Sinus floor augmentation with recombinant human growth and differentiation factor-5 (rhGDF-5): a pilot study in the Goettingen miniature pig comparing autogenous bone and rhGDF-5.
OBJECTIVE
The aim of this study was to test the hypothesis that recombinant human growth and differentiation factor-5 (rhGDF-5) in combination with a beta-tricalcium phosphate (beta-TCP) scaffold material results in superior bone formation in sinus floor augmentations in miniature pigs compared with a particulated autogenous bone graft combined with the scaffold material.


METHODS
Six adult female Goettingen minipigs underwent a maxillary sinus floor augmentation procedure. In a split-mouth design, the sinus floors were augmented with beta-TCP mixed with autogenous cortical bone chips, in a ratio of approximately 1 : 1, on one side. The contralateral test site was augmented using beta-TCP coated with two concentrations of rhGDF-5 (400 microg rhGDF-5/g beta-TCP or 800 microg rhGDF-5/g beta-TCP; three animals in each case). Simultaneously, one dental implant was inserted into each sinus floor augmentation. After 12 weeks, a histological and histomorphometric assessment of non-decalcified histological specimens was made.


RESULTS
There were significantly higher mean values of volume density of newly formed bone using beta-TCP coated with two concentrations of rhGDF-5 (400 microg: 32.9%; 800 microg: 23.9%) than with the corresponding control (autogenous bone/beta-TCP) (14.6%, 12.9%) (P=0.012, P=0.049). The bone-to-implant contact rates (BIC) were significantly enhanced in test sites (400 microg: 84.2%; 800 microg: 69.8%) compared with the corresponding control sites (24.8%, 40.8%) (P=.027, P=.045).


CONCLUSIONS
rhGDF-5 delivered on beta-TCP significantly enhanced bone formation compared with beta-TCP combined with autogenous bone in sinus lift procedures in miniature pigs.
Gruber
Rudolf Matthias
RM
Department of Oral and Maxillofacial Surgery, Georgia Augusta University, Goettingen, Germany. r.gruber@med.uni-goettingen.de
Ludwig
Arwed
A
Merten
Hans-Albert
HA
Pippig
Susanne
S
Kramer
Franz-Josef
FJ
Schliephake
Henning
H
D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D015519:Bone Density / Q000187:drug effects; D001861:Bone Regeneration / Q000187:drug effects; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods* / Q000473:pathology; D002130:Calcium Phosphates / Q000627:therapeutic use; D015921:Dental Implants; D005260:Female; D005456:Fluorescent Dyes; D055428:Growth Differentiation Factor 5 / Q000627:therapeutic use*; D006801:Humans; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery*; D023421:Models, Animal; D016348:Osseointegration / Q000187:drug effects; D010012:Osteogenesis / Q000187:drug effects; D010636:Phenols; D010865:Pilot Projects; D011897:Random Allocation; D011994:Recombinant Proteins; D013454:Sulfoxides; D013552:Swine; D013556:Swine, Miniature; D013997:Time Factors; D054457:Tissue Scaffolds; D014992:Xylenes
D018786:Bone Substitutes; D002130:Calcium Phosphates; D015921:Dental Implants; D005456:Fluorescent Dyes; D055428:Growth Differentiation Factor 5; D010636:Phenols; D011994:Recombinant Proteins; D013454:Sulfoxides; D014992:Xylenes; C485817:beta-tricalcium phosphate; C016833:xylenol orange