Modern Bone Regeneration Instead of Bone Transplantation: A Combination of Recombinant Human Bone Morphogenetic Protein-2 and Platelet-Rich Plasma for the Vertical Augmentation of the Maxillary Bone—A Single Case Report

Abstract

This publication describes the clinical case of a 75-year-old woman. She suffered from total alveolar ridge atrophy due to 20 years of wearing dentures. Bone transplantation, including harvesting of the iliac crest, was rejected by another clinic due to various existing diseases and risk of blood loss on donor side. Moreover, the minimal residual alveolar ridge did not allow bone fixation using screws nor did it allow osteodistraction. Before deciding which bone tissue engineering techniques should best be employed in this surgical treatment, cardiological and internistic consultations and treatments were carried out. In addition, anesthetic preparations were made. The surgical treatment was performed implementing special bridge flap techniques to preserve the periosteum. Tricalcium phosphate blocks soaked with recombinant human bone morphogenetic protein-2 and platelet-rich plasma were implanted on the narrow alveolar ridge. They were attached by tightening the soft tissue, including the periosteum. Four months later, after complication-free wound healing and bone regeneration, six dental implants were inserted into the new alveolar ridge. The histology of all bone samples showed vital lamellar bone. Three months after implantation, a new dental structure was fixed on the implants. The patient's quality of life improved significantly with this new situation.

Bone Tissue Engineering in Oral Surgery: A New Method of Bone Development in Periodontal Surgery

“…This was proved in implant treatment after bone development by means of tissue engineering (TE)-techniques using bone samples. 39,52 VBD was achieved in group 1 (-1 to 3 mm; average: 1.7 mm); group 2 (0 to 4 mm; average: 2.5 mm); and group 3 (1 to 7 mm; average: 3.2 mm) (Fig. 6).…”

“…Parallel to other indications, we realized that ACS is not able to provide suitable structural support. 37,38,52 In addition, the swelling of the soft tissue particularly in the papillae region forced us to develop a totally new surgical approach. We designed the endoscopically assisted periodontal surgery.…”

Ingénierie tissulaire osseuse en chirurgie buccale et maxillo-faciale : applications cliniques

“…Dans les reconstructions pré-implantaires, l'utilisation de rhBMP-2 semble très efficace au niveau des sinus maxillaires [31,48], mais également dans les greffes d'apposition [48,49] et dans le comblement des ostéolyses péri-implantaires [50]. La néoformation osseuse est rapide et se fait en grande quantité, de façon équivalente ou supérieure aux autogreffes [31].…”

Controlled Release Strategies for Bone, Cartilage, and Osteochondral Engineering—Part II: Challenges on the Evolution from Single to Multiple Bioactive Factor Delivery

“…The high-cost treatment and the simultaneous stimulation of development of both osteoblasts and osteoclasts with opposite effects are additional drawbacks. 83 Despite the complexity of angiogenic signaling pathways, extensive studies on the biology and delivery of vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF)-2, and potent GFs involved in vessel formation have been performed in both preclinical and small-scale clinical trials. Recent large-scale clinical trials 84 did not demonstrate significant therapeutic effects above placebo controls, leading to an inefficient promotion of angiogenic response.…”