Low-Dose Recombinant Human Bone Morphogenetic Protein-2 to Enhance the Osteogenic Potential of the Schneiderian Membrane in the Early Healing Phase: In Vitro and In Vivo Studies

Purpose: The objectives of this study were to confirm the osteogenic potential of the Schneiderian membrane and to elucidate the early healing pattern of low-dose recombinant human bone morphogenetic protein-2 (rhBMP-2)-coated biphasic calcium phosphate (BCP). Materials and Methods: The osteogenic potential of the Schneiderian membrane and enhancement by rhBMP-2 were evaluated by in vitro analysis. RhBMP-2-coated BCP (experimental group) and BCP soaked with saline (control group) were applied to the maxillary sinus in rabbits. After 2 weeks, micro-computed tomographic and histometric analyses were performed. Results: Enhanced osteogenic potential was found when cells from the Schneiderian membrane were treated with rhBMP-2. Micro-computed tomographic analysis showed that the total augmented volume was significantly larger in the experimental group. Different healing patterns were observed in 3 regions, although the area of new bone did not differ significantly. Although more newly formed bone appeared, particularly along the Schneiderian membrane in the experimental group, the difference was not statistically significant. Conclusions: RhBMP-2 enhanced the osteogenic potential of the Schneiderian membrane in vitro. However, low-dose rhBMP-2-coated BCP failed to exert a statistically significant effect in vivo, although it appeared to be effective in sinus augmentation specifically for the volumetric increase in the early phase. (C) 2014 American Association of Oral and Maxillofacial Surgeons