Platelet-rich plasma and its effect in bone regeneration in mandibular fractures. Controlled clinical trial / Plasma rico en plaquetas y su efecto en la regeneración ósea en fracturas mandibulares. Ensayo clínico controlado

Background: Currently there is great interest in developing clinical applications of platelet-rich plasma to enhance bone repair. Aim: To assess bone regeneration in mandibular fractures, with the application of this adjuvant. Methods: Twenty patients with mandibular fractures were included in a randomized clinical trial. Patients of the experimental group (n = 10) were submitted to internal fracture reduction and administration of platelet-rich plasma, and patients of the control group (n = 10) were submitted to the same surgical procedure without plasma application. Radiologic assessment was made before and at 1 and 3 months after surgery. X-rays were digitalized for analyze intensity and density as reflection of bone regeneration. Results: The average age was 32 ± 11.3 years and 31.2 ± 8.48 years respectively (p = 0.76). The radiographic intensity and density in the experimental group at the 1st and 3rd month were higher in contrast to the control group (p < 0.005). Bone regeneration time was 3.7 ± 0.48 and 4.5 ± 0.52 weeks respectively (p = 0.002). There was no morbidity related to the application of the platelet-rich plasma. Conclusion: The platelet-rich plasma increased the bone intensity and density in the fracture trace allowing bone regeneration and recovery in shorter time than patients in which it was not used.

Antecedentes: Actualmente existe interés en el desarrollo de aplicaciones clínicas del plasma rico en plaquetas (PRP) para mejorar la regeneración ósea (RO). Objetivo: Evaluar la RO en fracturas mandibulares con la aplicación de PRP. Métodos: Ensayo clínico controlado. Se incluyeron 20 pacientes con fractura de ángulo mandibular. El grupo de estudio (n = 10) se sometió a reducción de la fractura, fijación interna y aplicación de PRP, y el grupo control (n = 10) al mismo procedimiento sin administración de plasma. Se evaluaron en el preoperatorio y al primer y tercer mes posterior a la reducción mediante digitalización radiográfica para evaluar la regeneración ósea. Resultados: El promedio de edad fue de 32 ± 11.3 y 31.2 ± 8.48 años, respectivamente (p = 0.76). La intensidad y la densidad radiográfica al mes y a los 3 meses fueron superiores en el grupo de estudio que en el grupo control (p< 0.005). El tiempo de regeneración fue de 3.7 ± 0.48 y 4.5 ± 0.52 semanas, respectivamente (p = 0.002). Conclusiones: El PRP aumentó la intensidad y la densidad ósea en el trazo de las fracturas, sugestivas de RO, y recuperación en menor tiempo, en contraste con el grupo control.

[The effect of selenium on free-radical oxidation processes in the bone regenerate after a fracture]. / Vliianie selena na protsessy svobodnoradikal'nogo okisleniia v regenerate kosti posle pereloma.

The paper presents the results of examining the central part of the rat mandible for a month after its fracture. The rate of free radical oxidation was estimated by the levels of diene conjugates (DC), malonic dialdehyde (MDA) and by the activity of selenium-containing glutathione peroxidase (GPO). The findings suggest that there are profound injury-induced changes in free radical oxidation and antioxidative defense. The levels of DC and MDA showed the maximum upward change as a double-peaked curve and longer restoration to the level seen in control animals. These rats had the minimum enhanced GPO activity. In the animals receiving intragastric selenium methionine or selenium electrophoresis applied to the site of mandible fracture, alterations in DC and MDA were less pronounced and GPO showed a higher activity.

[Immunological and biochemical indices during the use of hyperbaric oxygenation for treating patients with jaw deformities]. / Immunologicheskie i biokhimicheskie pokazateli pri ispol'zovanii giperbaricheskoi oksigenatsii dlia lecheniia bol'nykh s deformatsiiami cheliustei.

Analysis of changes in the immunologic and biochemical parameters in the patients operated on for congenital deformations of the maxillary bones and poorly joined fractures has shown an increase of the immunologic reactivity under the effect of hyperbaric oxygenation therapy administered after surgery to patients with initially reduced levels of these parameters. Urinary excretion of hydroxyproline was found unchanged in patients with maxillary deformations.

[The protein content and cathepsin D activity of the mandibular bone in rats during fracture healing]. / Soderzhanie belka i aktivnost' katepsina D v kosti nizhnei cheliusti krys pri zazhivlenii pereloma.

Soluble and total protein content and cathepsin D activity were measured in rat mandibular bone tissue during healing of a fracture treated with proteolytic enzymes (andecalin) or protease inhibitors (contrykal) electrophoresis. Contrykal essentially elevated collagen content in mandibular bone tissue and reduced lysosomal enzymes activity. Andecalin had no noticeable effect on the levels of total protein and collagen, but it significantly increased the activity of cathepsin D. The findings evidence that local contrykal electrophoresis in the focus of injury creates an effective concentration of the drug that enhances the fracture healing and prevents the development of pyoinflammatory complications.