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Clinical Oral Investigations

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01-05-2019 | Original Article

Overaugmentation to compensate for postextraction ridge atrophy using a putty-type porcine bone substitute material with recombinant bone morphogenetic protein-2: 4 weeks of healing in a canine model

Authors: Hyun-Chang Lim, So-Ra Yoon, Jae-Kook Cha, Jung-Seok Lee, Daniel S. Thoma, Ui-Won Jung

Published in: Clinical Oral Investigations | Issue 5/2019

Abstract

Objectives

The aims of the present study were (i) to determine the short-term effects of putty-type porcine bone substitute material (PB) with recombinant bone morphogenetic protein-2 (rhBMP-2) for alveolar ridge preservation (ARP) and (ii) evaluate the early healing of labial overaugmentation.

Materials and methods

Two groups were randomly assigned to the extraction sockets in mandibular incisors of eight dogs: labial overaugmentation with (i) PB (control) or (ii) rhBMP-2-loaded PB (BMP). Microcomputed tomography (micro-CT), and histologic and histomorphometric analyses were performed after 4 weeks.

Results

Micro-CT revealed that some of the overaugmented PB was dispersed in both groups. The new bone volume was significantly larger in the BMP group than in the control group (18.4 ± 3.3 vs. 15.5 ± 3.0 mm³, mean ± SD, P < 0.05). Labial bone resorption was generally found histologically. No signs of mineralization were observed in the overaugmented area despite significantly increased ridge width, as compared to the adjacent tooth area. The area of new bone formation was larger in the BMP group than in the control group overall (23.7 ± 18.8 vs. 18.3 ± 21.2 mm²) and in three parts (apical, middle, and coronal), although the difference was statistically significant only in the coronal part (7.7 ± 7.9 vs. 4.6 ± 6.4 mm², P < 0.05).

Conclusions

The addition of rhBMP-2 enhanced ossification in the coronal part of the extraction socket relative to using PB alone. Overaugmentation increased the ridge dimension with no evidence of ossification in situ at 4 weeks.

Clinical relevance

In early healing following ARP, rhBMP-2 enhances bone formation within the socket, but ossification in the overaugmented area needs to be studied further.

Avila-Ortiz G, Elangovan S, Kramer KW, Blanchette D, Dawson DV (2014) Effect of alveolar ridge preservation after tooth extraction: a systematic review and meta-analysis. J Dent Res 93:950–958. https://doi.org/10.1177/0022034514541127 CrossRefPubMedPubMedCentral

De Risi V, Clementini M, Vittorini G, Mannocci A, De Sanctis M (2015) Alveolar ridge preservation techniques: a systematic review and meta-analysis of histological and histomorphometrical data. Clin Oral Implants Res 26:50–68. https://doi.org/10.1111/clr.12288 CrossRefPubMed

Mardas N, Trullenque-Eriksson A, MacBeth N, Petrie A, Donos N (2015) Does ridge preservation following tooth extraction improve implant treatment outcomes: a systematic review: group 4: therapeutic concepts & methods. Clin Oral Implants Res 26(Suppl 11):180–201. https://doi.org/10.1111/clr.12639 CrossRefPubMed

Vignoletti F, Matesanz P, Rodrigo D, Figuero E, Martin C, Sanz M (2012) Surgical protocols for ridge preservation after tooth extraction. A systematic review. Clin Oral Implants Res 23 Suppl 5:22–38. https://doi.org/10.1111/j.1600-0501.2011.02331.x CrossRefPubMed

Willenbacher M, Al-Nawas B, Berres M, Kammerer PW, Schiegnitz E (2015) The effects of alveolar ridge preservation: a meta-analysis. Clin Implant Dent Relat Res 18:1248–1268. https://doi.org/10.1111/cid.12364 CrossRefPubMed

Wang RE, Lang NP (2012) Ridge preservation after tooth extraction. Clin Oral Implants Res 23 Suppl 6:147–156. https://doi.org/10.1111/j.1600-0501.2012.02560.x CrossRefPubMed

