Does Periosteal Graft Combined With Platelet-Rich Plasma Enhance the Healing of Bone Defect?

Introduction: This study investigated the effect of periosteal graft + platelet-rich plasma (PRP) combination on facial bone defect healing. Methods: Five-millimeter critical sized defects in zygomatic arches of 12 adult New Zealand rabbits were created. Rabbits were randomly divided into 3 groups: First group (control group): bone defects of left zygomatic arches of 6 rabbits were wrapped with a silicone tube. Second group (periosteal graft group): bone defects of left zygomatic arches of 6 rabbits were wrapped with periosteal graft. Third group (experimental group): bone defects of right zygomatic arches of 12 rabbits were wrapped with periosteal graft–PRP combination. New bone formation was evaluated at 8th and 16th weeks. One rabbit was sacrificed at 8th week. Remaining 11 rabbits were imaged with 3-dimensional computed tomography (CT) at 16th week; then, zygomatic arches were removed for micro-CT and histologic examinations. Results: Three-dimensional CT analysis at 16th week revealed no significant difference between groups regarding new bone formation (P = 0.232). Micro-CT analysis of new regenerated bone at 16th week displayed significant differences between groups 1 and 3 regarding mean bone volume (BV, mm3) (P = 0.028) and mean bone mineral density (BMD, mm2) (P = 0.001). There was no difference between groups 2 and 3 or between groups 1 and 2, regarding BV or BMD. Histological Bone Regeneration Scorings at 16th week displayed significant difference between groups (P = 0.015). Negative correlation between 3-dimensional CT and histologic results (r = 0.120); positive correlations between BV/BMD values in micro-CT and histologic results (r = 0.524 and r = 0.456) were found. Conclusions: By enhancing bone formation capacity of periosteal grafts, periosteal graft–PRP combination provided bone formation having more volume and density comparing with silicone tube application. Address correspondence and reprint requests to Arzu Türkseven, MD, Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Göztepe Training and Research Hospital, Istanbul Medeniyet University, Kadiköy, Istanbul, Turkey; E-mail: arzuturkseven@gmail.com Received 14 June, 2017 Accepted 28 September, 2017 This study has been presented at the Turkish Plastic, Reconstructive and Aesthetic Surgery Society 36th National Conference in Istanbul, Turkey. The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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