Naslov
Bone morphogenetic proteins in clinical implant dentistry

Autori
Macan, Darko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, neobjavljeni rad, znanstveni

Izvornik
12th International Friadent Symposium. Salzburg, 24.-25.3.2006. / - , 2006

Skup
12th International Friadent Symposium 2006

Mjesto i datum
Salzburg, Austrija, 24.03.2006. - 25.03.2006

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
BMP ; bone grafting ; dental implants

Sažetak
Bone morphogenetic proteins belong to the transforming growth factor β (TGF- β ) superfamily. BMP-7 or OP-1 (osteogenic protein- 1) was cloned in the 1990’ s. It promotes an increase in chondrocyte proliferation and induces chondrogenic differentiation, and it stimulates cell proliferation, collagen synthesis and osteoblast differentiation. Studies on animal models have shown that OP-1 is capable of inducing endochondral ossification in segmental osteoperiosteal defects. The FDA of the United States has recently approved the use of BMP-7 for the treatment of spinal fusion, emphasizing its use in orthopedic and dental surgeries. A search of PubMed retrieved 2, 975 hits for the descriptor “ bone morphogenetic protein” but only 20 citations for Clinical Trials in Humans. The first studies were clinical trials analyzing the effect of BMPs for local alveolar ridge preservation or augmentation ; maxillary sinus floor augmentation ; regeneration of lost bone tissue due to periodontal disease ; increase in bone volume for placement of implants and restorative-endodontic procedures. To our knowledge, this is the first described case of dental implants inserted in the resected mandible reconstructed with hip chips bone graft using rhBMP-7. A 31-year-old female patient presented to the Department with an recurrent right sided lower jaw ameloblastoma (12 y. after initial treatment). Preoperative CT scan demonstrating the extent of the lesion in the right mandibular ramus. 3-D reconstruction demonstrated a multi-locular radiolucency. Becasue of the size of the lesion, the patient was scheduled for an en block resection with primary reconstruction of the defect. Once the tumor was exposed, a 2, 4 mm reconstruction plate was adapted to the mandible and secured in place. The plate was then removed, and a vertical ramous osteotomy was performed. The bone defect was six cm length. We adapted titanium mesh “ pocket” in to which a mixture of hip graft and of rh BMP-7 (Stryker Biotech) was aministered. The quality of BMP induced bone is indistinguishable from the natural bone. A year after, we inserted three ANKYLOS implants. One implant failed. Unfortunately, we had to perform reosteotomy and additional osteosynthesis because of malocclusion. Although this case has shown encouraging results, more Clinical studies are needed to truly understand the behavior of BMP in reconstructive surgery. Long-term results and the predictability of this type of reconstruction in humans are still unknown.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Dentalna medicina

POVEZANOST RADA