Human recombinant tissue factor, platelet-rich plasma, and tetracycilne induce a high-quality human bone graft: a 5-year survey.

PURPOSE: To increase human bone graft regeneration and quality by the use of a mixture containing autologous ground calvarial bone, human recombinant tissue factor (rhTF), platelet-rich plasma (PRP), and tetracycline.

MATERIALS AND METHODS: Maxillary sinus floor augmentation was performed on 18 patients by grafting a "bone paste" made of PRP (1.8 x 10(6) platelets/mm3 plasma), about 1 microg rhTF, calvarial bone chips (2 to 5 mm in size), and tetracycline (10 to 30 microg/mL preparation). Five to 6 months after the surgical phase and grafting a bone core was extracted for implant fixation, and the osseous core samples were analyzed microscopically.

RESULTS: Histology revealed vascularized connective tissue rich in lamellar bone spicules containing osteocytes and surrounded by osteoblasts. The success rate of grafting was 90.3%. In 6-month postoperative blood samples, no residual coagulating disturbances could be found.

DISCUSSION: The combination of calvarial bone chips, rhTF, PRP, and tetracycline results in a paste that is easy to handle, safe for patients, and possesses high bone-regeneration capacity.

CONCLUSION: The generalized use in implant dentistry, oral surgery, and orthopedics of such a protocol could facilitate the healing process as well as patient safety and surgeon comfort.