Use of Bone Marrow Aspirate Concentrate (BMAC) Associated with Hyperbaric Oxygenation Therapy in Maxillary Appositional Bone Reconstruction. A Randomized Clinical Trial

Antonio Carlos Aloise,Paulo Pasquali,José Luis Calvo-Guirado,André Antonio Pelegrine,Luis Guilherme Scavone De Macedo,Marcelo Sperandio,Marcelo Lucchesi Teixeira

doi:10.3390/sym10100533

Abstract

Objectives: The objective of this study was to evaluate bone reconstruction using xenograft alone and associated with bone marrow aspirate concentrate (BMAC) and hyperbaric oxygen therapy. Material and Methods: Twenty-four maxillary edentulous patients were randomly assigned into three groups: Control group (CG)—xenograft bone alone (n = 8); Group 1 (G1)—xenogeneic bone block combined with BMAC (n = 8), and Group 2 (G2)—xenogeneic bone block combined with BMAC and hyperbaric oxygenation (n = 8). Bone biopsies were harvested 6 months after grafting. Vital Mineralized Tissue (VMT), Non-vital Mineralized Tissue (NVMT), and Non-Mineralized Tissue (NMT) were measured. Computed tomography was also performed on three occasions T0 (preoperative), T4 (4 months postoperative), and T8 (8 months postoperative). The difference between T4 and T8 values with respect to T0 was used to determine the thickness level gain after 4 and 8 months, respectively. Results: The tomographic evaluation did not show significant differences between the groups either at 4 or at the 8 months postoperatively. Regarding the histomorphometric analysis, CG had the lowest percentages of VMT (36.58 ± 9.56%), whereas G1 and G2 had similar results (55.64 ± 2.83% and 55.30 ± 1.41%, respectively). Concerning NMT and NVMT levels, the opposite was observed, with CG levels of 51.21 ± 11.54% and 11.16 ± 2.37%, G1 of 39.76 ± 11.48% and 3.65 ± 0.87%, and G2 of 40.3 ± 11.48% and 4.10 ± 0.87%, respectively. Conclusions: The use of bone block xenograft associated with BMAC resulted in a significant increase of bone neoformation when compared to the xenograft alone, though hyperbaric oxygenation did not enhance the results.

Highlights

IntroductionThere are some issues that must be stated concerning this approach, such as morbidity of the donor site, limited bone supply, and loss of bone volume during healing
Autologous bone grafting is regarded as the gold standard for reconstruction of bony defects.The use of autologous bone grafts is a safe option to restore bone volume for implant supported dental rehabilitations, with the added benefit provided by the osteogenic, osteoinductive, Symmetry 2018, 10, 533; doi:10.3390/sym10100533 www.mdpi.com/journal/symmetrySymmetry 2018, 10, 533 and osteoconductive stimuli inherent of such tissues.there are some issues that must be stated concerning this approach, such as morbidity of the donor site, limited bone supply, and loss of bone volume during healing
The use of bone block xenograft associated with bone marrow aspirate concentrate (BMAC) resulted in a significant increase of bone neoformation when compared to the xenograft alone, though hyperbaric oxygenation did not enhance the results

Summary

Introduction

There are some issues that must be stated concerning this approach, such as morbidity of the donor site, limited bone supply, and loss of bone volume during healing. Other options such as synthetic, allograft, and xenogenic bone have been used for bone regeneration purposes [1]. In this field, the xenogenic equine block biomaterial is a reasonable alternative to autologous grafting, as it has been demonstrated to generate adequate levels of hard tissue gain in reconstructions of the atrophic maxilla [2].

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Conclusion