J Periodontal Implant Sci.  2017 Apr;47(2):86-95. 10.5051/jpis.2017.47.2.86.

Sinus augmentation using rhBMP-2-loaded synthetic bone substitute with simultaneous implant placement in rabbits

• Joo MJ
• Cha JK
• Lim HC
• Choi SH
• Jung UW

• KMID: 2377743
• DOI: http://doi.org/10.5051/jpis.2017.47.2.86

Abstract

PURPOSE
The aim of this study was to determine the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded synthetic bone substitute on implants that were simultaneously placed with sinus augmentation in rabbits.
METHODS
In this study, a circular access window was prepared in the maxillary sinus of rabbits (n=5) for a bone graft around an implant (Ø 3×6 mm) that was simultaneously placed anterior to the window. Synthetic bone substitute loaded with rhBMP-2 was placed on one side of the sinus to form the experimental group, and saline-soaked synthetic bone substitute was placed on the other side of the sinus to form the control group. After 4 weeks, sections were obtained for analysis by micro-computed tomography and histology.
RESULTS
Volumetric analysis showed that the median amount of newly formed bone was significantly greater in the BMP group than in the control group (51.6 mm3 and 46.6 mm3, respectively; P=0.019). In the histometric analysis, the osseointegration height was also significantly greater in the BMP group at the medial surface of the implant (5.2 mm and 4.3 mm, respectively; P=0.037).
CONCLUSIONS
In conclusion, an implant simultaneously placed with sinus augmentation using rhBMP-2-loaded synthetic bone substitute can be successfully osseointegrated, even when only a limited bone height is available during the early stage of healing.

Keyword

Bone substitutes; Collagen; Dental implants; Recombinant human bone morphogenetic protein-2; Sinus floor augmentation

MeSH Terms

Bone Substitutes*
Collagen
Dental Implants
Humans
Maxillary Sinus
Osseointegration
Rabbits*
Sinus Floor Augmentation
Transplants
Bone Substitutes
Collagen
Dental Implants

Figure

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  Figure 1 (A) Photograph of the implant used in this study. (B) Two implant sites and holes were prepared bilaterally. Venous-blood-filled parts of the sinus after placing the implants. Ant: anterior, Post: posterior.

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  Figure 2 Schematic showing the measured parameters. Med: medial, Lat: lateral, CBH: cortical bone height, AH: augmented height, PH: protruding height, OH: distance from the basal cortical bone to the highest point of osseointegration.

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  Figure 3 Radiographic findings on micro-CT. False-color representation of radiographic findings in a cross-sectional view. Note that the augmented bone substitutes (green) were well maintained within the maxillary sinus, and that the implants were thoroughly enveloped by newly formed bone (purple) and augmented bone substitute. (A, B) BMP group. (C, D) Control group. (A, C) are coronal views, while (B, D) are sagittal views. Med: medial, Lat: lateral, CT: computed tomography, Ant: anterior, Post: posterior, BMP: bone morphogenetic protein.

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  Figure 4 Histological photomicrographs of the total augmented area after 4 weeks of healing. (A) BMP group. (B) Control group. The osseointegration of the implant was evident throughout the cortical bone area in both groups. Hematoxylin-eosin stain; scale bar=1 mm. CB: cortical bone, RBS: residual bone substitute, BMP: bone morphogenetic protein.

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  Figure 5 Histological photomicrographs of the apical area after 4 weeks of healing. (A) BMP group. (B) Control group. More new bone formed around the apex of the implant in the BMP group than in the control group. Hematoxylin-eosin stain; scale bar=500 μm. SM: sinus membrane, NB: newly formed bone, BMP: bone morphogenetic protein, RBS: residual bone substitute.

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