Bone Quality and Quantity Alterations After Socket Augmentation with rhPDGF-BB or BMPs: A Systematic Review

Purpose: The aim of this study was to systematically analyze the effect of growth factors, particularly recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and bone morphogenetic proteins (BMPs), on volumetric and histomorphometric changes after socket augmentation in comparison with the natural healing sockets. Materials and Methods: An electronic search of four databases (1965 to February 2017) and a hand search of peer-reviewed journals for relevant articles were performed. Human clinical trials that reported quantitative and qualitative outcomes of soft and hard tissues in socket augmented sites with the use of rhPDGF-BB or BMPs, with a minimum five samples per group, were included. Results: Eight studies, including six randomized controlled trials and two case series, were selected. Five of them used BMPs, and three used rhPDGF-BB. Regarding linear bone width change, the weighted mean difference (WMD) between the sites with and without the use of BMPs was 1.66 mm (95% confidence interval = 0.29 to 3.02 mm, P = .02), favoring the BMP group. In terms of histomorphometric outcome, the WMD of the percentage of vital bone between the sites with the use of rhPDGF-BB and with grafting materials alone was 2.16% (95% confidence interval = -4.61% to 8.93%, P = .53). Conclusion: This systematic review revealed that the use of BMPs in socket augmentation yields better ridge width in comparison with a natural healing socket. However, more studies are needed to warrant the effectiveness when using rhPDGF-BB in socket augmentation procedures. Keywords: alveolar ridge augmentation, bone morphogenetic proteins, bone regeneration, growth factors, tissue preservation, tooth extraction