Platelet rich plasma prevents titanium mesh exposure in alveolar ridge augmentation with anorganic bovine bone

Abstract

4 5 6 7 Bone augmentation with the titanium mesh (Ti-mesh) technique is susceptible to a large ABSTRACT Objective: 8 rate of complications such as morbidity of bone graft donor site, and mesh exposure to 9 10 11 12 13 14 15 16 17 18 19 20 for clinical, radiographic and histological evaluation, and implant placement surgery. A the oral cavity. The purpose of this study was to evaluate the efficacy of anorganic bovine bone (ABB) in alveolar bone augmentation with the Ti-mesh technique, as an alternative to autologous bone grafts. In addition, we investigated the effect of platelet rich plasma (PRP) in preventing mesh exposure, by applying it to cover the Ti-mesh. Materials and Methods: The 30 patients recruited for this study underwent 43 alveolar bone augmentation with the Ti-mesh technique using in all of them ABB as graft material. In 15 patients the Ti-meshes were covered with PRP (PRP group) while in the other 15 the Ti-meshes were not (control group). After 6 months, patients were called 21 total of 97 implants were placed in the augmented bone and their evolution was 22 23 24 25 26 27 complications and bone formation. In the control group 28.5% of the cases suffered 28 followed up for a period of 24 months. Results: Significant differences were found between the two study groups in terms of 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. Interestingly, mesh exposure seemed to be a risk factor regarding graft resorption and failure. 29 30 31 32 33 Overall, 97.3% of implants placed in the control group and 100% of those placed in the 34 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. 35 36 37 38 39 40 Conclusions: Alveolar bone augmentation using ABB alone in the Ti-mesh technique is 41 sufficient for implant rehabilitation. Besides, covering the Ti-meshes with PRP was a determining factor for avoiding mesh exposure in this study. Titanium mesh exposure provoked significant bone loss, but in most cases it did not affect the subsequent placement of implants.