Bone morphogenetic protein-induced repair of the premaxillary cleft.
OBJECTIVE
The purpose of this study is to evaluate the bony regeneration of premaxillary clefts in humans using recombinant human bone morphogenetic protein type 2 in a collagen sponge carrier.


METHODS
Twelve patients with unilateral clefted premaxillas were evaluated preoperatively and 4 months postoperatively. Ten patients were repaired with recombinant human bone morphogenetic protein type 2 while 2 others were grafted with anterior iliac crest particulate marrow cancellous bone. Computed tomographic studies were used to evaluate preoperative alveolar cleft volumes, postoperative bone bridge volumes, and preoperative and postoperative volume ratios.


RESULTS
A preoperative and postoperative volume ratio for patients repaired with recombinant human bone morphogenetic protein type 2 ranged from 24.1% to 90.6% with a mean of 71.7%. Patients who were grafted with particulate marrow cancellous bone had similar preoperative and postoperative volume ratios ranging from 71.3% to 84.9% with a mean of 78.1%.


CONCLUSIONS
Clefts of the anterior maxilla can have complete osseous regeneration induced by recombinant human bone morphogenetic protein type 2 as an effective alternative to conventional anterior iliac particulate marrow cancellous bone grafts.
Herford
Alan S
AS
Department of Oral and Maxillofacial Surgery, Loma Linda University Medical Center, Loma Linda, CA 92350, USA. aherford@llu.edu
Boyne
Philip J
PJ
Rawson
Rick
R
Williams
Roland P
RP
D020341:Absorbable Implants; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000601:surgery; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000187:drug effects; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D002972:Cleft Palate / Q000601:surgery*; D024042:Collagen Type I; D004337:Drug Carriers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008437:Maxilla / Q000187:drug effects / Q000601:surgery; D009668:Nose Diseases / Q000601:surgery; D016155:Oral Fistula / Q000601:surgery; D010012:Osteogenesis / Q000187:drug effects; D011994:Recombinant Proteins; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*
C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D024042:Collagen Type I; D004337:Drug Carriers; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta