Sinus augmentation using rhBMP-2/ACS in a mini-pig model

Influence of an adjunctive ceramic bone biomaterial

Cristiano Susin, Jaebum Lee, Tiago Fiorini, Rubens Moreno De Freitas, Hsien Chung Chiu, Hari S. Prasad, Amanda N. Buxton, Ulf Me Wikesjo

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support significant bone formation when used to augment the maxillary sinus for implant dentistry. Nevertheless, bone biomaterials have been suggested to extend rhBMP-2/ACS with limited support of the merits of such approaches. Objectives: To evaluate local bone formation/dental implant osseointegration following implantation of rhBMP-2/ACS combined with a ceramic bone biomaterial using a mini-pig sinus augmentation model. Methods: Twelve adult Göttingen mini-pigs received rhBMP-2/ACS (rhBMP-2 adjusted to 0.43 mg/cc) alone or combined with an off-the- shelf biphasic ceramic (15%/85% HA/ß-TCP) biomaterial at 3:1, 1:1 and 1:3 ratios randomized to contra-lateral maxillary sinus sites yielding rhBMP-2/ACS fractions of 100%, 75%, 50% and 25%, respectively. A 4-cc implant volume was used for all sites. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each site. The animals were euthanized at 8 weeks for histologic analysis. Results: Surgical execution and healing were generally uneventful, infraorbital local swelling was observed in all animals until suture removal. rhBMP-2/ACS combined with the ceramic biomaterial did not significantly enhance local bone formation (range 9.0 ± 1.5 to 9.7 ± 2.1 mm) compared with rhBMP-2/ACS alone (8.6 ± 1.1 mm; p > 0.05). Variations in rhBMP-2/ACS to ceramic matrix ratios yielding rhBMP-2 doses approximating 0.4, 0.9, 1.3 and 1.7 mg/sinus did not appreciably influence bone formation/osseointegration. Conclusions: Whereas rhBMP-2/ACS supports significant bone formation/osseointegration in the mini-pig sinus augmentation model and thus appears an effective alternative for sinus augmentation procedures, adding a ceramic biomaterial to rhBMP-2/ACS does not produce meaningful biological advantages.

Original languageEnglish (US)
Pages (from-to)1005-1013
Number of pages9
JournalJournal of Clinical Periodontology
Volume45
Issue number8
DOIs
StatePublished - Jan 1 2018

Fingerprint

Ceramics
Porifera
Biocompatible Materials
Swine
Collagen
Bone and Bones
Osteogenesis
Osseointegration
Dental Implants
Maxillary Sinus
recombinant human bone morphogenetic protein-2
Transverse Sinuses
Dentistry
Sutures

Keywords

  • BMP-2
  • Bone biomaterials
  • Sinus augmentation
  • Tissue engineering

ASJC Scopus subject areas

  • Periodontics

Cite this

Susin, C., Lee, J., Fiorini, T., De Freitas, R. M., Chiu, H. C., Prasad, H. S., ... Wikesjo, U. M. (2018). Sinus augmentation using rhBMP-2/ACS in a mini-pig model: Influence of an adjunctive ceramic bone biomaterial. Journal of Clinical Periodontology, 45(8), 1005-1013. https://doi.org/10.1111/jcpe.12921

Sinus augmentation using rhBMP-2/ACS in a mini-pig model : Influence of an adjunctive ceramic bone biomaterial. / Susin, Cristiano; Lee, Jaebum; Fiorini, Tiago; De Freitas, Rubens Moreno; Chiu, Hsien Chung; Prasad, Hari S.; Buxton, Amanda N.; Wikesjo, Ulf Me.

In: Journal of Clinical Periodontology, Vol. 45, No. 8, 01.01.2018, p. 1005-1013.

