Home  About us  Contact
 

Alveolar Ridge Augmentation (alveolar + ridge_augmentation)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

rhBMP-2/,BSM® Induces Significant Vertical Alveolar Ridge Augmentation and Dental Implant Osseointegration

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2002
Ulf M.E. Wikesjö DDS
ABSTRACT Background: Recombinant human bone morphogenetic protein 2 (rhBMP-2) in a carrier has been shown to induce significant bone formation. Several candidate carriers, however, lack structural integrity to offset compressive forces that may compromise rhBMP-2 bone induction, in particular, for challenging onlay indications such as alveolar ridge augmentation. Purpose: The objective of this study was to evaluate rhBMP-2 in a calcium-phosphate cement carrier, ,BSM, for vertical alveolar ridge augmentation and immediate dental implant Osseointegration. Materials and Methods: Six adult Hound Labrador mongrels with 5 mm critical size supra-alveolar peri-implant defects were used. Three animals received rhBMP-2/,BSM (rhBMP-2 at 0.40 and 0.75 mg/mL) in contralateral jaw quadrants (total implant volume/defect , 1.5 mL). Three animals received ,BSM without rhBMP-2 (control group). The animals were euthanized at 16 weeks post surgery, and block biopsies were processed for histologie and histometric analysis. Results: rhBMP-2/,BSM induced substantial augmentation of the alveolar ridge. Control sites exhibited limited new bone formation. Vertical bone augmentation averaged (SD) 4.9 ± 1.0 mm (rhBMP-2 at 0.40 mg/mL), 5.3 ± 0.3 mm (rhBMP-2 at 0.75 mg/mL), and 0.4 ± 0.4 mm (control); new bone area 8.5 ± 4.2 mm 2, 9.0 ± 1.9 mm 2, and 0.5 ± 0.4 mm 2; new bone density 55.1 ± 6.4%, 61.1 ± 6.0%, and 67.7 ± 9.5%; and new bone-implant contact 26.9 ± 17.5%, 28.5 ± 1.4%, and 24.6 ± 16.1%, respectively. Residual ,BSM comprised 1% of the new bone. Bone density for the contiguous resident bone ranged from 65 to 71%, and bone-implant contact ranged from 49 to 64%. Conclusions: Surgical implantation of rhBMP-2/,BSM appears an effective protocol for vertical alveolar ridge augmentation procedures and immediate dental implant Osseointegration and for onlay indications of lesser complexity. [source]

Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5: histologic observations

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2010
Giuseppe Polimeni
Polimeni G, Wikesjö UME, Susin C, Qahash M, Shanaman RH, Prasad HS, Rohrer MD, Hall J. Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5: histologic observations. J Clin Periodontol 2010; 37: 759-768 doi: 10.1111/j.1600-051X.2010.01579.x. Abstract Objectives: In vitro and in vivo preclinical studies suggest that growth/differentiation factor-5 (GDF-5) may induce local bone formation. The objective of this study was to evaluate the potential of recombinant human GDF-5 (rhGDF-5) coated onto an oral implant with a purpose-designed titanium porous oxide surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Materials and Methods: Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with 30 or 60 ,g rhGDF-5, and six animals received implants coated with 120 ,g rhGDF-5 or left uncoated (control). Treatments were alternated between jaw quadrants. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7, and 8 post-surgery when they were euthanized for histologic evaluation. Results: The clinical examination showed no noteworthy differences between implants coated with rhGDF-5. The cover screw and implant body were visible/palpable through the alveolar mucosa for both rhGDF-5-coated and control implants. There was a small increase in induced bone height for implants coated with rhGDF-5 compared with the control, induced bone height averaging (±SD) 1.6±0.6 mm for implants coated with 120 ,g rhGDF-5 versus 1.2±0.5, 1.2±0.6, and 0.6±0.2 mm for implants coated with 60 ,g rhGDF-5, 30 ,g rhGDF-5, or left uncoated, respectively (p<0.05). Bone formation was predominant at the lingual aspect of the implants. Narrow yellow and orange fluorescent markers throughout the newly formed bone indicate relatively slow new bone formation within 3,4 weeks. Implants coated with rhGDF-5 displayed limited peri-implant bone remodelling in the resident bone; the 120 ,g dose exhibiting more advanced remodelling than the 60 and 30 ,g doses. All treatment groups exhibited clinically relevant osseointegration. Conclusions: rhGDF-5-coated oral implants display a dose-dependent osteoinductive and/or osteoconductive effect, bone formation apparently benefiting from local factors. Application of rhGDF-5 appears to be safe as it is associated with limited, if any, adverse effects. [source]

Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): histological observations

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2010
Cristiano Susin
Susin C, Qahash M, Polimeni G, Lu PH, Prasad HS, Rohrer MD, Hall J, Wikesjö UME. Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): histological observations. J Clin Periodontol 2010; 37: 574,581. doi: 10.1111/j.1600-051X.2010.01554.x. Abstract Background: Pre-clinical studies have shown that recombinant human bone morphogenetic protein-2 (rhBMP-2) coated onto purpose-designed titanium porous-oxide surface implants induces clinically relevant bone formation and osseointegration. The objective of this study was to examine the potential of rhBMP-7, also known as recombinant human osteogenic protein-1 (rhOP-1), coated onto titanium porous-oxide surface implants to support vertical alveolar ridge augmentation and implant osseointegration. Materials and Methods: Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in six young adult Hound Labrador mongrel dogs. The animals received implants coated with rhBMP-7 at 1.5 or 3.0 mg/ml randomized to contra-lateral jaw quadrants. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at 3, 4, 7, and 8 weeks post-surgery when they were euthanized for histological evaluation. Results: Without striking differences between treatments, the implant sites exhibited a swelling that gradually regressed to become hard to palpation disguising the implant contours. The histological evaluation showed robust bone formation; the newly formed bone assuming characteristics of the contiguous resident bone, bone formation (height and area) averaging 4.1±1.0 versus 3.6±1.7 mm and 3.6±1.9 versus 3.1±1.8 mm2; and bone density 56%versus 50% for implants coated with rhBMP-7 at 1.5 and 3.0 mg/ml, respectively. Both treatments exhibited clinically relevant osseointegration, the corresponding bone,implant contact values averaging 51% and 47%. Notable peri-implant resident bone remodelling was observed for implants coated with rhBMP-7 at 3.0 mg/ml. Conclusions: rhBMP-7 coated onto titanium porous-oxide surface implants induces clinically relevant local bone formation including osseointegration and vertical augmentation of the alveolar ridge, the higher concentration/dose associated with some local side effects. [source]

Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2: histologic observations

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2008
Ulf M. E. Wikesjö
Abstract Background: Studies using ectopic rodent, orthotopic canine, and non-human primate models show that bone morphogenetic proteins (BMPs) coated onto titanium surfaces induce local bone formation. The objective of this study was to examine the ability of recombinant human BMP-2 (rhBMP-2) coated onto a titanium porous oxide implant surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Material and Methods: Bilateral, critical-size, 5 mm, supra-alveolar, peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml, and six animals received implants coated with rhBMP-2 at 3.0 mg/ml or uncoated control. Treatments were randomized between jaw quadrants. The mucoperiosteal flaps were advanced, adapted and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7 and 8 post-surgery when they were euthanized for histologic evaluation. Results: Jaw quadrants receiving implants coated with rhBMP-2 exhibited gradually regressing swelling that became hard to palpate disguising the contours of the implants. The histologic evaluation showed robust bone formation reaching or exceeding the implant platform. The newly formed bone exhibited characteristics of the adjoining resident Type II bone including cortex formation for sites receiving implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml. Sites receiving implants coated with rhBMP-2 at 3.0 mg/ml exhibited more immature trabecular bone formation, seroma formation and peri-implant bone remodelling resulting in undesirable implant displacement. Control implants exhibited minimal, if any, bone formation. Thus, implants coated with rhBMP-2 at 0.75, 1.5 and 3.0 mg/ml exhibited significant bone formation (height and area) compared with the sham-surgery control averaging (±SD) 4.4±0.4, 4.2±0.7 and 4.2±1.2 versus 0.8±0.3 mm; and 5.0±2.2, 5.6±2.2 and 7.4±3.5 versus 0.7±0.3 mm2, respectively (p<0.01). All the treatment groups exhibited clinically relevant osseointegration. Conclusions: rhBMP-2 coated onto titanium porous oxide implant surfaces induced clinically relevant local bone formation including vertical augmentation of the alveolar ridge and osseointegration. Higher concentrations/doses were associated with untoward effects. [source]

Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): radiographic observations

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2008
Knut N. Leknes
Abstract Aim: The objective of this study was to radiographically evaluate the potential of a purpose-designed titanium porous-oxide implant surface coated with recombinant human bone morphogenetic protein-7 (rhBMP-7), also known as recombinant human osteogenic protein-1 (rhOP-1), to stimulate alveolar ridge augmentation. Material and Methods: Six young-adult Hound Labrador mongrel dogs were used. Three 10 mm titanium oral implants per jaw quadrant were placed 5 mm into the alveolar ridge in the posterior mandible following surgical extraction of the pre-molar teeth and reduction of the alveolar ridge leaving 5 mm of the implants in a supra-alveolar position. The implants had been coated with rhBMP-7 at 1.5 or 3.0 mg/ml and were randomized to contralateral jaw quadrants using a split-mouth design. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants. Radiographic registrations were made immediately post-surgery (baseline), and at weeks 4 and 8 (end of study). Results: rhBMP-7-coated implants exhibited robust radiographic bone formation. At 8 weeks, bone formation averaged 4.4 and 4.2 mm for implants coated with rhBMP-7 at 1.5 and 3.0 mg/ml, respectively. There were no significant differences between the rhBMP-7 concentrations at any observation interval. A majority of the implant sites showed voids within the newly formed bone at week 4 that generally resolved by week 8. The newly formed bone assumed characteristics of the resident bone. Conclusions: The titanium porous-oxide implant surface serves as an effective carrier for rhBMP-7 showing a clinically significant potential to stimulate local bone formation. [source]

Alveolar ridge augmentation with a prototype trilayer membrane and various bone grafts: a histomorphometric study in baboons

CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2005
Dieter Busenlechner
Abstract: Barrier membranes have become a standard treatment option in alveolar ridge augmentation prior to implant placement. However, non-resorbable membranes require secondary surgery and resorbable membranes show an unfavorable degradation profile. The purpose of this study was to evaluate the potential of a slowly biodegradable/bioresorbable prototype trilayer membrane (PTLM) for supporting bone regeneration in alveolar ridge augmentation. Clinically relevant cavities were made 3 months after the extraction of the first and second molars in each jaw of six baboons. Each animal was treated with four different regimens: (1) autogenous bone block (ABB) alone, (2) ABB+PTLM, (3) deproteinized bovine bone mineral (DBBM)+PTLM and (4) no treatment. After 9 months, the baboons were sacrificed and block sections of the augmented area were subjected to histologic and histomorphometric analyses. Newly formed bone areas were determined at a distance of 1, 3, 7 and 10 mm from crestal. The data showed a well-preserved ridge profile at the membrane-protected sites, whereas non-protected bone blocks and control sites underwent severe resorption resulting in knife-edge ridge profiles. Significant differences were found between ABB+PTLM and ABB (P=0.0137,0.0232). DBBM+PTLM also produced a larger bone area compared with ABB alone (P=0.0396,0.0439). No significant difference in bone area was detectable between ABB+PTLM and DBBM+PTLM (P>0.05). The present study supports the use of the slowly biodegradable/bioresorbable PTLM with autografts and DBBM for lateral ridge augmentation in this type of bone defects. Résumé Les membranes barrière sont devenues une option de traitement standard dans l'épaississement du rebord alvéolaire avant le placement des implants. Cependant, des membranes non-résorbables requièrent une seconde chirurgie et les membranes résorbables montrent un profil de dégradation peu favorable. Le but de cette étude a été d'évaluer le potentiel d'une membrane prototype de trois épaisseurs (PTLM) qui était biodégradable/biorésorbable lentement pour aider la régénération osseuse dans les épaississements de rebord alvéolaire. Des cavités cliniques ont été creusées trois mois après l'avulsion des premières et deuxièmes molaires de chaque mâchoire chez six babouins. Chaque animal a été traité de quatre manières différentes : 1) un bloc osseux autogène (ABB), 2) ABB+PTLM, 3) la partie minérale de l'os bovin déprotéiné (DBBM)+PTLM et 4) pas de traitement. Après neuf mois les babouins ont été euthanasiés et des coupes en blocs de la région épaissie ont été soumises aux analyses histologiques et histomorphométriques. Les zones d'os néoforméétaient déterminées à une distance de 1, 3, 7 et 10 mm du rebord alvéolaire. Les données ont montré un profil bien préservé au niveau des sites protégés par les membranes tandis que les blocs osseux non-protégés et les sites contrôles subissaient une résorption importante en un profil en forme de lame de couteau. Des différences significatives ont été trouvées entre ABB+PTLM et ABB (P=0,0137 àP=0,0232). DBBM+PTLM produisait aussi une aire osseuse plus importante comparéà ABB seul (P=0,0396 àP=0,0439). Aucune différence significative dans l'aire osseuse n'était visible entre ABB+PTLM et DBBM+PTLM (P>0,05). L'étude présente prône l'utilisation de la membrane prototype en trois couches biodégradable/biorésorbable lentement avec du minéral osseux bovin déprotéiné et des autogreffes pour l'augmentation latérale du rebord alvéolaire dans ce type de lésions osseuses. Zusammenfassung Muss vor der Implantation eine Knochenkammaugmentation durchgeführt werden, so ist die GBR mit der Membrantechnik als Standardbehandlung anzuführen. Nichtresorbierbare Membranen erfordern jedoch einen chirurgischen Zweiteingriff, und resorbierbare Membranen zeigen ein ungünstiges Verhalten während der Resorptionsphase. Das Ziel dieser Studie war, bei der GBR die Platzhalterfunktion des Prototyps einer dreischichtig aufgebautenen Membran (PTLM) zu untersuchen, die langsam biologisch abgebaut und resorbiert wird. Drei Monate nach der Extraktion der ersten und zweiten Molaren in jedem Kiefer von sechs Pavianaffen präparierte man klinisch relevante Kavitäten. Jedes Tier erhielt vier verschiedene Behandlungsmodalitäten: (1) nur autologe Knochenblöcke (ABB), (2) ABB+PTLM, (3) entproteinisiertes Knochenmineral vom Rind (DBBM)+PTLM und (4) keine Behandlung. Nach 9 Monaten opferte man die Paviane, entnahm von den aufgebauten Stellen Blockbiopsien und bereitete sie für die histologischen und histomorphometrischen Analysen auf. Auf die Suche nach Regionen mit neu gebildetem Knochen ging man in 1, 3, 7 und 10 mm Entfernung vom crestalen Knochen. Die Daten zeigten bei den mit Membranen abgedeckten und geschützten Stellen ein gut erhaltenes Alveolarkammprofil. Bei den ungeschützten Knochenblöcken und den Kontrollstellen kam es zu ausgedehnten Resorptionen, es resultierten messerscharf auslaufende Kammprofile. Man fand signifikante Unterschiede zwischen ABB+PTLM und ABB (P=0.0137 zu P=0.232). Auch DBBM+PTLM brachte, verglichen mit nur ABB, eine bessere Knochenauffüllung (P=0.0396 zu P=0.0439). Zwischen den Varianten ABB+PTLM und DBBM+PTLM fanden sich im untersuchten Kochen keine signifikanten Unterschiede (P>0.05). Diese Arbeit befürwortet bei der lateralen Knochenkammaugmentation eines solchen Knochendefektes den Einsatz eines Prototyps einer dreischichtigen Membran (PTLM), die langsam biologisch abgebaut und resorbiert wird, sowie von autologen Knochentransplantaten und entproteinisiertem Knochenmineral vom Rind. Resumen Las membranas de barrera se han convertido en una opción estándar de tratamiento en aumento de la cresta alveolar previo a la colocación del implante. De todos modos, las membranas no reabsorbibles requieren de un segundo procedimiento quirúrgico y las membranas reabsorbibles muestran un perfil de degradación desfavorable. El propósito de este estudio fue evaluar el potencial de un prototipo de membrana de tres capas (PTLM) biodegradable/biorreabsorbible para apoyar la regeneración ósea en el aumento de la cresta alveolar. Se realizaron cavidades clínicamente relevantes tres meses después de la extracción del primer y segundo molares de cada mandíbula de seis babuinos. Cada animal se trató con cuatro diferentes regímenes: (1) bloque de hueso autógeno (ABB) únicamente, (2) ABB+ PTLM, (3) hueso mineral bovino desproteinizado (DBBM)+PTLM y (4) sin tratamiento. Tras 9 meses se sacrificó a los babuinos y secciones en bloque del área aumentada se sometieron a análisis histológicos e histomorfométricos. Se determinaron las áreas de hueso neoformado a una distancia de 1, 3, 7, y 10 mm de la cresta. Los datos mostraron un perfil de la cresta bien preservado en los lugares protegidos por la membrana, mientras que los bloques de hueso no protegido y los lugares de control sufrieron una severa reabsorción resultando en unos perfiles de cresta en filo de cuchillo. Se encontraron diferencias significativas entre ABB+PTLM y ABB (P=0.0137 a P=0.0232). DBBM+PTLM también produjeron unas áreas mayores de hueso comparadas con ABB únicamente (P=0.0396 a P=0.0439). No se detectaron diferencias significativas entre ABB+PTLM y DBBM+PTLM (P>0.05). El presente estudio apoya el uso del prototipo de membrana de tres capas lentamente biodegradable/biorreabsorbible con autoinjertos y hueso mineral bovino desproteinizado para aumento lateral de la cresta en este tipo de defectos. [source]

