Possible Implications for Improved Osteogenesis? The Combination of Platelet-Rich Fibrin With Different Bone Substitute Materials

Sebastian Blatt; Daniel G E Thiem; Solomiya Kyyak; Andreas Pabst; Bilal Al-Nawas; Peer W Kämmerer

doi:10.3389/fbioe.2021.640053

Possible Implications for Improved Osteogenesis? The Combination of Platelet-Rich Fibrin With Different Bone Substitute Materials

Front Bioeng Biotechnol. 2021 Mar 16:9:640053. doi: 10.3389/fbioe.2021.640053. eCollection 2021.

Authors

Sebastian Blatt^{1

2}, Daniel G E Thiem¹, Solomiya Kyyak¹, Andreas Pabst³, Bilal Al-Nawas¹, Peer W Kämmerer¹

Affiliations

¹ Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
² Platform for Biomaterial Research, BiomaTiCS Group, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
³ Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Koblenz, Germany.

Abstract

Bone substitute materials (BSM) are widely used in oral regeneration, but sufficient angiogenesis is crucial for osteogenesis. The combination of BSM with autologous thrombocyte concentrations such as platelet-rich fibrin (PRF) may represent a clinical approach to overcome this limitation. This study analyzes the early influence on osteoblast (HOB) in vitro. Here, four different BSM (allogeneic, alloplastic, and two of xenogeneic origin) were combined with PRF. After the incubation with osteoblasts for 24 h, cell viability, migration, and proliferation were assessed. Next, marker of proliferation, migration, and differentiation were evaluated on gene and protein levels in comparison to the native BSM and osteoblast alone. Addition of PRF increased viability for both the xenogeneic BSM (p = 0.0008, p = 0.032, respectively) in comparison to HOB and vs. native BSM (p = 0.008), and led to a tendency for increased cell proliferation and migration for all BSM (each p > 0.05). On gene basis, allogeneic and alloplastic BSM displayed a significantly increased RUNX2 expression (each p = 0.050). Expression of alkaline phosphatase for alloplastic (p = 0.050) and collagen-1 for xenogeneic BSM (p = 0.05) were significantly increased in combination with PRF. In addition, bone morphogenic protein was expressed significantly higher when xenogeneic material was combined with PRF in comparison to HOB alone (each p = 0.05). In summary, the combination of PRF with different BSM increases initial viability and may influence early proliferation and migration potential of osteoblast via RUNX2, alkaline phosphatase, collagen, and BMP2 especially in combination with alloplastic and xenogeneic BSM. Biofunctionalization of BSM using PRF might improve osteogenesis and extend the range of indications.

Keywords: allograft; bone substitute; oral regeneration; osteoblast; platelet-rich fibrin; tissue engineering; xenograft.