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Histomorphometric Evaluation of Bone Regeneration in Peri-Implant Osseous Defects Treated With Titanium Prepared Platelet Rich Fibrin: An Experimental Study in a Rabbit Model

Year 2018, Volume: 25 Issue: 3, 243 - 250, 01.09.2018
https://doi.org/10.17343/sdutfd.332750

Abstract




Aim: The present study aims to investigate the healing of
artificially created peri-implant osseous defects using Titanium-Platelet Rich
Fibrin





Material and
Method:
Bone defects (9-mm diameter, 4-mm depth) were created and implant beds
(3-mm diameter, 6-mm depth) were prepared in the middle of them in rabbit
tibias (24 rabbits) used as the experimental model.
Afterwards, dental implants were installed into the left and right
tibia (diameter 3.0 mm, length 8 mm). In the experimental groups, the peri-implant
defect was filled with Autogenous grafts (AG), Titanium-Platelet Rich Fibrin (T-PRF),
Biphasic Calcium Phosphate grafts (BCP). The control group did not receive any
filling. The bone-to-implant contact (BIC) was obtained by
histomorphometrically examining the sections taken from
the study groups.



Results: AG group was resulted in a high degree of BIC. No
difference of statistical significance was found for the BIC as far as
autogenous graft and PRF groups are concerned.



Conclusion: Peri-implantal defects in regeneration of T-PRF were
found to be nearly as affective as the autogenous bone graft. We, therefore,
conclude that T-PRF can be used for guided bone regeneration in the function of
autogenic matrix in the future.













