COVID-19
Regístrese
metricas
covid
Revista Española de Cirugía Ortopédica y Traumatología (English Edition)
Buscar en
Revista Española de Cirugía Ortopédica y Traumatología (English Edition)
Toda la web
Inicio Revista Española de Cirugía Ortopédica y Traumatología (English Edition) Bone regeneration in experimental animals using calcium phosphate cement combine...
Journal Information
Back to article

Statistics

Follow this link to access the full text of the article

Research
Bone regeneration in experimental animals using calcium phosphate cement combined with platelet growth factors and human growth hormone
Regeneración ósea en animales de experimentación, mediante cemento de fosfato cálcico en combinación con factores de crecimiento plaquetarios y hormona de crecimiento humana
K. Emilov-Veleva,
Corresponding author
kaloyanvelev@yahoo.es

Corresponding author.
, C. Clemente-de-Arribab, M.Á. Alobera-Garcíac, E.M. Moreno-Sansalvadord, J. Campo-Loartea
a Servicio de Traumatología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
b Unidad de Embriología y Anatomía Humana, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
c Práctica privda, Alcalá de Henares, Madrid, Spain
d Centro de Atención Primaria María de Guzmán, Alcalá de Henares, Madrid, Spain
Read
1305
Times
was read the article
307
Total PDF
998
Total HTML
Share statistics
 array:24 [
  "pii" => "S1988885615000218"
  "issn" => "19888856"
  "doi" => "10.1016/j.recote.2015.03.003"
  "estado" => "S300"
  "fechaPublicacion" => "2015-05-01"
  "aid" => "528"
  "copyright" => "SECOT"
  "copyrightAnyo" => "2014"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:200-10"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 157
    "formatos" => array:2 [
      "HTML" => 112
      "PDF" => 45
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:18 [
      "pii" => "S1888441514001714"
      "issn" => "18884415"
      "doi" => "10.1016/j.recot.2014.07.011"
      "estado" => "S300"
      "fechaPublicacion" => "2015-05-01"
      "aid" => "528"
      "copyright" => "SECOT"
      "documento" => "article"
      "subdocumento" => "fla"
      "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:200-10"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 254
        "formatos" => array:3 [
          "EPUB" => 12
          "HTML" => 173
          "PDF" => 69
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">INVESTIGACI&#211;N</span>"
        "titulo" => "Regeneraci&#243;n &#243;sea en animales de experimentaci&#243;n&#44; mediante cemento de fosfato c&#225;lcico en combinaci&#243;n con factores de crecimiento plaquetarios y hormona de crecimiento humana"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "200"
            "paginaFinal" => "210"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Bone regeneration in experimental animals using calcium phosphate cement combined with platelet growth factors and human growth hormone"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1119
                "Ancho" => 1501
                "Tamanyo" => 274670
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">a&#41; PRP con cemento&#46; b&#41; GH con cemento&#46; c&#41; Defecto &#243;seo&#46; d&#41; Identificaci&#243;n del defecto mediante aguja Kirschner&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "K&#46; Emilov-Velev, C&#46; Clemente-de-Arriba, M&#46;&#193;&#46; Alobera-Garc&#237;a, E&#46;M&#46; Moreno-Sansalvador, J&#46; Campo-Loarte"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "K&#46;"
                "apellidos" => "Emilov-Velev"
              ]
              1 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Clemente-de-Arriba"
              ]
              2 => array:2 [
                "nombre" => "M&#46;&#193;&#46;"
                "apellidos" => "Alobera-Garc&#237;a"
              ]
              3 => array:2 [
                "nombre" => "E&#46;M&#46;"
                "apellidos" => "Moreno-Sansalvador"
              ]
              4 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Campo-Loarte"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1988885615000218"
          "doi" => "10.1016/j.recote.2015.03.003"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000218?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441514001714?idApp=UINPBA00004N"
      "url" => "/18884415/0000005900000003/v2_201504151346/S1888441514001714/v2_201504151346/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1988885615000206"
    "issn" => "19888856"
    "doi" => "10.1016/j.recote.2015.03.002"
    "estado" => "S300"
    "fechaPublicacion" => "2015-05-01"
    "aid" => "494"
    "copyright" => "SECOT"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:211-4"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 123
      "formatos" => array:2 [
        "HTML" => 88
        "PDF" => 35
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
      "titulo" => "Traumatic dislocation of posterior tibial tendon by avulsion of flexor retinacular release&#46; Reconstruction with suture anchors"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "211"
          "paginaFinal" => "214"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Luxaci&#243;n traum&#225;tica del tend&#243;n tibial posterior por avulsi&#243;n del retin&#225;culo flexor&#46; Reconstrucci&#243;n con suturas con anclajes"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figure 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 621
              "Ancho" => 1000
              "Tamanyo" => 106497
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Reinsertion of the retinaculum with non-absorbable suture supported by 3<span class="elsevierStyleHsp" style=""></span>mm titanium anchors&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; Godino, M&#46; Vides, E&#46; Guerado"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Godino"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Vides"
            ]
            2 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Guerado"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1888441514000812"
        "doi" => "10.1016/j.recot.2014.04.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441514000812?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000206?idApp=UINPBA00004N"
    "url" => "/19888856/0000005900000003/v2_201504040248/S1988885615000206/v2_201504040248/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1988885615000267"
    "issn" => "19888856"
    "doi" => "10.1016/j.recote.2015.03.008"
    "estado" => "S300"
    "fechaPublicacion" => "2015-05-01"
    "aid" => "537"
    "copyright" => "SECOT"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Rev Esp Cir Ortop Traumatol. 2015;59:186-99"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 169
      "formatos" => array:2 [
        "HTML" => 116
        "PDF" => 53
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "SECOT-GEDOS consensus on pre-surgical pain management in knee and hip arthrosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "186"
          "paginaFinal" => "199"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Consenso SECOT-GEDOS sobre el control del dolor prequir&#250;rgico en artrosis de rodilla y cadera"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1528
              "Ancho" => 1666
              "Tamanyo" => 202550
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Stages of the document of consensus&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46;A&#46; Ruiz Ib&#225;n, F&#46; Macul&#233;, P&#46; Torner, E&#46; Gil Garay, A&#46; Oteo-&#193;lvaro, J&#46;M&#46; L&#243;pez Mill&#225;n, J&#46; D&#237;az Heredia, E&#46; Loza"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "M&#46;A&#46;"
              "apellidos" => "Ruiz Ib&#225;n"
            ]
            1 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Macul&#233;"
            ]
            2 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Torner"
            ]
            3 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Gil Garay"
            ]
            4 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Oteo-&#193;lvaro"
            ]
            5 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "L&#243;pez Mill&#225;n"
            ]
            6 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "D&#237;az Heredia"
            ]
            7 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Loza"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1888441514001969"
        "doi" => "10.1016/j.recot.2014.09.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441514001969?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000267?idApp=UINPBA00004N"
    "url" => "/19888856/0000005900000003/v2_201504040248/S1988885615000267/v2_201504040248/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Research</span>"
    "titulo" => "Bone regeneration in experimental animals using calcium phosphate cement combined with platelet growth factors and human growth hormone"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "200"
        "paginaFinal" => "210"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "K&#46; Emilov-Velev, C&#46; Clemente-de-Arriba, M&#46;&#193;&#46; Alobera-Garc&#237;a, E&#46;M&#46; Moreno-Sansalvador, J&#46; Campo-Loarte"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "K&#46;"
            "apellidos" => "Emilov-Velev"
            "email" => array:1 [
              0 => "kaloyanvelev&#64;yahoo&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Clemente-de-Arriba"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "M&#46;&#193;&#46;"
            "apellidos" => "Alobera-Garc&#237;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "E&#46;M&#46;"
            "apellidos" => "Moreno-Sansalvador"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Campo-Loarte"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Servicio de Traumatolog&#237;a&#44; Hospital Universitario Puerta de Hierro&#44; Majadahonda&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Embriolog&#237;a y Anatom&#237;a Humana&#44; Facultad de Medicina&#44; Universidad de Alcal&#225;&#44; Alcal&#225; de Henares&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Pr&#225;ctica privda&#44; Alcal&#225; de Henares&#44; Madrid&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Centro de Atenci&#243;n Primaria Mar&#237;a de Guzm&#225;n&#44; Alcal&#225; de Henares&#44; Madrid&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Regeneraci&#243;n &#243;sea en animales de experimentaci&#243;n&#44; mediante cemento de fosfato c&#225;lcico en combinaci&#243;n con factores de crecimiento plaquetarios y hormona de crecimiento humana"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0030"
        "etiqueta" => "Figure 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr6.jpeg"
            "Alto" => 1586
            "Ancho" => 2236
            "Tamanyo" => 199444
