Defense Date

10-23-2008

Graduation Date

Fall 2008

Availability

Immediate Access

Submission Type

dissertation

Degree Name

PhD

Department

Pharmacology-Toxicology

School

School of Pharmacy

Committee Chair

David A. Johnson

Committee Member

Paula A. Witt-Enderby

Committee Member

Vicki L. Davis

Committee Member

C. Larry Bering

Keywords

AO, Dry Socket, Mesenchymal stem cells, Bone Growth, Platelet Rich Plasma, PRP

Abstract

Platelet rich plasma (PRP) is a methodology of using a patient's own platelets to enhance bone and soft tissue healing following oral surgical procedures. Whole blood is drawn from the patient by conventional phlebotomy techniques and then centrifuged with the formation of a distinct middle layer that contains platelets and white blood cells (WBCs). This layer of platelets and WBCs is then placed into the surgical site to enable faster and more predictable healing. This technique has also found use in general medical surgeries and is gaining in popularity.

Platelets contain growth factors and other cytokines that are beneficial for healing following surgical trauma. This project uses both in vitro and in vivo studies to provide the mechanistic basis for the continued and possible expanded clinical use of PRP.

A simple and inexpensive technique for acquiring PRP is examined and provides evidence that during the platelet harvesting steps the platelets are properly concentrated, not altered, and that growth factors (GFs) critical to bone formation are present.

A retrospective clinical trial provides data that illustrate a significant decrease (p < .0001) in the frequent complication of "dry socket" (alveolar osteitis, AO) formation following mandibular tooth extractions. The study reveals that not using PRP is a risk factor for AO formation.

The project also utilizes a molecular study utilizing human mesenchymal stem cells (hMSCs) to provide a mechanistic basis for bone formation following PRP use. Enhanced proliferation and inducement of differentiation of hMSCs were found to the possible explanations for the clinical successes reported with PRP use.

A prospective clinical study provides radiographic evidence for increased radiographic opacity (indicating bone formation) during the initial two weeks following placement of PRP at the time of mandibular third molar removal.

This translational research offers scientific support for the use of PRP in osseous surgeries. The use of this simple and inexpensive PRP technique could help patients recover faster, with fewer complications and greater bone formation predictability following surgeries involving bone manipulation.

Format

PDF

Language

English

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