Optimizing the Handling of Cancellous Bone Grafts to Preserve Their Osteogenic Potential in Craniofacial Surgery

Cancellous bone grafts are essential in orthopedic and plastic surgeries due to their osteoconductive and osteoinductive properties. However, handling, storage, and preservation challenges impact their viability and effectiveness in bone healing. This study assessed the effects of handling time, storage temperature, and preservation solutions on bone graft viability and osteogenesis using in vitro and in vivo models. Handling times exceeding 10 min significantly reduced cell viability, with 4 °C storage proving superior to 23 °C and 37 °C. In vivo, grafts stored at 4 °C showed enhanced bone regeneration, with PRP-treated grafts demonstrating greater osteogenic potential compared to those stored in blood or PBS. Micro-CT and histological analyses confirmed superior bone volume and tissue integration with PRP, particularly in older grafts. These findings underscore the importance of optimizing perioperative handling protocols. Storage at 4 °C and preservation in PRP emerge as promising strategies for improving bone graft outcomes in clinical applications.