title: RhBMP-7 improves survival and eruption in a growing tooth avulsion trauma model.
abstract: Long-term loss of avulsed and replanted teeth is a frequent clinical problem. Bone morphogenetic protein-7 (BMP 7) induces cementogenesis in periodontitis-associated periodontal ligament (PDL) defects. This study's aim was to assess the utility of rhBMP 7 in a tooth avulsion trauma model in growing individuals. Immature primary incisors of 12 minipigs were extracted. PDL and cementum were removed either partially (group 1: 4 mm2 [n=28 teeth]; group 2: 16 mm2 [n=26 teeth]) or totally (group 3 [n=26 teeth]). 500 microg rhBMP 7/g collagen matrix was applied to the teeth from one side while the corresponding teeth on the contralateral side served as controls (split mouth model). After an experimental period of 4 months, microradiography, fluorescence and light microscopy of nondecalcified sections were performed. All teeth of group 1 survived and all teeth of group 3 were lost, whether rhBMP-7 was applied or not. In group 2, nine out of ten teeth survived when rhBMP-7 was applied and four out of ten teeth were lost when rhBMP-7 was not applied. In the presence of rhBMP-7, eruption of teeth in group 2 was significantly improved (difference [median]: 5 mm, P<0.05, n=6). Even though there was a tendency towards increased deposition rates of cementum under rhBMP-7, this difference was not significant (Wilcoxon: P>0.05, ANOVA: P=0.002; n=6/group). In conclusion, rhBMP-7 improved survival rates and eruption of replanted teeth in growing individuals. No adverse effects were seen. Based on the present results, future clinical trials appear to be warranted.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Kiel, Arnold-Hellerstr. 16, D-24105 Kiel, Germany. springer@mkg.uni-kiel.de
authors.forename: Ingo N G
authors.initials: IN
authors.lastname: Springer
authors.forename: Yahya
authors.initials: Y
authors.lastname: Açil
authors.forename: Christian
authors.initials: C
authors.lastname: Spies
authors.forename: Sören
authors.initials: S
authors.lastname: Jepsen
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Warnke
authors.forename: Hendrik
authors.initials: H
authors.lastname: Bolte
authors.forename: Solveig
authors.initials: S
authors.lastname: Kuchenbecker
authors.forename: Paul A J
authors.initials: PA
authors.lastname: Russo
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltfang
authors.forename: Hendrik
authors.initials: H
authors.lastname: Terheyden
mesh_terms: D000818:Animals; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D023421:Models, Animal; D011994:Recombinant Proteins / Q000627:therapeutic use; D013552:Swine; D013556:Swine, Miniature; D014084:Tooth Avulsion / Q000188:drug therapy*; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*; D014947:Wounds and Injuries / Q000503:physiopathology*
chemical_list: D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta