Bone Replacement Materials and Techniques Used for Achieving Vertical Alveolar Bone Augmentation

Platelet-rich plasma is an autologous source of platelet-derived growth factor and transforming growth factor beta that is obtained by sequestering and concentrating platelets by gradient density centrifugation. This technique produced a concentration of human platelets of 338% and identified platelet-derived growth factor and transforming growth factor beta within them. Monoclonal antibody assessment of cancellous cellular marrow grafts demonstrated cells that were capable of responding to the growth factors by bearing cell membrane receptors. The additional amounts of these growth factors obtained by adding platelet-rich plasma to grafts evidenced a radiographic maturation rate 1.62 to 2.16 times that of grafts without platelet-rich plasma. As assessed by histomorphometry, there was also a greater bone density in grafts in which platelet-rich plasma was added (74.0% +/- 11%) than in grafts in which platelet-rich plasma was not added (55.1% +/- 8%; p = 0.005).

Preservation of alveolar bone volume following tooth extraction facilitates subsequent placement of dental implants and leads to an improved esthetic and functional prosthodontic result. The aim of the present study was to assess bone formation in the alveolus and the contour changes of the alveolar process following tooth extraction. The tissue changes after removal of a premolar or molar in 46 patients were evaluated in a 12-month period by means of measurements on study casts, linear radiographic analyses, and subtraction radiography. The results demonstrated that major changes of an extraction site occurred during 1 year after tooth extraction.

Bone tissue engineering is a rapidly developing area. Engineering bone typically uses an artificial extracellular matrix (scaffold), osteoblasts or cells that can become osteoblasts, and regulating factors that promote cell attachment, differentiation, and mineralized bone formation. Among them, highly porous scaffolds play a critical role in cell seeding, proliferation, and new 3D-tissue formation. A variety of biodegradable polymer materials and scaffolding fabrication techniques for bone tissue engineering have been investigated over the past decade. This article reviews the polymer materials, scaffold design, and fabrication methods for bone tissue engineering. Advantages and limitations of these materials and methods are analyzed. Various architectural parameters of scaffolds important for bone tissue engineering (e.g. porosity, pore size, interconnectivity, and pore-wall microstructures) are discussed. Surface modification of scaffolds is also discussed based on the significant effect of surface chemistry on cells adhesion and function.