Use of corticocancellous allogeneic bone blocks impregnated with bone marrow aspirate: a clinical, tomographic, and histomorphometric study.
The aim of this study was to evaluate the efficacy of allogeneic block grafts impregnated with autologous bone marrow in horizontal ridge augmentation therapy. Ten patients with severe ridge volume deficiency in the anterior maxilla were treated with horizontal ridge augmentation. The patients were randomized into two groups: Five patients, using two allogeneic block grafts, were in the control group, and five patients, using two allogeneic block grafts impregnated with autologous bone marrow, were in the test group. Hematologists collected 4 mL of bone marrow from the iliac crest of the patients in the test group immediately prior to the surgeries. The blocks were fixed using titanium screws to obtain rigid fixation and to standardize the reference points for measurement purposes. CT scans were obtained both preoperatively and six months postoperatively to allow evaluation of horizontal bone gain. After a healing period of six months, the sites were reopened and the screws were removed. Before implant placement, bone cores were harvested and prepared for histologic and histomorphometric evaluation. Tomographic and histomorphometric measurements were recorded.  The test group demonstrated better tomographic results (P < 0.05) in augmenting alveolar thickness, with a mean value of 4.60 ± 1.43 mm (118.23 ± 56.93%), while the control group had bone gain of 2.15 ± 0.47 mm (49.91 ± 20.24%). Despite the different results in alveolar thickness gained between groups, all sites received dental implants. The histomorphometric analysis also showed better results (P < 0.05) in the amount of vital mineralized bone in the test group as compared to the control group. The findings of this study suggest that an autologous bone marrow aspirate can increase the regenerative potential of corticocancellous allogeneic bone grafts.
School of Medicine, UNIFESP, Sao Paulo, Brazil.
Carlos Eduardo Sorgi
CE
da Costa
Andre Antonio
AA
Pelegrine
Djalma Jose
DJ
Fagundes
Manuel de Jesus
Mde J
Simoes
Murched Omar
MO
Taha
D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D016026:Bone Marrow Transplantation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged