Reconstruction of 10 major mandibular defects using bioimplants containing BMP-7.
OBJECTIVE
The limitations and morbidity associated with autogenous bone grafting have driven the search for predictable bone substitutes and bioimplants. A novel method of reconstruction was tested in this case series.


METHODS
Ten patients with major mandibular defects following resection of biopsy-proven ameloblastoma lesions or osteomyelitis of the mandibular body or ramus were included in this study. The resection defects were spanned with rigid reconstruction plates to hold the remaining mandibular segments in the correct position. The defects were filled with a bioimplant containing bone morphogenetic protein-7 (BMP-7) in a demineralized bone matrix (DBM) suspended in a reverse-phase medium to effect sustained BMP delivery.


RESULTS
The postoperative course for all 10 patients was uneventful. Radiographic evidence of mandibular bone formation was found in all cases. At the end of 1 year, functional and esthetic reconstruction of the mandible was complete.


CONCLUSIONS
Bioimplants containing BMP-7 in DBM suspended in a reverse phase medium were successful in restoring major mandibular defects in nonirradiated beds in this series of 10 patients.
Clokie
Cameron M L
CM
Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, ON M5G 1G6.
Sándor
George K B
GK
D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D000564:Ameloblastoma / Q000534:rehabilitation / Q000601:surgery*; D001857:Bone Matrix / Q000637:transplantation; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000494:pharmacology*; D001860:Bone Plates; D001861:Bone Regeneration / Q000187:drug effects; D018786:Bone Substitutes; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D016212:Transforming Growth Factor beta / Q000494:pharmacology*
C525819:BMP7 protein, human; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D018786:Bone Substitutes; D016212:Transforming Growth Factor beta; C511401:osteogenic protein 1 putty, recombinant human