title: Transport distraction osteogenesis with recombinant human bone morphogenic protein-2 for large calvarial defect reconstruction.
abstract: BACKGROUND
  Transport distraction osteogenesis (TDO) has been used in attempts to treat large calvarial defects but has, until now, lacked consistency and reliability. To achieve sufficient bone formation, the effect of TDO was compared to the effect of TDO combined with recombinant human bone morphogenic protein-2 (rhBMP-2).
  
  
  METHODS
  Fourteen dogs were divided into 2 groups; 6 animals in the control group received TDO only, and 8 received TDO combined with rhBMP-2. A calvarial defect 33 × 35 mm in size was generated, and the drug-delivering internal distractor was applied. After a 5-day latency period, distraction with rhBMP-2 at 10 μg/day was initiated at a rate of 2 mm/day. This was followed by a consolidation period of 3 months, after which areas of osteogenesis and strength were measured and histologic examinations were conducted.
  
  
  RESULTS
  The average area of osteogenesis was higher in the experimental group (P < 0.01). Regenerated bone of the experimental group showed increased strength (P < 0.05). Histological examination showed typical mature bone in the experimental group. Prominent osteoblastic rimming was observed in the bone marrow of the experimental group.
  
  
  CONCLUSIONS
  TDO with an internal distraction device delivering rhBMP-2 can enhance bone regeneration of large calvarial defects in a dog model. These results suggest the potential for human clinical testing of TDO combined with rhBMP-2.
authors.affiliation: From the *Department of Plastic Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul; †Department of Plastic and Reconstructive Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Gyeonggi-do; and ‡Cardiovascular Devices Division, Ministry of Food and Drugs, Osong, Republic of Korea.
authors.forename: Seung Yong
authors.initials: SY
authors.lastname: Song
authors.forename: In Sik
authors.initials: IS
authors.lastname: Yun
authors.forename: Chung Hun
authors.initials: CH
authors.lastname: Kim
authors.forename: Dae Gon
authors.initials: DG
authors.lastname: Woo
authors.forename: Yong Oock
authors.initials: YO
authors.lastname: Kim
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D001847:Bone Diseases / Q000473:pathology / Q000601:surgery*; D001853:Bone Marrow / Q000473:pathology; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000187:drug effects; D019245:Compressive Strength; D004285:Dogs; D004337:Drug Carriers; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016268:Internal Fixators; D010006:Osteoblasts / Q000473:pathology; D010012:Osteogenesis / Q000187:drug effects; D019857:Osteogenesis, Distraction / Q000379:methods*; D011994:Recombinant Proteins / Q000627:therapeutic use; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D012886:Skull / Q000473:pathology / Q000601:surgery*; D013314:Stress, Mechanical; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*
chemical_list: D055396:Bone Morphogenetic Protein 2; D004337:Drug Carriers; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2