Study on rhBMP-2 Combined with DBBM Used in External Sinus Floor Elevation

doi:10.13701/j.cnki.kqyxyj.2026.03.007

Abstract

Abstract: Objective: To evaluate the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) combined with deproteinized bovine bone mineral (DBBM) used in external sinus floor elevation (ESFE). Methods: From February 2019 to September 2023, 34 eligible patients were randomly divided into group A using DBBM in ESFE, group B using rhBMP-2+DBBM in ESFE. Implant surgeries were performed at 6 months after ESFE. Bone blocks in implant osteotomy sites were harvested for subsequent micro-computed tomography (micro-CT) scans and histological analysis. Implant stability quotients (ISQ) were recorded at 3 and 6 months after implant surgeries. Results: Micro-CT analysis showed statistically significant differences in bone volume/tissue volume and material volume/tissue volume between the two groups (P<0.05); analysis of bone biopsies showed statistically significant differences in new bone percentage between the two groups (P<0.05); and the difference in ISQ between the two groups was statistically significant (P<0.05) at 3 months after the implant surgeries. Conclusion: The combined application of rhBMP-2 and DBBM in ESFE is more favorable to the formation of new bone than DBBM alone, which can create more favorable bone conditions for subsequent implant surgery.

Key words: external sinus floor elevation, recombinant human bone morphogenetic protein-2, deproteinized bovine bone mineral, oral implantology

TANG Zhengting, YANG Dezhao, LI Guangcheng, MENG Fanwen. Study on rhBMP-2 Combined with DBBM Used in External Sinus Floor Elevation[J]. Journal of Oral Science Research, 2026, 42(3): 213-218.

References

[1] Chackartchi T, Iezzi G, Goldstein M, et al. Sinus floor augmentation using large (1-2 mm) or small (0.25-1 mm) bovine bone mineral particles: a prospective, intra-individual controlled clinical, micro-computerized tomography and histomorphometric study[J]. Clin Oral Implants Res, 2011, 22(5): 473-480.
[2] Al-Moraissi EA, Alkhutari AS, Abotaleb B, et al. Do osteoconductive bone substitutes result in similar bone regeneration for maxillary sinus augmentation when compared to osteogenic and osteoinductive bone grafts? A systematic review and frequentist network meta-analysis[J]. Int J Oral Maxillofac Surg, 2020, 49(1):107-120.
[3] Starch-Jensen T, Schou S, Terheyden H, et al. Bone regeneration after maxillary sinus floor augmentation with different ratios of autogenous bone and deproteinized bovine bone mineral an in vivo experimental study[J]. Clin Oral Implants Res, 2023, 34(12):1406-1416.
[4] Eixarch H, Calvo-Barreiro L, Montalban X, et al. Bone morphogenetic proteins in multiple sclerosis: Role in neuroinflammation[J]. Brain Behav Immun, 2018, 68:1-10.
[5] Jung RE, Glauser R, Schärer P, et al. Effect of rhBMP-2 on guided bone regeneration in humans[J]. Clin Oral Implants Res, 2003, 14(5):556-568.
[6] Zara JN, Siu RK, Zhang X, et al. High doses of bone morphogenetic protein 2 induce structurally abnormal bone and inflammation in vivo[J]. Tissue Eng Part A, 2011,17(9-10):1389-1399.
[7] Nguyen V, Meyers CA, Yan N, et al. BMP-2-induced bone formation and neural inflammation[J]. J Orthop, 2017, 14(2):252-256.
[8] Kim HJ, Chung JH, Shin SY, et al. Efficacy of rhBMP-2/hydroxyapatite on sinus floor augmentation: A multicenter, randomized controlled clinical trial[J]. J Dent Res, 2015, 94(9 Suppl):158S-165S.
[9] Kao DW, Kubota A, Nevins M, et al. The negative effect of combining rhBMP-2 and Bio-Oss on bone formation for maxillary sinus augmentation[J]. Int J Periodontics Restorative Dent, 2012, 32(1):61-67.
[10] Canellas J, Drugos L, Ritto FG, et al. Xenograft materials in maxillary sinus floor elevation surgery: a systematic review with network meta-analyses[J]. Br J Oral Maxillofac Surg, 2021, 59(7):742-751.
[11] Scarano A, Degidi M, Iezzi G, et al. Maxillary sinus augmentation with different biomaterials: a comparative histologic and histomorphometric study in man[J]. Implant Dent, 2006,15(2):197-207.
[12] Mordenfeld A, Hallman M, Johansson CB, et al. Histological and histomorphometrical analyses of biopsies harvested 11 years after maxillary sinus floor augmentation with deproteinized bovine and autogenous bone[J]. Clin Oral Implants Res, 2010, 21(9):961-970.
[13] Um IW, Ku JK, Kim YK, et al. Histological review of demineralized dentin matrix as a carrier of rhBMP-2[J]. Tissue Eng Part B Rev, 2020, 26(3):284-293.
[14] Gutwald R, Haberstroh J, Stricker A, et al. Influence of rhBMP-2 on bone formation and osseointegration in different implant systems after sinus-floor elevation. An in vivo study on sheep[J]. J Craniomaxillofac Surg, 2010, 38(8):571-579.
[15] Xia L, Xu Y, Chang Q, et al. Maxillary sinus floor elevation using BMP-2 and Nell-1 gene-modified bone marrow stromal cells and TCP in rabbits[J]. Calcif Tissue Int, 2011, 89(1):53-64.
[16] Li RH, Wozney JM. Delivering on the promise of bone morphogenetic proteins[J]. Trends Biotechnol, 2001, 19(7):255-265.
[17] 李奭慧,李忠海.人重组骨形态蛋白-2在脊柱融合中并发症的研究[J].生物骨科材料与临床研究, 2020,17(3):55-58.
[18] 叶建新,沈如杰.新型含重组人骨形态发生蛋白2骨修复材料的制备及生物学评价[J].中国组织工程研究与临床康复, 2008,12(45):8819-8822.
[19] Panmekiate S, Ngonphloy N, Charoenkarn T, et al. Comparison of mandibular bone microarchitecture between micro-CT and CBCT images[J]. Dentomaxillofac Radiol, 2015, 44(5):20140322.
[20] Choi SY, Jang YJ, Choi JY, et al. Histomorphometric analysis of sinus augmentation using bovine bone mineral with two different resorbable membranes[J]. Clin Oral Implants Res, 2013, 24 Suppl A100:68-74.
[21] Chittoria A, Malviya Y, Adurti A. Sinus savvy: Exploring the current techniques of maxillary sinus augmentation[J]. Cureus, 2024, 16(6):e61933.