Horizontal ridge augmentation of the atrophic anterior maxilla using rhBMP-2/ACS or autogenous bone grafts: a proof-of-concept randomized clinical trial

J Clin Periodontol. 2013 Oct;40(10):968-75. doi: 10.1111/jcpe.12148.

Abstract

Aim: 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.

Keywords: alveolar ridge augmentation; autogenous bone graft; randomized-controlled trial; recombinant human bone morphogenetic protein; rhBMP-2.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorbable Implants
  • Adult
  • Alveolar Process / diagnostic imaging
  • Alveolar Ridge Augmentation / methods*
  • Atrophy
  • Autografts / transplantation*
  • Biocompatible Materials / chemistry
  • Bone Morphogenetic Protein 2 / therapeutic use*
  • Bone Transplantation / methods*
  • Collagen
  • Cone-Beam Computed Tomography / methods
  • Dental Implantation, Endosseous / methods
  • Dental Implants
  • Drug Carriers
  • Female
  • Follow-Up Studies
  • Humans
  • Jaw, Edentulous, Partially / diagnostic imaging
  • Jaw, Edentulous, Partially / surgery
  • Male
  • Maxilla / diagnostic imaging
  • Maxilla / surgery*
  • Middle Aged
  • Osteogenesis / physiology
  • Recombinant Proteins / therapeutic use
  • Surgical Mesh
  • Titanium / chemistry
  • Transforming Growth Factor beta / therapeutic use*

Substances

  • Biocompatible Materials
  • Bone Morphogenetic Protein 2
  • Dental Implants
  • Drug Carriers
  • Recombinant Proteins
  • Transforming Growth Factor beta
  • recombinant human bone morphogenetic protein-2
  • Collagen
  • Titanium