ABSTRACT
PURPOSE: The purpose of this study is to evaluate the bony regeneration of premaxillary clefts in humans using recombinant human bone morphogenetic protein type 2 in a collagen sponge carrier. PATIENTS AND METHODS: Twelve patients with unilateral clefted premaxillas were evaluated preoperatively and 4 months postoperatively. Ten patients were repaired with recombinant human bone morphogenetic protein type 2 while 2 others were grafted with anterior iliac crest particulate marrow cancellous bone. Computed tomographic studies were used to evaluate preoperative alveolar cleft volumes, postoperative bone bridge volumes, and preoperative and postoperative volume ratios. RESULTS: A preoperative and postoperative volume ratio for patients repaired with recombinant human bone morphogenetic protein type 2 ranged from 24.1% to 90.6% with a mean of 71.7%. Patients who were grafted with particulate marrow cancellous bone had similar preoperative and postoperative volume ratios ranging from 71.3% to 84.9% with a mean of 78.1%. CONCLUSIONS: Clefts of the anterior maxilla can have complete osseous regeneration induced by recombinant human bone morphogenetic protein type 2 as an effective alternative to conventional anterior iliac particulate marrow cancellous bone grafts.
Subject(s)
Bone Morphogenetic Proteins/therapeutic use , Cleft Palate/surgery , Transforming Growth Factor beta/therapeutic use , Absorbable Implants , Alveolar Process/diagnostic imaging , Alveolar Process/surgery , Bone Morphogenetic Protein 2 , Bone Regeneration/drug effects , Bone Transplantation/methods , Child , Collagen Type I , Drug Carriers , Female , Follow-Up Studies , Humans , Image Processing, Computer-Assisted , Male , Maxilla/drug effects , Maxilla/surgery , Nose Diseases/surgery , Oral Fistula/surgery , Osteogenesis/drug effects , Recombinant Proteins , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
MATERIALS AND METHODS: Examples of defects including mandibular continuity defects, preprosthetic atrophic alveolar ridge deficiencies, traumatic defects, and maxillary clefts were included. RESULTS: All patients demonstrated osseous regeneration stimulated by rhBMP-2. CONCLUSION: rhBMP-2 is successful in regenerating bone in a variety of maxillofacial defects. In the future, rhBMP-2 will play a significant role in the treatment of bone deficiencies.
