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Bone Morphogenic Protein: Is this Required for New Implant Cases?

posted in Bone Grafting, advice, Regenerative Products

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Dr. L. asks:
I am now offering implants to patients and I am trying to keep up with the literature. I do not see my periodontist or oral surgeon using BMP or PRP or any of the new bioactive materials to promote osseointegration. Should I expect them to use these kinds of materials? I send all the difficult implant cases to them. From what I am reading, materials like this are important adjuncts. Should I leave the decision to use these materials up to them or should I request it or should I just forget the whole thing?

4 Responses to “ Bone Morphogenic Protein: Is this Required for New Implant Cases? ”

• NJHamp March 31st, 2009

  
  

  They do help in some cases. It all depends on the case! My experience is I can achieve the same result using Demin or mineralized cortical with Calcium sulfate. The Demin cortical is low in calcium content and high in BMPs…it also depends on how the tissue bank processes the bone. Some of the treatments kill off more BMPs than is needed…I use an expert in the allograft market for all of my grafting procedures. Regenetix can answer majority of your questions and has a lot of knowledge in the dental field…

  Now with that said…just remember it depends on the case at hand, and the sad part is those extras can really inrease your overhead and the patients cost for a small gain than other grafting techniques.

  Good luck

• SerioPerio March 31st, 2009

  
  

  I would agree with NJHamp. In addition, what looks good today may not look the same next year. There was a lot of initial noise about PRP but newer studies are suggesting that it may have more soft tissue than hard tissue benefits. If you look at the literature on bone grafting going back 30 years, many different modalities and materials give similar radiographic results. It is only a lot of clinical experience that develops the judgment of what to use when, or to use at all! By the way, have you seen the price of Infuse (recombinant BMP)? You are looking at thousands of dollars- well worth it in the severely atrophic case, but for routine implant placement- probably not.

• Empirical Medicine March 31st, 2009

  
  

  I would suggest you have this conversation with your Oral and Maxillofacial surgeon. This is the whole reason to nurture a relationship with the specialist. They may be able to help you find better perspective.

  Currently, many grafting techniques are quite successful. Autogenous grafts are still and will likely be the gold standard into the future.

  BMP’s (generally used off label, if not a sinus lift) are one costly option ($900 for an xx small kit of Infuse(.5×2cm)).

  Most patients find the cost prohibitive as we can get similar results with other techniques.

  With that said, there are times when you can get wild success with BMP’s in places that normally get mixed results with allografts.

  As always case selection is the key.

• David Nelson DDS April 18th, 2009

  
  

  Check out gem21s. less expensive

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