Mandibular reconstruction in miniature pigs with prefabricated vascularized bone grafts using recombinant human osteogenic protein-1: a preliminary study.
A new technique of prefabrication of vascularized bone grafts in the latissimus dorsi muscle of miniature pigs, using recombinant human osteogenic protein-1 (rhOP-1) and xenogenic bone mineral as a carrier, is presented. The grafts were used to reconstruct a mandible using microsurgical anastomosis of the thoracodorsal vessels of the flap with a branch of the external carotid artery and the external jugular vein. The technique provided enough bone to reconstruct a mandible. The bone marrow stayed viable after transplantation, demonstrated by fluorescence microscopy and scintigraphy. Compared with identical defects of the contralateral side, which were treated with directly applied rhOP-1/bone mineral, a significantly better result was obtained with the prefabrication technique. The prefabrication technique may provide a means to treat irradiated patients with bone grafts produced by osteoinductive proteins and has a potential to become a clinical alternative to conventional vascularized bone grafts.
Terheyden
H
H
Department of Oral and Maxillofacial Surgery, University of Kiel, Germany. terheyden@mkg.uni-kiel.de
Jepsen
S
S
Rueger
D R
DR
D000818:Animals; D055395:Bone Morphogenetic Protein 1; D019485:Bone Morphogenetic Proteins / Q000494:pharmacology*; D001861:Bone Regeneration / Q000187:drug effects* / Q000502:physiology; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D008334:Mandible / Q000601:surgery*; D008666:Metalloendopeptidases / Q000494:pharmacology; D018482:Muscle, Skeletal / Q000201:enzymology; D011994:Recombinant Proteins / Q000494:pharmacology; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps / Q000098:blood supply; D013552:Swine; D013556:Swine, Miniature; D016042:Transplantation, Heterotopic
D019485:Bone Morphogenetic Proteins; D011994:Recombinant Proteins; D008666:Metalloendopeptidases; C525705:BMP1 protein, human; D055395:Bone Morphogenetic Protein 1