Supplementation of platelet-derived products in distraction osteogenesis for alveolar ridge augmentation: A systematic review

Abstract

Background: Distraction osteogenesis (DO) is one of the recent tissue engineering techniques which have been utilized for alveolar ridge augmentation procedures. It makes use of tensional strains created within the fractured segments to initiate a cascade of responses ultimately resulting in the formation of new mature bone. Supplementation of platelet-derived products such as platelet-rich plasma and platelet-rich fibrin in DO could stimulate this cascade and accelerate the formation of new bone with improved quality. Materials and Methods: Literature search was performed on eminent databases for studies using platelet-derived products with DO in alveolar ridge augmentation. Data relating to bibliographic information, and study outcomes were extracted. A risk of bias assessment was performed for each study. Measures of outcome included increase in bone height, and any reported postoperative complications. Results: Planned alveolar height was reached in all the studies with an adequate amount of bone formation for the placement of dental implants. Studies reported long-term implant survival. Postoperative complications included displacement of fractured segments, temporary paresthesia, and scar formation. Conclusion: DO supplemented with platelet-derived products provides an ideal micro-environment for the recruitment of various signaling molecules and stem cell precursors inducing the formation of new bone. It circumvents the unpredictable outcomes and complications such as donor site morbidity, which is associated with conventional placement of bone grafts. However, the available literature is scarce in this area and further randomized studies are required to form a conclusive body of evidence to support the translatability of this innovative technique into clinical practice.