Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5: Histologic observations

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

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objectives: In vitro and in vivo preclinical studies suggest that growth/differentiation factor-5 (GDF-5) may induce local bone formation. The objective of this study was to evaluate the potential of recombinant human GDF-5 (rhGDF-5) coated onto an oral implant with a purpose-designed titanium porous oxide surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Materials and Methods: Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with 30 or 60 μg rhGDF-5, and six animals received implants coated with 120 μg rhGDF-5 or left uncoated (control). Treatments were alternated 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: The clinical examination showed no noteworthy differences between implants coated with rhGDF-5. The cover screw and implant body were visible/palpable through the alveolar mucosa for both rhGDF-5-coated and control implants. There was a small increase in induced bone height for implants coated with rhGDF-5 compared with the control, induced bone height averaging (±SD) 1.6±0.6 mm for implants coated with 120 μg rhGDF-5 versus 1.2±0.5, 1.2±0.6, and 0.6±0.2 mm for implants coated with 60 μg rhGDF-5, 30 μg rhGDF-5, or left uncoated, respectively (p<0.05). Bone formation was predominant at the lingual aspect of the implants. Narrow yellow and orange fluorescent markers throughout the newly formed bone indicate relatively slow new bone formation within 3-4 weeks. Implants coated with rhGDF-5 displayed limited peri-implant bone remodelling in the resident bone; the 120 μg dose exhibiting more advanced remodelling than the 60 and 30 μg doses. All treatment groups exhibited clinically relevant osseointegration. Conclusions: rhGDF-5-coated oral implants display a dose-dependent osteoinductive and/or osteoconductive effect, bone formation apparently benefiting from local factors. Application of rhGDF-5 appears to be safe as it is associated with limited, if any, adverse effects.

Original languageEnglish (US)
Pages (from-to)759-768
Number of pages10
JournalJournal of Clinical Periodontology
Volume37
Issue number8
DOIs
StatePublished - Aug 1 2010

Fingerprint

Growth Differentiation Factor 5
Alveolar Ridge Augmentation
Osteogenesis
Bone and Bones
Osseointegration
human GDF5 protein
Newfoundland and Labrador
Bone Remodeling
Jaw
Tongue

Keywords

  • GDF-5
  • alveolar augmentation
  • dental/oral implants
  • dogs
  • growth/ differentiation factor-5
  • osseointegration
  • tissue engineering
  • titanium
  • titanium porous oxide

ASJC Scopus subject areas

  • Periodontics

Cite this

Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5 : Histologic observations. / Polimeni, Giuseppe; Wikesjö, Ulf M E; Susin, Cristiano; Qahash, Mohammed; Shanaman, Richard H.; Prasad, Hari S.; Rohrer, Michael D.; Hall, Jan.

In: Journal of Clinical Periodontology, Vol. 37, No. 8, 01.08.2010, p. 759-768.

Research output: Contribution to journalArticle

Polimeni, Giuseppe ; Wikesjö, Ulf M E ; Susin, Cristiano ; Qahash, Mohammed ; Shanaman, Richard H. ; Prasad, Hari S. ; Rohrer, Michael D. ; Hall, Jan. / Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5 : Histologic observations. In: Journal of Clinical Periodontology. 2010 ; Vol. 37, No. 8. pp. 759-768.
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abstract = "Objectives: In vitro and in vivo preclinical studies suggest that growth/differentiation factor-5 (GDF-5) may induce local bone formation. The objective of this study was to evaluate the potential of recombinant human GDF-5 (rhGDF-5) coated onto an oral implant with a purpose-designed titanium porous oxide surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Materials and Methods: Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with 30 or 60 μg rhGDF-5, and six animals received implants coated with 120 μg rhGDF-5 or left uncoated (control). Treatments were alternated 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: The clinical examination showed no noteworthy differences between implants coated with rhGDF-5. The cover screw and implant body were visible/palpable through the alveolar mucosa for both rhGDF-5-coated and control implants. There was a small increase in induced bone height for implants coated with rhGDF-5 compared with the control, induced bone height averaging (±SD) 1.6±0.6 mm for implants coated with 120 μg rhGDF-5 versus 1.2±0.5, 1.2±0.6, and 0.6±0.2 mm for implants coated with 60 μg rhGDF-5, 30 μg rhGDF-5, or left uncoated, respectively (p<0.05). Bone formation was predominant at the lingual aspect of the implants. Narrow yellow and orange fluorescent markers throughout the newly formed bone indicate relatively slow new bone formation within 3-4 weeks. Implants coated with rhGDF-5 displayed limited peri-implant bone remodelling in the resident bone; the 120 μg dose exhibiting more advanced remodelling than the 60 and 30 μg doses. All treatment groups exhibited clinically relevant osseointegration. Conclusions: rhGDF-5-coated oral implants display a dose-dependent osteoinductive and/or osteoconductive effect, bone formation apparently benefiting from local factors. Application of rhGDF-5 appears to be safe as it is associated with limited, if any, adverse effects.",
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author = "Giuseppe Polimeni and Wikesj{\"o}, {Ulf M E} and Cristiano Susin and Mohammed Qahash and Shanaman, {Richard H.} and Prasad, {Hari S.} and Rohrer, {Michael D.} and Jan Hall",
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T2 - Histologic observations

AU - Polimeni, Giuseppe

AU - Wikesjö, Ulf M E

AU - Susin, Cristiano

AU - Qahash, Mohammed

AU - Shanaman, Richard H.

AU - Prasad, Hari S.

AU - Rohrer, Michael D.

AU - Hall, Jan

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N2 - Objectives: In vitro and in vivo preclinical studies suggest that growth/differentiation factor-5 (GDF-5) may induce local bone formation. The objective of this study was to evaluate the potential of recombinant human GDF-5 (rhGDF-5) coated onto an oral implant with a purpose-designed titanium porous oxide surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Materials and Methods: Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with 30 or 60 μg rhGDF-5, and six animals received implants coated with 120 μg rhGDF-5 or left uncoated (control). Treatments were alternated 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: The clinical examination showed no noteworthy differences between implants coated with rhGDF-5. The cover screw and implant body were visible/palpable through the alveolar mucosa for both rhGDF-5-coated and control implants. There was a small increase in induced bone height for implants coated with rhGDF-5 compared with the control, induced bone height averaging (±SD) 1.6±0.6 mm for implants coated with 120 μg rhGDF-5 versus 1.2±0.5, 1.2±0.6, and 0.6±0.2 mm for implants coated with 60 μg rhGDF-5, 30 μg rhGDF-5, or left uncoated, respectively (p<0.05). Bone formation was predominant at the lingual aspect of the implants. Narrow yellow and orange fluorescent markers throughout the newly formed bone indicate relatively slow new bone formation within 3-4 weeks. Implants coated with rhGDF-5 displayed limited peri-implant bone remodelling in the resident bone; the 120 μg dose exhibiting more advanced remodelling than the 60 and 30 μg doses. All treatment groups exhibited clinically relevant osseointegration. Conclusions: rhGDF-5-coated oral implants display a dose-dependent osteoinductive and/or osteoconductive effect, bone formation apparently benefiting from local factors. Application of rhGDF-5 appears to be safe as it is associated with limited, if any, adverse effects.

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KW - growth/ differentiation factor-5

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