RESUMO
PURPOSE: The objective of this investigation was to assess vertical bone augmentation using deproteinized bovine bone mineral (DBBM) infused or not with recombinant human bone morphogenetic protein (rhBMP-2) in rabbit tibiae. MATERIALS AND METHODS: A total of 18 female rabbits (New Zealand) received two blocks of DBBM in each tibia. The DBBM blocks were randomly assigned into four experimental groups: DBBM (only the bone graft); DBBM associated with absorbable collagen sponge (ACS); DBBM plus rhBMP-2 (1.5 mg/mL); and DBBM infused with rhBMP-2 (1.5 mg/mL) in an ACS carrier. Animals were sacrificed after 12 weeks, and the tibiae containing the DBBM blocks were dissected and analyzed radiographically (microcomputed tomography [micro-CT]), histologically, and immunohistochemically. RESULTS: Micro-CT analysis showed a considerable increase in bone volume (BV) and BV/tissue volume in the rhBMP-2/ACS group compared with all the others. Trabeculae thickness also increased in the rhBMP-2/ACS group compared with the DBBM/ACS group. Trabecular number, separation, and bone mineral density were not different among groups. Histomorphometric evaluation showed increased newly formed bone in the rhBMP-2/ACS group compared with the DBBM and DBBM/ACS groups. The amount of residual bone graft was statistically higher in the rhBMP-2 groups compared with the DBBM/ACS group. Immunohistochemical analysis showed that the vascular endothelial growth factor (VEGF) expression was more intense in the rhBMP-2/ACS group compared with the DBBM/ACS group. The immunopositivity for type 1 collagen tended to be higher in the two groups with rhBMP-2. CONCLUSION: Collectively, the results of this study suggest that the addition of rhBMP-2 in an ACS carrier placed on top of the DBBM graft enhanced bone formation in this animal model.
Assuntos
Implantes Absorvíveis , Aumento do Rebordo Alveolar/métodos , Proteína Morfogenética Óssea 2/farmacologia , Regeneração Óssea/efeitos dos fármacos , Transplante Ósseo/métodos , Colágeno/farmacologia , Minerais/farmacologia , Fator de Crescimento Transformador beta/farmacologia , Animais , Produtos Biológicos/farmacologia , Densidade Óssea , Proteína Morfogenética Óssea 2/uso terapêutico , Bovinos , Colágeno/administração & dosagem , Modelos Animais de Doenças , Feminino , Coelhos , Proteínas Recombinantes/farmacologia , Proteínas Recombinantes/uso terapêutico , Tíbia/metabolismo , Tíbia/patologia , Tíbia/cirurgia , Fator de Crescimento Transformador beta/uso terapêutico , Fator A de Crescimento do Endotélio Vascular/metabolismo , Microtomografia por Raio-XRESUMO
A realização de enxertia óssea convencional visando corrigir defeitos ósseos, para posterior colocação de implantes dentários é uma opção viável e previsível, mas que aumenta o tempo e a morbidade dos tratamentos implantodônticos. Sendo assim, a realização da implantação mesmo em áreas com deficiente volume ósseo, associada à colocação de biomateriais e membranas reabsovíveis é uma opção para reduzir a duração e a morbidade do tratamento. De acordo com a literatura, esse método quando bem indicado e executado, proporciona resultados semelhantes à enxertia convencional. Diante do exposto, o objetivo do presente trabalho foi relatar e discutir o caso clínico de um paciente que apresentava perda óssea em região anterior de mandíbula e que foi tratado através de implantação, colocação de biomaterial e membrana reabsorvível sobre a superfície exposta do implante, no mesmo momento cirúrgico. Os resultados pós-operatórios demonstram estabilidade, tecidos moles mantidos em posição e volume gengival adequado, o que vem a evidenciar o sucesso do plano de tratamento executado.
The performance of conventional bone grafting aiming to correct bone defects, for later placement of dental implants is a viable and predictable option, but it increases implantodontic treatments time and morbidity. Thus, performing the implantation even in areas with poor bone volume associated with the placement of biomaterials and resorbable membranes is an option for reducing treatment duration and morbidity. According to the literature this method when well indicated and performed provides similar results to conventional grafting. Considering all this, the objective of this study was to report and discuss the case of a patient with bone loss in the anterior jaw, who was treated through implantation, placement of biomaterial and resorbable membrane on the exposed surface of the implant at the same surgical time. The postoperative results have demonstrated stability, soft tissue held in place and adequate gingival volume, which shows the success of the treatment plan implemented.
