Objectives:GBR of the mandible is a surgical procedure used in the pre-prosthetic and pre-implant management of atrophic bone tissue, and in the treatment of bone defects. Several bioengineering techniques have been proposed for the induction of osteogenesis of the alveolar bone. In this paper we have compared the effects of stimulating osteogenesis of the alveolar bone by using transplants comprising of bovine bone mineral as a carrier and autologous 1. bone marrow, 2. haematopoietic CD34+ stem cells (BM-MNC-CD34) and 3. platelet- rich plasma (PRP). The aim of the analysis was a quantitative evaluation of the architecture of augmented bone in comparison to healthy bone tissue of contra-lateral side.
Methods:The study included 25 male patients (age 27– 44 years old) and was performed three months after the above-mentioned transplantations into mandibular bone defects following cystectomy. Quantitative evaluation of the effects of bone augmentation was based on dental radiograms taken using the Vix-Win 2000 digital system. The trabecular structure of augmented bone was evaluated using Fourier analysis, which allowed to measure and compare the mean thickness and directions of newly formed bone trabeculae, as well as by fractal analysis, which allowed to investigate the complex nature and self-replication of analysed bone structures. After MANOVA analysis of variance, discriminant analysis was performed and Mahalanobis distances within the multiaxial space were calculated.
Results:Newly formed bone augmented under the influence of PRP seemed to show the closest similarity to the control, contra-lateral bone. The treatment using the population of CD-34+ bone marrow derived stem cells (BM-MNC-CD34) were less effective.
Conclusion:It seems that guided bone regeneration (GBR) of the mandibular bone needs active products, such as the growth factors contained in platelet-rich plasma (PRP), which are released quicker following transplantation than from progenitor cells derived from bone marrow.
Supported by the Grant No PBZ-KBN-083/PO5/2004