Osteogenesis distraction and platelet-rich plasma for bone restoration of the severely atrophic mandible: Preliminary results

Purpose: The purpose of this study was to evaluate a new method of restoring severe atrophic mandible using platelet-rich plasma (PRP) during distraction osteogenesis. Materials and Methods: Since 1999, 2 men and 3 women with severe atrophy (Cawood and Howell classes V and VI) of a completely edentulous mandible have been treated with a novel distraction procedure. During the surgery, a mixture of autologous bone graft, harvested from the iliac crest, and an autologous platelet concentrate, obtained from platelet-rich plasma, filled the distraction gap. This mixture constituted an autologous bone-platelet gel that was used to create a useful bony scaffold for distraction regenerate. After a latency period of 15 days, a distraction run of 0.5 mm/d, and a 60-day period of consolidation, the distraction device was removed and implants were placed simultaneously. Results: In all treated patients, planned distraction height was achieved with a considerable enhancement of bony regeneration, and in all cases it was possible to place implants at a planned time. Conclusions: The combination of these recent and innovative regenerative methods seems to be effective in restoring the severe atrophic mandible. (C) 2002 American Association of Oral and Maxillofacial Surgeons.