Objectives : Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein-2(rhBMP-2) is known to be used for medication-related osteonecrosis of the jaw(MRONJ) treatment by having a bone remodeling enhancement. The purpose of the study was to investigate the bone formation effect of rhBMP-2/ACS in patients with MRONJ.
Materials and Methods: In this retrospective study, 26 female patients diagnosed as MRONJ and underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. Experimental group was comprised of 18 patients who were received rhBMP-2/ACS after sequestrectomy, and the control group was comprised of 8 patients who were omitted this procedure after sequestrectomy. Total dose of 0.5mg of rhBMP was used in experimental group in the concentration of 0.5mg/ml. Follow up panoramic X-rays were taken immediately after the surgery, and more than 6 months after the surgery. Using those X-rays, radiographic index of bone defect area was calculated using modified Ihan Hren’s method which measuring the radiographic density of the normal bone and the defect site. Paired t-test test was used for analyzed effectiveness in each group, and Independent t-test was used for analyzed effectiveness between the experimental group and the control group.
Results: Average radiographic index in immediately after surgery and more than 6 months after the surgery for experimental group was 68.4% and 79.8%, respectively(Paired t-test, P<0.05). Average radiographic index in immediately after surgery and more than 6 months after the surgery for control group was 73.4% and 76.7%, respectively (Paired t-test, P>0.05). Average radiographic index increase of 11.4% in the experimental group and an average increase of 3.27% in the control group, respectively (Independent t-test, P>0.05) .
Conclusion: According to the result, it could be a successful strategy in treatment of MRONJ patient using rhBMP-2/ACS on bone defect site after sequestrectomy.