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Quek J, Vizetto-Duarte C, Teoh SH, Choo Y. Towards Stem Cell Therapy for Critical-Sized Segmental Bone Defects: Current Trends and Challenges on the Path to Clinical Translation. J Funct Biomater 2024; 15:145. [PMID: 38921519 PMCID: PMC11205181 DOI: 10.3390/jfb15060145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/18/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
The management and reconstruction of critical-sized segmental bone defects remain a major clinical challenge for orthopaedic clinicians and surgeons. In particular, regenerative medicine approaches that involve incorporating stem cells within tissue engineering scaffolds have great promise for fracture management. This narrative review focuses on the primary components of bone tissue engineering-stem cells, scaffolds, the microenvironment, and vascularisation-addressing current advances and translational and regulatory challenges in the current landscape of stem cell therapy for critical-sized bone defects. To comprehensively explore this research area and offer insights for future treatment options in orthopaedic surgery, we have examined the latest developments and advancements in bone tissue engineering, focusing on those of clinical relevance in recent years. Finally, we present a forward-looking perspective on using stem cells in bone tissue engineering for critical-sized segmental bone defects.
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Affiliation(s)
- Jolene Quek
- Developmental Biology and Regenerative Medicine Programme, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore; (J.Q.); (C.V.-D.)
| | - Catarina Vizetto-Duarte
- Developmental Biology and Regenerative Medicine Programme, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore; (J.Q.); (C.V.-D.)
| | - Swee Hin Teoh
- Centre for Advanced Medical Engineering, College of Materials Science and Engineering, Hunan University, Changsha 410012, China
| | - Yen Choo
- Developmental Biology and Regenerative Medicine Programme, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore; (J.Q.); (C.V.-D.)
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Delgado D, Beitia M, Mercader Ruiz J, Sánchez P, Montoya-Alzola M, Fiz N, Sánchez M. A Novel Fibrin Matrix Derived from Platelet-Rich Plasma: Protocol and Characterization. Int J Mol Sci 2024; 25:4069. [PMID: 38612879 PMCID: PMC11012499 DOI: 10.3390/ijms25074069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/31/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
Although fibrin matrices derived from Platelet-Rich Plasma (PRP) are widely used in regenerative medicine, they have some limitations that can hinder their application. Modifying the composition of the PRP-derived fibrin matrix may improve its properties, making it suitable for certain medical uses. Three types of fibrin matrices were obtained: a PRP-derived fibrin matrix (FM), a PRP-derived fibrin matrix with a high fibrinogen content and platelets (FM-HFP) and a PRP-derived fibrin matrix with a high fibrinogen content (FM-HF). The fibrinogen levels, biomechanical properties and cell behavior were analyzed. The presence of platelets in the FM-HFP generated an inconsistent fibrin matrix that was discarded for the rest of the analysis. The fibrinogen levels in the FM-FH were higher than those in the FM (p < 0.0001), with a concentration factor of 6.86 ± 1.81. The values of clotting and swelling achieved using the FM-HF were higher (p < 0.0001), with less clot shrinkage (p < 0.0001). The FM had a significantly higher stiffness and turned out to be the most adherent composition (p = 0.027). In terms of cell viability, the FM-HF showed less cell proliferation but higher live/dead ratio values (p < 0.01). The increased fibrinogen and platelet removal in the FM-HF improved its adhesion and other biomechanical properties without affecting cell viability.
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Affiliation(s)
- Diego Delgado
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain; (D.D.); (M.B.); (J.M.R.); (P.S.)
| | - Maider Beitia
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain; (D.D.); (M.B.); (J.M.R.); (P.S.)
| | - Jon Mercader Ruiz
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain; (D.D.); (M.B.); (J.M.R.); (P.S.)
| | - Pello Sánchez
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain; (D.D.); (M.B.); (J.M.R.); (P.S.)
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain; (M.M.-A.); (N.F.)
| | - Marta Montoya-Alzola
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain; (M.M.-A.); (N.F.)
| | - Nicolás Fiz
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain; (M.M.-A.); (N.F.)
| | - Mikel Sánchez
- Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain; (D.D.); (M.B.); (J.M.R.); (P.S.)
- Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008 Vitoria-Gasteiz, Spain; (M.M.-A.); (N.F.)
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Anitua E, Pino A, Prado R, Muruzabal F, Alkhraisat MH. Biochemical and biomechanical characterization of an autologous protein-based fibrin sealant for regenerative medicine. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2024; 35:15. [PMID: 38456966 PMCID: PMC10923958 DOI: 10.1007/s10856-024-06780-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/10/2024] [Indexed: 03/09/2024]
Abstract
Accidental events or surgical procedures usually lead to tissue injury. Fibrin sealants have proven to optimize the healing process but have some drawbacks due to their allogeneic nature. Autologous fibrin sealants present several advantages. The aim of this study is to evaluate the performance of a new autologous fibrin sealant based on Endoret®PRGF® technology (E-sealant). One of the most widely used commercial fibrin sealants (Tisseel®) was included as comparative Control. E-sealant´s hematological and biological properties were characterized. The coagulation kinetics and the microstructure were compared. Their rheological profile and biomechanical behavior were also recorded. Finally, the swelling/shrinkage capacity and the enzymatic degradation of adhesives were determined. E-sealant presented a moderate platelet concentration and physiological levels of fibrinogen and thrombin. It clotted 30 s after activation. The microstructure of E-sealant showed a homogeneous fibrillar scaffold with numerous and scattered platelet aggregates. In contrast, Control presented absence of blood cells and amorphous protein deposits. Although in different order of magnitude, both adhesives had similar rheological profiles and viscoelasticity. Control showed a higher hardness but both adhesives presented a pseudoplastic hydrogel nature with a shear thinning behavior. Regarding their adhesiveness, E-sealant presented a higher tensile strength before cohesive failure but their elastic stretching capacity and maximum elongation was similar. While E-sealant presented a significant shrinkage process, Control showed a slight swelling over time. In addition, E-sealant presented a high enzymatic resorption rate, while Control showed to withstand the biodegradation process in a significant way. E-sealant presents optimal biochemical and biomechanical properties suitable for its use as a fibrin sealant with regenerative purposes.
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Affiliation(s)
- Eduardo Anitua
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain.
- BTI-Biotechnology Institute, Vitoria, Spain.
| | - Ander Pino
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
| | - Roberto Prado
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
| | - Francisco Muruzabal
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
| | - Mohammad Hamdan Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
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Calabrese EJ, Kapoor R, Dhawan G, Calabrese V. Hormesis mediates platelet-rich plasma and wound healing. Wound Repair Regen 2023; 31:56-68. [PMID: 36458897 DOI: 10.1111/wrr.13060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/06/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022]
Abstract
Platelet-rich plasma (PRP) has become an accepted and general wound healing approach with an extremely wide range of applications. Despite considerable diversity in the composition of platelet-rich plasma products that are applied in specific wound healing usage, it is widely recognised that such diverse platelet-rich plasma complex mixtures routinely display hormetic-like biphasic concentrations that are independent of the tissue treated and endpoints measured. The present paper is the first to place the area of platelet-rich plasma-biomedical research and applications within an hormetic framework. The platelet-rich plasma area is also unique as it represents the application of the hormetic concept to the issue of complex biological mixtures.
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Affiliation(s)
- Edward J Calabrese
- Department of Environmental Health Sciences, Morrill I, N344, University of Massachusetts, Amherst, Massachusetts, USA
| | - Rachna Kapoor
- Saint Francis Hospital and Medical Center, Hartford, Connecticut, USA
| | - Gaurav Dhawan
- Sri Guru Ram Das (SGRD) University of Health Sciences, Amritsar, India
| | - Vittorio Calabrese
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
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Baek J, Ryu B, Kim J, Lee SG, Oh MS, Hong KS, Kim EY, Kim CY, Chung HM. Immunomodulation of Pluripotent Stem Cell-Derived Mesenchymal Stem Cells in Rotator Cuff Tears Model. Biomedicines 2022; 10:biomedicines10071549. [PMID: 35884853 PMCID: PMC9312476 DOI: 10.3390/biomedicines10071549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Rotator cuff tears (RCTs) induce chronic muscle weakness and shoulder pain. Treatment of RCT using surgery or drugs causes lipid infiltration and fibrosis, which hampers tissue regeneration and complete recovery. The pluripotent stem cell-derived multipotent mesenchymal stem cells (M-MSCs) represent potential candidate next-generation therapies for RCT. Methods: The difference between M-MSCs and adult-MSCs was compared and analyzed using next-generation sequencing (NGS). In addition, using a rat model of RCT, the muscle recovery ability of M-MSCs and adult-MSCs was evaluated by conducting a histological analysis and monitoring the cytokine expression level. Results: Using NGS, it was confirmed that M-MSC was suitable for transplantation because of its excellent ability to regulate inflammation that promotes tissue repair and reduced apoptosis and rejection during transplantation. In addition, while M-MSCs persisted for up to 8 weeks in vivo, they significantly reduced inflammation and adipogenesis-related cytokine levels in rat muscle. Significant differences were also confirmed in histopathological remission. Conclusions: M-MSCs remain in the body longer to modulate immune responses in RCTs and have a greater potential to improve muscle recovery by alleviating acute inflammatory responses. This indicates that M-MSCs could be used in potential next-generation RCT therapies.
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Affiliation(s)
- Jieun Baek
- Departmentof Stem Cell Biology, School of Medicine, Konkuk University, Seoul 05029, Korea; (J.B.); (S.-G.L.); (M.-S.O.)
| | - Bokyeong Ryu
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.R.); (J.K.)
- Department of Laboratory Animal Medicine, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Jin Kim
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.R.); (J.K.)
- Department of Laboratory Animal Medicine, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Seul-Gi Lee
- Departmentof Stem Cell Biology, School of Medicine, Konkuk University, Seoul 05029, Korea; (J.B.); (S.-G.L.); (M.-S.O.)
| | - Min-Seok Oh
- Departmentof Stem Cell Biology, School of Medicine, Konkuk University, Seoul 05029, Korea; (J.B.); (S.-G.L.); (M.-S.O.)
- Advanced Analysis Center, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea
| | - Ki-Sung Hong
- Mireacellbio Co., Ltd., Seoul 04795, Korea; (K.-S.H.); (E.-Y.K.)
| | - Eun-Young Kim
- Mireacellbio Co., Ltd., Seoul 04795, Korea; (K.-S.H.); (E.-Y.K.)
| | - C-Yoon Kim
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.R.); (J.K.)
- Correspondence: (C.-Y.K.); (H.-M.C.); Tel.: +82-10-9140-0136 (C.-Y.K.); +82-10-7190-1926 (H.-M.C.); Fax: +82-2-455-9012 (C.-Y.K. & H.-M.C.)
| | - Hyung-Min Chung
- Departmentof Stem Cell Biology, School of Medicine, Konkuk University, Seoul 05029, Korea; (J.B.); (S.-G.L.); (M.-S.O.)
- Mireacellbio Co., Ltd., Seoul 04795, Korea; (K.-S.H.); (E.-Y.K.)
- Correspondence: (C.-Y.K.); (H.-M.C.); Tel.: +82-10-9140-0136 (C.-Y.K.); +82-10-7190-1926 (H.-M.C.); Fax: +82-2-455-9012 (C.-Y.K. & H.-M.C.)
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Montazerian H, Davoodi E, Baidya A, Baghdasarian S, Sarikhani E, Meyer CE, Haghniaz R, Badv M, Annabi N, Khademhosseini A, Weiss PS. Engineered Hemostatic Biomaterials for Sealing Wounds. Chem Rev 2022; 122:12864-12903. [PMID: 35731958 DOI: 10.1021/acs.chemrev.1c01015] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hemostatic biomaterials show great promise in wound control for the treatment of uncontrolled bleeding associated with damaged tissues, traumatic wounds, and surgical incisions. A surge of interest has been directed at boosting hemostatic properties of bioactive materials via mechanisms triggering the coagulation cascade. A wide variety of biocompatible and biodegradable materials has been applied to the design of hemostatic platforms for rapid blood coagulation. Recent trends in the design of hemostatic agents emphasize chemical conjugation of charged moieties to biomacromolecules, physical incorporation of blood-coagulating agents in biomaterials systems, and superabsorbing materials in either dry (foams) or wet (hydrogel) states. In addition, tough bioadhesives are emerging for efficient and physical sealing of incisions. In this Review, we highlight the biomacromolecular design approaches adopted to develop hemostatic bioactive materials. We discuss the mechanistic pathways of hemostasis along with the current standard experimental procedures for characterization of the hemostasis efficacy. Finally, we discuss the potential for clinical translation of hemostatic technologies, future trends, and research opportunities for the development of next-generation surgical materials with hemostatic properties for wound management.
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Affiliation(s)
- Hossein Montazerian
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, California 90095, United States.,California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States.,Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Elham Davoodi
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, California 90095, United States.,California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States.,Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States.,Multi-Scale Additive Manufacturing Lab, Mechanical and Mechatronics Engineering Department, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Avijit Baidya
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Sevana Baghdasarian
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Einollah Sarikhani
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, California 90095, United States
| | - Claire Elsa Meyer
- Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Reihaneh Haghniaz
- Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Maryam Badv
- California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States.,Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, California 90095, United States.,Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, Alberta T2N 1N4, Canada
| | - Nasim Annabi
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, California 90095, United States.,Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Ali Khademhosseini
- Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States
| | - Paul S Weiss
- Department of Bioengineering, University of California, Los Angeles, 410 Westwood Plaza, Los Angeles, California 90095, United States.,California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California 90095, United States.,Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, California 90095, United States.,Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, California 90095, United States
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Alauddin MS, Yusof NM, Adnan AS, Said Z. Preliminary Novel Analysis on Antimicrobial Properties of Concentrated Growth Factor against Bacteria-Induced Oral Diseases. Eur J Dent 2022; 16:901-910. [PMID: 35189641 DOI: 10.1055/s-0041-1742121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Concentrated growth factor (CGF) is particularly gaining acceptance and popularity in regenerative dentistry. Nonetheless, there are no available studies showing its effect against microorganisms of oral cavity particularly in chronic oral disease-induced biofilms. This in vitro research was conducted to determine the antimicrobial effects of CGF against Staphylococcus aureus sp. (S. aureus) and Streptococcus mutans sp. (S. mutans). MATERIALS AND METHODS Blood samples were obtained from a healthy volunteer. CGF was then prepared using specialized centrifugation equipment (Medifuge, Silfradent, Santa Sofia FC, Italy) and protocol. Antimicrobial activity of the CGF was observed and recorded on standard strains of S. aureus and S. mutans using a well diffusion method to determine the inhibition zone, broth microdilution to determine minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), and crystal violet assay for biofilm assessment, with chlorhexidine (CHX) 0.12% used as a positive control. Statistical analysis was then performed using one-way analysis of variance followed by Tukey Test post hoc analysis. RESULTS It was observed that there was a presence of clear zones of inhibition around the CGF after 24 hours of incubation. The mean diameter of the inhibition zone was 1.26 ± 0.12 nm and 1.20 ± 0.06 nm for S. aureus and S. mutans, respectively, with significance difference (p < 0.05) against the control group CHX 0.12%. The MIC values of the CGF against S. aureus and S. mutans were 47.9% and 34.17%, respectively, and the MBC values of the CGF against S. aureus and S. mutans were 100%. The viability and the ability in inhibiting the biofilm formation of S. mutans and S. aureus following treatment with CGF showed a reduction in the concentration-dependent manner as compared with the control group. CONCLUSION CGF possesses antimicrobial and antibiofilm activity against S. aureus and S. mutans.
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Affiliation(s)
- Muhammad Syafiq Alauddin
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Nabilah Mohd Yusof
- Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Aini Sufinah Adnan
- Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Zulfahmi Said
- Department of Basic Sciences and Oral Biology, Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
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Karimi Ghahfarrokhi E, Meimandi-Parizi A, Oryan A, Ahmadi N. Effects of Combination of BMP7, PFG, and Autograft on Healing of the Experimental Critical Radial Bone Defect by Induced Membrane (Masquelet) Technique in Rabbit. THE ARCHIVES OF BONE AND JOINT SURGERY 2021; 9:585-597. [PMID: 34692943 DOI: 10.22038/abjs.2020.50852.2532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/02/2020] [Indexed: 01/08/2023]
Abstract
Background Healing of large segmental bone defects can be challenging for orthopedic surgeons. This research was conducted to provide further insight into the effects of BMP7 in combination with autograft and platelet fibrin glue (PFG) on bone regeneration by Masquelet technique (MT). Methods Twenty five domestic male rabbits, more than 6 months old, weighing 2.00±0.25 kg were randomly divided into five equal groups as follows: MT-blank cavity (without any biological or synthetic materials) (1), blank cavity (2), MT-autograft (3), MT-autograft-BMP7 (4), and MT-BMP7-PFG (5). A 20 mm segmental defect was made in radial bone in both forelimbs. The Masquelet technique was done in all groups except group 2. The study was evaluated by radiology, biomechanics, histopathology and scanning electron microscopy. Results The results showed that Masquelet technique enhanced the healing process, as, the structural and functional criteria of the injured bone showed significantly improved bone healing (P<0.05). Treatment by PFG-BMP7, Autograft-BMP7, and autograft demonstrated beneficial effects on bone healing. However, Autograft-BMP7 was more effective than autograft in healing of the radial defect in rabbits. Conclusion Our findings introduce the osteogenic materials in combination with Masquelet technique as an alternative for reconstruction of the big diaphyseal defects in the long bones in animal models. Our findings may be useful for clinical application in future.
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Affiliation(s)
| | | | - Ahmad Oryan
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Nasrollah Ahmadi
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
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Banyatworakul P, Pirarat N, Sirisawadi S, Osathanon T, Kalpravidh C. Efficacy of bubaline blood derived fibrin glue in silk ligature-induced acute periodontitis in Wistar rats. Vet World 2021; 14:2602-2612. [PMID: 34903915 PMCID: PMC8654744 DOI: 10.14202/vetworld.2021.2602-2612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/20/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND AIM Fibrin forms in the coagulation process, enhancing local hemostatic properties and promoting wound healing. The study aimed to evaluate the efficacy of bubaline-derived fibrin glue in silk ligature-induced periodontitis rats. MATERIALS AND METHODS Bubaline blood-derived fibrin glue was prepared using cryoprecipitation and cryocentrifugation. Periodontitis was induced in rats by placing 5-0 silk ligatures around the mandibular first molars. The animals were divided into two groups: (1) Non-treatment and (2) bubaline fibrin glue-treated groups. Plaque, gingival inflammation, and mobility index were scored on days 1, 7, and 14 after intervention. Histological examinations were performed. The mRNA expression of inflammatory cytokines and growth factors was evaluated using a real-time polymerase chain reaction. Ligature-induced periodontitis was confirmed by the increase in inflammatory cell infiltration as well as histological bone and attachment loss. RESULTS Compared to the non-treatment group, bubaline fibrin glue application reduced mononuclear cell infiltration into periodontal tissues corresponding to the reduction of collagen destruction. On days 7 and 14 after intervention, the inflammatory score and histological attachment loss were significantly lower in the bubaline fibrin glue-treated group than in the non-treatment group. A significant reduction in histological bone loss was observed in the treated group on day 7. Bubaline fibrin glue application led to a significant reduction of Tnfa and Il1b mRNA levels, while an increased expression of Pdgfa, Tgfb1, and Il10 was observed compared with the control. CONCLUSION Bubaline fibrin glue could be beneficial in periodontitis treatment aiming to reduce inflammation and delay the progression of periodontal disease.
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Affiliation(s)
- Poranee Banyatworakul
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Nopadon Pirarat
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Sujin Sirisawadi
- Biochemistry Unit, Department of Veterinary Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Thanaphum Osathanon
- Dental Stem Cell Biology Research Unit, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Chanin Kalpravidh
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330 Thailand
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10
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Development of Vancomycin Delivery Systems Based on Autologous 3D Platelet-Rich Fibrin Matrices for Bone Tissue Engineering. Biomedicines 2021; 9:biomedicines9070814. [PMID: 34356878 PMCID: PMC8301455 DOI: 10.3390/biomedicines9070814] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 01/05/2023] Open
Abstract
Autologous platelet-rich fibrin (PRF) is derived from the blood and its use in the bone tissue engineering has emerged as an effective strategy for novel drug and growth factor delivery systems. Studies have approved that combined therapy with PRF ensures higher biological outcomes, but patients still undergo additional treatment with antibiotic drugs before, during, and even after the implantation of biomaterials with PRF. These systematically used drugs spread throughout the blood and lead not only to positive effects but may also induce adverse side effects on healthy tissues. Vancomycin hydrochloride (VANKA) is used to treat severe Staphylococcal infections but its absorption in the target tissue after oral administration is low; therefore, in this study, we have developed and analyzed two kinds of VANKA carriers—liposomes and microparticles in 3D PRF matrices. The adjustment, characterization, and analysis of VANKA carriers in 3D PRF scaffolds is carried out in terms of encapsulation efficiency, drug release kinetics and antibacterial activity; furthermore, we have studied the micro- and macrostructure of the scaffolds with microtomography.
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Abstract
Purpose Growing evidence suggests different systemic exposure of anti-vascular endothelial growth factor (anti-VEGF) agents with repeated intravitreal application. Since the penetration of anti-VEGF agents through vascular barrier was reported, the interaction of anti-VEGF with nonresident platelets has become a topic of interest. The purpose of this study was to evaluate, with the help of visualization techniques, whether platelets take up the anti-VEGF agents ranibizumab, aflibercept, and bevacizumab. Methods The uptake of anti-VEGF agents with or without VEGF treatment was investigated using immunofluorescence and immunogold staining in human platelets. The role of actin filaments and clathrin-coated vesicles in the transport of ranibizumab, aflibercept, and bevacizumab was evaluated by two pharmacologic inhibitors: staurosporine (protein kinase C inhibitor) and cytochalasin D. Results All three anti-VEGF agents were taken up by platelets and colocalized with VEGF. Ranibizumab and aflibercept were mainly detected in alpha-granules; however, bevacizumab was equally localized in alpha-granules and in platelet vesicles. Both staurosporine and cytochalasin D completely inhibited the uptake of aflibercept into platelets. Both pharmacological inhibitors also decreased the transport of ranibizumab and bevacizumab into platelets. Bevacizumab was significantly more frequently colocalized within clathrin-coated vesicles than ranibizumab and aflibercept. Conclusion All three anti-VEGF agents are taken up by platelets and internalized in alpha-granules, which may result in a higher local exposure of anti-VEGF after the activation of platelets, potentially contributing to arterial thromboembolic events. Clathrin-coated vesicles seem to be more prominent in the transport of bevacizumab than ranibizumab and aflibercept. Nevertheless, whether the different localization and transport of bevacizumab are truly related to specific differences of receptor-mediated endocytosis has to be revealed by further research.
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Tokumoto H, Akita S, Kubota Y, Mitsukawa N. Utility of autologous fibrin glue in the donor site of free abdominal flap for breast reconstruction: A randomized controlled study. J Plast Reconstr Aesthet Surg 2021; 74:2870-2875. [PMID: 33992561 DOI: 10.1016/j.bjps.2021.03.073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 12/28/2020] [Accepted: 03/13/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Seroma formation at the donor site is a common complication of breast reconstruction using free abdominal flap. In this study, we assessed the benefits of use of autologous fibrin glue (AFG) at the donor site. METHODS This randomized controlled study compared AFG group (n = 61) with commercial fibrin glue (CFG) group (n = 79). Owing to the high volume of AFG (10 mL), AFG group received fibrin glue at both the anastomosis and the donor sites, whereas CFG group received fibrin glue only at the anastomosis site. Operative protocols and the criteria for postoperative drain removal were identical in both groups. Patient characteristics and abdominal discharge were compared between the two groups. RESULTS Since anemia was a contraindication for use of AFG, preoperative Hb in CFG group was significantly lower than that in AFG group; other factors were comparable in the two groups. The mean total abdominal drain volumes on first postoperative day (POD1) and POD2 was (AFG vs. CFG) 130.9 vs. 169.4 mL (P < 0.001) and 131.0 vs. 162.8 mL (P = 0.03), respectively. On POD3, there was no significant difference in this respect (116.2 vs. 128.4 mL, P = 0.19). The mean time for removal of all abdominal drains was significantly lower in AFG group (7.4 vs. 8.4 days; P = 0.01). CONCLUSIONS AFG reduced the discharge at the donor site of free abdominal flap, especially in the early postoperative period. AFG helped to reduce the abdominal drainage period.
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Affiliation(s)
- Hideki Tokumoto
- Department of Plastic and Reconstructive Surgery, Chiba Cancer Center Hospital, Chiba, Japan.
| | - Shinsuke Akita
- Department of Plastic, Reconstructive and Aesthetic Surgery, Chiba University, Faculty of Medicine, Chiba, Japan
| | - Yoshitaka Kubota
- Department of Plastic, Reconstructive and Aesthetic Surgery, Chiba University, Faculty of Medicine, Chiba, Japan
| | - Nobuyuki Mitsukawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Chiba University, Faculty of Medicine, Chiba, Japan
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13
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Yang Y, Xiao Y. Biomaterials Regulating Bone Hematoma for Osteogenesis. Adv Healthc Mater 2020; 9:e2000726. [PMID: 32691989 DOI: 10.1002/adhm.202000726] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/18/2020] [Indexed: 12/11/2022]
Abstract
Blood coagulation in tissue healing not only prevents blood loss, but also forms a natural scaffold for tissue repair and regeneration. As blood clot formation is the initial and foremost phase upon bone injury, and the quality of blood clot (hematoma) orchestrates the following inflammatory and cellular processes as well as the subsequent callus formation and bone remodeling process. Inspired by the natural healing hematoma, tissue-engineered biomimic scaffold/hydrogels and blood prefabrication strategies attract significant interests in developing functional bone substitutes. The alteration of the fracture hematoma ca significantly accelerate or impair the overall bone healing process. This review summarizes the impact of biomaterials on blood coagulation and provides evidence on fibrin network structure, growth factors, and biomolecules that contribute to bone healing within the hematoma. The aim is to provide insights into the development of novel implant and bone biomaterials for enhanced osteogenesis. Advances in the understanding of biomaterial characteristics (e.g., morphology, chemistry, wettability, and protein adsorption) and their effect on hematoma properties are highlighted. Emphasizing the importance of the initial healing phase of the hematoma endows the design of advanced biomaterials with the desired regulatory properties for optimal coagulation and hematoma properties, thereby facilitating enhanced osteogenesis and ideal therapeutic effects.
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Affiliation(s)
- Ying Yang
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, QLD, 4059, Australia
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He L, Sun X, Liu Z, Qiu Y, Niu Y. Pathogenesis and multidisciplinary management of medication-related osteonecrosis of the jaw. Int J Oral Sci 2020; 12:30. [PMID: 33087699 PMCID: PMC7578793 DOI: 10.1038/s41368-020-00093-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/11/2022] Open
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of bone-modifying agents and inhibits angiogenesis agents. Although the pathogenesis of MRONJ is not entirely clear, multiple factors may be involved in specific microenvironments. The TGF-β1 signalling pathway may have a key role in the development of MRONJ. According to the clinical stage, multiple variables should be considered when selecting the most appropriate treatment. Therefore, the prevention and management of treatment of MRONJ should be conducted in patient-centred multidisciplinary team collaborative networks with oncologists, dentists and dental specialists. This would comprise a closed responsibility treatment loop with all benefits directed to the patient. Thus, in the present review, we aimed to summarise the pathogenesis, risk factors, imaging features, clinical staging, therapeutic methods, prevention and treatment strategies associated with MRONJ, which may provide a reference that can inform preventive strategies and improve the quality of life for patients in the future.
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Affiliation(s)
- Lina He
- The First Affiliated Hospital of Harbin Medical University, Harbin, China.,School of Stomatology, Harbin Medical University, Harbin, China
| | - Xiangyu Sun
- The First Affiliated Hospital of Harbin Medical University, Harbin, China.,School of Stomatology, Harbin Medical University, Harbin, China
| | - Zhijie Liu
- The First Affiliated Hospital of Harbin Medical University, Harbin, China.,School of Stomatology, Harbin Medical University, Harbin, China
| | - Yanfen Qiu
- The First Affiliated Hospital of Harbin Medical University, Harbin, China.,School of Stomatology, Harbin Medical University, Harbin, China
| | - Yumei Niu
- The First Affiliated Hospital of Harbin Medical University, Harbin, China. .,School of Stomatology, Harbin Medical University, Harbin, China.
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Autologous platelet-rich plasma in the treatment of refractory corneal ulcers: A case report. Am J Ophthalmol Case Rep 2020; 20:100838. [PMID: 32913920 PMCID: PMC7472805 DOI: 10.1016/j.ajoc.2020.100838] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 06/25/2020] [Accepted: 07/15/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose To evaluate the efficacy of a low-cost preparation of platelet-rich plasma (PRP) eye drops in the treatment of persistent non-infectious corneal ulcer. Observations A 67-year-old female presented to our clinic with a wide corneal ulcer and severe paracentral corneal thinning refractory to medical therapy with antibiotics, lubricant and contact lens bandage. The patient received a novel preparation of PRP solution. After 15 days of therapy, we observed complete resolution of the corneal ulcer with regrowth of the epithelium and a reduction in corneal opacity. Conclusion and importance Although the low-cost PRP preparation gives a lower platelet concentration than standard procedures, our work shows this preparation to be effective in the treatment of refractory non-infectious corneal ulcer.
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Mehrabani D, Khodakaram-Tafti A, Shaterzadeh-Yazdi H, Zamiri B, Omidi M. Comparison of the regenerative effect of adipose-derived stem cells, fibrin glue scaffold, and autologous bone graft in experimental mandibular defect in rabbit. Dent Traumatol 2018; 34:413-420. [PMID: 30187637 DOI: 10.1111/edt.12435] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 08/30/2018] [Accepted: 08/30/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND/AIMS One of the main concerns for maxillofacial and orthopedic surgeons is finding a method to improve regeneration of large craniofacial bone defects. The aim of this study was to investigate the healing and regenerative effects of fibrin glue associated with adipose-derived stem cells (ADSCs) and fibrin glue scaffold alone with autologous bone grafts in experimental mandibular defects of the rabbit. METHODS Bilateral uni-cortical osteotomies were performed in the mandible of 20 male Dutch rabbits. The animals were randomly divided into 2 equal groups. In one group, the defect on the right side was treated by fibrin glue associated with ADSCs and the defect on the other side remained as the control. In another group, the defect on the right side was treated with fibrin glue and on the left side with autologous bone graft. After 28 and 56 days, five rabbits from each group were evaluated by computed tomography (CT) and histopathological examinations. RESULTS Coronal CT showed a remarkable reconstruction of cortical bone in the fibrin glue associated with ADSCs group at 28 and 56 days post-surgery. Histopathologically, new cortical bony bridge formation was seen increasingly in the fibrin glue, fibrin glue associated with ADSCs, and autologous bone graft groups after 28 days. Statistical analysis of the thickness of new cortical bone in the treatment versus control groups showed a significant difference between fibrin glue alone and fibrin glue associated with ADSCs groups (P = 0.02). No significant difference was found between the fibrin glue associated with ADSCs and the autologous bone graft groups (P > 0.05). CONCLUSIONS The healing process had a significant increase in the thickness of new cortical bone when fibrin glue scaffold associated with ADSCs was used.
