Polycaprolactone-20% Tricalcium Phosphate Scaffolds in Combination With Platelet-Rich Plasma for the Treatment of Critical-Sized Defects of the Mandible: A Pilot Study
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.
Conclusions
The pilot study showed that the treatment of critical-sized defects of the mandible with PCL-TCP scaffolds may be augmented by the addition of PRP.
⁎Graduate Student, Department of Oral and Maxillofacial Surgery, National University of Singapore, Singapore.
†Associate Professor, Department of Oral and Maxillofacial Surgery, National University of Singapore, Singapore.
‡Graduate Student, Graduate Program in Bioengineering, National University of Singapore, Singapore.
§Research Engineer, Division of Bioengineering, National University of Singapore, Singapore.
‖Graduate Student, Department of Mechanical Engineering, National University of Singapore, Singapore.
¶Graduate Student, Department of Mechanical Engineering, National University of Singapore, Singapore.
#Research Fellow, Department of Mechanical Engineering, National University of Singapore, Singapore.
⁎⁎Consultant Oral and Maxillofacial Surgeon, Mt Elizabeth Hospital; Regional Director, MSc Course in Implant Dentistry, University of Warwick, Singapore.
††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
This study was supported by a grant from the National University of Singapore (R-223-000-002-112/107).
ABSTRACT