title: Horizontal ridge augmentation of the atrophic anterior maxilla using rhBMP-2/ACS or autogenous bone grafts: a proof-of-concept randomized clinical trial.
abstract: OBJECTIVE
  To compare the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge carrier (ACS) with autogenous bone graft for augmentation of the edentulous atrophic anterior maxilla.
  
  
  METHODS
  Twenty-four subjects were enrolled in a randomized, controlled, parallel-group, open-label clinical trial. Subjects either received rhBMP-2/ACS (1.5 mg/ml) or particulated autogenous bone harvested from the mandibular retromolar region. A titanium-mesh was used to provide space and wound stability. A guide was used to standardize clinical recordings using an analogue caliper. Alveolar ridge width was also assessed using cone-beam computed tomography.
  
  
  RESULTS
  rhBMP-2/ACS yielded significantly greater radiographic horizontal bone gain compared with autogenous bone graft at immediate subcrestal levels (1.5 ± 0.7 versus 0.5 ± 0.9 mm; p = 0.01); non-significant differences were observed at mid- (2.9 ± 0.8 versus 2.9 ± 0.9 mm; p = 0.98) and apical (1.7 ± 0.9 versus 1.8 ± 1.1 mm; p = 0.85) crestal levels. No significant differences in clinical horizontal bone gain were observed at 6 months between rhBMP-2/ACS and autogenous bone graft (3.2 ± 0.9 mm versus 3.7 ± 1.4 mm; p = 0.31). Sixty-two implants were placed after 6 month of healing with no significant differences between groups for number of implants, implant size, primary stability and survival.
  
  
  CONCLUSIONS
  rhBMP-2/ACS appears a realistic alternative for augmentation of the edentulous atrophic anterior maxilla.
authors.affiliation: Department of Diagnosis and Surgery - Periodontics, UNESP - Univ Estadual Paulista, Araraquara Dental School, Araraquara, SP, Brazil.
authors.forename: Rubens Moreno
authors.initials: RM
authors.lastname: de Freitas
authors.forename: Cristiano
authors.initials: C
authors.lastname: Susin
authors.forename: Rubens
authors.initials: R
authors.lastname: Spin-Neto
authors.forename: Claudio
authors.initials: C
authors.lastname: Marcantonio
authors.forename: Ulf M E
authors.initials: UM
authors.lastname: Wikesjö
authors.forename: Luís Antônio Violin Dias
authors.initials: LA
authors.lastname: Pereira
authors.forename: Elcio
authors.initials: E
authors.lastname: Marcantonio
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000539:Alveolar Process / Q000000981:diagnostic imaging; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D064592:Autografts / Q000637:transplantation*; D001672:Biocompatible Materials / Q000737:chemistry; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods*; D003094:Collagen; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D004337:Drug Carriers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology; D011994:Recombinant Proteins / Q000627:therapeutic use; D013526:Surgical Mesh; D014025:Titanium / Q000737:chemistry; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*
chemical_list: D001672:Biocompatible Materials; D055396:Bone Morphogenetic Protein 2; 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
keywords: alveolar ridge augmentation; autogenous bone graft; randomized-controlled trial; recombinant human bone morphogenetic protein; rhBMP-2