title: Regenerating Mandibular Bone Using rhBMP-2: Part 1-Immediate Reconstruction of Segmental Mandibulectomies.
abstract: OBJECTIVE
  To describe a surgical technique using a regenerative approach and internal fixation for immediate reconstruction of critical size bone defects after segmental mandibulectomy in dogs.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  Dogs (n = 4) that had reconstruction after segmental mandibulectomy for treatment of malignant or benign tumors.
  
  
  METHODS
  Using a combination of extraoral and intraoral approaches, a locking titanium plate was contoured to match the native mandible. After segmental mandibulectomy, the plate was secured and a compression resistant matrix (CRM) infused with rhBMP-2, implanted in the defect. The implant was then covered with a soft tissue envelope followed by intraoral and extraoral closure.
  
  
  RESULTS
  All dogs that had mandibular reconstruction healed with intact gingival covering over the mandibular defect and had immediate return to normal function and occlusion. Mineralized tissue formation was observed clinically within 2 weeks and solid cortical bone formation within 3 months. CT findings at 3 months showed that the newly regenerated mandibular bone had ∼50% of the bone density and porosity compared to the contralateral side. No significant complications occurred.
  
  
  CONCLUSIONS
  Mandibular reconstruction using internal fixation and CRM infused with rhBMP-2 is an excellent solution for immediate reconstruction of segmental mandibulectomy defects in dogs.
authors.affiliation: Department of Surgical and Radiological Sciences, School of Veterinary Medicine, Davis, California.
authors.forename: Boaz
authors.initials: B
authors.lastname: Arzi
authors.forename: Frank J M
authors.initials: FJ
authors.lastname: Verstraete
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Huey
authors.forename: Derek D
authors.initials: DD
authors.lastname: Cissell
authors.forename: Kyriacos A
authors.initials: KA
authors.lastname: Athanasiou
mesh_terms: D000818:Animals; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D001860:Bone Plates / Q000662:veterinary; D001861:Bone Regeneration; D018786:Bone Substitutes; D004283:Dog Diseases / Q000601:surgery; D004285:Dogs; D006801:Humans; D008334:Mandible / Q000502:physiology* / Q000601:surgery; D008336:Mandibular Diseases / Q000601:surgery / Q000662:veterinary; D063168:Mandibular Osteotomy / Q000662:veterinary*; D063175:Mandibular Reconstruction / Q000662:veterinary; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D019651:Plastic Surgery Procedures / Q000662:veterinary; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*
chemical_list: D055396:Bone Morphogenetic Protein 2; D018786:Bone Substitutes; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2