Synergism between recombinant human bone morphogenetic protein 2/absorbable collagen sponge and bone substitutes favors vertical bone augmentation and the resorption rate of the biomaterials: Histomorphometric and 3D microcomputed tomography analysis

Abstract

Background: Recombinant human bone morphogenetic protein 2 (rhBMP-2) is an osteoinductor frequently used for bone regeneration in oral and maxillofacial surgery. There is no consensus about the ideal carrier for this growth factor. The aim of this study was to compare the bone augmentation, bone microarchitecture, and biodegradation rate of additional carriers to rhBMP-2/absorbable collagen sponge (ACS) in a vertical guided bone regeneration model. Methods: Four titanium cylinders were fixed onto the calvaria of rabbits (n = 20) that received (n = 10) or not (n = 10) rhBMP-2/ACS in conjunction with one of the carriers: beta-tricalcium phosphate (-TCP), biphasic calcium phosphate (BCP), bovine bone mineral (BBM) or blood clot. The samples were analyzed by means of microcomputed tomography and histomorphology after 14 weeks. Results: All the materials with rhBMP-2/ACS exhibited improvement on bone augmentation, mainly BCP (P = 0.033) and-TCP (P = 0.038), in the upper portion of the cylinder. Although trabecular anisotropy was improved in all the materials groups, trabecular connectivity was diminished when the biomaterials received rhBMP-2/ACS. Resorption rate of the remaining biomaterial was improved by rhBMP-2/ACS, mainly in BBM (P <0.01) and-TCP (P <0.01). BBM exhibited the highest osteoclast density compared with the other materials groups. Conclusions: BCP and-TCP biomaterials exhibited a synergic effect with rhBMP-2/ACS, acting as suitable and viable carriers for vertical bone augmentation. The addition of rhBMP-2 significantly affected the biodegradation of-TCP and BBM, accelerating the resorption of these materials.

Honeycomb scaffolds capable of achieving barrier membrane-free guided bone regeneration

“…57 The percent volume of new bone at 14 weeks post-implantation of recombinant human BMP 2 (rhBMP-2)containing collagen sponges in conjunction with β-TCP, biphasic calcium phosphate, bovine bone mineral, and blood clot was 28.7% ± 4.6%, 31.9% ± 5.1%, 18.0% ± 2.2%, and 15.3% ± 2.9%, respectively. 58 The percent volume of new bone formed in 3D printed porous TCP/HAp block-, anorganic bovine bone-, or TCP-filled titanium hemispheres was 23% ± 1.6%, 13.6% ± 1.5%, and 13.8% ± 1.5% at 8 weeks post-implantation and 35% ± 2%, 39% ± 2%, and 43% ± 6% at 16 weeks post-implantation, respectively. 59 Therefore, using only HC230 augments faster, higher, and more vertical bone growth than using the various combinations of scaffolds and supplements promoting bone formation (BMP, VEGF, sodium butyrate, dimethyloxalylglycine, and anabolic conjugate drug) or barriers for soft tissue invasion, such as titanium hemisphere.…”

“…For vertical bone augmentation, block-type scaffolds are considered favorable, because they facilitate shape forming and maintain the handleability, which are difficult when granular scaffolds are used. Various block-type scaffolds have been reported; 25,26] however, their ability for vertical bone augmentation is limited, and they need a combination of bone morphogenetic protein (BMP), [26][27][28] growth factors, 29] and stem and/or progenitor cells for favorable outcomes. [30][31][32][33][34] These combination approaches have several limitations, including severe swelling, cyst-like tissue formation, high cost, osteoclastic bone resorption, cumbersome procedures, and/or invasive manipulation requiring a minimum of two surgeries.…”

A Clinical Study on the Effect of Different Ratios of Recombinant Human Bone Morphogenetic Protein-2 Compound to Autogenous Bone on Cervical Interbody Fusion Based on Smart Healthcare

“…(2008) 1100111), the anterior intervertebral disc was excised with a long-pointed knife, and then, the disc and the posterior border of the vertebral bone cone were removed with the curette. (5) When the scope of decompression on both sides reached the Luschka joint and that on the posterior aspect reached the posterior longitudinal ligament or dura mater, the intervertebral foramen was enlarged, and the nerve root was thoroughly decompressed. ( 6) e superior and inferior vertebral cartilaginous laminae were curetted, leaving the intact cortical bone beneath the lamina to prevent collapse of the intervertebral space.…”

“…erefore, selecting the appropriate fusion material is the key to improving the rate of cervical interbody fusion for ACDF [4][5][6]. At present, the fusion materials commonly used in practice are mainly the autogenous or alloplastic bone, in which the autogenous bone is limited in extraction and the alloplastic bone may elevate the possibility of ACDF failure, so both of them do not have good application conditions.…”

Comparison of rhBMP-2 in Combination with Different Biomaterials for Regeneration in Rat Calvaria Critical-Size Defects

“…The precise positioning of the ACS can be complicated in some types of defects, and in some cases, postoperative displacement has been reported [ 13 ]. However, it produces a fast initial release of rhBMP-2 and rapid elimination compared to bone formation [ 14 – 16 ]. Therefore, supraphysiological doses are used to obtain good results and generate bone tissue [ 17 ], which creates potential complications, such as edema, erythema, pain, or even infection [ 18 ].…”