Periodontal repair in dogs: Evaluation of bioabsorbable space-providing macroporous membrane with recombinant human bone morphogenetic protein-2

Ulf M E Wikesjö, Won Hee Lim, Robert C. Thomson, Alonzo D. Cook, John M. Wozney, W. Ross Hardwick

Research output: Contribution to journalArticle

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Abstract

Background: Recombinant human bone morphogenetic protein-2 (rhBMP-2) technologies have been shown to significantly support alveolar bone formation. Biomaterial limitations, however, have restricted the biologic potential for onlay indications. The objective of this study was to evaluate regeneration of alveolar bone and periodontal attachment, and biomaterials reaction following surgical implantation of a space-providing, bioabsorbable, macroporous, polyglycolic acid -trimethylene carbonate (PGA-TMC) membrane combined with a rhBMP-2 construct in a discriminating onlay defect model. Methods: Routine supraalveolar periodontal defects were created at the mandibular premolar teeth in 9 beagle dogs. Contralateral jaw quadrants in subsequent animals were randomly assigned to receive the dome-shaped PGA-TMC (100 to 120 μm pores) membrane with rhBMP-2 (0.2 mg/mL) in a bioresorbable hyaluronan (Hy) carrier or the PGA-TMC membrane with Hy alone (control). The gingival flaps were advanced to submerge the membranes and teeth and sutured. Animals were euthanized at 8 and 24 weeks postsurgery for histologic observations. Results: Jaw quadrants receiving the PGA-TMC membrane alone experienced exposures at various time points throughout the study. Jaw quadrants receiving the PGA-TMC/rhBMP-2 combination remained intact, although one site experienced a late minor exposure. Newly formed alveolar bone approached and became incorporated into the macroporous PGA-TMC membrane in sites receiving rhBMP-2. The PGA-TMC biomaterial was occasionally associated with a limited inflammatory reaction. Residual PGA-TMC could not be observed at 24 weeks postsurgery. Residual Hy could not be observed at any time interval. Regeneration of alveolar bone height (means ± SD) was significantly increased in sites receiving the PGA-TMC/rhBMP 2 combination compared to control (3.8 ± 1.3 versus 0.7 ± 0.5 mm at 8 weeks and 4.6 ± 0.8 versus 2.1 ± 0.4 mm at 24 weeks; P <0.05). Limited cementum regeneration was observed for PGA-TMC/rhBMP-2 and PGA-TMC control sites. Ankylosis compromised regeneration in sites receiving PGA-TMC/rhBMP-2. Conclusions: The bioabsorbable, space -providing, macroporous PGA-TMC membrane appears to be a compatible biomaterial for bone augmentation procedures. rhBMP-2 significantly enhances alveolar bone augmentation and soft tissue healing when combined with the PGA-TMC membrane.

Original languageEnglish (US)
Pages (from-to)635-647
Number of pages13
JournalJournal of periodontology
Volume74
Issue number5
DOIs
StatePublished - May 1 2003

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Polyglycolic Acid
Dogs
Membranes
Biocompatible Materials
Hyaluronic Acid
Jaw
Inlays
Bone Regeneration
recombinant human bone morphogenetic protein-2
trimethylene carbonate
Bone and Bones
Regeneration
Tooth
Dental Cementum
Ankylosis
Bicuspid
Osteogenesis

Keywords

  • Alveolar ridge augmentation
  • Animal studies
  • Barrier
  • Bioabsorbale
  • Bone regeneration
  • Membranes
  • Periodontal attachment
  • Wound healing

ASJC Scopus subject areas

  • Periodontics

Cite this

Periodontal repair in dogs : Evaluation of bioabsorbable space-providing macroporous membrane with recombinant human bone morphogenetic protein-2. / Wikesjö, Ulf M E; Lim, Won Hee; Thomson, Robert C.; Cook, Alonzo D.; Wozney, John M.; Hardwick, W. Ross.

In: Journal of periodontology, Vol. 74, No. 5, 01.05.2003, p. 635-647.

