Off-label use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for reconstruction of mandibular bone defects in humans.
OBJECTIVE
The off-label use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for the treatment of mandibular bone defects was evaluated in 5 patients. The rhBMP-2 was used as an alternative to autogenous bone grafting.


METHODS
A total of 5 patients had mandibular defects reconstructed with rhBMP-2, 1.5 mg/mL, soaked collagen sponges alone or in combination with bone marrow cells and allogenic cancellous bone chips. Four of the patients had mandibular continuity defects and the fifth patient had 2 large bone cavities following removal of dentigerous cysts. Radiographs and clinical examinations were used to evaluate healing. The longest patient follow-up was 22 months after reconstruction.


RESULTS
Radiographic and clinical assessments revealed bone regeneration and restoration of the mandibular defects in 3 of the 5 patients. The rhBMP-2 failed in 2 patients with continuity defects. Both patients with failed rhBMP-2 grafts were successfully repaired using autogenous harvested from the iliac crest.


CONCLUSIONS
Mandibular bone defects can be successfully reconstructed using rhBMP-2 soaked sponges with and without including bone marrow cells and allogenic bone. Further studies are needed to determine the ideal combination of components that will predictably and reliably regenerate bone in different types of bone defects.
University of Washington, Department of Oral and Maxillofacial Surgery, Seattle, WA 98195-7134, USA.
Todd G
TG
Carter
Pardeep S
PS
Brar
Andrew
A
Tolas
O Ross
OR
Beirne
D000328:Adult; D000369:Aged, 80 and over; D016026:Bone Marrow Transplantation; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000494:pharmacology*; D001860:Bone Plates; D001861:Bone Regeneration / Q000187:drug effects*; D016025:Bone Transplantation; D003094:Collagen; D005260:Female; D018460:Fractures, Comminuted / Q000601:surgery; D006801:Humans; D007570:Jaw Cysts / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery*; D008336:Mandibular Diseases / Q000601:surgery*; D008337:Mandibular Fractures / Q000601:surgery; D010019:Osteomyelitis / Q000601:surgery; D011994:Recombinant Proteins / Q000494:pharmacology; D023822:Tissue Engineering / Q000379:methods; D016212:Transforming Growth Factor beta / Q000494:pharmacology*
C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; D003094:Collagen