THE OUTCOME OF MAXILLARY SINUS FLOOR AUGMENTATION WITH RECOMBINANT HUMAN BONE MORPHOGENIC PROTEIN 2 VERSUS CONVENTIONAL SINUS GRAFTING PROCEDURES: A SYSTEMATIC REVIEW

Abstract

Objectives: To study the effect of the recombinant human bone morphogenetic protein-2 (rhBMP-2) on sinus volumetric and histometric changes after sinus floor augmentation compared to a conventional approach utilizing other bone grafting materials, such as autografts, allografts, and xenografts. Materials and methods: A search of 3 electronic databases, including PubMed/MEDLINE, EMBASE, Cochran Library Central, and a hand search for peer- reviewed journal relevant articles were performed. Relevant articles that were published between the years of 1999-2019 were included in the search. Human clinical trials with data on comparison of sinus volumetric and histometric outcomes with and without the use of rhBMP-2 in sinus grafting procedures, with 10 or more augmentation sites in each study group, and with a follow-up period of at least 3 months, were included. Variables such as the primary outcome (vertical bone level gain) and the secondary outcome (including implant survival rate, bone density, and the histological parametrics) that were recorded for each study was compared and analyzed. Results: Seven randomized controlled trials (RCTs) were included. The two approaches (conventional bone grafting compared to bone morphogenic proteins (BMPs)) demonstrated comparable effectiveness for both clinical and histomorphometric measures. Conclusions: This systematic review revealed that the use of rhBMP-2 in maxillary sinus floor augmentation achieved similar clinical and histometric outcomes when compared to conventional sinus grafting procedures after a healing period of at least 3 months or longer. Currently, the concentration and amount of rhBMP-2 utilized to gain bone formation in maxillary sinus floor augmentation remains unclear and will need further clinical studies completed.