Research output: Contribution to journalArticle

Wikesjö, Ulf M E ; Lim, Won Hee ; Thomson, Robert C. ; Cook, Alonzo D. ; Wozney, John M. ; Hardwick, W. Ross. / Periodontal repair in dogs : Evaluation of bioabsorbable space-providing macroporous membrane with recombinant human bone morphogenetic protein-2. In: Journal of periodontology. 2003 ; Vol. 74, No. 5. pp. 635-647.
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abstract = "Background: Recombinant human bone morphogenetic protein-2 (rhBMP-2) technologies have been shown to significantly support alveolar bone formation. Biomaterial limitations, however, have restricted the biologic potential for onlay indications. The objective of this study was to evaluate regeneration of alveolar bone and periodontal attachment, and biomaterials reaction following surgical implantation of a space-providing, bioabsorbable, macroporous, polyglycolic acid -trimethylene carbonate (PGA-TMC) membrane combined with a rhBMP-2 construct in a discriminating onlay defect model. Methods: Routine supraalveolar periodontal defects were created at the mandibular premolar teeth in 9 beagle dogs. Contralateral jaw quadrants in subsequent animals were randomly assigned to receive the dome-shaped PGA-TMC (100 to 120 μm pores) membrane with rhBMP-2 (0.2 mg/mL) in a bioresorbable hyaluronan (Hy) carrier or the PGA-TMC membrane with Hy alone (control). The gingival flaps were advanced to submerge the membranes and teeth and sutured. Animals were euthanized at 8 and 24 weeks postsurgery for histologic observations. Results: Jaw quadrants receiving the PGA-TMC membrane alone experienced exposures at various time points throughout the study. Jaw quadrants receiving the PGA-TMC/rhBMP-2 combination remained intact, although one site experienced a late minor exposure. Newly formed alveolar bone approached and became incorporated into the macroporous PGA-TMC membrane in sites receiving rhBMP-2. The PGA-TMC biomaterial was occasionally associated with a limited inflammatory reaction. Residual PGA-TMC could not be observed at 24 weeks postsurgery. Residual Hy could not be observed at any time interval. Regeneration of alveolar bone height (means ± SD) was significantly increased in sites receiving the PGA-TMC/rhBMP 2 combination compared to control (3.8 ± 1.3 versus 0.7 ± 0.5 mm at 8 weeks and 4.6 ± 0.8 versus 2.1 ± 0.4 mm at 24 weeks; P <0.05). Limited cementum regeneration was observed for PGA-TMC/rhBMP-2 and PGA-TMC control sites. Ankylosis compromised regeneration in sites receiving PGA-TMC/rhBMP-2. Conclusions: The bioabsorbable, space -providing, macroporous PGA-TMC membrane appears to be a compatible biomaterial for bone augmentation procedures. rhBMP-2 significantly enhances alveolar bone augmentation and soft tissue healing when combined with the PGA-TMC membrane.",
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T2 - Evaluation of bioabsorbable space-providing macroporous membrane with recombinant human bone morphogenetic protein-2

AU - Wikesjö, Ulf M E

AU - Lim, Won Hee

AU - Thomson, Robert C.

AU - Cook, Alonzo D.

AU - Wozney, John M.

AU - Hardwick, W. Ross

PY - 2003/5/1

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N2 - Background: Recombinant human bone morphogenetic protein-2 (rhBMP-2) technologies have been shown to significantly support alveolar bone formation. Biomaterial limitations, however, have restricted the biologic potential for onlay indications. The objective of this study was to evaluate regeneration of alveolar bone and periodontal attachment, and biomaterials reaction following surgical implantation of a space-providing, bioabsorbable, macroporous, polyglycolic acid -trimethylene carbonate (PGA-TMC) membrane combined with a rhBMP-2 construct in a discriminating onlay defect model. Methods: Routine supraalveolar periodontal defects were created at the mandibular premolar teeth in 9 beagle dogs. Contralateral jaw quadrants in subsequent animals were randomly assigned to receive the dome-shaped PGA-TMC (100 to 120 μm pores) membrane with rhBMP-2 (0.2 mg/mL) in a bioresorbable hyaluronan (Hy) carrier or the PGA-TMC membrane with Hy alone (control). The gingival flaps were advanced to submerge the membranes and teeth and sutured. Animals were euthanized at 8 and 24 weeks postsurgery for histologic observations. Results: Jaw quadrants receiving the PGA-TMC membrane alone experienced exposures at various time points throughout the study. Jaw quadrants receiving the PGA-TMC/rhBMP-2 combination remained intact, although one site experienced a late minor exposure. Newly formed alveolar bone approached and became incorporated into the macroporous PGA-TMC membrane in sites receiving rhBMP-2. The PGA-TMC biomaterial was occasionally associated with a limited inflammatory reaction. Residual PGA-TMC could not be observed at 24 weeks postsurgery. Residual Hy could not be observed at any time interval. Regeneration of alveolar bone height (means ± SD) was significantly increased in sites receiving the PGA-TMC/rhBMP 2 combination compared to control (3.8 ± 1.3 versus 0.7 ± 0.5 mm at 8 weeks and 4.6 ± 0.8 versus 2.1 ± 0.4 mm at 24 weeks; P <0.05). Limited cementum regeneration was observed for PGA-TMC/rhBMP-2 and PGA-TMC control sites. Ankylosis compromised regeneration in sites receiving PGA-TMC/rhBMP-2. Conclusions: The bioabsorbable, space -providing, macroporous PGA-TMC membrane appears to be a compatible biomaterial for bone augmentation procedures. rhBMP-2 significantly enhances alveolar bone augmentation and soft tissue healing when combined with the PGA-TMC membrane.

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KW - Alveolar ridge augmentation

KW - Animal studies

KW - Barrier

KW - Bioabsorbale

KW - Bone regeneration

KW - Membranes

KW - Periodontal attachment

KW - Wound healing

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