Effect of rhPDGF-BB on bone turnover during periodontal repair
Author
: David P. Sarment
Publisher
: Blackwell Synergy
Summary :Purpose: Growth factors such as platelet-derived growth factor (PDGF) exert potent
effects on wound healing including the regeneration of periodontia. Pyridinoline crosslinked
carboxyterminal telopeptide of type I collagen (ICTP) is a well-known
biomarker of bone turnover, and as such is a potential indicator of osseous metabolic
activity. The objective of this study was to evaluate the release of the ICTP into the
periodontal wound fluid (WF) following periodontal reconstructive surgery using local
delivery of highly purified recombinant human PDGF (rhPDGF)-BB.
Methods: Forty-seven human subjects at five treatment centres possessing chronic
severe periodontal disease were monitored longitudinally for 24 weeks following
PDGF regenerative surgical treatment. Severe periodontal osseous defects were
divided into one of three groups and treated at the time of surgery with either: btricalcium
phosphate (TCP) osteoconductive scaffold alone (active control), b-
TCP10.3 mg/ml of rhPDGF-BB, or b-TCP11.0 mg/ml of rhPDGF-BB. WF was
harvested and analysed for local ICTP levels by radioimmunoassay. Statistical analysis
was performed using analysis of variance and an area under the curve analysis (AUC).
Results: The 0.3 and 1.0 mg/ml PDGF-BB treatment groups demonstrated increases
in the amount of ICTP released locally for up to 6 weeks. There were statistically
significant differences at the week 6 time point between b-TCP carrier alone group
versus 0.3 mg/ml PDGF-BB group (po0.05) and between b-TCP alone versus the
1.0 mg/ml PDGF-BB-treated lesions (po0.03). The AUC analysis revealed no
statistical differences amongst groups.
Conclusion: This study corroborates the release of ICTP as a measure of active bone
turnover following local delivery of PDGF-BB to periodontal osseous defects. The
amount of ICTP released from the WF revealed an early increase for all treatment
groups. Data from this study suggests that when PDGF-BB is delivered to promote
periodontal tissue engineering of tooth-supporting osseous defects, there is a direct
effect on ICTP released from the wound.
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