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

• Published in: Journal of clinical periodontology Vol. 40; no. 10; pp. 968 - 975
• Main Authors: de Freitas, Rubens Moreno, Susin, Cristiano, Spin-Neto, Rubens, Marcantonio, Claudio, Wikesjö, Ulf M. E., Pereira, Luís Antônio Violin Dias, Marcantonio Jr, Elcio
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.10.2013
• Subjects: Absorbable Implants; Adult; Alveolar Process - diagnostic imaging; alveolar ridge augmentation; Alveolar Ridge Augmentation - methods; Atrophy; autogenous bone graft; Autografts - transplantation; Biocompatible Materials - chemistry; Bone Morphogenetic Protein 2 - therapeutic use; Bone Transplantation - methods; Clinical trials; Collagen; Cone-Beam Computed Tomography - methods; Dental Implantation, Endosseous - methods; Dental Implants; Dentistry; 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; randomized-controlled trial; recombinant human bone morphogenetic protein; Recombinant Proteins - therapeutic use; rhBMP-2; Surgical Mesh; Titanium - chemistry; Transforming Growth Factor beta - therapeutic use; Transplants & implants; randomized-controlled trial; recombinant human bone morphogenetic protein; rhBMP-2; alveolar ridge augmentation; autogenous bone graft
• ISSN: 0303-6979; 1600-051X; 1600-051X
• DOI: 10.1111/jcpe.12148

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. View the pubcast on this paper at http://www.scivee.tv/journalnode/60739