Buccal Bone Formation After Flapless Extraction: A Randomized, Controlled Clinical Trial Comparing Recombinant Human Bone Morphogenetic Protein 2/Absorbable Collagen Carrier and Collagen Sponge Alone. Issue 4 (1st April 2014)

• Record Type: Journal Article
• Authors: Coomes, Angela M.; Mealey, Brian L.; Huynh‐Ba, Guy; Barboza‐Arguello, Concepcion; Moore, William S.; Cochran, David L.
• Is Part Of: Journal of periodontology. Volume 85:Issue 4(2014)
• Page Start: 525
• Page End: 535
• Publication Date: 2014-04-01
• Subjects: Bone morphogenetic proteins -- cone beam computed tomography -- dental implant -- intercellular signaling peptides and proteins -- regeneration -- tooth extraction; Periodontics -- Periodicals; 617.632
• DOI: 10.1902/jop.2013.130207
• Languages: English
• ISSNs: 0022-3492

Abstract

Abstract : Background: Flapless extraction of teeth allows for undisturbed preservation of the nearby periosteum and a source of osteoprogenitor cells. Recombinant human bone morphogenetic protein 2 (rhBMP‐2) has been used for different bone augmentation purposes with great osteoinductive capacity. The aim of this study is to compare the bone regenerative ability of rhBMP‐2 on an absorbable collagen sponge (ACS) carrier to a collagen sponge (CS) alone in extraction sites with ≥50% buccal dehiscence. Methods: Thirty‐nine patients requiring extraction of a hopeless tooth with ≥50% buccal dehiscence were enrolled. After flapless extraction and randomization, either rhBMP‐2/ACS carrier or CS alone was placed in the extraction site. After extraction, a baseline cone beam computed tomography (CBCT) scan was obtained of the site, and a similar scan was obtained 5 months postoperatively. Medical imaging and viewing software were used to compare the baseline and 5‐month postoperative images of the study site and assess ridge width measurements, vertical height changes, and buccal plate regeneration. Results: Radiographically, CBCT analysis showed that with ≥50% of buccal bone destruction, rhBMP‐2/ACS was able to regenerate a portion of the lost buccal plate, maintain theoretical ridge dimensions, and allow for implant placement 5 months after extraction. The test group performed significantly ( P <0.05) better in regard to clinical buccal plate regeneration (4.75 versus 1.85 mm), clinical ridge width at 5 months (6.0 versus 4.62 mm), and radiographic ridge width at 3 mm from the alveolar crest (6.17 versus 4.48 mm) after molar exclusion. There was also significantly ( P <0.05) less remaining buccal dehiscence, both clinically (6.81 versus 10.0 mm) and radiographically (3.42 versus 5.16 mm), at 5 months in the test group. Significantly ( P <0.05) more implants were placed in the test group without the need for additional augmentation. The mean loss in vertical ridge height (lingual/palatal) was less in the test sites but was not significantly ( P = 0.514) different between the test and control groups (0.39 versus 0.64 mm). Conclusions: rhBMP‐2/ACS compared to CS alone used in flapless extraction sites with a buccal dehiscence is able to regenerate lost buccal plate, maintain theoretical ridge dimensions, and allow for implant placement 5 months later.