Histological Comparison of Autogenous and Allogenic Demineralized Dentin Matrix Loaded with Recombinant Human Bone Morphogenetic Protein-2 for Alveolar Bone Repair: A Preliminary Report

Abstract

The goal of investigation is to examine the histological response to recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded demineralized dentin matrices (DDMs) of different origins. The evaluation site is chosen between the cover screw and gingiva, as the poor blood supply allows it to simulate a heterotopic condition. We hypothesize that the antigenicity and immunogenicity of the carrier allogenic DDMs are low enough to maintain both the biocompatibility of the scaff old and the activity of the loaded rhBMP-2. Three patients undergoing simultaneous implant placement and receiving a diff erent type of graft were included: allogenic DDM loaded with rhBMP-2(DDM/rhBMP-2), autogenous DDM/rhBMP-2 and autogenous DDM. Histological specimens were retrieved during the secondary surgery after 3-6 months. In histological examination, particles were encapsulated by dense fi brous tissue without any infl ammatory cells. The capsule contained an increased number of cell layers in the DDM/rhBMP-2 (allogenic and autogenous) compared to autogenous DDM. Resorption activity was higher in autogenous DDM/rhBMP-2 than in allogenic DDM/rhBMP-2. Within the limitations of this report, results demonstrated the successful use of DDM as a potential rhBMP2 carrier. Further studies will be required to confi rm the safety and eff ectiveness of autogenous and allogenic DDM/rhBMP-2.

Demineralized Dentin Matrix as a Carrier of Recombinant Human Bone Morphogenetic Proteins: <i>in Vivo</i> Study

“…In the preliminary human clinical report, the DDM/rhBMP-2 (0.2 mg/ml concentration) exhibited multiple irregularly shaped surfaces infiltrated by activated cells, as well as isolated spaces that filled with infiltrating cells. These spaces were consistent with collagenolytic resor ption with fibroblast infi ltration and were reminiscent of DDM undergoing resorption by multinucleated giant cells 49) .…”

Clinical application of autogenous demineralized dentin matrix loaded with recombinant human bone morphogenetic‐2 for socket preservation: A case series

“…29 In our preliminary clinical report, histological specimens of DDM/rhBMP-2 obtained at the time of second surgery had multiple irregularly shaped surfaces infiltrated by activated cells, as well as isolated spaces that became filled with infiltrating cells. 19 These spaces were consistent with collagenolytic resorption and fibroblast infiltration and were reminiscent of DDM undergoing resorption by multinucleated giant cells. These observations seem consistent with the reports of Ike and Urist 14 and Murata, 15 which showed that as the quantity of induced bone increased after treatment with DDM/rhBMP-2, the resorption and replacement of the dentin matrix (carrier) also increased.…”

“…In our preliminary clinical report, histological specimens of DDM/rhBMP‐2 obtained at the time of second surgery had multiple irregularly shaped surfaces infiltrated by activated cells, as well as isolated spaces that became filled with infiltrating cells . These spaces were consistent with collagenolytic resorption and fibroblast infiltration and were reminiscent of DDM undergoing resorption by multinucleated giant cells.…”

“…On the basis of the osteoinductive activity of DDM and its potential as a carrier for rhBMP‐2, as well as the reported synergistic effects of rhBMP‐2 and transforming growth factor beta in a variety of model systems, we hypothesized that the effect of DDM/rhBMP‐2 on socket preservation may be superior to that of DDM alone. Moreover, we expected synergistic effects between exogenous rhBMP‐2 and the endogenous growth factors in osteoinductive DDM that could allow the ideal concentration of exogenous rhBMP‐2 to be lowered …”

“…Moreover, we expected synergistic effects between exogenous rhBMP-2 and the endogenous growth factors in osteoinductive DDM that could allow the ideal concentration of exogenous rhBMP-2 to be lowered. 3,19 The aim of this case series study was to compare the efficacy of autogenous DDM/rhBMP-2 for socket preservation with that of autogenous DDM alone. The primary variables were the changes in height and width of the extraction socket 3-6 months after the graft procedure.…”