Interest of Mineralized Plasmatic Matrix in Secondary Autogenous Bone Graft for the Treatment of Alveolar Clefts

J Craniofac Surg. 2015 Oct;26(7):2148-51. doi: 10.1097/SCS.0000000000001951.

Abstract

The authors describe a new material termed mineralized plasmatic matrix (MPM), a combination of platelets, fibrin concentrate, and autogenous bone to repair alveolar cleft defects. Autogenous cancellous bone is widely used to this end because such bone affords the functionalities (osteogenesis, osteoinduction, and osteoconduction) required for successful outcomes. To optimize these features, autologous blood products high in platelet concentrations have recently been developed. On the basis of our experience with PRP (platelet-rich plasma) and PRF (platelet-rich fibrin), we developed MPM, which contains platelets and fibrin concentrate in a liquid state; these materials can become bound to bone particles. The filling material is easy to shape and a PRF-type membrane is also generated. Ten patients with cleft lips and alveoli, with or without cleft palates (median, or uni- or bilateral) benefited from secondary bone grafts placed using our new material. We transferred autogenous bone from the iliac crest, an abundant source of cancellous bone associated with a high success rate. The 6-month outcomes of all patients were excellent in terms of both bone graft stability and closure of the oronasal fistulae. The preparation procedure is simple and the technical requirements minimal. Upon further optimization, MPM may serve as a third-generation platelet concentrate with potential applications in various fields.

MeSH terms

  • Adolescent
  • Alveolar Bone Grafting / methods*
  • Autografts / transplantation*
  • Blood Platelets / physiology*
  • Bone Regeneration / physiology
  • Bone Transplantation / methods*
  • Child
  • Cleft Lip / surgery
  • Cleft Palate / surgery
  • Female
  • Fibrin / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Ilium / transplantation
  • Male
  • Nose Diseases / surgery
  • Oral Fistula / surgery
  • Osteogenesis / physiology
  • Respiratory Tract Fistula / surgery
  • Treatment Outcome

Substances

  • Fibrin