Reconstruction Of Severely Atrophic Pre-maxilla Using RhBMP-2 And Titanium Mesh For Dental Implants

Abstract

In order to achieve functional and esthetic oral rehabilitations, dental implants must be placed at an ideal tridimensional position in the alveolar bone. A clinical case is presented of a 49-year-old female with a severely resorbed pre-maxilla. Bone augmentation was conducted using the "tent pole" technique with human recombinant morphogenetic bone protein-2 embedded in an absorbable collagen sponge and deproteinized bovine bone. In addition, a titanium mesh was adapted over the graft to provide support. At 8 months postop, a cone beam computerized tomography (CBCT) scan showed significant bone consolidation. An ideal premaxilla ridge with more than 14 mm of vertical and 10 mm of horizontal width was observed. Four dental implants were placed. Re-entry was 6 months later. Individual crowns were made to substitute the incisors, which were in function for the 1-year follow-up.

Application of Recombinant Human BMP-2 with Bone Marrow Aspirate Concentrate and Platelet-Rich Fibrin in Titanium Mesh for Vertical Maxillary Defect Reconstruction prior to Implant Placement

“…For regenerative surgeries, many graft materials have been developed with variable properties. One relatively new material is rhBMP-2, a member of the transforming growth factor- β superfamily, which plays an important role in the modulation and differentiation of mesenchymal cells into osteoblasts [ 15 , 16 ].…”

“…rhBMP-2 is the most investigated growth factor for oral and maxillofacial applications that has shown a high success rate in bone defect reconstruction [ 17 ]. In 2008, the US Food and Drug Administration approved the clinical use of rhBMP-2 in sinus lifting and localized alveolar ridge defects associated with extraction sockets [ 16 ]. Many studies have reported offlabel uses of rhBMP-2 in the reconstruction of maxillary bone defects [ 14 , 16 , 18 ].…”

“…In 2008, the US Food and Drug Administration approved the clinical use of rhBMP-2 in sinus lifting and localized alveolar ridge defects associated with extraction sockets [ 16 ]. Many studies have reported offlabel uses of rhBMP-2 in the reconstruction of maxillary bone defects [ 14 , 16 , 18 ]. Moreover, it has become an alternative to autogenous bone and other bone grafts, as it can overcome the complications associated with harvesting bone from the iliac crest or other donor sites [ 19 ].…”