Bonus™: DBM with PRP

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Brodke D, Pedrozo HA, Kapur TA, Attawia M, Kraus KH, Holy CE et al. Bone grafts prepared with selective cell retention technology heal canine segmental defects as effectively as autograft. J Orthop Res 2006 May;24(5):857-66.

Summary: A study was done on dogs to determine the efficacy of bone grafting using demineralized bone and cancellous chips (DBM-CC) combined with osteoprogenitor cells obtained by selective cell retention (SCR) technology, and to assess the value of using plateletrich plasma (PRP) to clot the SCR-enriched grafts. The authors determined that SCR-enriched DBM-CC repaired critical-sized bone defects as well as autograft and that PRP may have helped to enhance bone maturation.

Quotation: "However, histological observations also revealed a more mature bone formation in the PRP clotted grafts as compared to the autograft group, which was similar to the marrowclotted SCR-enriched group. While not statistically significant, this result highlighted a potentially favorable effect of PRP on bone healing and is consistent with some of the previously published data that indicated trends of accelerated bone formation in PRP-grafted bone sites."

PubMed ID:1660211


Boyan BD, Ranly DM, Schwartz Z. Use of growth factors to modify osteoinductivity of demineralized bone allografts: lessons for tissue engineering of bone. Dent Clin North Am 2006 April;50(2):217-28, viii.

Abstract: “Biologically active bone graft substitute materials are needed for repair and regeneration of skeletal tissues. Current approaches are focused on the use of osteoinductive agents, including bone morphogenetic proteins (BMP) in combination with biodegradable carriers. Demineralized freeze-dried bone allograft (DFDBA) can provide an osteoconductive surface and, at the same time, function as a time-release carrier for BMP. Donor variability, however, limits the predictability of DFDBA as an osteoinductive material. This article examines the use of growth factors, including platelet-rich plasma, platelet-derived growth factor, enamel matrix derivatives, and BMP-2, to enhance the osteoinductive properties of human DFDBA.

PubMed ID: 16530059


Ascencio D, Hernandez-Pando R, Barrios J, Soriano RE, Perez-Guille B, Villegas F, Sanz CR, Lopez-Corella E, Carrasco D, Frenk S. Experimental induction of heterotopic bone in abdominal implants. Wound Repair Regen 2004 Nov-Dec;12(6):643-9.

Summary: This study evaluates the abilities of various implants to induce heterotopic bone formation in the abdomens of dogs. Several different types of implants were used, including a type I collagen sponge embedded with demineralized bone powder, platelet-rich plasma, thrombin, and calcium chloride wrapped with omentum. The authors concluded that many of the implants could be used to generate bone tissue.

Quotation: “These approaches are novel and efficient surgical procedures to produce mature trabecular bone that could be used as a potential source of bone tissue for autotransplantation.”

PubMed ID: 15555056


Kim SG, Kim WK, Park JC, Kim HJ. A comparative study of osseointegration of Avana implants in a demineralized freeze-dried bone alone or with platelet-rich plasma. J Oral Maxillofac Surg 2002 September;60(9):1018-25.

Summary: The authors evaluated the use of demineralized bone powder (DBP) with and without platelet-rich plasma (PRP) to improve the osseointegration of dental implants in dogs. The authors concluded that DBP could be used successfully with titanium implants and that PRP may help to enhance bone formation.

Quotation: “These results suggested that bone defects around titanium implants can be treated successfully with DBP and that PRP may improve bone formation.”

PubMed ID: 12215987


de Obarrio JJ, Rauz-Dutari JI, Chamberlain TM, Croston A. The use of autologous growth factors in periodontal surgical therapy: platelet gel biotechnology--case reports. Int J Periodontics Restorative Dent 2000 October;20(5):486-97.

Summary: Platelet gel was combined with demineralized freeze-dried bone allograft to treat periodontal osseous defects. The authors noted a significant reduction in probing depth as well as significant amounts of new bone as early as 2 months postoperative.

Quotation: “After periodontal surgical therapy was performed using PGBT [platelet gel biotechnology], there was a significant reduction in probing depth, and new bone formation was evident and confirmed by periapical radiographs and surgical reentries. Our clinical impression is that this new biotechnology significantly enhances periodontal wound healing.”

PubMed ID:11203586


Howes R, Bowness JM, Grotendorst GR, Martin GR, Reddi AH. Platelet-derived growth factor enhances demineralized bone matrix-induced cartilage and bone formation. Calcif Tissue Int 1988 January;42(1):34-8.

Summary: Several growth factors, including platelet-derived growth factor (PDGF), epithelial growth factor (EGF), and fibroblast growth factor (FGF), were combined with demineralized bone matrix (DBM) to help grow cartilage and bone in rats. It was found that DBM supplemented with PDGF could help to induce bone formation in mature rats.

Quotation: “Our results indicated that supplements of PDGF had little or no effect on the formation of cartilage and bone when bone matrix was implanted into young rats, indicating that repair may be maximal. However, PDGF increased cartilage and bone formation in the implants placed in mature rats where these processes were half that observed in the young animals.”

PubMed ID: 3129165


Ilgenli T, Dundar N, Kal BI. Demineralized freeze-dried bone allograft and platelet-rich plasma vs. platelet-rich plasma alone in infrabony defects: a clinical and radiographic evaluation. Clin Oral Invest 2007 March;11(1):51-59.

Summary: Twenty-eight periodontal infrabony defects in 22 patients were treated with either platelet-rich plasma (PRP) and demineralized freeze-dried bone allograft (DFDBA) or PRP alone. After a follow-up period of 18 months, the DFDBA+PRP group demonstrated better gains in clinical and radiographic outcomes than the PRP group alone.

Quotation: "The results of this study indicate that the DFDBA/PRP combination is more effective then PRP alone in the treatment of human infrabony defects, and the amount of CAL gain, PPD reduction, and bone fill increase when the infrabony defect is narrow and deep before the DFDBA/PRP combination treatment."

PubMed ID: 17160498



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