Alveolar Bone Loss/drug therapy* ; Alveolar Bone Loss/surgery ; Alveolar Ridge Augmentation/methods ; Animals ; Bone Morphogenetic Protein 2/therapeutic use* ; Bone Regeneration/drug effects* ; Bone Regeneration/physiology ; Bone Substitutes/therapeutic use ; Cattle ; Collagen ; Dogs ; Humans ; Male ; Mandible/drug effects ; Mandible/pathology ; Mandible/surgery ; Membranes, Artificial ; Minerals/therapeutic use ; Osteogenesis/drug effects ; Osteogenesis/physiology ; Random Allocation ; Recombinant Proteins/therapeutic use ; Tooth Extraction/adverse effects ; Tooth Socket/drug effects* ; Tooth Socket/pathology ; Tooth Socket/surgery ; Transforming Growth Factor beta/therapeutic use* ; X-Ray Microtomography/methods
Keywords
alveolar ridge augmentation ; bone morphogenetic protein 2 ; guided bone regeneration ; ooth extraction ; ridge preservation
Abstract
OBJECTIVES: This study evaluated the dimensional ridge alteration in a buccal-bone-deficient extraction socket, and ridge regeneration following socket grafting accompanied by recombinant human bone morphogenetic protein 2 (rhBMP-2) or a collagen membrane covering.
MATERIAL AND METHODS: In five beagle dogs, entire buccal bone of the extracted sockets of premolars was surgically removed and immediately grafted using one of the following graft protocols: (1) sham surgery without any grafting, and grafting with (2) deproteinized bovine bone mineral (DBBM), (3) DBBM/rhBMP-2 and (4) DBBM covered with a collagen membrane (DBBM/Membrane). Quantitative/qualitative analyses were performed radiographically/histologically after 8 weeks.
RESULTS: Buccal-deficient extraction sockets healed with significant reduction in buccolingual dimension along the entire length of the socket, but all grafting techniques reduced the dimensional changes compared to the non-grafted control sites. Histologically, sites received DBBM only exhibited minimal regeneration, whereas sites grafted with DBBM/rhBMP-2 or DBBM/Membrane exhibited greater new bone formation extending the entire augmented area.
CONCLUSIONS: Buccal-bone-deficiency may lead to significant volume reduction after tooth extraction along the entire length of the socket, and socket grafting accompanied by rhBMP-2 or covered with a membrane can be candidate therapies for preservation of the buccolingual dimension and successful ridge regeneration.