title: Human bone morphogenetic protein-2 use for maxillary reconstruction in cleft lip and palate patients.
abstract: BACKGROUND
  The conventional methods of maxillary alveolar reconstruction in patient with cleft are the periosteoplasty and autologous bone grafting. As an important alternative of bone substitution, there is the recombinant human bone morphogenetic protein-2 (rhBMP-2). This study compares the rhBMP-2 with periosteoplasty and autologous bone grafting.
  
  
  METHODS
  Patients with cleft and alveolar defect were divided into 3 groups of 6 patients who underwent to autologous iliac crest bone grafting, resorbable collagen sponge with rhBMP2, and periosteoplasty, respectively. The analysis was performed through computed tomographic scan preoperatively and at months 3, 6, and 12 postoperatively. The variables analyzed were the alveolar defect volume, formed bone volume, bone formation rate, maxillary height repair rate, and the formed bone density mean.
  
  
  RESULTS
  The formed bone volume was similar comparing the bone graft and BMP groups at 1-year postoperative analysis (P = 0.58). Both of them had the formed bone volume significantly larger than the periosteoplasty group at 3 and 6 months postoperatively. In this last group, the 1-year follow-up was canceled because the bone formation was insufficient. The bone formation rate, the maxillary height repair rate, and the mean of density of the formed bone were similar in the bone graft and BMP groups at 1-year follow-up with P values of 0.93, 0.90, and 0.81, respectively.
  
  
  CONCLUSIONS
  The amount of formed bone in the periosteoplasty group was insufficient. There was no difference among the bone graft and rhBMP-2 therapy considering the parameters analyzed.
authors.affiliation: Assistance Center for Cleft Lip and Palate (CAIF), Curitiba, Brazil. lwcananjr@gmail.com
authors.forename: Lady Wilson
authors.initials: LW
authors.lastname: Canan
authors.forename: Renato
authors.initials: R
authors.lastname: da Silva Freitas
authors.forename: Nivaldo
authors.initials: N
authors.lastname: Alonso
authors.forename: Daniela Yukie Sakai
authors.initials: DY
authors.lastname: Tanikawa
authors.forename: Diógenes Laércio
authors.initials: DL
authors.lastname: Rocha
authors.forename: Julio Cezar Uili
authors.initials: JC
authors.lastname: Coelho
mesh_terms: D000293:Adolescent; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D016025:Bone Transplantation; D002648:Child; D002971:Cleft Lip / Q000000981:diagnostic imaging / Q000601:surgery*; D002972:Cleft Palate / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D010012:Osteogenesis; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2