Is platelet-rich plasma the perfect enhancement factor? A current review.
Guided bone regeneration is an accepted surgical method employed in implant dentistry to increase the quantity and quality of the host bone in areas of localized alveolar defects. The lack of predictability in osseous regenerative procedures with various grafting materials suggests that improvement in the osteoinductive properties of these materials is highly desirable. Platelet-rich plasma (PRP), a modification of fibrin glue made from autologous blood, is being used to deliver growth factors in high concentration to sites requiring osseous grafting. Growth factors released from the platelets include platelet-derived growth factor, transforming growth factor beta, platelet-derived epidermal growth factor, platelet-derived angiogenesis factor, insulin-like growth factor 1, and platelet factor 4. These factors signal the local mesenchymal and epithelial cells to migrate, divide, and increase collagen and matrix synthesis. PRP has been suggested for use to increase the rate of bone deposition and quality of bone regeneration when augmenting sites prior to or in conjunction with dental implant placement Only 6 human studies using PRP have been found in the dental implant literature and 5 were case series or reports. Thus, there is clearly a lack of scientific evidence to support the use of PRP in combination with bone grafts during augmentation procedures. This novel and potentially promising technique requires well-designed, controlled studies to provide evidence of efficacy.
Sánchez
Andrés R
AR
Section of Periodontics, Department of Dental Specialties, Mayo Clinic, Rochester, Minnesota 55905, USA. sanchez.andres@mayo.edu
Sheridan
Phillip J
PJ
Kupp
Leo I
LI
D000540:Alveolar Ridge Augmentation; D043925:Angiogenesis Inducing Agents / Q000627:therapeutic use; D001792:Blood Platelets / Q000502:physiology*; D001861:Bone Regeneration / Q000187:drug effects / Q000502:physiology*; D016025:Bone Transplantation / Q000379:methods; D002455:Cell Division / Q000187:drug effects; D002465:Cell Movement / Q000187:drug effects; D002469:Cell Separation; D003758:Dental Implantation, Endosseous; D004815:Epidermal Growth Factor / Q000627:therapeutic use; D004847:Epithelial Cells / Q000187:drug effects; D006133:Growth Substances / Q000627:therapeutic use*; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000627:therapeutic use; D010978:Platelet Factor 4 / Q000627:therapeutic use; D017713:Platelet Transfusion; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use; D010983:Plateletpheresis; D012307:Risk Factors; D016212:Transforming Growth Factor beta / Q000627:therapeutic use; D014945:Wound Healing / Q000187:drug effects
D043925:Angiogenesis Inducing Agents; D006133:Growth Substances; D010982:Platelet-Derived Growth Factor; D016212:Transforming Growth Factor beta; D010978:Platelet Factor 4; D004815:Epidermal Growth Factor; D007334:Insulin-Like Growth Factor I