Evaluation of the Adjunctive Benefits of Platelet-Rich Plasma in Subantral Sinus Augmentation

Abstract

Subantral sinus augmentation is often necessary to permit placement of endosseous implants. Recent efforts to improve wound healing have focused on autogenous sources of bioactive mediators, such as platelet-rich plasma (PRP), which offer the potential to enhance the biological activity of bone replacement grafts. The purpose of this randomized, single-blinded, controlled study was to compare bone formation after subantral maxillary sinus augmentation with freeze-dried bone allograft (FDBA) plus PRP versus FDBA plus resorbable membrane. Ten patients underwent bilateral maxillary subantral sinus augmentation, with sites within subjects randomized to receive FDBA plus PRP or FDBA plus membrane. Core biopsy specimens were obtained 4.5 to 6 months after the grafting procedure at time of implant placement. Histomorphometric analysis revealed a significantly higher percentage of vital tissue in sinuses after treatment with FDBA and PRP (78.8 +/- 8.3) than with FDBA and membrane (63.0 +/- 15.7). Moreover, the percentage of bone formation in sinuses augmented with the combination of FDBA plus PRP (33.3 +/- 11.3) was nonsignificantly (P</= 0.10) higher than in sinuses grafted with FDBA plus membrane (26.5 +/- 6.8). Residual graft particles constituted a significantly higher percentage of the regenerate in sinuses treated with FDBA plus membrane than in sinuses augmented with FDBA plus PRP (37.0 +/- 15.7) versus (21.2 +/- 8.3, respectively). When comparing the relative proportion of vital bone to residual graft particles, a significant difference also was observed between sinuses treated with FDBA and membrane compared with sinuses augmented with FDBA and PRP (0.98 +/- 0.77 versus 1.82 +/- 0.88, respectively). The results of this study suggest that the combination of FDBA and PRP enhances the rate of formation of bone compared with FDBA and membrane, when used in subantral sinus augmentation. Future research is needed to determine the clinical significance and the cost- and risk-benefit considerations of the approach.

Allogeneic Adipose-Derived Stem Cells Protect Fat Grafts at the Early Stage and Improve Long-Term Retention in Immunocompetent Rats

“…However, some complications such as ecchymosis, hematomas and infections may occur after fat grafting. Specifically, the unexpected and low survival rate (approximately 20-80 %) is a common and important issue [2,3]. To solve the problem of traditional fat grafting, surgeons have begun to use cell-assisted lipotransfer (CAL), whereby adipose-derived stem cells (ASCs) are cotransplanted with fat grafts.…”

Efficacy of Platelet-Rich-Plasma (PRP) and Highly Purified Bovine Xenograft (Laddec®) Combination in Bone Regeneration after Cyst Enucleation: Radiological and Histological Evaluation

“…All these approaches are known as regenerative therapies. Recently it has been developed a procedure for bony defects regeneration utilizes PRP in addition to bone grafts, and several studies have showed that a combination of PRP with bone grafts promote bone regeneration [36][37][38][39][40][41][42]. However, other authors still argue the lack of scientific evidence for defending the use of PRP associated with bone grafts in bone regeneration and recommend the surgeon to maintain a critical mind regarding its efficacy [43,44].…”

State of the art and future perspectives of articular cartilage regeneration: a focus on adipose-derived stem cells and platelet-derived products

“…Although many controversial results are reported, PRP is also widely used in the field of bone tissue engineering. Clinical studies by Marx et al (1998) and Oyama et al (2004) in the field of oral-maxillofacial reconstructions showed a strong effect of PRP on bone formation (88 and 12 patients, respectively), while there was weak to absent effect on bone formation in other studies investigating 26 and 10 patients (Dori et al, 2008;Kassolis and Reynolds, 2005).…”