The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of rhPMP-2 coated implants on alveolar ridge augmentation in dogs

성견에서 골형성단백질이 코팅된 임플란트가 치조골 증대에 미치는 영향

  • Park, Chan-Kyung (Department of Advanced Prosthodontics, Graduate School of Clinical Dentistry, Institute of Clinical Dental Research, Korea University) ;
  • Kim, Jong-Eun (Department of Advanced Prosthodontics, Graduate School of Clinical Dentistry, Institute of Clinical Dental Research, Korea University) ;
  • Shin, Ju-Hee (Department of Advanced Prosthodontics, Graduate School of Clinical Dentistry, Institute of Clinical Dental Research, Korea University) ;
  • Ryu, Jae-Jun (Department of Advanced Prosthodontics, Graduate School of Clinical Dentistry, Institute of Clinical Dental Research, Korea University) ;
  • Huh, Jung-Bo (Department of Advanced Prosthodontics, Graduate School of Clinical Dentistry, Institute of Clinical Dental Research, Korea University) ;
  • Shin, Sang-Wan (Department of Advanced Prosthodontics, Graduate School of Clinical Dentistry, Institute of Clinical Dental Research, Korea University)
  • 박찬경 (고려대학교 임상치의학대학원 고급치과보철학과, 고려대학교 임상치의학연구소) ;
  • 김종은 (고려대학교 임상치의학대학원 고급치과보철학과, 고려대학교 임상치의학연구소) ;
  • 신주희 (고려대학교 임상치의학대학원 고급치과보철학과, 고려대학교 임상치의학연구소) ;
  • 류재준 (고려대학교 임상치의학대학원 고급치과보철학과, 고려대학교 임상치의학연구소) ;
  • 허중보 (고려대학교 임상치의학대학원 고급치과보철학과, 고려대학교 임상치의학연구소) ;
  • 신상완 (고려대학교 임상치의학대학원 고급치과보철학과, 고려대학교 임상치의학연구소)
  • Received : 2010.06.21
  • Accepted : 2010.07.07
  • Published : 2010.07.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was aimed to evaluate the effect of rhPMP-2 coated implants on alveolar ridge augmentation in dogs. Materials and methods: Six Beagle dogs were used in this study. Six 8.0 mm long anodized surface titanium implants were placed 5 mm into the mandibular alveolar ridge following 6 month of healing period after extraction. Each animal received three implants coated with rhBMP-2 and three uncoated control implants using the randomized split-mouth design. Radiographic examinations were undertaken immediately at implant placement (baseline), at weeks 4 and 8 after implant placement. The amount of bone augmentation was evaluated by measuring the distance from the uppermost point of the coverscrew to the marginal bone. Implant Stability Quotient (ISQ) values were measured immediately at implant placement and 8 weeks after implant placement. For the statistical analysis, Man-Whitney ranksum test and Wilcoxon signed rank test of SPSS 12.0 software were used (P=.05). Results: The BMP group exhibited radiographic vertical bone augmentation about $0.6{\pm}0.7$ mm at 8 weeks later while controls showed bone loss about $0.4{\pm}0.6$ mm. There was significant difference among the rhBMP-2 group and controls in bone level change (P<.05). The ISQ values were significantly higher in the BMP-2 group than the control group at 8 weeks later (P<.05), while there was no significant difference at surgery. Conclusion: Within the limitation of this study, the rhBMP-2 coated on anodized implant could stimulate vertical alveolar bone augmentation, which may increase implant stability significantly on completely healed alveolar ridge.

연구 목적: 이 연구의 목적은 골형성단백질 (recombinant human Bone Morphogenetic Protein-2; rhBMP-2)이 코팅된 임플란트가 치조골 증대에 미치는 영향을 알아보는 것이다. 연구 재료 및 방법: 6마리의 비글견이 실험에 사용되었다. 6개의 8 mm 길이의 임플란트가 발치 후 6개월 이상의 충분한 치유기간이 경과한 비글견의 치조골에 5 mm 깊이로 식립되었다. 각각의 동물에 좌측과 우측의 악궁-분할형으로 임의추출하여 한쪽에는 1.5 ml/mg 농도의 rhBMP-2가 코팅된 임플란트를, 반대편에는 코팅되지 않은 대조군 임플란트를 식립하고 임플란트 주변 골에 round bur를 이용하여 피질골 천공을 시행하였다. 점막골막판막에 이완절개를 시행하여 판막을 접합시키고 봉합하여 임플란트가 피개되도록 하였다. 방사선 사진 촬영은 수술 직후 (기준치), 수술 4주후, 수술 8주 후에 시행하였다. 측정은 각 방사선 사진의 임플란트 덮개나사 최상방에서 변연골까지의 거리를 측정하여 골 형성량을 계산하였다. 수술 직후와 수술 8주 후에 임플란트 안정도 (Implant Stability Quotient value; ISQ value)를 측정하였다. 통계분석을 위해 SPSS software를 사용하여 Man-Whitney ranksum test와 Wilcoxon signed ranksum test를 시행하였다. 통계적 유의수준은P=.05를 기준으로 하였다. 결과: 골형성단백질이 코팅된 임플란트에서 수직 결손부 상방으로 약 0.6 mm의 골 형성이 관찰되었다. 대조군에서는 제한된 양의 골 형성 혹은 골 소실이 일어났다. 각 시기에 따른 실험군과 대조군간의 골 형성량에 유의한 차이가 있었다 (P<.05). ISQ value는 수술 직후에는 실험군과 대조군의 유의한 차이가 없었지만 수술 8주 후에는 실험군에서 대조군 보다 유의하게 높게 증가되었다 (P<.05). 결론: 골형성단백질이 코팅된 임플란트는 완전히 치유된 치조골에서 임상적으로 유의한 골 증대 효과가 있는 것으로 보인다.

Keywords

References

  1. Urist MR. Bone: formation by autoinduction. Science 1965;150:893-9. https://doi.org/10.1126/science.150.3698.893
  2. Reddi AH. Bone and cartilage differentiation. Curr Opin Genet Dev 1994;4:737-44. https://doi.org/10.1016/0959-437X(94)90141-O
  3. Reddi AH. Role of morphogenetic proteins in skeletal tissue engineering and regeneration. Nat Biotechnol 1998;16:247-52. https://doi.org/10.1038/nbt0398-247
  4. Bostrom MP, Asnis P. Transforming growth factor beta in fracture repair. Clin Orthop Relat Res 1998;(355 Suppl):S124-31.
  5. Barnes GL, Kostenuik PJ, Gerstenfeld LC, Einhorn TA. Growth factor regulation of fracture repair. J Bone Miner Res 1999;14:1805-15. https://doi.org/10.1359/jbmr.1999.14.11.1805
  6. Bessa PC, Casal M, Reis RL. Bone morphogenetic proteins in tissue engineering: the road from the laboratory to the clinic, part I (basic concepts). J Tissue Eng Regen Med 2008;2:1-13. https://doi.org/10.1002/term.63
  7. Bessa PC, Casal M, Reis RL. Bone morphogenetic proteins in tissue engineering: the road from laboratory to clinic, part II (BMP delivery). J Tissue Eng Regen Med 2008;2:81-96. https://doi.org/10.1002/term.74
  8. Chen D, Zhao M, Mundy GR. Bone morphogenetic proteins. Growth Factors 2004;22:233-41. https://doi.org/10.1080/08977190412331279890
  9. Hall J, Sorensen RG, Wozney JM, Wikesjo UM. Bone formation at rhBMP-2-coated titanium implants in the rat ectopic model. J Clin Periodontol 2007;34:444-51. https://doi.org/10.1111/j.1600-051X.2007.01064.x
  10. Wikesjo UM, Xiropaidis AV, Qahash M, Lim WH, Sorensen RG, Rohrer MD, Wozney JM, Hall J. Bone formation at recombinant human bone morphogenetic protein-2-coated titanium implants in the posterior mandible (Type II bone) in dogs. J Clin Periodontol 2008;35:985-91. https://doi.org/10.1111/j.1600-051X.2008.01318.x
  11. Leknes KN, Yang J, Qahash M, Polimeni G, Susin C, Wikesjo UM. Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2: radiographic observations. Clin Oral Implants Res 2008;19:1027-33. https://doi.org/10.1111/j.1600-0501.2008.01567.x
  12. Simion M, Trisi P, Piattelli A. Vertical ridge augmentation using a membrane technique associated with osseointegrated implants. Int J Periodontics Restorative Dent 1994;14:496-511.
  13. Bessho K, Konishi Y, Kaihara S, Fujimura K, Okubo Y, Iizuka T. Bone induction by Escherichia coli - derived recombinant human bone morphogenetic protein-2 compared with Chinese hamster ovary cell-derived recombinant human bone morphogenetic protein-2. Br J Oral Maxillofac Surg 2000;38:645-9. https://doi.org/10.1054/bjom.2000.0533
  14. Hoar JE, Beck GH, Crawford EA, Resnik R. Prospective evaluation of crestal bone remodeling of a bone-density based dental implant system. Compend Contin Educ Dent 1998;19:17-24.
  15. Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (II). Etiopathogenesis. Eur J Oral Sci 1998;106:721-64. https://doi.org/10.1046/j.0909-8836..t01-6-.x