MacBeth N, Trullenque-Eriksson A, Donos N, Mardas N (2016) Hard and soft tissue changes following alveolar ridge preservation: a systematic review. Clin Oral Implants Res 28:982–1004. https://doi.org/10.1111/clr.12911 CrossRefPubMed

Vittorini Orgeas G, Clementini M, De Risi V, de Sanctis M (2013) Surgical techniques for alveolar socket preservation: a systematic review. Int J Oral Maxillofac Implants 28:1049–1061. https://doi.org/10.11607/jomi.2670 CrossRefPubMed

Iasella JM, Greenwell H, Miller RL, Hill M, Drisko C, Bohra AA, Scheetz JP (2003) Ridge preservation with freeze-dried bone allograft and a collagen membrane compared to extraction alone for implant site development: a clinical and histologic study in humans. J Periodontol 74:990–999. https://doi.org/10.1902/jop.2003.74.7.990 CrossRefPubMed

10.

Fickl S, Schneider D, Zuhr O, Hinze M, Ender A, Jung RE, Hurzeler MB (2009) Dimensional changes of the ridge contour after socket preservation and buccal overbuilding: an animal study. J Clin Periodontol 36:442–448. https://doi.org/10.1111/j.1600-051X.2009.01381.x CrossRefPubMed

11.

Fickl S, Zuhr O, Wachtel H, Kebschull M, Hurzeler MB (2009) Hard tissue alterations after socket preservation with additional buccal overbuilding: a study in the beagle dog. J Clin Periodontol 36:898–904. https://doi.org/10.1111/j.1600-051X.2009.01463.x CrossRefPubMed

12.

Lee JS, Jung JS, Im GI, Kim BS, Cho KS, Kim CS (2015) Ridge regeneration of damaged extraction sockets using rhBMP-2: an experimental study in canine. J Clin Periodontol 42:678–687. https://doi.org/10.1111/jcpe.12414 CrossRefPubMed

13.

Vignoletti F, Abrahamsson I (2012) Quality of reporting of experimental research in implant dentistry. Critical aspects in design, outcome assessment and model validation. J Clin Periodontol 39 Suppl 12:6–27. https://doi.org/10.1111/j.1600-051X.2011.01830.x CrossRefPubMed

14.

Kilkenny C, Browne WJ, Cuthill IC, Emerson M, Altman DG (2010) Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research. PLoS Biol 8:e1000412. https://doi.org/10.1371/journal.pbio.1000412 CrossRefPubMedPubMedCentral

15.

Sanz-Sanchez I, Ortiz-Vigon A, Sanz-Martin I, Figuero E, Sanz M (2015) Effectiveness of lateral bone augmentation on the alveolar crest dimension: a systematic review and meta-analysis. J Dent Res 94:128S–142S. https://doi.org/10.1177/0022034515594780 CrossRefPubMed

16.

Fiorellini JP, Howell TH, Cochran D, Malmquist J, Lilly LC, Spagnoli D, Toljanic J, Jones A, Nevins M (2005) Randomized study evaluating recombinant human bone morphogenetic protein-2 for extraction socket augmentation. J Periodontol 76:605–613. https://doi.org/10.1902/jop.2005.76.4.605 CrossRefPubMed

17.

Howell TH, Fiorellini J, Jones A, Alder M, Nummikoski P, Lazaro M, Lilly L, Cochran D (1997) A feasibility study evaluating rhBMP-2/absorbable collagen sponge device for local alveolar ridge preservation or augmentation. Int J Periodontics Restorative Dent 17:124–139PubMed

18.

Kim YJ, Lee JY, Kim JE, Park JC, Shin SW, Cho KS (2014) Ridge preservation using demineralized bone matrix gel with recombinant human bone morphogenetic protein-2 after tooth extraction: a randomized controlled clinical trial. J Oral Maxillofac Surg 72:1281–1290. https://doi.org/10.1016/j.joms.2014.01.022 CrossRefPubMed

19.

