title: Acceleration of Alveolar Ridge Augmentation Using a Low Dose of Recombinant Human Bone Morphogenetic Protein-2 Loaded on a Resorbable Bioactive Ceramic.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the effect of a porous silica-calcium phosphate composite (SCPC50) loaded with and without recombinant human bone morphogenetic protein-2 (rhBMP-2) on alveolar ridge augmentation in saddle-type defects.
  
  
  METHODS
  Micro-granules of SCPC50 resorbable bioactive ceramic were coated with rhBMP-2 10 mg and then implanted into a saddle-type defect (12 × 7 mm) in a dog mandible and covered with a collagen membrane. Control groups included defects grafted with SCPC50 granules without rhBMP-2 and un-grafted defects. Bone healing was evaluated at 8 and 16 weeks using histologic and histomorphometric techniques. The increase in bone height and total defect fill were assessed for each specimen using the ImageJ 1.46 program. The release kinetics of rhBMP-2 was determined in vitro. The height of the bone in the grafted defects and the total defect fill were statistically analyzed.
  
  
  RESULTS
  SCPC50 enhanced alveolar ridge augmentation as indicated by the increased vertical bone height, bone surface area, and bone volume after 16 weeks. SCPC50-rhBMP-2 provided a sustained release profile of a low effective dose (BMP-2 4.6 ± 1.34 pg/mL per hour) during the 1- to 21-day period. The slow rate of release of rhBMP-2 from SCPC50 accelerated synchronized complete bone regeneration and graft material resorption in 8 weeks. Successful rapid reconstruction of the alveolar ridge by SCPC50 and SCPC50-rhBMP-2 occurred without any adverse excessive bone formation, inflammation, or fluid-filled voids.
  
  
  CONCLUSIONS
  Results of this study suggest that SCPC50 is an effective graft material to preserve the alveolar ridge after tooth extraction. Coating SCPC50-rhBMP-2 further accelerated bone regeneration and a considerable increase in vertical bone height. These findings make SCPC50 the primary choice as a carrier for rhBMP-2. SCPC50-rhBMP-2 can serve as an alternative to autologous bone grafting.
authors.affiliation: Lecturer, Department of Oral Medicine and Periodontology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
authors.forename: Rania A
authors.initials: RA
authors.lastname: Fahmy
authors.affiliation: Professor, Department of Oral Medicine and Periodontology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
authors.forename: Naguiba
authors.initials: N
authors.lastname: Mahmoud
authors.affiliation: Professor, Department of Oral Biology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
authors.forename: Samia
authors.initials: S
authors.lastname: Soliman
authors.affiliation: Professor, Department of Surgery, Faculty of Veterinary Medicine, Alexandria University, Alexandria, Egypt.
authors.forename: Samir R
authors.initials: SR
authors.lastname: Nouh
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Kentucky, Lexington, KY.
authors.forename: Larry
authors.initials: L
authors.lastname: Cunningham
authors.affiliation: Associate Professor, Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, NC. Electronic address: arelgha@uncc.edu.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Ghannam
mesh_terms: D000540:Alveolar Ridge Augmentation / Q000295:instrumentation / Q000379:methods*; D000818:Animals; D001846:Bone Development / Q000187:drug effects; D055396:Bone Morphogenetic Protein 2 / Q000008:administration & dosage / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D002516:Ceramics / Q000627:therapeutic use*; D004285:Dogs; D004343:Drug Implants / Q000008:administration & dosage; D008334:Mandible / Q000601:surgery; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D017640:Silicates / Q000627:therapeutic use*
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D002130:Calcium Phosphates; D004343:Drug Implants; D011994:Recombinant Proteins; D017640:Silicates; C499768:silica-calcium phosphate nanocomposite