RESUMO
OBJECTIVE: We evaluated the effectiveness of platelet-rich plasma (PRP) on the regeneration of autogenous cancellous bone and marrow grafted in the alveolar cleft. DESIGN: Twenty patients with alveolar clefts were examined; 6 were the control group and received cancellous bone and marrow grafts without PRP, while the remaining 14 comprised the PRP group and received grafts with PRP. Prior to surgery, 50 ml of blood was withdrawn and 5 ml of PRP gel produced through centrifugal separation. The bone graft mixed with PRP was then packed into the alveolar cleft. Postoperative bone density was assessed as the aluminium-equivalent value on occlusal X-ray films in a qualitative analysis. Quantitative evaluation of regenerated bone was made with computed tomography and panoramic radiographs at 1 month, 6 months and 1 year after surgery. RESULTS: Satisfactory bone bridging formation was observed in all patients without any complications. The bone density of the PRP group was lower than that of the control group at 1 week, but the same after 1 month. The added PRP reduced the resorption of regenerated bone postoperatively. CONCLUSION: Autogenous cancellous bone grafting with PRP, which significantly reduces postoperative bone resorption, is a reliable technique for alveolar bone grafting of cleft patients.
Assuntos
Perda do Osso Alveolar/prevenção & controle , Processo Alveolar/anormalidades , Alveoloplastia/métodos , Regeneração Óssea , Transplante Ósseo , Fissura Palatina/complicações , Plasma Rico em Plaquetas , Adolescente , Adulto , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Processo Alveolar/cirurgia , Alveoloplastia/efeitos adversos , Regeneração Óssea/efeitos dos fármacos , Transplante Ósseo/métodos , Criança , Fissura Palatina/cirurgia , Feminino , Humanos , Masculino , Fator de Crescimento Derivado de Plaquetas/farmacologia , Radiografia Panorâmica , Método Simples-Cego , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
PURPOSE: Atrophy of the alveolar ridge is a problem in prosthetic and esthetic treatment. In the present study, to examine effects of PGE1 on the alveolar bone after tooth extraction, PGE1 was applied to rat incisal sockets utilizing a slow drug release system using PLGA as the drug carrier. MATERIALS AND METHODS: Thirty-six male Wistar rats, 10 weeks old, were divided into 3 groups. After all right mandibular incisors were extracted, the sockets were treated in the following manner. The first group was untreated (control group), the second group received a PLGA rod (PLGA group), and the third group was treated with a PLGA rod containing 0.5 mg PGE1 (PGE1 group). Six rats in each group were sacrificed at 4 weeks, and the remaining rats were sacrificed at 8 weeks. For fluorescence labeling, half of the animals were injected with calcein and tetracycline 8 days and 1 day before sacrifice, respectively. After sacrifice, the mandibles were radiologically and histologically examined. RESULTS: In the PGE1 group, the bone volume of the alveolar ridge including the socket was significantly (P < .05) greater than in the control and PLGA groups at 4 and 8 weeks. At 4 weeks in the PGE1 group, the mineral apposition rate and number of osteoclasts were higher than in the other groups, whereas these parameters were similar in all groups at 8 weeks. CONCLUSION: Based on this animal study, it appears that local application has the potential to preserve and/or augment the alveolar ridge after tooth extraction.