Assessment of the potential of growth factors for localized alveolar ridge augmentation: a systematic review.
OBJECTIVE
To systematically assess the literature regarding the clinical, histological, and radiographic outcome of bone morphogenetic proteins (BMP-2, BMP-7), growth/differentiation factor-5 (GDF-5), platelet-derived growth factor (PDGF), and parathyroid hormone (PTH) for localized alveolar ridge augmentation.


METHODS
Five separate Medline searches were performed in duplicate for human and animal studies, respectively. The primary outcome of the included studies was bone regeneration of localized alveolar ridge defects or craniofacial defects.


RESULTS
In six human studies, BMP-2 affected local bone augmentation with increasing volume for higher doses. A majority (43 of 45) of animal studies using BMP-2 showed a positive effect in favour of the growth factor (GF). In six of eight studies, a positive effect was associated with the use of BMP-7. Only one animal study was included for GDF-5 revealing statistically significantly higher bone volume. Regarding PDGF, statistically significantly higher bone volume was observed in five of 10 included studies. Four animal studies using PTH revealed statistically significantly more bone regeneration compared with controls.


CONCLUSIONS
Differing levels and quantity of evidence were noted to be available for the GFs evaluated, revealing that BMP-2, BMP-7, GDF-5, PDGF, and PTH may stimulate local bone augmentation to various degrees. Human data for the potential of rhBMP-2 are supportive.
Jung
Ronald E
RE
Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland. ronald.jung@zzmk.uzh.ch
Thoma
Daniel S
DS
Hammerle
Christoph H F
CH
D000539:Alveolar Process / Q000187:drug effects; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use; D055419:Bone Morphogenetic Protein 7 / Q000627:therapeutic use; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use; D055428:Growth Differentiation Factor 5 / Q000627:therapeutic use; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000627:therapeutic use*; D010012:Osteogenesis / Q000187:drug effects; D010281:Parathyroid Hormone / Q000627:therapeutic use; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use; D016896:Treatment Outcome
D055396:Bone Morphogenetic Protein 2; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D055428:Growth Differentiation Factor 5; D036341:Intercellular Signaling Peptides and Proteins; D010281:Parathyroid Hormone; D010982:Platelet-Derived Growth Factor