References

  • 1. Berglundh T, Persson L, Klinge B. A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years. J Clin Periodontol 2002; 29 Suppl 3: 197-212; discussion 232-233.
  • 2. O'Mahony A, Spencer P. Osseointegrated implant failures. J Ir Dent Assoc 1999; 45(2): 44-51.
  • 3. Anitua E. Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants 1999; 14(4): 529-535.
  • 4. Artzi Z, Tal H, Dayan D. Porous bovine bone mineral in healing of human extraction sockets: 2. Histochemical observations at 9 months. J Periodontol; 2001; 72(2): 152-159.
  • 5. Oh KC, Cha JK, Kim CS, Choi SH, Chai JK, Jung UW. The influence of perforating the autogenous block bone and the recipient bed in dogs. Part I: a radiographic analysis. Clin Oral Implants Res 2011; 22(11): 1298-1302.
  • 6. Knapp CI, Feuille V, Cochran D, Melloning JT. Clinical and histological evaluation of bone replacement grafts in the treatment of localized alveolar ridge defects. Part 2: bioactive glass particulates. Int J Periodontics Rest Dent. 2003;23(2):129–37.
  • 7. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101(3): e37-44.
  • 8. Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G. Slow release of growth factors and thrombospondin-1 in Choukroun's platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors 2009; 27(1): 63-69.
  • 9. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol 2009; 27(3): 158-67.
  • 10. Dohan Ehrenfest DM, Bielecki T, Jimbo R, Barbé G, Del Corso M, Inchingolo F, et al. Do the fibrin architecture and leukocyte content influence the growth factor release of platelet concentrates? An evidence-based answer comparing a pure platelet-rich plasma (P-PRP) gel and a leukocyte- and platelet-rich fibrin (L-PRF). Curr Pharm Biotechnol. 2012;13:1145-1152
  • 11. He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:707-13.
  • 12. Simonpieri A, Del Corso M, Vervelle A, Jimbo R, Inchingolo F, Sammartino G, et al. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 2: Bone graft, implant and reconstructive surgery. Curr Pharm Biotechnol. 2012;13:1231-56.
  • 13. Anitua EA. Enhancement of osseointegration by generating a dynamic implant surface. J Oral Implantol. 2006;32:72-76.
  • 14. Anitua E, Orive G, Pla R, Roman P, Serrano V, Andia I. The effects of PRGF on bone regeneration and on titanium implant osseointegration in goats: a histologic and histomorphometric study. J Biomed Mater Res A. 2009;91:158-165.
  • 15. Tunalı M, Özdemir H, Küçükodacı Z, Akman S, Yaprak E, Toker H, Fıratlı E. A novel platelet concentrate: titanium-prepared platelet-rich fibrin. Biomed Res Int 2014; 2014:209548.
  • 16. Tunali M, Özdemir H, Küçükodacı Z, Akman S, Fıratlı E. In vivo evaluation of titanium-prepared platelet-rich fibrin (T-PRF): a new platelet concentrate. Br J Oral Maxillofac Surg 2013; 51(5): 438-443.
  • 17. O’Connell SM Safety issues associated with platelet rich fibrin method. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 2007; 103:587-93
  • 18. Sung-Won Kim and In-Ho Cho. On the osseointegration of zirconia and titanium implants installed at defect site filled with xenograft material . J Korean Acad Prosthodont. 2014 Jan;52(1):9-17.
  • 19. Donath K, Breuner G. A method for the study of undecalcified bones and teeth with attached soft tissues. The Sage-Schliff (sawing and grinding) technique. J Oral Pathol 1982; 11(4): 318-26.
  • 20. Chen ST, Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla--a systematic review. Int J Oral Maxillofac Implants. 2014;29 Suppl:186-215.
  • 21. Al-Sulaimani AF, Mokeem SA, Anil S. Peri-implant defect augmentation with autogenous bone: a study in beagle dogs. J Oral Implantol 2013; 39(1): 30-36.
  • 22. Schuler RF, Janakievski J, Hacker BM, O'Neal RB, Roberts FA. Effect of implant surface and grafting on implants placed into simulated extraction sockets: a histologic study in dogs. Int J Oral Maxillofac Implants, 2010; 25(5): 893-900.
  • 23. Kim S, Jung UW, Lee YK, Choi SH. Effects of biphasic calcium phosphate bone substitute on circumferential bone defects around dental implants in dogs. Int J Oral Maxillofac Implants, 2011; 26(2): 265-273.
  • 24. Lee JW, Kim SG, Kim JY, Lee YC, Choi JY, Dragos R, Rotaru H. Restoration of a peri-implant defect by platelet-rich fibrin. Oral Surg Oral Med Oral Pathol Oral Radiol; 2012; 113(4): 459-463.
  • 25. Fontana S, Olmedo DG, Linares JA, Guglielmotti MB, Crosa ME. Effect of platelet-rich plasma on the peri-implant bone response: an experimental study. Implant Dent. 2004;13:73-8
  • 26. Fuerst G, Gruber R, Tangl S, Sanroman F, Watzek G. Enhanced bone-to-implant contact by platelet-released growth factors in mandibular cortical bone: a histomorphometric study in minipigs. Int J Oral Maxillofac Implants. 2003;18:685-90.
  • 27. Wu J, Bai YX, Wang BK. Biomechanical and histomorphometric characterizations of osseointegration during mini-screw healing in rabbit tibiae. Angle Orthod. 2009;79:558-63
  • 28. Şimşek S, Özeç İ, Kürkçü M, Benlidayı E. Histomorphometric Evaluation of Bone Formation in Peri-Implant Defects Treated With Different Regeneration Techniques: An Experimental Study in a Rabbit Model. J Oral Maxillofac Surg. 2016 Sep;74(9):1757-64.
  • 29. Magremanne M, Baeyens W, Awada S, Vervaet C. Solitary bone cyst of the mandible and platelet rich fibrin (PRF). Rev Stomatol Chir Maxillofac, 2009; 110(2): 105-108.
  • 30. Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, Dohan AJ, Mouhyi J, Dohan DM. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101(3): 299-303.
  • 31. Xuan F, Lee CU, Son JS, Jeong SM, Choi BH. A comparative study of the regenerative effect of sinus bone grafting with platelet-rich fibrin-mixed Bio-Oss and commercial fibrin-mixed Bio-Oss: an experimental study. J Craniomaxillofac Surg 2014; 42(4): e47-50.

Periimplantal Kemik Defektlerinin Titanyum Tüplerde Hazırlanan Trombositten Zengin Fibrin ile Kemik Rejenerasyonunun Histomorfometrik Değerlendirmesi: Tavşan Tibiasinda Deneysel Çalışma

Year 2018, Volume: 25 Issue: 3, 243 - 250, 01.09.2018
https://doi.org/10.17343/sdutfd.332750

Abstract



Amaç: Bu çalışmanın amacı titanyum tüplerde hazırlanan
trombositten zengin fibrinin (T-PRF) deneysel olarak hazırlanmış periimplantal
kemik defektlerindeki rejenerasyonu incelemektir.



