title: The use of recombinant human bone morphogenetic protein-2 for the repair of extraction socket defects: a technical modification and case series report.
abstract: OBJECTIVE
  The purpose of this case series was to evaluate the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge (ACS) carrier for the repair of significant bone defects following tooth removal. The surgical technique was modified because primary closure was not obtained over the grafted sockets.
  
  
  METHODS
  The present series included 10 consecutively treated patients with failed endodontically treated maxillary central incisors. Computed tomographic scans were obtained preoperatively. The extraction sockets all had > 50% buccal bone loss. The sockets were grafted with rhBMP-2/ACS and a small amount of bone substitute. Dental implants were inserted after 4 to 6 months of healing.
  
  
  RESULTS
  Healing of the grafted sockets was uneventful. Dental implants were placed in all grafted sites without the need for further bone augmentation. A comparison of preoperative and postgrafting computed tomographic scans found a slight loss in alveolar width at the crest of 1.07 mm. Connective tissue grafts were placed in five patients. All 10 implants integrated well and were restored with single crowns.
  
  
  CONCLUSIONS
  The use of rhBMP-2/ACS was effective in repairing osseous defects prior to implant placement. The lack of primary closure over the graft did not appear to complicate healing or compromise bone growth. This modification simplifies the technique and may reduce postoperative morbidity caused by flap manipulation.
authors.affiliation: New York University College of Dentistry, New York, New York, USA. misch@bonegraft.com
authors.forename: Craig M
authors.initials: CM
authors.lastname: Misch
mesh_terms: D020341:Absorbable Implants; D016301:Alveolar Bone Loss / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D055396:Bone Morphogenetic Protein 2 / Q000502:physiology / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000187:drug effects; D001862:Bone Resorption / Q000188:drug therapy; D016025:Bone Transplantation / Q000379:methods*; D003758:Dental Implantation, Endosseous / Q000379:methods; D006801:Humans; D013516:Oral Surgical Procedures, Preprosthetic / Q000379:methods; D011994:Recombinant Proteins; D014081:Tooth Extraction / Q000009:adverse effects*; D020390:Tooth Socket / Q000601:surgery*
chemical_list: D055396:Bone Morphogenetic Protein 2; D011994:Recombinant Proteins