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Affiliation(s)
- Davood Mehrabani
- Stem Cell and Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Barbad Zamiri
- Department of Craniomaxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Omidi
- Department of Oral and Maxillofacial Radiology and Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Natarajan DM, Rao K DB. Improving gingival zenith in a unilateral cleft patient using Platelet-Rich Fibrin (PRF). J Oral Biol Craniofac Res 2018; 8:182-187. [PMID: 30191105 DOI: 10.1016/j.jobcr.2017.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/25/2017] [Indexed: 11/27/2022] Open
Abstract
This case evaluated the short term outcome of alveolar ridge augmentation in a unilateral alveolar cleft patient. A 22 year old female patient reported with gaps in her front teeth in 2011. Clinical examination revealed a repaired unilateral cleft of the hard palate (on left side) with a missing 21 and 22. Diagnosis was class II Subdivision with crossbite in 13 region. A non-extraction plan with a quad helix appliance, proximal stripping of lower anteriors. Canine substitution of 23 to replace 22 and prosthetic rehabilitation to replace 21. An alveolar ridge augmentation procedure using PRF (Platelet-rich fibrin) extracted from patient blood using a plasma centrifuge system. The success of grafted bone were evaluated radiologically at 6 months, 12 months postoperatively.
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Affiliation(s)
- Dr Madhumitha Natarajan
- Associate Professor, Department of Orthodontics, Manipal College of Dental Sciences(MCODS), Manipal University, Manipal, Karnataka, India
| | - Dr Bharath Rao K
- Associate Professor, Department of Oral Biology, Faculty of Dentistry, Melaka Manipal Medical College(MMMC), Manipal University, Manipal, Karnataka, India
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18
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Meimandi-Parizi A, Oryan A, Gholipour H. Healing potential of nanohydroxyapatite, gelatin, and fibrin-platelet glue combination as tissue engineered scaffolds in radial bone defects of rats. Connect Tissue Res 2018; 59:332-344. [PMID: 29035127 DOI: 10.1080/03008207.2017.1387541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Different biomaterials have been used in orthopedic surgery. Evaluation of biomaterials for bone healing promotion has been a wide area of research of the orthopedic field. Sixty critical size defects of 5 mm long were bilaterally created in the radial diaphysis of 30 rats. The animals were randomly divided into six equal groups as empty defect, autograft, nanohydroxyapatite (nHA), Gelatin (Gel)-nHA, fibrin-platelet glue (FPG)-nHA, and Gel-FPG-nHA groups (n = 10 in each group). Radiographs of each forelimb were taken postoperatively on the 1st day and then at the 28th and 56th days post injury. After 56 days, the rats were euthanized and their harvested healing bone samples were evaluated by histopathology, scanning electron microscopy, and biomechanical testing. All the treated defects demonstrated significantly superior new bone formation, remodeling, and bone tissue volume. Moreover, the defects treated with FPG-nHA showed significantly higher ultimate load, yield load, and stiffness. The Gel-FPG-nHA moderately improved bone regeneration that was not close to the autograft in some parameters, whereas FPG-nHA significantly improved bone healing closely comparable with the autograft group in most parameters. In conclusion, although all the nHA-containing scaffolds had some beneficial effects on bone regeneration, the FPG-nHA scaffold was more effective in improving the structural and functional properties of the newly formed bone and was more osteoinductive than the Gel and was comparable to the autograft. Therefore, the FPG can be regarded as a promising option to be used in conjunction with mineral scaffolds for bone tissue engineering.
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Affiliation(s)
- Abdolhamid Meimandi-Parizi
- a Division of Surgery, Department of Clinical Sciences, School of Veterinary Medicine , Shiraz University , Shiraz , Iran
| | - Ahmad Oryan
- b Department of Pathology, School of Veterinary Medicine , Shiraz University , Shiraz , Iran
| | - Hojjat Gholipour
- a Division of Surgery, Department of Clinical Sciences, School of Veterinary Medicine , Shiraz University , Shiraz , Iran
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Sharipov OI, Kutin MA, Bayuklin AV, Imaev AA, Abdilatipov AA, Kurnosov AB, Fomichev DV, Mikhaylov NI, Kalinin PL. [The use of platelet gel for repair of a cerebrospinal fluid fistula of the skull base (a case report and literature review)]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2018. [PMID: 29543220 DOI: 10.17116/neiro201882186-92] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nasal liquorrhea is a serious problem in surgery of skull base tumors, which is associated with a high risk of purulent-septic complications. This paper presents a case of successful repair of a cerebrospinal fluid fistula with an autologous platelet gel in the postoperative period after removal of meningioma of the anterior cranial fossa base, which was accompanied by a purulent-inflammatory complication in the surgical wound area.
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Affiliation(s)
- O I Sharipov
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - M A Kutin
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - A V Bayuklin
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - A A Imaev
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - A A Abdilatipov
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - A B Kurnosov
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - D V Fomichev
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - N I Mikhaylov
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
| | - P L Kalinin
- Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
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20
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The effects of gelatin, fibrin-platelet glue and their combination on healing of the experimental critical bone defect in a rat model: radiological, histological, scanning ultrastructural and biomechanical evaluation. Cell Tissue Bank 2017; 19:341-356. [PMID: 29264693 DOI: 10.1007/s10561-017-9679-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 12/12/2017] [Indexed: 01/09/2023]
Abstract
Fibrin-platelet glue (FPG) is a blood derivative, in which platelets and fibrinogen are concentrated in a small plasma volume, by differential centrifugation and precipitation. It can form a three-dimensional and biocompatible fibrin scaffold with a myriad of growth factors and proteins that are released progressively to the local environment and contribute to the accelerated postoperative bone healing. Gelatin (Gel) is a derivative of collagen and can promote cell adhesion and proliferation due to its unique sequence of amino acids, so it is suitable for bone tissue applications. This study examined the effects of Gel, FPG and their combinations as bone scaffold on the healing of surgically created critical-size defects in rat radius. Fifty critical size defects of 5 mm long were bilaterally created in the radial diaphysis of 25 rats. The animals were randomly divided into five equal groups as empty defect, autograft, Gel, FPG and Gel-FPG groups (n = 10 in each group). Radiographs of each forelimb were taken postoperatively on the 1st day and then at the 28th and 56th days post injury to evaluate bone formation, union and remodeling of the defect. After 56 days, the rats were euthanized and their harvested healing bone samples were evaluated by histopathology, scanning electron microscopy (SEM) and biomechanical testing. The results of present study showed that the Gel alone did not significantly affect bone healing and regeneration; however, the Gel treated defects promoted healing more than those that were left untreated (negative control). Furthermore, the FPG-enhanced grafts provided a good scaffold containing numerous growth factors for proliferation of osteoinduction and was effective in improving the structural and functional properties of the newly formed bone more than that of the untreated and also the Gel treated groups. Incorporation of Gel into the FPG scaffold improved healing potential of the FPG scaffold; however, it was still inferior to the autograft (positive control). Although the Gel-FPG scaffolds had best effectiveness during bone regeneration, it still needs to be further enhanced by incorporation of the ceramic and osteoinductive biomaterials.
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Effects of low-level laser therapy and platelet concentrate on bone repair: Histological, histomorphometric, immunohistochemical, and radiographic study. J Craniomaxillofac Surg 2017; 45:1846-1853. [DOI: 10.1016/j.jcms.2017.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 07/03/2017] [Accepted: 08/10/2017] [Indexed: 11/21/2022] Open
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Mancini IA, Bolaños RAV, Brommer H, Castilho M, Ribeiro A, van Loon JP, Mensinga A, van Rijen MH, Malda J, van Weeren R. Fixation of Hydrogel Constructs for Cartilage Repair in the Equine Model: A Challenging Issue. Tissue Eng Part C Methods 2017; 23:804-814. [PMID: 28795641 PMCID: PMC7116030 DOI: 10.1089/ten.tec.2017.0200] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To report on the experiences with the use of commercial and autologous fibrin glue (AFG) and of an alternative method based on a 3D-printed polycaprolactone (PCL) anchor for the fixation of hydrogel-based scaffolds in an equine model for cartilage repair. METHODS In a first study, three different hydrogel-based materials were orthotopically implanted in nine horses for 1-4 weeks in 6 mm diameter full-thickness cartilage defects in the medial femoral trochlear ridge and fixated with commercially available fibrin glue (CFG). One defect was filled with CFG only as a control. In a second study, CFG and AFG were compared in an ectopic equine model. The third study compared the efficacy of AFG and a 3D-printed PCL-based osteal anchor for fixation of PCL-reinforced hydrogels in three horses for 2 weeks, with a 4-week follow-up to evaluate integration of bone with the PCL anchor. Short-term scaffold integration and cell infiltration were evaluated by microcomputed tomography and histology as outcome parameters. RESULTS The first study showed signs of subchondral bone resorption in all defects, including the controls filled with CFG only, with significant infiltration of neutrophils. Ectopically, CFG induced clear inflammation with strong neutrophil accumulation; AFG was less reactive, showing fibroblast infiltration only. In the third study the fixation potential for PCL-reinforced hydrogels of AFG was inferior to the PCL anchor. PCL reinforcement had disappeared from two defects and showed signs of dislodging in the remaining four. All six constructs fixated with the PCL anchor were still in place after 2 weeks. At 4 weeks, the PCL anchor showed good integration and signs of new bone formation. CONCLUSIONS The use of AFG should be preferred to xenogeneic products in the horse, but AFG is subject to individual variations and laborious to make. The PCL anchor provides the best fixation; however, this technique involves the whole osteochondral unit, which entails a different conceptual approach to cartilage repair.
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Affiliation(s)
- Irina A.D. Mancini
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Rafael A. Vindas Bolaños
- Cátedra de Cirugía de Especies Mayores, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Harold Brommer
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Miguel Castilho
- Division of Surgery, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Alexandro Ribeiro
- Division of Surgery, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johannes P.A.M. van Loon
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Anneloes Mensinga
- Division of Surgery, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mattie H.P. van Rijen
- Division of Surgery, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jos Malda
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- Division of Surgery, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - René van Weeren
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Dejyong K, Kaewamatawong T, Brikshavana P, Durongphongtorn S. Efficacy of bubaline fibrin glue on full-thickness pinch and punch skin grafting in a pig. J Biomater Appl 2017; 31:1215-1224. [PMID: 28181448 DOI: 10.1177/0885328217693126] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fibrin glue, which is formed from the action of thrombin (a serine protease) on fibrinogen, has been developed for use as an adhesive to increase the success of skin graft surgery. The objective of this study was to evaluate if bubaline fibrin glue would promote skin graft survival in pigs. The grafting was divided into two steps. First, granulation wound preparation was performed in a healthy swine by creating four full-skin depth wounds (3 × 12 cm2) at the dorsal part of the loin area on each side. Second, pinch and punch skin grafting, where eight skin discs (0.6 cm diameter) were regularly placed (0.6 cm distance apart) in the granulation tissue bed of each wound, was performed 5 days later. The bubaline fibrin glue was added prior to application of the 16 skin graft discs in two of the wounds, while no glue was added to the other 16 skin graft discs in the other two wounds. The number of surviving graft pieces and histological examination was evaluated after 3, 7, and 14 days post-operation and compared by pairing between the control and the bubaline fibrin glue groups. The number of grafts that remained at 3 and 7 days post-operation and the number of new microvessels at 3 days post-operation were significantly higher ( p < 0.05) in the bubaline fibrin glue group than in the control group. However, there was no significant difference in the number of fibroblasts, the intensity of scarring and the intensity of inflammation between the two groups, except for the significantly lower intensity of inflammation at 7 days post-operation in the bubaline fibrin glue group. In conclusion, bubaline fibrin glue has the advantage of decreasing the skin graft loss by approximately 31.3-37.5% compared with the control group and also promotes angiogenesis.
