Bone block allograft impregnated with bone marrow aspirate.
OBJECTIVE
To evaluate the influence of bone marrow aspirate when added to bone block allograft to repair osseous defects.


BACKGROUND
Bone-marrow aspirate has been combined with xenograft and allograft particulate material and has produced a significant quantity of new bone growth. However, the use of allograft bone blocks has advantages in some clinical situations. This article discusses cell-based therapies by means of in vivo transplantation of stem cells derived from bone-marrow aspirate and incorporated into allograft corticocancellous bone block for bone regeneration.


METHODS
A technique for combining bone-marrow aspirate with block allografts was developed. To evaluate its influence in repairing osseous defects, a maximum of 3 to 4 mL of bone marrow was aspirated from the anterior iliac crest of 5 patients who had severely atrophic maxillary and mandibular ridges. Five sites were grafted with allograft bone blocks saturated with bone-marrow aspirate and secured with bone screws (ACE Surgical Supply Company, Inc. Brockton, MA). At one of the sites a core specimen was taken 4 months after implant placement and submitted for standard histologic and histomorphometric analysis.


RESULTS
After 4 to 8 months of healing, all the grafts had integrated into the recipient bone. Implants were placed at all 5 sites and osseointegrated successfully. Examination of the bone core showed the graft to be well-integrated, with 54% of the core consisting of bone and 46% of marrow. Eighty-nine percent of the bone was vital.


CONCLUSIONS
Impregnation of bone-marrow aspirate into allograft bone block activates the body's ability to form new bone. The bone-marrow aspiration technique is less invasive than harvesting autogenous bone from a second surgical site, offers predictable results, and is cost effective.
Soltan
Muna
M
soltandds@aol.com
Smiler
Dennis
D
Prasad
Hari S
HS
Rohrer
Michael D
MD
D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D016026:Bone Marrow Transplantation / Q000379:methods*; D001862:Bone Resorption / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome