Trujillo Robert L, Kadioglu Onur, Currier G Fräns, Smith Kevin S, Yetkiner Enver
Private Practice, Sammamish, WA.
Associate Professor and Program Director, Department of Orthodontics, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
J Oral Maxillofac Surg. 2018 Sep;76(9):1991-1997. doi: 10.1016/j.joms.2018.03.009. Epub 2018 Mar 21.
To compare the volumetric changes in successfully treated clefts with secondary alveolar grafting using recombinant human bone morphogenic protein-2 (rhBMP-2) delivered in β-tricalcium phosphate (βTCP) scaffold versus autogenous grafts obtained from the iliac crest and mandibular symphysis.
We performed a retrospective cohort study of cone-beam computed tomography scans of 25 subjects with unilateral or bilateral clefts. Of the 25 patients, 7 received an iliac crest bone graft, 9 received a mandibular symphyseal bone graft, and 9 subjects received the rhBMP-2/βTCP bone substitute. Volumetric rendering software was used to calculate the amount of new bone formation and residual bone defect present in the cleft area. The data were analyzed using Wilcoxon and Kruskal-Wallis tests and Pearson's correlation coefficient.
The mean percentage of new bone formation for the iliac crest, symphysis, and rhBMP-2/βTCP was 85.47, 80.56, and 81.22%, respectively (P = .0854). The initial cleft volume had a weak positive correlation with the percentage of new bone formation (r = 0.18), but the postoperative residual cleft volume had a strong negative correlation (r = 0.71).
rhBMP2 delivered in a βTCP scaffold in alveolar cleft patients can be a viable alternative to autogenous iliac crest and symphysis grafts, eliminating donor site morbidity.
比较使用重组人骨形态发生蛋白-2（rhBMP-2）负载于β-磷酸三钙（βTCP）支架进行二期牙槽骨植骨成功治疗的腭裂患者的体积变化，与取自髂嵴和下颌联合的自体骨移植情况。
我们对25名单侧或双侧腭裂患者的锥形束计算机断层扫描进行了回顾性队列研究。25例患者中，7例接受了髂嵴骨移植，9例接受了下颌联合骨移植，9例接受了rhBMP-2/βTCP骨替代物。使用容积再现软件计算腭裂区域新骨形成量和残余骨缺损量。数据采用Wilcoxon检验、Kruskal-Wallis检验和Pearson相关系数进行分析。
髂嵴、下颌联合和rhBMP-2/βTCP的新骨形成平均百分比分别为85.47%、80.56%和81.22%（P = 0.0854）。初始腭裂体积与新骨形成百分比呈弱正相关（r = 0.18），但术后残余腭裂体积呈强负相关（r = 0.71）。
在牙槽嵴裂患者中，βTCP支架负载的rhBMP2可作为自体髂嵴和下颌联合移植的可行替代方案，消除供区并发症。
