Evaluation of bone healing using rhBMP-2 soaked hydroxyapatite in ridge augmentation: a prospective observational study
김현석, 박주철, 윤필영, 김영균,
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김현석 ( Kim Hyun-Suk ) - Seoul National University Bundang Hospital Section of Dentistry Department of Oral and Maxillofacial Surgery
박주철 ( Park Ju-Cheol ) - Seoul National University School of Dentistry Department of Oral Histology
윤필영 ( Yun Pil-Young ) - Seoul National University Bundang Hospital Section of Dentistry Department of Oral and Maxillofacial Surgery
김영균 ( Kim Young-Kyun ) - Seoul National University Bundang Hospital Section of Dentistry Department of Oral and Maxillofacial Surgery
Abstract
Background: The goal of this study is to evaluate complication and effectiveness of alveolar ridge augmentations using a hydroxyapatite-based alloplastic bony substitute with rhBMP-2.
Methods: A total of 10 patients (4 males, 6 females; 58.5?±?8.6 years) participated in this clinical research. Alveolar ridge augmentations were performed in edentulous (4 maxillary posterior, 5 mandibular posterior, and 1 mandibular anterior) regions. Anorganic bovine bone (ABB; Bio-Oss®, Geistlich Pharma AG, Wolhusen, Switzerland) was used as the bone graft material in the control group (n =?5)) while hydroxyapatite-based alloplastic bony substitute with rhBMP-2(HA+rhBMP-2; NOVOSIS®-Dent, CGBio Inc., Seongnam, Korea) was used in the experimental group (n =?5). In order to evaluate relative changes in bone volume and resorption rate of the bone graft material, CBCT radiographs were taken immediately and at 4 months after the bone graft in all subjects. Among the 10 patients, 8 received dental implants in Seoul National University Bundang Hospital, while the others received in local clinics. Bone specimens for further histomorphometric examinations were gained from these 8 patients using trephine burs during the implant placements. Clinical, radiographic, and histomorphometric evaluations were focused because of the small sample size.
Results: When CBCT radiographs were compared between immediately and at 4.07?±?0.13 months after the bone graft, both alveolar bone widths (ABB 2.52?±?0.18 mm, HA+rhBMP-2 1.75 ± 0.85 mm) and heights (ABB 1.68?±?0.17 mm, HA+rhBMP-2 1.57?±?0.28 mm) increased in the two groups. Resorption rates of transplanted bone graft material in the alveolar bone widths and heights were (ABB 29.7?±?8.8%, HA+rhBMP-2 31.5?±?7.4%) and (ABB 39.2?±?21.8%, HA+rhBMP-2 52.6?±?6.5%), respectively. Histomorphometrically, ABB group showed bone formation via osteoconduction and HA+rhBMP-2 group via osteoinduction. HA+rhBMP-2 group showed more bone formation around the bone graft materials than the ABB group. Postoperative complications were not found in all subjects.
Conclusions: Our study had following conclusions: (1) Ridge augmentations using HA+rhBMP-2 could be clinically useful to supplement implant placements in edentulous regions. (2) Serious postoperative complications related to the graft material did not occur.
키워드
Alveolar ridge augmentation; Bone morphogenetic protein 2; Bone regeneration; Hydroxyapatite
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