Abstract
Objectives: The purpose of this paper is to report long-term results on the use of
autologous bone graft and platelet-rich plasma in alveolar distraction osteogenesis (DO) for
restoration of severe atrophic mandible. We tested the efficacy as to reabsorption of bone
volume, peri-implant reabsorption, implant survival and success rate.
Materials and methods: Twelve patients were treated. The surgical procedure consisted in
mixing autologous bone, harvested from the iliac crest, with autologous platelet
concentrate (APC) and in filling the distraction gap with this graft. After a latency of 15
days, a distraction rate of 0.5 mm/day was followed. After a 60-day period of consolidation,
the distraction device was removed and implants were placed simultaneously. The
abutment connection was accomplished after 6 months. In addition, every patient was
evaluated clinically and radiographically annually for 5 years.
Results: Planned alveolar height was reached in 11 out of 12 patients. The total number of
implants positioned was 47. At the time of implant positioning, the mean decrease of total
bone volume was 2.3%. The mean peri-implant resorption was 0.40mm at the time of
abutment connection, 0.61mm 1 year after implant loading and 1.51mm after 5 years.
After 5 years of follow-up, the mean rate of vertical bone loss was 18.7%. Instead, the
implant survival and success rates were 97.9% and 91.5%, respectively.
Conclusions: Long-term results allow us to confirm the combination of autologous boneplatelet
gel with alveolar DO as an effective and predictable procedure in restoration of
severe atrophic mandible.