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Affiliation(s)
- Krittee Dejyong
- 1 Department of Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Theerayuth Kaewamatawong
- 2 Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Pasakorn Brikshavana
- 1 Department of Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Sumit Durongphongtorn
- 1 Department of Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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Silva LF, Curra C, Munerato MS, Deantoni CC, Matsumoto MA, Cardoso CL, Curi MM. Surgical management of bisphosphonate-related osteonecrosis of the jaws: literature review. Oral Maxillofac Surg 2015; 20:9-17. [PMID: 26659615 DOI: 10.1007/s10006-015-0538-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 12/01/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE Surgical management of bisphosphonate-related osteonecrosis of the jaws (BRONJ) has been performed in an attempt to increase healing rates of the affected cases. This literature review aimed to identify clinical studies of surgical management of bisphosphonate-related osteonecrosis of the jaws (BRONJ) in order to assess their surgical treatment modalities, outcome and the follow-up. METHODS A search in the PubMed (Medline) database using specific terms and/or phrases as "bisphosphonate-related osteonecrosis" or "jaw osteonecrosis", and "surgical treatment" or "surgical management" was conducted in order to identify clinical trials and cases of surgical treatment of BRONJ. The review search covered the time period from 2004 to 2014. All studies identified in the search were selected according to the inclusion criteria. Relevant information was recorded according to the following items: author, year, number of patients, BRONJ clinical stage, surgical treatment modality, clinical success, and follow-up. RESULTS The initial database search yielded 345 titles. After filtering, 67 abstracts were selected culminating in 67 full text articles. A variety of surgical approach was found in this review: debridement, sequestrectomy bone resection, and bone reconstruction. Adjunctive therapies included hyperbaric oxygen, laser therapy, growth factors, and ozone. CONCLUSION Although there are many indexed studies about BRONJ, well-documented reports concerning surgical therapeutically techniques are scarce, resulting from a lack of well-established protocols. Considerable differences were found regarding sample size, surgical treatment modalities and outcomes. Clinical studies with larger number of patients and longer follow-up are required to provide best information for each surgical treatment modality and its outcomes.
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Affiliation(s)
| | - Cláudia Curra
- Department of Oral and Maxillofacial Surgery, Universidade do Sagrado Coração, Rua Irmã Arminda 10-50, CEP: 17011-160, Bauru, São Paulo, Brazil
| | - Marcelo Salles Munerato
- Department of Oral and Maxillofacial Surgery, Universidade do Sagrado Coração, Rua Irmã Arminda 10-50, CEP: 17011-160, Bauru, São Paulo, Brazil.
| | - Carlos Cesar Deantoni
- Department of Oral and Maxillofacial Surgery, Universidade do Sagrado Coração, Rua Irmã Arminda 10-50, CEP: 17011-160, Bauru, São Paulo, Brazil
| | | | - Camila Lopes Cardoso
- Universidade do Sagrado Coração, Bauru, SP, Brazil.,Department of Stomatology, Hospital Santa Catarina, Sao Paulo, Brazil
| | - Marcos Martins Curi
- Universidade do Sagrado Coração, Bauru, SP, Brazil.,Department of Stomatology, Hospital Santa Catarina, Sao Paulo, Brazil
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25
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Wu X, Ren J, Wang G, Wang J, Wang F, Fan Y, Li Y, Han G, Zhou Y, Song X, Quan B, Yao M, Li J. Evaluating the use of fibrin glue for sealing low-output enterocutaneous fistulas: study protocol for a randomized controlled trial. Trials 2015; 16:445. [PMID: 26445823 PMCID: PMC4597766 DOI: 10.1186/s13063-015-0966-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/17/2015] [Indexed: 01/22/2023] Open
Abstract
Background The management of an enterocutaneous fistula poses a significant challenge to surgeons and is often associated with a costly hospital stay and long-term discomfort. The use of fibrin glue in the fistula tract has been shown to promote closure of low output enterocutaneous fistulas. Our previous nonrandomized study demonstrated that autologous platelet-rich fibrin glue treatment significantly decreased time to fistula closure and promoted closure rates. However, there are several limitations in the study, which may lead to bias in our conclusion. Thus, a multicenter, randomized, controlled clinical trial is required. Methods/Design The study is designed as a randomized, open-label, three-arm, multicenter study in nine Chinese academic hospitals for evaluating the efficacy and safety of fibrin glue for sealing low-output fistulas. An established number of 171 fistula patients will undergo prospective random assignment to autologous fibrin glue, commercial porcine fibrin sealants or drainage cessation (1:1:1). The primary endpoint is fistula closure time (defined as the interval between the day of enrollment and day of fistula closure) during the 14-day treatment period. Discussion To our knowledge, this is the first study to evaluate the safety and efficacy of both autologous and commercial fibrin glue sealing for patients with low-output volume fistulas. Trial registration NCT01828892. Registration date: April 2013. Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-0966-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiuwen Wu
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
| | - Jianan Ren
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
| | - Gefei Wang
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
| | - Jianzhong Wang
- Department of General Surgery, The 1st Affiliated Hospital of Gannan Medical College, Ganzhou, China.
| | - Feng Wang
- Department of General Surgery, The Affiliated Hospital of Neimenggu Medical University, Huhehaote, China.
| | - Yueping Fan
- Department of General Surgery, Chinese Medical University Aviation Hospital, Beijing, China.
| | - Yuanxin Li
- Department of General Surgery, The 309th Hospital of The Chinese People's Liberation Army, Beijing, China.
| | - Gang Han
- Department of Surgery, The Second Hospital of Jilin University, Changchun, China.
| | - Yanbing Zhou
- Department of General Surgery, Affiliated Hospital of Medical College Qingdao University, Qingdao, China.
| | - Xiaofei Song
- Department of General Surgery, Henan Province People's Hospital, Zhengzhou, China.
| | - Bin Quan
- Department of Gastrointestinal Surgery, Xuzhou Central Hospital, Xuzhou, China.
| | - Min Yao
- Department of Surgery, VA Medical Center, 830 Chalkstone Avenue, Providence, USA.
| | - Jieshou Li
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
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26
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Sonker A, Dubey A, Bhatnagar A, Chaudhary R. Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft. Asian J Transfus Sci 2015; 9:155-8. [PMID: 26420935 PMCID: PMC4562136 DOI: 10.4103/0973-6247.162712] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background and objectives: Platelets are a source of numerous growth factors which facilitate repair and healing. Thus platelet rich plasma has been increasingly used as a treatment modality in the field of reconstructive surgeries for wound healing. This preliminary study was carried out to explore whether platelet growth factors from platelet rich plasma could be used for enhancement of split thickness skin graft survival. Materials and Methods: Twenty patients (13 males and 7 females) requiring split thickness skin graft for various clinical reasons were enrolled in the study. Platelet rich plasma was collected by apheresis and frozen at −80° C. It was thawed at room temperature immediately before its intended application. PRP was applied only on one half of the wound, while another half served as control. Patient was followed for 6 weeks. The effect was assessed at first dressing in terms of graft uptake and subsequently as time taken for complete healing. Results: There was 100% uptake of the graft in the area where platelet rich plasma was applied. In the control area, there was complete graft loss in 4 cases, partial loss in 7 cases and complete uptake in 9 cases. Conclusion: This study demonstrated promising results on application of PRP to split thickness skin grafts. Further randomized studies with greater sample size may be undertaken to establish platelet rich plasma as a validated treatment modality.
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Affiliation(s)
- Atul Sonker
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anju Dubey
- Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ankur Bhatnagar
- Department of Plastic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Rajendra Chaudhary
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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27
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Wu TE, Chen CJ, Hu CC, Cheng CK. Easy-to-prepare autologous platelet-rich plasma in the treatment of refractory corneal ulcers. Taiwan J Ophthalmol 2014; 5:132-135. [PMID: 29018685 PMCID: PMC5602710 DOI: 10.1016/j.tjo.2014.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 09/16/2014] [Accepted: 09/19/2014] [Indexed: 11/17/2022] Open
Abstract
As platelets are rich in growth factors for tissue regeneration, autologous platelet-rich plasma (PRP) has been used to treat some refractory corneal defects. Although PRP is effective, the cost of its preparation is very high. This article presents three cases of refractory corneal ulcer under the prescription of autologous PRP. The autologous PRP used in these cases was easily prepared in the blood bank laboratory. In this paper, we collected three patients with refractory corneal ulcer who were unresponsive to conventional treatment. The patients presented with neurotrophic ulcer, exposure corneal ulcer, and limbal deciency with corneal ulcer after hepatitic keratitis. Although we easily prepared autologous PRP eye drops using simple laboratory centrifugation, this preparation still had a clinical effect on corneal defect. The mean intervention time was 24 ± 6.9 days. The case with exposure corneal ulcer had significant wound healing and the other two cases felt subjective symptom relief. There were some clinical improvements of refractory corneal ulcers in our three cases. We present the clinical results of three cases and report an easy procedure for the preparation of autologous PRP. Autologous PRP prepared simply in the laboratory, it may be an alternative option for treating refractory corneal ulcer.
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Affiliation(s)
- Tzu En Wu
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.,National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Chiung Ju Chen
- Department of Pathology and Laboratory Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chao-Chien Hu
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Cheng-Kuo Cheng
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
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28
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DurmuŞlar MC, Alpaslan C, Alpaslan G, Çakır M, Kahali R, Nematollahi Z. Clinical and radiographic evaluation of the efficacy of platelet-rich plasma combined with hydroxyapatite bone graft substitutes in the treatment of intra-bony defects in maxillofacial region. Acta Odontol Scand 2014; 72:948-53. [PMID: 25005628 DOI: 10.3109/00016357.2014.926023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the efficacy of platelet-rich plasma (PRP) clinically and radiographically when combined with bovine derived hydroxyapatite (HA) bone grafting materials and resorbable collagen membranes for the treatment of intra-bony defects frequently seen at the distal aspect of mandibular second molars following the surgical extraction of fully impacted mandibular wisdom teeth. STUDY DESIGN Eighteen patients were scheduled for post-operative visits at 1, 3 and 6 months post-operatively, probing depths were measured and digital panoramic radiographs were taken. RESULTS There were no significant differences on probing depths among two groups. Radiographic assessment also showed no significant difference among groups at 1st and 6th month intervals, while 3 months post-operatively the amount of radiographic density at the PRP side was significantly higher. CONCLUSION Combined use of PRP and bovine-derived HA graft materials for the treatment of intra-bony defects might be an appropriate approach when the main goal is providing earlier bone regeneration.
