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Implant survival in regenerated bone

Friday, 1st March 2019

Hall B - (Ruby and Jade)


Background: Autologous bone grafting, in spite of certain disadvantages, is considered the gold standard for reconstruction of maxillofacial bone defects. Protein guided bone regeneration using bone morphogenetic protein (BMP’s) are increasingly becoming popular. The aim of this study was to evaluate jaw bone regeneration using rhBMP2 and studying the dental implant survival on such regenerated bone in subjects with critical sized defects of the jaw bones.

Methods: This retrospective study, from clinical archives, included 21 subjects aged 4–59 years with critical size jaw defects (≥ 50 mm2) in either jaw and not suffering from any systemic illness that compromise the bone remodeling phenomenon. The critical sized defects were corrected with using rhBMP2 with or without autologous bone grafting, using standard, previously described procedures. Later, after a latency period of 4 to 6 months, dental implants were placed on the regenerated bone as well as adjacent normal bone. After, a period of 1 month, the crown was fixed and the subjects were followed for 6 months. The dental implant survival was assessed clinically and radiographically. Functional outcomes and patient satisfaction were also assessed.

Results: Of the 21 patients, 17 had tumor/cyst related resection, 2 patients each were involved with congenital anomalies and trauma related bone deficits. In total, 48 dental implants were placed in the regenerated bone and 17 in host bone. After surgeries, there was significant new bone formation induced by the rhBMP2 and the regenerated bone volume was adequate for dental implant installation. Healing of dental implants was uneventful, without adverse events. The primary and secondary stability were in regenerated and host bone was not statistically significant (P=0.787). The bone remodeling around the dental implants were normal and exhibited no anomalies. Subjects were satisfied with the esthetic and functional outcomes.

Conclusions: The results of this study indicated that dental implants can be placed ideally in regenerated jaw bone by following certain precautions. Additional further histopathological studies and long follow up are essential to draw a more acceptable standard protocol for dental implant placement in regenerated bone.

This novel augmentation procedure warrants further investigation and may form the basis of a valid treatment protocol, challenging the current gold standard.