Thorwarth Michael, Wehrhan Falk, Schultze-Mosgau Stefan, Wiltfang Jörg, Schlegel Karl Andreas
Department of Oral and Maxillofacial Surgery/Plastic Surgery, University of Jena, Erlanger Allee 101, D-07747 Jena, Germany.
Bone. 2006 Jan;38(1):30-40. doi: 10.1016/j.bone.2005.06.020. Epub 2005 Oct 28.
This experimental study (domestic pig) examined the bone formation after filling defined defects of the frontal skull with autogenous bone or a deproteinized bovine bone matrix (DBBM) in combination with platelet-rich plasma (PRP). Six groups, both materials with and without PRP in two different concentrations (4.1x and 6.5x referring to untreated whole blood) were evaluated at 2, 4, 12, and 26 weeks by means of immunohistochemical staining for different bone matrix proteins, microradiography, light microscopy and polychromatic fluorescence labeling. The sequential expression of bone matrix proteins reflected the specific roles these proteins fulfil in the mineralization of hard tissue. Collagen I expression at 2 weeks was enhanced in all autogenous bone groups. No specific modification of the collagen I expression was found after use of DBBM with or without PRP. Osteopontin and especially osteonectin showed a remarkable enhancement at 4 weeks in nearly all autogenous bone and DBBM groups. These increased levels closely resembled the mineralization content evaluated by microradiography at that time. For the three autogenous bone groups, an expression peak for osteocalcin was demonstrated at 12 weeks, further reflecting the way of de novo bone formation. The microradiographic evaluation demonstrated a statistically significant enhancement in bone regeneration by PRP only after use of autogenous bone plus PRP at 2 weeks (P = 0.002). After 4 weeks, mineralization values after use of autogenous bone were significantly lower if PRP was added to the autogenous bone (P = 0.002). No long-term effects of the PRP administration were found in the mineralization process. In all DBBM groups, bone formation remained unchanged, confirming the lack of any osteoinductive capacity of PRP. PRP modulated the expression of bone matrix proteins in this experimental setting. However, an enhancement of bone formation was demonstrated only at 2 weeks after application of the higher PRP concentration in combination with autogenous bone. In conjunction with an anorganic bovine bone no effects of PRP on defect mineralization were discovered, demonstrating the lack of osteoinductive capacity in PRP as well as in DBBM.
本实验研究（家猪）检测了用自体骨或脱蛋白牛骨基质（DBBM）联合富血小板血浆（PRP）填充额骨特定缺损后的骨形成情况。设置了六组，分别为两种材料（有PRP和无PRP），PRP有两种不同浓度（分别为未处理全血的4.1倍和6.5倍），在2周、4周、12周和26周时，通过对不同骨基质蛋白进行免疫组织化学染色、显微放射照相、光学显微镜检查和多色荧光标记来评估。骨基质蛋白的顺序表达反映了这些蛋白在硬组织矿化过程中所起的特定作用。在所有自体骨组中，2周时I型胶原蛋白的表达增强。使用含或不含PRP的DBBM后，未发现I型胶原蛋白表达有特异性改变。骨桥蛋白，尤其是骨连接蛋白，在4周时在几乎所有自体骨和DBBM组中均有显著增强。这些增加的水平与当时通过显微放射照相评估的矿化含量非常相似。对于三组自体骨组，骨钙素在12周时出现表达峰值，进一步反映了新生骨形成的方式。显微放射照相评估显示，仅在2周时使用自体骨加PRP后，PRP对骨再生有统计学意义的增强作用（P = 0.002）。4周后，如果在自体骨中添加PRP，自体骨使用后的矿化值显著降低（P = 0.002）。在矿化过程中未发现PRP给药的长期影响。在所有DBBM组中，骨形成保持不变，证实PRP缺乏任何骨诱导能力。在本实验环境中，PRP调节了骨基质蛋白的表达。然而，仅在应用较高浓度PRP联合自体骨后2周时，才显示出骨形成增强。与无机牛骨联合使用时，未发现PRP对缺损矿化有影响，这表明PRP以及DBBM均缺乏骨诱导能力。
