Huh Jung-Bo, Park Chan-Kyung, Kim Se-Eun, Shim Kyung-Mi, Choi Kyung-Hee, Kim Sun-Jong, Shim June-Sung, Shin Sang-Wan
Postgraduate School of Clinical Dentistry, Institute for Clinical Dental Research, Korea University, Seoul, Korea.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Jul;112(1):42-9. doi: 10.1016/j.tripleo.2010.09.063. Epub 2010 Dec 30.
The aim of this study was to examine the effect of Escherichia coli-derived recombinant human bone morphogenetic protein 2 (ErhBMP-2) coated onto anodized implant to stimulate local bone formation, including osseointegration and the vertical augmentation of the alveolar ridge.
Six young male adult beagle dogs were used. A crestal area was leveled on both sides of each test subject by removing minimal cortical bone using a round bur and without exposing cancellous bone. After a 2-month healing period, 3 anodized implants (length 8 mm, diameter 4 mm; Cowellmedi, Busan, Korea) were placed 5 mm into the mandibular alveolar ridge in either side. Each animal received 6 implants that were either coated with ErhBMP-2 (0.75 or 1.5 mg/mL concentration; Cowellmedi) or uncoated. This was performed using a randomized split-mouth design. A total of 36 implants were used for this study. Twelve noncoated implants were used as control, and 24 BMP-coated implants were used as our experimental group, which was further divided into 2 groups of 12 implants each with different BMP concentration of 0.75 and 1.5 mg/mL. Radiologic examinations were performed immediately after implant placement and 4 and 8 weeks after implant placement. The amount of bone augmentation was evaluated by measuring the distance from the uppermost point of the cover screw to the marginal bone. Implant stability quotient (ISQ) values were measured immediately after surgery and 8 weeks after implant placement. Statistical analysis was performed using one-way analysis of variance (SPSS version 17.0) and multiple-comparison tests. Statistical significance was established at the 95% confidence level.
Implants coated with ErhBMP-2 at 0.75 mg/mL (BMP 0.75 group) and 1.5 mg/mL (BMP 1.5 group) exhibited significant vertical bone formation compared with the control group (mean ± SD): 0.88 ± 0.94 versus 0.60 ± 0.64 versus -0.52 ± 0.64 mm, respectively; P < .05. There was a significant difference between the 3 groups in bone level change (P < .05). The BMP 0.75 and BMP 1.5 groups exhibited significant changes in ISQ compared with the control group: 8.17 ± 8.31 versus 11.50 ± 9.02 versus 2.17 ± 7.61, respectively; P < .05.
Within the limits of this study, the ErhBMP-2 coating on an anodized implant may stimulate vertical bone augmentation, which significantly increases implant stability on completely healed alveolar ridges.
本研究旨在探讨涂覆在阳极氧化种植体上的大肠杆菌衍生重组人骨形态发生蛋白2(ErhBMP-2)对刺激局部骨形成的作用,包括骨整合和牙槽嵴垂直增高。
选用6只成年雄性年轻比格犬。通过使用圆钻去除最小量的皮质骨且不暴露松质骨,在每个实验对象的两侧平整嵴顶区域。经过2个月的愈合期后,将3枚阳极氧化种植体(长度8mm,直径4mm;韩国釜山Cowellmedi公司)植入下颌牙槽嵴两侧5mm深处。每只动物植入6枚种植体,分别为涂有ErhBMP-2(浓度0.75或1.5mg/mL;Cowellmedi公司)的种植体或未涂覆的种植体。采用随机分组的双侧对照设计。本研究共使用36枚种植体。12枚未涂覆的种植体作为对照组,24枚涂有BMP的种植体作为实验组,实验组又进一步分为两组,每组12枚种植体,BMP浓度分别为0.75和1.5mg/mL。在种植体植入后即刻、植入后4周和8周进行影像学检查。通过测量覆盖螺丝最上点到边缘骨的距离评估骨增高量。在手术后即刻和植入后8周测量种植体稳定性商数(ISQ)值。使用单因素方差分析(SPSS 17.0版)和多重比较检验进行统计分析。在95%置信水平确定统计学显著性。
与对照组相比,涂有0.7mg/mL ErhBMP-2的种植体(BMP 0.75组)和涂有1.5mg/mL ErhBMP-2的种植体(BMP 1.5组)表现出显著的垂直骨形成(均值±标准差):分别为0.88±0.94、0.60±0.64和-0.52±0.64mm;P<.05。三组在骨水平变化方面存在显著差异(P<.05)。与对照组相比,BMP 0.75组和BMP 1.5组的ISQ有显著变化:分别为8.17±8.31、11.50±9.02和2.17±7.61;P<.05。
在本研究的范围内,阳极氧化种植体上的ErhBMP-2涂层可能刺激垂直骨增高,这显著提高了完全愈合牙槽嵴上种植体的稳定性。