Sigurdsson T J, Nguyen S, Wikesjo U M
Faculty of Health Sciences, University of Akureyri, Iceland.
Int J Periodontics Restorative Dent. 2001 Oct;21(5):461-73.
The objective of this study was to examine alveolar ridge augmentation following implantation of recombinant human bone morphogenetic protein (rhBMP-2) with an allogeneic freeze-dried demineralized bone matrix (DBM) mixed with autologous blood. A second objective was to evaluate bone-to-implant contact in induced bone. Bilateral surgically created supraalveolar ridge defects in five young adult beagle dogs were implanted with the rhBMP-2-DBM-blood device. Transmucosal dental implants were placed at weeks 8 and 16 postsurgery The animals were euthanized 24 weeks following ridge augmentation. Healing was uneventful in all animals. Radiographic observations indicated substantial bone formation, including regions of radiolucency, at week 8. At week 16, the radiolucencies were generally resolved, and the trabecular structure of the induced bone resembled that of the adjacent residual bone. There were no remarkable differences in radiographic observations between weeks 16 and 24 after ridge augmentation. Histologic analysis revealed dense woven and lamellar induced bone. Any residual DBM appeared remineralized, at least in part. A large portion of the dental implants (approximately 70%) were housed in induced bone with evidence of limited crestal resorption. There was no significant difference in bone density between induced and residual bone, and the levels of bone-to-implant contact were similar (approximately 55%). The rhBMP-2 construct used in this study has a potential to augment alveolar ridge defects. Also, no difference in levels of osseointegration may be expected in induced and residual bone following a two-stage procedure of rhBMP-2-induced ridge augmentation and dental implant placement.
本研究的目的是检查重组人骨形态发生蛋白（rhBMP-2）与同种异体冻干脱矿骨基质（DBM）混合自体血植入后牙槽嵴增高情况。第二个目的是评估诱导骨中骨与种植体的接触情况。在5只年轻成年比格犬双侧手术制造的牙槽嵴上植入rhBMP-2-DBM-血液装置。术后第8周和第16周放置经黏膜牙种植体。牙槽嵴增高24周后对动物实施安乐死。所有动物愈合过程顺利。影像学观察显示术后第8周有大量骨形成，包括透射区。第16周时，透射区基本消失，诱导骨的小梁结构与相邻剩余骨相似。牙槽嵴增高后第16周和第24周的影像学观察无显著差异。组织学分析显示有致密的编织骨和板层诱导骨。任何残留的DBM至少部分出现再矿化。大部分牙种植体（约70%）位于诱导骨内，有有限的嵴顶吸收迹象。诱导骨和剩余骨的骨密度无显著差异，骨与种植体的接触水平相似（约55%）。本研究中使用的rhBMP-2构建体有增加牙槽嵴缺损的潜力。此外，在rhBMP-2诱导牙槽嵴增高和牙种植体植入的两阶段手术后，诱导骨和剩余骨的骨结合水平预计无差异。
