title: Reconstruction of the alveolar cleft: can growth factor-aided tissue engineering replace autologous bone grafting? A literature review and systematic review of results obtained with bone morphogenetic protein-2.
abstract: The alveolar cleft in patients with clefts of lip, alveolus and palate (CLAP) is usually reconstructed with an autologous bone graft. Harvesting of autologous bone grafts is associated with more or less donor site morbidity. Donor site morbidity could be eliminated if bone is fabricated by growth factor-aided tissue engineering. The objective of this review was to provide an oversight on the current state of the art in growth factor-aided tissue engineering with regard to reconstruction of the alveolar cleft in CLAP. Medline, Embase and Central databases were searched for articles on bone morphogenetic protein 2 (BMP-2), bone morphogenetic protein 7, transforming growth factor beta, platelet-derived growth factor, insulin-like growth factor, fibroblast growth factor, vascular endothelial growth factor and platelet-rich plasma for the reconstruction of the alveolar cleft in CLAP. Two-hundred ninety-one unique search results were found. Three articles met our selection criteria. These three selected articles compared BMP-2-aided bone tissue engineering with iliac crest bone grafting by clinical and radiographic examinations. Bone quantity appeared comparable between the two methods in patients treated during the stage of mixed dentition, whereas bone quantity appeared superior in the BMP-2 group in skeletally mature patients. Favourable results with BMP-2-aided bone tissue engineering have been reported for the reconstruction of the alveolar cleft in CLAP. More studies are necessary to assess the quality of bone. Advantages are shortening of the operation time, absence of donor site morbidity, shorter hospital stay and reduction of overall cost.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, PO Box 85500, The Netherlands.
authors.forename: Wouter M M T
authors.initials: WM
authors.lastname: van Hout
authors.forename: Aebele B
authors.initials: AB
authors.lastname: Mink van der Molen
authors.forename: Corstiaan C
authors.initials: CC
authors.lastname: Breugem
authors.forename: Ronald
authors.initials: R
authors.lastname: Koole
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Van Cann
mesh_terms: D000539:Alveolar Process / Q000002:abnormalities*; D000543:Alveoloplasty / Q000379:methods*; D015519:Bone Density; D055396:Bone Morphogenetic Protein 2 / Q000494:pharmacology*; D019485:Bone Morphogenetic Proteins / Q000493:pharmacokinetics; D016025:Bone Transplantation; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D024042:Collagen Type I; D006801:Humans; D008648:Mesoderm / Q000187:drug effects; D010012:Osteogenesis / Q000187:drug effects*; D011994:Recombinant Proteins / Q000493:pharmacokinetics; D023822:Tissue Engineering; D054457:Tissue Scaffolds; D016212:Transforming Growth Factor beta / Q000493:pharmacokinetics
chemical_list: D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D024042:Collagen Type I; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2