Platelet-rich plasma may prevent titanium-mesh exposure in alveolar ridge augmentation with anorganic bovine bone

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2010
Jesús Torres
Torres J, Tamimi F, Alkhraisat MH, Manchón Á, Linares R, Prados-Frutos JC, Hernández G, López Cabarcos E. Platelet-rich plasma may prevent titanium-mesh exposure in alveolar ridge augmentation with anorganic bovine bone. J Clin Periodontol 2010; 37: 943,951. doi: 10.1111/j.1600-051X.2010.01615.x. Abstract Objective: Bone augmentation with the titanium-mesh (Ti-mesh) technique is susceptible to a large rate of complications such as morbidity of bone graft donor site, and mesh exposure to the oral cavity. The purpose of this study was to evaluate the effectiveness of anorganic bovine bone (ABB) in alveolar bone augmentation with the Ti-mesh technique. In addition, we investigated the effect of platelet-rich plasma (PRP) in preventing mesh exposure by using it to cover the Ti-mesh. Patients and Methods: Patients included in the clinical trial were randomly allocated by a blinded assistant into two groups. The 30 patients recruited for this study underwent 43 alveolar bone augmentation with the Ti-mesh technique using ABB as graft material in all of them. In 15 patients, the Ti-meshes were covered with PRP (PRP group) whereas in the other 15 the Ti-meshes were not (control group). After 6 months, patients were called for clinical, radiographic, and histological evaluation, and implant placement surgery. A total of 97 implants were placed in the augmented bone and their evolution was followed up for a period of 24 months. Results: Significant differences were found between the two study groups in terms of complications and bone formation. In the control group, 28.5% of the cases suffered from mesh exposure, while in the PRP group, no exposures were registered. Radiographic analysis revealed that bone augmentation was higher in the PRP group than in the control group. Overall, 97.3% of implants placed in the control group and 100% of those placed in the PRP group were successful during the monitoring period. We suggest that the positive effect of PRP on the Ti-mesh technique is due to its capacity to improve soft tissue healing, thereby protecting the mesh and graft material secured beneath the gingival tissues. Conclusions: Alveolar bone augmentation using ABB alone in the Ti-mesh technique is sufficient for implant rehabilitation. Besides, covering the Ti-meshes with PRP was a determining factor in avoiding mesh exposure. Ti-mesh exposure provoked significant bone loss, but in most cases it did not affect the subsequent placement of implants. [source]

Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): histological observations

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2010
Cristiano Susin
Susin C, Qahash M, Polimeni G, Lu PH, Prasad HS, Rohrer MD, Hall J, Wikesjö UME. Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): histological observations. J Clin Periodontol 2010; 37: 574,581. doi: 10.1111/j.1600-051X.2010.01554.x. Abstract Background: Pre-clinical studies have shown that recombinant human bone morphogenetic protein-2 (rhBMP-2) coated onto purpose-designed titanium porous-oxide surface implants induces clinically relevant bone formation and osseointegration. The objective of this study was to examine the potential of rhBMP-7, also known as recombinant human osteogenic protein-1 (rhOP-1), coated onto titanium porous-oxide surface implants to support vertical alveolar ridge augmentation and implant osseointegration. Materials and Methods: Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in six young adult Hound Labrador mongrel dogs. The animals received implants coated with rhBMP-7 at 1.5 or 3.0 mg/ml randomized to contra-lateral jaw quadrants. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at 3, 4, 7, and 8 weeks post-surgery when they were euthanized for histological evaluation. Results: Without striking differences between treatments, the implant sites exhibited a swelling that gradually regressed to become hard to palpation disguising the implant contours. The histological evaluation showed robust bone formation; the newly formed bone assuming characteristics of the contiguous resident bone, bone formation (height and area) averaging 4.1±1.0 versus 3.6±1.7 mm and 3.6±1.9 versus 3.1±1.8 mm2; and bone density 56%versus 50% for implants coated with rhBMP-7 at 1.5 and 3.0 mg/ml, respectively. Both treatments exhibited clinically relevant osseointegration, the corresponding bone,implant contact values averaging 51% and 47%. Notable peri-implant resident bone remodelling was observed for implants coated with rhBMP-7 at 3.0 mg/ml. Conclusions: rhBMP-7 coated onto titanium porous-oxide surface implants induces clinically relevant local bone formation including osseointegration and vertical augmentation of the alveolar ridge, the higher concentration/dose associated with some local side effects. [source]

Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): radiographic observations

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2008
Knut N. Leknes
Abstract Aim: The objective of this study was to radiographically evaluate the potential of a purpose-designed titanium porous-oxide implant surface coated with recombinant human bone morphogenetic protein-7 (rhBMP-7), also known as recombinant human osteogenic protein-1 (rhOP-1), to stimulate alveolar ridge augmentation. Material and Methods: Six young-adult Hound Labrador mongrel dogs were used. Three 10 mm titanium oral implants per jaw quadrant were placed 5 mm into the alveolar ridge in the posterior mandible following surgical extraction of the pre-molar teeth and reduction of the alveolar ridge leaving 5 mm of the implants in a supra-alveolar position. The implants had been coated with rhBMP-7 at 1.5 or 3.0 mg/ml and were randomized to contralateral jaw quadrants using a split-mouth design. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants. Radiographic registrations were made immediately post-surgery (baseline), and at weeks 4 and 8 (end of study). Results: rhBMP-7-coated implants exhibited robust radiographic bone formation. At 8 weeks, bone formation averaged 4.4 and 4.2 mm for implants coated with rhBMP-7 at 1.5 and 3.0 mg/ml, respectively. There were no significant differences between the rhBMP-7 concentrations at any observation interval. A majority of the implant sites showed voids within the newly formed bone at week 4 that generally resolved by week 8. The newly formed bone assumed characteristics of the resident bone. Conclusions: The titanium porous-oxide implant surface serves as an effective carrier for rhBMP-7 showing a clinically significant potential to stimulate local bone formation. [source]

rhBMP-2/,BSM® Induces Significant Vertical Alveolar Ridge Augmentation and Dental Implant Osseointegration

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2002
Ulf M.E. Wikesjö DDS
ABSTRACT Background: Recombinant human bone morphogenetic protein 2 (rhBMP-2) in a carrier has been shown to induce significant bone formation. Several candidate carriers, however, lack structural integrity to offset compressive forces that may compromise rhBMP-2 bone induction, in particular, for challenging onlay indications such as alveolar ridge augmentation. Purpose: The objective of this study was to evaluate rhBMP-2 in a calcium-phosphate cement carrier, ,BSM, for vertical alveolar ridge augmentation and immediate dental implant Osseointegration. Materials and Methods: Six adult Hound Labrador mongrels with 5 mm critical size supra-alveolar peri-implant defects were used. Three animals received rhBMP-2/,BSM (rhBMP-2 at 0.40 and 0.75 mg/mL) in contralateral jaw quadrants (total implant volume/defect , 1.5 mL). Three animals received ,BSM without rhBMP-2 (control group). The animals were euthanized at 16 weeks post surgery, and block biopsies were processed for histologie and histometric analysis. Results: rhBMP-2/,BSM induced substantial augmentation of the alveolar ridge. Control sites exhibited limited new bone formation. Vertical bone augmentation averaged (SD) 4.9 ± 1.0 mm (rhBMP-2 at 0.40 mg/mL), 5.3 ± 0.3 mm (rhBMP-2 at 0.75 mg/mL), and 0.4 ± 0.4 mm (control); new bone area 8.5 ± 4.2 mm 2, 9.0 ± 1.9 mm 2, and 0.5 ± 0.4 mm 2; new bone density 55.1 ± 6.4%, 61.1 ± 6.0%, and 67.7 ± 9.5%; and new bone-implant contact 26.9 ± 17.5%, 28.5 ± 1.4%, and 24.6 ± 16.1%, respectively. Residual ,BSM comprised 1% of the new bone. Bone density for the contiguous resident bone ranged from 65 to 71%, and bone-implant contact ranged from 49 to 64%. Conclusions: Surgical implantation of rhBMP-2/,BSM appears an effective protocol for vertical alveolar ridge augmentation procedures and immediate dental implant Osseointegration and for onlay indications of lesser complexity. [source]

Alveolar ridge augmentation with a prototype trilayer membrane and various bone grafts: a histomorphometric study in baboons

CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2005
Dieter Busenlechner
Abstract: Barrier membranes have become a standard treatment option in alveolar ridge augmentation prior to implant placement. However, non-resorbable membranes require secondary surgery and resorbable membranes show an unfavorable degradation profile. The purpose of this study was to evaluate the potential of a slowly biodegradable/bioresorbable prototype trilayer membrane (PTLM) for supporting bone regeneration in alveolar ridge augmentation. Clinically relevant cavities were made 3 months after the extraction of the first and second molars in each jaw of six baboons. Each animal was treated with four different regimens: (1) autogenous bone block (ABB) alone, (2) ABB+PTLM, (3) deproteinized bovine bone mineral (DBBM)+PTLM and (4) no treatment. After 9 months, the baboons were sacrificed and block sections of the augmented area were subjected to histologic and histomorphometric analyses. Newly formed bone areas were determined at a distance of 1, 3, 7 and 10 mm from crestal. The data showed a well-preserved ridge profile at the membrane-protected sites, whereas non-protected bone blocks and control sites underwent severe resorption resulting in knife-edge ridge profiles. Significant differences were found between ABB+PTLM and ABB (P=0.0137,0.0232). DBBM+PTLM also produced a larger bone area compared with ABB alone (P=0.0396,0.0439). No significant difference in bone area was detectable between ABB+PTLM and DBBM+PTLM (P>0.05). The present study supports the use of the slowly biodegradable/bioresorbable PTLM with autografts and DBBM for lateral ridge augmentation in this type of bone defects. Résumé Les membranes barrière sont devenues une option de traitement standard dans l'épaississement du rebord alvéolaire avant le placement des implants. Cependant, des membranes non-résorbables requièrent une seconde chirurgie et les membranes résorbables montrent un profil de dégradation peu favorable. Le but de cette étude a été d'évaluer le potentiel d'une membrane prototype de trois épaisseurs (PTLM) qui était biodégradable/biorésorbable lentement pour aider la régénération osseuse dans les épaississements de rebord alvéolaire. Des cavités cliniques ont été creusées trois mois après l'avulsion des premières et deuxièmes molaires de chaque mâchoire chez six babouins. Chaque animal a été traité de quatre manières différentes : 1) un bloc osseux autogène (ABB), 2) ABB+PTLM, 3) la partie minérale de l'os bovin déprotéiné (DBBM)+PTLM et 4) pas de traitement. Après neuf mois les babouins ont été euthanasiés et des coupes en blocs de la région épaissie ont été soumises aux analyses histologiques et histomorphométriques. Les zones d'os néoforméétaient déterminées à une distance de 1, 3, 7 et 10 mm du rebord alvéolaire. Les données ont montré un profil bien préservé au niveau des sites protégés par les membranes tandis que les blocs osseux non-protégés et les sites contrôles subissaient une résorption importante en un profil en forme de lame de couteau. Des différences significatives ont été trouvées entre ABB+PTLM et ABB (P=0,0137 àP=0,0232). DBBM+PTLM produisait aussi une aire osseuse plus importante comparéà ABB seul (P=0,0396 àP=0,0439). Aucune différence significative dans l'aire osseuse n'était visible entre ABB+PTLM et DBBM+PTLM (P>0,05). L'étude présente prône l'utilisation de la membrane prototype en trois couches biodégradable/biorésorbable lentement avec du minéral osseux bovin déprotéiné et des autogreffes pour l'augmentation latérale du rebord alvéolaire dans ce type de lésions osseuses. Zusammenfassung Muss vor der Implantation eine Knochenkammaugmentation durchgeführt werden, so ist