.001
Between the group it is 0.70. No statistical significant differences .
Follow-up after a 9th month clinical and radiographical control:
PRP
PD
5.1+-1.36mm
3 to 7mm
CAL
6 to 10mm
7.7+-1.30mm
Not significant between the group p<-0.19 at the end of 9th months.
PRP+ABM
4.2+-1.2mm
3 to 6 mm
6 to 9 mm
6.8+-1.05mm
Histomorphometric evaluation follow-up 3rd months:
1.autogenous bone (46.97%+-2.57%) and .MSCs-PRP-FHA (45.97+-2.57%) produced a statistical significant
p<0.05 higher vital bone than
PRP-FHA (37.95%+-2.23%) or FHA (36.03%+-1.86%).
2. No significant differences of residual graft particle between MSCs-PRP-FHA (30.73%+-1.61%,)
PRP-FHA(32.83%+-1.39%), and FHA alone (33.80%+-1.40%)
MSCs-PRP-FHA showed a significantly higher result p<0.05 compared with PRP-FHA.
Maxillofacial
Bone graft
reconstruction of
mandibular defects
after extirpation
tumor
Sinus
augumentation
uni and bilateral in
maxillofacial)
Regeneration with:
1.PRP+BDX
2.PPP+BDX
(Test control in
vivo) (Yilmaz et al
2011)
Regeneration
with:
1.MG CSH+PRP
2.CRP( colagen
resorbable plag
)(vivo) (Kutkut et
al 2012)
Regeneration
with:
1.native mandible
2.bone grafts
3.bone
grafts+PRP
(Test control in
vivo) (Marx et al
1998)
1.sinus
Regeneration
with:
1.PRP+BDX
2. BDX+Collagen
membrane:
(Yilmaz et al
2013)
2. regeneration
with chips bone:
Mix I .PepgenP-15
Follow-up after a 12 month clinical and radiographical control:
Group:PRP+BDX
Group:PPP+BDX
PD
3.87+-0.86mm
3.76+-0.80mm
CAL
2.51+-0.97mm
2.18+-0.87mm
RBl
2.11+-0.87mm
2.19+-0.96mm
Statistical significant in these two groups p=0.85 (p>0.05)
Histomorphometric evaluation follow-up 3 months: p<0.05
MG CSH+PRP
PRP colagen resorbable plag
66.5%+-10.4%
38.3%+-9.3%
No statistical significant difference of vertical and horizontal bone resorbtion p>0.05
Histomorphometric findings
Follow-up after 6th months:
Native Bone
38.9%+-6%
Bone graft
Bone graft+PRP
55.1%+-8%
P=0.005
74.0%+-11%
P=0.005
Histomorphometric findings
Follow-up after 8th months:
PRP+BDX
BDX+ collagen membrane
12.77±2.45mm
p=0.762
Histomorphometric result follow-up 4th -5th months:
%
Vital bone
12.76±1.93mm
Mix I
5th month
24.2±4.7
Mix II
5th month
27.8±9.4
Mix III
4th month
14.6±9.0
particies+DFDBA+
10%
Autogenous bone
Mix II.PepGenP15 Flow+
additional
PepGenP-15
particles+10%
autogenous bone
Mix III.PepGenP15 particles
+PRP+10%autoge
nous bone
(Gelbart et al
2005)
3.Regeneration in sinus
augumentation (six
case-vivo):
I. FDBA
II. FDBA,DFDBA
+PerioGlass +PRP
III.FDBA+PRP
IV.autogenous +PRP
V.BioOss+autogenous
+PRP
VI. FDBA+PRP
(Danesh-Meyer et al
2001)
Res. graft
marrow
22.8±13.0
17.3±7.4
21.8±15.4
53.3±11.3
55.3±9.8
63.2±8.6
p=0.008 no statistical differences between vital bone ,residual graft material and morrow.
Histological result follow-up 6th-9th months:
I.
II .
III
IV
V
VI
FDBA
FDBA
FDBA
Autog.
BioOss
FDBA
PerioGlass
PRP
PRP
Autog.
PRP
PRP
Newly formed bone,osteoblast,osteocytes, very little residual
FDBA at 9th month
Non vital
DFDBA
surrounded
by dense
connective
tissues, few
osteoblasts
PRP
Limited new
bone
formation,
few
osteoblasts.
