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Oral Maxillofacial Surgery: Bone Regeneration

In the field of dentistry, stem cell research is directed towards achieving regeneration of damaged coronal dentine and pulp, regeneration of resorbed root, cervical or apical dentin and perforations, periodontal regeneration, craniofacial defects and whole tooth regeneration. Pulp tissue regeneration involves delivery of autologous stem cells to the root canals.

“Cells separated with the Harvest System are more viable than those derived via chemical density gradient separation technique. The method is extremely well tolerated reducing complications associated with autologous graft harvesting, allowing faster and more consistent ossification.” Sauerbier, Schmelzeisen: University of Freiburg, Department of Oral Maxillofacial Surgery 2007

Sinus Lift Bone Grafting

The dimension of alveolar ridge is decreased by bone atrophy and pneumatization of the maxillary sinus after loss of teeth in the posterior maxilla. The sinus cavity often limits the amount of available bone for the placement of implants in the posterior maxilla. The sinus augmentation procedures are performed to create bone quantity and quality to ensure the placement of dental implants. The sinus lift operation and graft is a technique that can add grafted bone in excess of 10 to 16 mm through a lateral wall quadrilateral osteotomy. Impregnation of bone-marrow aspirate into allograft bone block activates the body's ability to form new bone. Greater bone density in grafts was observed in which platelet-rich plasma was added than in grafts in which platelet-rich plasma was not added.

References - Oral Surgery/Periodontology/Implant Surgery

Whitman, D, et al, Platelet Gel: An Autologous Alternative to Fibrin Glue with Applications in Oral and Maxillofacial Surgery, Journal Oral Maxillofacial Surgery, 1997; 55:1294-1299.

Marx, R, et al, Platelet-Rich Plasma - Growth Factor Enhancement for Bone Grafts, Oral Radiol Endod, 1998; 85:638-646

Fennis, J, et al, Mandibular Reconstruction: A Clinical and Radiographic Animal Study on the Use of Autogenous Scaffolds and Platelet-Rich Plasma, International Journal of Oral Maxillofacial Implants, 2001; 31:281-286

Kim, S, et al, A Comparative Study of Osseointegation of Avana Implants in a Demineralized Freeze-Dried Bone Alone or with Platelet-Rich Plasma, Journal of Oral Maxillofacial Surgery, 2002; 60:1018-1025

Carlson, N, et al, Platelet-Rich Plasma: Clinical Applications in Dentistry, Journal of American Dental Assoc, 2002; 133:1383-1386

Camargo, P, et al, Platelet-Rich Plasma and Bovine Porous Bone Mineral Combined with Guided Tissue Regeneration in the Treatment of Intrabody Defects in Humans, Journal Periodontal Restoration, 2002; 37:300-306

Zechner, W, et al, Influence of Platelet-Rich Plasma on Osseous Healing of Dental Implants: A Histologic and Histomorphometric Study in Minipigs, International Journal of Oral Maxillofacial Implants, 2003; 18:15-22

Babbush, C, et al, An In Vitro and In Vivo Evaluation of Autologous Platelet Concentrate in Oral Reconstruction, Implant Dentistry, 2003; 12:24-34

Lekovic, V, et al, Effectiveness of a Combination of Platelet-Rich Plasma, Bovine Porous Bone Mineral and Guided Tissue Regeneration in the Treatment of Mandibular Grade II Molar Furcations in Humans, Journal of Clinical Periodontology, 2003; 30:746-751

Rodriguez, et al, Maxillary Sinus Augmentation with Deproteinated Bovine Bone and Platelet Rich Plasma with Simultaneous Insertion of Endosseous Implants, Journal of Oral Maxillofacial Surgery, 2003; 61:157-163

Mancuso, J, et al, Platelet-Rich Plasma: A Preliminary Report in Routine Impacted Mandibular Third Molar Surgery and the Prevention of Alveolar Osteitis, Journal of Oral Maxillofacial Surgery, 2003; Supplement 1

Aghaloo, T, et al, Comparison of Allograft Materials with and without Platelet Rich Plasma, Journal of Oral Maxillofacial Surgery, 2003; Supplement 1

Hanna, R, et al, Treatment of Intrabony Defects with Bovine-Derived Xenograft Alone and in Combination with Platelet-Rich Plasma: A Randomized Clinical Trial, Journal of Periodontology, 2004; 75:1668-1677