Gereç ve Yöntem: Çalışmada 12 adet erkek wistar rat kullanılmış olup
her bir tavşanın sağ ve sol tibiasına trephan frez ile 7 mm genişliğinde 4 mm
derinliğinde defektler oluşturulmuştur. Daha sonra 3,3X8 mm lik implantlar
tibialara yerleştirilmiş olup periimplantal defektler sırasıyla Otojen greft,
T-PRF, Bifazik Kalsiyum Fosfat greft (BCP) ile restore edilmiştir. Kontrol
grubu boş bırakılıp spontan iyileşmeye bırakılmıştır. 4 hafta sonra tüm
tavşanlar 
ötenazi ile öldürülerek
implant ile beraber etrafındaki kemik alındı. Kemik-implant kontağı toludin
mavisi ile boyanan kesitlerin histomorfometrik incelenmesi ile
değerlendirilmiştir.



Bulgular: Otojen grupta (5267,50±228,95) kemik implant kontağı
değeri en yüksek çıkmıştır. Ancak otojen grup ile T-PRF grubu (3932,50±275,50)
arasında istatistiksel olarak bir fark gözlenmemiştir. BCP grubu ile kontrol
grubunda en düşük BIC değerleri gözlenmiştir.



Sonuçlar: Peri-implantal defektlerin rejenerasyonunda T-PRF
grubunda neredeyse otojen grup kadar BIC değerleri bulunmuştur. Bu yüzden T-PRF
gelecekte yönlendirilmiş kemik rejenerasyonunda otojen matriks 
fonksiyonu görevi görebilir.

