Influence of rhBMP-2 on bone formation and osseointegration in different implant systems after sinus-floor elevation. An in vivo study on sheep

Abstract

SUMMARY.Background: Several studies have reported certain bone morphogenic proteins (BMPs) to have positive effects on bone generation. Although some investigators have studied the effects of human recombinant BMP (rhBMP-2) in sinus augmentation in sheep, none of these studies looked at the placement of implants at the time of sinus augmentation. Furthermore, no literature could be found to report on the impact that different implant systems, as well as the positioning of the implants had on bone formation if rhBMP-2 was utilized in sinus-lift procedures. Purpose: The aim of this study was to compare sinus augmentation with rhBMP-2 on a poly-D, L-lactic-co-glycolic acid gelatine (PLPG) sponge with sinus augmentation with autologous pelvic cancellous bone in the maxillary sinus during the placement of different dental implants. Materials and methods: Nine adult female sheep were submitted to bilateral sinus-floor elevation. In one side (test group) the sinus lift was performed with rhBMP-2 on a PLPG-sponge, while the contralateral side served as the control by using cancellous bone from the iliac crest. Three different implants (Bränemark Ò , 3i Ò and Straumann Ò ) were inserted either simultaneously with the sinus augmentation or as a two staged procedure 6 weeks later. The animals were sacrificed at 6 and 12 weeks for histological and histomorphometrical evaluations during which boneto-implant contact (BIC) and bone density (BD) were evaluated. Results: BD and BIC were significantly higher at 12 weeks in the test group if the implants were placed at the time of the sinus lift (p \ 0.05). No difference was observed between the different implant systems or positions. Conclusions: The use of rhBMP-2 with PLPG-sponge increased BIC as well as BD in the augmented sinuses if compared to autologous bone. Different implant systems and positions of the implants had no effect on BIC or BD. Ó 2010 European Association for Cranio-Maxillo-Facial Surgery

Efficient Bone Formation in a Swine Socket Lift Model Using <b><i>Escherichia coli-</i></b>Derived Recombinant Human Bone Morphogenetic Protein-2 Adsorbed in β-Tricalcium Phosphate

“…Therefore, E-BMP-2 could potentially be an optimal solution since it has been shown to have an effectiveness similar to that of C-BMP-2 but at a relatively low production cost [Yano et al, 2009]. Nevertheless, although a large number of studies have reported positive effects of C-BMP-2 in a variety of animal models and clinical situations [Hanisch et al, 1997;Gutwald et al, 2010], the application of E-BMP-2 in the field of dentistry still requires additional evidence regarding its efficiency and safety. In the dental field, several reports have already shown positive results of E-BMP-2 application in alveolar bone formation [Huh et al, 2011[Huh et al, , 2012, but there is still a need to investigate and confirm the effectiveness of E-BMP-2 in bone augmentation and implant stability in a sinus lift model.…”

Zoledronate induces osteonecrosis of the jaw in sheep

“…Sheep show a similar weight, size, bone and joint structure and display both cortical and trabecular bone remodeling cycles comparable to humans. Sheep are subject to research in the maxillofacial area, including osteosynthesis and fracture healing and dental implants, and facilitate the ideal anatomical conditions to assess augmentation procedures such as sinus augmentations (Gutwald et al, 2010(Gutwald et al, , 2011.…”

The use of absorbable polyglactin/polydioxanon implant (Ethisorb®) in non-surgical closure of oro-antral communication

“…Ethisorb is successfully used as nonwoven cell scaffolds for cartilage tissue engineering (Rotter et al, 1998). It has been shown in bone surgery that bone regeneration can be induced by using the osteoconductive potential of lactide acid (Merten and Becker, 2002), with evidence of increased bone implant contact after sinus floor elevation in sheep (Gutwald et al, 2010). Clinical results showed that periosteum-derived osteoblasts on Ethisorb Ò matrix promote mineralized trabecular bone 3 months after implantation (Schimming and Schmelzeisen, 2004).…”