Bone Regeneration Using N-Methyl-2-pyrrolidone as an Enhancer for Recombinant Human Bone Morphogenetic Protein-2 in a Rabbit Sinus Augmentation Model

The aim of this study was to determine whether N-methyl-2-pyrrolidone (NMP) can decrease the dose of recombinant human bone morphogenetic protein-2 (rhBMP-2) in sinus augmentation of rabbits. In each of 15 rabbits, 2 sinuses were randomly grafted using 1 of 3 treatment modalities: (i) biphasic calcium phosphate (BCP; control), (ii) rhBMP-2-coated BCP (BMP), or (iii) rhBMP-2-coated BCP soaked in NMP solution (BMP/NMP). The rabbits were sacrificed 2 weeks postoperatively. Histologic and histomorphometric analyses were performed. Bone formation in all groups was predominantly located close to the access window and the lateral walls. Newly formed bone within the total augmented area (NB(TA)) was greatest in BMP/NMP (1.94 ± 0.69 mm(2)), followed by BMP (1.50 ± 0.72 mm(2)) and BCP (1.28 ± 0.52 mm(2)) (P > 0.05). In the center of the augmentation (NB(ROI_C)) and the area close to the sinus membrane (NB(ROI_M)), BMP/NMP produced the largest area of NB (NB(ROI_C): 0.10 ± 0.11 mm(2); NB(ROI_M): 0.17 ± 0.08 mm(2)); the corresponding NB values for BCP were 0.05 ± 0.05 mm(2) and 0.08 ± 0.09 mm(2), respectively (P > 0.05 for all comparisons). The effect of NMP on bone regeneration was inconsistent between the specimens. Adding NMP as an adjunct to rhBMP-2-coated BCP produced inconsistent effects on bone regeneration, resulting in no significant benefit compared to controls.