Research output: Contribution to journalArticle

Susin, C, Lee, J, Fiorini, T, De Freitas, RM, Chiu, HC, Prasad, HS, Buxton, AN & Wikesjo, UM 2018, 'Sinus augmentation using rhBMP-2/ACS in a mini-pig model: Influence of an adjunctive ceramic bone biomaterial', Journal of Clinical Periodontology, vol. 45, no. 8, pp. 1005-1013. https://doi.org/10.1111/jcpe.12921
Susin, Cristiano ; Lee, Jaebum ; Fiorini, Tiago ; De Freitas, Rubens Moreno ; Chiu, Hsien Chung ; Prasad, Hari S. ; Buxton, Amanda N. ; Wikesjo, Ulf Me. / Sinus augmentation using rhBMP-2/ACS in a mini-pig model : Influence of an adjunctive ceramic bone biomaterial. In: Journal of Clinical Periodontology. 2018 ; Vol. 45, No. 8. pp. 1005-1013.
@article{9dd1c5a4a304498da5e745c269e60a8f,
title = "Sinus augmentation using rhBMP-2/ACS in a mini-pig model: Influence of an adjunctive ceramic bone biomaterial",
abstract = "Background: Recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support significant bone formation when used to augment the maxillary sinus for implant dentistry. Nevertheless, bone biomaterials have been suggested to extend rhBMP-2/ACS with limited support of the merits of such approaches. Objectives: To evaluate local bone formation/dental implant osseointegration following implantation of rhBMP-2/ACS combined with a ceramic bone biomaterial using a mini-pig sinus augmentation model. Methods: Twelve adult G{\"o}ttingen mini-pigs received rhBMP-2/ACS (rhBMP-2 adjusted to 0.43 mg/cc) alone or combined with an off-the- shelf biphasic ceramic (15{\%}/85{\%} HA/{\ss}-TCP) biomaterial at 3:1, 1:1 and 1:3 ratios randomized to contra-lateral maxillary sinus sites yielding rhBMP-2/ACS fractions of 100{\%}, 75{\%}, 50{\%} and 25{\%}, respectively. A 4-cc implant volume was used for all sites. Two threaded dental implants ({\o}4.0 × 11.5 mm) were placed at each site. The animals were euthanized at 8 weeks for histologic analysis. Results: Surgical execution and healing were generally uneventful, infraorbital local swelling was observed in all animals until suture removal. rhBMP-2/ACS combined with the ceramic biomaterial did not significantly enhance local bone formation (range 9.0 ± 1.5 to 9.7 ± 2.1 mm) compared with rhBMP-2/ACS alone (8.6 ± 1.1 mm; p > 0.05). Variations in rhBMP-2/ACS to ceramic matrix ratios yielding rhBMP-2 doses approximating 0.4, 0.9, 1.3 and 1.7 mg/sinus did not appreciably influence bone formation/osseointegration. Conclusions: Whereas rhBMP-2/ACS supports significant bone formation/osseointegration in the mini-pig sinus augmentation model and thus appears an effective alternative for sinus augmentation procedures, adding a ceramic biomaterial to rhBMP-2/ACS does not produce meaningful biological advantages.",
keywords = "BMP-2, Bone biomaterials, Sinus augmentation, Tissue engineering",
author = "Cristiano Susin and Jaebum Lee and Tiago Fiorini and {De Freitas}, {Rubens Moreno} and Chiu, {Hsien Chung} and Prasad, {Hari S.} and Buxton, {Amanda N.} and Wikesjo, {Ulf Me}",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/jcpe.12921",
language = "English (US)",
volume = "45",
pages = "1005--1013",
journal = "Journal of Clinical Periodontology",
issn = "0303-6979",
publisher = "Blackwell Munksgaard",
number = "8",

}

TY - JOUR

T1 - Sinus augmentation using rhBMP-2/ACS in a mini-pig model

T2 - Influence of an adjunctive ceramic bone biomaterial

AU - Susin, Cristiano

AU - Lee, Jaebum

AU - Fiorini, Tiago

AU - De Freitas, Rubens Moreno

AU - Chiu, Hsien Chung

AU - Prasad, Hari S.

AU - Buxton, Amanda N.

