Periodontal regeneration using bone morphogenetic protein 2 incorporated biomimetic calcium phosphate in conjunction with barrier membrane: A pre-clinical study in dogs

Aim To evaluate the effect of bone morphogenetic protein 2 (BMP-2) incorporated biomimetic calcium phosphate (BMP-2/BioCaP) in conjunction with barrier membrane on periodontal regeneration in chronic periodontitis experimental model. Material and Methods Chronic periodontitis experimental model with critical-sized supra-alveolar defects was created in 15 dogs' mandibles. After the initial periodontal therapy, the defects were randomly assigned to the following groups: (a) control; (b) barrier membrane; (c) deproteinized bovine bone mineral + barrier membrane; (d) BioCaP + barrier membrane and (e) BMP-2/BioCaP + barrier membrane (6 quadrants with 18 teeth per group). Eight weeks later, clinical examinations, micro-CT, and histomorphometric analyses were performed. Results Clinical examinations, including plaque index, bleeding index, and probing depth, were similar for all groups. In contrast, the clinical attachment loss was significantly lower in defects grafted with BMP-2/BioCaP and barrier membrane. The micro-CT results showed that the height of mineralized tissue in defects grafted with BMP-2/BioCaP and barrier membrane was significantly higher. For histometric analysis, the defects grafted with BMP-2/BioCaP and barrier membrane exhibited significantly more connective tissue height, new cementum height, new bone height and area, as well as less down-growth of junctional epithelium. Conclusion BMP-2/BioCaP could be a promising bone substitute for periodontal regeneration.