A Case Report of Bilateral Mandibular Vertical Guided Bone Regeneration With and Without Bovine Thrombin/Calcium Chloride Activated Platelet-Rich Plasma
One patient with a bilateral vertical defect was treated on one side with guided bone regeneration (GBR) and an autologous bone graft and on the contralateral side with the addition of platelet-rich plasma (PRP). At the 6-month reentry, clinically and radiographically enough bone width and height were present to allow implant placement in both sites. At the same time point, at the histologic level, no differences were noticeable. Similar results were obtained in this case in vertical bone regeneration with and without bovine thrombin/calcium chloride activated PRP applied to GBR techniques.Abstract

Computerized tomography scan. (a) Preoperative view showing insufficient bone in the apicocoronal and buccolingual dimension to place implants according to the prosthetic needs. (b) Postoperative view showing a robust bone regeneration of about 4 to 5 mm in the area corresponding to the radiopaque marks on the surgical stent. (c) At the contralateral side new bone formation is noticeable around the tenting stainless steel screw placed for space maintenance under a nonresorbable membrane.

Figure 2 . (a) Clinical view of the edentulous ridge with 2 stainless steel screws in place before ridge augmentation. (b) Clinical view of the same area showing the screws completely covered by the newly regenerated bone. Figure 3. Panorex view. (a) Preoperative view showing contralateral edentulous area in the mandible to be treated with vertical ridge augmentation before implant placement. (b) Follow-up panorex 6 months after contralateral augmentation: the left side is treated with guided bone regeneration and autologous bone graft, the right side in the identical manner with additional platelet-rich plasma.

Figure 4 . (a) Implant site preparation. The middle implant site is prepared with a surgical trephine of 2 mm internal and 3 mm external diameter to allow core harvesting. (b) Core bone biopsy of approximately 4–5 mm obtained with the surgical trephine bur. Figure 5. Histologic evaluation (hematoxylin and eosin). (a) Platelet-rich plasma (PRP) side. (b) Side without PRP. Representative histologic view under transmitted light microscopy. Similar features were observed in all the sections enclosed in this report. The newly formed bone is recognizable for the presence of osteocyte containing lacunae and for the woven structure. The intertrabecular spaces exhibit a mild degree of fibrosis but no features of inflammatory reaction.
Contributor Notes