Post-extraction Alveoli Research Articles

Marsupialization of a maxillary cyst – case report.

Cysts of the upper and lower jaw are a usual radiographic finding, sometimes detected by chance, that affect the dentition and the adjacent anatomical structures. There have been described various approaches for their management, but two of them are nowadays applied, namely marsupialization and enucleation. The aim of this study is to assess marsupialization as a usual treatment for cystic lesions and highlight the usefulness of oral radiology in their diagnosis and treatment. A clinical case of maxillary cyst is presented. The patient visited the School of Dentistry and, after the clinical examination and radiographic images (OPG and CBCT), a wide cyst was diagnosed in the anterior left region of the upper jaw. The cyst had penetrated the buccal and palatal alveolar bone, as well as the osseous floor of the left nasal cavity. The surgeons suggested marsupialization as the best surgical choice. So, after patient's consent, teeth #23 and #24 were extracted and the cyst's epithelium was excised through their post-extraction alveoli. The formation of osseous bridge was monitored with regular CBCT imaging. This clinical case is being presented to highlight the value of marsupialization in managing large cysts.

Comparison of different dual-wavelength photobiomodulation protocols application in third molar extractions. A split-mouth randomized controlled trial

ObjectiveTo compare the use of PBMT in the soft tissue and bone healing after third molar extraction using the dual-wavelength laser directly into the post-extraction alveoli (PBMT-I), or PBMT with a red laser directly into the alveoli and with an infrared laser externally on the patient's face (PBMT-IE). MethodsTwenty patients underwent extraction of four third molars were involved in this split-mouth double-blind randomized controlled trial. The Post-extraction alveoli were treated with the following protocols: PBMT-IE: Application of a red laser directly into the alveolus, and infrared laser irradiation transcutaneously and PBMT-I: Application of dual-wavelength laser intraorally. Patients were clinically evaluated 3, 7, 14, 30, and 90 days after the surgical procedure. The analyses in this study were divided into qualitative (centered on the patient's report and on the evaluators' analysis), and quantitative analyses (measurement of the vertical and horizontal dimensions of the face with the objective of measuring post-surgical edema and radiographic analyses for evaluation of the density and structure of the newly formed bone). ResultsA progressive improvement was observed in all parameters evaluated in this study, however, this improvement was time dependent, with no distinct effect observed between the PBMT treatments applied. ConclusionThe different dual-wavelength PBMT protocols induced a similar postoperative clinical course in third molar extraction surgeries, with a reduced occurrence of complications and a good healing pattern of hard and soft tissues.

Evaluation of post-extraction alveolar regeneration time in advanced periodontal disease employing novel hydroxyapatitepolymeric (FlexiOss®Vet) in dogs.

The purpose of the study was to demonstrate bone regeneration and the time of formation of new alveolar bone based on implanted FlexiOss®Vet bone substitute material. The study attempted to determine the time taken to fill bone defects with newly formed osseous bone compared to alveoli with a standard method of filling the post-extraction alveolus with a collagen sponge. The study was conducted on a group of 12 dogs with advanced periodontal disease (stage IV) in which polymeric hydroxyapatite bone substitute material (FlexiOss®Vet) was implanted into alveoli on the right side, and collagen sponge was implanted into alveoli on the left side in the same patient. The patients underwent macroscopic inspection and X-ray examination at different periods of regeneration after the procedure. On the right side, macroscopically, the alveoli showed features of marked enlargement, and on X-ray examination they gave opacity to X-rays and there was no clear border between the alveolus and alveolar bone. On the left side, the alveoli were clearly penetrable to X-rays, and hollow alveoli filled mainly with connective tissue were observed. The study also showed a significant reduction in bone healing time in alveoli with implants compared to self-healing alveoli. These results suggest that the implanted material is significantly beneficial in the process of bone regeneration in large bone defects in dogs and notably shortens the process of bone regeneration after tooth extractions. It is presumed that this could reflect a model for the treatment of large bone defects in not only the maxilla and mandible, but also long bones, and that it could be a model for alveolar healing in humans.

Evaluation of the effects of melatonin on the post-extraction sockets of wistar rats exposed to a therapeutic dose of alendronate

ObjectivesThe objective was to evaluate the effects of melatonin administration on the post-extraction alveoli of rats exposed to alendronate. Materials and methodsThis was a pre-clinical cohort study of adult male Wistar rats, conducted over a period of 5 months in an animal facility suitable for animal experiments.Rats in groups 1 and 2 received melatonin and vitamin D respectively per os at a rate of 1 mg/kg/week and 0.25 mg/kg twice a week for 4 weeks. Group 3 received saline subcutaneously. All rats received alendronate at a dose of 0.05 mg/kg twice/week for 8 weeks. Four weeks after drug administration, a dental extraction was performed along with blood sampling to determine serum levels of RANKL and OPG. At eight weeks, the rats were sacrificed and the jaw blocks were removed for CT and histological examination. ResultsOverall, three groups of 12 rats were formed. From the fourth to the eighth week, the frequency of stage 3 osteonecrotic lesions in the post-extraction sockets had increased in the control group from 8.33% to 66.6%. In the melatonin and vitamin D groups, the frequency of corresponding stage 3 osteonecrotic lesions increased from 0 to 17% and 0–8.33% respectively. ConclusionOral administration of melatonin prior to tooth extraction in alendronate-exposed rats reduces the risk of developing osteonecrotic jaw lesions.

Magnetic Mallet and Laser for a Minimally Invasive Implantology: A Full Arch Case Report

In the past, complex rehabilitations, such as the rehabilitation of an entire arch with a prosthesis on implants, were reserved for the few patients who presented an optimal state of health as the interventions were long and traumatic. Nowadays, the use of devices such as the Magnetic Mallet and the laser allows us to perform the same interventions in less time and in a minimally invasive way. The case report we present shows how a fragile patient, subjected to the insertion of eight implants on the same day, had a positive response, thanks to the use of a Magnetic Mallet to prepare the implant sites, the application of the photodynamic therapy without dye (diode laser + hydrogen peroxide) to decontaminate the post-extraction alveoli and the use of an erbium laser to induce more bone bleeding and promote healing. The implants were then loaded in 48 h with a Toronto-type temporary total prosthesis. The patient had a pain-free and complication-free outcome. It is interesting to note how technological development, aimed at reducing the morbidity of surgery, makes it possible to perform almost all surgical therapies, even the most advanced, on any patient, regardless of general health conditions.

Interventions for managing medication-related osteonecrosis of the jaw.

Interventions for managing medication-related osteonecrosis of the jaw.

Influence of PRGF and PRF on postextractive alveolus regeneration: a randomised controlled trial.

Healing of postextraction alveolus is a complex process that involves soft and hard tissue regeneration. Pain, swelling, difficulty in opening the mouth, delayed bone tissue healing, alveolitis, and horizontal or vertical resorption of bone tissue are the main problems that impact on consequent treatment. Blood concentrates PRGF (plasma rich in growth factors) and PRF (platelet-rich fibrin), which are rich in growth factors, create better conditions for postextraction alveolus healing, enhance quality of soft tissues and bone regeneration, and decrease pain. The study objective was to compare physiologic healing of the postextraction zone with PRF- and PRGF-induced changes. In total, 43 patients were randomly divided into three groups: control group (mandibular molar extraction and filling of postextraction alveolus with hemostatic sponge containing gentamicin), group 2 (postextraction alveolus filled with PRGF), and group 3 (postextraction alveolus filled with PRF). Bone regeneration was evaluated in CBCT scans after 1 month. Pain was evaluated using the visual analog scale (VAS). After evaluating VAS results 1 day after surgery the lowest pain score was in the PRGF group. Tooth alveolus vertical and diagonal dimensions in the control group were significantly (P = .017) smaller than in the PRGF group. The vertical dimension of the alveolar ridge did not change significantly (P = .859) in the PRGF group; however, it was significantly reduced (P = .04) in the PRF group. One month after surgery the age of the control group was inversely proportionally correlated with the height and diagonal dimension of callus. Both blood concentrates had great anti-inflammatory properties, but PRGF had better osteoblastic properties and resulted in lower postoperative pain.

