Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2: Histologic observations

Ulf M E Wikesjö, Mohammed Qahash, Giuseppe Polimeni, Cristiano Susin, Richard H. Shanaman, Michael D. Rohrer, John M. Wozney, Jan Hall

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

Background: Studies using ectopic rodent, orthotopic canine, and non-human primate models show that bone morphogenetic proteins (BMPs) coated onto titanium surfaces induce local bone formation. The objective of this study was to examine the ability of recombinant human BMP-2 (rhBMP-2) coated onto a titanium porous oxide implant surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Material and Methods: Bilateral, critical-size, 5 mm, supra-alveolar, peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml, and six animals received implants coated with rhBMP-2 at 3.0 mg/ml or uncoated control. Treatments were randomized between jaw quadrants. The mucoperiosteal flaps were advanced, adapted and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7 and 8 post-surgery when they were euthanized for histologic evaluation. Results: Jaw quadrants receiving implants coated with rhBMP-2 exhibited gradually regressing swelling that became hard to palpate disguising the contours of the implants. The histologic evaluation showed robust bone formation reaching or exceeding the implant platform. The newly formed bone exhibited characteristics of the adjoining resident Type II bone including cortex formation for sites receiving implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml. Sites receiving implants coated with rhBMP-2 at 3.0 mg/ml exhibited more immature trabecular bone formation, seroma formation and peri-implant bone remodelling resulting in undesirable implant displacement. Control implants exhibited minimal, if any, bone formation. Thus, implants coated with rhBMP-2 at 0.75, 1.5 and 3.0 mg/ml exhibited significant bone formation (height and area) compared with the sham-surgery control averaging (±SD) 4.4±0.4, 4.2±0.7 and 4.2±1.2 versus 0.8±0.3 mm; and 5.0±2.2, 5.6±2.2 and 7.4±3.5 versus 0.7±0.3 mm2, respectively (p<0.01). All the treatment groups exhibited clinically relevant osseointegration. Conclusions: rhBMP-2 coated onto titanium porous oxide implant surfaces induced clinically relevant local bone formation including vertical augmentation of the alveolar ridge and osseointegration. Higher concentrations/doses were associated with untoward effects.

Original languageEnglish (US)
Pages (from-to)1001-1010
Number of pages10
JournalJournal of Clinical Periodontology
Volume35
Issue number11
DOIs
StatePublished - Nov 1 2008

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Alveolar Ridge Augmentation
Osteogenesis
Osseointegration
Jaw
Bone and Bones
Newfoundland and Labrador
Seroma
Bone Morphogenetic Proteins
Aptitude
Bone Remodeling
recombinant human bone morphogenetic protein-2
Titanium
Primates
Canidae
Young Adult
Rodentia
Dogs

Keywords

  • Alveolar augmentation
  • Bone morphogenetic protein
  • Dental/oral implants
  • Dogs
  • Osseointegration
  • Seroma
  • Tissue engineering
  • Titanium
  • Titanium porous oxide
  • rhBMP-2

ASJC Scopus subject areas

  • Periodontics

Cite this

Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2 : Histologic observations. / Wikesjö, Ulf M E; Qahash, Mohammed; Polimeni, Giuseppe; Susin, Cristiano; Shanaman, Richard H.; Rohrer, Michael D.; Wozney, John M.; Hall, Jan.

In: Journal of Clinical Periodontology, Vol. 35, No. 11, 01.11.2008, p. 1001-1010.

Research output: Contribution to journalArticle

Wikesjö, UME, Qahash, M, Polimeni, G, Susin, C, Shanaman, RH, Rohrer, MD, Wozney, JM & Hall, J 2008, 'Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2: Histologic observations', Journal of Clinical Periodontology, vol. 35, no. 11, pp. 1001-1010. https://doi.org/10.1111/j.1600-051X.2008.01321.x
Wikesjö, Ulf M E ; Qahash, Mohammed ; Polimeni, Giuseppe ; Susin, Cristiano ; Shanaman, Richard H. ; Rohrer, Michael D. ; Wozney, John M. ; Hall, Jan. / Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2 : Histologic observations. In: Journal of Clinical Periodontology. 2008 ; Vol. 35, No. 11. pp. 1001-1010.
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T1 - Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2

T2 - Histologic observations

AU - Wikesjö, Ulf M E

AU - Qahash, Mohammed

AU - Polimeni, Giuseppe

AU - Susin, Cristiano

AU - Shanaman, Richard H.

