Human Recombinant Tissue Factor, Platelet-rich Plasma, and Tetracycline 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 (1.8×106 platelets/mm3 plasma), about 1 µg rhTF, calvarial bone chips (2 to 5 mm in size), and tetracycline (10 to 30 µg/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.