Horizontal ridge augmentation of the atrophic anterior maxilla using rhBMP‐2/ACS or autogenous bone grafts: a proof‐of‐concept randomized clinical trial

Source abstract

Abstract Aim To compare the effect of recombinant human bone morphogenetic protein‐2 (rhBMP‐2) in an absorbable collagen sponge carrier (ACS) with autogenous bone graft for augmentation of the edentulous atrophic anterior maxilla. Methods Twenty‐four subjects were enrolled in a randomized, controlled, parallel‐group, open‐label clinical trial. Subjects either received rhBMP‐2/ACS (1.5 mg/ml) or particulated autogenous bone harvested from the mandibular retromolar region. A titanium‐mesh was used to provide space and wound stability. A guide was used to standardize clinical recordings using an analogue caliper. Alveolar ridge width was also assessed using cone‐beam computed tomography. Results rhBMP‐2/ACS yielded significantly greater radiographic horizontal bone gain compared with autogenous bone graft at immediate subcrestal levels (1.5 ± 0.7 versus 0.5 ± 0.9 mm; p = 0.01); non‐significant differences were observed at mid‐ (2.9 ± 0.8 versus 2.9 ± 0.9 mm; p = 0.98) and apical (1.7 ± 0.9 versus 1.8 ± 1.1 mm; p = 0.85) crestal levels. No significant differences in clinical horizontal bone gain were observed at 6 months between rhBMP‐2/ACS and autogenous bone graft (3.2 ± 0.9 mm versus 3.7 ± 1.4 mm; p = 0.31). Sixty‐two implants were placed after 6 month of healing with no significant differences between groups for number of implants, implant size, primary stability and survival. Conclusions rhBMP‐2/ACS appears a realistic alternative for augmentation of the edentulous atrophic anterior maxilla.