Positive effect of platelet rich fibrin on osseointegration

Abstract

Background: Leukocyte-platelet rich fibrin (L-PRF) is a second generation platelet concentrate clinically used to accelerate tissue healing and bone regeneration. Achieving reduced implant osseointegration time could provide immediate or early loading of implants. The aim of this study was to evaluate the L-PRF-induced osseointegration and bone-implant contact (BIC) in an experimental animal model.

Material and methods: Twelve 4-month-old New Zealand white rabbits were used. Following general anesthesia, 3-5 mL of blood was obtained from the central artery in rabbit ear and L-PRF was prepared. Two implant cavities (5 mm long and 3 mm in diameter) were created in each tibia with a total of four cavities in each animal. Two of these cavities were selected and covered with PRF (test group). The remaining L-PRF was used to soak the implants placed into the L-PRF covered sockets. Other cavities were left as controls. In total, 48 implants were placed. Animals were sacrificed after two, three, or four weeks. Histological samples were obtained and peri-implant tissues were histomorphometrically evaluated for bone-to-implant contact and new bone formation.

Results: Histomorphometric analyses of the defects revealed that the L-PRF was detectable up to the second week. Application of L-PRF increased the rate and amount of new bone formation in the experimental group compared to the control group. Bone-to-implant contact was enhanced when the surface was pre-wetted with L-PRF (p<0.01).

Conclusions: The results of this study demonstrated that L-PRF application may increases amount and rate of new bone formation during the early healing period and provides a faster osseointegration around implants.

Figure 1

Study design and sequence of events. Panel A. L-PRF clot in the middle of the tube, Panel B. Fibrin clots transferred to L-PRF Box, Panel C. The implants were washed completely, Panel D. L-PRF membrane placed in implant socket, Panel E. Implants placed in sockets which coated with L-PRF, Panel F. Implants placed in sockets in control group, Panel G. The periosteum and skin were closed in a layer using 5-0 vicryl resorbable sutures.

Figure 2

Second, third and fourth weeks macroscopic view of the test and control groupsafter sacrifice. Panel A. The image of the control group at 2nd week, Panel B. The image of the control group at 3rdweek, Panel C.The image of the control group at 4th week, Panel D.The image of the test group at 2nd week, L-PRF was not resolved in the second week of the test groups was shown by the red arrow, Panel E. The image of the test group at 3rd week, implants uppermost coated with bone tissue, Panel F. The image of the test group at 4th week, implants cannot be observed due to new bone formation at the peak of the implants.

Figure 3

Photographs of the histological sections seen by light microscopy at second and fourth week view of the image in test and control groups. Sections were stained with toluidine blue. Original magnification, 20×. Panel A.Photographs of the histological sections seen by light microscopy at 2nd weeks in control group, percentage of new bone formation and bone to implant contact was shown. Panel B Photographs of the histological sections seen by light microscopy at 2nd weeks in test group, L-PRF was not resolved in the second week of the test groups was shown. Panel C. Photographs of the histological sections seen by light microscopy at 4th weeks in control group, percentage of new bone formation and bone to implant contact was seen, there was almost no bone contact in the uppermost on the implant surface . Panel D. Photographs of the histological sections seen by light microscopy at 4th weeks in test group, the regenerated bone covered nearly all the surface in this group.

Figure 4

Percentage of new bone formation in the test and control groups.