Pre-Treatment of Titanium Alloy with Platelet-Rich Plasma Enhances Human Osteoblast Responses

ABSTRACT

Osseointegration, the histological direct bone-to-implant contact, is the ultimate goal of implant healing and the first prerequisite for long-term success of endosseous implants. It is well-known that metal implants with rough surfaces achieve better osseointegration than those with smooth surfaces in vivo. The implantation of metal materials into bone is always accompanied by bleeding. The implant surface is initially coated with blood and these initial events could determine subsequent osseointegration. However, there is little concordance between in vitro results and in vivo findings regarding the effect of surface roughness on osseointegration. Here, we show that the osteoblast response to metal surfaces pre-treated with platelets and plasma proteins elucidates the superior osseointegration of rough surfaced implants in vivo. We found that osteoblast attachment, proliferation, and osteoblastic differentiation were significantly higher on a rough titanium surface pre-treated with platelet-rich plasma (PRP) than on the same surface without pretreatment. Furthermore, we found that the three-dimensional fibrillar network formed on the rough surface of the titanium by PRP pre-treatment might enhance osteoblast responses. Our results demonstrate why osseointegration is found to be most active on metal implants with a rough surface in vivo. We anticipate that our assay would be a useful tool for mimicking the in vivo model of osseointegration. Because cellular responses to the titanium implant that are pre-treated with platelet and plasma proteins on their surfaces after the biomimetic process in vitro, may be more similar to the events that occur in vivo.