Human recombinant tissue factor, platelet-rich plasma, and tetracycilne induce a high-quality human bone graft: a 5-year survey.
OBJECTIVE
To increase human bone graft regeneration and quality by the use of a mixture containing autologous ground calvarial bone, human recombinant tissue factor (rhTF), platelet-rich plasma (PRP), and tetracycline.


METHODS
Maxillary sinus floor augmentation was performed on 18 patients by grafting a "bone paste" made of PRP (1.8 x 10(6) platelets/mm3 plasma), about 1 microg rhTF, calvarial bone chips (2 to 5 mm in size), and tetracycline (10 to 30 microg/mL preparation). Five to 6 months after the surgical phase and grafting a bone core was extracted for implant fixation, and the osseous core samples were analyzed microscopically.


RESULTS
Histology revealed vascularized connective tissue rich in lamellar bone spicules containing osteocytes and surrounded by osteoblasts. The success rate of grafting was 90.3%. In 6-month postoperative blood samples, no residual coagulating disturbances could be found.


CONCLUSIONS
The combination of calvarial bone chips, rhTF, PRP, and tetracycline results in a paste that is easy to handle, safe for patients, and possesses high bone-regeneration capacity.


CONCLUSIONS
The generalized use in implant dentistry, oral surgery, and orthopedics of such a protocol could facilitate the healing process as well as patient safety and surgeon comfort.
Philippart
Pierre
P
Head, Oral and Maxillofacial Surgery Department, Bracops Public Hospital Iris South, Brussels, Belgium.
Brasseur
Michèle
M
Hoyaux
Daphne
D
Pochet
Roland
R
D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000187:drug effects; D016025:Bone Transplantation / Q000379:methods* / Q000473:pathology; D003238:Connective Tissue / Q000473:pathology; D003758:Dental Implantation, Endosseous; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010006:Osteoblasts / Q000473:pathology; D010011:Osteocytes / Q000473:pathology; D017713:Platelet Transfusion; D011994:Recombinant Proteins; D013752:Tetracycline / Q000627:therapeutic use*; D013925:Thromboplastin / Q000627:therapeutic use*; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D011994:Recombinant Proteins; D013925:Thromboplastin; D013752:Tetracycline