Hassanein Aladdin H, Couto Rafael A, Kurek Kyle C, Rogers Gary F, Mulliken John B, Greene Arin K
Cleft Palate Craniofac J. 2013 May;50(3):358-62. doi: 10.1597/11-273. Epub 2012 Aug 31.
Background : Particulate bone graft and recombinant human bone morphogenetic protein-2 (rhBMP-2) are options for inlay cranioplasty in children who have not developed a diploic space. The purpose of this study was to determine whether particulate bone graft or rhBMP-2 has superior efficacy for inlay cranioplasty and to compare these substances to split cranial bone. Methods : A 17 mm × 17 mm critical-sized defect was made in the parietal bones of 22 rabbits and managed in four ways: Group I (no implant; n=5), Group II (particulate bone graft; n=5), Group III (rhBMP-2; n=7), and Group IV (split cranial bone graft; n=5). Animals underwent microcomputed tomography and histologic analysis 16 weeks after cranioplasty. Results : Defects without an implant (Group I) demonstrated inferior ossification (41.4%; interquartile range [IQR], 28.9% to 42.5%) compared to those treated with particulate bone graft (Group II: 99.5%; IQR, 97.8% to 100%), rhBMP-2 (Group III: 99.6%; IQR, 99.5% to 100%), or split cranial bone (Group IV: 100%) (P < .0001). There was no difference between Groups II, III, and IV (P = .1). Defects treated with rhBMP-2 exhibited thinner bone (0.90 mm; IQR, 0.64 to 0.98) than particulate bone graft (1.95 mm; IQR, 1.09 to 2.83) or split cranial bone (1.72 mm; IQR, 1.54 to 1.88) (P = .006); particulate and split cranial bone grafted defects had a similar thicknesses (P = .6). Conclusions : Particulate bone graft, rhBMP-2, and split cranial bone close inlay calvarial defect areas equally, although the thickness of bone healed with rhBMP-2 is inferior. Clinically, particulate bone graft or split cranial bone graft may be superior to rhBMP-2 for inlay cranioplasty.
对于尚未形成板障间隙的儿童颅骨镶嵌成形术，颗粒状骨移植和重组人骨形态发生蛋白-2（rhBMP-2）是可供选择的方法。本研究的目的是确定颗粒状骨移植或rhBMP-2在颅骨镶嵌成形术中是否具有更优的疗效，并将这些物质与劈开的颅骨进行比较。方法：在22只兔子的顶骨上制造一个17mm×17mm的临界尺寸缺损，并采用四种方法进行处理：第一组（不植入；n = 5），第二组（颗粒状骨移植；n = 5），第三组（rhBMP-2；n = 7），第四组（劈开的颅骨移植；n = 5）。颅骨成形术后16周对动物进行微型计算机断层扫描和组织学分析。结果：与接受颗粒状骨移植（第二组：99.5%；四分位数间距[IQR]，97.8%至100%）、rhBMP-2（第三组：99.6%；IQR，99.5%至100%）或劈开的颅骨（第四组：100%）治疗的缺损相比，未植入的缺损（第一组）显示出较差的骨化（41.4%；IQR，28.9%至42.5%）（P <.0001）。第二组、第三组和第四组之间无差异（P =.1）。与颗粒状骨移植（1.95mm；IQR，1.09至2.83）或劈开的颅骨（1.72mm；IQR，1.54至1.88）相比，用rhBMP-2治疗的缺损骨更薄（0.90mm；IQR，0.64至0.98）（P =.006）；颗粒状和劈开的颅骨移植缺损厚度相似（P =.6）。结论：颗粒状骨移植、rhBMP-2和劈开的颅骨在闭合颅骨镶嵌缺损区域方面效果相同，尽管用rhBMP-2愈合的骨厚度较差。临床上，对于颅骨镶嵌成形术，颗粒状骨移植或劈开的颅骨移植可能优于rhBMP-2。
