Critical-sized bone defects regeneration using a bone-inspired 3D bilayer collagen membrane in combination with leukocyte and platelet-rich fibrin membrane (L-PRF): An in vivo study

Tissue Cell. 2020 Apr:63:101326. doi: 10.1016/j.tice.2019.101326. Epub 2019 Dec 17.

Abstract

Objectives: We aim to develop a 3D-bilayer collagen (COL) membrane reinforced with nano beta-tricalcium-phosphate (nβ-TCP) particles and to evaluate its bone regeneration in combination with leukocyte-platelet-rich fibrin (L-PRF) in vivo.

Background data: L-PRF has exhibited promising results as a cell carrier in bone regeneration in a number of clinical studies, however there are some studies that did not confirm the positive results of L-PRF application.

Methods: Mechanical & physiochemical characteristics of the COL/nβ-TCP membrane (1/2 & 1/4) were tested. Proliferation and osteogenic differentiation of seeded cells on bilayer collagen/nβ-TCP thick membrane was examined. Then, critical-sized calvarial defects in 8 white New Zealand rabbits were filled with either Col, Col/nβ-TCP, Col/nβ-TCP combined with L-PRF membrane, or left empty. New bone formation (NBF) was measured histomorphometrically 4 & 8 weeks postoperatively.

Results: Compressive modulus increases while porosity decreases with higher β-TCP concentrations. Mechanical properties improve, with 89 % porosity (pore size ∼100 μm) in the bilayer-collagen/nβ-TCP membrane. The bilayer design also enhances the proliferation and ALP activity. In vivo study shows no significant difference among test groups at 4 weeks, but Col/nβ-TCP + L-PRF demonstrates more NBF compared to others (P < 0.05) after 8 weeks.

Conclusion: The bilayer-collagen/nβ-TCP thick membrane shows promising physiochemical in vitro results and significant NBF, as ¾ of the defect is filled with lamellar bone when combined with L-PRF membrane.

Keywords: Beta-Tricalcium phosphate; Bone regeneration; Leukocyte and platelet-rich fibrin; Rabbit.

MeSH terms

  • Animals
  • Bone Diseases / genetics
  • Bone Diseases / pathology
  • Bone Diseases / therapy*
  • Bone Regeneration / genetics*
  • Collagen / chemistry
  • Collagen / pharmacology*
  • Humans
  • Leukocytes / metabolism
  • Membranes / chemistry
  • Osteogenesis / drug effects
  • Osteogenesis / genetics
  • Platelet-Rich Fibrin / chemistry
  • Platelet-Rich Fibrin / metabolism*
  • Rabbits

Substances

  • Collagen