die GBR mit der Membrantechnik als Standardbehandlung anzuführen. Nichtresorbierbare Membranen erfordern jedoch einen chirurgischen Zweiteingriff, und resorbierbare Membranen zeigen ein ungünstiges Verhalten während der Resorptionsphase. Das Ziel dieser Studie war, bei der GBR die Platzhalterfunktion des Prototyps einer dreischichtig aufgebautenen Membran (PTLM) zu untersuchen, die langsam biologisch abgebaut und resorbiert wird. Drei Monate nach der Extraktion der ersten und zweiten Molaren in jedem Kiefer von sechs Pavianaffen präparierte man klinisch relevante Kavitäten. Jedes Tier erhielt vier verschiedene Behandlungsmodalitäten: (1) nur autologe Knochenblöcke (ABB), (2) ABB+PTLM, (3) entproteinisiertes Knochenmineral vom Rind (DBBM)+PTLM und (4) keine Behandlung. Nach 9 Monaten opferte man die Paviane, entnahm von den aufgebauten Stellen Blockbiopsien und bereitete sie für die histologischen und histomorphometrischen Analysen auf. Auf die Suche nach Regionen mit neu gebildetem Knochen ging man in 1, 3, 7 und 10 mm Entfernung vom crestalen Knochen. Die Daten zeigten bei den mit Membranen abgedeckten und geschützten Stellen ein gut erhaltenes Alveolarkammprofil. Bei den ungeschützten Knochenblöcken und den Kontrollstellen kam es zu ausgedehnten Resorptionen, es resultierten messerscharf auslaufende Kammprofile. Man fand signifikante Unterschiede zwischen ABB+PTLM und ABB (P=0.0137 zu P=0.232). Auch DBBM+PTLM brachte, verglichen mit nur ABB, eine bessere Knochenauffüllung (P=0.0396 zu P=0.0439). Zwischen den Varianten ABB+PTLM und DBBM+PTLM fanden sich im untersuchten Kochen keine signifikanten Unterschiede (P>0.05). Diese Arbeit befürwortet bei der lateralen Knochenkammaugmentation eines solchen Knochendefektes den Einsatz eines Prototyps einer dreischichtigen Membran (PTLM), die langsam biologisch abgebaut und resorbiert wird, sowie von autologen Knochentransplantaten und entproteinisiertem Knochenmineral vom Rind. Resumen Las membranas de barrera se han convertido en una opción estándar de tratamiento en aumento de la cresta alveolar previo a la colocación del implante. De todos modos, las membranas no reabsorbibles requieren de un segundo procedimiento quirúrgico y las membranas reabsorbibles muestran un perfil de degradación desfavorable. El propósito de este estudio fue evaluar el potencial de un prototipo de membrana de tres capas (PTLM) biodegradable/biorreabsorbible para apoyar la regeneración ósea en el aumento de la cresta alveolar. Se realizaron cavidades clínicamente relevantes tres meses después de la extracción del primer y segundo molares de cada mandíbula de seis babuinos. Cada animal se trató con cuatro diferentes regímenes: (1) bloque de hueso autógeno (ABB) únicamente, (2) ABB+ PTLM, (3) hueso mineral bovino desproteinizado (DBBM)+PTLM y (4) sin tratamiento. Tras 9 meses se sacrificó a los babuinos y secciones en bloque del área aumentada se sometieron a análisis histológicos e histomorfométricos. Se determinaron las áreas de hueso neoformado a una distancia de 1, 3, 7, y 10 mm de la cresta. Los datos mostraron un perfil de la cresta bien preservado en los lugares protegidos por la membrana, mientras que los bloques de hueso no protegido y los lugares de control sufrieron una severa reabsorción resultando en unos perfiles de cresta en filo de cuchillo. Se encontraron diferencias significativas entre ABB+PTLM y ABB (P=0.0137 a P=0.0232). DBBM+PTLM también produjeron unas áreas mayores de hueso comparadas con ABB únicamente (P=0.0396 a P=0.0439). No se detectaron diferencias significativas entre ABB+PTLM y DBBM+PTLM (P>0.05). El presente estudio apoya el uso del prototipo de membrana de tres capas lentamente biodegradable/biorreabsorbible con autoinjertos y hueso mineral bovino desproteinizado para aumento lateral de la cresta en este tipo de defectos. [source]