Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 21 Apr 2020

Randomized and Controlled Clinical Trial of Bone Healing After Alveolar Ridge Preservation Using Xenografts and Allografts Versus Plasma Rich in Growth Factors

DDS,
DDS, PhD,
DDS, PhD,
DDS, MSD, PhD, and
DDS, MSD, PhD
Page Range: 515 – 525
DOI: 10.1563/aaid-joi-D-19-00179
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The aim of this study was to compare bone regeneration in the anterior maxilla between bone substitutes and autologous platelet concentrate in alveolar ridge preservation. Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the following 4 treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM), and plasma rich in growth factors (PRGF) alone. Bone biopsies and histomorphometrical analysis were performed after 3 months of healing. The following parameters were assessed: newly formed mineralized tissue, newly formed nonmineralized tissue, and residual bone-grafting material (if applicable). Statistical analysis was performed to provide descriptive analysis and to compare the parameters of the bone regeneration between the study groups. Histomorphometrical analysis revealed the highest new mineralized tissue formation in the PRGF group. Statistically significant differences in new mineralized tissue formation were found between control/PRGF (46.4% ± 15.2% vs 75.5% ± 16.3%), control/(BBM/CM) (46.4% ± 15.2% vs 20.3% ± 21.9%), control/(FDBA/CM) (46.4% ± 15.2% vs 7.2% ± 8.6%), PRGF/(BBM/CM) (75.5% ± 16.3% vs 20.3% ± 21.9%), and PRGF/(FDBA/CM) (75.5% ± 16.3% vs 7.2% ± 8.6%) groups. The new mineralized tissue formation was in the following order: PRGF > control > BBM > FDBA. Alveolar ridge preservation in the esthetic zone with PRGF was the most effective for bone regeneration of the alveolar ridge.

Figure 1.
Figure 1.

Study flow chart. BBM indicates natural bovine bone mineral; CM, collagen membrane; FDBA, freeze-dried bone allograft; PRGF, platelet-derived growth factor.


Figure 2.
Figure 2.

Representative histological images illustrating regenerated bone of each treatment group. (a) Control group (magnification, ×10). (b) Bovine bone mineral covered with resorbable native collagen membrane group (magnification, ×10). (c) Freeze-dried bone allograft covered with resorbable native collagen membrane group (magnification, ×10). (d) Plasma rich in growth factor group (magnification, ×10).


Figure 3.
Figure 3.

Histological images of regenerated bone prepared from the most center part of biopsy. (a) Control group (magnification, ×5). (b) Bovine bone mineral covered with resorbable native collagen membrane group (magnification, ×5). (c) Freeze-dried bone allograft covered with resorbable native collagen membrane group (magnification, ×5). (d) Plasma rich in growth factor group (magnification, ×5).


Figure 4.
Figure 4.

Representative histological images illustrating regenerated bone of each treatment group. (a) Control group (magnification, ×5). (b) Bovine bone mineral covered with resorbable native collagen membrane group (magnification, ×5). (c) Freeze-dried bone allograft covered with resorbable native collagen membrane group (magnification, ×5). (d) Plasma rich in growth factor group (magnification, ×5).


Contributor Notes

Corresponding author, e-mail: arturas.stu@gmail.com
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