Bone regeneration with PRP growth factors in association with filling biomaterials: a case report

PRP (Platelet Rich Plasma) is a reservoir of growth factors (PDGF,TGF-β,IGF-1,FGF,EGF), which can stimulate angiogenesis, macrophage chemotaxis, fibroblast proliferation and collagen synthesis.

AIM
The aim of the present study is to demonstrate the short-term and long-term effectiveness of PRP, in association with filling biomaterials, for bone regeneration of atrophic areas in implantology.

MATERIALS AND METHODS
We present the case of a 40-year-old female patient with a fixed prosthesis. In one surgery, we avulsed tooth 15, performed Summer’s crestal sinus lift by placing PRP-imbibed fibrin sponges and then placed 2 implants; PRP was obtained by sampling autologous blood in sterile test tubes without anticoagulant and by centrifugation.

RESULTS
Postsurgical orthopantomography (OPT) showed an hyper-transparent sinus (empty), indicating the complete absence of bone grafts and only the presence of PRP-imbibed fibrin sponges; OPT and CT scan performed 6 months after surgery revealed a radiographic integration and an increased density of the perimplant bone.

DISCUSSION AND CONCLUSIONS
PRP, being rich in growth factors, associated with fibrin sponges which substantially act as a scaffold, has allowed to achieve a satisfying neo-apposition and bone regeneration, as proved by long-term radiological examinations.
The combined use of PRP, associated with filling biomaterials, is certainly a very interesting technique, which deserves long-term clinical investigations and prospective, experimental studies on a statistically-significant number of patients, with strict and well-defined inclusion criteria and without statistic bias.


Fig.1 PRP obtained after centrifugation


Fig.2 Dextran Fisiograft sponge and gel


Fig.3 OPT detail


Fig.4 Incisions and detachment


Fig.5 Small lift and implants


Fig.6 Postsurgical OPT(hyper-transparency)


Fig.7 OPT and CT scan 6 months after surgery (increased density of the perimplant bone)


Fig.7


Fig.8 Zirconia ceramic single crowns

Congresso Nazionale dei Docenti di Discipline Odontostomatologiche e Chirurgia Maxillo Facciale
Firenze – Siena, 14-16 Aprile 2011

Università degli Studi di Bari Dipartimento di Odontostomatologia e Chirurgia
Direttore: Prof.ssa D. DE VITO
Calabrodental S.r.l. Unità Operativa di Chirurgia Maxillo-Facciale Regione Calabria – Crotone Dir. San: Dott. M. W. Marrelli

AUTHORS
F. Inchingolo, F. Carbotti, G. Dipalma, M. Serafini, M. Marrelli, A.M. Inchingolo, S. di Teodoro, A. Palladino, M. De Carolis, A.D. Inchingolo, M. Tatullo

REFERENCES

Marx RE, Carlson ER, Eichstaed RM, Schimmele SR, Strauss JE, Georgeff KR. Platelet-rich plasma: growth factor enhancement for bone graft. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:638-46
Cavicchia F, Bravi F, Petrelli G. Localized augmentation of the maxillary sinus floor thtrough a coronal approach for the placement of implants. Int J Periodont Rest Dent 2001;21:475-85
Chiapasco M, Romeo E. “Riabilitazione implanto-protesica dei casi complessi”. Utet, Torino, 2003

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