Augmentation of alveolar bone and dental implant osseointegration: clinical implications of studies with rhBMP-2.
BACKGROUND
The surgical placement of dental implants is governed primarily by the prosthetic design and secondarily by the morphology and quality of the alveolar bone. Implant placement may be difficult, if at all possible, due to alveolar ridge aberrations. In consequence, prosthetically dictated dental implant positioning often entails augmentation of the alveolar ridge and adjacent structures. The objective of this review is to discuss recent observations of the biologic potential, the clinical relevance, and the perspectives of the application of recombinant human bone morphogenetic protein-2 (rhBMP-2) technology for alveolar bone augmentation and dental implant fixation.


METHODS
Our studies use discriminating, critical-size, supraalveolar defects in dogs to evaluate the biologic potential of the rhBMP-2 technology. We also use clinical modeling, including peri-implantitis and alveolar ridge defects and the maxillary sinus in preparation for clinical indications, in dogs and inhuman primates.


RESULTS
The results suggest that rhBMP-2 has substantial potential to augment alveolar bone and support dental implant fixation and functional loading.


CONCLUSIONS
Inclusion of rhBMP-2 for alveolar bone augmentation and dental implant fixation will not only enhance the predictability of the existing clinical protocol but will also allow new approaches to these procedures.
Wikesjö
U M
UM
Department of Periodontology, Temple University School of Dentistry, Philadelphia, Pennsylvania 19140, USA. uwikesjo@dental.temple.edu
Sorensen
R G
RG
Wozney
J M
JM
D016301:Alveolar Bone Loss / Q000628:therapy; D000540:Alveolar Ridge Augmentation; D000818:Animals; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000008:administration & dosage*; D003758:Dental Implantation, Endosseous; D004337:Drug Carriers; D011994:Recombinant Proteins / Q000008:administration & dosage; D016212:Transforming Growth Factor beta
C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D004337:Drug Carriers; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta