Successful management of spontaneous bone regeneration after jaws cystectomy using PRGF approach; case series

Abstract

In the jaws, the healing process of bone defects occurs differently compared with other anatomical sites where healing is done by the formation of scar tissue. This is due to physiological bone remodeling and continuous bone resorption and apposition. In the case of large cysts, there is an increased risk of postoperative infection due to the retraction of the blood clot on the bony walls. The use of plasma rich in growth factors (PRGF), with or without autologous bone addition, for filling the cystic cavities is beneficial not only for its antimicrobial effect, but also due to simultaneously release of growth factors from platelet alpha granules and adhesive proteins. The aim of our work was to emphasize the spontaneous bone healing of the maxilla and mandible after the enucleation of large and medium-sized cysts in asymptomatic patients of different age. The outcome of three patients who underwent surgery for removal of radicular cysts is presented. Imagistic [cone-beam computed tomography (CBCT)] and histological examination was performed aiming to evaluate the quality of new bone at the site of the bone defect, after different time intervals. By using PRGF approach, the healing of mandibular bone occurred 18 months after cystectomy in a smoker patient, 54-year-old, while the healing of maxillary bone using autologous bone mixed with PRGF occurred after six months in a 63-year-old patient. In a young patient (14 years old), the regeneration period was six months, using PRGF and a fibrin cloth for filling the defect.

Radiographic bone volume alteration after jaw cyst enucleation with or without simultaneous bone grafts: A prospective randomized study

“…Traditionally, the left bony cavity can be regenerated through a programmed sequence of maturing steps without any fillings, starting with the blood clot 21 . Several researches have reported bone healing after enucleation and simple primary closure without bone grafts 10,22,23 . A computerized radiographic study showed a spontaneous increase of bone density of 7%, 27%, 46% after 2, 6, and 12 months, respectively 9 .…”

Study on the Osteogenesis Effect of Bio-Oss Bone Powder Combined with Medical Collagen Sponge Following Jaw Cyst Surgery

“…Despite the oral cavity's high potential for self-regeneration of bone defects [16] , studies have demonstrated that patients not using any lling materials post-cystectomy exhibit a spontaneous bone healing index of only 12.34% [17] at six months post-surgery. Such results indicate that spontaneous bone healing is insu cient for complete bone formation.…”

The pioneer use of a modified PRGF–Endoret® technique for wound healing in a hemodialyzed diabetic patient in a terminal stage of renal disease

“…PRGF application should not be regarded as an alternative to conventional therapy (involving debridement of necrotic tissue), but as an adjunctive therapy [ 24 , 37 ]. PRGF was used in maxillofacial surgery to stimulate regeneration of osseous and epithelial tissues [ 25 , 38 ], in orthopedic surgery, sports medicine [ 39 ], arthroscopic surgery [ 40 ]. This innovative system also has application in anti-ageing since it stimulates the body’s own healing process for rejuvenation.…”