Influence of rhBMP-2 on Guided Bone Regeneration for Placement and Functional Loading of Dental Implants: A Radiographic and Histologic Study in Dogs

• Published in: The International journal of oral and maxillofacial implants Vol. 32; no. 6; p. e265
• Main Authors: Ben Amara, Heithem, Lee, Jung-Won, Kim, Jung-Ju, Kang, Yun-Mi, Kang, Eun-Jung, Koo, Ki-Tae
• Format: Journal Article
• Language: English
• Published: United States 01-11-2017
• Subjects: Absorbable Implants; Alveolar Bone Loss - surgery; Alveolar Process - pathology; Alveolar Ridge Augmentation; Animals; Bone Density - drug effects; Bone Morphogenetic Protein 2 - pharmacology; Bone Regeneration - drug effects; Cattle; Dental Implantation, Endosseous; Dental Implants; Disease Models, Animal; Dogs; Guided Tissue Regeneration, Periodontal - methods; Humans; Mandible - surgery; Osseointegration - drug effects; Recombinant Proteins - pharmacology; Titanium; Transforming Growth Factor beta - pharmacology
• ISSN: 1942-4434
• DOI: 10.11607/jomi.5986

Evidence on the outcomes of functional loading placed in recombinant human bone morphogenetic protein 2 (rhBMP-2)/acellular collagen sponge (ACS)-induced bone is lacking. The aim of this study was to verify whether guided bone regeneration (GBR) with rhBMP-2/ACS enhances regeneration of missing bone and osseointegration of dental implants subject to functional loading.
Two bilateral standardized large saddle-type defects (≈10 × 10 × 6 mm) were surgically created in each mandible of seven beagle dogs 2 months after tooth extraction. Defects were immediately reconstructed randomly using rhBMP-2 (O-BMP or InFuse) soaked in ACS, deproteinized bovine bone mineral (DBBM) granules, or ACS alone as surgical control and subsequently covered with collagen membrane. Screw-type sand-blasted, acid-etched dental implants were placed 3 months later into the reconstructed defects and into adjacent bone. Osseointegration was allowed to progress for 3 months before functional loading of 3 months until sacrifice.
Significantly more bone fill was radiographically observed for GBR with rhBMP-2/ACS (O-BMP: 92.5%, InFuse: 79%) in comparison to the DBBM (52%) and ACS alone groups (56.6%). Osseointegration was achieved and maintained in all experimental defects challenged by prostheses-driven functional load. The bone density ranged from 37.49% in the ACS group to 64.9% in the rhBMP-2/ACS (InFuse) group with no significance. The highest mean percentage of BIC was found in rhBMP-2/ACS (InFuse: 52.98%) with no statistical difference. Crestal bone resorption was observed around implants placed in reconstructed areas without any significant difference.
GBR with rhBMP-2/ACS provided the greatest bone fill among the three treatment procedures. GBR with rhBMP-2/ACS showed efficacy for placement, osseointegration, and functional loading of titanium implants in alveolar ridge defects.