Minimally Invasive Alveolar Ridge Augmentation Procedures (Tunneling Technique) Using rhPDGF-BB in Combination with Three Matrices: A Case Series

This study investigated a minimally invasive surgical procedure for alveolar ridge augmentation that combined recombinant human platelet-derived growth factor BB (rhPDGF-BB) and three different matrices. The minimally invasive tunneling ridge augmentation procedure was applied to 12 patients randomized into three groups: rhPDGF-BB (0.3 mg/mL) was combined with freeze-dried bone allograft (FDBA; group A), anorganic bovine bone graft (ABBG; group B), or anorganic bovine bone graft/mineralized collagen bone substitute (ABBG/MCBS; group C). Computed tomography (CT) scans were obtained presurgically and prior to 14- week re-entry surgery. Clinical reentry revealed adequate bone volume to place implants in all patients in groups A and B and two of four patients in group C. Trephine core biopsies were obtained and evaluated by microCT, backscatter scanning electron microscopy (BE-SEM), and light microscopy. New bone formation was consistently observed with BE-SEM and histologic analysis for group A and B specimens. Newly formed woven and lamellar bone were in close contact with graft particles. The ABBG/MCBS specimens (group C) had more variable results, with fibrous encapsulation of graft particles and limited histologic evidence of new bone formation. Within the limits of this study, the FDBA and ABBG carriers appear to be appropriate scaffolds to deliver rhPDGF-BB for ridge augmentation via minimally invasive surgical techniques.