RESUMO
PURPOSE: This study investigated bone gap healing in a zygomatic arch defect using recombinant human bone morphogenetic protein-2 (rhBMP-2; Genetics Institute, Andover, MA) in an absorbable collagen sponge (ACS) carrier. METHODS: Zygomatic arch osteotomies were completed 15 mm apart and the arch was mobilized in 6 adult female mongrel dogs. The segment was then repositioned laterally 8 to 10 mm and secured with a titanium reconstruction plate. Bone gaps in either the right or left arches received rhBMP-2, with the contralateral side being left empty in 4 animals and the defects received buffer/ACS without rhBMP-2 in 2 animals as controls. Submentovertex radiographs were taken immediately postoperatively and every 4 weeks until killing at 12 weeks. RESULTS: Clinical evaluation indicated no significant differences in the degree of inflammation between the groups. However, the rhBMP-2 sites were found to be firm on palpation, in contrast to a soft tissue defect palpated in the control sites. Radiographic examination showed significant bone formation in all rhBMP-2 grafted sites as early as 4 weeks. The radiopacity of the bone continued to increase over the time of this study. Five of six control sites did not show bone formation through the course of this study. In addition to lack of bone formation, 5 of 6 control sites showed collapse of the repositioned arch. All arches in the rhBMP-2 sites remained in their lateral position and formed bone in the gaps. In 2 animals, bone formation moderately exceeded the confines of the gap, and in 2 animals excessive bone formation occurred. CONCLUSIONS: This study confirms that rhBMP-2 has the potential to be used to stimulate bone gap healing in the craniofacial complex.
