Purpose: This retrospective study evaluated the use of a composite graft of recombinant human bone morphogenetic protein-2 (rhBMP-2) and particulate mineralized bone allograft protected by a titanium mesh for vertical bone augmentation. Materials and Methods: A review of data on patients from four oral and maxillofacial surgery practices in the United States who required vertical augmentation prior to implant treatment was conducted. Vertical augmentation was accomplished with rhBMP-2 in an absorbable collagen sponge (ACS) carrier and particulate allograft. Cone beam computed tomography was used to measure vertical bone gains using this technique. Results: Sixteen vertical ridge augmentation procedures were performed in 15 patients. The maximum vertical bone gains ranged from 4.4 to 16.3 mm. The average maximum vertical bone gain was 8.53 mm. The procedure allowed implant placement in all patients. Forty implants were inserted into the grafted ridges after a minimum of 6 months of healing. All implants integrated and were used for prosthetic support. Conclusion: This study suggests that rhBMP-2/ACS and particulate mineralized bone allograft protected by a titanium mesh offers favorable vertical bone gains to allow dental implant placement. Keywords: cone beam computed tomography, recombinant human bone morphogenetic protein-2, titanium mesh, vertical bone augmentation

The use of guided bone regeneration to fill large bone voids in the mandible created through en bloc resection and chronic granulation in three primates was examined. In each of three animals, en bloc resections of implants and surrounding bone were done bilaterally (10 × 8 mm and 16 × 8 mm). Tissues were allowed to heal in a chronic state (for 6 months). A reinforced expanded polytetrafluorethylene (e-PTFE) membrane was then surgically placed over each defect site to be followed for 1 year postsurgically. Two of the six membranes became infected during the first month and were removed. The remaining four membranes were removed en bloc after 1 year. Bone regeneration (greater than 90% of the defect) was observed clinically, and subtraction radiology demonstrated bone gain of between 544 and 733 mg. Histomorphometry after fluorescent labeling demonstrated a mean growth rate of 2.77 µm/wk for all sites measured, and a decrease in the number of osteons from the new bone at the crest to the mature bone at the base of the original defect. This study gives evidence that substantial quantities of new bone can be produced in atrophic mandibles and that this regenerated bone exhibits normal maturation dynamics. Keywords: guided bone regeneration, mandibular defects, monkeys