Journal of Oral Implantology December 2012 - (Page 767)

LITERATURE REVIEW Bone Morphogenic Protein: An Elixir for Bone Grafting—A Review Prasun Shah, MD1* Louis Keppler, MD1 James Rutkowski, DMD, PhD2 Bone morphogenetic proteins (BMPs) are multifunctional growth factors that belong to the transforming growth factor beta superfamily. This literature review focuses on the molecular biology of BMPs, their mechanism of action, and subsequent applications. It also discusses uses of BMPs in the fields of dentistry and orthopedics, research on methods of delivering BMPs, and their role in tissue regeneration. BMP has positive effects on bone grafts, and their calculated and timely use with other growth factors can provide extraordinary results in fractured or nonhealing bones. Use of BMP introduces new applications in the field of implantology and bone grafting. This review touches on a few unknown facts about BMP and this ever-changing field of research to improve human life. Key Words: BMP, bone morphogenic proteins, bone grafts, transforming growth factor beta, BMP-2, BMP-4, SMADS INTRODUCTION one, primarily an osseous tissue, is a relatively hard and lightweight composite material, formed mostly of calcium phosphate in the chemical arrangement termed calcium hydroxyapatite. Although bone is a rigid structure, it is dynamic as it is continuously being remodeled by the cells within it. This enables the turnover and replacement of the matrix in the interior of the bone throughout the life of a person.1,2 Three major cell types are found throughout the extracellular bone matrix: osteoblasts, osteocytes, and osteoclasts.2 Osteoblasts are mononucleate bone-forming cells that originate from mesenchymal stem cells and contribute to the production of new bone.1,2 They are responsible for producing and secreting major components of bone matrix, eg, type I collagen, osteocalcin, osteonectin, and alkaline phosphatase. Some osteoblasts remain 1 2 B active, synthesizing and regulating the deposition and mineralization of bone, while others become embedded in their own secretions and are trapped within the hard mineralized bone matrix.1,2 These cells form resting osteocytes, which do not multiply and are chiefly responsible for bone maintenance. The counterpart to the osteoblast is the osteoclast, a cell that is responsible for breaking down bone. Osteoclasts are giant multinucleated cells derived from hemopoietic stem cells in the bone marrow. These cells are involved in bone resorption and therefore remodeling.1,2 BONE MORPHOGENIC PROTEINS St Vincent Charity Hospital, Cleveland, Ohio. Clarion Research Center, Clarion, Pa. * Corresponding author, e-mail: shahprasun@hotmail.com DOI: 10.1563/AAID-JOI-D-10-00196 Bone morphogenetic proteins (BMPs) have roles in the processes of chemotaxis, mitogenesis and differentiation of mesenchymal stem cells, and promotion of angiogenesis.1 They induce bone formation through sequential multistep events that consist of the chemotaxis of progenitor cells; proliferation of mesenchymal cells; differentiation of cartilage; vascular invasion; and differentiation, mineralization, and remodeling of bone.3,4 Various BMPs are produced during the process of bone Journal of Oral Implantology 767

Table of Contents for the Digital Edition of Journal of Oral Implantology December 2012

AAID Priceless Membership Benefit
Lateral Augmentation of the Maxilla and Mandible Using Framework Technique With Allogeneic Bone Grafts
Accuracy of Cone Beam Computerized Tomography and a Three-Dimensional Stereolithographic Model in Identifying the Anterior Loop of the Mental Nerve: A Study on Cadavers
Evaluation of Microgap Size and Microbial Leakage in the Connection Area of 4 Abutments With Straumann (ITI) Implant
Buccal Bone Plate Remodeling After Immediate Implant Placement With and Without Synthetic Bone Grafting and Flapless Surgery: Radiographic Study in Dogs
Evaluation of Soft Tissues Around Single Tooth Implants in the Anterior Maxilla Restored With Cemented and Screw-Retained Crowns
Accuracy of a Newly Developed Cone-Beam Computerized Tomography-Aided Surgical Guidance System for Dental Implant Placement: An Ex Vivo Study
Nasopalatine Canal Position Relative to the Maxillary Central Incisors: A Cone Beam Computed Tomography Assessment
Esthetics in Implant-Supported Prostheses: A Literature Review
Reliability of Implant Surgical Guides Based on Soft-Tissue Models
Clinical Evaluation of Short and Wide-Diameter Implants Immediately Placed Into Extraction Sockets of Posterior Areas: A 2-Year Retrospective Study
Single Stage Immediate Implant Placements in the Esthetic Zone
Removal of Fractured Dental Implant Screw Using a New Technique: A Case Report
Restoration of Failing Maxillary Implant-Supported Fixed Prosthesis With Cross Arch Splinted Unilateral Zygomatic Implant: A Clinical Report
Oral Rehabilitation of Severe Dentoalveolar Trauma: A Clinical Report
Implant Installation With Bone Augmentation and Transmucosal Healing With Demineralized Human Cortical Bone in the Maxillary Anterior Region: Report of 3 Cases
Bone Morphogenic Protein: An Elixir for Bone Grafting—A Review
Orthodontic Considerations in Restorative Management of Hypodontia Patients With Endosseous Implants
Squamous Cell Carcinoma in Association With Dental Implants: An Assessment of Previously Hypothesized Carcinogenic Mechanisms and a Case Report
Indirect Osteotome Maxillary Sinus Floor Elevation: An Update
Reliability of Implant Surgical Guides Based on Soft-Tissue Models: A Methodological Mistake

Journal of Oral Implantology December 2012