Overaugmentation to compensate for postextraction ridge atrophy using a putty-type porcine bone substitute material with recombinant bone morphogenetic protein-2: 4 weeks of healing in a canine model

  • Hyun-Chang Lim
  • So-Ra Yoon
  • Jae-Kook Cha
  • Jung-Seok Lee
  • Daniel S. Thoma
  • Ui-Won JungEmail author
Original Article



The aims of the present study were (i) to determine the short-term effects of putty-type porcine bone substitute material (PB) with recombinant bone morphogenetic protein-2 (rhBMP-2) for alveolar ridge preservation (ARP) and (ii) evaluate the early healing of labial overaugmentation.

Materials and methods

Two groups were randomly assigned to the extraction sockets in mandibular incisors of eight dogs: labial overaugmentation with (i) PB (control) or (ii) rhBMP-2-loaded PB (BMP). Microcomputed tomography (micro-CT), and histologic and histomorphometric analyses were performed after 4 weeks.


Micro-CT revealed that some of the overaugmented PB was dispersed in both groups. The new bone volume was significantly larger in the BMP group than in the control group (18.4 ± 3.3 vs. 15.5 ± 3.0 mm3, mean ± SD, P < 0.05). Labial bone resorption was generally found histologically. No signs of mineralization were observed in the overaugmented area despite significantly increased ridge width, as compared to the adjacent tooth area. The area of new bone formation was larger in the BMP group than in the control group overall (23.7 ± 18.8 vs. 18.3 ± 21.2 mm2) and in three parts (apical, middle, and coronal), although the difference was statistically significant only in the coronal part (7.7 ± 7.9 vs. 4.6 ± 6.4 mm2, P < 0.05).


The addition of rhBMP-2 enhanced ossification in the coronal part of the extraction socket relative to using PB alone. Overaugmentation increased the ridge dimension with no evidence of ossification in situ at 4 weeks.

Clinical relevance

In early healing following ARP, rhBMP-2 enhances bone formation within the socket, but ossification in the overaugmented area needs to be studied further.


Animal model Bone regeneration Ridge preservation rhBMP-2 



This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science, ICT & Future Planning) (No. NRF-2017R1A2B2002537).

Compliance with ethical standards

All procedures for the animal experiments were approved by the Institutional Animal Care and Use Committee of Yonsei Medical Center, Seoul, Korea (IACUC Approval No. 2013-0317-4).

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

Informed consent

The present study does not require informed consent.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Periodontology, School of DentistryKyung Hee UniversitySeoulSouth Korea
  2. 2.Department of Periodontology, Research Institute for Periodontal Regeneration, College of DentistryYonsei UniversitySeoulSouth Korea
  3. 3.Clinic for Fixed and Removable Prosthodontics and Dental Material ScienceUniversity of ZurichZurichSwitzerland

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