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The Journal of Bone and Joint Surgery (American) 83:S136-S145 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Clinical Applications of BMPs in Oral and Maxillofacial Surgery

Augmentation of Alveolar Bone and Dental Implant Osseointegration: Clinical Implications of Studies with rhBMP-2

A Comprehensive Review

Ulf M.E. Wikesjö, DDS, PhD, Rachel G. Sorensen and John M. Wozney, PhD

Laboratory for Applied Periodontal and Craniofacial Regeneration, Department of Periodontology, Temple University School of Dentistry, Philadelphia, Pennsylvania, and Bone Biology and Applications, Musculoskeletal Sciences, Genetics Institute, Inc., Andover, Massachusetts, U.S.A.
Ulf M.E. Wikesjö, DDS, PhD
Temple University School of Dentistry, Laboratory for Applied Periodontal and Craniofacial Regeneration, Department of Periodontology, 3223 North Broad Street, Philadelphia, PA 19140. E-mail address for U.M.E. Wikesjö: uwikesjo{at}dental.temple.edu

Rachel G. Sorenson
John M. Wozney, PhD
Bone Biology and Applications Group, Genetics Institute, Inc., One Burtt Road, Andover, MA 01810, U.S.A.

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: The surgical placement of dental implants is governed primarily by the prosthetic design and secondarily by the morphology and quality of the alveolar bone. Implant placement may be difficult, if at all possible, due to alveolar ridge aberrations. In consequence, prosthetically dictated dental implant positioning often entails augmentation of the alveolar ridge and adjacent structures. The objective of this review is to discuss recent observations of the biologic potential, the clinical relevance, and the perspectives of the application of recombinant human bone morphogenetic protein-2 (rhBMP-2) technology for alveolar bone augmentation and dental implant fixation.

Methods: Our studies use discriminating, critical-size, supraalveolar defects in dogs to evaluate the biologic potential of the rhBMP-2 technology. We also use clinical modeling, including peri-implantitis and alveolar ridge defects and the maxillary sinus in preparation for clinical indications, in dogs and inhuman primates.

Results: The results suggest that rhBMP-2 has substantial potential to augment alveolar bone and support dental implant fixation and functional loading.

Conclusion and Clinical Relevance: Inclusion of rhBMP-2 for alveolar bone augmentation and dental implant fixation will not only enhance the predictability of the existing clinical protocol but will also allow new approaches to these procedures.


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