title: The efficacy of platelet-rich plasma in grafted maxillae. A randomised clinical trial.
abstract: OBJECTIVE
  The aim of this randomised, controlled, parallel-group clinical trial was to evaluate the clinical effect of platelet-rich plasma (PRP) on bone graft healing and implant integration in iliac crest grafted maxillae.
  
  
  METHODS
  Twenty-two consenting patients were randomised to PRP (13 patients) and control (9 patients) groups. Both groups received onlays and 16 patients had their maxillary sinus grafted with particulate bone (lateral window approach) with iliac crest bone grafts. Autologous platelet concentrates were prepared from the patients' blood and autologous thrombin was produced. PRP was mixed with the test group bone grafts. Outcome measures were implant integration, implant stability, soft tissue healing, graft resorption, and donor and recipient site complications. Implant stability measurements were recorded at placement and exposure using a resonance frequency analysis device. Patients were followed up to abutment connection. Multiple linear regression analyses using robust standard error were performed, taking the patient as the unit of measurement. The t test was also used where appropriate.
  
  
  RESULTS
  One bone graft failed in the PRP group and regrafting was required. No statistically significant differences were observed for soft tissue healing indices (P = 0.4) and mean graft resorption (P = 0.5) between groups. All implants were found clinically integrated at time of exposure. No statistically significant differences in implant stability were observed between groups at implant placement (P = 0.059) and exposure (P = 0.1). Using a post-hoc analysis, posterior implants in the PRP group showed statistically significantly higher stability values (61 ± 2.6) than anterior implants (60 ± 2.4) at implant placement (mean difference -0.95, P = 0.04). However, this difference was not clinically significant.
  
  
  CONCLUSIONS
  No appreciable clinical effect could be observed when using PRP with autologous iliac crest bone graft in the maxilla.
authors.affiliation: Oral and Maxillofacial Surgery, School of Dentistry, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. medodont@hotmail.com
authors.forename: Mohamed
authors.initials: M
authors.lastname: Badr
authors.forename: Paul
authors.initials: P
authors.lastname: Coulthard
authors.forename: Rami
authors.initials: R
authors.lastname: Alissa
authors.forename: Richard
authors.initials: R
authors.lastname: Oliver
mesh_terms: D000328:Adult; D000539:Alveolar Process / Q000473:pathology; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods* / Q000473:pathology; D000044:Dental Abutments; D015921:Dental Implants; D017268:Dental Prosthesis Retention; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D006085:Graft Survival; D006801:Humans; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008443:Maxillary Sinus / Q000601:surgery; D016348:Osseointegration / Q000502:physiology; D053657:Platelet-Rich Plasma; D011183:Postoperative Complications; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D015921:Dental Implants