Medikeri Raghavendra Shrishail, Meharwade Vinayak Venkoosa, Sinha Kumar Ankit
Department of Periodontology, Sinhgad Dental College and Hospital, Pune, Maharashtra, India.
J Indian Soc Periodontol. 2019 Jul-Aug;23(4):311-315. doi: 10.4103/jisp.jisp_748_18.
Bone morphogenetic proteins have a powerful osteoinductive capacity and have been used as a new adjunct to graft materials for bone regeneration. The objectives of this systematic review are to assess the amount of radiographic bone fill, clinical attachment level (CAL) gain, and reduction in pocket depth (PD) in patients with intrabony defects in periodontitis patients following the use of recombinant human bone morphogenetic protein-2 (rhBMP-2).
Electronic bibliographic databases search of Medline, Science Direct, and Google Scholar was made from January 1980 to December 2017. Studies using rhBMP-2 to treat periodontal intrabony defects of the maxillary or mandibular region with follow-up period of at least 6 months were searched. Two reviewers performed the systematic review using the PRISMA Statement for reporting and the Cochrane risk-of-bias tool was used for quality assessment.
It was found that rhBMP-2 showed statistically significant results with respect to radiographic defect resolution, CAL, and PD reduction at 9 months compared to open-flap debridement but showed statistically significant results only with respect to radiographic bone fill when compared with platelet-rich fibrin at 6 months.
The rhBMP-2 may provide a promising alternative to traditional grafting procedures therapy that can enhance periodontal regeneration in patients having intrabony defects. Due to limited human studies, it can be concluded that no definitive evidence exists to ascertain the effectiveness of rhBMP-2 in the treatment of intrabony defects in periodontal diseases.
骨形态发生蛋白具有强大的骨诱导能力,已被用作骨再生移植材料的一种新辅助手段。本系统评价的目的是评估牙周炎患者骨内缺损在使用重组人骨形态发生蛋白-2(rhBMP-2)后,影像学骨填充量、临床附着水平(CAL)增加情况以及牙周袋深度(PD)减少情况。
对1980年1月至2017年12月期间的Medline、Science Direct和谷歌学术电子文献数据库进行检索。检索使用rhBMP-2治疗上颌或下颌区域牙周骨内缺损且随访期至少6个月的研究。两名评价者使用PRISMA声明进行系统评价,并使用Cochrane偏倚风险工具进行质量评估。
发现与开放瓣清创术相比,rhBMP-2在9个月时在影像学缺损修复、CAL和PD减少方面显示出统计学显著结果,但与富血小板纤维蛋白相比,在6个月时仅在影像学骨填充方面显示出统计学显著结果。
rhBMP-2可能为传统移植手术治疗提供一种有前景的替代方法,可增强骨内缺损患者的牙周再生。由于人体研究有限,可以得出结论,尚无确凿证据确定rhBMP-2在治疗牙周疾病骨内缺损中的有效性。