title: Bone formation and reosseointegration in peri-implantitis defects following surgical implantation of rhBMP-2.
abstract: This study was designed to evaluate bone formation and reosseointegration following surgical implantation of recombinant human bone morphogenetic protein-2 (rhBMP-2) in peri-implantitis defects. Hydroxyapatite-coated dental implants were placed bilaterally in the mandibular and maxillary premolar area in four rhesus monkeys and were allowed to osseointegrate for 1 year. Cotton ligatures were then placed around the healing abutments, and plaque was allowed to accumulate for 11 months. Resulting circumferential peri-implantitis defects exhibited a large intrabony and horizontal component. At reconstructive surgery, peri-implantitis defects in contralateral jaw quadrants were randomly assigned to receive rhBMP-2 (0.43 mg/mL implant volume) in an absorbable collagen sponge carrier or a carrier control. The animals were sacrificed 4 months postsurgery, and block sections were prepared for histometric analysis. Summary statistics included means calculated per animal. Paired t tests were used to evaluate differences between experimental conditions (n = 4). Defect depth amounted to 3.4 +/- 0.9 mm and 3.2 +/- 0.9 mm for rhBMP-2 and control defects, respectively. Vertical bone gain in rhBMP-2 defects (2.6 +/- 1.2 mm) was significantly greater than in controls (0.8 +/- 0.8 mm; P < .01). Reosseointegration within the confines of the defect for rhBMP-2 defects (29.0 +/- 10.5%) differed significantly from that in the control (3.5 +/- 2.5%; P < .01). Reosseointegration within the extent of newly formed bone averaged 40.0 +/- 11.0% in rhBMP-2 defects as compared to 8.9 +/- 7.8% in the control (P < .01). Osseointegration in resident bone amounted to 69.5 +/- 6.9% and 72.6 +/- 8.0% for rhBMP-2 and control defects, respectively. There is significant evidence that rhBMP-2 has potential to promote bone formation and reosseointegration in advanced peri-implantitis defects in a demanding nonhuman primate model.
authors.affiliation: Department of Prosthodontics, University of Aachen, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Hanisch
authors.forename: D N
authors.initials: DN
authors.lastname: Tatakis
authors.forename: M M
authors.initials: MM
authors.lastname: Boskovic
authors.forename: M D
authors.initials: MD
authors.lastname: Rohrer
authors.forename: U M
authors.initials: UM
authors.lastname: Wikesjö
mesh_terms: D016301:Alveolar Bone Loss / Q000209:etiology / Q000473:pathology / Q000601:surgery; D000539:Alveolar Process / Q000473:pathology; D000818:Animals; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000009:adverse effects*; D015921:Dental Implants; D003773:Dental Plaque / Q000209:etiology; D017886:Durapatite; D005260:Female; D005781:Gelatin Sponge, Absorbable; D008253:Macaca mulatta; D008334:Mandible / Q000473:pathology / Q000601:surgery; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D016348:Osseointegration; D010012:Osteogenesis; D010518:Periodontitis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D011897:Random Allocation; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*; D014945:Wound Healing
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D015921:Dental Implants; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; D003094:Collagen; D017886:Durapatite