Abstract
We aimed to evaluate the efficacy of demineralized dentin matrix (DDM) fixed with recombinant human bone morphogenetic protein-2 (rhBMP-2) through an experimental and a clinical study. Unilateral upper second and third premolars of eight beagles were extracted. A mucoperiosteal flap was elevated around the extraction socket, and a bone defect was made using a surgical drill. Each DDM was fixed with rhBMP-2, and autogenous bone was grafted at the bone defect area with a collagenous membrane. The beagles were euthanized at two, four, eight, and 12 weeks after receiving the bone graft. Block specimens involving grafted bone and surrounding natural bone were extracted. A total of 23 patients who received bone grafts using human DDM fixed with rhBMP-2 (AutoBT BMP) with implant placements (36 implants; maxilla: 14, mandible: 22) were selected. The implant stability, marginal bone loss, and clinical outcome were evaluated. Three trephine cores were harvested fourmonths after bone grafting, and histologic examination was performed. In the histological evaluation performed four weeks after the bone graft, autogenous bone showed 52% new bone formation and DDM fixed with rhBMP-2 showed 33% new bone formation. Twelve weeks after the bone graft, autogenous bone showed 75% new bone formation and DDM fixed with rhBMP-2 showed 48% new bone formation. In the clinical study, favorable osseointegration was obtained in 35 out of 36 implant sites (one case of osseointegration failure). In all cases, severe complications were not observed. Histomorphometrically, new bone formation was observed in 14.98% of the cases. The residual DDM particles were 6.22%. AutoBT BMP provides good osteoinductive and osteoconductive potential and clinical efficacy.
Highlights
Autogenous bone has osteogenic, osteoinductive, and osteoconductive abilities and is an ideal bone graft material for defects with increased susceptibility to infections and poor blood circulation.The major drawbacks of autogenous bone are that it requires a secondary donor site and can be collected in a rather limited amount
The minerals of the teeth consist of fivetypes of biological calcium phosphate (hydroxyapatite (HA), tricalcium phosphate (TCP), octacalcium phosphate (OCP), amorphous calcium phosphate (ACP), and dicalcium phosphate dehydrate (DCPD))
When HA is manufactured by sintering at a high temperature, it shows a high-crystalline structure and the sintering process leads to grain growth, resulting in a size at least an order of magnitude larger than the apatite in bone tissue
Summary
Autogenous bone has osteogenic, osteoinductive, and osteoconductive abilities and is an ideal bone graft material for defects with increased susceptibility to infections and poor blood circulation.The major drawbacks of autogenous bone are that it requires a secondary donor site and can be collected in a rather limited amount. Materials 2017, 10, 1049 material for autogenic bone graft, has osteoinductive ability, but facesthe risk of viral infections, while heterogenic bone and synthetic bones have only osteoconductive ability; these grafts are limited in their ability to promote the regeneration of new bone [1]. The fivetypes of calcium phosphate interact, and when implanted into the body, they are expected to produce good bone remodeling. The apatite in human bone tissue has a low-crystalline structure with a particle size in the range of 10–100 nm. When HA is manufactured by sintering at a high temperature, it shows a high-crystalline structure and the sintering process leads to grain growth, resulting in a size at least an order of magnitude larger than the apatite in bone tissue
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