Use of Recombinant Human Bone Morphogenetic Protein (rhBMP2) in Bilateral Alveolar Ridge Augmentation: Case Report

Davor Katanec, Marko Granić, Martina Majstorović, Zdenko Trampuš, Dragana Gabrić Pandurić

Abstract


In recent years, the delivery of osteoinductive factors such as bone morphogenic proteins (BMPs)  has become an alternative approach to traditional bone grafting due to their capacity to produce bone healing and new bone formation. BMP-2 has proved to possess the highest osteoinductive potential among BMPs. The case reported the clinical use of  recombinant human BMP-2 for bilateral vertical alveolar ridge augmentation. In a case of 61 year-old patient with a significant bilateral vertical bony deficiency of the mandible, rhBMP-2 administered via an absorbable collagen sponge carrier (ACS) was used for bilateral alveolar ridge bone induction. Augmented sites were covered and fixed with titanium mesh. Augmented sites were reopened 6 months after surgery. Titanium membrane and retaining screws were removed and three dental implants were placed. The tissue samples for the histologic analysis were harvested. Following 3 months healing period, the submerged implants were uncovered and restored with zirconium-ceramic crowns. Cone beam computed tomography (CBCT), panoramix and 3D radiographic evaluation were obtained prior to and after the surgical procedure. Vertical gain of the bone was 5,5 mm on the left and 5 mm on the right side, with 6 mm width of the bone. Histologic analysis revealed formation of  mature trabecular bone with signs of osteoblastic proliferation. Implant stability quotient (ISQ) values were in the range between 69 and 75 for all three implants. No suppuration, gingival recession or pain were present 24 months after surgery.  Vertical bone augmentation using rhBMP-2 is optional treatment modality to consider when planning dental implant placement in sites where severe vertical insufficiency exists.


Keywords*


rhBMP-2, collagen sponge carrier, vertical alveolar ridge augmentation, implant placement

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