Dimensional stability of the alveolar ridge after implantation of a bioabsorbable bone graft substitute: a radiographic and histomorphometric study in rats

This study evaluated reconstruction of the alveolar ridge after molar extraction in rats with bioabsorbable bone repair scaffolds. The material was prepared from the unsaturated polyester poly(propylene glycol-co-fumaric acid) (PPF), which may be cured in situ to form a porous scaffold. The intention is to use this material either as a stand-alone bone graft substitute or as an extender to autograft harvested from mandibular reconstruction sites. The bioactivity of the graft substitute was investigated in a rat residual ridge resorption model. PPF bone repair material was injected into the defect site, where it cross-linked in situ in the presence of a hydroxyapatite (HA) filler and effervescent agents. The PPF-based material develops porosity during an in situ cure by generating carbon dioxide during the effervescent reaction of citric acid and sodium bicarbonate. The incorporation of HA promotes osteoconduction within the bone repair scaffold. In this study, bioactivity of the porous scaffold was evaluated as a function of HA particle size (micrometer-sized vs nanometer-sized particles). The maxillary or mandibular molars on the right side were extracted from 96 adult Sprague-Dawley rats. A 2-mm round bur was used to create a uniform trench defect measuring 2 mm in diameter, 2 mm in depth, and 4 mm in length at each extraction site. The defect site was (1) treated with PPF bone repair material containing nanometer-sized HA, (2) treated with PPF material containing micrometer-sized HA, (3) treated with demineralized freeze-dried bone allograft, or (4) left untreated. Rats were sacrificed at 2, 4, 7, and 12 weeks postoperative. Resorption of the residual alveolar ridge was assessed by radiographic outcomes. Bone ingrowth through the defect site was measured by histomorphometric outcomes. Mandibular and maxillary ridge heights increased for all treatments used in this study. There were no clinical indications that addition of either of the PPF bone repair materials retarded hard- or soft-tissue healing of the extraction sites. Although not statistically significant, the mandibular defects treated with PPF containing nanometer-sized HA healed at a faster rate as determined by ridge height and new bone formation measurements when compared with the other treatments. These findings suggest the feasibility of using PPF bone graft substitutes for oral-maxillofacial applications.     

类骨质羟磷灰石和自体骨修复兔下颌骨临界性骨缺损的研究

目的探讨类骨质羟磷灰石（SBR）的生物相容性,并探讨该替代材料和自体骨混合修复骨缺损的生物学特性。方法选用新西兰大白兔,在实验动物双侧下颌骨内侧形成10 mm×10 mm×2 mm大小的临界性缺损,左侧骨缺损按照1∶1比例植入SBR和自体骨,右侧骨缺损内分别植入自体骨或缺如,术后2、4、8周取标本,进行大体标本、X线、组织学和Masson新三色染色法的形态学分析。结果生物替代物具有良好的生物相容性,与自体骨混合能有效地促进骨缺损的修复愈合。骨髓细胞很容易在该材料表面黏附,自体骨的加入更有利于新骨长入材料的孔隙中,分化增殖,形成骨基质,并钙化成熟。结论SBR是一种良好的骨替代材料,自体骨的加入更有利于早期成骨和替代材料的自我改建的完成。     

同种异体骨支架复合自体骨髓间充质干细胞修复下颌骨节段缺损动物模型的建立

目的:建立同种复合自体骨髓间充质干细胞修复下颌骨节段性的动物模型,为研究同种异体骨支架复合自体骨髓间充质干细胞修复下颌骨节段性缺损效果及其机制打下基础。方法:24只1岁龄比格犬,拔出所有动物右侧下颌前磨牙和磨牙,伤口愈合后制造左侧下颌骨3 mm节段性缺损(从颏孔后1 mm到下颌角前),随机分两组,实验组用同种异体骨支架复合骨髓间充质干细胞修复重建,对照组仅用同种异体骨修复重建。术后4、12、24、48周处死动物(每组3只),取标本并行CT检查。结果:实验组和对照组所有动物同种异体骨均能与自体骨愈合,48周时实验组动物同种异体骨几乎全部被自体骨替代,但是新骨的大小较植入时同种异体骨支架变小。对照组中,新骨主要在同种异体骨与自体骨结合部形成,新骨大小与原植入时同种异体骨大小变化不大。结论:同种异体骨支架复合自体骨髓间充质干细胞能加速成骨,该动物模型的成功建立,为进一步研究同种异体骨支架复合自体骨髓间充质干细胞修复下颌骨节段行缺损的效果及其机制打下基础。     