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Statistical results of the morphometric study&#46; &#40;a&#41; ANOVA of the density of the total new bone formation area&#46; &#40;b&#41; ANOVA of the density of the new bone formation area in the medullary cavity&#46; &#40;c&#41; ANOVA of the density of the new bone formation area outside the medullary channel&#46; &#40;d&#41; ANOVA of the density of the area of the remaining biomaterial&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0035" class="elsevierStylePara elsevierViewall">The need to achieve <span class="elsevierStyleItalic">bone regeneration</span> in situations where a patient&#39;s spontaneous regenerative capacity is insufficient is a common situation in daily clinical practice&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Most bone lesions which present cavities are self-regenerating as they are not of a sufficient size to be termed &#8220;critical defects&#8221;&#46; A cavity of a size which does not close or regenerate spontaneously is defined as a &#8220;critical defect&#8221;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The formulation of calcium phosphate ceramics as bone cement has introduced new materials for bone regeneration since&#44; in most cases&#44; its reaction process produces a hydroxyapatite which is very similar to biological hydroxyapatite&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">In addition to <span class="elsevierStyleItalic">bone substitutes</span>&#44; the development and use of diverse <span class="elsevierStyleItalic">growth factors and hormones</span> are another line of research towards promoting bone regeneration&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Growth factors from platelet-rich plasma &#40;PRP&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> are the simplest to apply because of the way they can be gathered&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Platelets transport platelet growth factors<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a>&#58; platelet derived growth factor and vascular endothelial growth factor&#44; as well as transforming growth factor-beta and bone sialoprotein&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Furthermore&#44; in terms of the role played by hormones in bone regeneration&#44; numerous studies have shown the relationship between growth hormone &#40;GH&#41; and bone metabolism&#46; In fact&#44; growth hormones have a significant action at bone level on the bone forming cells&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> The increased proliferation of osteoblasts brought about by GH&#44; would translate as a greater number of these cells appearing at the level of the critical defect&#44; and early cellular differentiation would significantly accelerate the synthesis and mineralization of the osteiod matrix&#46; All of which would favor the process of bone regeneration in the critical defect&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Despite the vast arsenal of bone grafts and substitutes&#44; the problem of how to achieve entirely satisfactory bone regeneration with their use has as yet not been fully solved&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">This work is a further step towards finding new methods of achieving total bone regeneration in bone cavities with critical defects&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methodology</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Materials</span><p id="par0080" class="elsevierStylePara elsevierViewall">15 New Zealand rabbits were used as experimental animals for this work&#46; They were healthy&#44; adult males of between 8 and 12 months old from the Animal Experimentation Centre of the Faculty of Medicine of the University of Alcal&#225; which complies with national and international animal experimentation regulations&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The animals were alive and in good health up until 28 days after surgery&#59; they had direct access to water and food ad libitum&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Surgical instruments&#58; the usual instruments for bone tissue surgery were used&#46; A contra-angle coupled to a surgical motor with an irrigation system and a trephine drill 6<span class="elsevierStyleHsp" style=""></span>mm in diameter adapted to the contra-angle&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The following products were used&#58;<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">A&#46;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Tricalcium phosphate cement &#40;Calcibon<span class="elsevierStyleSup">&#174;</span>&#41;&#58; a calcium phosphate-based cement&#46; It consists of two separate components&#58; powder and liquid&#46; When the mixture is made up&#44; at the time of surgery&#44; calcium carbonate phosphate apatite forms which comprises small crystals similar to the inorganic phase of bone tissue&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">B&#46;</span><p id="par0105" class="elsevierStylePara elsevierViewall">Growth hormone&#46; Norditropin Simplex<span class="elsevierStyleSup">&#174;</span> 15<span class="elsevierStyleHsp" style=""></span>mg&#47;1&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#46; It contains a biosynthetic human growth hormone called somatropin which is identical to human growth hormone&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">C&#46;</span><p id="par0110" class="elsevierStylePara elsevierViewall">PRP&#46; This comes from the animal&#39;s own blood and is obtained using the specific method which is described later&#46;</p></li></ul></p><p id="par0115" class="elsevierStylePara elsevierViewall">Histological and morphometric material&#58;<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">A&#46;</span><p id="par0120" class="elsevierStylePara elsevierViewall">Histological cutting equipment&#58; EXAKT<span class="elsevierStyleSup">&#174;</span> Cutting Grinding System &#40;Exakt Apparatebau&#44; Nordersted&#44; Germany&#41; for hard tissues&#44; comprising a diamond saw and polisher with discs of different grain diameters&#46;</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">B&#46;</span><p id="par0125" class="elsevierStylePara elsevierViewall">Histological stain solutions&#46;</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">C&#46;</span><p id="par0130" class="elsevierStylePara elsevierViewall">Two-dimensional imaging software for quantitative study of the samples &#40;MIP-45&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">D&#46;</span><p id="par0135" class="elsevierStylePara elsevierViewall">Optical microscope and conventional optics camera for histological study&#46;</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">E&#46;</span><p id="par0140" class="elsevierStylePara elsevierViewall">Morphometric material&#58; optical microscope&#44; computer system and application for MIP-45&#46;</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">F&#46;</span><p id="par0145" class="elsevierStylePara elsevierViewall">Statgraphics plus v&#46; 5&#46;1 software for statistical analysis&#46;</p></li></ul></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methodology</span><p id="par0150" class="elsevierStylePara elsevierViewall">The animals were divided into three groups&#58;<ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">&#8226;</span><p id="par0155" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Control Group</span>&#44; comprising 5 animals in which only tricalcium phosphate was used as the filler material for the defect created in the tibial metaphysis&#46;</p></li><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">&#8226;</span><p id="par0160" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">PRP Group</span>&#44; comprising 5 animals using tricalcium phosphate bathed in PRP as the filler material&#46;</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">&#8226;</span><p id="par0165" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">GH Group</span>&#44; comprising 5 animals using tricalcium phosphate bathed in growth hormone as the filler material&#46;</p></li></ul></p><p id="par0170" class="elsevierStylePara elsevierViewall">A&#46; Surgical technique&#58;<ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">&#8211;</span><p id="par0175" class="elsevierStylePara elsevierViewall">All the experimental animals were <span class="elsevierStyleItalic">anaesthetized</span> using ketamine chlorydrate at a dose of 5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg body weight&#46;</p></li><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel">&#8211;</span><p id="par0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Preparation of PRP&#58;</span> The PRP group&#44; comprising 5 animals&#44; required platelet rich plasma to be gathered prior to surgery&#46; The technique described by Anitua et al&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> was used to gather the PRP from each animal&#46;</p></li><li class="elsevierStyleListItem" id="lsti0105"><span class="elsevierStyleLabel">&#8211;</span><p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Preparation of the tricalcium phosphate &#40;Calcibon</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#174;</span></span><span class="elsevierStyleItalic">&#41;&#58;</span></p></li></ul></p><p id="par0190" class="elsevierStylePara elsevierViewall">The solid and liquid components of the tricalcium phosphate were prepared by mixing&#46; 3&#46;3<span class="elsevierStyleHsp" style=""></span>g of Calcibon<span class="elsevierStyleSup">&#174;</span> powder was dissolved in 1<span class="elsevierStyleHsp" style=""></span>cc of Calcibon<span class="elsevierStyleSup">&#174;</span> liquid&#44; mixed for 1<span class="elsevierStyleHsp" style=""></span>min and left for 4<span class="elsevierStyleHsp" style=""></span>min before being placed in the bone defect&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">In the PRP group&#44; the filler material was made up mixing tricalcium phosphate cement with 1<span class="elsevierStyleHsp" style=""></span>cc&#46; PRP &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41;&#44; mixing for 1<span class="elsevierStyleHsp" style=""></span>min&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0200" class="elsevierStylePara elsevierViewall">In the GH group&#44; tricalcium phosphate bathed in growth hormone &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>b&#41; was used as the filler material&#44; adding 4 UI of growth hormone&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">&#8211; <span class="elsevierStyleItalic">Preparation of the bone defect&#58;</span> both tibias of each rabbit were operated successively making bone defects in each&#46; Both defects were treated with the same type of filler in the two tibias according to the animal&#39;s experimental group &#40;control&#44; PRP or GH&#41;&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">After shaving the operation site above the tibia&#44; the skin surface was disinfected using povidone-iodine&#46; Then a sagittal incision was made of about 4<span class="elsevierStyleHsp" style=""></span>cm&#44; at the level of the internal face in the proximal end of the tibia&#44; carefully separating the periosteum and exposing the bone&#46; An experimental circular defect was made using a trephine drill of 6<span class="elsevierStyleHsp" style=""></span>mm in diameter mounted on a contra-angle &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>c&#41;&#46; We chose this site based on previous references&#44; as the metaphysiary region responds more intensely to stimuli than the tibial diaphysis&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">The bone defects were subsequently filled with tricalcium phosphate alone&#44; or with tricalcium phosphate and PRP or GH&#44; depending on the experimental group &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>d&#41;&#46; The operation was performed on both limbs of the animal&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">The site of the filled defect was marked with a 1&#46;2<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mm Kirschner wire in order to identify it later in the histological study &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>d&#41;&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Finally&#44; the periosteum was carefully sutured with absorbable suture and the skin was sutured with silk&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Taking the study samples&#58; all the animals were sacrificed 28 days after surgery by lethal injection of barbiturates &#40;sodium pentothal&#41;&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">B&#46; Macroscopic study&#58; macroscopic study assessed the appearance of the proximal region of the tibia of the animals once the soft parts had been dissected&#46; The appearance of the proximal part of the tibia was assessed in the 3 experimental groups&#44; checking the filling of the critical defect in all of the animals&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">C&#46; Optical microscopy study</p><p id="par0245" class="elsevierStylePara elsevierViewall">Once the tibias had been taken&#44; they were fixed in 5&#37; formalin buffered at pH 7 to prevent decalcification&#46; The samples were then processed in the Human Anatomy and Embryology Department of the Faculty