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The International Journal of Oral & Maxillofacial Implants



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Int J Oral Maxillofac Implants 23 (2008), No. 5     15. Sep. 2008
Int J Oral Maxillofac Implants 23 (2008), No. 5  (15.09.2008)

Page 818-826, PubMed:19014150

Improved Bone Healing by Angiogenic Factor-Enriched Platelet-Rich Plasma and Its Synergistic Enhancement by Bone Morphogenetic Protein-2
Park, Eun-Jin / Kim, Eun-Seok / Weber, Hans-Peter / Wright, Robert F. / Mooney, David J.
Purpose: The purpose of this study was to modify the method of platelet-rich plasma (PRP) preparation for obtaining optimal angiogenic potential and accelerate bone healing. Also, the potential synergistic effect of a suboptimal concentration of bone morphogenic protein-2 (BMP-2) and modified PRP (mPRP) on bone healing was evaluated in vivo.
Materials and Methods: The angiogenic factor-enriched PRP, which included peripheral blood mononuclear cells (mostly lymphocytes and monocytes, excluding polymorphonuclear leukocytes [PMNs], was achieved by lowering concentrations of thrombin and CaCl2, after pre-activation with shear stress using a table-top vortex machine and collagen. In vitro, endothelial cell migration activity in the mPRP group was compared to conventional PRP preparation using a modified Boyden chamber assay. In an animal study, PGA scaffold, PGA scaffold + mPRP, PGA scaffold + mPRP + rhBMP-2, and PGA scaffold + rhBMP-2 were applied to critical-sized calvarial defects in 28 nude rats. At 2 weeks, periosteal blood flow was measured using laser Doppler perfusion imaging, and bone formation was evaluated at 8 weeks by histology, dual energy x-ray absorptiometry, and micro-computed tomography.
Results: mPRP induced faster migration of cord blood-derived outgrowth endothelial-like cells. In vivo, the group with mPRP with a low dose of rhBMP-2 showed significantly increased numbers of blood vessels at 2 weeks and notable synergistic effect on bone healing at 8 weeks as evaluated with histology, bone mineral density and bone mineral content, and µCT.
Conclusion: The mPRP used in this study improved vascular perfusion around the defect and resulted in enhanced bone healing. Also, combining mPRP with a suboptimal dosage of rhBMP-2 improved bone formation and enhanced bone density.

Keywords: angiogenic potential, athymic rat, calvarial defect, rhBMP-2