The use of recombinant human platelet-derived growth factor-BB in combination with β-tricalcium phosphate and rhPDGF-BB in combination with freeze-dried bone allograft plus barrier in two separate complex infrabony defects with long-term follow-up

Background

Reports from a large-scale, prospective, masked, randomized controlled clinical trial demonstrated gain in attachment level, linear bone gain, and percentage bone fill in infrabony defects treated with recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and β-tricalcium phosphate (β-TCP) at 6 months. A follow up to that trial at 24 months showed the results were stable in terms of gain in clinical parameters, and assessment of selective cases demonstrated stability at 5 years. The cases presented in this report provide clinical applications to support the use of this biologic in complex infrabony defects. An infrabony defect is described as a periodontal pocket with its base apical to the crest of the alveolar bone. Infrabony defects may have one, two, or three bony walls creating challenges in management.

Methods

Two complex infrabony defect cases are presented in this report: one using rhPDGF-BB with β-TCP and the other using rhPDGF-BB with freeze-dried bone allograft (FDBA) and a resorbable barrier membrane. The techniques are described with results showing long-term follow up and reentry at 8 and 14 years (respectively).

Results

Both cases demonstrate significant gains in clinical attachment levels as well as bone-like fill as observed radiographically and at reentry.

Conclusions

These case reports of combining rhPDGF-BB with β-TCP or with FDBA and a barrier membrane support the literature showing improvement in attachment levels and demonstrating bone fill in complex infrabony defects. The results can be maintained long term.