Mandibular reconstruction with prefabricated vascularized bone grafts using recombinant human osteogenic protein-1: an experimental study in miniature pigs. Part II: transplantation.
Osteogenic Protein-1 (rhOP-1), also called bone morphogenetic protein-7 (BMP-7), is osteoinductive. The aim of this study was to present a new surgical technique: the prefabrication of a vascularized bone graft using rhOP-1 and its microsurgical transplantation. During 6 weeks, osteomuscular grafts were prefabricated in the latissimus dorsi muscle of five adult minipigs. Six hundred micrograms rhOP-1 on a carrier of xenogenic bone mineral in block form were used. The grafts were transplanted into defects of the mandibular angles performing a microsurgical anastomosis and using miniplates for fixation. Identical defects of the contralateral side were treated by direct application of 600 microg rhOP-1 and xenogenic bone mineral. A polychrome sequential labelling was applied. After transplantation the bone stayed viable, demonstrated by continuous apposition of fluorochromes (non-decalcified histologic sections) and bone scintigraphy. The reconstructive result was significantly superior in the prefabrication technique, assessed by histology and computerized tomography (CT). In conclusion, the method has a potential to become a clinical alternative for conventional vascularized bone grafts.
Terheyden
H
H
Department of Oral and Maxillofacial Surgery, University of Kiel, Germany. terheyden@mkg.uni-kiel.de
Warnke
P
P
Dunsche
A
A
Jepsen
S
S
Brenner
W
W
Palmie
S
S
Toth
C
C
Rueger
D R
DR
D000714:Anastomosis, Surgical; D000818:Animals; D001857:Bone Matrix / Q000637:transplantation; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D001860:Bone Plates; D001863:Bone Screws; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods* / Q000473:pathology; D005260:Female; D005456:Fluorescent Dyes; D006085:Graft Survival; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008852:Microradiography; D008856:Microscopy, Fluorescence; D008866:Microsurgery; D008903:Minerals / Q000627:therapeutic use; D018482:Muscle, Skeletal / Q000637:transplantation; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins; D013524:Surgical Flaps; D013552:Swine; D013556:Swine, Miniature; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives*; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*; D014183:Transplantation, Heterologous
C525819:BMP7 protein, human; C077540:Bio-Oss; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D018786:Bone Substitutes; D005456:Fluorescent Dyes; D008903:Minerals; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate