Toriumi D M, Kotler H S, Luxenberg D P, Holtrop M E, Wang E A
Department of Otolaryngology-Head and Neck Surgery, University of Illinois College of Medicine, Chicago 60612.
Arch Otolaryngol Head Neck Surg. 1991 Oct;117(10):1101-12. doi: 10.1001/archotol.1991.01870220049009.
Bone morphogenetic protein-2 (BMP-2) is a human recombinant bone-inducing factor that stimulates bone formation within 14 days. Twenty-six dogs underwent reconstruction of 3-cm full-thickness mandibular defects. After stabilizing the defects with stainless steel reconstruction plates, test implants composed of inactive dog bone matrix carrier and human recombinant BMP-2 were placed in defects of 12 animals (group 1). Control implants (carrier without BMP-2) were used in 10 animals (group 2), and no implants were placed in mandibular defects of four animals (group 3). Animals were killed at 3 and 6 months. The reconstructed segments were evaluated by roentgenography, analysis of functional stability, histology, histomorphometry, and analysis of biomechanical strength using three-point bend testing. In group 1, reconstruction plates were removed at 10 weeks because stiff, noncompressible mineralized bone formed across the defects, allowing the animals to chew a solid diet. The defects from groups 2 and 3 showed minimal, if any, bone formation and remained grossly unstable, prohibiting plate removal or advancement to a solid diet. Histomorphometric analysis at 6 months revealed that 68% of the group 1 implants were replaced by mineralized bone, whereas mineralized bone occupied less than 4% of the implants in groups 2 and 3. Biomechanical testing at 6 months revealed that the average bending strength of the reconstructed hemimandibles (expressed as a percentage of the contralateral hemimandible) was 27% for group 1 and 0% for group 2. The biomechanical strength of the defects reconstructed with BMP-2 increased significantly from 3 to 6 months and was related to degree of mineralization and thickness of bone bridging the defect.
骨形态发生蛋白-2（BMP-2）是一种重组人骨诱导因子，可在14天内刺激骨形成。26只犬接受了3厘米全层下颌骨缺损的重建。用不锈钢重建板稳定缺损后，将由无活性犬骨基质载体和重组人BMP-2组成的测试植入物植入12只动物的缺损处（第1组）。10只动物使用对照植入物（不含BMP-2的载体）（第2组），4只动物的下颌骨缺损处未植入任何植入物（第3组）。在3个月和6个月时处死动物。通过X线摄影、功能稳定性分析、组织学、组织形态计量学以及使用三点弯曲试验分析生物力学强度来评估重建节段。在第1组中，10周时取出重建板，因为缺损处形成了坚硬、不可压缩的矿化骨，使动物能够咀嚼固体食物。第2组和第3组的缺损处即使有骨形成也极少，并且仍然严重不稳定，无法取出钢板或改用固体食物。6个月时的组织形态计量学分析显示，第1组68%的植入物被矿化骨替代，而第2组和第3组中矿化骨占植入物的比例不到4%。6个月时的生物力学测试显示，第1组重建半下颌骨的平均弯曲强度（以对侧半下颌骨的百分比表示）为27%，第2组为0%。用BMP-2重建的缺损处的生物力学强度在3至6个月时显著增加，并且与矿化程度和跨越缺损的骨厚度有关。
