title: Immediate distraction osteogenesis: the sandwich technique in combination with rhBMP-2 for anterior maxillary and mandibular defects.
abstract: The goal of this study was to demonstrate the technique and effectiveness of incorporating recombinant human bone morphogenetic protein-2 (rhBMP-2) to the established sandwich osteotomy technique. Although the success of the sandwich osteotomy procedure has been well documented, we hope to show that the addition of rhBMP-2 will enhance bone formation.We performed a sandwich osteotomy technique in patients who had been treated initially by grafting with suboptimal results. Only defects involving the anterior maxilla (3 patients) or the anterior mandible (1 patient) were included. There were 4 patients, 2 men and 2 women, with an age range of 19 to 62 years. The causes of the ridge deficiencies ranged from pathology to trauma. The height (distance) of distracted transport bone segment was measured. The amount of relapse was measured 6 months after the surgery.All patients exhibited a significant increase in bone height. The amount distracted was 6.75 mm (range, 5-11 mm). The amount of relapse was 8.5% (range, 0%-18%). Dental implants were placed in the reconstructed ridges in all patients. There were no instances of permanent paresthesia. Two patients had exposure of a portion of the hardware, which healed uneventfully.The sandwich osteotomy technique has proven to be an effective method for augmenting deficient alveolar ridges. The addition of rhBMP-2 may aid in its success rate by promoting osteogenesis at the osteotomy site, especially in multiple-operated patients where other traditional techniques have failed to gain the desired ridge height.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Loma Linda University, Loma Linda, California, USA.
authors.forename: Alan Scott
authors.initials: AS
authors.lastname: Herford
authors.forename: Rahul
authors.initials: R
authors.lastname: Tandon
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Stevens
authors.forename: Enrico
authors.initials: E
authors.lastname: Stoffella
authors.forename: Marco
authors.initials: M
authors.lastname: Cicciu
mesh_terms: D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008567:Membranes, Artificial; D008875:Middle Aged; D010012:Osteogenesis / Q000187:drug effects; D019857:Osteogenesis, Distraction / Q000379:methods*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D011994:Recombinant Proteins / Q000627:therapeutic use; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D055396:Bone Morphogenetic Protein 2; D018786:Bone Substitutes; D008567:Membranes, Artificial; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2