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Affiliation(s)
| | | | | | | | - Roozbeh Kahali
- Department of Oral and Maxillofacial Surgery, Buali Hospital, Azad University of Medical Sciences, Tehran, IR Iran
| | - Zahra Nematollahi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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29
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Kim YK, Yun PY, Oh JS, Kim SG. Prognosis of closure of large sinus membrane perforations using pedicled buccal fat pads and a resorbable collagen membrane: case series study. J Korean Assoc Oral Maxillofac Surg 2014; 40:188-94. [PMID: 25247149 PMCID: PMC4170659 DOI: 10.5125/jkaoms.2014.40.4.188] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 05/12/2014] [Accepted: 05/22/2014] [Indexed: 11/07/2022] Open
Abstract
For large membrane perforations that develop during sinus-bone grafting, we performed repairs using a pedicled buccal fat pad and a resorbable collagen membrane simultaneously with the bone graft. This study included eight patients. Postoperative maxillary sinusitis developed in two patients, which we managed with incision and drainage, and antibiotics. Ultimately, six patients received 12 implants, three of which failed (75% success). Implant replacement was performed after the removal of the failed replacement, at which point the prosthetic treatment was considered complete. In all of the six cases that we were able to follow-up with, the sinus-bone graft was healing favorably. We observed that the sinus bone height decreased gradually with time. Based on these case series, we conclude that our procedure of repairing large sinus-membrane perforations with a pedicled buccal fat pad and a collagen membrane is a reliable technique.
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Affiliation(s)
- Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, Section of Dentistry, Seoul National University, Seongnam, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, Section of Dentistry, Seoul National University, Seongnam, Korea
| | - Ji-Su Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Su-Gwan Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
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30
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Sarkarat F, Kalantar Motamedi MH, Jahanbani J, Sepehri D, Kahali R, Nematollahi Z. Platelet-Rich Plasma in Treatment of Zoledronic Acid-Induced Bisphosphonate-related Osteonecrosis of the Jaws. Trauma Mon 2014; 19:e17196. [PMID: 25032151 PMCID: PMC4080617 DOI: 10.5812/traumamon.17196] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 01/27/2014] [Indexed: 11/30/2022] Open
Abstract
Background: Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a well-known challenging entity warranting management. Platelet-Rich Plasma (PRP) plays an important role in bone biology by enhancing bone repair and regeneration. Objectives: The aim of this animal study was to evaluate the effects of PRP on zoledronic acid-induced BRONJ. Materials and Methods: Seven rats were given 0.04 mg Zoledronic acid intravenously once a week for five weeks. Two weeks later, the animals underwent extraction of their first lower molars, bilaterally. After clinical confirmation of the osteonecrosis, PRP was injected randomly into one of the extraction sockets of each rat. Three weeks later, all rats were sacrificed in order to obtain histological sections. The analysis of epithelialization was performed by McNamar’s test, and the analysis of osteogenesis and angiogenesis was performed by the Wilcoxon Sign Rank test. P value was set at 0.05. Results: We found no significant differences between the two groups regarding the amount of epithelialization, angiogenesis or sequestrum formation (P > 0.05), but a significant difference was seen between the two groups regarding the amount of existing vital bone (P < 0.05). Conclusions: Our study demonstrates positive results (preservation or regeneration of bone) using PRP in treatment of BRONJ. Although PRP may enhance osseous regeneration, long-term follow-ups are required to confirm its benefits.
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Affiliation(s)
- Farzin Sarkarat
- Department of Oral and Maxillofacial Surgery, Buali Hospital, Azad University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Hosein Kalantar Motamedi
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Department of Maxillofacial Surgery, Azad University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Mohammad Hosein Kalantar Motamedi, Trauma Research Center, Office of the Editor, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel.: +98-9121937154, Fax: +98-2188053766, E-mail:
| | - Jahanfar Jahanbani
- Department of Oral and Maxillofacial Pathology, Dental Branch, Azad University of Medical Sciences, Tehran, IR Iran
| | | | - Roozbeh Kahali
- Department of Oral and Maxillofacial Surgery, Buali Hospital, Azad University of Medical Sciences, Tehran, IR Iran
| | - Zahra Nematollahi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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31
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Hillerup S, Elberg JJ, Thorn JJ, Andersen M. Reconstruction of irradiated mandible after segmental resection of osteoradionecrosis-a technique employing a microvascular latissimus dorsi flap and subsequent particulate iliac bone grafting. Craniomaxillofac Trauma Reconstr 2014; 7:190-6. [PMID: 25136407 DOI: 10.1055/s-0034-1371003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 05/27/2013] [Indexed: 10/25/2022] Open
Abstract
The fibula osteocutaneous flap has revolutionized the options of mandibular segmental defect bridging in osteoradionecrosis (ORN). In selected cases, however, the fibula flap is not an option because of atherosclerosis or other features that compromise the vascularity of the lower leg and foot. The aim of this study is to present an alternative method of mandibular segmental reconstruction employing a latissimus dorsi (LD) flap and subsequent particulate iliac free bone graft reconstruction. In 15 patients with ORN, a mandibular segmental defect was bridged with a reconstruction plate, and the defect site was primed with a LD musculocutaneous flap wrapped around the reconstruction plate to bring in vascularized tissue and optimize healing conditions for a subsequent particulate iliac free bone graft reconstruction. The management of defect closure was successful in all 15 patients. Twelve patients had a subsequent bone grafting from the posterior ileum for repair of defects up to 14 cm length. Three patients had no bone graft for various reasons. In three patients dental rehabilitation was achieved with implant supported prosthodontic appliances. Ten patients met the success criteria of uneventful graft healing with restitution of osseous continuity, mandibular height, symmetry and function, and avoidance of reconstruction plate fracture.
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Affiliation(s)
- Soren Hillerup
- Department of Oral and Maxillofacial Surgery, Rigshospitalet, University of Copenhagen
| | - Jens Jorgen Elberg
- Department of Plastic and Reconstructive Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens Jorgen Thorn
- Department of Oral and Maxillofacial Surgery, Hospital of South-West Denmark, Esbjerg, Denmark
| | - Mikael Andersen
- Department of Plastic and Reconstructive Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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32
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Jeong SM, Lee CU, Son JS, Oh JH, Fang Y, Choi BH. Simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material. J Craniomaxillofac Surg 2014; 42:990-4. [PMID: 24503388 DOI: 10.1016/j.jcms.2014.01.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 09/28/2013] [Accepted: 01/03/2014] [Indexed: 11/28/2022] Open
Abstract
Recently, several authors have shown that simultaneous sinus lift and implantation using autologous platelet-rich fibrin as the sole filling material is a reliable procedure promoting bone augmentation in the maxillary sinus. The aim of this study was to examine the effect of simultaneous sinus lift and implantation using platelet-rich fibrin as the sole grafting material on bone formation in a canine sinus model. An implant was placed after sinus membrane elevation in the maxillary sinus of six adult female mongrel dogs. The resulting space between the membrane and sinus floor was filled with autologous platelet-rich fibrin retrieved from each dog. The implants were left in place for six months. Bone tissue was seen at the lower part of the implants introduced into the sinus cavity. The height of the newly formed bone around the implants ranged from 0 mm to 4.9 mm (mean; 2.6 ± 2.0 mm) on the buccal side and from 0 mm to 4.2 mm (mean; 1.3 ± 1.8 mm) on the palatal side. The findings from this study suggest that simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material is not a predictable and reproducible procedure, especially with respect to the bone formation around the implants in the sinus cavity.
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Affiliation(s)
- Seung-Mi Jeong
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Chun-Ui Lee
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jeong-Seog Son
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Ji-Hyeon Oh
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Yiqin Fang
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Byung-Ho Choi
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea.
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33
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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 2013; 42:e47-50. [PMID: 23911120 DOI: 10.1016/j.jcms.2013.05.029] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 05/29/2013] [Accepted: 05/30/2013] [Indexed: 12/12/2022] Open
Abstract
Anorganic bovine bone (Bio-Oss®) particles are one of the most popular grafting materials. The particles are often mixed with platelet-rich fibrin (PRF) or a commercial fibrin (Tisseel®) to form a mouldable graft material. The objective of this study was to compare the potentials of PRF-mixed Bio-Oss® and Tisseel®-mixed Bio-Oss® to enhance bone regeneration in a canine sinus model. Six mongrel dogs were used in this study. After elevating the sinus membrane in both maxillary sinus cavities, an implant was placed into the sinus cavity. In one of the sinus cavities, the PRF/Bio-Oss® composite was grafted, and the Tisseel®/Bio-Oss® composite was grafted in the other sinus cavity. After a 6 month healing period, bone formation in the graft sites and bone-implant contact were evaluated. The mean osseointegration rate was 43.5 ± 12.4% and new bone formation rate 41.8 ± 5.9% in the PRF/Bio-Oss® composite sites. In the Tisseel®/Bio-Oss® composite sites they were 30.7 ± 7.9% and 31.3 ± 6.4%. There were statistically significant differences between the groups. The findings from this study suggest that when platelet-rich fibrin is used as an adjunct to Bio-Oss® particles for bone augmentation in the maxillary sinus, bone formation in the graft sites is significantly greater than when Tisseel® is used.
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Affiliation(s)
- Feng Xuan
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Chun-Ui Lee
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jeong-Seog Son
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Seung-Mi Jeong
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Byung-Ho Choi
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea.
