Informative title: Guided bone regeneration with and without rhBMP‐2: 17‐year results of a randomized controlled clinical trial

Abstract

Objectives To assess long‐term outcomes of implants placed in conjunction with guided bone regeneration (GBR) with or without recombinant human bone morphogenetic protein‐2 (rhBMP‐2). Materials and Methods Eleven patients with at least two lateral bone defects (split‐mouth design) received a total of 34 implants. The defects were treated with a xenogenic bone substitute with (test) or without (control) rhBMP‐2 and covered with a collagen membrane. Eight patients could be reexamined after at least 17 years. Wilcoxon signed‐rank tests were performed to assess differences between test and control groups. Results The implant survival rate was 100% for all test and control sites. Mean marginal bone levels were 2.51 mm (SD ±1.64) (mesial test), 1.83 mm (SD ±0.93) (mesial control) (p = .055), 2.36 mm (SD ±1.70) (distal test), and 2.13 mm (SD ±0.84) (distal control) (p = 1.000). Compared with the mean values at baseline, a mean bone loss of 1.16 mm (SD ±1.60) (test) and 0.70 mm (SD ±1.02) (control) was found. The mean buccal bone gain after 17 years was 5.38 mm (test) and 3.14 mm (control) based on the comparison between the measurements at the cone beam CT after 17 years and the data from the intraoperative measurements at baseline. Further, mean values for (i) bone thickness ranged from 1.36 to 3.09 mm (test) and 1.18 to 3.39 mm (control) and for (ii) mucosal thickness of 1.24 mm (test) and 1.26 mm (control). Conclusion Implants placed in conjunction with GBR applying a xenogenic bone substitute and a collagen membrane with and without the addition of rhBMP‐2 demonstrate excellent clinical and radiographic results after at least 17 years.

A comparative in vitro and in vivo study of porcine‐ and bovine‐derived non‐cross‐linked collagen membranes

“…Cross‐linking methods have been developed to strengthen the collagen membrane to decelerate the degradation speed, such as dehydrothermal treatment 21,22,23 . The combination of non‐cross‐linked collagen membranes and bone substitute grafts is another solution in most clinical settings 24,25 . However, non‐cross‐linked collagen membranes from different species and manufacturing methods also differ in biophysical properties and degradation patterns, which could affect the GBR process 26 …”

“…21,22,23 The combination of non-cross-linked collagen membranes and bone substitute grafts is another solution in most clinical settings. 24,25 However, non-crosslinked collagen membranes from different species and manufacturing methods also differ in biophysical properties and degradation patterns, which could affect the GBR process. 26 The main raw materials of non-cross-linked collagen membranes used in GBR are type I and III collagens, mainly derived from pigs, cows, and some other mammalian species.…”

Clinical and patient‐reported outcomes of tissue engineering strategies for periodontal and peri‐implant reconstruction

“…Tissue engineering strategies for peri-implant bone augmentation were described in five studies, 147,150,189,190,231 with three of them reporting data from the same patient population with different follow-up intervals. 147,189,190 These trials utilized recombinant human bone morphogenetic protein-2 or recombinant human plateletderived growth factor-BB in combination with different bone graft materials. 147,150,189,190,231 The characteristics of the aforementioned randomized controlled trials are presented in detail in Table 13 and Appendix S1.…”

“…147,189,190 These trials utilized recombinant human bone morphogenetic protein-2 or recombinant human plateletderived growth factor-BB in combination with different bone graft materials. 147,150,189,190,231 The characteristics of the aforementioned randomized controlled trials are presented in detail in Table 13 and Appendix S1.…”

“…Postoperative morbidity was not assessed in the aforementioned studies 147,150,189,190,231 (Table 14). Two articles about the same cohort reported patient-reported outcome measures.…”