Mandibular reconstruction with a prefabricated vascularized bone graft using recombinant human osteogenic protein-1: an experimental study in miniature pigs. Part I: Prefabrication.
Osteogenic protein-1 (rhOP-1), also called bone morphogenetic protein-7 (BMP-7), is osteoinductive. It may be possible to reconstruct a mandible by local application of rhOP-1. However, in tumour patients this can be impossible due to scars or preceding radiotherapy. Usually vascularized bone grafts are indicated. The aim of this study was to prefabricate a vascularized bone graft in the latissimus dorsi muscle for microsurgical transplantation. In nine minipigs 600 microgram rhOP-1 were used with 8 ml xenogenic bone mineral (BioOss, Geistlich, Waldenburg, Germany) as a carrier and inserted into a pouch prepared in the M. latissimus dorsi. After 6, 12, and 24 weeks the grafts were harvested. The results were evaluated using computed tomography, histology, macro- and microangiography. A high yield of newly formed bone was obtained on the osteoconductive scaffold of the xenogenic bone. It was possible to create a vascularized osseous graft in the given shape of the BioOss blocks. In cross-sections, 68% of the scaffold was coated with new bone. The amount of new bone did not differ between the prefabrication times. Bone overgrowth was 2.1% of the graft volume. In conclusion, this study has shown that it can be possible to prefabricate a neomandible within a muscle graft, which then could be transferred for microvascular reconstruction of the mandible. Further research is required before this technique can be refined for clinical use.
Terheyden
H
H
Department of Oral and Maxillofacial Surgery, University of Kiel, Germany. terheyden@mkg.uni-kiel.de
Knak
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C
Jepsen
S
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Palmie
S
S
Rueger
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DR
D000818:Animals; D001857:Bone Matrix / Q000098:blood supply / Q000637:transplantation*; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000494:pharmacology*; D018786:Bone Substitutes; D016025:Bone Transplantation / Q000379:methods* / Q000502:physiology; D005260:Female; D006801:Humans; D008334:Mandible / Q000601:surgery*; D008903:Minerals; D018482:Muscle, Skeletal; D019647:Oral Surgical Procedures; D010012:Osteogenesis / Q000187:drug effects*; D011994:Recombinant Proteins / Q000494:pharmacology; D013552:Swine; D013556:Swine, Miniature; D023822:Tissue Engineering / Q000379:methods*; D016212:Transforming Growth Factor beta
C525819:BMP7 protein, human; C077540:Bio-Oss; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D018786:Bone Substitutes; D008903:Minerals; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta