Autologous Platelet Rich Plasma (PRP)
Stephen L. Wheeler, D.D.S.
320 Santa Fe Drive, Suite #304 Encinitas, Calif. 92024
(760) 942-1333
Steve@Wheelerdds.com
Purpose: Autologous Platelet Rich Plasma (PRP) has the features of a non-toxic, non-immune reactive accelerator of existing wound healing pathways. Specific studies with PRP have identified several factors which can initiate bone regeneration and sustain long term healing and bone formation. Unfortunately there are few quantification studies to validate this premise. A prospective study was started in the summer of 1998 using PRP along with a xenograph (Bio-Oss®) and/or particulate autogenous bone harvested from the iliac crest in sinus lift cases prior to implant placement. The purpose of this study was to see if histomorphometric analysis would evidence a larger volume of bone formation in those grafts using PRP, and if there were differences in the effects of PRP when an alloplast was used instead of autogenous bone.
Methods: Fifteen healthy patients were selected for the study who had between 3-5mm of residual crestal bone in the posterior maxilla and required sinus grafting to place implants of adequate length. Both unilateral and bilateral cases were accepted. Bilateral cases would be used to compare a graft on one side with PRP and on the other side without. Cores were harvested after six months of healing and compared on bilateral cases and with previous sinus graft cases without PRP using histomorphometric analysis.
Results: Histomorphometric results showed an average of 17.3% vital bone formation in grafts using Bio-Oss alone (3 cores, 15-21% range), 32.25% average vital bone formation when adding PRP to the xenograft (12 cores, 13-54% range), and 37% average vital bone formation when PRP was added to particulate bone harvested from the iliac crest (5 cores, 10-52% range). In one case, bilateral sinus grafts were done using BioOss alone on one side and BioOss with PRP on the opposite side. Results showed a 41% increase in bone formation on the side where PRP was added (21% vs. 36%). Interestingly, the ranges of bone volumes were very similar between both the BioOss and PRP and autogenous bone and PRP (13-54% and 10-52%) with final averages only 15% apart. Thirty-six implants were placed in these grafts and have now been followed for up to three years with no failures
320 Santa Fe Drive, Suite #304 Encinitas, Calif. 92024
(760) 942-1333
Steve@Wheelerdds.com
Purpose: Autologous Platelet Rich Plasma (PRP) has the features of a non-toxic, non-immune reactive accelerator of existing wound healing pathways. Specific studies with PRP have identified several factors which can initiate bone regeneration and sustain long term healing and bone formation. Unfortunately there are few quantification studies to validate this premise. A prospective study was started in the summer of 1998 using PRP along with a xenograph (Bio-Oss®) and/or particulate autogenous bone harvested from the iliac crest in sinus lift cases prior to implant placement. The purpose of this study was to see if histomorphometric analysis would evidence a larger volume of bone formation in those grafts using PRP, and if there were differences in the effects of PRP when an alloplast was used instead of autogenous bone.
Methods: Fifteen healthy patients were selected for the study who had between 3-5mm of residual crestal bone in the posterior maxilla and required sinus grafting to place implants of adequate length. Both unilateral and bilateral cases were accepted. Bilateral cases would be used to compare a graft on one side with PRP and on the other side without. Cores were harvested after six months of healing and compared on bilateral cases and with previous sinus graft cases without PRP using histomorphometric analysis.
Results: Histomorphometric results showed an average of 17.3% vital bone formation in grafts using Bio-Oss alone (3 cores, 15-21% range), 32.25% average vital bone formation when adding PRP to the xenograft (12 cores, 13-54% range), and 37% average vital bone formation when PRP was added to particulate bone harvested from the iliac crest (5 cores, 10-52% range). In one case, bilateral sinus grafts were done using BioOss alone on one side and BioOss with PRP on the opposite side. Results showed a 41% increase in bone formation on the side where PRP was added (21% vs. 36%). Interestingly, the ranges of bone volumes were very similar between both the BioOss and PRP and autogenous bone and PRP (13-54% and 10-52%) with final averages only 15% apart. Thirty-six implants were placed in these grafts and have now been followed for up to three years with no failures
posted by Ajou Huang | 8:57 PM
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