Alveolar Bone Preservation Using a Combination of Nanocrystalline Hydroxyapatite and Injectable Platelet-Rich Fibrin: A Study in Rats

Abstract: Alveolar bone resorption is a post-extraction complication wherein there is a reduction
in the dimensions and quality of the alveolar bone. This study aimed to examine the effects
of implantation of a combination of nanocrystalline hydroxyapatite (nHA) and injectable
platelet-rich fibrin (IPRF) on the expression of tartrate-resistant acid phosphatase (TRAP), alkaline
phosphatase (ALP), osteocalcin (OCN), and new bone formation. A total of 32 male rats had
their upper right incisors extracted under general anesthesia and were then divided into a control
group, nHA group, IPRF group, and nHA-IPRF group. Decapitation was carried out on day
14 and day 28 in each group and the jaws of each rat were subjected to immunohistochemical and
histological analysis. The results showed a decrease in TRAP expression in the nHA-IPRF group
compared with the control group on day 14 (p = 0.074) and day 28 (p = 0.017). The study also showed
an increase in ALP and OCN in the HA-IPRF group on day 14 and day 28 compared with the control
group. New bone formation suggested a significant increase in the nHA-IPRF group compared with
the control group on day 14 (p = 0.001) and day 28 (p = 0.001). nHA-IPRF implantation can suppress
alveolar bone resorption, which is indicated by decreased TRAP expression, and it can increase bone
growth, as indicated by increased expression of ALP, OCN, and new bone formation.