title: Platelet-rich plasma may prevent titanium-mesh exposure in alveolar ridge augmentation with anorganic bovine bone.
abstract: OBJECTIVE
  Bone augmentation with the titanium-mesh (Ti-mesh) technique is susceptible to a large rate of complications such as morbidity of bone graft donor site, and mesh exposure to the oral cavity. The purpose of this study was to evaluate the effectiveness of anorganic bovine bone (ABB) in alveolar bone augmentation with the Ti-mesh technique. In addition, we investigated the effect of platelet-rich plasma (PRP) in preventing mesh exposure by using it to cover the Ti-mesh.
  
  
  METHODS
  Patients included in the clinical trial were randomly allocated by a blinded assistant into two groups. The 30 patients recruited for this study underwent 43 alveolar bone augmentation with the Ti-mesh technique using ABB as graft material in all of them. In 15 patients, the Ti-meshes were covered with PRP (PRP group) whereas in the other 15 the Ti-meshes were not (control group). After 6 months, patients were called for clinical, radiographic, and histological evaluation, and implant placement surgery. A total of 97 implants were placed in the augmented bone and their evolution was followed up for a period of 24 months.
  
  
  RESULTS
  Significant differences were found between the two study groups in terms of complications and bone formation. In the control group, 28.5% of the cases suffered from mesh exposure, while in the PRP group, no exposures were registered. Radiographic analysis revealed that bone augmentation was higher in the PRP group than in the control group. Overall, 97.3% of implants placed in the control group and 100% of those placed in the PRP group were successful during the monitoring period. We suggest that the positive effect of PRP on the Ti-mesh technique is due to its capacity to improve soft tissue healing, thereby protecting the mesh and graft material secured beneath the gingival tissues.
  
  
  CONCLUSIONS
  Alveolar bone augmentation using ABB alone in the Ti-mesh technique is sufficient for implant rehabilitation. Besides, covering the Ti-meshes with PRP was a determining factor in avoiding mesh exposure. Ti-mesh exposure provoked significant bone loss, but in most cases it did not affect the subsequent placement of implants.
authors.affiliation: Ciencias de la Salud III, Universidad Rey Juan Carlos, Alcorcón, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Torres
authors.forename: Faleh
authors.initials: F
authors.lastname: Tamimi
authors.forename: Mohammad Hamdan
authors.initials: MH
authors.lastname: Alkhraisat
authors.forename: Angel
authors.initials: A
authors.lastname: Manchón
authors.forename: Rafael
authors.initials: R
authors.lastname: Linares
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Prados-Frutos
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Hernández
authors.forename: Enrique
authors.initials: E
authors.lastname: López Cabarcos
mesh_terms: D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001861:Bone Regeneration; D018786:Bone Substitutes; D003758:Dental Implantation, Endosseous; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D011183:Postoperative Complications / Q000517:prevention & control*; D016037:Single-Blind Method; D013526:Surgical Mesh; D014025:Titanium
chemical_list: D018786:Bone Substitutes; D014025:Titanium