Effect of continuous and intermittent sodium alendronate oral dosing on post-extraction alveoli healing in rats

ObjectiveThis study aimed to compare alveolar healing after tooth extraction in two experimental rat models using continuous or discontinuous dosing of sodium alendronate (ALN). DesignForty-eight male Wistar rats were divided into eight experimental groups (n = 6/group) and administered ALN (2.5, 5.0, or 7.5 mg/kg) by gavage, weekly, either intermittently or following a continuous regimen (2.5, 5.0, or 7.5 mg/kg) before tooth extraction. The positive control rats were administered zoledronic acid (ZA; 0.2 mg/kg, intravenous), whereas negative control rats received sterile saline (0.9% NaCl, gavage). ResultsOnly the ZA-treated animals showed a larger radiolucent extraction site area compared to the saline group (p = 0.007). Small areas of bone tissue filling the alveoli were visualized in the 7.5 mg/kg continuous ALN group and compared with the saline group (p < 0.001). Increased amounts of empty osteocyte lacunae (p < 0.001) and osteoclasts with signs of apoptosis (p = 0.004) were observed in the continuous ALN groups (2.5, 5.0, and 7.5 mg/kg) compared with the saline group. Increased immunolabeling for TNF-α was observed in the 7.5 mg/kg discontinuous ALN group and all continuous ALN groups compared with the saline group (p < 0.001). The number of tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts was higher in the two continuous ALN groups (5.0 and 7.5 mg/kg) than in the saline group (p < 0.001). ConclusionsContinuous administration of ALN impaired post-extraction alveolar bone healing in rats; however, discontinuation of ALN administration before tooth extraction allowed for adequate post-dental extraction alveolar healing.

Effect of Platelet-Rich Fibrin Application on Non-Infectious Complications after Surgical Extraction of Impacted Mandibular Third Molars.

Due to the frequent development of non-infectious complications after surgical removal of the third lower impacted tooth, many techniques are used to reduce their severity. Among them is the technique of applying platelet-rich fibrin to the post-extraction alveolus. The study included 90 consecutively enrolled patients. Eligible patients were randomly assigned to two groups: patients with and without platelet-rich fibrin introduced into the postoperative alveolus. Pain, swelling, trismus, and temperature were evaluated after the procedure. Pain intensity was significantly higher in the control group than in the study group at 6 h, 1, and 3 days after surgery. PRF application did not significantly affect the intensity of swelling. Body temperature was significantly higher in the control group than the study group on day two after surgery. The trismus was significantly higher in the control group than in the study group at one, two, and seven days after surgery. Application of the PRF allows for a faster and less traumatic treatment process. It will enable for speedier recovery and return to active life and professional duties.

The Impact of Double Layer Membrane Technique on Bone Regeneration in Postextraction Alveoli – A Pathohistological Experimental Study in Dogs

Abstract Post extraction alveolar ridge preservation is a preventive oral surgical procedure aimed to preserve the dimensions of the alveolar ridge after removal of the teeth. According to literature data, the utilization of guided bone regeneration for this purpose is absolutely justified. The aim of this study was to examine the effect of resorbable collagen membranes placed in two layers in respect to the application of membranes placed in one layer to the degree of bone regeneration after a tooth extraction. This experimental study was conducted on six adult dogs. In the first phase all four premolars were extracted on both sides in the lower jaw. After the volume-standardisation with bone drill, three post extraction alveoli were filled with bone substitute of equine origin and then covered with: collagen bioresor bable membrane of porcine origin; collagen bioresorbable membrane of equine origin; pericardial bioresorbable membrane of equine origin. The membranes on the left side were placed in single-layer and on the right side in double-layer manner. After different monitoring periods, histopathological analysis of the samples taken from the experimental regions was performed. A different degree of bone regeneration was achieved between experimental regions in which membranes were placed in one layer and those where membranes were placed in two layers. There was no difference between regions where membranes of different origin were placed in the same manner. The procedure of covering the post extraction alveoli, filled with bone substitute and with resorbable membranes placed in two layers resulted in a higher degree of bone regeneration compared to those where resorbable membranes were placed in one layer.

Photobiomodulation Enhances the Healing of Postextraction Alveolar Sockets: A Randomized Clinical Trial With Histomorphometric Analysis and Immunohistochemistry