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34
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Sano H, Ichioka S, Minamimura A, Tanaka R, Ikebuchi K, Suzuki M. Preservation of the properties of elastic plasma protein plus platelet film for wound dressing. J Plast Surg Hand Surg 2013; 47:458-61. [PMID: 23848423 DOI: 10.3109/2000656x.2013.779582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Experimental results have previously been reported for a new biological dressing consisting of concentrated plasma proteins and platelet-rich plasma (PRP), which is named Platelet-Protein film (PPF). Based on the results of this experimental study, a clinical trial was begun to examine the usefulness of PPF. Although fresh autologous PPF is being used in the clinical trial, it is considered that the use of a preserved material prepared in advance would enable more convenient application. To verify the usefulness of preserved PPF, this preliminary study was conducted to examine the effects of fresh PPF, preserved PPF or blood clot, as control, applied to excisional skin defects in healing-impaired mice. The wound area and vascular density were analysed on day 9 after wound creation. Significant decrease of the wound size was observed in the preserved PPF and fresh PPF groups (4.2 (3.7), 2.2 (0.53)%) in comparison with that in the control group (38.5 (18.6)%, p < 0.05). Furthermore, a significant increase of the vascular density was also observed in the preserved PPF and fresh PPF groups (0.055 (0.021), 0.050 (0.019) mm(2)/mm(2)) as compared with that in the control group (0.016 (0.010) mm(2), p < 0.01). There was no significant difference in the effect on the wound size or vascular density between the preserved PPF and fresh PPF groups. The results showed that the properties of PPFs could be maintained for at least 1 week under appropriate storage conditions. The possibility of preservation of PPF for future use could be of practical advantage in actual clinical situations.
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Affiliation(s)
- Hitomi Sano
- Department of Plastic and Reconstructive Surgery, Saitama Medical University , Saitama , Japan
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35
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Kim HS, Kim NH, Kim J, Cha IH. Inducing re-epithelialization in skin wound through cultured oral mucosal keratinocytes. J Korean Assoc Oral Maxillofac Surg 2013; 39:63-70. [PMID: 24471020 PMCID: PMC3858151 DOI: 10.5125/jkaoms.2013.39.2.63] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 03/29/2013] [Accepted: 03/30/2013] [Indexed: 11/07/2022] Open
Abstract
Objectives The purpose of this study was to investigate the wound healing effect of primary cultured oral mucosal keratinocytes (OMKs) and to assess their roles in skin wounds. Materials and Methods OMK labeled with BromodeoxyUridine were scattered onto 1.5×1.5 cm skin defects of adult female nude mice (OMK group, n=15). For the control, culture media were placed on the wound (control group, n=15). Mice in both groups were sacrificed at three days (n=5), one week (n=5), and two weeks (n=5), and histomorphometric and immunoblot analyses with keratinocyte growth factor (KGF), interleukin (IL)-6, and IL-1α antibody were performed for the biopsied wound specimen. To verify the effect of the cytokine, rhIL-1α was applied instead of OMK transplantation, and the OMK and control groups were compared with regard to re-epithelialization. Results Histomorphometric analyses demonstrated faster re-epithelialization in the graft group than in the control group at the third day, first week, and second week. Newly forming epithelium showed maintenance of the histological character of the skin epithelium. The graft group showed superior expression of KGF, IL-6, and IL-1α protein, compared with the control group. Similar faster re-epithelialization was observed after treatment with rhIL-1α instead of OMK transplantation. Conclusion We successfully confirmed that the graft of primary cultured OMKs promoted regeneration of skin defects. The mechanism of accelerated wound healing by primary cultured OMKs was attributed to inducement of cytokine expression as required for re-epithelialization.
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Affiliation(s)
- Hyun Sil Kim
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea. ; Department of Oral Pathology, Yonsei University College of Dentistry, Seoul, Korea
| | - Nam Hee Kim
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Jin Kim
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea. ; Department of Oral Pathology, Yonsei University College of Dentistry, Seoul, Korea
| | - In Ho Cha
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea. ; Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
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Sano H, Ichioka S, Minamimura A, Tanaka R, Ikebuchi K, Suzuki M. Treatment of chronic ulcer with elastic plasma protein and platelet film for wound dressing. J Plast Surg Hand Surg 2013; 47:462-6. [PMID: 23586320 DOI: 10.3109/2000656x.2013.783485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Experimental results have previously been reported for a new biological dressing consisting of concentrated plasma proteins and platelet-rich plasma (PRP), which is named Platelet-Protein film (PPF). This study reports clinical experience using PPF produced from the patients' own blood by the original technique. Ten patients with chronic wounds underwent PPF treatment and evaluated the transcutaneous oxygen tension (TcPO2) and vascular density. Eight of the 10 patients received a split-thickness skin graft on induced granulation tissue and have remained free from complications for more than 12 months since treatment. The TcPO2 values significantly increased at 4 days after treatment (before 38.4 (14.1) mmHg, after 55 (19.9) mmHg, p < 0.01). The vascular density at the ulcer base increased at 14 days after treatment in all the cases. The results showed that PPF has the potential to enhance chronic wound healing.
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Affiliation(s)
- Hitomi Sano
- Department of Plastic and Reconstructive Surgery, Saitama Medical University
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Burnouf T, Goubran HA, Chen TM, Ou KL, El-Ekiaby M, Radosevic M. Blood-derived biomaterials and platelet growth factors in regenerative medicine. Blood Rev 2013; 27:77-89. [DOI: 10.1016/j.blre.2013.02.001] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Trouillas M, Prat M, Doucet C, Ernou I, Laplace-Builhé C, Blancard PS, Holy X, Lataillade JJ. A new platelet cryoprecipitate glue promoting bone formation after ectopic mesenchymal stromal cell-loaded biomaterial implantation in nude mice. Stem Cell Res Ther 2013; 4:1. [PMID: 23290259 PMCID: PMC3706764 DOI: 10.1186/scrt149] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 12/20/2012] [Indexed: 01/07/2023] Open
Abstract
Introduction This study investigated the promising effect of a new Platelet Glue obtained from Cryoprecipitation of Apheresis Platelet products (PGCAP) used in combination with Mesenchymal Stromal Cells (MSC) loaded on ceramic biomaterials to provide novel strategies enhancing bone repair. Methods PGCAP growth factor content was analyzed by ELISA and compared to other platelet and plasma-derived products. MSC loaded on biomaterials (65% hydroxyapatite/35% beta-TCP or 100% beta-TCP) were embedded in PGCAP and grown in presence or not of osteogenic induction medium for 21 days. Biomaterials were then implanted subcutaneously in immunodeficient mice for 28 days. Effect of PGCAP on MSC was evaluated in vitro by proliferation and osteoblastic gene expression analysis and in vivo by histology and immunohistochemistry. Results We showed that PGCAP, compared to other platelet-derived products, allowed concentrating large amount of growth factors and cytokines which promoted MSC and osteoprogenitor proliferation. Next, we found that PGCAP improves the proliferation of MSC and osteogenic-induced MSC. Furthermore, we demonstrated that PGCAP up-regulates the mRNA expression of osteogenic markers (Collagen type I, Osteonectin, Osteopontin and Runx2). In vivo, type I collagen expressed in ectopic bone-like tissue was highly enhanced in biomaterials embedded in PGCAP in the absence of osteogenic pre-induction. Better results were obtained with 65% hydroxyapatite/35% beta-TCP biomaterials as compared to 100% beta-TCP. Conclusions We have demonstrated that PGCAP is able to enhance in vitro MSC proliferation, osteoblastic differentiation and in vivo bone formation in the absence of osteogenic pre-induction. This clinically adaptable platelet glue could be of interest for improving bone repair.
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Simon E, Merkx M, Kalyanyama B, Shubi F, Stoelinga P. Immediate reconstruction of the mandible after resection for aggressive odontogenic tumours: a cohort study. Int J Oral Maxillofac Surg 2013; 42:106-12. [DOI: 10.1016/j.ijom.2012.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Revised: 05/24/2012] [Accepted: 07/19/2012] [Indexed: 10/28/2022]
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Healing and expression of growth factors (TGF-β and PDGF) in canine radial ostectomy gap containing platelet-rich plasma. Vet Comp Orthop Traumatol 2012; 25:445-52. [PMID: 23111655 DOI: 10.3415/vcot-10-10-0146] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 06/11/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate bone healing in an experimental radial ostectomy in dogs treated with autologous platelet-rich plasma (PRP), through histological, densitometric, radiographic studies, as well as expression of growth factors in the ostectomy gap. METHODS Twenty-one dogs were randomly divided into either a control or a PRP group. All underwent unilateral ostectomy of the radius to generate a gap of 2.0 mm, that was stabilized with external skeletal fixation. The ostectomy gap was either filled with PRP or left empty as a control. The radiographic and densitometric studies were performed after surgery, then at intervals until 60 days during the post-surgery period. Histological and immunohistochemical evaluations were performed at seven or 60 days post-surgery. Analyses were performed using a statistical analysis system, and the level of significance was set at p <0.05. RESULTS The median radiographic healing score in the PRP group increased significantly between day 0 and day 60. Furthermore, at 60 days, the median healing score and the proportion of healed ostectomies in the control group (score 1; 1/6 healed) and the PRP group (score 5; 4/5 healed) were significantly different. There were differences between groups in radiographic and densitometric values at days 45 and 60. The histological evaluation showed advanced bone healing at 60 days in the PRP group and signs of delayed union in the control group. CLINICAL RELEVANCE Platelet-rich plasma can be used as an adjuvant therapy because it may promote better bone healing of a radial ostectomy treated with external skeletal fixation in dogs.
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Effect of preoperative subcutaneous platelet-rich plasma and fibrin glue application on skin flap survival. Aesthetic Plast Surg 2012; 36:1246-53. [PMID: 22890863 DOI: 10.1007/s00266-012-9954-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Accepted: 06/11/2012] [Indexed: 01/25/2023]
Abstract
BACKGROUND The aim of this study was to compare the effects of preoperative subcutaneous platelet-rich plasma and fibrin glue administration on skin flap survival. METHODS One week before surgery; saline, platelet-rich plasma, fibrin glue, and thrombin solutions were applied under rat skin flap areas in Groups I, II, III, and IV, respectively. Unipedicled epigastric flaps were elevated in the first three groups but could not be elevated in Group IV because of preoperative abdominal skin necrosis. Necrotic area measurements, microangiography, and histological and immunohistochemical evaluations were performed. RESULTS Platelet-rich plasma reduced the percentage of necrotic area when compared to other groups. Histologically and microangiographically an increased number of arterioles were observed in the platelet-rich plasma group. Thrombin (when used alone) caused abdominal skin necrosis. Increased expression of VEGF and PDGF was found in all platelet-rich plasma-treated flaps. There was no significant difference between groups with respect to TGF-β3 staining intensity. CONCLUSION In this study preoperative administration of platelet-rich plasma mimicked the pharmacological delay effect and enhanced flap survival. Individual use of thrombin was found to be unsuitable in flap surgery. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article.
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Magesh DPU, Kumaravelu C, Maheshwari GU. Efficacy of PRP in the Reconstruction of Mandibular Segmental Defects Using Iliac Bone Grafts. J Maxillofac Oral Surg 2012; 12:160-7. [PMID: 24431834 DOI: 10.1007/s12663-012-0418-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 06/12/2012] [Indexed: 11/26/2022] Open
Abstract
This retrospective study was conducted to evaluate the role of platelet-rich plasma (PRP) in the reconstruction of segmental mandibular defects using iliac bone grafts. Thirteen patients underwent reconstruction of post-resection segmental defects of the mandible using titanium reconstruction plates, cortico cancellous iliac bone graft. The patients were randomly separated into two groups. One group of the patients received a PRP graft in addition to the iliac bone graft. Post-operative dimensions of the graft were measured and compared to assess the efficacy of PRP in reconstruction of segmental defects. The post-operative follow-up radiographs confirmed consolidation of the graft in all cases and the segmental defect was obliterated. Thereby mandibular continuity was successfully achieved in all cases. Two patients in the non-PRP group developed an infection and were administered additional antibiotics. The infection was contained and the grafts survived. The use of PRP along with autogenous bone graft may be advantageous since it appeared to enhance the quantity of bone formed. Further long-term follow-up and studies are required to effectively establish the efficacy of PRP and autogenous free bone grafts in the reconstruction of bony defects.
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Affiliation(s)
- D P Uma Magesh
- Chennai Dental Centre, 4/579 Rajiv Gandhi Salai, Kotivakkam, Chennai, 600 041 India
| | - C Kumaravelu
- Chennai Dental Centre, 4/579 Rajiv Gandhi Salai, Kotivakkam, Chennai, 600 041 India
| | - G Uma Maheshwari
- Chennai Dental Centre, 4/579 Rajiv Gandhi Salai, Kotivakkam, Chennai, 600 041 India
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Biochemical, mechanical, and morphological properties of a completely autologous platelet-rich wound sealant. Blood Coagul Fibrinolysis 2012; 23:290-5. [PMID: 22395185 DOI: 10.1097/mbc.0b013e328351ad12] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The optimal composition of fibrin sealant preparations is not known. We, therefore, sought to construct a series of sealants from autologous components and compare their functioning to Bioseal a commonly used sealant. Characteristics of the platelet-rich plasma, cryoprecipitate, and thrombin were determined and compared to commercial glue from composition, function, and microscopy aspects. The concentrations of platelets as well as fibronectin in autologous fibrin glues were significantly higher than those in commercial ones (P < 0.001). Mechanical values (maximum amplitude and clot strength) obtained from thrombelastograph assays in two groups were not significantly different (P > 0.05). A dense platelet surface and fibrin net structures could be observed in the autologous samples, whereas there were only sparse fibrin nets without cellular components in Bioseal. Characterization of autologous and Bioseal fibrin sealants and their performance do not have significant difference in biochemical and mechanical properties. The entirely autologous platelet-rich gel in the present study may get wide application in future practice after confirmation of its safety, efficiency, and economic benefits.
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Korpi JT, Kainulainen VT, Sándor GK, Oikarinen KS. Long-term follow-up of severely resorbed mandibles reconstructed using tent pole technique without platelet-rich plasma. J Oral Maxillofac Surg 2012; 70:2543-8. [PMID: 22921752 DOI: 10.1016/j.joms.2012.07.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 06/14/2012] [Accepted: 07/15/2012] [Indexed: 12/18/2022]
Abstract
PURPOSE To investigate the results of edentulous patients with severely resorbed mandibles who were treated with a modified tent pole procedure. PATIENTS AND METHODS Twenty-two edentulous patients (3 men, 19 women; mean age, 62 yr; range, 51 to 72 yr) with a history of conservative prosthodontic treatment failures were included this study. Using a transcutaneous submental approach, 4 endosseous dental implants were placed in the anterior mandible of each patient and covered with autogenous bone grafts harvested from the posterior iliac crest without the addition of platelet-rich plasma. Follow-up ranged from 3 to 9 years. RESULTS The postoperative course of the patients was uneventful, without any surgical infections. At 3 months postoperatively, the density of the grafted bone appeared to closely resemble that of the surrounding alveolar bone on panoramic radiographs. The average alveolar augmentation was 6.3 mm (standard deviation, 1.59 mm; range, 4 to 10 mm) and long-term follow-up showed no bone resorption around the endosseous implants. CONCLUSIONS The modified tent pole technique without the addition of platelet-rich plasma is a safe and effective method to reconstruct the severely resorbed mandible.
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Affiliation(s)
- Jarkko T Korpi
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Oulu and Oulu University Hospital, Oulu, Finland
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Kurikchy MQ, Al-Rawi NH, Ayoub RS, Mohammed SS. Histological evaluation of bone healing using organic bovine bone in combination with platelet-rich plasma (an experimental study on rabbits). Clin Oral Investig 2012; 17:897-904. [PMID: 22619092 DOI: 10.1007/s00784-012-0751-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 05/03/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study was carried out to histologically assess the effect of bone grafting materials extracted from bovine origin on the bone healing process either alone or when mixed with autologous platelet-rich plasma which could be used in many procedures of oral and maxillofacial bone and implant reconstructive surgery. MATERIALS AND METHODS Sixteen rabbits were used; three intrabony defects in the femur bone of each rabbit were created, one left unfilled for normal healing process and served as control, the second filled with xenogenic graft (Gen-Ox-lyophilized bovine bone organic matrix), and the third filled with (Gen-Ox-lyophilized bovine bone organic matrix) mixed with autologous platelet-rich plasma. Histological examination of the sections was performed after staining with H&E and Van Geison stains. The histomorphometric analysis including counting of bone cells (osteoblasts, osteocytes, and osteoclasts) with performance of osteon diameter and lamellar thickness at the end of the fourth week postoperatively was obtained. RESULTS It has been shown that with the use of autologous platelet-rich plasma in combination with the xenogenic bone graft prepared from bovine origin, new bone formation and neovascularization were enhanced significantly when compared with xenogenic graft alone. CONCLUSION The addition of PRP to xenogenic bone substitute in small bone defects of the rabbit femur showed a histomorphometric increase in bone formation (at the fourth week of healing). CLINICAL RELEVANCE Platelet concentrate might be used to accelerate the osseointegration of enosseous dental implants.
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Ren J, Wu X, Hong Z, Li J. Management of a Patient with Colocutaneous Fistula by Autologous Platelet-rich Fibrin Glue. Am Surg 2012. [DOI: 10.1177/000313481207800215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Jianan Ren
- Department of Surgery Jinling Hospital Medical School of Nanjing University Nanjing, China
| | - Xiuwen Wu
- Department of Surgery Jinling Hospital Medical School of Nanjing University Nanjing, China
| | - Zhiwu Hong
- Department of Surgery Jinling Hospital Medical School of Nanjing University Nanjing, China
| | - Jieshou Li
- Department of Surgery Jinling Hospital Medical School of Nanjing University Nanjing, China
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Singh I, Gupta H, Pradhan R, Sinha VP, Gupta S. Role of platelet-rich plasma in combination with alloplastic bone substitute in regeneration of osseous defects. J Oral Biol Craniofac Res 2011; 1:17-23. [PMID: 25756013 PMCID: PMC3942012 DOI: 10.1016/s2212-4268(11)60006-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION Bone grafts are frequently used for the treatment of bone defects, but can cause postoperative complications, and sometimes a sufficient quantity of bone is not available. Hence, synthetic biomaterials have been used as an alternative to autogenous bone grafts. Recent clinical reports suggest that application of autologous blood plasma enriched with platelets can enhance the formation of new bone. There are very few in vitro or in vivo studies published on the efficiency of platelet-rich plasma (PRP). The objective of this study was to evaluate the alloplastic bone substitute for its osteogenic potential with or without PRP. MATERIALS AND METHODS Twenty-three patients with periapical bony defects were selected for this study. Clinical parameters such as pain visual analog scale (VAS), swelling, infection, graft migration, rejection, radiographical interpretations at regular interval and scintigraphic evaluation were done to evaluate osteogenic potential of alloplastic bone substitute with or without PRP. RESULTS The highest acceleration in bone formation was observed in groups where alloplastic bone substitute was used with PRP. There were no statistically significant differences between the two groups regarding other outcome variables throughout the postoperative period. CONCLUSION Addition of PRP significantly accelerates vascularization of the graft, improves soft tissue healing, reduces postoperative morbidity and enhances bone regeneration.
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Affiliation(s)
- Indrajeet Singh
- Resident, Department of Oral and Maxillofacial Surgery, BBD College of Dental Sciences, Lucknow, UP, India
| | - Hemant Gupta
- Professor, Department of Oral and Maxillofacial Surgery, BBD College of Dental Sciences, Lucknow, UP, India
| | - R Pradhan
- Professor, Department of Oral and Maxillofacial Surgery, BBD College of Dental Sciences, Lucknow, UP, India
| | - VP Sinha
- Professor, Department of Oral and Maxillofacial Surgery, BBD College of Dental Sciences, Lucknow, UP, India
| | - Sumit Gupta
- Reader, Department of Oral and Maxillofacial Surgery, BBD College of Dental Sciences, Lucknow, UP, India
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Jia X, Peters PG, Schon L. The Use of Platelet-Rich Plasma in the Management of Foot and Ankle Conditions. OPER TECHN SPORT MED 2011. [DOI: 10.1053/j.otsm.2011.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Eskan MA, Greenwell H. Theoretical and Clinical Considerations for Autologous Blood Preparations: Platelet-Rich Plasma, Fibrin Sealants, and Plasma-Rich Growth Factors. Clin Adv Periodontics 2011. [DOI: 10.1902/cap.2011.110034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Bisphosphonate-related osteonecrosis of the jaws--an initial case series report of treatment combining partial bone resection and autologous platelet-rich plasma. J Oral Maxillofac Surg 2011; 69:2465-72. [PMID: 21763050 DOI: 10.1016/j.joms.2011.02.078] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 02/09/2011] [Accepted: 02/13/2011] [Indexed: 11/22/2022]
Abstract
PURPOSE Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a well-recognized pathologic entity that is challenging and difficult to manage. Recent literature contains several articles, with most recommending conservative management. This report describes a treatment modality for advanced cases of BRONJ that involves bone resection and autologous platelet-rich plasma (PRP). PATIENTS AND METHODS This case series consisted of 25 patients with BRONJ lesions and a history of intravenous bisphosphonate therapy for metastatic bone diseases that did not respond to conservative treatment. All patients were surgically managed by a standardized protocol combining bone resection and PRP. RESULTS Of the 25 patients, 20 (80%) showed complete wound healing during follow-up. Median follow-up was 36 months. Microscopic examination showed actinomyces in 15 specimens. CONCLUSION BRONJ has been shown to be refractory to conservative management. Treatment of refractory BRONJ with a combination of bone resection and PRP was found to be an effective therapy in most patients and should be considered an alternative treatment modality for management of advanced cases.
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