Bone Marrow Aspirate Concentrate and Xenograft Vs. Autograft and Xenograft in 3D Reconstruction of Atrophic Maxillary Ridges: A Split Mouth Randomized Controlled Trial.

Abstract

Purpose: The aim of the study was to evaluate bone quality and quantity after threedimensional augmentation of vertically and horizontally atrophied maxillary ridges using bone marrow aspirate concentrate (BMAC) and xenograft versus autograft and xenograft, both using pre-bent titanium mesh over a virtually augmented model.

Methods: 10 fully edentulous patients with severe maxillary vertical and horizontal bone loss were recruited. Virtual vertical and horizontal bone augmentation was done for the deficient ridge to produce virtually augmented models for pre-bending of titanium meshes preoperatively. In the study side, the mesh was loaded with a mix of xenograft and BMAC from the anterior iliac crest, while in the control side the mesh was loaded with a 1:1 xenograft to autograft mix. The meshes were fixed in place using mini screws.

Results: CBCT was performed 6 months postoperatively for all patients. The intervention side showed a mean vertical bone gain of (3.47±0.87) mm which was comparable to that of the control side (4.10±0.67) mm, and a mean horizontal bone gain of (3.476±0.59) mm which was higher than the control side (2.918±0.80) mm. while the mean resorption rate in the study group (106.2±108.6) mm was lower than the mean value in the control group (193.3±107.9) mm.The differences in bone gain were not statistically significant, However, a statistically significant higher bone area percent as well as a higher percentage of mature bone were detected in the study group (47.9%) and (67.7%) compared to the control group (28.5%) and (26.5%) respectively.

Conclusion: The three-dimensional alveolar reconstruction using pre-bent titanium meshes loaded with xenograft mixed with BMAC could be a reliable, less morbid technique.