De novo bone regeneration in human extraction sites using recombinant human bone morphogenetic protein-2/ACS: a clinical, histomorphometric, densitometric, and 3-dimensional cone-beam computerized tomographic scan evaluation.

INTRODUCTION: To preserve alveolar bone after extractions, it is important to graft socket sites to prevent bone loss from repair and remodeling. OBJECTIVE: The objective of this case series was to assess the clinical, densitometric, and histomorphometric results from extraction sockets treated with recombinant human bone morphogenetic protein (rhBMP-2/ACS). STUDY DESIGN: After extraction and socket debridement, INFUSE (rhBMP-2) on absorbable sponges was placed over each socket. After 4 months, 3-dimensional cone-beam computerized tomographic (CT) scans were taken. Trephined bone cores were taken as the first step in the implant site osteotomy and submitted for histomorphometric analysis. RESULTS: Histomorphometric analysis showed a mean of 49.6% vital bone with a SD of 10.8%. CT scans showed mean density of 510.6 Hounsfield units. CONCLUSIONS: Use of INFUSE in socket preservation surgery results in adequate de novo bone formation to support ideal implant placement after 4 months.

Treating human gingival recession defects with acellular dermis matrix and enamel matrix derivative using coronally advanced flaps.

This article documents the results of a study that used a coronally advanced flap (CAF) technique with an enamel matrix protein derivative (EMD) and acellular dermis matrix (ADM) to treat Miller Class I and II recession sites. Twenty sites with Miller Class I or II recession were selected randomly to be treated with CAF over EMD and ADM. Clinical measurements were made and recession depth, keratinized tissue width, and clinical attachment level were recorded at 3 months for each site. According to the 3-month results, there was significant gain in root coverage, gain in clinical attachment, and increases in width of keratinized gingiva for all recession sites treated with CAF over EMD and ADM.

Postextraction ridge preservation and augmentation with mineralized allograft with or without recombinant human platelet-derived growth factor BB (rhPDGF-BB): a consecutive case series.

In an attempt to reduce postextraction alveolar bone resorption, ridge preservation and augmentation procedures have become standard-of-care treatment following tooth removal. This consecutive case series compares histologic and histomorphometric bone regenerative findings at 4 months following grafting for ridge preservation and augmentation in intact sockets and sockets with buccal wall defects. Sites were treated with mineralized allograft alone (control) or in combination with 0.3 mg/mL recombinant human platelet-derived growth factor BB (rhPDGF-BB) (test). Sites were allowed to heal for 4 months and then re-entered for trephine core biopsy and implant placement. At the end of 4 months, the mean percent remaining mineralized allograft was statistically significantly less in the test group than in the control group. The difference in mean percent vital bone between the groups showed a strong trend toward greater bone formation for the test group (41.8%) compared to the control group (32.5%) at the end of 4 months. Addition of growth factor signaling molecules to current grafting procedures may lead to accelerated bone regeneration, making it possible to successfully place implants at earlier time points.