Thoma DS, Naenni N, Benic GI, Munoz F, Hammerle CHF, Jung RE (2017) Effect of ridge preservation for early implant placement—is there a need to remove the biomaterial? J Clin Periodontol 44:556–565. https://doi.org/10.1111/jcpe.12709 CrossRefPubMed

20.

Perelman-Karmon M, Kozlovsky A, Liloy R, Artzi Z (2012) Socket site preservation using bovine bone mineral with and without a bioresorbable collagen membrane. Int J Periodontics Restorative Dent 32:459–465PubMed

21.

Jung UW, Lee JS, Lee G, Lee IK, Hwang JW, Kim MS, Choi SH, Chai JK (2013) Role of collagen membrane in lateral onlay grafting with bovine hydroxyapatite incorporated with collagen matrix in dogs. J Periodontal Implant Sci 43:64–71. https://doi.org/10.5051/jpis.2013.43.2.64 CrossRefPubMedPubMedCentral

22.

Cochran DL, Schenk R, Buser D, Wozney JM, Jones AA (1999) Recombinant human bone morphogenetic protein-2 stimulation of bone formation around endosseous dental implants. J Periodontol 70:139–150. https://doi.org/10.1902/jop.1999.70.2.139 CrossRefPubMed

23.

Araujo MG, Wennstrom JL, Lindhe J (2006) Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installation. Clin Oral Implants Res 17:606–614. https://doi.org/10.1111/j.1600-0501.2006.01315.x CrossRefPubMed

24.

Caneva M, Botticelli D, Pantani F, Baffone GM, Rangel IG Jr, Lang NP (2012) Deproteinized bovine bone mineral in marginal defects at implants installed immediately into extraction sockets: an experimental study in dogs. Clin Oral Implants Res 23:106–112. https://doi.org/10.1111/j.1600-0501.2011.02202.x CrossRefPubMed

25.

Delgado-Ruiz R, Romanos GE, Alexandre Gerhke S, Gomez-Moreno G, Mate-Sanchez de Val JE, Calvo-Guirado JL (2016) Biological effects of compressive forces exerted on particulate bone grafts during socket preservation: animal study. Clin Oral Implants Res 29:792–801. https://doi.org/10.1111/clr.12942 CrossRefPubMed

26.

Kim JJ, Schwarz F, Song HY, Choi Y, Kang KR, Koo KT (2016) Ridge preservation of extraction sockets with chronic pathology using Bio-Oss(R) Collagen with or without collagen membrane: an experimental study in dogs. Clin Oral Implants Res 28:727–733. https://doi.org/10.1111/clr.12870 CrossRefPubMed

27.

Al-Askar M, O'Neill R, Stark PC, Griffin T, Javed F, Al-Hezaimi K (2013) Effect of single and contiguous teeth extractions on alveolar bone remodeling: a study in dogs. Clin Implant Dent Relat Res 15:569–575. https://doi.org/10.1111/j.1708-8208.2011.00403.x CrossRefPubMed

28.

Calvo-Guirado JL, Boquete-Castro A, Negri B, Delgado Ruiz R, Gomez-Moreno G, Iezzi G (2014) Crestal bone reactions to immediate implants placed at different levels in relation to crestal bone. A pilot study in Foxhound dogs. Clin Oral Implants Res 25:344–351. https://doi.org/10.1111/clr.12110 CrossRefPubMed

Title: Overaugmentation to compensate for postextraction ridge atrophy using a putty-type porcine bone substitute material with recombinant bone morphogenetic protein-2: 4 weeks of healing in a canine model
Authors: Hyun-Chang Lim
So-Ra Yoon
Jae-Kook Cha
Jung-Seok Lee
Daniel S. Thoma
Ui-Won Jung
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 5/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2663-z

At a glance: The STEP trials

Springer Medicine

Overaugmentation to compensate for postextraction ridge atrophy using a putty-type porcine bone substitute material with recombinant bone morphogenetic protein-2: 4 weeks of healing in a canine model

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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