Comparison of efficiency of platelet rich plasma, hematopoieic stem cells and bone marrow in augmentation of mandibular bone defects.

Comparison of the effectiveness of three techniques used for the programmed augmentation of mandibular bone, which is part of the therapeutic procedure used in pre-prosthetic, pre-implantology surgery. The techniques are based on stimulation of natural events continuously present in living bone, that is, the process of bone remodelling. We compared the effects of stimulation of osteogenesis of alveolar bone by transplants of 1. autologous bone marrow; 2. freshly isolated mononuclear cells from bone marrow containing CD34+ cells; and 3. platelet rich plasma (PRP). It was shown that newly formed bone augmented under the influence of platelet rich plasma shows the closest similarity to the control contralateral bone. Less effective was the treatment by the population of CD-34 bone marrow derived stem cells or autologous bone marrow. It seems that guided bone regeneration of mandibular bone needs the active products as cytokines or growth factors contained in platelet rich plasma. Most probably they are released more quickly after transplantation than from progenitor cells derived from bone marrow. "The gold standard" of autogenic bone grafts was not used, because we believe that if possible, alternative techniques should be applied to avoid additional trauma to patients.