title: Bone augmentation of the atrophic posterior mandible for dental implants using rhBMP-2 and titanium mesh: clinical technique and early results.
abstract: The atrophic posterior mandible has unique challenges when implant placement is planned. The purpose of this case series was to evaluate the use of recombinant human bone morphogenetic protein 2÷acelluar collagen sponge (rhBMP-2÷ACS) and titanium mesh for augmentation of the atrophic posterior mandible prior to implant insertion. The case series included five patients with inadequate bone in the posterior mandible for implant placement. The residual ridges were augmented with rhBMP-2÷ACS and a small amount of bone substitute. Titanium mesh was used to protect the graft sites. Dental implants were inserted after 6 months of healing. Healing of the grafted ridges was uneventful. Dental implants were placed in all grafted sites without the need for further bone augmentation. All 10 implants integrated well and were restored with single crowns. The use of rhBMP-2÷ACS with titanium mesh was effective in this case series for augmentation of the atrophic posterior mandible prior to implant placement. This approach offers many advantages, including technical ease, no need for bone harvesting, decreased morbidity, and reduced surgical time.
authors.affiliation: New York, University College of Dentistry, New York, NY, USA. mish@bonegraft.com
authors.forename: Craig M
authors.initials: CM
authors.lastname: Misch
mesh_terms: D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D001672:Biocompatible Materials; D015519:Bone Density / Q000502:physiology; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000502:physiology; D001863:Bone Screws; D018786:Bone Substitutes / Q000627:therapeutic use; D003094:Collagen; D054893:Cone-Beam Computed Tomography; D003442:Crowns; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D004337:Drug Carriers; D005500:Follow-Up Studies; D006801:Humans; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D016348:Osseointegration / Q000502:physiology; D010027:Osteotomy / Q000379:methods; D016300:Radiography, Bitewing; D011994:Recombinant Proteins / Q000627:therapeutic use; D013524:Surgical Flaps; D013526:Surgical Mesh; D014025:Titanium; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D001672:Biocompatible Materials; D055396:Bone Morphogenetic Protein 2; D018786:Bone Substitutes; D015921:Dental Implants; D004337:Drug Carriers; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2; D003094:Collagen; D014025:Titanium