J Periodontal Implant Sci.  2018 Aug;48(4):224-235. 10.5051/jpis.2018.48.4.224.

Effects of platelet-rich plasma on tooth replantation in dogs: a histologic and histomorphometric analysis

• Yang JM
• Yang KI
• Lee KH
• Choi SH
• Kim BO
• Park JC
• Yu SJ

• KMID: 2465388
• DOI: http://doi.org/10.5051/jpis.2018.48.4.224

Abstract

PURPOSE
The purpose of this study was to evaluate the effects of platelet-rich plasma (PRP) on periodontal healing of replanted root surfaces in dogs histologically and histomorphometrically.
METHODS
A total of 36 roots of mandibular incisors and premolars from 6 mongrel dogs were used. The roots were randomly divided into 3 groups: 1) a positive control group (n=12), in which the periodontal ligament (PDL) and cementum were retained and the roots were soaked in saline; 2) a negative control group (n=12), in which the PDL and cementum were removed and the roots were soaked in saline; and 3) an experimental group (n=12), in which the PDL and cementum were removed and the roots were soaked in PRP. After soaking the root surfaces, the extracted roots were replanted into the extraction sockets. The roots were covered using a coronally repositioned flap
RESULTS
Histologically, irregular-thickness PDL-like and cementum-like tissues were observed in the 4-week experimental group and the positive control group. PDL-like tissue and cementum-like tissue with a more uniform thickness were observed at 8 weeks. In the negative control group, PDL-like tissue and cementum-like tissue were rarely found, and root resorption and ankylosis were observed. In the cross-sectional histomorphometric analysis, the experimental group demonstrated a higher rate of formation of cementum-like tissue and a lower tooth ankylosis rate than the positive and negative control groups at 4 and 8 weeks. Although there was a significant difference in the tooth ankylosis rate and the formation of cementum-like tissue across the 3 groups (P < 0.05), no statistical significance was observed between any pair of groups (P > 0.017).
CONCLUSIONS
Applying PRP to root surfaces during tooth replantation in dogs can reduce tooth ankylosis and increase PDL-like and cementum-like tissue formation.

Keyword

Dental cementum; Periodontal ligament; Periodontitis; Platelet-rich plasma; Tooth replantation

MeSH Terms

Animals
Ankylosis
Bicuspid
Clothing
Dental Cementum
Dogs*
Incisor
Periodontal Ligament
Periodontitis
Platelet-Rich Plasma*
Root Resorption
Tooth Ankylosis
Tooth Replantation*
Tooth*

Figure

• 

  Figure 1 Schematic illustration representing the study design; (A) positive control group, (B) negative control group, and (C) experimental group. PDL: periodontal ligament, Ce: cementum, De: dentin, P: pulp, PRP: platelet-rich plasma.

• 

  Figure 2 The surgical procedure. (A) The crowns and furcation areas of the premolars were sectioned in the middle and parallel to the long axis of the root with a fissure bur. (B) The extractions were performed as atraumatically as possible. (C) The periodontal ligament and cementum were removed by scaling and root planing in the negative control and experimental groups. (D) The roots were soaked in 1.0 mL of platelet-rich plasma in the experimental group. (E) After replanting, the root canals were filled with calcium hydroxide, and the crowns were removed. (F) The roots were covered using a coronally repositioned flap.

• 

  Figure 3 Schematic illustration representing the horizontal root plane for the histomorphometric analysis. Red, green, and blue arrows shown are periodontal ligament/newly formed periodontal ligament-like tissue, replacement resorption, and cementum/newly formed cementum-like tissue, respectively. Bo: alveolar bone, PDL: periodontal ligament, Ce: cementum, De: dentin.

• 

  Figure 4 Longitudinal sections of periodontal wound healing at 4 weeks after replantation (all samples were stained with hematoxylin and eosin). (A, D) PDL and cementum were observed around the dentin (positive control group). (B, E) Alveolar bone was in direct contact with the dentin (negative control group). (C, F) PDL-like tissue and cementum-like tissue were observed around the dentin (experimental group). However, the width of the PDL-like tissue space and cementum-like tissue was irregular in comparison to the positive control group. PDL: periodontal ligament, Bo: alveolar bone, Ce: cementum, De: dentin, NPDLT: newly formed periodontal ligament-like tissue, NCeT: newly formed cementum-like tissue.

• 

  Figure 5 Horizontal sections of periodontal wound healing at 4 weeks after replantation (all samples were stained with hematoxylin and eosin). (A, D) PDL and cementum were observed almost around the dentin (positive control group). However, ankylosis and surface resorption were occasionally observed around the dentin. (B, E) Alveolar bone was in direct contact with the dentin (negative control group). (C, F) The width of the PDL-like tissue space was regular and PDL-like tissue was denser than in the positive control group (experimental group). However, cementum-like tissue was observed around the dentin. PDL: periodontal ligament, Bo: alveolar bone, Ce: cementum, De: dentin, NPDLT: newly formed periodontal ligament-like tissue, NCeT: newly formed cementum-like tissue.

• 

  Figure 6 Longitudinal sections of periodontal wound healing at 8 weeks after replantation (all samples were stained with hematoxylin and eosin). (A, D) PDL and cementum were observed around the dentin (positive control group). (B, E) Alveolar bone was in direct contact with the dentin (negative control group). Wide and deep inflammatory resorption was observed on the dentin surface. (C, F) PDL-like tissue and cementum-like tissue were observed around the dentin (experimental group). The cementum-like tissue was thinner than the cementum of the positive control group. However, the thickness of the cementum-like tissue was uniform, as in the positive control group. PDL: periodontal ligament, Bo: alveolar bone, PDL: periodontal ligament, Ce: cementum, De: dentin, NPDLT: newly formed periodontal ligament-like tissue, NCeT: newly formed cementum-like tissue.

• 

  Figure 7 Horizontal sections of periodontal wound healing at 8 weeks after replantation (all samples were stained with hematoxylin and eosin). (A, D) PDL and cementum were observed around the dentin (positive control group). (B, E) Alveolar bone was in direct contact with the dentin (negative control group). (C, F) PDL-like tissue and cementum-like tissue were observed around the dentin (experimental group). Cementum-like tissue had formed in the area of surface resorption. PDL: periodontal ligament, Bo: alveolar bone, Ce: cementum, De: dentin, NPDLT: newly formed periodontal ligament-like tissue, NCeT: newly formed cementum-like tissue.

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