Wound healing of postextraction sockets is a complex process that permits to reach the bone reformation in about 3 months, and that could be characterized by the presence of some complications, mainly dependent on the duration of the surgery. The aim of this study is to evaluate the impact of photobiomodulation (PBMT) on the healing processes of mucosa overlying postextraction alveolus and on related complications. Twenty systemically healthy patients who needed to extract both lower third molars were selected in a private clinic and included in this prospective split-mouth randomized clinical trial. Inclusion criteria were no smokers subjects with the necessity to extract both lower third molars with surgeries overlapping for duration and difficulty. A computer-based randomization procedure was permitted to choose the side, subject to PBMT, by means of a neodymium-doped YAG (Nd: YAG) laser (test) and controls. Both surgeries were performed by the same operator with a gap of 40days. Twenty-two days after each surgery, a biopsy in correspondence to the alveolar mucosa of the socket was obtained from both sites and observed with an optical microscope and analyzed with histomorphometric analysis and immunohistochemistry. Each of the 20 participants included in this study (11 women and 9 men, nonsmokers, mean age 16years in the range of 15 to 17 years) were subjected to the extraction of both lower third molars, and a side was treated as control, the other, as the test. The histomorphometric analysis and immunohistochemistry showed that the tested sites, contrary to controls, were characterized by a lower presence of inflammatory cells, a more mature epithelium and myofibroblasts incorporated in a network of fibers parallel to the basal membrane, with little positivity to alpha-SMA antibodies and anti-myosin but positivity to anti-desmin. In conclusion, PBMT accelerates the healing process of postextraction alveolus after third molar extraction.

Safety and Efficacy of a New Synthetic Material Based on Monetite, Silica Gel, PS-Wallastonite, and a Hydroxyapatite Calcium Deficient: A Randomized Comparative Clinic Trial.

Background and Objectives: Maxillary bone defects related to post-extraction alveolar ridge resorption are usual. These defects may lead to failure in further surgical implant phases given the lack of bone volume to perform the dental implant. The objective of this clinical assay was to evaluate the safety and efficacy of an experimental synthetic bone substitute in the preservation of post-extraction maxillary alveoli. Materials and Methods: 33 voluntary patients who had at least one maxillary premolar tooth that was a candidate for exodontia (n = 39) and subsequent implant rehabilitation participated. The regenerated alveoli were monitored by means of periodic clinical examinations (days 9 ± 1, 21 ± 4, 42 ± 6, and 84 ± 6), measuring the height and width of the alveolar crest (days 0 and 180 ± 5), measurement of radiodensity using tomographic techniques (days 0–5 and 175 ± 5), and histological examination of biopsies collected at 180 ± 5 days. Results: No significant differences were observed during the entire follow-up period between the two groups with respect to the safety variables studied. A variation in width of −0.9 ± 1.3 mm and −0.6 ± 1.5 mm, and a variation in height of −0.1 ± 0.9 mm and −0.3 ± 0.7 mm was observed for experimental material Sil-Oss® and Bio-Oss®, respectively. The radiodensity of the alveoli regenerated with the experimental material was significantly lower than that corresponding to Bio-Oss®. However, the histological study showed greater osteoid matrix and replacement of the material with newformed bone in the implanted beds with the experimental material. Conclusions: Both materials can be used safely and proved equally effective in maintaining alveolar flange dimensions, they are also histologically biocompatible, bioactive and osteoconductive. The experimental material showed the advantage of being resorbable and replaced with newformed bone, in addition to promoting bone regeneration.

Platelet-rich fibrin and collagen membrane in the preservation of the alveolar bone: Feasibility of the elemental inorganic composition and scanning electron microscopy analysis.

The success of dental implants is related to the amount, quality, and composition of the alveolar bone. The placement of platelet-rich fibrin (PRF) clot associated with a resorbable collagen membrane (RCM) in a postextraction alveolus is a technique used for ridge preservation. This case report study analyzed the ultrastructural characteristics of cross-sectioned alveolar bone that received PRF and RCM using scanning electron microscopy and the inorganic composition using "energy dispersive X-ray spectrometry," in order to explore the feasibility of this method to clinical studies. Three alveolar bone samples from two male patients (37 and 58 years old), obtained in the procedure of placing the dental implant, were analyzed. Two bone samples previously received PRF and RCM (M37 and M58), the third sample represented a physiological bone formation without treatment (M37-control). The bone sample M37 showed irregularly shaped islets of calcified material intermingled with connective tissue. The other samples, from the 58-year-old patient with PRF and RCM (M58); and the other untreated bone sample from the same 37-year-old patient (M37-control) showed similar ultrastructural morphology with trabecular conformation without islets agglomerations. The inorganic composition analysis showed higher concentrations of calcium and phosphorus in both samples treated with PRF and RCM in comparison to the untreated bone sample. The Ca/P ratio was higher in the M37 sample compared to the others samples. The results showed morphology and inorganic composition differences among the treatments used, suggesting that this method is feasible to analyze parameters of the alveolar bone tissue.

Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies.