AU - Rohrer, Michael D.

AU - Wozney, John M.

AU - Hall, Jan

PY - 2008/11/1

Y1 - 2008/11/1

N2 - Background: Studies using ectopic rodent, orthotopic canine, and non-human primate models show that bone morphogenetic proteins (BMPs) coated onto titanium surfaces induce local bone formation. The objective of this study was to examine the ability of recombinant human BMP-2 (rhBMP-2) coated onto a titanium porous oxide implant surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Material and Methods: Bilateral, critical-size, 5 mm, supra-alveolar, peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml, and six animals received implants coated with rhBMP-2 at 3.0 mg/ml or uncoated control. Treatments were randomized between jaw quadrants. The mucoperiosteal flaps were advanced, adapted and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7 and 8 post-surgery when they were euthanized for histologic evaluation. Results: Jaw quadrants receiving implants coated with rhBMP-2 exhibited gradually regressing swelling that became hard to palpate disguising the contours of the implants. The histologic evaluation showed robust bone formation reaching or exceeding the implant platform. The newly formed bone exhibited characteristics of the adjoining resident Type II bone including cortex formation for sites receiving implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml. Sites receiving implants coated with rhBMP-2 at 3.0 mg/ml exhibited more immature trabecular bone formation, seroma formation and peri-implant bone remodelling resulting in undesirable implant displacement. Control implants exhibited minimal, if any, bone formation. Thus, implants coated with rhBMP-2 at 0.75, 1.5 and 3.0 mg/ml exhibited significant bone formation (height and area) compared with the sham-surgery control averaging (±SD) 4.4±0.4, 4.2±0.7 and 4.2±1.2 versus 0.8±0.3 mm; and 5.0±2.2, 5.6±2.2 and 7.4±3.5 versus 0.7±0.3 mm2, respectively (p<0.01). All the treatment groups exhibited clinically relevant osseointegration. Conclusions: rhBMP-2 coated onto titanium porous oxide implant surfaces induced clinically relevant local bone formation including vertical augmentation of the alveolar ridge and osseointegration. Higher concentrations/doses were associated with untoward effects.

AB - Background: Studies using ectopic rodent, orthotopic canine, and non-human primate models show that bone morphogenetic proteins (BMPs) coated onto titanium surfaces induce local bone formation. The objective of this study was to examine the ability of recombinant human BMP-2 (rhBMP-2) coated onto a titanium porous oxide implant surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Material and Methods: Bilateral, critical-size, 5 mm, supra-alveolar, peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml, and six animals received implants coated with rhBMP-2 at 3.0 mg/ml or uncoated control. Treatments were randomized between jaw quadrants. The mucoperiosteal flaps were advanced, adapted and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7 and 8 post-surgery when they were euthanized for histologic evaluation. Results: Jaw quadrants receiving implants coated with rhBMP-2 exhibited gradually regressing swelling that became hard to palpate disguising the contours of the implants. The histologic evaluation showed robust bone formation reaching or exceeding the implant platform. The newly formed bone exhibited characteristics of the adjoining resident Type II bone including cortex formation for sites receiving implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml. Sites receiving implants coated with rhBMP-2 at 3.0 mg/ml exhibited more immature trabecular bone formation, seroma formation and peri-implant bone remodelling resulting in undesirable implant displacement. Control implants exhibited minimal, if any, bone formation. Thus, implants coated with rhBMP-2 at 0.75, 1.5 and 3.0 mg/ml exhibited significant bone formation (height and area) compared with the sham-surgery control averaging (±SD) 4.4±0.4, 4.2±0.7 and 4.2±1.2 versus 0.8±0.3 mm; and 5.0±2.2, 5.6±2.2 and 7.4±3.5 versus 0.7±0.3 mm2, respectively (p<0.01). All the treatment groups exhibited clinically relevant osseointegration. Conclusions: rhBMP-2 coated onto titanium porous oxide implant surfaces induced clinically relevant local bone formation including vertical augmentation of the alveolar ridge and osseointegration. Higher concentrations/doses were associated with untoward effects.

KW - Alveolar augmentation

KW - Bone morphogenetic protein

KW - Dental/oral implants

KW - Dogs

KW - Osseointegration

KW - Seroma

KW - Tissue engineering

KW - Titanium

KW - Titanium porous oxide

KW - rhBMP-2

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