rhBMP-2 significantly enhances guided bone regeneration

Ulf M E Wikesjö, Mohammed Qahash, Robert C. Thomson, Alonzo D. Cook, Michael D. Rohrer, John M. Wozney, W. Ross Hardwick

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Abstract

Background: Previous studies have shown a limited potential for bone augmentation following guided bone regeneration (GBR) in horizontal alveolar defects. Surgical implantation of recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge carrier (ACS) significantly enhances bone regeneration in such defects; however, sufficient quantities of bone for implant dentistry are not routinely obtained. The objective of this study was to evaluate the potential of rhBMP-2/ACS to enhance GBR using a space-providing, macro-porous expanded polytetraf luoroethylene (ePTFE) device. Methods: Bilateral, critical size, supra-alveolar, peri-implant defects were surgically created in four Hound Labrador mongrel dogs. Two turned and one surface-etched 10-mm titanium dental implant were placed 5 mm into the surgically reduced alveolar ridge creating 5-mm supra-alveolar defects. rhBMP-2/ACS (rhBMP-2 at 0.2 mg/ml) or buffer/ACS was randomly assigned to left and right jaw quadrants in subsequent animals. The space-providing, macroporous ePTFE device was placed to cover rhBMP-2/ACS and control constructs and dental implants. Gingival flaps were advanced for primary wound closure. The animals were euthanized at 8 weeks postsurgery for histologic and histometric analysis. Results: Bone formation was significantly enhanced in defects receiving rhBMP-2/ACS compared to control. Vertical bone gain averaged (± SD) 4.7 ± 0.3 and 4.8 ± 0.1 mm, and new bone area 10.3 ± 2.0 and 8.0 ± 2.5 mm2 at turned and surface-etched dental implants, respectively. Corresponding values for the control were 1.8 ± 2.0 and 1.3 ± 1.3 mm, and 1.8 ± 1.3 and 1.2 ± 0.6 mm2. Bone-implant contact in rhBMP-2-induced bone averaged 6.4 ± 1.4% and 9.6 ± 7.5% for turned and surface-etched dental implants, respectively (P = 0.399). Corresponding values for the control were 14.6 ± 19.4% and 23.7 ± 9.7% (P = 0.473). Bone-implant contact in resident bone ranged between 43% and 58% without significant differences between dental implant surfaces. Conclusions: rhBMP-2/ACS significantly enhances GBR at turned and surface-etched dental implants. The dental implant surface technology does not appear to substantially influence bone formation.

Original languageEnglish (US)
Pages (from-to)194-204
Number of pages11
JournalClinical Oral Implants Research
Volume15
Issue number2
DOIs
StatePublished - Apr 1 2004

Keywords

  • Differentiation factors
  • Metal implants
  • Seroma
  • Tissue engineering

ASJC Scopus subject areas

  • Oral Surgery

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    Wikesjö, U. M. E., Qahash, M., Thomson, R. C., Cook, A. D., Rohrer, M. D., Wozney, J. M., & Hardwick, W. R. (2004). rhBMP-2 significantly enhances guided bone regeneration. Clinical Oral Implants Research, 15(2), 194-204. https://doi.org/10.1111/j.1600-0501.2004.00971.x