Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2:: radiographic observations

Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2:: radiographic observations
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DOI:
10.1111/j.1600-0501.2008.01567.x
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发表时间:
2008-10-01
影响因子:
4.3
通讯作者:
Wikesjoe, Ulf M. E.
Wikesjoe, Ulf M. E.
中科院分区:
工程技术2区
文献类型:
--
作者:
Leknes, Knut N.;Yang, Jie;Wikesjoe, Ulf M. E.

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目的:有效的载体技术和剂量似乎是成功使用骨形态发生蛋白(BMP)的关键。本研究通过放射学方法评价了一种特殊设计的钛多孔氧化物种植体表面复合重组人骨形态发生蛋白-2(rhBMP-2)刺激牙槽骨隆起的潜力。材料和方法:12只年轻成年拉布拉多犬。拔除前磨牙,缩小牙槽骨后,每颌象限植入3颗直径为10 mm的钛种植体,植入牙槽骨内5 mm。6只动物接受以0.75或1.5 mg/ml包被的rhBMP-2种植体,随机分配到对侧颌骨象限。另外6只动物接受以3 mg/ml的重组人骨形态发生蛋白-2包被的植入物或未包被的对照,采用相同的裂口设计。粘骨膜瓣被推进、调整和缝合以淹没植入物。术后即刻(基线)、第4周和第8周(研究结束)进行放射学登记。结果:从第4周开始,涂有rhBMP-2的种植体显示出强劲的放射学骨形成,延伸到种植体平台和平台上方(P<0.01)。一些rhBMP-2涂层的种植体在新形成的骨中出现空洞,逐渐溶解和/或种植体移位,在接受3 mg/ml的rhBMP-2涂层的两只动物中,情况严重。对照组在术后4周和8周显示有限的新骨形成。结论:多孔氧化钛表面可作为重组人骨形态发生蛋白-2的有效载体,具有良好的促进局部骨形成的潜能。使用载体技术,治疗剂量似乎在0.75-1.5 mg/ml的范围内。
Objectives: Effective carrier technologies and dosing appear critical for the successful use of bone morphogenetic proteins (BMPs). This study evaluated radiographically the potential of a purpose-designed titanium porous-oxide implant surface combined with recombinant human BMP-2 (rhBMP-2) to stimulate alveolar ridge augmentation.Material and methods: Twelve young-adult Labrador dogs were used. Three 10-mm titanium implants per jaw quadrant were placed 5 mm into the alveolar ridge following extraction of the premolar teeth and reduction of alveolar ridge. Six animals received implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml randomized to contralateral jaw quadrants. Another six animals received implants coated with rhBMP-2 at 3 mg/ml or uncoated control using the same split-mouth design. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants. Radiographic registrations were made immediately postsurgery (baseline), and at weeks 4 and 8 (end of study).Results: rhBMP-2-coated implants exhibited robust radiographic bone formation extending to and above the implant platform from week 4 (P < 0.01). Some rhBMP-2-coated implants showed voids within the newly formed bone that gradually resolved and/or implant displacement, being severe in two animals receiving implants coated with rhBMP-2 at 3 mg/ml. Controls showed limited, if any, new bone formation at weeks 4 and 8 postsurgery. There were no significant differences among the rhBMP-2 groups in bone gain.Conclusions: The titanium porous-oxide surface serves as an effective carrier for rhBMP-2, showing a clinically significant potential to stimulate local bone formation. With the carrier technology used, therapeutic dosage appears to be in the range of 0.75-1.5 mg/ml.