Jung Ronald E, Schmoekel Hugo G, Zwahlen Roger, Kokovic Vladimir, Hammerle Christoph H F, Weber Franz E
Department of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
Clin Oral Implants Res. 2005 Dec;16(6):676-82. doi: 10.1111/j.1600-0501.2005.01183.x.
The aim of the present study was (1) to test whether or not platelet-rich plasma (PRP) or commercially available fibrin can increase bone regeneration compared with non-treated defects and (2) to test whether or not PRP or fibrin increases bone regeneration when used as a delivery system for recombinant human bone morphogenetic protein-2 (rhBMP-2). In 16 New Zealand White rabbits, four evenly distributed 6 mm diameter defects were drilled into the calvarial bone. The following five treatment modalities were randomly allocated to all 64 defects: (0) untreated control, (1) fibrin alone, (2) PRP alone, (3) fibrin with 15 microg rhBMP-2 and (4) PRP with 15 microg rhBMP-2. For the fibrin gels and the PRP containing rhBMP-2, the 15 microg rhBMP-2 was incorporated by precipitation within the matrices before their gelation. After 4 weeks, the animals were sacrificed and the calvarial bones were removed for histological preparation. The area fraction of newly formed bone was determined in vertical sections from the middle of the defect by applying histomorphometrical analysis. A mean area fraction of newly formed bone was found within the former defect of 23.4% (+/-13.5%) in the control sites, of 28.4% (+/-17.4%) in the fibrin sites and of 34.5% (+/-17.4%) in the PRP sites. The statistical analysis revealed no significant difference in bone formation between the three groups (ANOVA). Addition of 15 microg rhBMP-2 in the fibrin gel (59.9+/-20.3%) and the PRP gels (63.1+/-25.3%) increased bone formation significantly. No significant difference was observed between sites, where PRP or fibrin has been used as a delivery system for rhBMP-2 (ANOVA). In conclusion, the application of fibrin gels or PRP gels to bone defects is not superior to leaving the defect untreated. Regarding the amount of bone formation, the application of 15 microg rhBMP-2 in bone defects enhances the healing significantly at 4 weeks. In this animal model, commercially available fibrin and autologous PRP gels are equally effective as delivery systems for rhBMP-2.
（1）测试与未治疗的缺损相比，富血小板血浆（PRP）或市售纤维蛋白是否能促进骨再生；（2）测试当PRP或纤维蛋白用作重组人骨形态发生蛋白-2（rhBMP-2）的递送系统时，是否能促进骨再生。在16只新西兰白兔的颅骨上钻出4个均匀分布的直径为6毫米的缺损。将以下五种治疗方式随机分配到所有64个缺损处：（0）未治疗的对照组，（1）单独使用纤维蛋白，（2）单独使用PRP，（3）含15微克rhBMP-2的纤维蛋白，（4）含15微克rhBMP-2的PRP。对于纤维蛋白凝胶和含rhBMP-2的PRP，在凝胶化前，通过沉淀将15微克rhBMP-2掺入基质中。4周后，处死动物并取出颅骨进行组织学制备。通过组织形态计量学分析，在缺损中部的垂直切片中测定新形成骨的面积分数。在对照组的原缺损处，新形成骨的平均面积分数为23.4%（±13.5%），在纤维蛋白组为28.4%（±17.4%），在PRP组为34.5%（±17.4%）。统计分析显示三组之间骨形成无显著差异（方差分析）。在纤维蛋白凝胶（59.9±20.3%）和PRP凝胶（63.1±25.3%）中添加15微克rhBMP-2可显著增加骨形成。在将PRP或纤维蛋白用作rhBMP-2递送系统的部位之间未观察到显著差异（方差分析）。总之，将纤维蛋白凝胶或PRP凝胶应用于骨缺损并不优于不治疗缺损。就骨形成量而言，在骨缺损处应用15微克rhBMP-2可在4周时显著促进愈合。在该动物模型中，市售纤维蛋白和自体PRP凝胶作为rhBMP-2的递送系统同样有效。
