Craig M Misch1. 1. Private Practice, Oral & Maxillofacial Surgery and Prosthodontics, Sarasota, FL; Clinical Associate Professor, Department of Periodontics and Prosthodontics, University of Florida School of Dentistry, Gainesville, FL.
Abstract
PURPOSE: Because of limitations of the absorbable collagen sponge (ACS), recombinant bone morphogenetic protein (rhBMP-2) requires a scaffolding device for ridge augmentation. MATERIALS AND METHODS: Twenty-one patients were treated with 37 allogeneic block grafts and rhBMP-2/ACS. Cone-beam computed tomography (CBCT) was used to measure the ridge at 2 points preoperatively, postoperatively, and after graft healing. Dental implants were placed after 6 months of healing. RESULTS: The CBCT scan measurements revealed variable graft resorption at 2.0 mm and 5.0 mm above the crest (point A: 0%-33.82%; point B: 0%-31.51%). The graft resorption at point A averaged 14.7 ± 11.59% and at point B averaged 6.67 ± 8.25%. There was no statistically significant difference between these 2 points. All 37 bone blocks were found well incorporated. The range of horizontal augmentation gain at the crest (point A) was 2.8 mm to 7.7 mm (average horizontal gain 4.61 ± 0.82 mm). Sixty dental implants were inserted into the blocks in all planned sites. One implant failed during prosthetic treatment for an implant survival of 98.3%. Follow-up at 3 to 34 months found no additional failures. CONCLUSION: This case series suggests that allogeneic bone blocks may be a suitable replacement for titanium mesh as a resorbable scaffold with rhBMP-2/ACS. The growth factor may also improve allogeneic block graft incorporation.
PURPOSE: Because of limitations of the absorbable collagen sponge (ACS), recombinant bone morphogenetic protein (rhBMP-2) requires a scaffolding device for ridge augmentation. MATERIALS AND METHODS: Twenty-one patients were treated with 37 allogeneic block grafts and rhBMP-2/ACS. Cone-beam computed tomography (CBCT) was used to measure the ridge at 2 points preoperatively, postoperatively, and after graft healing. Dental implants were placed after 6 months of healing. RESULTS: The CBCT scan measurements revealed variable graft resorption at 2.0 mm and 5.0 mm above the crest (point A: 0%-33.82%; point B: 0%-31.51%). The graft resorption at point A averaged 14.7 ± 11.59% and at point B averaged 6.67 ± 8.25%. There was no statistically significant difference between these 2 points. All 37 bone blocks were found well incorporated. The range of horizontal augmentation gain at the crest (point A) was 2.8 mm to 7.7 mm (average horizontal gain 4.61 ± 0.82 mm). Sixty dental implants were inserted into the blocks in all planned sites. One implant failed during prosthetic treatment for an implant survival of 98.3%. Follow-up at 3 to 34 months found no additional failures. CONCLUSION: This case series suggests that allogeneic bone blocks may be a suitable replacement for titanium mesh as a resorbable scaffold with rhBMP-2/ACS. The growth factor may also improve allogeneic block graft incorporation.