title: RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration.
abstract: BACKGROUND
  Recombinant human bone morphogenetic protein 2 (rhBMP-2) in a carrier has been shown to induce significant bone formation. Several candidate carriers, however, lack structural integrity to offset compressive forces that may compromise rhBMP-2 bone induction, in particular, for challenging onlay indications such as alveolar ridge augmentation.
  
  
  OBJECTIVE
  The objective of this study was to evaluate rhBMP-2 in a calcium-phosphate cement carrier, alphaBSM, for vertical alveolar ridge augmentation and immediate dental implant osseointegration.
  
  
  METHODS
  Six adult Hound Labrador mongrels with 5 mm critical size supra-alveolar peri-implant defects were used. Three animals received rhBMP-2/alphaBSM (rhBMP-2 at 0.40 and 0.75 mg/mL) in contralateral jaw quadrants (total implant volume/defect approximately 1.5 mL). Three animals received alphaBSM without rhBMP-2 (control group). The animals were euthanized at 16 weeks post surgery, and block biopsies were processed for histologic and histometric analysis.
  
  
  RESULTS
  rhBMP-2/alphaBSM induced substantial augmentation of the alveolar ridge. Control sites exhibited limited new bone formation. Vertical bone augmentation averaged (+/- SD) 4.9 +/- 1.0 mm (rhBMP-2 at 0.40 mg/mL), 5.3 +/- 0.3 mm (rhBMP-2 at 0.75 mg/mL), and 0.4 +/- 0.4 mm (control); new bone area 8.5 +/- 4.2 mm2, 9.0 +/- 1.9 mm2, and 0.5 +/- 0.4 mm2; new bone density 55.1 +/- 6.4%, 61.1 +/- 6.0%, and 67.7 +/- 9.5%; and new bone-implant contact 26.9 +/- 17.5%, 28.5 +/- 1.4%, and 24.6 +/- 16.1%, respectively. Residual alphaBSM comprised < 1% of the new bone. Bone density for the contiguous resident bone ranged from 65 to 71%, and bone-implant contact ranged from 49 to 64%.
  
  
  CONCLUSIONS
  Surgical implantation of rhBMP-2/alphaBSM appears an effective protocol for vertical alveolar ridge augmentation procedures and immediate dental implant osseointegration and for onlay indications of lesser complexity.
authors.affiliation: Laboratory for Applied Periodontal and Craniofacial Regeneration, Department of Periodontology, Temple University School of Dentistry, Philadelphia, PA 19140, USA. uwikesjo@temple.edu
authors.forename: Ulf M E
authors.initials: UM
authors.lastname: Wikesjö
authors.forename: Rachel G
authors.initials: RG
authors.lastname: Sorensen
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Kinoshita
authors.forename: John M
authors.initials: JM
authors.lastname: Wozney
mesh_terms: D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D001843:Bone Cements; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000008:administration & dosage*; D001861:Bone Regeneration / Q000187:drug effects*; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D004285:Dogs; D004337:Drug Carriers; D017886:Durapatite; D006801:Humans; D006882:Hydroxyapatites; D020007:Implants, Experimental; D008297:Male; D008334:Mandible / Q000601:surgery; D016348:Osseointegration; D011994:Recombinant Proteins / Q000008:administration & dosage; D016212:Transforming Growth Factor beta
chemical_list: C525718:BMP2 protein, human; D001843:Bone Cements; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D015921:Dental Implants; D004337:Drug Carriers; D006882:Hydroxyapatites; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C475044:hydroxyapatite cement; C499469:recombinant human bone morphogenetic protein-2; D017886:Durapatite