Craniofacial Surgery Unit, Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Universidade de São Paulo (USP), Sao Paulo, Brazil.
Craniofacial Surgery Unit, Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Universidade de São Paulo (USP), Sao Paulo, Brazil.
J Plast Reconstr Aesthet Surg. 2014 Sep;67(9):1201-8. doi: 10.1016/j.bjps.2014.05.014. Epub 2014 May 20.
Recombinant human bone morphogenetic protein (rhBMP)-2 has been used in some craniofacial centers worldwide. However, its influence on nasal morphology is unknown. Thus, the objective of this investigation was to assess the effect of maxillary alveolar reconstruction on nasal position and symmetry in unilateral complete cleft lip patients who underwent traditional iliac crest bone grafting transferring versus reconstruction using rhBMP-2.
Nineteen unilateral complete cleft lip patients were randomly divided into two groups. In group 1, patients underwent traditional iliac crest bone grafting transferring (n = 11) and in group 2, patients underwent alveolar reconstruction using collagen matrix with lyophilized rhBMP-2 (n = 8). Computerized tomography (CT) imaging was performed preoperatively and at 6 months postoperatively using a previously standardized protocol. Linear distances using anatomic landmarks were performed using tridimensional CT data reformatted by the OsiriX(®) software. Quantitative and qualitative measurements to assess intra- and inter-group nasal position modifications were performed.
Intra-group pre- and postoperative comparisons showed significant differences (p < 0.05) in two linear measurements of group 1, while group 2 did not present a difference (p > 0.05). Group 2 presented significant postoperative enhancement (p < 0.05) in the quantitative nasal symmetry in one measurement. Qualitative analysis showed postoperative nasal symmetry enhancement in 75% of the measurements of group 2 and 36% of group 1. There was no statistically significant difference in the inter-group comparisons.
Our study demonstrated that both groups showed similar effect on nasal symmetry.
重组人骨形态发生蛋白（rhBMP）-2 已在世界范围内的一些颅面中心使用。然而，其对鼻形态的影响尚不清楚。因此，本研究的目的是评估上颌牙槽重建对上颌牙槽裂患者鼻位置和对称性的影响，这些患者接受了传统的髂嵴骨移植转移与使用 rhBMP-2 的重建的治疗。
19 例单侧完全唇裂患者随机分为两组。在第 1 组中，患者接受传统的髂嵴骨移植转移（n=11），在第 2 组中，患者接受胶原基质与冻干 rhBMP-2 的牙槽重建（n=8）。使用以前标准化的方案，在术前和术后 6 个月进行计算机断层扫描（CT）成像。使用 OsiriX（®）软件对三维 CT 数据进行重建成像，通过解剖学标志进行线性距离测量。使用三维 CT 数据进行定量和定性测量，以评估鼻位置的组内和组间变化。
组内术前和术后比较显示，第 1 组的两个线性测量值存在显著差异（p<0.05），而第 2 组没有差异（p>0.05）。第 2 组在一个测量中表现出显著的术后定量鼻对称性增强（p<0.05）。定性分析显示，第 2 组 75%的测量和第 1 组 36%的测量术后鼻对称性增强。组间比较无统计学差异。
我们的研究表明，两组对上颌牙槽裂患者的鼻对称性都有类似的影响。