Comparison of three block bone substitutes for bone regeneration: long-term observation in the beagle dog

This study aimed to evaluate the impact of three types of block bone substitute material on bone formation and graft resorption in vivo. Standardized bone defects (n?=?4 defects/animal) were created in the calvaria of nine dogs. Block bone substitutes made of deproteinized bovine bone mineral (DBBM), beta-tricalcium phosphate (β-TCP) and a mixture alpha-TCP and hydroxyapatite (α-TCP/HA) were inserted into the bone defects. A fourth defect was left untreated (empty). All sites were covered with a collagenous membrane. Block biopsies were harvested at 3, 6 and 12 months post-implantation and analyzed by micro-CT and histology. Biomaterial absorption was minimal and incorporation within the defect margin was good for all biomaterials. However, β-TCP demonstrated a relatively greater volume of new bone formation and less residual material volume when compared with DBBM and α-TCP/HA. Conversely, α-TCP/HA showed higher osteoconductive potential and a greater new bone area compared with the other two biomaterials. The block bone substitutes used in the present in vivo study showed advantageous in terms of maintenance of their original form in bony defect. However, the positive impact of all biomaterials on new bone formation and replacement of bone was minor even at 12 months. These findings indicate that block bone substitutes are not well suited to vertical bone augmentation. Further investigations are required to improve the insufficient new bone volume for promising clinical results.     

Bone healing and graft resorption of autograft, anorganic bovine bone and beta-tricalcium phosphate. A histologic and histomorphometric study in the mandibles of minipigs

OBJECTIVE: The purpose was to qualitatively and quantitatively compare the bone formation and graft resorption of two different bone substitutes used in both orthopedic and oral surgery, with autogenous bone as a positive control. MATERIALS AND METHODS: Three standardized bone defects were prepared in both mandibular angles of 12 adult minipigs. The defects were grafted with either autograft, anorganic bovine bone (ABB), or synthetic beta-tricalcium phosphate (beta-TCP). Sacrifice was performed after 1, 2, 4, and 8 weeks for histologic and histomorphometric analysis. RESULTS: At 2 weeks, more new bone formation was seen in defects filled with autograft than with ABB (P approximately 0.0005) and beta-TCP (P approximately 0.002). After 4 weeks, there was no significant difference between beta-TCP and the two other materials. Defects grafted with ABB still exhibited less bone formation as compared with autograft (P approximately 0.004). At 8 weeks, more bone formation was observed in defects grafted with autograft (P approximately 0.003) and beta-TCP (P approximately 0.00004) than with ABB. No difference could be demonstrated between beta-TCP and autograft. beta-TCP resorbed almost completely over 8 weeks, whereas ABB remained stable. CONCLUSION: Both bone substitutes seemed to decelerate bone regeneration in the early healing phase as compared with autograft. All defects ultimately regenerated with newly formed bone and a developing bone marrow. The grafting materials showed complete osseous integration. Both bone substitutes may have a place in reconstructive surgery where different clinical indications require differences in biodegradability.     

同期神经化增强髂骨瓣术后骨髓间充质干细胞的活性

目的： 比较神经化髂骨瓣和传统髂骨瓣重建下颌骨缺损术后,移植骨块骨髓间充质干细胞（bone marrow mesenchymal stem cells,BMMSCs）的干细胞活性。方法： 游离血管化髂骨瓣移植修复下颌骨缺损术后半年,从移植骨骨髓体外分离、培养BMMSCs,通过集落形成观察、Brdu摄入实验、群体倍增时间、体外成骨茜素红染色法、裸鼠皮下成骨法检测BMMSCs增殖、自我更新及成骨分化能力。采用SPSS 24.0软件包对数据进行统计学分析。结果： 神经化髂骨移植术后分离、培养的BMMSCs的集落形成、增殖、群体倍增时间、体外及体内成骨分化能力均显著高于非神经化组（P<0.05）。结论： 神经化髂骨瓣重建下颌骨缺损可以增强BMMSCs的自我更新、增殖、成骨分化等潜能,有助于维持移植骨的术后内环境稳定,减少术后移植骨吸收。     