of Medicine of the University of Alcal&#225;&#44; where their fixation in formalin continued to be monitored&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">The bone regeneration was then examined histologically and histomorphometrically in undecalcified bone tissue samples&#46; The Exakt<span class="elsevierStyleSup">&#174;</span> cutting and polishing system was used for this purpose&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">The next step was to put the sample into a polymer&#46; Therefore a block of Methacrylate was made containing the tibias&#46; Then the samples were cut with the diamond cutting band of the Exakt<span class="elsevierStyleSup">&#174;</span> system&#44; obtaining 5 cuts per sample for subsequent histological study&#46; The cuts were made perpendicular to the longitudinal axis of the tibial diaphysis&#44; following a transverse plane&#44; in order to be able to assess the entire cavity&#44; from the inside to the surface&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">The usual stains were used for the bone tissue study in the laboratory&#58;<ul class="elsevierStyleList" id="lis0035"><li class="elsevierStyleListItem" id="lsti0110"><span class="elsevierStyleLabel">&#8211;</span><p id="par0265" class="elsevierStylePara elsevierViewall">Masson&#39;s Trichrome&#46;</p></li><li class="elsevierStyleListItem" id="lsti0115"><span class="elsevierStyleLabel">&#8211;</span><p id="par0270" class="elsevierStylePara elsevierViewall">Hematoxylin&#8211;eosin&#46;</p></li><li class="elsevierStyleListItem" id="lsti0120"><span class="elsevierStyleLabel">&#8211;</span><p id="par0275" class="elsevierStylePara elsevierViewall">Toluidine blue&#46;</p></li></ul></p><p id="par0280" class="elsevierStylePara elsevierViewall">The following histological variables were assessed&#58;<ul class="elsevierStyleList" id="lis0040"><li class="elsevierStyleListItem" id="lsti0125"><span class="elsevierStyleLabel">&#8226;</span><p id="par0285" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Mature bone tissue</span>&#58; characterized by the fact that its bone matrix &#40;mineralized interstitial substance&#41; organizes itself forming bone lamellae 3&#8211;7<span class="elsevierStyleHsp" style=""></span>&#956;m thick&#46; Cells of mature bone are osteocytes and occupy spaces called lacunae&#44; arranged concentrically&#44; like lamellae&#46;</p></li><li class="elsevierStyleListItem" id="lsti0130"><span class="elsevierStyleLabel">&#8226;</span><p id="par0290" class="elsevierStylePara elsevierViewall">The lamellae are parallel and concentric&#46;</p></li><li class="elsevierStyleListItem" id="lsti0135"><span class="elsevierStyleLabel">&#8226;</span><p id="par0295" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Newly formed bone tissue</span>&#58; contains a relatively higher proportion of osteocytes&#44; with larger lacunae than those which appear in mature bone and collagen fibers which follow various directions&#46;</p></li><li class="elsevierStyleListItem" id="lsti0140"><span class="elsevierStyleLabel">&#8226;</span><p id="par0300" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Quantity and appearance of the biomaterial &#40;calcium phosphate cement&#41;</span>&#58; the appearance of the biomaterial placed inside the cavity which had been made experimentally in the tibia was also studied histologically&#46;</p></li><li class="elsevierStyleListItem" id="lsti0145"><span class="elsevierStyleLabel">&#8226;</span><p id="par0305" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Response of the bone tissue to the biomaterial</span>&#58; signs of inflammatory reaction were looked for&#44; such as the appearance of lymphocytes or foreign body cells&#46; Finally&#44; signs of allergic reaction were investigated&#44; such as the presence of eosinophyls&#46;</p></li></ul></p><p id="par0310" class="elsevierStylePara elsevierViewall">D&#46; Morphometric study</p><p id="par0315" class="elsevierStylePara elsevierViewall">After the qualitative histological study&#44; quantitative analysis was undertaken using two-dimensional morphometry&#46;</p><p id="par0320" class="elsevierStylePara elsevierViewall">This enabled us to objectively quantify the amount of newly formed bone tissue which had regenerated in the cavities of the different groups&#46; To do this&#44; we used image-analyzing software&#44; called MIP-45&#46;</p><p id="par0325" class="elsevierStylePara elsevierViewall">D&#46;1&#46; Study technique&#58;</p><p id="par0330" class="elsevierStylePara elsevierViewall">We used a point template as a measurement estimator designed so that each point had an associated area of 1<span class="elsevierStyleHsp" style=""></span>mm&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> The count of impact points enabled us to obtain the values of our variables&#46;</p><p id="par0335" class="elsevierStylePara elsevierViewall">D&#46;2&#46; Variables of the histomorphometric study&#46; In order to obtain the study variables&#44; we had to calculate the following areas beforehand&#58;<ul class="elsevierStyleList" id="lis0045"><li class="elsevierStyleListItem" id="lsti0150"><span class="elsevierStyleLabel">1&#46;</span><p id="par0340" class="elsevierStylePara elsevierViewall">Total area of the sample&#58; this includes the area occupied by the entire bone&#44; and the area occupied by the medullary cavity&#46;</p></li><li class="elsevierStyleListItem" id="lsti0155"><span class="elsevierStyleLabel">2&#46;</span><p id="par0345" class="elsevierStylePara elsevierViewall">Area of cortical bone&#46;</p></li><li class="elsevierStyleListItem" id="lsti0160"><span class="elsevierStyleLabel">3&#46;</span><p id="par0350" class="elsevierStylePara elsevierViewall">Area of newly formed bone which we subdivided into&#58;<ul class="elsevierStyleList" id="lis0050"><li class="elsevierStyleListItem" id="lsti0165"><span class="elsevierStyleLabel">a&#46;</span><p id="par0355" class="elsevierStylePara elsevierViewall">Area of newly formed bone inside the medullary cavity&#46;</p></li><li class="elsevierStyleListItem" id="lsti0170"><span class="elsevierStyleLabel">b&#46;</span><p id="par0360" class="elsevierStylePara elsevierViewall">Area of newly formed bone outside the medullary cavity&#46;</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0175"><span class="elsevierStyleLabel">4&#46;</span><p id="par0365" class="elsevierStylePara elsevierViewall">Area occupied by the remaining biomaterial&#46;</p></li></ul></p><p id="par0370" class="elsevierStylePara elsevierViewall">Once the above areas had been calculated&#44; the study variables were determined in the five sections or cuts taken from each animal&#39;s tibia&#46; These variables were as follows&#58;<ul class="elsevierStyleList" id="lis0055"><li class="elsevierStyleListItem" id="lsti0180"><span class="elsevierStyleLabel">1&#46;</span><p id="par0375" class="elsevierStylePara elsevierViewall">Density of the area of the remaining biomaterial &#40;&#37; biomaterial area&#41;&#58;<elsevierMultimedia ident="eq0005"></elsevierMultimedia></p></li><li class="elsevierStyleListItem" id="lsti0185"><span class="elsevierStyleLabel">2&#46;</span><p id="par0380" class="elsevierStylePara elsevierViewall">Density of the area of new bone formation in the medullary cavity &#40;&#37; medullary area&#41;&#58;<elsevierMultimedia ident="eq0010"></elsevierMultimedia></p></li><li class="elsevierStyleListItem" id="lsti0190"><span class="elsevierStyleLabel">3&#46;</span><p id="par0385" class="elsevierStylePara elsevierViewall">Density of the area of new bone formation outside the medullary cavity &#40;&#37; periosteal area&#41;&#58;<elsevierMultimedia ident="eq0015"></elsevierMultimedia></p></li><li class="elsevierStyleListItem" id="lsti0195"><span class="elsevierStyleLabel">4&#46;</span><p id="par0390" class="elsevierStylePara elsevierViewall">Density of the total area of new bone formation &#40;&#37; total area&#41;&#58;<elsevierMultimedia ident="eq0020"></elsevierMultimedia></p></li></ul></p><p id="par0395" class="elsevierStylePara elsevierViewall">D&#46;4&#46; Study of the reliability of the method&#46; A prior pilot study for dependent samples was undertaken to check the degree of reliability in order to establish the morphometry&#44; with the objective of evaluating the accuracy of the estimator or probe &#40;measurement unit&#41; used&#44; by calculating the error coefficient for this probe&#46; This study enabled a measurement probe to be designed for the samples&#44; comprising a point template&#44; each point with an associated area of 1<span class="elsevierStyleHsp" style=""></span>mm&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a></p><p id="par0400" class="elsevierStylePara elsevierViewall">The reliability study&#44; its calculation and methodology were as follows&#58;</p><p id="par0405" class="elsevierStylePara elsevierViewall">Calculation of sampling reliability for dependent samples&#58; cuts parallel to each other&#44; perpendicular to the longitudinal axis of the sample &#40;Cavalieri cuts&#41;&#58; the error coefficient is a statistical concept which allows us to know the degree of precision of the estimator used&#46; Its value will depend on the number of sampling units and the size of the estimator &#40;in other words&#44; the distance between the points of the measuring template&#41;&#46; This information enables us to identify the minimum value we require of cuts from one single sample&#44; and the minimum distance between the points used to measure them&#44; so that the data obtained using these two constants enable us to make a reliable statistical calculation&#46;</p><p id="par0410" class="elsevierStylePara elsevierViewall">E&#46; Statistical study&#58; the significant differences between the study groups were assessed by analysis of variance &#40;ANOVA&#41; using the Stagraphics program version 5&#46;1&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0415" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0060"><li class="elsevierStyleListItem" id="lsti0200"><span class="elsevierStyleLabel">I&#46;</span><p id="par0420" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Macroscopic results</span>&#58; the site in the tibias which had been operated 28 days earlier was screened&#46;<ul class="elsevierStyleList" id="lis0065"><li class="elsevierStyleListItem" id="lsti0205"><span class="elsevierStyleLabel">1&#46;</span><p id="par0425" class="elsevierStylePara elsevierViewall">In the <span class="elsevierStyleItalic">control group</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>a&#41; the samples did not show that the calcium phosphate cement which had been placed during surgery had integrated&#46; The site of the critical defect was clearly differentiated&#59; the cement appeared as an amorphous mass which filled the defect with no integration of any type&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0210"><span class="elsevierStyleLabel">2&#46;</span><p id="par0430" class="elsevierStylePara elsevierViewall">In the <span class="elsevierStyleItalic">PRP group</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>b&#41;&#44; on the one hand&#44; it was observed that the critical defect was well filled&#44; and on the other&#44; the cement appeared to have produced better bone integration than in the control group&#46;</p></li><li class="elsevierStyleListItem" id="lsti0215"><span class="elsevierStyleLabel">3&#46;</span><p id="par0435" class="elsevierStylePara elsevierViewall">On observing the critical defect made in the tibias of the rabbits in the <span class="elsevierStyleItalic">GH group</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>c&#41;&#44; macroscopically the filling appeared to be better osseointegrated and it was difficult to distinguish the bone tissue from the filled defect&#46; The site of the critical defect can be seen in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>c&#44; marked with a Kirschner wire&#44; which is difficult to distinguish from the rest of the cortex&#46;</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0220"><span class="elsevierStyleLabel">II&#46;</span><p id="par0440" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Histological