Tissue engineering with recombinant human platelet-derived growth factor BB for implant site development

Currently, PDGF-BB is FDA-approved for periodontal regeneration as part of a dental bone-filling device only. Although this device uses beta-TCP as the scaffold carrier, there has been considerable clinical interest in combining this growth factor with other bone replacement grafts, particularly bone allografts. This article reports on clinical experiences using rhPDGF-BB with bone allografts for implant site development. After careful evaluation of clinical parameters and consideration of current and emerging evidence, the off-label use of rhPDGF-BB was determined in the following case reports to be consistent with good clinical practice and in the patient's best interest. Clinical, radiographic, and histologic observations from the following selected cases are presented to illustrate treatment outcomes achieved using this combination strategy: ridge preservation for extraction sockets with alveolar wall defects; ridge preservation for extraction sockets minimally invasive techniques; lateral ridge augmentation; and sinus augmentation. All of the cases presented and reviewed were surgically managed using 0.5 ml of 0.3 mg/ml of rhPDGF delivered using a particulate bone allograft (FDBA or DFDBA) as a scaffold. Controlled clinical trials are necessary to establish the relative effectiveness of rhPDGF-BB combined with different mammalian scaffolds for alveolar augmentation.