Histomorphologic Assessment of Osteoregeneration in a Rabbit Femur Model With Xenograft, Bone Morphogenetic Protein-2, Platelet-Rich Plasma, and Denosumab

Background: This study investigated whether the combination of thermally processed bone xenograft (XG) and recombinant human bone morphogenetic protein-2 (rhBMP-2) with platelet-rich plasma (PRP) or Prolia (denosumab) can enhance bone regeneration in a rabbit femoral bone defect model. Methods: Seventy-two rabbits with created femoral bone defects (5 mm) were divided into 4 groups: (1) XG + rhBMP-2 + Prolia; (2) XG + rhBMP-2 + PRP; (3) XG + rhBMP-2; and (4) XG. At 14, 30, and 60 days after implantation, samples were prepared for histological and histomorphometric analysis. Results: < 0.001). At day 60, XG + rhBMP-2 + Prolia showed no cortical bone increase because of concurrent resorption. Conclusions: Combined therapy using thermally processed bone graft, rhBMP-2, and PRP improves bone healing in femoral defects in rabbits.