A Novel Drilling Procedure and Subsequent Bone Autograft Preparation: A Technical Note

Purpose: To describe a new drilling system that allows the surgeon to obtain autologous living bone that, when associated with a plasma rich in growth factors (PRGF), can be used in bone grafting. Materials and Methods: Bone particles collected using both conventional and new drilling systems were analyzed by means of optic and electronic microscopy in 10 patients. Blood was collected from 43 volunteers and used to prepare PRGF. Quantitative aspects of the PRGF, including number of platelets and concentration of growth factors (insulin growth factor [IGF-I], transforming growth factor [TGF-b1], platelet-derived growth factor [PDGF-AB], vascular endothelial growth factor [VEGF], hepatocyte growth factor [HGF], and epidermal growth factor [EGF]) were assessed. A demonstrative case study was presented. Results: Microscopic examination showed that the bone structure and the presence of living cells in the bone chips were conserved in all samples obtained from drilling at low speed, whereas material obtained by conventional drilling did not maintain these qualities. Mean counts for TGF-b1 (55.27 ± 16.23 ng/mL), PDGF-AB (27.96 ± 12.13 ng/mL), VEGF (421.09 ± 399.0 pg/mL), EGF (455.49 ± 210.04 pg/mL), and HGF (605.70 ± 269.20 pg/mL) were significantly correlated with the number of platelets (590,000 ± 197,000 platelets/µL; P .05). Discussion and Conclusion: The new drilling procedure was developed based on biologic criteria. The method may reduce damage to the host tissue and can be used to obtain a mass of living bone for subsequent grafting in association with autologous growth factors. This new procedure may present new possibilities for enhanced bone healing and needs to be evaluated in a clinical trial. (Technical Note) Parole chiave: autografts, dental implants, low-speed drills, preparation rich in growth