Bone marrow aspirate containing adult stem cells when mixed with bioengineered graft materials provide a scaffold to support the proliferation, differentiation, and maturation of the stem cells, as well as facilitating angiogenesis. This article presents histological evidence that stem cells aspirated from bone marrow and transplanted onto biocompatible scaffolds can successfully regenerate bone. This new standard for bone grafting may emerge as an alternative to autogenous bone grafts.

Many edentulous posterior maxilla are found to be encumbered by alveolar resorption and increased pneumatization of the sinus. These factors limit the quantity and quality of bone necessary for successful implant placement in these areas. One solution is to use shorter implants, but this often results in an unfavorable crown-root ratio. To create an improved environment in such regions, the classic sinus floor elevation with bone augmentation is a well-accepted technique. However, when the edentulous area is limited to a zone between 1 and 2 teeth, lifting the membrane becomes difficult and may subject it to iatrogenic injury. The antral membrane balloon elevation technique, which is introduced in this preliminary report, is a modification of the currently used sinus lift. It elevates the membrane easily and makes the antral floor accessible for augmentation with grafting materials.

Bone-marrow aspirate seems to contain a significantly greater percentage of hematopoietic, endothelial, and MSCs than peripheral blood. Of particular significance is the higher percentage of bone-marrow cells reacting to CD105, an indication of the presence of MSCs. The ability of multipotent MSCs to form osteoblasts for bone regeneration makes transplanted bone-marrow aspirate a promising tool for enhancing bone regeneration.

Impregnation of bone-marrow aspirate into allograft bone block activates the body's ability to form new bone. The bone-marrow aspiration technique is less invasive than harvesting autogenous bone from a second surgical site, offers predictable results, and is cost effective.

Bone regeneration requires an orchestrated interaction between various cells and other biological components. The synthesis of bone matrix with the release of cellular cytokines and growth factors facilitates and regulates cell growth. This leads to the maturation of bone that can support functional implants. Bone-marrow aspirate is a rich source of cells, cytokines, and growth factors needed for bone formation. Harvesting the marrow from the anterior iliac crest is a simple, safe, and cost-effective procedure. Mixing it with a resorbable scaffold and transplanting it to a site can predictably enhance bone regeneration. This article explores the anatomy of the bone marrow and describes the necessary elements for successful bone grafts, such as cells, bone matrix, and cellular regulators (both soluble and insoluble).