Sequential delivery of BMP-2 and BMP-7 for bone regeneration using a heparinized collagen membrane.

To investigate the effect of the sequential delivery of bone morphogenetic proteins BMP-2 and BMP-7 on bone regeneration in rat calvarial defects (40 Sprague-Dawley rats, 8mm defect size), all animals were treated with a hydroxyapatite (HA)/tricalcium phosphate (TCP) bone graft covered with a collagen membrane. The experimental groups were as follows: (1) control group: unmodified collagen (no treatment); (2) BMP-2 group: 5 µg of BMP-2; (3) hep-BMP-7 group: 5 µg BMP-7 chemically bound to heparinized collagen; and (4) BMP-2/hep-BMP-7 group: 2.5 µg BMP-7 bound to heparinized collagen and subsequently treated with 2.5 µg BMP-2. Defect healing was examined at 2 and 8 weeks after surgery. The BMP-2 group showed the largest new bone area at week 2 (29.3 ± 7.3%; P = 0.009); new bone areas in the hep-BMP-7 and BMP-2/hep-BMP-7 groups were similar (11.8 ± 3.4% and 12.9 ± 5.71%, respectively; P = 0.917). After 8 weeks, the BMP-2/hep-BMP-7 group showed the largest new bone area (43.3 ± 6.2%), followed by the BMP-2 and hep-BMP-7 groups (P = 0.013). Accordingly, in comparison with single deliveries of BMP-2 and BMP-7, sequential delivery of BMP-2 and BMP-7 using a heparinized collagen membrane significantly induced new bone formation with a smaller quantity of BMP-2 in rat calvarial defects.

Photoelastic stress analysis of load transfer to implants and natural teeth comparing rigid and semirigid connectors.

STATEMENT OF PROBLEM: Controversy exists regarding the connection of implants to natural teeth. PURPOSE: This simulation study measured photoelastically the biologic behavior of implants. Stress transfer patterns with variable implant support and simulated natural teeth through rigid and nonrigid connection were examined under simulated functional loads. MATERIAL AND METHODS: A photoelastic model of a human left mandible edentulous distal to first premolar was fabricated having 2 screw type implants (3.75x13 mm) embedded within the edentulous area. Two fixed prosthetic restorations were fabricated with either a nonsplinted proximal contact or a soldered proximal contact, and cast precision dowel attachment between implant areas and simulated tooth. Simulated vertical occlusal loads were applied at fixed locations on the restorations. Stresses, which developed in the supporting structure, were monitored photoelastically and recorded photographically. RESULTS: The rigid connector in the 1 implant situation caused only slightly higher stresses in the supporting structure than the nonrigid connector. The distally loaded 1 and 2 implant-supported restoration produced the highest apical stresses, which occurred at the distal implant. The rigid connector demonstrated the greatest stress transfer in the 2 implant-supported restoration. CONCLUSIONS: Lower stresses apical to the tooth or implant occurred with forces applied further from the supporting abutment. Although the least stress was observed when using a nonrigid connector, the rigid connector in particular situations caused only slightly higher stresses in the supporting structure. The rigid connector demonstrated more widespread stress transfer in the 2 implant-supported restoration. Recommendations for selection of connector design should be based on sound clinical periodontal health of a tooth and the support provided by implants.