RESUMO
OBJECTIVES: To provide the histological background to a new method of local bone augmentation, we examined the events occurring beneath a barrier membrane applied with recombinant human bone morphogenetic protein-2 (rhBMP-2). MATERIALS AND METHODS: The effects on bone augmentation of rhBMP-2, applied with a membrane mold (BMP-Memb), over surgically-induced bone defects in rat calvaria were examined histologically, and the results compared with those from application of rhBMP-2 (BMP) alone, or of a molded membrane (Memb) alone. RESULTS: At postoperative week 2, the BMP group showed the most marked bone formation. However, the bone diminished in size by week 8. The Memb group showed slow but continuous bone formation by week 8. In the BMP-Memb group, bone filled the space in the mold at week 2, and this was maintained until week 8. Moreover, the soft tissue that had intervened between newly formed bone and the membrane in the Memb group was not evident in the BMP-Memb group, in which bone had formed directly on the membrane. CONCLUSIONS: The results suggest that the combination of rhBMP-2 and barrier membrane has advantages in producing and maintaining bone in the intended shape by inducing osteoblasts directly on the inner surface of the membrane.
Assuntos
Proteínas Morfogenéticas Ósseas/farmacologia , Regeneração Tecidual Guiada/métodos , Membranas Artificiais , Osteogênese/efeitos dos fármacos , Fator de Crescimento Transformador beta , Animais , Proteína Morfogenética Óssea 2 , Humanos , Técnicas Imunoenzimáticas , Masculino , Osteoblastos/efeitos dos fármacos , Osteoblastos/enzimologia , Politetrafluoretileno , Ratos , Ratos Wistar , Proteínas Recombinantes/farmacologia , Crânio , Engenharia Tecidual/métodosRESUMO
Reconstruction of the medial support system of the elbow joint was perfomed after dislocation in a 54-year-old man with pseudoarthrosis at the medial epicondyle of the humerus. The patient fell and dislocated the elbow. Although it was manually reduced, the medial side of the elbow remained extremely unstable. The medial epicondyle of the humerus had an old pseudoarthrosis and the bone fragment of the medial epicondyle was dislocated at the level of the humeroulrar joint. Because conservative therapy would result in an unstable medial side of the joint, an unique method for reconstruction of the medial support system of the elbow was performed. The tendon of the palmaris longus muscle was placed between the dislocated bone fragment of the medial epicondyle and it's original position of the humerus. A good result was obtained.
