The effects of recombinant human growth/differentiation factor-5 (rhGDF-5) on bone regeneration around titanium dental implants in barrier membrane-protected defects: a pilot study in the mandible of beagle dogs

Int J Oral Maxillofac Implants. Jan-Feb 2009;24(1):31-7.

Abstract

Purpose: This dog study sought to evaluate guided bone regeneration (GBR) in peri-implant defects following implantation of beta-tricalcium phosphate (beta-TCP) with and without osteoinductive recombinant human growth/differentiation factor-5 (rhGDF-5).

Materials and methods: In five beagle dogs, all mandibular premolars and the first molar were extracted. After 2 months, six buccolingual critical-size defects were created, and an implant was inserted into the center of each defect. One defect was filled with beta-TCP coated with rhGDF-5 (600 microg/g beta-TCP) and covered with a titanium-reinforced e-PTFE membrane (GDF group). A second defect received the same treatment, but pure uncoated beta-TCP was used (TCP group). A third defect was filled with beta-TCP mixed with autograft and not protected with a membrane (control group). The remaining three defects were filled with other biomaterials. After 2 months, total new bone area, regenerated bone height, and residual amount of beta-TCP were determined histomorphometrically.

Results: All implants osseointegrated. One membrane in each group became exposed. Mean new bone area for GDF, TCP, and control sites was 43.9 +/- 18.7 mm2, 32.3 +/- 16.1 mm2, and 13.1 +/- 4.0 mm2, respectively, with a significant difference between GDF and control groups. Mean regenerated bone height was 103.8 +/- 29.7%, 75.4 +/- 36.6%, and 67.2 +/- 19.1% for the GDF, TCP, and control groups, respectively. Mean residual matrix volumes were 25.9 +/- 13.6%, 30.0 +/- 13.0%, and 13.4 +/- 6.5%, respectively. Membrane protection of peri-implant defects filled with beta-TCP resulted in a stronger effect on bone regeneration, although this was not statistically significant. The most pronounced regenerative results were achieved in rhGDF-5/beta-TCP filled membrane-protected defects.

Conclusion: Delivery of rhGDF-5 on beta-TCP might have the potential to enhance the results of GBR in peri-implant defects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alveolar Bone Loss / surgery
  • Alveolar Process / pathology
  • Animals
  • Biocompatible Materials / therapeutic use
  • Bone Regeneration / drug effects*
  • Bone Substitutes / therapeutic use
  • Bone Transplantation
  • Calcium Phosphates / therapeutic use
  • Dental Implants*
  • Dental Materials*
  • Dogs
  • Female
  • Growth Differentiation Factor 5 / therapeutic use*
  • Guided Tissue Regeneration / instrumentation*
  • Human Growth Hormone / therapeutic use*
  • Humans
  • Mandible / pathology
  • Mandible / surgery*
  • Membranes, Artificial*
  • Osseointegration / physiology
  • Polytetrafluoroethylene / chemistry
  • Random Allocation
  • Recombinant Proteins
  • Titanium*

Substances

  • Biocompatible Materials
  • Bone Substitutes
  • Calcium Phosphates
  • Dental Implants
  • Dental Materials
  • GDF5 protein, human
  • Growth Differentiation Factor 5
  • Membranes, Artificial
  • Recombinant Proteins
  • beta-tricalcium phosphate
  • Human Growth Hormone
  • Polytetrafluoroethylene
  • Titanium