results</span>&#58; the histological study enabled us to histologically evaluate and compare bone tissue formation and the presence of biomaterial inside the critical defect between the 3 groups studied&#46; Mature bone&#44; immature bone&#44; residual biomaterial&#44; the Kirschner&#39;s wire which served to mark the critical bone defect&#44; and the presence of connective tissue and bone marrow could be observed in the transverse cuts&#46;<ul class="elsevierStyleList" id="lis0070"><li class="elsevierStyleListItem" id="lsti0225"><span class="elsevierStyleLabel">1&#46;</span><p id="par0445" class="elsevierStylePara elsevierViewall">A great many tricalcium phosphate &#40;Calcibon<span class="elsevierStyleSup">&#174;</span>&#41; particles were observed in the <span class="elsevierStyleItalic">control group</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>a and b&#41; distributed throughout the entire area of the sample&#44; lightly stained by hematoxylin&#44; with a greenish shade in the Masson&#39;s Trichrome preparations and a grayish appearance in the Toluidine blue preparations&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0450" class="elsevierStylePara elsevierViewall">Little new formation was noticed&#44; with some young&#44; short and isolated trabeculae&#44; close to the external and internal surface of the cortex and between the particles of calcium cement&#46; No osteoblasts or osteoclasts were found&#46;</p></li><li class="elsevierStyleListItem" id="lsti0230"><span class="elsevierStyleLabel">2&#46;</span><p id="par0455" class="elsevierStylePara elsevierViewall">Greater formation of immature bone tissue was observed in the <span class="elsevierStyleItalic">PRP Group</span> &#40;calcium phosphate cement<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>PRP filler&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>a&#8211;d&#41; filling both the critical defect and the spaces between the particles of biomaterial compared with the control group&#46; No inflammatory tissue was found and only a little connective tissue&#46; The tricalcium phosphate presented as an amorphous mass and we observed no osteoclastic activity&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0235"><span class="elsevierStyleLabel">3&#46;</span><p id="par0460" class="elsevierStylePara elsevierViewall">We observed the greatest degree of new bone formation in the form of immature bone tissue in the <span class="elsevierStyleItalic">GH group</span> &#40;calcium phosphate cement<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>GH filler&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>a&#8211;d&#41; compared with the histological cuts of the control group and the PRP group&#46; Numerous bone trabeculae were seen between the particles of biomaterial&#46; It is worth noting that the formation of the bone tissue was greater in the defect and inside the medullary channel compared with the cuts from the control group and the PRP group&#46; These observations suggest greater osteoblastic activity due to the effect of the GH in this group&#46; No osteoclastic activity or inflammatory tissue was found&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0240"><span class="elsevierStyleLabel">III&#46;</span><p id="par0465" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Morphometric results</span>&#58; once the reliability of the study had been confirmed the results were obtained of the proposed variables &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1&#8211;3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0245"><span class="elsevierStyleLabel">IV&#46;</span><p id="par0470" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Statistical results of the morphometric data&#58;</span> using Statgraphics 5&#46;1&#46; software&#44; we applied the ANOVA test to look for statistically significant differences between the three study groups&#58;</p></li></ul><ul class="elsevierStyleList" id="lis0075"><li class="elsevierStyleListItem" id="lsti0250"><span class="elsevierStyleLabel">1&#46;</span><p id="par0475" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Comparison of &#37; total area between the control groups&#44; PRP and GH&#58;</span> in terms of the total newly-formed bone in the control&#44; PRP and GH groups&#44; we found percentage values which were clearly greater in the GH group &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#44; &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>a&#41;&#46;</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0255"><span class="elsevierStyleLabel">2&#46;</span><p id="par0480" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Comparison of &#37; medullary area between the control groups&#44; PRP and GH&#58;</span> we found more new bone formation inside the medullary channel or canal in the GH group compared with the control group and the PRP group&#46; The difference was statistically significant &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; This result demonstrates that GH has a positive effect on new bone formation compared with PRP &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>b&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0260"><span class="elsevierStyleLabel">3&#46;</span><p id="par0485" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Comparison of &#37; periosteal area between the control groups&#44; PRP and GH&#58;</span> on comparing the control&#44; PRP and GH control groups&#44; we found no major differences in the percentage value of newly formed bone outside the filled defect&#46; This could be explained by the surgical technique used&#44; where the periosteal closure was completed through the suture in all the animals&#44; therefore no growth factor or hormone would have left the periosteum&#46; This would explain the new bone formation being similar in the three groups &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>c&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0265"><span class="elsevierStyleLabel">4&#46;</span><p id="par0490" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Comparison of &#37; biomaterial area between the control&#44; PRP and GH groups&#58;</span> no significant differences were found in the percentage of biomaterial between the control&#44; PRP and GH groups&#46; The reabsorption process of the calcium phosphate cement appears not to have started&#44; in the time frame studied of 28 days &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>d&#41;&#46;</p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">The type of experimental animal model</span><p id="par0495" class="elsevierStylePara elsevierViewall">A&#47;&#46; Animal species&#58;</p><p id="par0500" class="elsevierStylePara elsevierViewall">Rabbits were chosen as the experimental models because they reach &#8220;skeletal maturity&#8221; at around 8&#8211;10 months and have true cortex remodeling with faster bone turnover than that of other species&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> This makes them appropriate models for the study of drugs which regulate this remodeling&#46; The most suitable models are certain species of primates&#44; but research using these models is expensive&#44; laborious and is not free from risk&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a></p><p id="par0505" class="elsevierStylePara elsevierViewall">The animal&#39;s tibia is the most frequently chosen site as it is easy to access&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0510" class="elsevierStylePara elsevierViewall">B&#47;&#46; Influence of gender&#58; males were used in our study because they are not subject to cyclical hormonal changes&#46; We believe that using females might have increased the variability of the results&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a></p><p id="par0515" class="elsevierStylePara elsevierViewall">C&#47;&#46; Influence of age&#58; a series of morphological differences have been described in rabbits which might explain a lower intensity of regeneration in old animals&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a></p><p id="par0520" class="elsevierStylePara elsevierViewall">Animals of between 8 and 12 months of age were used in our study&#44; which had completed their skeletal growth&#46; At this age rabbits no longer display the excellent osteo-regenerative capacity of those younger than 2 months&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Site and size of the bone defect</span><p id="par0525" class="elsevierStylePara elsevierViewall">The studies of bone regeneration in rabbits were undertaken on different anatomic sites&#58; the mandible&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> the femur&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> and the calvaria&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> in order to assess bone repair after induced damage&#46;</p><p id="par0530" class="elsevierStylePara elsevierViewall">The tibia has been used by some authors<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15&#44;16</span></a> to induce bone defects&#46; The anatomo-surgical site of the medial face of the proximal tibia&#44; in particular&#44; is susceptible to induced bone defects&#44; as it has a wide&#44; slightly convex surface which has no muscular insertions&#46; The repair of bone defects will depend on their size rather than the anatomic site&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a></p><p id="par0535" class="elsevierStylePara elsevierViewall">In literature&#44; the tibial bone defects most used in rabbits have been full cortical thickness circular in shape and 3&#44; 6 and 8<span class="elsevierStyleHsp" style=""></span>mm in diameter&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a></p><p id="par0540" class="elsevierStylePara elsevierViewall">We chose to use defects of 6<span class="elsevierStyleHsp" style=""></span>mm&#44; in accordance with authors such as Katthagen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> who consider that these defects do not regenerate spontaneously&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Biomaterials used</span><p id="par0545" class="elsevierStylePara elsevierViewall">Historically&#44; bone autografts and allografts have been used in addition to a great variety of biomaterials to repair bone defects&#46;</p><p id="par0550" class="elsevierStylePara elsevierViewall">The ideal bone substitute would be biocompatible&#44; bioabsorbable&#44; osteoconductive&#44; of a similar structure to bone&#44; easy to use clinically and economically priced&#46;</p><p id="par0555" class="elsevierStylePara elsevierViewall">Ceramic biomaterials are amongst the groups of greatest interest in the reconstruction of bone defects due to their acknowledged osteoconductive properties&#44; proven biocompatibility&#44; biodegradation capacity&#44; unlimited availability&#44; suitability as drug vehicles and because they have the appropriate conditions to be used as casts for tissue engineering&#46; Alpha-tricalcium phosphate cement belongs to this group&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">19&#44;20</span></a></p><p id="par0560" class="elsevierStylePara elsevierViewall">However&#44; after examining the literature&#44; we have found no studies where an evaluation and comparison has been made of the effect produced by the mixture of calcium phosphate cement with platelet factors or growth hormone on spontaneous bone regeneration&#44; using a quantitative methodology and a bone defect model in animals&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Growth factors used</span><p id="par0565" class="elsevierStylePara elsevierViewall">A&#47;&#46; PRP&#58; PRP is considered to be a regenerative biomaterial which favors the circulation of stem cells&#44; the proliferation of fibroblasts and synthesis of type I collagen&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a></p><p id="par0570" class="elsevierStylePara elsevierViewall">Our morphometric results did not demonstrate a positive effect of PRP on bone regeneration&#46; We agree with the work of other authors who have not demonstrated