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Bone morphogenic proteins (BMP) are members of the family of transforming growth factors. Fifteen different BMP have been identified, all with varying degrees of cellular activity, including cartilage- or bone-inductive properties. Two recombinant proteins are available: recombinant human bone morphogenetic protein (rhBMP)-2 and rhBMP-7. These products have been investigated as alternatives to autogenous bone grafts in a variety of clinical situations, including spinal fusions, fracture repair, treatment of bone defects, and reconstruction of maxillofacial conditions. Reconstruction in the maxillofacial region includes alveolar ridge augmentation, mandibular reconstruction, and maxillary sinus augmentation.

The use of onplant-supported orthodontic anchorage is still in its early stages. The concepts presented in this article have tried to stress the importance of anchorage control in orthodontic cases, some problems associated with traditional means to augment orthodontic anchorage, the rationale for developing a skeletal anchorage unit based on endosseous implant technology, and the effectiveness of the onplant as an anchorage unit. Cephalometric superimpositions are most likely the best method to determine the effectiveness of the onplant's contribution to anchorage control and have been included here to that end. Further research into its effectiveness may broaden the use of onplants in future orthodontic cases.

1. Prior to placing implants, the health of the adjacent teeth and supporting tissues should be good. The presence of acute infection (exudate, granulation tissue, gingival hyperplasia), poor oral hygiene, or active chronic periodontal disease are associated with an increased incidence of infection or tissue breakdown. 2. Avoid excessive dissection of papilla. 3. Stabilize membranes with apical tacks and secure the coronal portion to the implant with the cover screw. 4. Relieve the periosteum to allow for a tension-free closure. 5. Avoid postoperative trauma on the surgical site.

When a patient is missing posterior teeth and desires a fixed prosthesis, bone grafting is often needed. Since 1983, our clinical experience indicates that sinus grafting can provide very good restoration of the posterior quadrants. If the implants are loaded in a physiologically stable manner, one may expect maintenance of bone levels.