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, 12 (3), 205-212

Comparison of Recombinant Human Bone Morphogenetic protein-2-infused Absorbable Collagen Sponge, Recombinant Human Bone Morphogenetic protein-2-coated Tricalcium Phosphate, and Platelet-Rich Fibrin-Mixed Tricalcium Phosphate for Sinus Augmentation in Rabbits

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Comparison of Recombinant Human Bone Morphogenetic protein-2-infused Absorbable Collagen Sponge, Recombinant Human Bone Morphogenetic protein-2-coated Tricalcium Phosphate, and Platelet-Rich Fibrin-Mixed Tricalcium Phosphate for Sinus Augmentation in Rabbits

Chul-Hun Kim et al. J Dent Sci.

Abstract

Background/purpose: Numerous grafting materials have been used in the bone regeneration of maxillary sinus to obtain a sufficient amount of new bone in implant dentistry. The objective of this study was to compare the potentials of Type I absorbable collagen sponge (ACS) impregnated with recombinant human bone morphogenetic protein (rhBMP)-2, rhBMP-2-coated tricalcium phosphate (TCP), platelet-rich fibrin-mixed TCP for enhancing bone regeneration in sinus augmentation in rabbits.

Materials and methods: The sinus defects were grafted with rhBMP-2+ACS (Group A), rhBMP-2-coated TCP (Group B), and platelet-rich fibrin-mixed TCP (Group C). The specimens underwent decalcification, and were stained for histomorphometric analysis.

Results: There were no significant differences in inflammatory features among the groups 1-week postoperation. In a histomorphometric analysis, the new bone formation ratio showed significant differences between groups at 2 weeks. rhBMP-2+ACS showed a larger and more rapid bone formation area at 2 weeks than those of Groups B and C.

Conclusion: Our histological evaluation demonstrates that Type I ACS can be used as a carrier of rhBMP-2, and rhBMP-2+ACS showed rapid bone formation, remodeling, and calcification at Week 2 in rabbit.

Keywords: BMP-2; PRF; TCP; absorbable collagen sponge; sinus augmentation.

Figures

Figure 1
Figure 1
(A) Two symmetric ovoid bone defects were created, and both sinus membranes were depressed by the periosteal and sinus membrane elevator for grafting. (B) Grafted maxillary sinus site was harvested and grafted materials are stable (black arrow).
Figure 2
Figure 2
Traces of the newly formed bone outline using Aperio Technologies Scanscope. NB = newly formed bone; TCP = tricalcium phosphate.
Figure 3
Figure 3
Comparison of the inflammatory reactions at Week 1 in (A) Group A, (B) Group B, and (C) Group C. HE staining revealed normal red blood cell (red arrow) with slight acute inflammatory cell infiltration (black arrow) but not remarkable inflammatory activity in all groups. HE = hematoxylin and eosin; TCP = tricalcium phosphate.
Figure 4
Figure 4
Histologic view at Week 2 in (A) Group A, (B) Group B, and (C) Group C. Early osteoblast proliferation (black arrow) and new bone formation was observed in Group A rather than Groups B and C. (A“) The total hematoxylin and eosin view of Group A (rhBMP-2+ACS) showed abundant bone formation around ACS after 2 weeks. ACS = absorbable collagen sponge; NB = newly formed bone; RBC = red blood cell.
Figure 5
Figure 5
Osteopontin immunohistochemical staining at Week 4 in (A) Group A, (B) Group B, and (C) Group C. All of the groups demonstrated large amount of osteopontin staining around grafted materials and newly formed bone (black arrow). NB = newly formed bone; TCP = tricalcium phosphate.
Figure 6
Figure 6
Quantitative analysis of bone formation area. At Week 2, Group A showed higher bone formation area than Groups B and C. ACS = absorbable collagen sponge; BMP = bone morphogenetic proteins; PRF = platelet-rich fibrin; TCP = tricalcium phosphate.
Figure 7
Figure 7
Kruskal–Wallis test of bone formation area. All groups showed increasing bone formation patterns to Week 6. In particular, Group A (rhBMP-2+ACS) showed earlier peak bone formation than Group B or C. ACS = absorbable collagen sponge; BMP = bone morphogenetic proteins; PRF = platelet-rich fibrin; TCP = tricalcium phosphate.

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