a positive effect of PRP on bone generation either&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a></p><p id="par0575" class="elsevierStylePara elsevierViewall">Considering the proven positive effect of platelet growth hormones on the processes of bone regeneration&#44; it appears that the reason for the differences between studies is due to the different procedures used by the authors for collecting PRP&#46; It has been found that the concentration of growth hormones varies greatly depending on the methodology used for collecting them&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a></p><p id="par0580" class="elsevierStylePara elsevierViewall">For the future&#44; it appears that this methodology needs to be protocolized in order to obtain the exact concentration of platelet growth factors to achieve an optimal effect on bone regeneration&#46;</p><p id="par0585" class="elsevierStylePara elsevierViewall">B&#47;&#46; Growth hormone&#58; GH stimulates the production of collagen and non-collagen proteins by osteoblasts&#59; and&#44; moreover&#44; by stimulating the synthesis by the liver and the osteoblasts themselves of insulin-like growth factors &#40;IGF&#41;&#44; favors the differentiation of preosteoblasts and the proliferation of osteoblasts&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">24&#44;25</span></a></p><p id="par0590" class="elsevierStylePara elsevierViewall">These actions on bone tissue at the level of critical defects are interesting because of the possibility of applying GH locally at clinical level&#46;</p><p id="par0595" class="elsevierStylePara elsevierViewall">The data obtained in our research work&#44; with the local application of GH&#44; demonstrated significant histomorphometric differences between the control group and the GH group&#46; 28 days after surgery&#44; GH at a local dose of 4 UI &#40;1&#46;2<span class="elsevierStyleHsp" style=""></span>mg&#41;&#44; significantly increased the parameters of bone regeneration&#58; the density of the area of new bone formation in the medullary cavity&#46;</p><p id="par0600" class="elsevierStylePara elsevierViewall">In this regard&#44; we agree with the data obtained by Blom and Tresguerres&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">26&#44;27</span></a></p><p id="par0605" class="elsevierStylePara elsevierViewall">In the references we found mentions of the use of GH<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a> as a therapeutic agent&#44; through systemic application&#44; in the treatment of fractures&#46; All the authors agree on its positive effect in curing fractures&#44; however&#44; the majority reported adverse systemic effects&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">28&#44;29</span></a> Nonetheless&#44; there are few studies on their local use&#44; and those which we managed to find&#44; did not report systemic effects&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> This could justify the local application of the hormone being of clinical interest&#44; which would achieve the benefits of this hormone in curing bone lesions&#44; and avoid its possible side effects when applied systemically&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusions</span><p id="par0610" class="elsevierStylePara elsevierViewall">The following conclusions can be drawn from the results obtained from this study&#58;<ul class="elsevierStyleList" id="lis0080"><li class="elsevierStyleListItem" id="lsti0270"><span class="elsevierStyleLabel">1&#46;</span><p id="par0615" class="elsevierStylePara elsevierViewall">The macroscopic appearance of the critical defect&#44; after treatment&#44; is better in the PRP group and in the GH group than in the control group&#46;</p></li><li class="elsevierStyleListItem" id="lsti0275"><span class="elsevierStyleLabel">2&#46;</span><p id="par0620" class="elsevierStylePara elsevierViewall">New bone formation was observed histologically&#44; both inside and outside the defect&#44; in the three groups&#46;</p></li><li class="elsevierStyleListItem" id="lsti0280"><span class="elsevierStyleLabel">3&#46;</span><p id="par0625" class="elsevierStylePara elsevierViewall">However&#44; the quantitative morphometric study did not detect statistically significant differences between the new bone formation achieved in the PRP group and the control group&#46;</p></li><li class="elsevierStyleListItem" id="lsti0285"><span class="elsevierStyleLabel">4&#46;</span><p id="par0630" class="elsevierStylePara elsevierViewall">Statistically significant differences were found which indicated more new bone formation in the GH group compared to the other two groups&#46;</p></li></ul></p><p id="par0635" class="elsevierStylePara elsevierViewall">Final conclusion&#58; GH facilitates bone regeneration in critical defects&#44; filled with calcium phosphate&#44; in New Zealand rabbits in the period of time studied&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Evidence level</span><p id="par0640" class="elsevierStylePara elsevierViewall">Evidence level <span class="elsevierStyleSmallCaps">I</span>&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Ethical responsibilities</span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Protection of human beings and animals</span><p id="par0645" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed conform to the ethical standards of the committee for responsible human experimentation and in accordance with the World Medical Association and the Helsinki Declaration&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Data confidentiality</span><p id="par0650" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Right to privacy and informed consent</span><p id="par0655" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflict of interest</span><p id="par0660" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:13 [
        0 => array:3 [
          "identificador" => "xres471347"
          "titulo" => "Abstract"
          "secciones" => array:5 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Materials"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Methods"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Results"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Conclusion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec493833"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres471348"
          "titulo" => "Resumen"
          "secciones" => array:5 [
            0 => array:1 [
              "identificador" => "abst0030"
            ]
            1 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Materiales"
            ]
            2 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "M&#233;todo"
            ]
            3 => array:2 [
              "identificador" => "abst0045"
              "titulo" => "Resultados"
            ]
            4 => array:2 [
              "identificador" => "abst0050"
              "titulo" => "Conclusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec493834"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Materials and methodology"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Materials"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Methodology"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Results"
        ]
        7 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Discussion"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "The type of experimental animal model"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Site and size of the bone defect"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Biomaterials used"
            ]
            3 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Growth factors used"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Evidence level"
        ]
        10 => array:3 [
          "identificador" => "sec0065"
          "titulo" => "Ethical responsibilities"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Protection of human beings and animals"
            ]
            1 => array:2 [
              "identificador" => "sec0075"
              "titulo" => "Data confidentiality"
            ]
            2 => array:2 [
              "identificador" => "sec0080"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        11 => array:2 [
          "identificador" => "sec0085"
          "titulo" => "Conflict of interest"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2014-05-23"
    "fechaAceptado" => "2014-07-22"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec493833"
          "palabras" => array:6 [
            0 => "Critical bone defect"
            1 => "Bone regeneration"
            2 => "Calcium phosphate cements"
            3 => "Platelet-rich plasma"
            4 => "Growth hormone"
            5 => "Morphometry"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec493834"
          "palabras" => array:6 [
            0 => "Defecto &#243;seo cr&#237;tico"
            1 => "Regeneraci&#243;n &#243;sea"
            2 => "Cemento de fosfato c&#225;lcico"
            3 => "Plasma rico en plaquetas"
            4 => "Hormona de crecimiento"
            5 => "Morfometr&#237;a"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Many substances &#40;growth factors and hormones&#41; have osteoinduction properties and when added to some osteoconduction biomaterial they accelerate bone neoformation properties&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Materials</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The materials included 15 New Zealand rabbits&#44; calcium phosphate cement &#40;Calcibon<span class="elsevierStyleSup">&#174;</span>&#41;&#44; human growth hormone &#40;GH&#41;&#44; and plasma rich in platelets &#40;PRP&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Each animal was operated on in both proximal tibias and a critical size bone defect of 6<span class="elsevierStyleHsp" style=""></span>mm of diameter was made&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The animals were separated into the following study groups&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0005" class="elsevierStylePara elsevierViewall">Control &#40;regeneration only by Calcibon<span class="elsevierStyleSup">&#174;</span>&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0010" class="elsevierStylePara elsevierViewall">PRP &#40;regeneration by Calcibon<span class="elsevierStyleSup">&#174;</span> and PRP&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0015" class="elsevierStylePara elsevierViewall">GH &#40;regeneration by Calcibon<span class="elsevierStyleSup">&#174;</span> and GH&#41;&#46;</p></li></ul></p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">All the animals were sacrificed at 28 days&#46; An evaluation was made of the appearance of the proximal extreme of rabbit tibiae in all the animals&#44; and to check the filling of the critical size defect&#46; A histological assessment was made of the tissue response&#44; the presence of new bone formation&#44; and the appearance of the biomaterial&#46; Morphometry was performed using the MIP 45 image analyser&#46; ANOVA statistical analysis was performed using the Statgraphics software application&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The macroscopic appearance of the critical defect was better in the PRP and the GH group than in the control group&#46; Histologically greater new bone formation was found in the PRP and GH groups&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">No statistically significant differences were detected in the morphometric study between bone formation observed in the PRP group and the control group&#46; Significant differences in increased bone formation were found in the GH group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41; compared to the other two groups&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">GH facilitates bone regeneration in critical defects filled with calcium phosphate cement in the time period studied in New Zealand rabbits&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:1 [
