New Era of Bone Augmentation Using Bone Marrow Stem Cells

 

 

Introduction: Guided bone regeneration is considered a reliable technique; yet there is a wide range of results

concerning quality and quantity of the regenerated bone. The aim of This study was to assess both the quality

and quantity of the regenerated bone for horizontal augmentation of full arch split mouth maxillary cases using

prebent titanium meshes loaded with bone marrow aspirate mixed with xenograft ( study group)versus

xenograft mixed with autografts in 1:1 ratio ( control group) in a randomized clinical trial.

 

Method: 8 patients suffered from severe horizontal full arch maxillary deficiency were subjected to guided bone

regeneration. Virtual horizontal bone augmentation was done for the whole maxillary alveolar deficient ridge

using special software to produce virtually augmented stereolithographic plastic models to guide for

prebending of titanium meshes preoperatively. In the study group, prebent meshes were loaded with a mix of

xenograft and Bone marrow aspirate concentrate (BMAC) from the iliac crest. While in the control group the

meshes were loaded with xenograft mixed with autograft only with ratio of 1:1. And meshes were fixed in place

using mini screws

 

Results: wound healing was uneventful for all patients. CBCT was performed 6 months postoperatively for

each patient who showed a 5.2 mm horizontal bone gain in the study group and 4.3 mm for that of the control.

At the re-entry surgery; core biopsies were retrieved from the regenerated sites using trephine burs for

histomorphometric analysis. a statistically significant higher bone area percent was detected in study group

(47.9 %) as compared to control group (28.5%). A statistically significant higher percentage of mature bone as

detected by Masson trichrome was also detected in study group (67.7 %) as compared to control group

(26.5%).

 

Conclusion: horizontal bone augmentation using prebent titanium meshes loaded with xenograft with bone

marrow aspirate could be a reliable less morbid technique.

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