Bone Quality and Quantity Alterations After Socket Augmentation with rhPDGF-BB or BMPs: A Systematic Review.

Abstract

The aim of this study was to systematically analyze the effect of growth factors, particularly recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and bone morphogenetic proteins (BMPs), on volumetric and histomorphometric changes after socket augmentation in comparison with the natural healing sockets. An electronic search of four databases (1965 to February 2017) and a hand search of peer-reviewed journals for relevant articles were performed. Human clinical trials that reported quantitative and qualitative outcomes of soft and hard tissues in socket augmented sites with the use of rhPDGF-BB or BMPs, with a minimum five samples per group, were included. Eight studies, including six randomized controlled trials and two case series, were selected. Five of them used BMPs, and three used rhPDGF-BB. Regarding linear bone width change, the weighted mean difference (WMD) between the sites with and without the use of BMPs was 1.66 mm (95% confidence interval = 0.29 to 3.02 mm, P = .02), favoring the BMP group. In terms of histomorphometric outcome, the WMD of the percentage of vital bone between the sites with the use of rhPDGF-BB and with grafting materials alone was 2.16% (95% confidence interval = -4.61% to 8.93%, P = .53). This systematic review revealed that the use of BMPs in socket augmentation yields better ridge width in comparison with a natural healing socket. However, more studies are needed to warrant the effectiveness when using rhPDGF-BB in socket augmentation procedures.