Effect of rhPDGF-BB on bone turnover during periodontal repair.
OBJECTIVE
Growth factors such as platelet-derived growth factor (PDGF) exert potent effects on wound healing including the regeneration of periodontia. Pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP) is a well-known biomarker of bone turnover, and as such is a potential indicator of osseous metabolic activity. The objective of this study was to evaluate the release of the ICTP into the periodontal wound fluid (WF) following periodontal reconstructive surgery using local delivery of highly purified recombinant human PDGF (rhPDGF)-BB.


METHODS
Forty-seven human subjects at five treatment centres possessing chronic severe periodontal disease were monitored longitudinally for 24 weeks following PDGF regenerative surgical treatment. Severe periodontal osseous defects were divided into one of three groups and treated at the time of surgery with either: beta-tricalcium phosphate (TCP) osteoconductive scaffold alone (active control), beta-TCP+0.3 mg/ml of rhPDGF-BB, or beta-TCP+1.0 mg/ml of rhPDGF-BB. WF was harvested and analysed for local ICTP levels by radioimmunoassay. Statistical analysis was performed using analysis of variance and an area under the curve analysis (AUC).


RESULTS
The 0.3 and 1.0 mg/ml PDGF-BB treatment groups demonstrated increases in the amount of ICTP released locally for up to 6 weeks. There were statistically significant differences at the week 6 time point between beta-TCP carrier alone group versus 0.3 mg/ml PDGF-BB group (p<0.05) and between beta-TCP alone versus the 1.0 mg/ml PDGF-BB-treated lesions (p<0.03). The AUC analysis revealed no statistical differences amongst groups.


CONCLUSIONS
This study corroborates the release of ICTP as a measure of active bone turnover following local delivery of PDGF-BB to periodontal osseous defects. The amount of ICTP released from the WF revealed an early increase for all treatment groups. Data from this study suggests that when PDGF-BB is delivered to promote periodontal tissue engineering of tooth-supporting osseous defects, there is a direct effect on ICTP released from the wound.
Sarment
David P
DP
Department of Periodontics and Oral Medicine, Center for Craniofacial Regeneration, School of Dentistry, University of Michigan, Ann Arbor, MI 48106, USA.
Cooke
Jason W
JW
Miller
Sarah E
SE
Jin
Qiming
Q
McGuire
Michael K
MK
Kao
Richard T
RT
McClain
Pamela K
PK
McAllister
Bradley S
BS
Lynch
Samuel E
SE
Giannobile
William V
WV
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000601:surgery; D000077214:Becaplermin; D001861:Bone Regeneration / Q000187:drug effects*; D018786:Bone Substitutes / Q000627:therapeutic use; D002130:Calcium Phosphates / Q000627:therapeutic use; D024042:Collagen Type I / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000032:analysis; D010510:Periodontal Diseases / Q000601:surgery*; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use*; D020574:Proto-Oncogene Proteins c-sis; D011994:Recombinant Proteins; D012038:Regeneration / Q000187:drug effects; D014945:Wound Healing / Q000187:drug effects
D018786:Bone Substitutes; D002130:Calcium Phosphates; D024042:Collagen Type I; D010455:Peptides; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D011994:Recombinant Proteins; C485817:beta-tricalcium phosphate; C052929:collagen type I trimeric cross-linked peptide; D000077214:Becaplermin