Abstract
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is an osteoinductive protein approved for use in oral and maxillofacial defect reconstruction. Growth factors act as mediators of cellular growth on morphogenesis and mythogenesis phases. Utilized as recombinant proteins, these growth factors need the presence of local target cells capable of obtaining the required results. This cell population may be present at the wound site or added to scaffolding material before implantation at the surgical site.The aim of this study is to evaluate the clinical and radiographic results of a reported case with a large bone defect, treated with an absorbable collagen sponge, rhBMP-2 and a titanium plate and mesh. The Authors want to report a case which shows the resulting effectiveness of the rhBMP2 action regarding a large, mandibular defect reconstruction. This case also shows how the removal of a rare tumor such as a ghost cell tumor of the jaw may be treated without harvesting bone from another body site. A quick diagnosis of the lesions is important in order to perform the most suitable treatment. The Authors also underline the clinical and histological steps to insure the correct treatment is carried out to solve the case.Moreover, from results obtained from this case, it is possible to highlight several clinical benefits for the patient by adding rhBMP-2 to the common allograft to not only have alveolar reconstruction defects and sinus floor augmentation, but also to have alveolar cleft reconstruction and to treat segmental defects.
Highlights
The aim of this study is to evaluate the clinical and radiographic results of a reported case with a large bone defect, treated with an absorbable collagen sponge, Recombinant human bone morphogenetic protein-2 (rhBMP-2) and a titanium plate and mesh
Recombinant human bone morphogenetic protein-2 is an osteoinductive growth factor that has the potential to greatly reduce the need for autogenous bone grafts [1]
The published literature suggests that rhBMP-2 is clinically effective in treatment of critical size defects in both extremities as well as in the maxillofacial region
Summary
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is an osteoinductive growth factor that has the potential to greatly reduce the need for autogenous bone grafts [1]. Urist demonstrated the capabilities of demineralized bone matrixes to induce ectopic bone formation in a rat muscle pouch. He first introduced the concept that growth factors can induce bone formation independently of the bone tissue condition [2]. The emergence of rhBMP-2 as a viable alternative to common bone grafts is related to two important clinical challenges. The first is to eliminate the need to harvest bone from the iliac crest or other sites when performing oral and maxillofacial reconstruction techniques because of morbidity associated with these procedures [3]. The second reason is to enhance the degree of new bone formation, leading to positioning of dental implants, for treating several defects of the facial skeleton [4, 5]
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