Background: Nowadays, patients involved in antiplatelet therapy required special attention during oral surgery procedures, due to the antiplatelet drugs assumption. The motivations of the assumption may be different and related to the patient’s different systemic condition. For this reason, accordingly to the current international guidelines, different protocols can be followed. The aim of this work is to analyze how the dentist’s approach to these patients has changed from the past to the present, evaluating the risk exposure for the patients. Methods: This review paper considered different published papers in literature through quoted scientific channels, going in search of “ancient” works in such a way as to highlight the differences in the protocols undertaken. The analyzed manuscripts are in the English language, taking into consideration reviews, case reports, and case series in such a way as to extrapolate a sufficient amount of data and for evaluating the past therapeutic approaches compared to those of today. Results: Colleagues in the past preferred to subject patients to substitution therapy with low molecular weight anticoagulants, by suspending antiplatelet agents to treatment patients, often for an arbitrary number of days. The new guidelines clarify everything, without highlighting an increased risk of bleeding during simple oral surgery in patients undergoing antiplatelet therapy. Conclusion: Either patients take these medications for different reasons, because of cardiovascular pathologies, recent cardiovascular events, or even for simple prevention, although the latest research shows that there is no decrease of cardiovascular accidents in patients who carry out preventive therapy. Surely, it will be at the expense of the doctor to assess the patient’s situation and risk according to the guidelines. For simple oral surgery, it is not necessary to stop therapy with antiplatelet agents because the risk of bleeding has not increased, and is localized to a post-extraction alveolus or to an implant preparation, compared to patients who do not carry out this therapy. From an analysis of the results it emerges that the substitutive therapy should no longer be performed and that it is possible to perform oral surgery safely in patients who take antiplatelet drugs, after a thorough medical history. Furthermore, by suspending therapy, we expose our patients to more serious risks, concerning their main pathology, where present.

The Use of Tooth Particles as a Biomaterial in Post-Extraction Sockets. Experimental Study in Dogs.

Objectives: The objective of this study was to evaluate new bone formation derived from freshly crushed extracted teeth, grafted immediately in post-extraction sites in an animal model, compared with sites without graft filling, evaluated at 30 and 90 days. Material and Methods: The bilateral premolars P2, P3, P4 and the first mandibular molar were extracted atraumatically from six Beagle dogs. The clean, dry teeth were ground immediately using the Smart Dentin Grinder. The tooth particles obtained were subsequently sieved through a special sorting filter into two compartments; the upper container isolating particles over 1200 μm, the lower container isolated particles over 300 μm. The crushed teeth were grafted into the post-extraction sockets at P3, P4 and M1 (test group) (larger and smaller post-extraction alveoli), while P2 sites were left unfilled and acted as a control group. Tissue healing and bone formation were evaluated by histological and histomorphometric analysis after 30 and 90 days. Results: At 30 days, test site bone formation was greater in the test group than the control group (p < 0.05); less immature bone was observed in the test group (25.71%) than the control group (55.98%). At 90 days, significant differences in bone formation were found with more in the test group than the control group. No significant differences were found in new bone formation when comparing the small and large alveoli post-extraction sites. Conclusions: Tooth particles extracted from dog’s teeth, grafted immediately after extractions can be considered a suitable biomaterial for socket preservation.

Post operative complications associated with non- surgical tooth extraction

Aim: The purpose of this study was to evaluate the clinical pattern of post-extraction wound healing and determination the types, incidence, and pattern of healing complications following non-surgical tooth extraction.Materials and Methods: this study includes 156 patients, who were come for extractions of teeth. This study was carried out at specialized dental centre of AL-Thawra during the period from the beginning of May to the end of September 2007). For each patient collected information pre-operatively included age and gender of the patient, indications of extraction, and tooth/teeth removed. Extractions were performed under local anesthesia with dental forceps, elevators, or both. Patients were evaluated on the third and seventh postoperative days for alveolus healing assessmentResults: one hundred forty-one patients (141) with 159 extraction teeth were evaluated for alveolus healing. Uncomplicated healing was in 142 (89.3 %), while 17 alveoli (10.7 %) developed healing complications. These complications were: localized osteitis 13 (8.2 %); acutely infected alveolus 3 (1.9 %); and an acutely inflamed alveolus1 (0.6%). Females developed more complications than males (p=0.003). Most complications were found in molars (82.5 %) and premolars (17.5 %). Localized osteitis caused severe pain in all cases, while infected and inflamed alveolus caused mild or no pain.Conclusions: Most of the post-extraction alveoli healed uneventfully. Apart from alveolar osteitis (AO), post-extraction alveolus healing was also complicated by acutely infected alveoli and acutely inflamed alveoli. This study also demonstrated a painful alveolus is not necessarily a disturbance of post-extraction site wound healing; a thorough clinical examination must, therefore, be made to exclude any of the complications.