AU - Wikesjo, Ulf Me

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support significant bone formation when used to augment the maxillary sinus for implant dentistry. Nevertheless, bone biomaterials have been suggested to extend rhBMP-2/ACS with limited support of the merits of such approaches. Objectives: To evaluate local bone formation/dental implant osseointegration following implantation of rhBMP-2/ACS combined with a ceramic bone biomaterial using a mini-pig sinus augmentation model. Methods: Twelve adult Göttingen mini-pigs received rhBMP-2/ACS (rhBMP-2 adjusted to 0.43 mg/cc) alone or combined with an off-the- shelf biphasic ceramic (15%/85% HA/ß-TCP) biomaterial at 3:1, 1:1 and 1:3 ratios randomized to contra-lateral maxillary sinus sites yielding rhBMP-2/ACS fractions of 100%, 75%, 50% and 25%, respectively. A 4-cc implant volume was used for all sites. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each site. The animals were euthanized at 8 weeks for histologic analysis. Results: Surgical execution and healing were generally uneventful, infraorbital local swelling was observed in all animals until suture removal. rhBMP-2/ACS combined with the ceramic biomaterial did not significantly enhance local bone formation (range 9.0 ± 1.5 to 9.7 ± 2.1 mm) compared with rhBMP-2/ACS alone (8.6 ± 1.1 mm; p > 0.05). Variations in rhBMP-2/ACS to ceramic matrix ratios yielding rhBMP-2 doses approximating 0.4, 0.9, 1.3 and 1.7 mg/sinus did not appreciably influence bone formation/osseointegration. Conclusions: Whereas rhBMP-2/ACS supports significant bone formation/osseointegration in the mini-pig sinus augmentation model and thus appears an effective alternative for sinus augmentation procedures, adding a ceramic biomaterial to rhBMP-2/ACS does not produce meaningful biological advantages.

AB - Background: Recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support significant bone formation when used to augment the maxillary sinus for implant dentistry. Nevertheless, bone biomaterials have been suggested to extend rhBMP-2/ACS with limited support of the merits of such approaches. Objectives: To evaluate local bone formation/dental implant osseointegration following implantation of rhBMP-2/ACS combined with a ceramic bone biomaterial using a mini-pig sinus augmentation model. Methods: Twelve adult Göttingen mini-pigs received rhBMP-2/ACS (rhBMP-2 adjusted to 0.43 mg/cc) alone or combined with an off-the- shelf biphasic ceramic (15%/85% HA/ß-TCP) biomaterial at 3:1, 1:1 and 1:3 ratios randomized to contra-lateral maxillary sinus sites yielding rhBMP-2/ACS fractions of 100%, 75%, 50% and 25%, respectively. A 4-cc implant volume was used for all sites. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each site. The animals were euthanized at 8 weeks for histologic analysis. Results: Surgical execution and healing were generally uneventful, infraorbital local swelling was observed in all animals until suture removal. rhBMP-2/ACS combined with the ceramic biomaterial did not significantly enhance local bone formation (range 9.0 ± 1.5 to 9.7 ± 2.1 mm) compared with rhBMP-2/ACS alone (8.6 ± 1.1 mm; p > 0.05). Variations in rhBMP-2/ACS to ceramic matrix ratios yielding rhBMP-2 doses approximating 0.4, 0.9, 1.3 and 1.7 mg/sinus did not appreciably influence bone formation/osseointegration. Conclusions: Whereas rhBMP-2/ACS supports significant bone formation/osseointegration in the mini-pig sinus augmentation model and thus appears an effective alternative for sinus augmentation procedures, adding a ceramic biomaterial to rhBMP-2/ACS does not produce meaningful biological advantages.

KW - BMP-2

KW - Bone biomaterials

KW - Sinus augmentation

KW - Tissue engineering

UR - http://www.scopus.com/inward/record.url?scp=85053731687&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053731687&partnerID=8YFLogxK

U2 - 10.1111/jcpe.12921

DO - 10.1111/jcpe.12921

M3 - Article

VL - 45

SP - 1005

EP - 1013

JO - Journal of Clinical Periodontology

JF - Journal of Clinical Periodontology

SN - 0303-6979

IS - 8

ER -