Alveolar ridge and sinus augmentation utilizing platelet-rich plasma in combination with freeze-dried bone allograft: Case series

Background: Alveolar bone regeneration is frequently necessary prior to pla cement of implants. Efforts to improve wound healing have focused on factor s that may enhance bone formation following guided bone regeneration (GBR) techniques alone or in combination with bone replacement graft materials. R ecent reports suggest that platelet-rich plasma (PRP), presumably high in l evels of peptide growth factors, may enhance the formation of new bone when used in combination with autogenous graft material. Methods: In this report, the clinical and radiographic results are presente d on 15 consecutively treated patients using autologous PRP in combination with freeze-dried bone allograft (FDBA) for sinus elevation and/or ridge au gmentation. FDBA and PRP (0.5 g/2cc PRP) were mixed and placed as a composi te graft material. A gel formed by mixing autologous thrombin-rich plasma w ith PRP (1:4 ratio) was used to cover the graft material. Core biopsies of grafted areas were obtained in several patients as part of implant site pre paration and were evaluated histologically to determine site maturation. Results: Of 36 implant fixtures, 32 (89%) were considered clinically succes sful demonstrating complete bone coverage of the implant, no mobility, and a normal radiographic appearance at the time of re-entry and 12 months post -implant exposure. Four implants were removed due to mobility at the time o f surgical exposure, Histologic evaluation of biopsy specimens revealed num erous areas of osteoid and bone formation around FDBA particles, with no ev idence of inflammatory cell infiltrate. Conclusions: These clinical and histological findings suggest that ridge au gmentation and sinus grafting with FDBA in combination with PRP provide a v iable therapeutic alternative for implant placements. Future studies are ne cessary to determine whether PRP enhances new bone formation or maturation with bone replacement allografts.