Effect of Platelet Rich Plasma (PRP) on Bone Graft in Alveolar Cleft Repair

Abstract

Background: Ultimate repair of alveolar defects is a great challenge in practical field, many bone graft materials have been evolved in the literatures for alveolar defect reconstruction as autogenous, allogenic, xenogenic, and alloplastic grafts [1], autogenous iliac crest bone graft is the gold standard among other graft materials evaluated. However, the procedure associated with a potential risk of early complications such as graft resorption, graft leakage, infection, or graft failure, failure rate is about 30% [2].Objectives: To assess the efficacy of using Platelet Rich Plasma (PRP) in alveolar cleft reconstruction; in combination with Iliac Crest Bone Graft (ICBG) in comparison to the conventional Iliac Crest Bone Grafting (ICBG).Patients and Methods: 20 patients underwent alveolar cleft reconstruction at the age of mixed dentition over a 3year's period; their mean age was 8.8±2.3 years years and their mean post-operative follow-up was 13.4 months. Of these, 10 patients treated with ICBG combined with PRP (Group I), and 10 patients repaired by ICBG alone Group II (control group) results were assessed by rating the radiographs obtained 3, 6, and 12 months post-operatively according to cone beam CT (CBCT) volume and density assessment.Results: Alveolar cleft repairs using PRP combined cancellous bone (Group I) were 90 percent successful, alveolar cleft repairs using cancellous bone (Group I) were 70 percent successful as regard; bone resorption reduction, bone volume gaining and improved bone density in CBCT at 3, 6, and 12 months post-operative with decreased post-operative complication rates. Conclusion:Application of PRP enhances bone formation in alveolar clefts when admixed with autologous bone graft harvested from the iliac crest as it leads to early bone formation, increased bone density, decreases bone resorption, low infection rate and least post-operative complications.

Bioactive Scaffolds as a Promising Alternative for Enhancing Critical-Size Bone Defect Regeneration in the Craniomaxillofacial Region

“…In another study, alveolar clefts and bone defects created by removing mandibular lesions were also treated with autologous bone mixed with PRP, using as control group patients whose bone defects were grafted with autologous bone alone. As expected, lesions treated with PRP showed more bone growth than controls after 12 months of surgery. , …”

“…As expected, lesions treated with PRP showed more bone growth than controls after 12 months of surgery. 163,164 In another clinical study, bilateral mandibular fractures were treated with a bone allograft containing autologous PRP in a patient whose psychiatric conditions impaired the obtention and use of autologous iliac bone. The fractures healed completely 36 months after treatment, supporting the utility of PRP to enhance bone repair.…”

Effect of adjuvant autologous platelet concentrates on secondary repair of alveolar clefts: A systematic review and meta‐analysis

“…Five studies reported immediate post‐operative complications like bleeding, pain, infection, discharge and wound dehiscence 26,29,32–34 . The closure of wound dehiscence with secondary healing in subsequent follow‐ups was also reported.…”

“…Among the RCTs, only two studies were of low risk, 27,41 while two were classified as unclear risk, 32,33 and three were high risk 26,31,42 (Figure 2A). Among two CCTs, one study was assessed to have moderate risk, 34 whereas the other was judged under serious risk of bias 29 (Figure 2B). The primary source of bias was the randomization method, allocation concealment, and selective reporting.…”

A New Technique of Two Iliac Cortical Bone Blocks Sandwich Technique for Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients

“…Growth factors obtained from platelet rich plasma PRP was introduced with the advantages of promote tissue healing and accelerates recovery. PRP is proved enhances bone formation in alveolar clefts when admixed with iliac autologous bone graft as it leads to early bone formation, increased bone density, decreases bone resorption, low infection rate and least post-operative complications [25][26][27]. In the year 2006, platelet-rich fibrin (PRF) is introduced by Chokroun as the second generation concentrate of PRP [28].…”