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Recombinant human BMP-2 enhances the effects of materials used for reconstruction of large cranial defects.
Elsalanty, Mohammed E; Por, Yong-Chen; Genecov, David G; Salyer, Kenneth E; Wang, Qian; Barcelo, C R; Troxler, Karen; Gendler, El; Opperman, Lynne A.
Affiliation
  • Elsalanty ME; Department of Oral Biology and Maxillofacial Pathology, School of Dentistry, Medical School of Georgia, Augusta, GA, USA.
J Oral Maxillofac Surg ; 66(2): 277-85, 2008 Feb.
Article in En | MEDLINE | ID: mdl-18201609
PURPOSE: Cranial defect reconstruction presents 2 challenges: induction of new bone formation, and providing structural support during the healing process. This study compares quantity and quality of new bone formation based on various materials and support frameworks. MATERIALS AND METHODS: Eighteen dogs underwent surgical removal of a significant portion of their cranial vault. Demineralized bone matrix was used to fill the defect in all animals. In 9 dogs, recombinant human bone morphogenetic protein-2 (rhBMP-2) was added, while the other 9 served as the non-rhBMP-2 group. In each group, 3 animals were fixed with cobalt chrome plates, 3 with adding platelet-rich plasma, and 3 fixed with a Lactosorb (Walter Lorenz Surgical, Inc, Jacksonville, FL) resorbable mesh. Necropsy was done at 12 weeks postoperative. Histomorphometry, density, and mechanical properties of the regenerate were analyzed. RESULTS: The non-rhBMP-2 groups showed minimal substitution of demineralized bone matrix with new bone, while only sporadic remnants of demineralized bone matrix were present in the rhBMP-2 groups. The defect showed more new bone formation (P < .001) and density (P < .001) in the rhBMP-2 groups by Kruskal-Wallis test. The area of new bone was not significantly different among the rhBMP-2 subgroups. The resorbable mesh struts showed no sign of bone invasion or substitution. In the non-rhBMP-2 resorbable mesh group, demineralized bone matrix almost totally disintegrated without replacement by new bone. CONCLUSIONS: The addition of rhBMP-2 to demineralized bone matrix accelerated new bone formation in large cranial defects, regardless of the supporting framework or the addition of platelet-rich plasma. The use of a resorbable mesh in such defects is advisable only if rhBMP-2 is added.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Skull / Bone Regeneration / Transforming Growth Factor beta / Bone Transplantation / Bone Substitutes / Bone Morphogenetic Proteins Type of study: Diagnostic_studies Limits: Animals / Humans / Male Language: En Journal: J Oral Maxillofac Surg Year: 2008 Document type: Article Affiliation country: United States Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Skull / Bone Regeneration / Transforming Growth Factor beta / Bone Transplantation / Bone Substitutes / Bone Morphogenetic Proteins Type of study: Diagnostic_studies Limits: Animals / Humans / Male Language: En Journal: J Oral Maxillofac Surg Year: 2008 Document type: Article Affiliation country: United States Country of publication: United States