References

  • 1. Berglundh T, Persson L, Klinge B. A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years. J Clin Periodontol 2002; 29 Suppl 3: 197-212; discussion 232-233.
  • 2. O'Mahony A, Spencer P. Osseointegrated implant failures. J Ir Dent Assoc 1999; 45(2): 44-51.
  • 3. Anitua E. Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants 1999; 14(4): 529-535.
  • 4. Artzi Z, Tal H, Dayan D. Porous bovine bone mineral in healing of human extraction sockets: 2. Histochemical observations at 9 months. J Periodontol; 2001; 72(2): 152-159.
  • 5. Oh KC, Cha JK, Kim CS, Choi SH, Chai JK, Jung UW. The influence of perforating the autogenous block bone and the recipient bed in dogs. Part I: a radiographic analysis. Clin Oral Implants Res 2011; 22(11): 1298-1302.
  • 6. Knapp CI, Feuille V, Cochran D, Melloning JT. Clinical and histological evaluation of bone replacement grafts in the treatment of localized alveolar ridge defects. Part 2: bioactive glass particulates. Int J Periodontics Rest Dent. 2003;23(2):129–37.
  • 7. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101(3): e37-44.
  • 8. Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G. Slow release of growth factors and thrombospondin-1 in Choukroun's platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors 2009; 27(1): 63-69.
  • 9. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol 2009; 27(3): 158-67.
  • 10. Dohan Ehrenfest DM, Bielecki T, Jimbo R, Barbé G, Del Corso M, Inchingolo F, et al. Do the fibrin architecture and leukocyte content influence the growth factor release of platelet concentrates? An evidence-based answer comparing a pure platelet-rich plasma (P-PRP) gel and a leukocyte- and platelet-rich fibrin (L-PRF). Curr Pharm Biotechnol. 2012;13:1145-1152
  • 11. He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:707-13.
  • 12. Simonpieri A, Del Corso M, Vervelle A, Jimbo R, Inchingolo F, Sammartino G, et al. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 2: Bone graft, implant and reconstructive surgery. Curr Pharm Biotechnol. 2012;13:1231-56.
  • 13. Anitua EA. Enhancement of osseointegration by generating a dynamic implant surface. J Oral Implantol. 2006;32:72-76.
  • 14. Anitua E, Orive G, Pla R, Roman P, Serrano V, Andia I. The effects of PRGF on bone regeneration and on titanium implant osseointegration in goats: a histologic and histomorphometric study. J Biomed Mater Res A. 2009;91:158-165.
  • 15. Tunalı M, Özdemir H, Küçükodacı Z, Akman S, Yaprak E, Toker H, Fıratlı E. A novel platelet concentrate: titanium-prepared platelet-rich fibrin. Biomed Res Int 2014; 2014:209548.
  • 16. Tunali M, Özdemir H, Küçükodacı Z, Akman S, Fıratlı E. In vivo evaluation of titanium-prepared platelet-rich fibrin (T-PRF): a new platelet concentrate. Br J Oral Maxillofac Surg 2013; 51(5): 438-443.
  • 17. O’Connell SM Safety issues associated with platelet rich fibrin method. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 2007; 103:587-93
  • 18. Sung-Won Kim and In-Ho Cho. On the osseointegration of zirconia and titanium implants installed at defect site filled with xenograft material . J Korean Acad Prosthodont. 2014 Jan;52(1):9-17.
  • 19. Donath K, Breuner G. A method for the study of undecalcified bones and teeth with attached soft tissues. The Sage-Schliff (sawing and grinding) technique. J Oral Pathol 1982; 11(4): 318-26.
  • 20. Chen ST, Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla--a systematic review. Int J Oral Maxillofac Implants. 2014;29 Suppl:186-215.
  • 21. Al-Sulaimani AF, Mokeem SA, Anil S. Peri-implant defect augmentation with autogenous bone: a study in beagle dogs. J Oral Implantol 2013; 39(1): 30-36.
  • 22. Schuler RF, Janakievski J, Hacker BM, O'Neal RB, Roberts FA. Effect of implant surface and grafting on implants placed into simulated extraction sockets: a histologic study in dogs. Int J Oral Maxillofac Implants, 2010; 25(5): 893-900.
  • 23. Kim S, Jung UW, Lee YK, Choi SH. Effects of biphasic calcium phosphate bone substitute on circumferential bone defects around dental implants in dogs. Int J Oral Maxillofac Implants, 2011; 26(2): 265-273.
  • 24. Lee JW, Kim SG, Kim JY, Lee YC, Choi JY, Dragos R, Rotaru H. Restoration of a peri-implant defect by platelet-rich fibrin. Oral Surg Oral Med Oral Pathol Oral Radiol; 2012; 113(4): 459-463.
  • 25. Fontana S, Olmedo DG, Linares JA, Guglielmotti MB, Crosa ME. Effect of platelet-rich plasma on the peri-implant bone response: an experimental study. Implant Dent. 2004;13:73-8
  • 26. Fuerst G, Gruber R, Tangl S, Sanroman F, Watzek G. Enhanced bone-to-implant contact by platelet-released growth factors in mandibular cortical bone: a histomorphometric study in minipigs. Int J Oral Maxillofac Implants. 2003;18:685-90.
  • 27. Wu J, Bai YX, Wang BK. Biomechanical and histomorphometric characterizations of osseointegration during mini-screw healing in rabbit tibiae. Angle Orthod. 2009;79:558-63
  • 28. Şimşek S, Özeç İ, Kürkçü M, Benlidayı E. Histomorphometric Evaluation of Bone Formation in Peri-Implant Defects Treated With Different Regeneration Techniques: An Experimental Study in a Rabbit Model. J Oral Maxillofac Surg. 2016 Sep;74(9):1757-64.
  • 29. Magremanne M, Baeyens W, Awada S, Vervaet C. Solitary bone cyst of the mandible and platelet rich fibrin (PRF). Rev Stomatol Chir Maxillofac, 2009; 110(2): 105-108.
  • 30. Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, Dohan AJ, Mouhyi J, Dohan DM. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101(3): 299-303.
  • 31. Xuan F, Lee CU, Son JS, Jeong SM, Choi BH. A comparative study of the regenerative effect of sinus bone grafting with platelet-rich fibrin-mixed Bio-Oss and commercial fibrin-mixed Bio-Oss: an experimental study. J Craniomaxillofac Surg 2014; 42(4): e47-50.
There are 31 citations in total.

Details

Subjects Clinical Sciences
Journal Section Research Articles
Authors

Hakan Ozdemir

Turan Emre Kuzu

Publication Date September 1, 2018
Submission Date August 4, 2017
Acceptance Date August 20, 2017
Published in Issue Year 2018 Volume: 25 Issue: 3

Cite

Vancouver Ozdemir H, Kuzu TE. Histomorphometric Evaluation of Bone Regeneration in Peri-Implant Osseous Defects Treated With Titanium Prepared Platelet Rich Fibrin: An Experimental Study in a Rabbit Model. Med J SDU. 2018;25(3):243-50.

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