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Journal of Clinical Periodontology

Horizontal ridge augmentation of the atrophic anterior maxilla using rhBMP-2/ACS or autogenous bone grafts: a proof-of-concept randomized clinical trial

Authors

  • Rubens Moreno de Freitas,

    1. Department of Diagnosis and Surgery – Periodontics, UNESP – Univ Estadual Paulista, Araraquara Dental School, Araraquara, SP, Brazil
    2. Laboratory for Applied Periodontal & Craniofacial Regeneration, Departments of Periodontics and Oral Biology, College of Dental Medicine, Augusta, GA, USA
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  • Cristiano Susin,

    1. Laboratory for Applied Periodontal & Craniofacial Regeneration, Departments of Periodontics and Oral Biology, College of Dental Medicine, Augusta, GA, USA
    2. Department of Orthopedics, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
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  • Rubens Spin-Neto,

    1. Department of Diagnosis and Surgery – Periodontics, UNESP – Univ Estadual Paulista, Araraquara Dental School, Araraquara, SP, Brazil
    2. Department of Dentistry, Oral Radiology, Aarhus University, Aarhus, Denmark
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  • Claudio Marcantonio,

    1. Department of Diagnosis and Surgery – Periodontics, UNESP – Univ Estadual Paulista, Araraquara Dental School, Araraquara, SP, Brazil
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  • Ulf M. E. Wikesjö,

    1. Laboratory for Applied Periodontal & Craniofacial Regeneration, Departments of Periodontics and Oral Biology, College of Dental Medicine, Augusta, GA, USA
    2. Department of Orthopedics, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
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  • Luís Antônio Violin Dias Pereira,

    1. Department of Histology and Embryology, UNICAMP – State University of Campinas, Institute of Biology, Campinas, SP, Brazil
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  • Elcio Marcantonio Jr

    Corresponding author
    1. Department of Diagnosis and Surgery – Periodontics, UNESP – Univ Estadual Paulista, Araraquara Dental School, Araraquara, SP, Brazil
    • Address:

      Elcio Marcantonio Jr

      Department of Diagnosis and Surgery – Periodontics

      UNESP – Univ Estadual Paulista, Araraquara Dental School

      Rua Humaitá, 1680 – 2nd floor

      Araraquara, SP, Brazil 14801-903

      E-mail: elciojr@foar.unesp.br

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  • Conflict of interest and source of funding statement

    The authors declare no conflict of interest for this study. Research funding was provided from the São Paulo Research Foundation (FAPESP – grant number 2009/16016-8), São Paulo, Brazil and CAPES, Brasilia, Brazil. Dr. Susin was supported in part by a 3M Non-Tenured Faculty Grant, St Paul, MN, USA. Drs Wikesjö and Susin were supported in part by a grant from Nobel Biocare AB, Göteborg, Sweden.

Abstract

Aim

To compare the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge carrier (ACS) with autogenous bone graft for augmentation of the edentulous atrophic anterior maxilla.

Methods

Twenty-four subjects were enrolled in a randomized, controlled, parallel-group, open-label clinical trial. Subjects either received rhBMP-2/ACS (1.5 mg/ml) or particulated autogenous bone harvested from the mandibular retromolar region. A titanium-mesh was used to provide space and wound stability. A guide was used to standardize clinical recordings using an analogue caliper. Alveolar ridge width was also assessed using cone-beam computed tomography.

Results

rhBMP-2/ACS yielded significantly greater radiographic horizontal bone gain compared with autogenous bone graft at immediate subcrestal levels (1.5 ± 0.7 versus 0.5 ± 0.9 mm; p = 0.01); non-significant differences were observed at mid- (2.9 ± 0.8 versus 2.9 ± 0.9 mm; p = 0.98) and apical (1.7 ± 0.9 versus 1.8 ± 1.1 mm; p = 0.85) crestal levels. No significant differences in clinical horizontal bone gain were observed at 6 months between rhBMP-2/ACS and autogenous bone graft (3.2 ± 0.9 mm versus 3.7 ± 1.4 mm; p = 0.31). Sixty-two implants were placed after 6 month of healing with no significant differences between groups for number of implants, implant size, primary stability and survival.

Conclusions

rhBMP-2/ACS appears a realistic alternative for augmentation of the edentulous atrophic anterior maxilla.

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