Simultaneous augmentation of hard and soft tissues for implant site preparation using recombinant human...

This paper documents the treatment of a patient for whom a tissue engineering approach was used for both soft and hard tissue implant site development following the extraction of a failing maxillary left central incisor. The tooth had advanced pocketing and recurrent abscess formation secondary to failing endodontic treatment. Extraction revealed a lack of buccal plate as well as insufficient soft tissue for anterior esthetics. After extraction, the bony defect was filled with freeze-dried mineralized bone allograft mixed with recombinant human platelet-derived growth factor (rhPDGF), and a titanium-reinforced expanded polytetrafluoroethylene membrane was placed over it. The soft tissue deficiency was corrected with a pediculated connective tissue graft, and the graft bed was rinsed with rhPDGF. Seven months after surgery, the site was re-entered for implant placement. The grafted site was trephined for histologic analysis and an implant was placed. Subsequently, the implant osseointegrated and was restored. The radiographic and clinical results were acceptable. Histologic analysis revealed bone regeneration. Although this approach needs further investigation, this report emphasizes the potential for the use of rhPDGF for simultaneous soft and hard tissue implant site preparation.