            "identificador" => "abst0005"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materials"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Determinadas sustancias &#40;factores de crecimiento y hormonas&#41; tienen propiedades osteoinductivas y a&#241;adidas a un biomaterial osteoconductivo aumentan sus propiedades de neoformaci&#243;n &#243;sea&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Materiales</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Quince conejos de la raza Nueva Zelanda&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Los biomateriales y factores utilizados fueron&#58; cemento de fosfato tric&#225;lcico &#40;Calcibon<span class="elsevierStyleSup">&#174;</span>&#41;&#44; hormona de crecimiento humana y plasma rico en plaquetas PRP&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todo</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Cada conejo fue intervenido en ambas tibias donde se le realiz&#243; un defecto de 6<span class="elsevierStyleHsp" style=""></span>mm&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Los animales de experimentaci&#243;n se repartieron en los siguientes grupos&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0020" class="elsevierStylePara elsevierViewall">Grupo control &#40;regeneraci&#243;n solo con TCP&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0025" class="elsevierStylePara elsevierViewall">Grupo PRP &#40;regeneraci&#243;n con TCP<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>PRP&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0030" class="elsevierStylePara elsevierViewall">Grupo GH &#40;regeneraci&#243;n con TCP<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>GH&#41;&#46;</p></li></ul></p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Todos los animales fueron sacrificados a los 28 d&#237;as&#46; Se valor&#243; el aspecto del defecto cr&#237;tico comprobando su relleno&#46; Histol&#243;gicamente valoramos la respuesta tisular&#44; la presencia de tejido &#243;seo neoformado&#44; y el aspecto del biomaterial&#46; Se realiz&#243; la morfometr&#237;a con analizador de im&#225;genes MIP 45&#46; Usamos el test ANOVA para el estudio estad&#237;stico mediante el programa Statgraphics&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">El aspecto macrosc&#243;pico del defecto cr&#237;tico&#44; fue mejor en el grupo PRP y en el grupo GH que en el grupo control&#46; Histol&#243;gicamente se observ&#243; mayor neoformaci&#243;n &#243;sea en los grupos PRP y GH&#46;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">El estudio morfom&#233;trico no detect&#243; diferencias significativas en la neoformaci&#243;n &#243;sea entre el grupo PRP y control&#46; Se detect&#243; mayor neoformaci&#243;n &#243;sea en el grupo GH &#40;p &#61; 0&#44;03&#41; frente a los otros dos grupos&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">La GH facilita la regeneraci&#243;n &#243;sea en defectos cr&#237;ticos&#44; rellenos con cemento de fosfato c&#225;lcico&#44; en el per&#237;odo de tiempo estudiado en conejos de Nueva Zelanda&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:1 [
            "identificador" => "abst0030"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Materiales"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "M&#233;todo"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Emilov-Velev K&#44; Clemente-de-Arriba C&#44; Alobera-Garc&#237;a MA&#44; Moreno-Sansalvador EM&#44; Campo-Loarte J&#46; Regeneraci&#243;n &#243;sea en animales de experimentaci&#243;n&#44; mediante cemento de fosfato c&#225;lcico en combinaci&#243;n con factores de crecimiento plaquetarios y hormona de crecimiento humana&#46; Rev Esp Cir Ortop Traumatol&#46; 2015&#59;59&#58;200&#8211;210&#46;</p>"
      ]
    ]
    "multimedia" => array:13 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1119
            "Ancho" => 1501
            "Tamanyo" => 305920
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; PRP with cement&#46; &#40;b&#41; GH with cement&#46; &#40;c&#41; Bone defect&#46; &#40;d&#41; Identification of the defect with Kirschner wire&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1848
            "Ancho" => 700
            "Tamanyo" => 231352
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Macroscopic study&#46; &#40;a&#41; Defect filled with calcium phosphate&#46; Control group&#46; &#40;b&#41; Defect filled with calcium phosphate<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>PRP&#46; PRP group&#46; &#40;c&#41; Appearance of the critical defect of the GH group&#46; In these cases we found the Kirschner wire useful for locating the site&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 592
            "Ancho" => 1401
            "Tamanyo" => 162747
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Control group histology&#46; &#40;a&#41; Rabbit control group 15 increases&#46; Transverse cut Masson&#39;s trichrome stain&#46; General appearance&#46; The bone tissue is distinguished from the cortex &#40;a&#41;&#44; the calcium phosphate cement which fills the medullary channel &#40;b&#41; and the cortical critical defect marked with Kirschner wire &#40;c&#41;&#46; &#40;b&#41; Rabbit control group 30 increases&#46; Masson&#39;s trichrome stain&#46; Kirschner wire used as a marker &#40;a&#41;&#44; surrounded by biomaterial &#40;b&#41; in the site of the critical defect&#46; No bone tissue formation is observed&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 806
            "Ancho" => 1501
            "Tamanyo" => 254568
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Transverse cut&#46; Masson&#39;s trichrome stain&#46; Overall appearance of calcium phosphate<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>PRP&#58; greater bone formation is observed in the site of the critical defect and between the particles of calcium cement&#46; &#40;b&#41; Rabbit PRP group&#44; 30 increases&#46; Two-fold increase from the previous image&#46; &#40;a&#41; Newly formed bone &#40;immature&#41; filling the defect&#46; &#40;b&#41; Mature bone of the cortex&#46; &#40;c&#41; Bone between the particles of the biomaterial&#46; &#40;c&#41; Rabbit PRP group&#44; 15 increases&#46; Transverse cut&#46; Masson&#39;s stain&#46; General appearance&#58; &#40;a&#41; cortex&#44; &#40;b&#41; newly formed bone y &#40;c&#41; biomaterial&#46; &#40;d&#41; Rabbit PRP group&#44; 30 increases&#46; Immature bone between the particles of calcium phosphate&#46; The color of this figure can only be appreciated in the electronic version of the article&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 887
            "Ancho" => 1500
            "Tamanyo" => 262139
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">GH group histology&#46; &#40;a&#41; Rabbit GH group&#44; 15 increases&#46; General image hematoxylin&#8211;eosin stain&#46; &#40;a&#41; Newly formed bone tissue between the particles of the biomaterial &#40;b&#41; in the site of the cortical defect&#44; marked with Kirschner wire &#40;c&#41;&#46; &#40;b&#41; Rabbit GH group&#44; 30 increases&#46; Hematoxylin&#8211;eosin stain&#46; Newly formed bone tissue in contact with biomaterial&#46; &#40;c&#41; Rabbit GH group&#44; 60 increases&#46; Newly formed bone tissue &#40;arrows&#41; in contact with the biomaterial &#40;tricalcium phosphate<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>GH&#41;&#46; &#40;d&#41; Rabbit GH group&#44; 100 increases&#46; Toluidine blue stain&#46; Front of osteoblasts &#40;arrows&#41;&#46; The color of this figure can only be appreciated in the electronic version of the article&#46;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "fig0030"
        "etiqueta" => "Figure 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr6.jpeg"
            "Alto" => 1586
            "Ancho" => 2236
            "Tamanyo" => 199444
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Statistical results of the morphometric study&#46; &#40;a&#41; ANOVA of the density of the total new bone formation area&#46; &#40;b&#41; ANOVA of the density of the new bone formation area in the medullary cavity&#46; &#40;c&#41; ANOVA of the density of the new bone formation area outside the medullary channel&#46; &#40;d&#41; ANOVA of the density of the area of the remaining biomaterial&#46;</p>"
        ]
      ]
      6 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Treatment reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Biomaterial area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Medullary area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Periosteal area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Total area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Control 3 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Control 3 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Control 5 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Control 5 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Control 10 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Control 10 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Control 12 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Control 12 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Control 13 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Control 13 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab730846.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Results of the control group morphometry&#46;</p>"
        ]
      ]
      7 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Treatment reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Biomaterial area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Medullary area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Periosteal area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Total area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PRP 2 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PRP 2 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PRP 4 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PRP 4 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PRP 6 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PRP 6 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PRP 9 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PRP 9 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PRP 11 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PRP 11 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab730848.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Results of the PRP group morphometry&#46;</p>"
        ]
      ]
      8 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Treatment reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Biomaterial area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Medullary area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Periosteal area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; Total area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">GH 14 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">GH 14 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">GH 15 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">GH 15 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">GH 16 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">GH 16 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">GH 17 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">GH 17 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">GH 18 right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">GH 18 left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab730847.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">Results of the GH group morphometry&#46;</p>"
        ]
      ]
      9 => array:5 [
        "identificador" => "eq0005"
        "tipo" => "MULTIMEDIAFORMULA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Formula" => array:5 [
          "Matematica" => "Biomaterial&#8201;areaTotal&#8201;area&#215;100"
          "Fichero" => "STRIPIN_si1.jpeg"
          "Tamanyo" => 2138
          "Alto" => 32
          "Ancho" => 151
        ]
      ]
      10 => array:5 [
        "identificador" => "eq0010"
        "tipo" => "MULTIMEDIAFORMULA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Formula" => array:5 [