纳米羟基磷灰石-聚酰胺人工骨修复犬下颌骨体缺损的实验研究

目的　研究新型纳米羟基磷灰石 聚酰胺 (n HA PA6 6 )复合人工骨修复犬下颌骨缺损的效果。方法　在犬下颌骨体上设计两个 15mm× 10mm× 5mm的箱状缺损 ,在其中一个植入相应大小的n HA PA6 6预制块 ,另一缺损作空白对照。于术后 2、4、8、12、16周切取组织标本 ,进行X线摄片和组织学切片检查 ,观察骨缺损修复情况。结果　术区未见明显的排斥反应。第 2～ 8周人工骨周围被纤维结缔组织包裹 ,12周时人工骨—组织界面上出现膜性成骨迹象 ,第 16周n HA PA6 6人工骨被新生骨组织完全包裹 ,受植床与人工骨形成骨性结合。结论　n HA PA6 6人工骨有良好的生物相容性 ,具有骨引导和潜在的骨诱导作用     

In vivo bone engineering in a rabbit femur

The repair of bone defects in reconstructive surgery has significant limitations. Donor site morbidity, limited supply of autograft, and risks and complications associated with allografting and synthetic bone substitutes are among the most significant. In an effort to address these problems, the search for an ideal bone replacement has led to the development of a new method of poly(lactide-co-glycolide) (PLGA) foam processing, enabling the production of a biodegradable scaffold with similar porosity to human trabecular bone. In this study, these scaffolds were evaluated for bone repair in vivo in a femoral critical-sized segmental defect in New Zealand White (NZW) rabbits. Three groups of nine animals were investigated. In the first group, the critical-sized defects were empty. Scaffolds alone were implanted in the second group, whereas autologous bone marrow cell-loaded scaffolds were implanted in the third group. Animals ambulated freely for 8 weeks after surgery, and bone formation throughout the defects was serially assessed radiographically and quantified using a bone formation index (BFI) measure. Postmortem radiography and histology were also undertaken to examine bone formation. There was a significant effect of applying this technology to the amount of bone formed in the defects as determined by the BFI (F = 3.41, P < 0.05). The mean BFI for the cell-loaded scaffolds was greater than for the control group at all measured time points (2-, 4-, 6-, and 8-week radiographs). This difference was significant for the 2- and 8-week radiographs (P < 0.05). Qualitative histological assessment confirmed these findings. We concluded from these findings that these PLGA scaffolds loaded with marrow-derived progenitor cells yield significant bone formation in a critical-sized rabbit femoral defect. This technology comprising a novel scaffold design and autologous cells may provide an alternative to current strategies for reconstruction of bony defects.     

组织工程骨与Bio-Oss修复大鼠下颌骨缺损的比较研究

目的:利用组织工程骨(tissue engineering bone)修复大鼠下颌骨缺损,观察血管内皮生长因子(vascular endothelial growth factor,VEGF)在组织工程骨修复骨缺损中的作用,为解决临床种植术中的骨量不足提供一定的实验依据。方法:实验中植入不同类型的骨替代材料用于修复大鼠下颌骨缺损,植入物分别为:①牛无机松质骨骨粉(Bio-Oss);②Bio-Oss+骨髓基质细胞(bone marrow stromal cells,BMSC);③Bio-Oss+VEGF基因转染后的BMSC。大鼠分别于植入后第4、12周处死,取下颌骨进行大体观察、X线观察、HE染色以及免疫组织化学染色观察,并分析实验结果。结果:相对于第一组,第二、三组的骨粉吸收速度更快,血管新生和成骨作用更好。其中第三组的血管新生、骨再生以及支架材料的吸收均要优于其他两组。结论:VEGF对组织工程骨的血管化起了重要的作用,尤其是通过外源基因导入BMSC构建的组织工程骨明显加快了骨组织的再生过程。     

Bone graft in the shape of human mandibular condyle reconstruction via seeding marrow-derived osteoblasts into porous coral in a nude mice model.

