title: Using growth factors in human extraction sockets: a histologic and histomorphometric evaluation of short-term healing.
abstract: OBJECTIVE
  Ridge preservation protocols reduce crestal remodeling after tooth extraction. There is insufficient evidence on bone grafting in combination with platelet-rich plasma (PRP) or recombinant human platelet-derived growth factor (rhPDGF-BB). The aim of this study is to evaluate healing of grafted and nongrafted sockets and the effect of PRP and rhPDGF-BB on early remodeling.
  
  
  METHODS
  Forty-one patients whose treatment plan included extraction of anterior or premolar teeth were randomized into four groups. Group 1: collagen plug (control). Group 2: mineralized freeze-dried bone allograft (FDBA)/β-tricalcium phosphate (β-TCP)/collagen plug. Group 3: FDBA/β-TCP/PRP/collagen plug. Group 4: FDBA/β-TCP/rhPDGF-BB/collagen plug. At 8 weeks, a core was harvested from the center of 41 sockets. Histomorphometric analysis took place. Differences were analyzed using one-way analysis of variance (ANOVA) or chi-square tests for continuous and categorical data. Pairwise comparisons were tested using least squares means. Spearman correlation coefficients were used to evaluate the relationship of bone growth with potential confounders. A P value < .05 was considered statistically significant.
  
  
  RESULTS
  ANOVA did not indicate statistical significance in age, gender, smoking, ethnicity, or race distribution. Significant differences in tissue distribution were identified between groups and between different thirds of harvested core. More new bone and amorphous organic matrix was noted in the control group. In sites where bone graft was combined with growth factors, the amount of residual particles was less than in sites where bone graft was used alone.
  
  
  CONCLUSIONS
  Inclusion of bone replacement graft suppressed new bone formation during early healing. Inclusion of PRP and rhPDGF-BB produced less residual bone graft material, indicating more rapid turnover of bone graft. All treatment modalities achieved a significant amount of new vital bone at 8 weeks postextraction.
authors.forename: Nico
authors.initials: N
authors.lastname: Geurs
authors.forename: Athanasios
authors.initials: A
authors.lastname: Ntounis
authors.forename: Philip
authors.initials: P
authors.lastname: Vassilopoulos
authors.forename: Ubele
authors.initials: U
authors.lastname: Van der Velden
authors.forename: Bruno G
authors.initials: BG
authors.lastname: Loos
authors.forename: Michael
authors.initials: M
authors.lastname: Reddy
mesh_terms: D016301:Alveolar Bone Loss / Q000517:prevention & control*; D000077214:Becaplermin; D016025:Bone Transplantation; D002130:Calcium Phosphates / Q000494:pharmacology; D003094:Collagen / Q000494:pharmacology; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D020574:Proto-Oncogene Proteins c-sis / Q000494:pharmacology*; D014081:Tooth Extraction; D020390:Tooth Socket / Q000187:drug effects / Q000378:metabolism* / Q000473:pathology; D014184:Transplantation, Homologous; D014945:Wound Healing / Q000187:drug effects
chemical_list: D002130:Calcium Phosphates; D036341:Intercellular Signaling Peptides and Proteins; D020574:Proto-Oncogene Proteins c-sis; C485817:beta-tricalcium phosphate; D000077214:Becaplermin; D003094:Collagen