          "Matematica" => "Area&#8201;of&#8201;new&#8201;bone&#8201;formation&#8201;in&#8201;the&#8201;medullary&#8201;cavityTotal&#8201;area&#215;100"
          "Fichero" => "STRIPIN_si2.jpeg"
          "Tamanyo" => 4343
          "Alto" => 32
          "Ancho" => 368
        ]
      ]
      11 => array:5 [
        "identificador" => "eq0015"
        "tipo" => "MULTIMEDIAFORMULA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Formula" => array:5 [
          "Matematica" => "Area&#8201;of&#8201;new&#8201;bone&#8201;formation&#8201;outside&#8201;the&#8201;medullary&#8201;cavityTatal&#8201;area&#215;100"
          "Fichero" => "STRIPIN_si3.jpeg"
          "Tamanyo" => 4849
          "Alto" => 54
          "Ancho" => 362
        ]
      ]
      12 => array:5 [
        "identificador" => "eq0020"
        "tipo" => "MULTIMEDIAFORMULA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Formula" => array:5 [
          "Matematica" => "Area&#8201;of&#8201;new&#8201;bone&#8201;formation&#8201;inside&#43;area&#8201;of&#8201;new&#8201;bone&#8201;formation&#8201;outsideTotal&#8201;area&#215;100"
          "Fichero" => "STRIPIN_si4.jpeg"
          "Tamanyo" => 5806
          "Alto" => 32
          "Ancho" => 503
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:30 [
            0 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Platelet-rich plasma&#58; a literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46;S&#46; Arora"
                            1 => "T&#46; Ramanayake"
                            2 => "Y&#46;F&#46; Ren"
                            3 => "G&#46;E&#46; Romanos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/ID.0b013e31819e8ec6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Implant Dent"
                        "fecha" => "2009"
                        "volumen" => "18"
                        "paginaInicial" => "303"
                        "paginaFinal" => "310"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19667818"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autologous platelets as a source of proteins for healing and tissue regeneration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46; Anitua"
                            1 => "I&#46; Andia"
                            2 => "B&#46; Ardanza"
                            3 => "P&#46; Nurden"
                            4 => "A&#46;T&#46; Nurden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1160/TH03-07-0440"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thromb Haemost"
                        "fecha" => "2004"
                        "volumen" => "91"
                        "paginaInicial" => "4"
                        "paginaFinal" => "15"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14691563"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence for a direct effect of growth hormone on osteoblasts"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Morel"
                            1 => "P&#46; Chavassieux"
                            2 => "B&#46; Barenton"
                            3 => "P&#46;M&#46; Dubois"
                            4 => "P&#46;F&#46; Meunier"
                            5 => "G&#46; Boivin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cell Tissue Res"
                        "fecha" => "1993"
                        "volumen" => "273"
                        "paginaInicial" => "279"
                        "paginaFinal" => "286"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8364969"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Plasma rich in growth factors&#58; preliminary results of use in the preparation of future sites for implants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E&#46; Anitua"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Oral Maxillofac Implants"
                        "fecha" => "1999"
                        "volumen" => "14"
                        "paginaInicial" => "529"
                        "paginaFinal" => "535"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Small-animal models for testing macroporus ceramic bone substitutes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Le Guehennec"
                            1 => "E&#46; Goyenvalle"
                            2 => "E&#46; Aguado"
                            3 => "M&#46; Houchmand-Cuny"
                            4 => "B&#46; Enkel"
                            5 => "P&#46; Pilet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Biomed Mater Res Appl Biomater"
                        "fecha" => "2005"
                        "volumen" => "72"
                        "paginaInicial" => "69"
                        "paginaFinal" => "78"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The potential of sheep for the study of osteopenia&#58; current status and comparison with other animal models"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Newman"
                            1 => "A&#46;S&#46; Turner"
                            2 => "J&#46;D&#46; Wark"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Bone"
                        "fecha" => "1995"
                        "volumen" => "16"
                        "paginaInicial" => "277"
                        "paginaFinal" => "284"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone regeneration with rabbit bone marrow-derived mesenchymal stem cells and bone graft materials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;E&#46; Lee"
                            1 => "S&#46;J&#46; Heo"
                            2 => "J&#46;Y&#46; Koak"
                            3 => "S&#46;K&#46; Kim"
                            4 => "C&#46;H&#46; Han"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Oral Maxillofac Implants"
                        "fecha" => "2012"
                        "volumen" => "27"
                        "paginaInicial" => "1389"
                        "paginaFinal" => "1399"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23189288"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Osseointegration of dental implants in rabbit bone with low mineral density"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Mori"
                            1 => "M&#46; Manabe"
                            2 => "Y&#46; Kurachi"
                            3 => "M&#46; Nagumo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Oral Maxillofac Surg"
                        "fecha" => "1997"
                        "volumen" => "55"
                        "paginaInicial" => "351"
                        "paginaFinal" => "361"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9120698"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sex steroids and the construction and conservation of the adult skeleton"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46;L&#46; Riggs"
                            1 => "S&#46; Khosla"
                            2 => "J&#46; Melton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Endocr Rev"
                        "fecha" => "2002"
                        "volumen" => "23"
                        "paginaInicial" => "15"
                        "paginaFinal" => "24"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The chondrogenic potential of periosteum decreases with age"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46;V&#46;M&#46; O&#8217;Driscoll"
                            1 => "D&#46;B&#46;F&#46; Saris"
                            2 => "Y&#46; Ito"
                            3 => "J&#46;S&#46; Fitzimmons"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0736-0266(00)00014-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Orthop Res"
                        "fecha" => "2001"
                        "volumen" => "19"
                        "paginaInicial" => "95"
                        "paginaFinal" => "103"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11332626"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Osteoporosis-like bone conditions affect osseointegration of implants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;C&#46; Keller"
                            1 => "M&#46; Roehm"
                            2 => "G&#46;B&#46; Schneider"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Oral Maxillofac Implants"
                        "fecha" => "2004"
                        "volumen" => "19"
                        "paginaInicial" => "687"
                        "paginaFinal" => "694"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15508984"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Restoration of critical-size defects in the rabbit mandible using porous nanohydroxyapatite-polyamide scaffolds"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Guo"
                            1 => "Z&#46; Meng"
                            2 => "G&#46; Chen"
                            3 => "D&#46; Xie"
                            4 => "Y&#46; Chen"
                            5 => "H&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Tissue Eng A"
                        "fecha" => "2012"
                        "volumen" => "18"
                        "paginaInicial" => "1239"
                        "paginaFinal" => "1252"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of resorbable bioactive material for grafting of critical-size cancellous defects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;L&#46; Wheeler"
                            1 => "E&#46;J&#46; Eschbach"
                            2 => "R&#46;G&#46; Hoellrich"
                            3 => "M&#46;J&#46; Montfort"
                            4 => "D&#46;L&#46; Chamberland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jor.1100180120"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Orthop Res"
                        "fecha" => "2000"
                        "volumen" => "18"
                        "paginaInicial" => "140"
                        "paginaFinal" => "148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10716290"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Animal models for bone tissue engineering of critical-sized defects &#40;CSDs&#41; bone pathologies and orthopedic disease states"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;P&#46; Mooney"
                            1 => "M&#46;I&#46; Siegel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Bone tissue engineering"
                        "paginaInicial" => "217"
                        "paginaFinal" => "244"
                        "serieFecha" => "2005"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative study of healing and remodelling in various bones"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46;A&#46; Najjar"
                            1 => "D&#46; Kahn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Oral Surg"
                        "fecha" => "1977"
                        "volumen" => "35"
                        "paginaInicial" => "375"
                        "paginaFinal" => "379"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/265375"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guided tissue regeneration using degradable and nondegradable membranes in rabbit tibia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Aaboe"
                            1 => "E&#46;M&#46; Pinholt"
                            2 => "E&#46; Hjorting-Hansen"
                            3 => "E&#46; Solheim"
                            4 => "F&#46; Pr&#230;torius"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Oral Implants Res"
                        "fecha" => "1993"
                        "volumen" => "4"
                        "paginaInicial" => "172"
                        "paginaFinal" => "176"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The critical size defect as an experimental model for craniomandibulofacial nonunions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;P&#46; Schmitz"
                            1 => "J&#46;O&#46; Hollinger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Orthop Relat Res"
                        "fecha" => "1986"
                        "volumen" => "205"
                        "paginaInicial" => "299"
