title: Bone augmentation of the atrophic anterior maxilla for dental implants using rhBMP-2 and titanium mesh: histological and tomographic analysis.
abstract: The loss of multiple teeth or trauma to the anterior maxilla often results in a deficient ridge width for prosthetic tooth rehabilitation. This study evaluated the use of titanium mesh and recombinant human bone morphogenetic protein 2 (rhBMP-2) for the repair of major bone defects in the alveolar bone. Five patients were enrolled in the study; these patients required implant replacements for two contiguous missing teeth in the anterior maxilla, which lacked sufficient bone. Residual ridges were augmented with rhBMP-2 and titanium mesh to direct the geometry of the newly formed bone. Seven months later, a bone biopsy specimen was removed from the implantation site before osteotomy and insertion of dental implants. Cone beam computed tomography (CBCT) scans were obtained preoperatively, postoperatively (baseline), and 48 months after implantation to evaluate implant healing. All dental implants were placed in the grafted sites without the need for further bone augmentation. The most frequent adverse effects were facial oedema and oral erythema. Biopsy specimens were used to evaluate bone quality. CBCT scans provided a prediction of alveolar restoration and long-term success. The combination of rhBMP-2 and titanium mesh provided effective augmentation of the atrophic anterior maxilla prior to implant placement.
authors.affiliation: Department of Stomatological Science, School of Dentistry, Federal University of Goiás, Goiás, Brazil.
authors.forename: S A
authors.initials: SA
authors.lastname: Ribeiro Filho
authors.affiliation: Department of Implantology, São Leopoldo Mandic Dental Research Centre, Campinas, São Paulo, Brazil.
authors.forename: C E
authors.initials: CE
authors.lastname: Francischone
authors.affiliation: Department of Prosthodontics, UNIPLAC Dental School, Brasília, DF, Brazil.
authors.forename: J C
authors.initials: JC
authors.lastname: de Oliveira
authors.affiliation: School of Medicine, Federal University of Goiás, Goiás, Brazil.
authors.forename: L Z
authors.initials: LZ
authors.lastname: Ribeiro
authors.affiliation: Department of Implantology, São Leopoldo Mandic Dental Research Centre, Campinas, São Paulo, Brazil.
authors.forename: F Z X
authors.initials: FZ
authors.lastname: do Prado
authors.affiliation: Department of Restorative Dentistry, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Electronic address: bruno.sotto@ufjf.edu.br.
authors.forename: B S
authors.initials: BS
authors.lastname: Sotto-Maior
mesh_terms: D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D001706:Biopsy; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D054893:Cone-Beam Computed Tomography; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D005260:Female; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging / Q000534:rehabilitation; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy; D011446:Prospective Studies; 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
chemical_list: D055396:Bone Morphogenetic Protein 2; D015921:Dental Implants; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2; D014025:Titanium
keywords: atrophic ridge; dental implant; follow-up