Repair of alveolar clefts with recombinant human bone morphogenetic protein (rhBMP-2) in patients with clefts.
This article demonstrates the feasibility of using recombinant human bone morphogenetic protein (rhBMP-2) as a substitute for autogenous iliac crest bone for repair of congenital facial clefts in humans. In this series, 50 cleft sites were repaired in 43 patients using rhBMP-2 without the use of autogenous graft tissue. Successful osseous union was achieved in 49 of the 50 sites. In one patient, the graft failed to consolidate. Severe clefts were managed by combining distraction osteogenesis and rhBMP-2. Eliminating the need to harvest autogenous iliac crest bone resulted in substantial decrease in morbidity. The constructed alveolus performed clinically as normal bone and responded to natural tooth eruption and orthodontic movement. Histology of the tissue constructed showed normal, vital bone. Although additional investigation is warranted to determine the optimum protocol for the use of this material in alveolar cleft repair, the technique should be considered as a viable treatment option in cases in which avoiding iliac crest harvesting is desirable.
Chin
Martin
M
mchin1@ix.netcom.com
Ng
Theodore
T
Tom
William K
WK
Carstens
Michael
M
D000293:Adolescent; D000539:Alveolar Process / Q000002:abnormalities* / Q000473:pathology / Q000503:physiopathology; D000543:Alveoloplasty / Q000379:methods*; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D002985:Clinical Protocols; D004337:Drug Carriers; D005240:Feasibility Studies; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D008334:Mandible / Q000002:abnormalities / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000379:methods; D013524:Surgical Flaps; D013536:Suture Techniques; D014078:Tooth Eruption / Q000502:physiology; D014087:Tooth Movement Techniques; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*; D014945:Wound Healing / Q000502:physiology
C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D004337:Drug Carriers; D016212:Transforming Growth Factor beta