title: Recombinant human bone morphogenetic protein 2 combined with an osteoconductive bulking agent for mandibular continuity defects in nonhuman primates.
abstract: OBJECTIVE
  Recombinant human bone morphogenetic protein 2 (rhBMP-2) is an option for reconstructing mandibular continuity defects. A challenge of this technique is the need to maintain sufficient space to avoid compression of the defect. A compression-resistant matrix (CRM) provides a bulking agent that provides support during the bone formation phase.
  
  
  METHODS
  Thirteen Rhesus Macaque monkeys were used to evaluate different forms of an osteoconductive bulking agent compared with an absorbable collagen alone placed into a critical-sized mandibular defect. A total of 5 groups (26 defects) were evaluated: group A, rhBMP-2/absorbable collagen sponge (ACS) (1.5 mg/mL); group B, rhBMP-2/ACS with ceramic granules (15% hydroxyapatite/85% β-tricalcium phosphate) at 1.5 mg/mL; group C, rhBMP-2 (2.0 mg/mL) with a CRM; group D, rhBMP-2 (0.75 mg/mL) with a CRM; and group E, a CRM alone.
  
  
  RESULTS
  Histology and micro computed tomography were used to evaluate and compare new bone formation in the defects. The reconstructed bone was evaluated with regard to the new bone formation, residual voids, and density. Animals treated with the CRM and rhBMP-2 at 2.0 mg/mL (group C) showed significantly higher amounts of new bone formation, bone density, and reduced voids when compared with rhBMP-2 and ACS (1.5 mg/mL) (P < .05).
  
  
  CONCLUSIONS
  The carrier system CRM combined with rhBMP-2 and a reconstruction plate results in significantly higher bone density and better space maintenance than rhBMP-2 combined with ACS in a nonhuman primate mandibular bone repair model.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Loma Linda University, Loma Linda, CA 92350, USA. aherford@sd.llu.edu
authors.forename: Alan S
authors.initials: AS
authors.lastname: Herford
authors.forename: Mei
authors.initials: M
authors.lastname: Lu
authors.forename: Amanda N
authors.initials: AN
authors.lastname: Buxton
authors.forename: JoAnne
authors.initials: J
authors.lastname: Kim
authors.forename: Jennifer
authors.initials: J
authors.lastname: Henkin
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Boyne
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Caruso
authors.forename: Kitichai
authors.initials: K
authors.lastname: Rungcharassaeng
authors.forename: Jie
authors.initials: J
authors.lastname: Hong
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D001672:Biocompatible Materials; D015519:Bone Density; D055396:Bone Morphogenetic Protein 2 / Q000008:administration & dosage / Q000502:physiology*; D001861:Bone Regeneration / Q000187:drug effects / Q000502:physiology*; D018786:Bone Substitutes / Q000008:administration & dosage; D002130:Calcium Phosphates / Q000008:administration & dosage; D004337:Drug Carriers / Q000008:administration & dosage; D004338:Drug Combinations; D048091:Guided Tissue Regeneration; D006801:Humans; D006882:Hydroxyapatites / Q000008:administration & dosage; D020007:Implants, Experimental; D008253:Macaca mulatta; D008297:Male; D008334:Mandible / Q000187:drug effects / Q000601:surgery; D016348:Osseointegration / Q000187:drug effects / Q000502:physiology*; D011897:Random Allocation; D011994:Recombinant Proteins; D054457:Tissue Scaffolds
chemical_list: D001672:Biocompatible Materials; D055396:Bone Morphogenetic Protein 2; D018786:Bone Substitutes; D002130:Calcium Phosphates; D004337:Drug Carriers; D004338:Drug Combinations; D006882:Hydroxyapatites; D011994:Recombinant Proteins; C485817:beta-tricalcium phosphate