Occasional
osteoclast
associated
with residual
FDBA
particles
Fibrous
encapsulation
of residual
graft particles,
areas of nonvital bone,
localized areas
of newly
formed bone
and ostioclasts
Numerous
graft
particles
present , no
osteoblastic
activity,
abundant
connective
tissue.
Small localized
areas of viable
bone with
associated
osteoblasts,
FDBA remnants
surrounded by
fibrous
connective
tissues
.
4. Regeneration in
mandible defects
with:
1.bone graft+PRP
and without PRP
(inlay bone graft)
Intrabony
defects in the
femur bone
(Study in vitro)
Transplantation
in femora and
tibiae in
patients with
achondroplasia
and
pseudarthrosis
(study in vivo)
2.particle bone+
PRP or block bone
without PRP (onlay
bone graft).
(Stenport et al
2011)
Regeneration with:
1.Gen-ox bovine
bone only
2. Gen-ox bovine
bone only + PRP
(Kurikchy et al
2013)
Regeneration with:
MSCs (iliac
crist),+PRP gel
(Kitoh et al 2004)
Histomorphometrically follow-up 3rd months:
Inlay control
2.09±0.48ml
Inlay
PRP
2.21±0.77ml
Onlay
block
3.09±0.095 ml
Onlay
PRP
1. 82±0.54ml
p<0.05 was considered statistically significant. New bone to total bone demonstrated that the PRPtreated inlay grafts and onlay grafts had higher new bone compared with control samples.
Histopathological findings follow-up fourth week postoperatively:
Control group
Gen-Ox bovine
24.60±2.7, p<0.05
osteocytes
13.60±1.5
p<0.05
61.67±5.4
Gen-Ox bovine
PRP
13.20±1.2
77.00±11.5 , p<0.05
98.67±1.2
osteoclast
2.00±1.14 NS
2.75±0.5
1.67±0.3
osteon
lamellat
Healing index and radiological control:
22.75±4.0
7.12±1.59
23.50±2.66, p<0.05
7.83±1.12, p<0.05
37.00±3.15
13.87±1.80
osteoblast
Control Group
22.3 to 65.7 day /cm
MSCs +PRP
37.8 days/cm
PRF
Bone
augumentation
in rabbit
calvaria model.
(vitro)
Maxillary
Sinus
augumentation
(Vivo)
Bone
regeneration
grafts in
rabbit’s
calvarial defects
(vitro)
Graft material
Guided bone
regeneration:
1.Bio-oss
2. 4 Bone
3.PRF (Ozdemir et
al 2013).
Guided
regeneration:
1.Membrane
collagen +Bio-Oss
2.Membrane
PRF+Bio-Oss
(Gassling et al
2013).
Graft regeneration
in sinus
augumentation:
1.Bio-oss+PRF
mixture
2.Bio-Oss Alone
(Zhang et al 2012)
Regeneration with:
1.PRF+Tricalcium
phosphate
2.rhBMP 2 (bone
morfogenetic
protein 2) coated
+TCP (Kim et al
2012)
Regeneration with:
Histomorphometric analysis follow-up 3rd months:
Control group versus BIO-Oss, 4 Bone, PRF P<0.05
4 Bone P<0.05 versus Bio-Oss and PRF
After 3 months we have new bone area in the expiremental groups.
Histomorphometric analysis follow-up 5th months:
Collagen
membrane
Vital bone
Bone –substitute material in%
17.2(8.5-24.2)
17.0(7.8-27.8)
PRF
17.0 (7.8-27.8)
15.9(0.9-33.4)
Histological observation showed after 6th months:
Control group
Group PRF
Group Bio-oss+PRF
18.35%±5.62%
vs
12.95%±5.33%
28.54%±12.01%
Vs
19.16%±6.89%
p=0.138
21.45%±14.57%
Vs
18.57%±5.39%
p=0.141
Histomorphometric analysis follow-up 2nd -4th - 6th -8th week:
PRF+TCP
rhBMP-2
2nd week
4th week
0.068±0,013
0.16±0,017
0.029±0.008
0.13±0.012
6th week
0.24±0.021
0.17±0.014
8th week
0.25±0.0016
0.18±0.013
p<0.01
p<0.01
th
Histomorphometric analysis follow-up 8 week:
in rabbit
calvarial defects
.
