[Mandibular reconstruction with autologous bone and osseoinductive implant in the Göttingen minipig].
BACKGROUND
Direct mandibular reconstruction with an autologous bone transplant was compared with an osteoinductive implant following an extensive continuity resection of the lower jaw in Göttinger mini-pigs.


METHODS
In nine full-grown mini-pigs a one-sided continuity defect (5 cm) was created in the lower jaw. In four animals it was filled with a 50 x 25 x 15 mm(3) collagenous carrier enhanced by rhBMP-2 (400 micro g/cm(3) rhBMP-2). In two animals only the carrier was implanted as a control. Three animals received the resected autologous bone as a free transplant. Bone regeneration and consolidation of the defects was analyzed radiographically and histologically.


RESULTS
Following implantation of the osteoinductive implant, complete osseous consolidation of the continuity defect in the lower jaw was observed in all animals. The defects were completely filled with a biomechanically stable bone which showed signs of functional adaptation. The replantation of the orthotopic autologous bone did not lead to functional stability quickly enough. In the periphery only an incomplete bony bridge was formed which was interrupted by large pseudarthrosis. No consolidation of the defects was found in the control group (carrier alone).


CONCLUSIONS
Direct reconstruction of an extensive, biomechanically loaded defect with an osteoinductive implant proved to be the superior method. The osseous regeneration observed shows an immediate functional orientation. The necessity for extensive adaptive remodeling is thus minimized.
Würzler
K K
KK
Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Bayerische Julius-Maximilians-Universität Würzburg. kristian.wuerzler@t-online.de
Heisterkamp
M
M
Böhm
H
H
Kübler
N R
NR
Sebald
W
W
Reuther
J F
JF
D000818:Animals; D015519:Bone Density / Q000187:drug effects; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000494:pharmacology*; D001861:Bone Regeneration / Q000187:drug effects / Q000502:physiology; D016025:Bone Transplantation / Q000379:methods*; D020099:Coated Materials, Biocompatible; D003094:Collagen; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008341:Mandibular Prosthesis; D019930:Mandibular Prosthesis Implantation / Q000379:methods*; D016348:Osseointegration / Q000187:drug effects*; D011542:Pseudarthrosis / Q000473:pathology; D013552:Swine; D013556:Swine, Miniature; D016212:Transforming Growth Factor beta
D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D020099:Coated Materials, Biocompatible; D016212:Transforming Growth Factor beta; D003094:Collagen