Steigmann, M, et al, A Comparative Study of Bilateral Sinus Lifts Performed with Platelet Rich Plasma Alone Versus Alloplastic Graft Material Reconstituted with Blood, Implant Dentistry, 2005; 14:261-266

Kassolis, J, et al, Evaluation of the Adjunctive Benefits of Platelet-Rich Plasma in Subantral Sinus Augmentation, Journal of Craniofacial Surgery, 2005; 16:280-287

Mannai, C, Early Implant Loading in Severely Resorbed Maxilla Using Xenograft, Autograft, and Platelet-Rich Plasma in 97 Patients, Journal of Oral Maxillofacial Surgery, 2006; 64:1420-1426

Kanno, T, Platelet-Rich Plasma Enhances Human Osteoblast-Like Cell Proliferation and Differentiation, Journal of Oral Maxillofacial Surgery, 2005; 63:362-369

Lucarelli, E, Stromal Stem Cells and Platelet-Rich Plasma Improve Bone Allograft Integration, Clinical Orthopaedics and Related Research, 2005; 435:62-68

Nagai, M, et al, Effects of Application of Platelet Releasate in Periodontal Regeneration Therapy, International Journal Periodontics Restorative Dent, 2005; 25:571-583

Caridad, J, et al, Frontal Sinus Obliteration and Craniofacial Reconstruction with Platelet Rich Plasma in a Patient with Fibrous Dysplasia, International Journal of Oral Maxillofacial Surgery, 2006; 35:88-91

Mannai, C, Early Implant Loading in Severely Resorbed Maxilla Using Xenograft, Autograft, and PRP in 97 Patients, Journal of Oral Maxillofacial Surgery, 2006; 64:1420-1426

Rutkowski, J, et al, Inhibition of Alveolar Osteitis in Mandibular Tooth Extraction Sites Using Platelet-Rich Plasma, Journal of Oral Implantology, 2007; 33:116-121

Mish, C, Particulate Autologous Sinus Bone Grafts and Implant Insertion using Autologous Platelet Concentrate Enriched with Growth Factors (APC+) - Case Review

Misch, M, Distraction Osteogenesis and Ramus Onlay Bone Grafting using Autologous Platelet Concentrate Enriche Petrungaro, P, Enhancement of Acellular Dermal Matrix Grafts with Autologous Platelet Concentrate Enriched with Growth Factors (APC+) - Case Review

Petrungaro, P, Using Autologous Platelet Concentrate Enriched with Growth Factors (APC+) and Pepgen P-15 to Regenerate the Lost Periodontal Apparatus Following Advanced Periodontal Disease: Case 1- Case Review

Petrungaro, P, Using Autologous Platelet Concentrate Enriched with Growth Factors (APC+) and Pepgen P-15 to Regenerate the Lost Periodontal Apparatus Following Advanced Periodontal Disease Case 2- Case Review

Petrungaro, P, Enhancement of Acellular Dermal Matrix Grafts with Autologous Platelet Concentrate Enriched with Growth Factors (APC+) - Case Review

Petrungaro, P, Enhancing Connective Tissue Grafts Harvested for Root Coverage with Autologous Platelet Concentrate Enriched with Growth Factors (APC+) - Case Review

Petrungaro, P, Treatment of the Infected Implant Site using Autologous Platelet Concentrate Enriched with Growth Factors (APC+) - Case Review

Petrungaro, P, Repairing Peri-implant Defects with Autologous Platelet Concentrate Enriched with Growth Factors (APC+). Enhanced Graft Materials: Reducing Healing Time and Elimination of Conventional Regenerative Barriers - Case Review

Babbush, C, Maxillary Antroplasty using Autologous Platelet Concentrate Enriched with Growth Factors (APC+) - Case Review

Pikos, M, Vertical Augmentation of the Posterior Mandible with Mandibular Block Autografts using Autologous Platelet Concentrate Enriched with Growth Factors (APC+) - Case Review

Nicholas Toscano, DDS, MS; and Dan Holtzclaw, DDS, MS, Surgical Considerations in the Use of Platelet-Rich Plasma, Compendium, April 2008—Volume 29, Number 3