engleski

Horizontal ridge augmentation utilizing platelet derived growth factor (rhPDGF-BB) and demineralized bovine bone graft without the use of membranes

Aim: Placing implants in the posterior mandible frequently presents a challenge due to inadequate bone quantity. Extremely narrow ridges require bone grafting procedures to allow implant placement. This requires harvesting autogenous bone or particulated bone grafts with the use of barrier membranes making surgical procedures technically demanding and increasing the risk of complications and graft failure. The introduction of protein therapy in regenerative procedures could overcome the use of barrier membranes in certain cases making grafting procedures easier. Platelet derived growth factor (rhPDGF-BB) induces chemotaxis of osteogenic periosteal cells and animal and human case reports showed that membrane use could be excluded when this growth factor is used. Material and Methods: Case reports Two patients, a smoking and non-smoking needed bone grafting in the posterior mandible. They both had 1-2mm narrow non-contained ridges. rhPDGF-BB was combined with demineralised bovine bone and placed over the residual ridge without the use of membrane. Following releasing periosteal incisions flaps were primarely closed and this was maintained during 5 months of healing. In each patient 2 implants were placed and horizontal core biopsies were harvested and analyzed by micro-CT and histology. Results: Discussion The width of the ridges increased to 5-7mm. Implants successfully integrated and were reconstructed. Micro-CT and histology showed replacement of graft particles with new bone completely surrounding the particles. Radiographs showed stable bone levels around implants 1-year later. Conclusion: Combination of rhPDGF-BB and particulated bovine bone without membrane placement successfully increased ridge width allowing implant placement. This treatment modality could simplify regenerative procedures and decrease complications.

periodontitis; preiodontal regeneration; rhPDGF-BB

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