Recombinant Human BMP-2 Enhances the Effects of Materials Used for Reconstruction of Large Cranial Defects

Mohammed Elsayed Elsalanty, Yong Chen Por, David G. Genecov, Kenneth E. Salyer, Qian Wang, C. R. Barcelo, Karen Troxler, El Gendler, Lynne A. Opperman

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)277-285
Number of pages9
JournalJournal of Oral and Maxillofacial Surgery
Volume66
Issue number2
DOIs
StatePublished - Feb 1 2008

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Bone Matrix
Osteogenesis
Bone and Bones
Platelet-Rich Plasma
Dogs
Cobalt
recombinant human bone morphogenetic protein-2
human BMP2 protein

ASJC Scopus subject areas

  • Dentistry(all)
  • Surgery

Cite this

Recombinant Human BMP-2 Enhances the Effects of Materials Used for Reconstruction of Large Cranial Defects. / Elsalanty, Mohammed Elsayed; Por, Yong Chen; Genecov, David G.; Salyer, Kenneth E.; Wang, Qian; Barcelo, C. R.; Troxler, Karen; Gendler, El; Opperman, Lynne A.

In: Journal of Oral and Maxillofacial Surgery, Vol. 66, No. 2, 01.02.2008, p. 277-285.

Research output: Contribution to journalArticle

Elsalanty, ME, Por, YC, Genecov, DG, Salyer, KE, Wang, Q, Barcelo, CR, Troxler, K, Gendler, E & Opperman, LA 2008, 'Recombinant Human BMP-2 Enhances the Effects of Materials Used for Reconstruction of Large Cranial Defects', Journal of Oral and Maxillofacial Surgery, vol. 66, no. 2, pp. 277-285. https://doi.org/10.1016/j.joms.2007.06.626
Elsalanty, Mohammed Elsayed ; Por, Yong Chen ; Genecov, David G. ; Salyer, Kenneth E. ; Wang, Qian ; Barcelo, C. R. ; Troxler, Karen ; Gendler, El ; Opperman, Lynne A. / Recombinant Human BMP-2 Enhances the Effects of Materials Used for Reconstruction of Large Cranial Defects. In: Journal of Oral and Maxillofacial Surgery. 2008 ; Vol. 66, No. 2. pp. 277-285.
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abstract = "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.",
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AU - Elsalanty, Mohammed Elsayed

AU - Por, Yong Chen

AU - Genecov, David G.

AU - Salyer, Kenneth E.

AU - Wang, Qian

AU - Barcelo, C. R.

AU - Troxler, Karen

AU - Gendler, El

AU - Opperman, Lynne A.

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N2 - 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.

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