December 12, 2013
Study demonstrates a direct relationship between the dose of recombinant human bone morphogenetic protein type 2 (rhBMP-2) and the amount of vital bone formation following sinus augmentation procedures. However, there was no statistically significant difference in vital bone formation between the sinuses with different dosing of rhBMP-2 compared to the sinuses that only received bone graft particles.
Researchers from the New York University College of Dentistry (NYUCD) and the Bluestone Center for Clinical Research have published “Histomorphometric Comparison of Different Concentrations of Recombinant Human Bone Morphogenetic Protein with Allogeneic Bone Compared to the Use of 100% Mineralized Cancellous Bone Allograft in Maxillary Sinus Grafting” in The International Journal of Periodontics & Restorative Dentistry.
The subantral augmentation (sinus elevation) procedure has been shown to be a predictable method for placing root form implants in areas of the posterior maxilla with deficient bone quantity and/or quality. However, the need for a second surgical site increased the length of the surgical intervention, the surgical risk, and the postsurgical morbidity since healing was required in multiple sites. Bone replacement graft materials have been used in the sinus elevation procedure to avoid the drawbacks inherent in the harvesting of autogenous bone. They have been shown to be effective and have demonstrated high implant success rates. Recently, a growth factor (bone morphogenic protein) has been successfully used to regenerate bone in extraction sockets and sinus augmentation procedures. The purpose of this study was to histomorphometrically evaluate the amount of vital bone formed 6 to 9 months after grafting in the maxillary sinus, using two different doses of recombinant human bone morphogenetic protein/acellular collagen sponge (rhBMP-2/ACS) combined with mineralized cancellous bone allograft (MCBA) and to compare the results to the control sinus grafted with MCBA only.
Sixteen subjects who required bilateral subantral sinus grafting (resulting in a total of 32 maxillary sinus augmentation sites) were enrolled in the study, and randomized to receive one of the following study treatments in each sinus: control (MCBA only), MCBA + 5.6 mL rhBMP-2/ACS, or MCBA + 2.8 mL rhBMP-2/ACS. Investigators found that the percentage of vital bone 6 to 9 months post-graft surgery was significantly higher in the test group with the high concentration of rhBMP-2/ACS than in the group with the low concentration of rhBMP-2/ACS. There was no difference between the control group and either test group. The investigators recommend further studies involving a larger number of subjects to verify these results.
The article was authored by Stuart J. Froum, DDS, clinical professor and director of clinical research in the Ashman Department of Periodontology and Implant Dentistry, NYUCD. Other authors include Ismael Khouly, DDS, MS, clinical assistant professor of oral and maxillofacial surgery and clinical research coordinator at the Bluestone Center for Clinical Research; Patricia Corby, DDS, MS, Associate Director, Bluestone Center for Clinical Research; Stephen Wallace, DDS; Sang-Choo Cho, DDS; Edwin Rosenberg, DMD; Scott Froum, DDS; Timothy Bromage, PhD; Robert Schoor, DDS; Robert Norman, PhD; and Dennis Tarnow, DDS.
About the Bluestone Center for Clinical Research: The Bluestone Center for Clinical Research, in conjunction with the NYU Oral Cancer Center, is an academic research organization located at the NYU College of Dentistry. Bluestone’s mission is to take a creative scientific approach to transform world health. Bluestone is dedicated to conducting research in oral cancer, cancer symptomology, pharmaceuticals, medical devices, emerging biotechnology, periodontics, implants, and oral health products.
About New York University College of Dentistry: New York University College of Dentistry (NYUCD) is the third oldest and the largest dental school in the US, educating more than 8 percent of all dentists. NYUCD has a significant global reach and provides a level of national and international diversity among its students that is unmatched by any other dental school.