Clinical evaluation of use of platelet rich plasma in bone healing

Abstract

Background: Tooth extraction is performed for a wide variety of reasons as we know. Several techniques aiming at enhancing the regeneration process in the extraction socket have been adopted such as filling the socket with autogenous bone grafts or bone substitutes. We know platelets play a central role in hemostasis and healing processes but relative contradictory effect of platelet in bone regenerating capacity have been published in different in vitro and in vivo studies.

Method: To explore this we used platelet-rich plasma (PRP) (autogenous) alone in empty extraction socket of bilateral impacted mandibular third molars. For that we selected five patients having bilateral impacted teeth. Out of two sockets one was used as intervention by filling with PRP and the other was allowed to heal without PRP. All patients were followed for clinical and radiological evaluation by using digital OPG view after 1 week, 1, 2 and 4 months period.

Result and conclusion: PRP enhanced the osteogenic response in initial bone healing at 1 month duration but there was no added benefit in late bone healing at 4 months period compared in both intervention and control groups. However PRP significantly improved the soft tissue healing in PRP treated sites compared to control group.

Keywords: Early and late bone healing; Extraction socket; Platelet-rich plasma (PRP).

Figures

Fig. 1

Centrifugation machine

Fig. 2

Armamentarium for PRP preparation

Fig. 3

Armamantarium for tooth extraction

Fig. 4

Withdrawing of blood

Fig. 5

First spin centrifugation

Fig. 6

Paltelet poor plasma and platelet rich plasma after second spin centrifugation

Fig. 7

Platelet rich plasma gel

Fig. 8

Bilateral 3rd molars removed, PRP placed to 38

Fig. 9

Panoromic views: PRP applied to left 3rd molar socket

Fig. 10

Total platelet count in whole blood and PRP

Fig. 11

Total platelet count with mean and standard deviation

Fig. 12

Wound healing at 1 week visit

Fig. 13

Bone density after 1 week in intervention group

Fig. 14

Bone density after 1 week in control group

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Bone density after 4 weeks in intervention group

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Bone density after 4 weeks in control group

Fig. 17

Bone density after 8 weeks in intervention group

Fig. 18

Bone density after 8 weeks in control group

Fig. 19

Bone density after 16 weeks in intervention group

Fig. 20

Bone density after 16 weeks in control group