ReviewThe use of platelet-rich plasma in bone reconstruction therapy
Section snippets
Bone regeneration
Throughout the life of an individual, bone is subjected to micro-damages that undergo regeneration or repair without giving rise to functional or anatomical defects. Differently, the regeneration or repair of the missing bone in large defects may be difficult to be accomplished without interventions such as bone grafting. Recent exciting discoveries in bone biology [1], [2] have introduced novel therapeutic approaches for bone regeneration based on recombinant osteoinductive proteins. Clinical
Why platelet-rich plasma can be helpful in bone reconstruction therapy
PRP is developed from autologous blood upon re-suspension of platelets in a low volume of plasma. Platelet count in PRP may vary according to the preparation technique, ranging from two to several fold above the physiological levels. Upon activation by an agonist, such as thrombin, the platelets contained in PRP release the following factors (in alphabetical order): ADP and ATP, Angiopoietin-2 (Ang-2), Connective Tissue-Activating Peptide III (CATP III), Epidermal Growth Factor (EGF), Factor V,
How platelet-rich plasma can be helpful in bone reconstruction therapy
By analyzing the effect that each of the biological factors released by the platelets can have on osteo-competent cells, it can be concluded that the rationale for using PRP in bone regenerative therapy dwells on the consideration that activated platelets, by releasing their growth and adhesive factors within a bone defect, may promote bone regeneration. The review of the literature on platelet-released factors is compelling and strongly supports the rationale for the use of platelets in bone
Guidelines for the use of platelet-rich plasma in bone reconstruction therapy
Based on the analysis of the above mentioned studies, it can be gathered that when PRP is used following a specific preparation and a specific activation protocol [8], [12] it can be beneficial to the bone regenerative therapy. It should be further noted that in the clinical studies mentioned above [8], [128], [130], [131] all but one [129] delivered PRP within the bony defect in combination with a bone filler such as demineralized allografts, xenografts, or autologous bone. Growth factors have
Acknowledgments
I am indebted to Joelle Carlo, Ph.D. (Harvard School of Dental Medicine, Boston, MA, USA) for the in-depth review of this manuscript. I acknowledge Sebastiano Andreana D.D.S., M.S. (University at Buffalo, School of Dental Medicine, Buffalo, NY, USA), Libuse A. Bobek, Ph.D. (University at Buffalo, School of Dental Medicine, Buffalo, NY, USA), Moon-Il Cho, Ph.D. (University at Buffalo, School of Dental Medicine, Buffalo, NY, USA), Rosemary Dziak, Ph.D. (University at Buffalo, School of Dental
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