Dental implants have become a reliable long-term treatment option. Complex cases such as tumor resections or extreme atrophy result in considerable patient pain and other comorbidities from slow or incomplete healing, however, prompting a need for different bone substitution materials.
Now, researchers at the Medical Center of the Goethe University Frankfurt in Germany have used a combination of a xenogenic bone substitute (BO) and platelet-rich fibrin (PRF) to successfully perform an implantation in a severely compromised mandible in a former head and neck cancer patient.
A 61-year-old female with cancer in her mandible was treated by a tumor resection in her jaw as well as neck dissection on both sides, resulting in disfiguration to her lower jaw. After enduring a painful cancer treatment, she did not desire another surgery to harvest bone for dental implants and opted for the BO and PRF alternative.
The patient’s blood was drawn, centrifuged, and combined with the BO to fill an anatomy-specific 3-D titanium mesh that was designed and made from a CT scan-generated model of her mandible. The mesh was placed at the involved surgical site and covered with a collagen matrix that previously had been shown to aid in tissue regeneration. A final layer of PRF clots was used to cover the matrix.
No complications were observed during the 16-month, full implantation procedure in which six implants were successfully integrated into the mandible. From bone biopsies taken during the procedure, the researchers were able to histologically confirm that the combination of BO and PRF created a successful integration and is a strong alternative to direct bone harvesting from the patient. The histology also revealed increased blood flow in the connective tissue, aiding tissue regeneration and new bone formation during the augmentation healing phase.
While the researchers call this method promising, they say that more research is necessary to determine its longer-term effects on bone regeneration. The study, “Individualized Titanium Mesh Combined With Platelet-Rich Fibrin and Deproteinized Bovine Bone: A New Approach for Challenging Augmentation,” was published by the Journal of Oral Implantology.