title: Continuity resection of the mandible after ameloblastoma - feasibility of oral rehabilitation with rhBMP-2 associated to bovine xenograft followed by implant installation.
abstract: Recombinant human morphogenetic protein (rhBMP) is a graft alternative for extensive mandibular reconstruction after tumor resections. However, the feasibility of rhBMP-2 to receive osseointegrated implants and prosthetic rehabilitation has been rarely reported. This study reports on a case of an extensive solid ameloblastoma along the mandibular body. The treatment consisted of resection followed by off-label use of rhBMP type 2 associated with bovine bone xenograft. Eleven months postoperatively, the patient was prosthetically rehabilitated with dental implants, without evidence of resorption or complications. The literature on mandibular reconstructions using rhBMP and their feasibility for future osseointegrated implant placement was also reviewed. Based on the presented case, the association between rhBMP-2 and a bovine bone xenograft could be considered a feasible option for the reconstruction and rehabilitation of large mandibular defects after tumor resection. According to the literature, the use of rhBMP as a graft material is encouraging, with good clinical outcome. However, there are no long-term studies demonstrating success and survival rates of implants placed in these grafts. Future investigations will be required to ascertain the long-term survival of implants in areas grafted with rhBMP. Also, there is a lack of information regarding the prosthetic rehabilitation of these patients.
authors.affiliation: Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil. Electronic address: romulomlustosa@gmail.com.
authors.forename: Romulo Maciel
authors.initials: RM
authors.lastname: Lustosa
authors.affiliation: Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil.
authors.forename: Diogo de Vasconcelos
authors.initials: Dde V
authors.lastname: Macedo
authors.affiliation: Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil.
authors.forename: Lilian Cristina Vessoni
authors.initials: LC
authors.lastname: Iwaki
authors.affiliation: Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil.
authors.forename: Elen de Souza
authors.initials: Ede S
authors.lastname: Tolentino
authors.affiliation: Department of Implantology, Unipar, Umuarama, Paraná, Brazil.
authors.forename: Paulo Norberto
authors.initials: PN
authors.lastname: Hasse
authors.affiliation: Department of Implantology, Unipar, Umuarama, Paraná, Brazil.
authors.forename: Giordano Bruno de Oliveira
authors.initials: GB
authors.lastname: Marson
authors.affiliation: Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil.
authors.forename: Liogi
authors.initials: L
authors.lastname: Iwaki Filho
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000564:Ameloblastoma / Q000601:surgery*; D000818:Animals; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods*; D002417:Cattle; D003094:Collagen; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D003829:Denture, Partial; D005240:Feasibility Studies; D005500:Follow-Up Studies; D064593:Heterografts / Q000187:drug effects / Q000637:transplantation*; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods*; D008567:Membranes, Artificial; D008903:Minerals / Q000627:therapeutic use; D016348:Osseointegration / Q000187:drug effects / Q000502:physiology; D011994:Recombinant Proteins / Q000627:therapeutic use; D013526:Surgical Mesh; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*
chemical_list: C077540:Bio-Oss; D055396:Bone Morphogenetic Protein 2; D015921:Dental Implants; D008567:Membranes, Artificial; D008903:Minerals; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2; D003094:Collagen
keywords: Bone graft; Bone morphogenetic protein type 2; Dental implants; Mandibular reconstruction; Xenograft