PURPOSE: The purpose of this study was to develop a tissue-engineered bone graft model in the shape of a human mandibular condyle. MATERIALS AND METHODS: Natural coral with a pore size of 150 to 220 microm and porosity of about 36% was molded into the shape of a human mandibular condyle. Culture-expanded rabbit marrow mesenchymal stem cells were induced by recombinant human bone morphogenetic protein-2 (rhBMP2) to improve osteoblastic phenotype. Then marrow-derived osteoblasts were seeded into natural coral at a density of 2 x 10(8)/mL and incubated in vitro for 3 days before implantation. The cell-coral complexes were implanted subcutaneously into the backs of nude mice and incubated in vivo for 2 months before harvesting. Implantation of coral alone acted as control. The specimens were processed for gross inspection, radiographic examination, and histologic and scanning electronic microscopic observation. RESULTS: The results showed that new bone grafts in the shape of a human mandibular condyle were successfully developed 2 months after implantation and maintained the initial shape of the natural coral scaffold. New bone could be observed histologically on the surface and in the pores of natural coral in all specimens in the cell-seeding group (6 of 6), whereas in the control group there was no evidence of osteogenesis process (0 of 4). CONCLUSION: This study suggests the feasibility of using porous coral as scaffold material transplanted with marrow-derived osteoblasts to restore bone graft in the shape of human mandibular condyle and shows the potential of using this method for the reconstruction of bone defects.     

Micro-computed tomography analysis of early stage bone healing using micro-porous titanium mesh for guided bone regeneration: preliminary experiment in a canine model

The aim of this study was to evaluate the amount of bone formation beneath a defect area after treatment with titanium mesh membranes with different thicknesses and pore sizes alone or in combination with bone graft to induce bone formation during the early stage of healing time. The mandibular premolars were extracted bilaterally from three adult beagle dogs, and 8-mm-diameter bone defects were created on the buccal site of the premolar regions. Hydroxyapatite bone graft substitute was applied in the defect site unilaterally, and other site was left empty. Then, a novel micro-porous mesh (50 μm in pore diameter) or commercially available macro-porous titanium mesh (1700 μm in pore diameter) was placed on the defect and secured with screws. After 4 weeks, the mandibles were harvested, imaged using micro-computed tomography, and prepared for histological and morphometric evaluation. Higher new bone volumes (mm³), percentage of new bone volumes in the total defect volumes (bone ratio: %), and new bone area (mm²) through morphometric evaluation were found on the novel membranes with 50-μm-diameter pores compared to the commercial titanium mesh. Moreover, experiment sites without bone graft were observed with higher new bone volume and bone ratio compared with sites with bone graft. However, bone mineral density of novel mesh was observed to be lower compared with other experimental sites. Under the experimental condition, the result of this study suggests that titanium meshes with 50-μm-diameter pores were effective for guided bone regeneration in the early stage of healing.     

The use of TriCalcium Phosphate (TCP) and stem cells for the regeneration of osteoperiosteal critical-size mandibular bony defects,an in vitro and preclinical study

The investigation aims to assess the reconstruction of critical-size mandibular bone defects in rabbits using beta-Tricalcium Phosphate (β-TCP) scaffolding loaded with stem cells. A 20 mm-long mandibular osteoperiosteal continuity defect was created in 8 New Zealand rabbits and filled with β-TCP scaffolding. In 6 cases bone marrow stem cells (BMSCs) harvested, and enriched, from the posterior iliac crest of the same rabbit were seeded into the scaffolding, while a scaffold was used alone in two cases chosen at random. Radiographic analysis was carried out immediately following surgery and 4, 8 and 12 weeks postoperatively. Cone Beam CT (CBCT) scanning, biomechanical testing and histology assessments were carried out on the explanted mandibles three months postoperatively. The radiography showed minimal new bone formation in all the cases, with significant amounts of undegraded scaffold material visible. Sporadic areas of bone formation were seen, these did not bridge the gap of the created surgical defect. The mechanical properties of the regenerated bone were of an inferior quality when compared with that of the contralateral non-operated side. The addition of BMSCs to the biodegradable β-TCP scaffold did not improve reconstruction of the created mandibular defect. Despite successful aspiration and culture of BMSCs, the survival of these cells in vivo was questionable.     

骨基质明胶和壳聚糖复合修复下颌骨缺损的实验研究

目的 :探讨骨基质明胶 (BoneMatrixGelatin ,简称BMG)对骨诱导形成作用影响 ,评价骨基质明胶与壳聚糖 (Chitosan简称CH)复合修复骨缺损的作用。方法 :在 80例Wistar大白鼠的下颌骨缺损内植入BMG/CH复合材料 ,并设空白对照。植入后 1周、2周、4周、8周行X线摄片 ,组织学观察骨缺损区骨形成的情况。结果 :BMG/CH复合移植是较为理想的骨缺损修复材料 ,其成骨方式为软骨化骨。结论 :BMG/CH复合材料具有良好的骨诱导作用 ,是一种有临床应用前景的骨移植材料。     

Effect of Gusuibu graft on bone formation.

