The histological comparison of platelet rich plasma and platelet rich fibrin effects in the bone regeneration in healthy and experimentally diabetes mellitus induced animals.

At the present time, bone procedures play an significant role in surgery. Bone defects in various sizes occur as a result of bone loss triggering trauma, infection, bone tumors or cysts and orthognatic surgery. While defects in small sizes are repaired by self-repair capability of bone, defects in big sizes need various graft and implant materials.Beside of defect filling properties of graft and implant materials; various studies are carried on bone generation property by stimulation of peripheral tissues in large bone defects that need comprehensive repair. The mixture of graft materials with growth factors has come up for faster and more qualified results. Thrombocyte Rich Plasma (PRP) and Thrombocyte Rich Fibrin (PRF) are two of growth factors.In patients with systemic disorders, especially diabetes mellitus; healing in soft and hard tissues are late and complicated. Hence, graft application to the patients with diabetes mellitus is have more risk than that to healthy patients.Plasma rich plasma (PRP) and Plasma Rich Fibrin (PRF), vascular endothelial growth factor (VEGF), platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor ? and ß (TGF ? and ß) epidermal growth factors (EGF), fibroblast growth factor (FGF), insulin like growth factor (IGF) etc. are growth factors including substances produced by the centrifuge of blood in two different speeds. Thrombocyte level in acquired plasma is 3-5 times of the level in normal plasma. A lot of mediators are secreted from thrombocyte ?-granules by the addition of thrombin to this product. These are all mediators that play a role in bone healing. The advantages of these products include easy usage,fast effect and compability with thrombin generation. Clinically, these are used for healing in nerve anastomosis, soft tissue defects with homeostasis and kerotinocyte cultures. Another experimental usage is the application in fracture healing as transporter with periostal cells produced in cultures.In oral and maxillofacial surgery, researchers try to develop bone grafting techniques as well as faster and denser bone regeneration techniques. PRP and PRF are used routinely to improve wound healing and regeneration in head, throat and neck surgery, oral and maxillofacial surgery, plastic surgery and cardiovascular surgery.The aim of this study is to compare the histological effects of PRP and PRF, similar except thrombocyte concentration, in the integration of bone defects with grafts and in the healing of experimentally diabetes mellitus induced and healthy animals.Our experimental study were performed on 80 wistar albino rats. 8 rats are used to obtain PRP and PRF, 72 rats were divided into daibetic and healthy groups and each groups divided into 3 groups: Graft, Graft+ PRP and Graft+ PRF groups. Collagen membrane and graft was applied in all groups. Anesthesia of the rats was inducted by the intramuscular administration of 0.1 ml Xylozin Hydrochlorid (RompunR, Bayer, Türkiye) and 0.2 ml Ketamin (KetalarR, Eczacıbası, Türkiye). The leg of the rats were shaved and cleaned with antiseptic solution. The tibia were surgically exposed and bone defects were prepared in size of 10x3x2 mm.Rats were sacrificed in postoperative 7th, 14th and 42th days and tibia were evaluated histopathologically. The quality of newly formed bone and the effect of PRP were evaluated by histological methods. The results showed no significant difference on 7th and 14th days. On the 42th day, the results in new bone formation showed an increase in all three groups; Graft, Graft+ PRP and Graft+ PRF. Graft+ PRP and Graft+ PRF was better healing process than Graft alone group. In Graft+ PRF groups osteoblastic activity better than Graft+ PRP groups in both healthy and diabetic groups. The histological study revealed that the bone formation was more effective when PRF was used with graft.In conclusion, it was found that using the graft combined with PRP and PRF leads differences in new bone formation. The growth factor in PRF maintains better healing process but the effect of PRF on bone healing process should be furtherly investigated.