title: Effects of Recombinant Human Bone Morphogenetic Protein-2 Dose and Ceramic Composition on New Bone Formation and Space Maintenance in a Canine Mandibular Ridge Saddle Defect Model.
abstract: Treatment of mandibular osseous defects is a significant clinical challenge. Maintenance of the height and width of the mandibular ridge is essential for placement of dental implants and restoration of normal dentition. While guided bone regeneration using protective membranes is an effective strategy for maintaining the anatomic contour of the ridge and promoting new bone formation, complications have been reported, including wound failure, seroma, and graft exposure leading to infection. In this study, we investigated injectable low-viscosity (LV) polyurethane/ceramic composites augmented with 100 μg/mL (low) or 400 μg/mL (high) recombinant human bone morphogenetic protein-2 (rhBMP-2) as space-maintaining bone grafts in a canine mandibular ridge saddle defect model. LV grafts were injected as a reactive paste that set in 5-10 min to form a solid porous composite with bulk modulus exceeding 1 MPa. We hypothesized that compression-resistant LV grafts would enhance new bone formation and maintain the anatomic contour of the mandibular ridge without the use of protective membranes. At the rhBMP-2 dose recommended for the absorbable collagen sponge carrier in dogs (400 μg/mL), LV grafts maintained the width and height of the host mandibular ridge and supported new bone formation, while at suboptimal (100 μg/mL) doses, the anatomic contour of the ridge was not maintained. These findings indicate that compression-resistant bone grafts with bulk moduli exceeding 1 MPa and rhBMP-2 doses comparable to that recommended for the collagen sponge carrier support new bone formation and maintain ridge height and width in mandibular ridge defects without protective membranes.
authors.affiliation: 1 Department of Chemical and Biomolecular Engineering, Vanderbilt University , Nashville, Tennessee.
authors.forename: Anne D
authors.initials: AD
authors.lastname: Talley
authors.affiliation: 2 Medtronic Spinal , Memphis, Tennessee.
authors.forename: Kerem N
authors.initials: KN
authors.lastname: Kalpakci
authors.affiliation: 2 Medtronic Spinal , Memphis, Tennessee.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Shimko
authors.affiliation: 1 Department of Chemical and Biomolecular Engineering, Vanderbilt University , Nashville, Tennessee.
authors.forename: Katarzyna J
authors.initials: KJ
authors.lastname: Zienkiewicz
authors.affiliation: 3 Department of Periodontics, University of Texas Health Science Center at San Antonio , San Antonio, Texas.
authors.forename: David L
authors.initials: DL
authors.lastname: Cochran
authors.affiliation: 1 Department of Chemical and Biomolecular Engineering, Vanderbilt University , Nashville, Tennessee.|4 Department of Biomedical Engineering, Vanderbilt University , Nashville, Tennessee.|5 Center for Bone Biology, Vanderbilt University Medical Center , Nashville, Tennessee.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Guelcher
mesh_terms: D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D000818:Animals; D055396:Bone Morphogenetic Protein 2 / Q000494:pharmacology*; D002516:Ceramics / Q000494:pharmacology*; D004195:Disease Models, Animal; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008334:Mandible / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D010012:Osteogenesis / Q000187:drug effects*; D011994:Recombinant Proteins / Q000494:pharmacology; D013027:Space Maintenance, Orthodontic; D016212:Transforming Growth Factor beta / Q000494:pharmacology*; D055114:X-Ray Microtomography
chemical_list: D055396:Bone Morphogenetic Protein 2; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2