The Benefits of Platelet-Rich Fibrin in Promoting Post-Extraction Healing

The aim of this study was to evaluate pain intensity and wound healing of the post-extraction sites after the use of Platelet-Rich Fibrin (PRF). 240 patients which needed difficult or multiple extractions were included in the study. The extractions were realized under local anesthesia, with piezotome and pliers. The patients were divided in two groups, the first group of 120 patients which benefited the application of PRF in the post-extraction alveoli, and the second group of 120 patients represented the control group (without application of PRF). A questionnaire was realized after a VAS analog scale and was used to quantify the post-intervention pain intensity in the postoperative four days. The assessment of the post-extraction sites healing period was performed clinically. According to the obtained results, the healing period of the post-extraction sites was shorter in the patients of first group (PRF), compared to the sites of control group patients. No postextractional healing complications occurred in the patients of first group/PRF. The study demonstrated the benefits of PRF insertion in post-intervention healing.

Interventions for managing medication-related osteonecrosis of the jaw.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: (A) To assess the effects of interventions versus no treatment, placebo or an active control for prophylaxis of MRONJ in patients exposed to antiresorptive or antiangiogenic drugs. (B) To assess the effects of nonsurgical or surgical interventions (either single or in combination) versus no treatment, placebo or an active control for treatment of patients with manifest MRONJ.

Bovine and equine biomaterials in mandibular alveolar dog model: Split-mouth study

A predictable rehabilitation of severely atrophied alveolar ridge defects still remains a matter of concern in implant dentistry. Objective: The aim of this study was to compare histologically biomaterials of bovine (Genox®) and equine (Bio-Gen®) origin associated or not to platelet-rich plasma (PRP), analyzing bone maturity, amount of mature (type I) and immature (type III) collagen present at sixty and ninety days in post-extraction alveolus. Materials and Methods: Four Beagle dogs were used from which the six mandibular premolars were extracted. The alveolus contained respectively: right side, Bio-Gen ® (group B), preserved the clot (group C), Genox ® (group G); left side, Bio-Gen ® + PRP group (BP), Clot + PRP (group CP) and Genox ® + PRP (group GP). After sixty and ninety days, two dogs were sacrificed at each date and the pieces were histologically processed and stained with picrosirius red, a specific stain for analysis of different types of collagen. Results: Comparisons of the averages of mature collagen at 60 days indicated significant differences between Group G when compared to Groups C and B. The biomaterial of bovine origin demonstrated higher amounts of mature collagen in 90 days while the biomaterial of equine origin had a higher average of immature collagen in 90 days. Conclusion: Groups associated to PRP were effective in the production of mature and immature collagen. Genox® associated with PRP demonstrated a more advanced stage of bone regeneration presenting as an alternative to fill post-extraction alveolus.

Scientific evidence on the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in oral and maxillofacial surgery.

This study aimed to identify the main indications for the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for bone repair and maintenance in the maxilla and mandible through a review of clinical trials evaluating the viability of using rhBMP-2 to delay the installation of dental implants, thus allowing satisfactory bone formation and long-term osseointegration. Literature search of the PubMed/Medline databases was performed using the following MeSH index terms-"bone morphogenetic protein 2" and "dentistry". Only clinical trials necessarily published in English, related to dentistry, and focused on bone reconstruction in critical defects, post-extraction alveoli, increasing the atrophic alveolar ridge, or surgery for maxillary sinus elevation were included, regardless of the age, sex, ethnicity, associated morbidities, or period of publication. Of the 17 studies identified based on the search filters, 2 were excluded. Therefore, 15 studies were finally included in this review. Based on the results of our review, we concluded that the use of rhBMP-2 for the preservation of the alveolar ridge after tooth extraction or for increasing the local defects is safe and viable. The use of rhBMP-2/Bio-Oss® for the elevation of the maxillary sinus membrane is unnecessary; however, it can improve and accelerate the maturation process in cases of guided bone regeneration in peri-implant defects. Compounds comprising rhBMP-2, allogenic bone, and plasma-rich platelet (PRP) can act as autograft substitutes in mandibular critical defects.