Facial pain after dental implant installation on maxilla

Abstract

Objectives: To evaluate the efficacy of demineralised dentin matrix (DDM) fixed with recombinant human bone morphogenetic protein-2 (rhBMP-2) through experimental and clinical study. Methods: Experimental study: unilateral upper second and third premolars of eight beagles were extracted. The mucoperiosteal flap was elevated around extraction socket and bone defect was formed by surgical drill. Each DDM fixed with rhBMP-2 and autogenous bone were grafted at bone defect area with collagenous membrane. Beagles were sacrificed at 2, 4, 8, 12 weeks after bone graft. Block specimens involving grafted bone and surrounding nature bone were extracted. Clinical Study: A total of 23 patients who received bone graft using human DDM fixed with rhBMP-2 (AutoBT BMP) with implant placements (36 implants; maxilla: 14, mandible: 22) were selected. The implant stability, marginal bone loss and clinical outcome were evaluated. Findings: In the histological evaluation, four weeks after bone graft, autogenous bone showed 41% of new bone formation and DDM fixed with rhBMP-2 showed 5% of new bone formation. Eight weeks after bone graft, autogenous bone showed 46% of new bone formation and DDM fixed with rhBMP-2 showed 13% of new bone formation. At periapical radiograph, both groups showed newly formed bone which was continuously connected with the original bone. Favourable osseointegration was obtained in 35 out of 36 implant sites (one osseointegration failure). In all cases, severe complications were not observed. Conclusion: DDM fixed with rhBMP-2 (AutoBT BMP) provided good osteoinductive and osteoconductive potentials and clinical efficacy.