P
R
G
F
1.-PRF+autogenous
bone graft
-PRF+ de
proteinized bovine
bone
2. autogenous bone
graft
-deproteinized
bovine bone
(Pripatnanont et al
2013)
Intrabony
Defects in
chronic
Periodontitis
Graft with:
1.HA+PRF
2.PRF alone
(Pradeep et al 2012 )
Periapical cyst
defects .
=0.77Regeneration
with:
1.PRF+βTCP
(tricalciumphosphate).
(Jayalakshm et al
2012)
Regeneration with:
1.PRGF
2.autogenos bone
graft
(Lafz et al 2012)
Defects
periodontal
Study in vivo.
Percentage of new bone (mean±SD)
Control(non PRF)
Experiment (PRF)
Empty defect
6.24±5.01
18.81±9.27
Autogenous
26.21±10.58, p<0.05 38.03±4.23, p˂0.05
bone
DBB+
21.29±3.52 , p<0.05
22.63±3.61
autogenous
bone
DBB
9.63±5.47
13.07±3.64
Radiological and clinical parameters follow-up 9th months:
PRF
PRF+HA
Control group
PD
3.90±1.09
4.27±0.98
2.97±0.93
CAL
3.03±1.16
3.67±1.03
2.67±1.09
IBD
56.46±9.26
63,39±16.52
15.96±13.91
rd
th
th
th
Radiographical follow-up at 3 ,6 ,9 , 12 month: in addition of PRF to β-tricalcium Phosphate allograft
accelerates regenerative capacity of bone.
Clinical parameters after 6th months:
Soft tissues
Hard tissues
CPD
p
VCAL
p=0.56
HCAL
p=65
EHPD
VDBC
VDBD
p=0.25
p=0.41
p=0.68
Bone defects in
rabbits study.
Experimental
model in rabbit
femur (vitro)
Experimental
model in rabbit
calvaria .
Regeneration with:
1.PRGF
2.Autologous bone
+PRGF
3.Autologous bone.
(Molina-Minano et
al 2009)
Regeneration with :
1.PRGF bovine
bone mineral ,,Nu
Oss,,
2.only PRGF
3.,,Nu Oss,, RCM
membrane .
(Guerra et al 2011 )
Bone rgeneration
with:
1.Nano HA
(hidroxyapatite)
2.Nano HA+PRGF
3.Nano HA+MSCs
4.Nano
Ha+MSCs+PRGF
(Behnia et al 2013).
LGM p=0.59
LID
p=0.68
Statistical significance based on p<0.05, in asterisk indicates.
Histomorphometry follow-up 1st -2nd month and radiographic after 1st month p=0.005, and p=0.006.
Observation period month
1st month, p=0.658
2nd month, p=0.648
PRGF
Control AB+PRGF AB
PRGF
Control AB+PRGF AB
28,58
22.90
35.01
±
±
±
11.22
12.23
5.31
Histological exam follow-up at 4th
4th week
NuOss
34.61 41.02
30.59
±
±
±
16.93 9.15
5.69
th
week and 8 week:
8th week
57.66±24.39
63.35±27.69
NuOss/PRGF 58.62±20.37
58.42±24.77
NuOss/RCM
membrane
Control
group
70.82±20.34
78.02±15.13
33.07±5.49
40.28±27.32
Histomorphometric analysis:
Groups
Bone formation ration
6th week
12th week
Nano HA
11.35%
32.53%
Nano HA+PRGF
29.10%
39.74%
Nano HA+MSCs
25.82%
39.11%
Nano HA+PRGF
+MSCs
29.45%
44.55%
40.63
±
14.74
46.04
±
10.36
PD-probing depth
CAL-clinical attachment level
IBD intrabony defect
FHA-fluorohidroxiapatita
RBL-radiographic bone levels
CSH -calcium sulfate hemihydrate
BDX-bovine drived xenograft
FDBA-Freeze Dried Bone Allograft
CPD- clinical probing depth
V-CAL- vertical clinical attachment level
H-CAL- horizontal clinical attachment
L-GM- location of gingival margins
E-HPD-horizontal probing depth of the bony defects surgically exposed
V-DBC- vertical depth of the bone crystal.
V-DBD- vertical depth of the base of bone defect
LID-length of the intra bony defect.