title: Three-dimensional technology and bone morphogenetic protein in frontal bone reconstruction.
abstract: Osteoinductive bone morphogenetic proteins (BMPs) may be used in humans to facilitate healing of bony defects. The effect of different BMPs is, as with many other growth factors, highly dependent on the delivery vehicle. Bovine type I collagen is currently used in the clinical setting as a carrier and has been approved in several countries for human use. Here, we report the reconstruction of a frontal bone defect using heparin together with bovine type I collagen, hyaluronic acid, and fibrin as vehicles for BMP-2. A bony structure was created on the back of the patient by treating the latissimus dorsi muscle with the growth factor. A polyamide mold was used as a template to achieve the desired shape. The bone structure was transplanted into the defect site via microsurgical techniques. Although the prefabricated bone was not large enough tocover the entire frontal defect, the reconstruction was completed by using an additional cranial implant.
authors.affiliation: Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Claes
authors.initials: C
authors.lastname: Arnander
authors.forename: Anders
authors.initials: A
authors.lastname: Westermark
authors.forename: Riikka
authors.initials: R
authors.lastname: Veltheim
authors.forename: Ann-Charlotte
authors.initials: AC
authors.lastname: Docherty-Skogh
authors.forename: Jöns
authors.initials: J
authors.lastname: Hilborn
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrand
mesh_terms: D000818:Animals; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000008:administration & dosage / Q000494:pharmacology*; D018786:Bone Substitutes; D016025:Bone Transplantation / Q000379:methods*; D002417:Cattle; D024042:Collagen Type I; D003399:Craniotomy / Q000379:methods; D005337:Fibrin; D005624:Frontal Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006493:Heparin / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D006820:Hyaluronic Acid; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000187:drug effects; D010012:Osteogenesis / Q000187:drug effects*; D014677:Pharmaceutical Vehicles; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology; D019651:Plastic Surgery Procedures / Q000379:methods; D023822:Tissue Engineering / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016212:Transforming Growth Factor beta / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D018786:Bone Substitutes; D024042:Collagen Type I; D014677:Pharmaceutical Vehicles; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; D005337:Fibrin; D006820:Hyaluronic Acid; D006493:Heparin