                        "paginaFinal" => "308"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3084153"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone regeneration with bone substitutes&#58; an animal study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46;D&#46; Katthagen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1986"
                        "editorial" => "Springer Verlag"
                        "editorialLocalizacion" => "Berlin"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histological evaluation of the bone response to calcium phosphate cement implanted in cortical bone"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;M&#46; Ooms"
                            1 => "J&#46;G&#46; Wolke"
                            2 => "M&#46;T&#46; van de Heuvel"
                            3 => "B&#46; Jeschke"
                            4 => "J&#46;A&#46; Jansen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Biomaterials"
                        "fecha" => "2003"
                        "volumen" => "24"
                        "paginaInicial" => "989"
                        "paginaFinal" => "1000"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12504521"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Calcium phosphate cements as drug delivery materials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;P&#46; Ginebra"
                            1 => "C&#46; Canal"
                            2 => "M&#46; Espanol"
                            3 => "D&#46; Pastorino"
                            4 => "E&#46;D&#46; Montufar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.addr.2012.01.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Adv Drug Deliv Rev"
                        "fecha" => "2012"
                        "volumen" => "64"
                        "paginaInicial" => "1090"
                        "paginaFinal" => "1110"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22310160"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Platelet-rich plasma enhances human osteoblast-like cell proliferation and differentiation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Kanno"
                            1 => "T&#46; Takahashi"
                            2 => "T&#46; Tsujisawa"
                            3 => "W&#46; Ariyoshi"
                            4 => "T&#46; Nishihara"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.joms.2004.07.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Oral Maxillofac Surg"
                        "fecha" => "2005"
                        "volumen" => "63"
                        "paginaInicial" => "362"
                        "paginaFinal" => "369"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15742288"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone formation in long bone defect model using platelet-rich plasma loaded collagen scaffold"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;R&#46; Sarkar"
                            1 => "P&#46; Augat"
                            2 => "S&#46;J&#46; Shefelbine"
                            3 => "S&#46; Schorlemmer"
                            4 => "M&#46; Huber-Lang"
                            5 => "L&#46; Claes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.biomaterials.2005.10.039"
                      "Revista" => array:6 [
                        "tituloSerie" => "Biomaterials"
                        "fecha" => "2006"
                        "volumen" => "27"
                        "paginaInicial" => "1817"
                        "paginaFinal" => "1823"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16307796"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Classification of platelet concentrates&#58; from pure platelet-rich plasma &#40;P-PRP&#41; to leucocyte- and platelet-rich fibrin &#40;L-PRF&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;M&#46; Dohan Ehrenfest"
                            1 => "L&#46; Rasmusson"
                            2 => "T&#46; Albrektsson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.tibtech.2008.11.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Trends Biotechnol"
                        "fecha" => "2009"
                        "volumen" => "27"
                        "paginaInicial" => "158"
                        "paginaFinal" => "167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19187989"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Local administration of growth hormone enhances periimplant bone reaction in an osteoporotic rabbit model"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46;F&#46; Tresguerres"
                            1 => "C&#46; Clemente"
                            2 => "M&#46; Donado"
                            3 => "L&#46; G&#243;mez-Pellico"
                            4 => "L&#46; Blanco"
                            5 => "M&#46;A&#46; Alobera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Oral Implants Res"
                        "fecha" => "2002"
                        "volumen" => "13"
                        "paginaInicial" => "613"
                        "paginaFinal" => "616"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Growth hormone stimulates longitudinal bone growth directly"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "O&#46;G&#46; Isaksson"
                            1 => "J&#46;O&#46; Jannsson"
                            2 => "I&#46;A&#46; Gause"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Science"
                        "fecha" => "1982"
                        "volumen" => "216"
                        "paginaInicial" => "1237"
                        "paginaFinal" => "1239"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7079756"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cortical bone ingrowth in growth hormone-loaded grooved implants with calcium phosphate coating in goat femurs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;J&#46; Blom"
                            1 => "J&#46;G&#46;C&#46; Verheij"
                            2 => "J&#46;M&#46;A&#46; de Blieck-Hogervorst"
                            3 => "L&#46; di Silvio"
                            4 => "C&#46;P&#46;A&#46;T&#46; Klein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Biomaterials"
                        "fecha" => "1998"
                        "volumen" => "19"
                        "paginaInicial" => "263"
                        "paginaFinal" => "270"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9678875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histologic&#44; morphometric and densitometric study of peri-implantant bone in rabbits with local administration of growth hormone"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46;F&#46; Tresguerres"
                            1 => "M&#46;A&#46; Alobera"
                            2 => "R&#46; Baca"
                            3 => "J&#46;A&#46;F&#46; Tresguerres"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Oral Maxillofac Implants"
                        "fecha" => "2005"
                        "volumen" => "20"
                        "paginaInicial" => "193"
                        "paginaFinal" => "202"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15839112"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of growth hormone in patients with tibial fracture&#58; a randomised&#44; double-blind&#44; placebo-controlled clinical trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Raschke"
                            1 => "M&#46;H&#46; Rasmussen"
                            2 => "S&#46; Govender"
                            3 => "D&#46; Segal"
                            4 => "M&#46; Suntum"
                            5 => "J&#46;S&#46; Christiansen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1530/EJE-06-0598"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Endocrinol"
                        "fecha" => "2007"
                        "volumen" => "156"
                        "paginaInicial" => "341"
                        "paginaFinal" => "351"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17322494"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased mortality associated with growth hormone treatment in critically ill adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Takala"
                            1 => "E&#46; Ruokonen"
                            2 => "N&#46;R&#46; Webster"
                            3 => "M&#46;S&#46; Nielsen"
                            4 => "D&#46;F&#46; Zandstra"
                            5 => "G&#46; Vundelinckx"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199909093411102"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1999"
                        "volumen" => "341"
                        "paginaInicial" => "785"
                        "paginaFinal" => "792"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10477776"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human growth hormone locally released in bone sites by calcium-phosphate biomaterial stimulates ceramic bone substitution without systemic effects&#58; a rabbit study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Guicheux"
                            1 => "O&#46; Gautthier"
                            2 => "E&#46; Aguado"
                            3 => "P&#46; Pilet"
                            4 => "S&#46; Couilland"
                            5 => "D&#46; Jegou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1359/jbmr.1998.13.4.739"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Res"
                        "fecha" => "1998"
                        "volumen" => "13"
                        "paginaInicial" => "739"
                        "paginaFinal" => "748"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9556073"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/19888856/0000005900000003/v2_201504040248/S1988885615000218/v2_201504040248/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "7585"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Research"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/19888856/0000005900000003/v2_201504040248/S1988885615000218/v2_201504040248/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885615000218?idApp=UINPBA00004N"
]
Article information
ISSN: 19888856
Original language: English
DOI:10.1016/j.recote.2015.03.003
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 4 0 4
2024 October 15 6 21
2024 September 13 2 15
2024 August 21 7 28
2024 July 21 3 24
2024 June 22 1 23
2024 May 20 4 24
2024 April 20 4 24
2024 March 28 3 31
2024 February 20 5 25
2024 January 21 3 24
2023 December 24 9 33
2023 November 22 5 27
2023 October 25 6 31
2023 September 16 4 20
2023 August 15 6 21
2023 July 31 3 34
2023 June 21 4 25
2023 May 31 3 34
2023 April 53 1 54
2023 March 30 2 32
2023 February 15 0 15
2023 January 11 3 14
2022 December 19 5 24
2022 November 17 6 23
2022 October 17 7 24
2022 September 15 6 21
2022 August 17 8 25
2022 July 11 9 20
2022 June 15 6 21
2022 May 14 8 22
2022 April 42 20 62
2022 March 15 8 23
2022 February 8 3 11
2022 January 10 6 16
2021 December 24 9 33
2021 November 16 8 24
2021 October 16 9 25
2021 September 7 12 19
2021 August 10 3 13
2021 July 14 5 19
2021 June 12 5 17
2021 May 9 5 14
2021 April 28 7 35
2021 March 22 9 31
2021 February 16 10 26
2021 January 13 4 17
2018 February 11 0 11
2018 January 4 2 6
2017 December 11 1 12
2017 November 9 4 13
2017 October 10 4 14
2017 September 9 3 12
2017 August 10 1 11
2017 July 12 2 14
2017 June 23 5 28
2017 May 13 0 13
2016 December 0 1 1
2016 November 0 1 1
2016 September 0 2 2
2016 July 0 1 1
2016 June 0 4 4
2016 March 0 1 1
2016 February 0 3 3
2015 December 0 1 1
2015 November 0 1 1
2015 September 0 4 4
2015 July 0 2 2
2015 June 0 2 2
Show all

Follow this link to access the full text of the article

Subscribe to our newsletter

Publish in
Revista Española de Cirugía Ortopédica y Traumatología
Revista Española de Cirugía Ortopédica y Traumatología (English Edition) is a member and subscribes the principles of, the Committee on Publication Ethics (COPE)
www.publicationethics.org.
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos