Concentrated Bone Marrow Aspirate-Coated Hydroxyapatite for Reconstruction of Small-to-Moderate-Sized Mandibular Defects Caused by the Removal of Benign Pathologies

Raja Sekhar Gali; Ravindran Chinnaswamy; Sathya Kumar Devireddy; Mahaboob Vali Shaik; Rayadurgam Venkata Kishore Kumar; Sridhar Reddy Kanubaddy; Ramesh Babu Vaka; Y S Harish; Rama Mohan Pathapati

doi:10.4103/ccd.ccd_745_18

Concentrated Bone Marrow Aspirate-Coated Hydroxyapatite for Reconstruction of Small-to-Moderate-Sized Mandibular Defects Caused by the Removal of Benign Pathologies

Contemp Clin Dent. 2018 Oct-Dec;9(4):535-540. doi: 10.4103/ccd.ccd_745_18.

Authors

Raja Sekhar Gali¹, Ravindran Chinnaswamy², Sathya Kumar Devireddy¹, Mahaboob Vali Shaik³, Rayadurgam Venkata Kishore Kumar¹, Sridhar Reddy Kanubaddy¹, Ramesh Babu Vaka¹, Y S Harish¹, Rama Mohan Pathapati³

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.
² Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India.
³ Department of Pharmacology, Advanced Research Centre, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India.

Abstract

Purpose: The aim of this study was to evaluate the bone regeneration potential of concentrated bone marrow aspirate (BMA)-coated hydroxyapatite (HA) for reconstruction of mandibular defects caused by the removal of benign pathologies.

Patients and methods: This prospective clinical study included ten patients with histopathologically proven benign pathologies of the mandible measuring <5 cm anteroposteriorly, who were treated with enucleation or marginal resection, followed by autologous concentrated BMA-coated synthetic biphasic HA (HA and beta-tricalcium phosphate) graft placement. Clinical and radiological evaluations of grafted sites of the mandible were done at 1 week, 1, 3, and 6 months postoperatively using Irwin's radiologic staging and grayscale histogram.

Results: All patients (10/10, 100%) had proper incorporation of the graft with the normal adjacent bone. Grayscale histogram revealed the initial stages of graft resorption, followed by formation of new bone-grafted sites. No complications such as infection and total graft loss were encountered except for one patient who had partial wound dehiscence that responded well to local wound care and resuturing.

Conclusion: Concentrated BMA-coated synthetic HA effectively promotes bone regeneration in small-to-moderate-sized defects of the mandible.

Keywords: Bone graft substitute; bone marrow aspirate; bone marrow stem cells; bone regeneration; calcium phosphate ceramic; hydroxyapatite; mandible; mesenchymal stem cells; osteoprogenitors; tissue engineering.