Polycaprolactone-20% tricalcium phosphate scaffolds in combination with platelet-rich plasma for the treatment of critical-sized defects of the mandible: a pilot study.
OBJECTIVE
Our group has recently fabricated 3-dimensional scaffolds of unique architecture to mediate favorable cell binding, proliferation, and differentiation. In this study, the osteoconductive and bioactive polycaprolactone-20% tricalcium phosphate (PCL-TCP) scaffolds were assessed for the treatment of critical-sized defects of the mandible, with respect to new bone formation. Platelet-rich plasma (PRP) was combined with some scaffolds to test if bone regeneration could be enhanced.


METHODS
Autologous PRP was prepared from whole blood collected from 8 mongrel dogs. In each dog, 3 defects (18 x 10 x 7 mm) were created at either the left or right mandible and treated with 1 of 2 treatment modalities: 1) grafting with scaffolds alone; or 2) grafting with scaffolds loaded with PRP. The scaffolds were stabilized using 2 dental implants each to prevent rotation. Micro-CT and histologic analysis were carried out on samples after 6 and 9 months.


RESULTS
Micro-CT measurements showed that PRP-treated defects had 98.3% and 58.3% more bone volume fraction than defects grafted with scaffolds alone at 6 and 9 months, respectively (P < .05). No significant difference was noted between caudal and frontal situated PRP-treated defects, but a significant difference was observed between male and female dogs. Histologic analyses verified the deposition of osteoid and new bone trabeculae throughout the section at 6 months. The defect margins were filled with mature bone trabeculae at 9 months but the middle section of the scaffolds manifested disturbed mineralization. The scaffolds experienced 33% degradation from 6 to 9 months. PRP treatment had negligible effect on the degradation of the scaffolds.


CONCLUSIONS
The pilot study showed that the treatment of critical-sized defects of the mandible with PCL-TCP scaffolds may be augmented by the addition of PRP.
Rai
Bina
B
Department of Oral and Maxillofacial Surgery, National University of Singapore, Singapore.
Ho
Kee Hai
KH
Lei
Yang
Y
Si-Hoe
Kuan-Ming
KM
Jeremy Teo
Choon-Mengjeremy
CM
Yacob
Kamal Bin
KB
Chen
Fulin
F
Ng
Fooi-Chin
FC
Teoh
Swee Hin
SH
D020341:Absorbable Implants; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D015519:Bone Density / Q000502:physiology; D001857:Bone Matrix / Q000473:pathology / Q000503:physiopathology; D001861:Bone Regeneration / Q000502:physiology; D002113:Calcification, Physiologic / Q000502:physiology; D002130:Calcium Phosphates / Q000627:therapeutic use*; D015921:Dental Implants; D004285:Dogs; D005260:Female; D008297:Male; D008334:Mandible / Q000473:pathology / Q000503:physiopathology; D008336:Mandibular Diseases / Q000473:pathology / Q000601:surgery*; D010012:Osteogenesis / Q000502:physiology; D010865:Pilot Projects; D053657:Platelet-Rich Plasma; D011091:Polyesters / Q000627:therapeutic use*; D012737:Sex Factors; D013997:Time Factors; D054457:Tissue Scaffolds; D014057:Tomography, X-Ray Computed / Q000379:methods
D001672:Biocompatible Materials; D002130:Calcium Phosphates; D015921:Dental Implants; D011091:Polyesters; C016240:polycaprolactone; C018392:tricalcium phosphate