Polycaprolactone-20% Tricalcium Phosphate Scaffolds in Combination With Platelet-Rich Plasma for the Treatment of Critical-Sized Defects of the Mandible: A Pilot Study

Rai, Bina; Ho, Kee Hai; Lei, Yang; Si-Hoe, Kuan-Ming; Jeremy Teo, Choon-MengJeremy; Yacob, Kamal bin; Chen, Fulin; Ng, Fooi-Chin; Teoh, Swee Hin

doi:10.1016/j.joms.2006.11.026

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 11 , Pages 2195-2205, November 2007

Polycaprolactone-20% Tricalcium Phosphate Scaffolds in Combination With Platelet-Rich Plasma for the Treatment of Critical-Sized Defects of the Mandible: A Pilot Study

Bina Rai, PhD
- Graduate Student, Department of Oral and Maxillofacial Surgery, National University of Singapore, Singapore.
Kee Hai Ho, BDS, FDSRCPS, FDSRCS
- Associate Professor, Department of Oral and Maxillofacial Surgery, National University of Singapore, Singapore.
Yang Lei, MS
- Graduate Student, Graduate Program in Bioengineering, National University of Singapore, Singapore.
Kuan-Ming Si-Hoe, BS
- Research Engineer, Division of Bioengineering, National University of Singapore, Singapore.
Choon-MengJeremy Jeremy Teo, PhD
- Graduate Student, Department of Mechanical Engineering, National University of Singapore, Singapore.
Kamal bin Yacob, MS
- Graduate Student, Department of Mechanical Engineering, National University of Singapore, Singapore.
Fulin Chen, MBBS, PhD
- Research Fellow, Department of Mechanical Engineering, National University of Singapore, Singapore.
Fooi-Chin Ng, BDS, MDS, FDSRCS
- Consultant Oral and Maxillofacial Surgeon, Mt Elizabeth Hospital; Regional Director, MSc Course in Implant Dentistry, University of Warwick, Singapore.
Swee Hin Teoh, PhD
- Professor, Department of Mechanical Engineering, National University of Singapore, Singapore.
- Address correspondence and reprint requests to Dr Teoh: Dept of Mechanical Engineering, Faculty of Engineering, National University of Singapore, Room Ea 05-30, Singapore

Purpose

Our group has recently fabricated 3-dimensional scaffolds of unique architecture to mediate favorable cell binding, proliferation, and differentiation. In this study, the osteoconductive and bioactive polycaprolactone-20% tricalcium phosphate (PCL-TCP) scaffolds were assessed for the treatment of critical-sized defects of the mandible, with respect to new bone formation. Platelet-rich plasma (PRP) was combined with some scaffolds to test if bone regeneration could be enhanced.

Materials and Methods

Autologous PRP was prepared from whole blood collected from 8 mongrel dogs. In each dog, 3 defects (18 × 10 × 7 mm) were created at either the left or right mandible and treated with 1 of 2 treatment modalities: 1) grafting with scaffolds alone; or 2) grafting with scaffolds loaded with PRP. The scaffolds were stabilized using 2 dental implants each to prevent rotation. Micro-CT and histologic analysis were carried out on samples after 6 and 9 months.

Results

Micro-CT measurements showed that PRP-treated defects had 98.3% and 58.3% more bone volume fraction than defects grafted with scaffolds alone at 6 and 9 months, respectively (P < .05). No significant difference was noted between caudal and frontal situated PRP-treated defects, but a significant difference was observed between male and female dogs. Histologic analyses verified the deposition of osteoid and new bone trabeculae throughout the section at 6 months. The defect margins were filled with mature bone trabeculae at 9 months but the middle section of the scaffolds manifested disturbed mineralization. The scaffolds experienced 33% degradation from 6 to 9 months. PRP treatment had negligible effect on the degradation of the scaffolds.