PURPOSE: We compared the amount of new bone produced by Gusuibu in collagen grafts to that produced by bone grafts and collagen grafts. MATERIALS AND METHODS: Twenty bone defects were created in the parietal bone of 14 New Zealand White rabbits. In the experimental group, 5 defects were grafted with Gusuibu extract mixed with absorbable collagen sponge, and 5 defects were grafted with autogenous endochondral bone. In the control groups, 5 defects were grafted with absorbable collagen sponge alone (active control) and 5 were left empty (passive control). Animals were killed on day 14 and the defects were dissected and prepared for histologic assessment. Serial sections were cut across each defect. Quantitative analysis of new bone formation was made on 150 sections using image analysis. RESULTS: A total of 24% and 90% more new bone were present in defects grafted with Gusuibu in collagen grafts than those grafted with bone and collagen, respectively. No bone was formed in the passive control group. CONCLUSIONS: Gusuibu in collagen grafts have the effect of increased new bone formation locally and can be used as a bone graft material.     

下颌骨缺损游离髂骨移植骨块的准确就位及坚固固定

目的 了髂骨移植修复下颌骨缺损过程中骨段的准确就位和坚固内固定方法。方法 按缺损范围,将46例下颌骨缺损分为四种类型。应用术前、术中模板技术,同时参照标本及正常颌骨解剖形态,将髂骨块截开、分段塑形、就位。根据每类缺损的部位及特点,选择不同的坚固内固定方法和螺钉固位数目。结果 术后面形恢复良好,总体感染率21.7％,肿瘤复发率2％。术后3－6个月X线片示骨痂形成。传统义齿修复率13％,种植义齿修复率8.7％。结论 游离髂骨移植修复下颌骨缺损,应用模板技术可使植骨块准确就位;根据缺损的应力分布,选择最稳定的坚固内固定方法,则最终修复效果满意,感染率低。     

Influence of bisphosphonate treatment on bone substitute performance in osteoporotic conditions

Objective

Considering the elevated number of osteoporotic patients in need of bone graft procedures, we here evaluated the effect of alendronate (ALN) treatment on the regeneration of bone defects in osteoporotic rats. Bone formation was histologically and histomorphometrically assessed in rat femoral condyle bone defects filled with bone graft (Bio-Oss®) or left empty.

Methods

Male Wistar rats were induced osteoporotic through orchidectomy (ORX) and SHAM-operated. The animals were divided into three groups: osteoporotic (ORX), osteoporotic treated with ALN (ORX + ALN) and healthy (SHAM). Six weeks after ORX or SHAM surgeries, bone defects were created bilaterally in femoral condyles; one defect was filled with Bio-Oss® and the other one left empty. Bone regeneration within the defects was analyzed by histology and histomorphometry after 4 and 12 weeks.

Results

Histological samples showed new bone surrounding Bio-Oss® particles from week 4 onward in all three groups. At week 12, the data further showed that ALN treatment of osteoporotic animals enhanced bone formation to a 10-fold increase compared to non-treated osteoporotic control. Bio-Oss® filling of the defects promoted bone formation at both implantation periods compared to empty controls.

Conclusion

Our histological and histomorphometric results demonstrate that the enteral administration of alendronate under osteoporotic bone conditions leverages bone defect regeneration to a level comparable to that in healthy bone. Additionally, Bio-Oss® is an effective bone substitute, increasing bone formation, and acting as an osteoconductive scaffold guiding bone growth in both healthy and osteoporotic bone conditions.

Significance

Based on the results of this study, enteral use of ALN mitigates adverse effects of an osteoporotic condition on bone defect regeneration.     

Bone regeneration in standardized bone defects with autografts or bone substitutes in combination with platelet concentrate: a histologic and histomorphometric study in the mandibles of minipigs

