All ETDs from UAB

Advisory Committee Chair

Maria Geisinger

Advisory Committee Members

Ramzi Abou-Arraj

Nico Geurs

Amjad Javed

Document Type


Date of Award


Degree Name by School

Master of Science (MS) School of Dentistry


Patients presenting with significant alveolar bone loss can pose challenges for the clinician. Traditional bone augmentation techniques may be inadequate in achieving necessary gains to restore missing teeth with dental implants. The adjunctive use of growth factors may accelerate the healing process and enhance tissue regeneration. GEM21S is a product that includes a recombinant growth factor approved by the Federal Drug Administration for oral surgery. It is delivered as a two-component system: 1) recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and 2) betatricalcium phosphate (β-TCP).[1] The research on GEM 21S for ridge augmentation is mostly limited to case studies.[2- 4] Biologically, PDGF-BB triggers chemotaxis and mitogenesis of cells of mesenchymal origin.[5,6] It also works synergistically with BMP-2 in bone formation.[7-9] These are ideal properties for wound and bone healing that should be investigated further for potential beneficial effects in ridge augmentation cases. Today, platelet-rich fibrin (PRF) is commonly used as an adjunctive measure in ridge augmentation. PRF is a second-generation autologous platelet concentrate that contains a supraphysiologic concentration of molecular mediators, including a variety of growth iv factors.[10] The concept of utilizing PRF to make a growth factor-enriched bone graft matrix (“sticky bone”) has been described. The addition of PRF has been noted to improve handling properties and volumetric stability of the bone graft. Further, due to its natural fibrin clot formation, PRF may provide a scaffold to allow more gradual release of growth factors during healing. Although the use of PRF in oral surgery has the potential to enhance wound healing, its utility may have limitations as PRF has been shown to resorb within a 2 to 3-week period and no osteoinductive capabilities of PRF have been demonstrated. The rationale for this study is that PDGF-BB is proven to play a critical role in wound healing. It is postulated that a combinatorial approach with PRF could provide clinicians the benefits of a clinically proven and consistent dose of rhPDGF-BB to improve wound healing and bone formation in conjunction with the benefits of the improved physical handling properties of PRF as well as the potential for a longer duration of growth factor delivery.

Included in

Dentistry Commons



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