Early therapeutic effect of platelet-rich fibrin combined with allogeneic bone marrow-derived stem cells on rats' critical-sized mandibular defects

Muhammad A Awadeen; Fouad A Al-Belasy; Laila E Ameen; Mohamad E Helal; Mohammed E Grawish

doi:10.4252/wjsc.v12.i1.55

Early therapeutic effect of platelet-rich fibrin combined with allogeneic bone marrow-derived stem cells on rats' critical-sized mandibular defects

World J Stem Cells. 2020 Jan 26;12(1):55-69. doi: 10.4252/wjsc.v12.i1.55.

Authors

Muhammad A Awadeen¹, Fouad A Al-Belasy², Laila E Ameen³, Mohamad E Helal³, Mohammed E Grawish¹

Affiliations

¹ Department of Oral Biology, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Mansoura 11152, Egypt.
² Department of Oral Surgery and Anesthesia, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Mansoura 11152, Egypt.
³ Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt.

Abstract

Background: Critically sized bone defects represent a significant challenge to orthopaedic surgeons worldwide. These defects generally result from severe trauma or resection of a whole large tumour. Autologous bone grafts are the current gold standard for the reconstruction of such defects. However, due to increased patient morbidity and the need for a second operative site, other lines of treatment should be introduced. To find alternative unconventional therapies to manage such defects, bone tissue engineering using a combination of suitable bioactive factors, cells, and biocompatible scaffolds offers a promising new approach for bone regeneration.

Aim: To evaluate the healing capacity of platelet-rich fibrin (PRF) membranes seeded with allogeneic mesenchymal bone marrow-derived stem cells (BMSCs) on critically sized mandibular defects in a rat model.

Methods: Sixty-three Sprague Dawley rats were subjected to bilateral bone defects of critical size in the mandibles created by a 5-mm diameter trephine bur. Rats were allocated to three equal groups of 21 rats each. Group I bone defects were irrigated with normal saline and designed as negative controls. Defects of group II were grafted with PRF membranes and served as positive controls, while defects of group III were grafted with PRF membranes seeded with allogeneic BMSCs. Seven rats from each group were killed at 1, 2 and 4 wk. The mandibles were dissected and prepared for routine haematoxylin and eosin (HE) staining, Masson's trichrome staining and CD68 immunohistochemical staining.

Results: Four weeks postoperatively, the percentage area of newly formed bone was significantly higher in group III (0.88 ± 0.02) than in groups I (0.02 ± 0.00) and II (0.60 ± 0.02). The amount of granulation tissue formation was lower in group III (0.12 ± 0.02) than in groups I (0.20 ± 0.02) and II (0.40 ± 0.02). The number of inflammatory cells was lower in group III (0.29 ± 0.03) than in groups I (4.82 ± 0.08) and II (3.09 ± 0.07).

Conclusion: Bone regenerative quality of critically sized mandibular bone defects in rats was better promoted by PRF membranes seeded with BMSCs than with PRF membranes alone.

Keywords: Bone marrow-derived stem cells; Critical-sized mandibular defects; Histological and immunohistochemical staining; Platelet-rich fibrin membrane; Rats.