Extraction socket grafting using recombinant human bone morphogenetic protein-2-clinical implications and...

Area of Science:

• Dentistry
• Regenerative Medicine
• Biomaterials

Background:

• Maintaining alveolar bone height after tooth extraction is crucial for successful dental implant rehabilitation.
• Recombinant Bone Morphogenetic Protein-2 (rhBMP-2) is known for its osteoinductive properties, aiding bone augmentation.
• Beta-tricalcium phosphate (β-TCP) serves as a scaffold for bone regeneration, and platelet-rich fibrin (PRF) enhances healing.

Purpose of the Study:

• To evaluate the efficacy of rhBMP-2 delivered on a β-TCP scaffold combined with PRF for bone induction in extraction sockets.
• To assess the suitability of this graft combination for subsequent dental implant placement.

Main Methods:

• Socket grafting was performed using rhBMP-2 mixed with β-TCP and PRF following tooth extraction.
• Crestal bone width was measured at baseline and three months post-grafting.
• Bone hardness was assessed tactilely during implant preparation, and radiographic bone fill was evaluated at three months.

Main Results:

• Minimal changes in crestal bone width were observed three months after grafting, with minor bone loss noted.
• Tactile evaluation indicated bone hardness comparable to softwoods, suggesting adequate bone maturation.
• Complete radiographic bone fill was achieved within three months, eliminating the need for additional augmentation during implant placement.
• Histology confirmed no residual graft material, indicating successful integration and de novo bone formation.

Conclusions:

• The combination of rhBMP-2, β-TCP, and PRF is effective for socket grafting, promoting significant de novo bone formation.
• This novel graft combination can be recommended for pre-implant augmentation following tooth extraction.
• The treatment facilitates successful dental implant placement by regenerating adequate bone volume and quality.