RECOMBINANT HUMAN BONE MORPHOGENETIC PROTEIN-2 VERSUS AUTOGENOUS BONE GRAFT IN THE RECONSTRUCTION OF MAXILLARY ANTERIOR ALVEOLAR RIDGE DEFECTS

The purpose of this study was to evaluate the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) delivered in an absorbable collagen sponge (ACS) carrier on reconstructing the alveolar ridge defect and obtain newly formed bone as an alternative to autogenous bone grafting thus eliminating the dilemma and morbidity related to donor site.
A clinical investigation was carried out on sixteen patients at outpatient clinic of the Oral Surgery Department, Faculty of Oral and Dental Medicine, Cairo University, presented with alveolar ridge defects in the anterior maxilla. Thorough pre-operative assessment of the patients was carried out including history taking, physical examination and radiographic examination. The pre-operative volume, height, width and density of the defective alveolar ridge were measured on Computed Tomographic Cone Beam scan (CBCT).
The patients were divided into 2 groups; Group (I) comprised 8 patients who received (rhBMP-2) delivered in an absorbable collagen sponge (ACS), Group (II) comprised 8 patients who received autogenous chin graft.
The follow-up period was 6 months in the form of clinical evaluation and radiographic evaluation by CBCT scans to measure the amount of bone fill and bone density.
At the end of the follow-up period no signs of infection or evidence of bone resorption were found. The radiographs showed newly formed bone and increase in alveolar bone dimensions in all cases.
There was significant increase of bone width, height volume and density six months post-operatively in both group I (rhBMP-2) and Group II (Autogenous Bone) (p <0.001). However, there was no significant difference between Group I (rhBMP-2) and Group II (Autogenous Bone) postoperatively as regards bone width, height volume and density respectively (p> 0.01).
rhBMP-2/ACS is an alternative source to substitute the autogenous bone graft to obtain newly formed bone and eliminate the dilemma and morbidity related to donor site.