PURPOSE: To evaluate the effect of the addition of platelet concentrate (PC) to autografts or bone substitutes on bone regeneration in standardized bone defects. MATERIALS AND METHODS: Three standardized bone defects were prepared in both mandibular angles of 12 adult minipigs. The defects were grafted with autograft, anorganic bovine bone, or synthetic beta-tricalcium phosphate (beta-TCP). PC was added to only 1 side. The animals were divided into 4 groups, which were sacrificed at 4 different time points (1, 2, 4, and 8 weeks) for histologic and histomorphometric analysis. The concentrations of platelets and growth factors were measured to identify correlation to the histologic and histomorphometric results. RESULTS: No correlation was found between platelet count in whole blood and platelet count in PC (r(p) = 0.36). Furthermore, no correlation could be demonstrated between the platelet count of the PC and the concentrations of PDGF-AB (r(p) = -0.27) and TGF-beta (r(p) = 0.34). There were no signs of a stimulating effect of PC on bone formation in combination with autografts or bone substitutes at any time point (P = .89). Addition of PC did not alter the pattern of graft degradation. DISCUSSION: The present study underlines the need for further investigation to identify the optimal concentrations of platelets and combinations of growth factors to achieve a predictable stimulatory effect on bone regeneration. One of the first steps to achieve this goal will be the development of a reliable method for the procurement of PC. CONCLUSION: PC had no impact on bone formation and graft degradation in standardized bone defects in the mandibles of minipigs.     

聚乳酸膜和脱钙冻干胚胎骨促进骨修复的比较研究

目的 比较聚乳酸（ＰＬＡ）膜和脱钙冻干胚胎骨（ＦｅｔａｌＢｏｎｅ，ＦＢ）促进骨修复的能力，方法 在１２只日本大耳白兔双侧下颌骨下缘中份作方块切除形成缺损，一侧缺损植入ＦＢ，另一侧缺损表面覆盖ＰＬＡ膜，术后４，８，１２周分期处死动物，下颌骨标示行放射学和组织学观察，结果 两种材料均能有效修复骨缺损，ＦＢ植入４Ｗ后术区内有大量新骨形成，术后８Ｗ缺损内骨形成活跃程度和骨形成量均高于ＰＬＡ膜侧，结论 ＦＢ     

Reconstruction of mandibular defects with autologous tissue-engineered bone.

PURPOSE: Maxillofacial reconstructive procedures often require bone graft harvesting, which results in donor site morbidity; the use of tissue-engineered bone would eliminate this problem. In this study, a novel scaffold design and new fabrication protocol were used to produce autologous tissue-engineered constructs (scaffolds seeded with cells) to reconstruct segmental mandibular defects in a minipig model. MATERIALS AND METHODS: Porcine mesenchymal stem cells were isolated from the ilium. They were expanded in culture and seeded onto poly-dl-lactic-coglycolic acid scaffolds. The constructs were placed in a bioreactor and incubated for 10 days in medium and osteogenic supplements. Four full-thickness bony defects (2 x 2 cm) were created in the same pig's mandible. The constructs (n = 2) were placed into 2 of the defects as autologous grafts. One unseeded scaffold and 1 empty defect served as controls. At 6 weeks postimplantation, the pig was sacrificed, the mandible was harvested, and the grafted sites were evaluated by clinical, radiographic, and histologic methods. RESULTS: The construct-implanted defects appeared to be filled with hard tissue resembling bone, whereas controls were filled with fibrous tissue. Radiographically, the tissue-engineered constructs were uniformly radiodense with bone distributed throughout. The interface between native bone and constructs was indistinct. Complete bone ingrowth was not observed in control defects. Osteoblasts, osteocytes, bone trabeculae, and blood vessels were identified throughout the defects implanted with constructs. CONCLUSION: This "proof-of-principle" study indicates that porcine mandibular defects can be successfully reconstructed by in vitro cultured autologous porcine mesenchymal stem cells on a biodegradable polymer scaffold with penetration of bone and blood vessels.     

Efficacy of PRP in the Reconstruction of Mandibular Segmental Defects Using Iliac Bone Grafts

This retrospective study was conducted to evaluate the role of platelet-rich plasma (PRP) in the reconstruction of segmental mandibular defects using iliac bone grafts. Thirteen patients underwent reconstruction of post-resection segmental defects of the mandible using titanium reconstruction plates, cortico cancellous iliac bone graft. The patients were randomly separated into two groups. One group of the patients received a PRP graft in addition to the iliac bone graft. Post-operative dimensions of the graft were measured and compared to assess the efficacy of PRP in reconstruction of segmental defects. The post-operative follow-up radiographs confirmed consolidation of the graft in all cases and the segmental defect was obliterated. Thereby mandibular continuity was successfully achieved in all cases. Two patients in the non-PRP group developed an infection and were administered additional antibiotics. The infection was contained and the grafts survived. The use of PRP along with autogenous bone graft may be advantageous since it appeared to enhance the quantity of bone formed. Further long-term follow-up and studies are required to effectively establish the efficacy of PRP and autogenous free bone grafts in the reconstruction of bony defects.