Evaluation of maxillary alveolar reconstruction using a resorbable collagen sponge with recombinant human bone morphogenetic protein-2 in cleft lip and palate patients.
BACKGROUND
A resorbable collagen matrix with recombinant human bone morphogenetic protein (rhBMP-2) was compared with traditional iliac crest bone graft for the closure of alveolar defects during secondary dental eruption.


METHODS
Sixteen patients with unilateral cleft lip and palate, aged 8 to 12 years, were selected and randomly assigned to group 1 (rhBMP-2) or group 2 (iliac crest bone graft). Computed tomography was performed to assess both groups preoperatively and at months 6 and 12 postoperatively. Bone height and defect volume were calculated through Osirix Dicom Viewer (Pixmeo, Apple Inc.). Overall morbidity was recorded.


RESULTS
Preoperative and follow-up examinations revealed progressive alveolar bone union in all patients. For group 1, final completion of the defect with a 65.0% mean bone height was detected 12 months postoperatively. For group 2, final completion of the defect with an 83.8% mean bone height was detected 6 months postoperatively. Dental eruption routinely occurred in both groups. Clinical complications included significant swelling in three group 1 patients (37.5%) and significant donor-site pain in seven group 2 patients (87.5%).


CONCLUSIONS
For this select group of patients with immature skeleton, rhBMP-2 therapy resulted in satisfactory bone healing and reduced morbidity compared with traditional iliac crest bone grafting.
Alonso
Nivaldo
N
Division of Plastic Surgery, University of São Paulo Medical School, São Paulo, Brazil. nivalonso@gmail.com
Tanikawa
Daniela Yukie Sakai
DY
Freitas
Renato da Silva
Rda S
Canan
Lady
L
Ozawa
Terumi Okada
TO
Rocha
Diógenes Laércio
DL
D055396:Bone Morphogenetic Protein 2 / Q000008:administration & dosage*; D002648:Child; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D003094:Collagen; D006801:Humans; D011994:Recombinant Proteins / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
D055396:Bone Morphogenetic Protein 2; D011994:Recombinant Proteins; D003094:Collagen