EXPERIMENTAL SUBSTANTIATION OF THE EFFICACY OF COMBINED PLATELET-RICH PLASMA AND PHONOPHORESIS FOR OPTIMIZING REPARATIVE OSTEOGENESIS

Abstract

The management of traumatic injuries to the facial skeleton, particularly mandibular fractures, remains a significant challenge in modern oral and maxillofacial surgery due to the high incidence of postoperative complications, such as delayed union and pseudoarthrosis formation. A pivotal avenue for improving treatment outcomes lies in developing osteogenic stimulation methods that combine cellular pool activation (via growth factors) with adequate mineral substrate provision. The aim of the study was to experimentally substantiate the efficacy of the combined application of PRP injections and phonophoresis for optimizing reparative osteogenesis in a laboratory animal model of a traumatic bone defect. Materials and Methods. An in vivo study was conducted on 23 Chinchilla rabbits. A bone defect (4–5 mm in diameter) was created in the femoral diaphysis. The animals were stratified into four groups: Group I (n = 6) received PRP injection monotherapy; Group II (n = 5) received phonophoresis monotherapy with “Bishofit Poltavsky” gel; Group III (n = 7) received combined PRP and Bischofite phonophoresis; and Group IV (n = 5) served as the control (spontaneous healing). Outcomes were assessed at days 30 and 60 using digital radiography and densitometry. Results and Discussion. It was established that healing in the control group was compromised: pathological fractures and pseudoarthrosis formation were diagnosed in 60 % of the animals, and regenerate density at day 60 was the lowest (26.98 ± 2.18 arbitrary units). PRP monotherapy (Group I) promoted active angiogenesis but did not result in complete defect closure. Superior outcomes were observed in the combined treatment group (Group III): complete anatomical restitution of the bone was documented by day 60. The radiographic density values in this group reached 38.38 ± 2.85 a.u., which did not differ statistically from those of intact bone tissue, p > 0.05. Conclusions. The combined application of PRP and Bischofite phonophoresis demonstrates a pronounced synergistic effect: growth factors initiate osteoblast proliferation, while the magnesium complex ensures osteoid mineralization. The proposed method effectively prevents complications and achieves full structural restoration of the bone, thereby justifying the feasibility of clinical trials for this approach in the comprehensive treatment of mandibular fractures.