Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
J Craniofac Surg. 2021;32(2):787-793. doi: 10.1097/SCS.0000000000006937.
Rebuilding atrophied alveolar ridges can present a significant challenge for the maxillofacial surgeons. A multitude of treatment options including guided bone regeneration, onlay block grafting, and distraction osteogenesis are today available as safe procedures.The recent Food and Drug Administration approval of recombinant human bone morphogenetic proteins (rhBMPs) has given clinicians an added treatment option for reconstructing localized and large jaw defects. Currently, several patients have been successfully treated with the combination of bone graft and rhBMP-2 and the results have been documented as predictable and safe by clinical and radiologic examinations follow-up. In this study, a literature review was conducted using Medline, Medpilot, and Cochrane Database of Systematic Reviews. It was concentrated on manuscripts and overviews published in the last 20 years (2000-2020). The key terms employed were platelet-rich plasma, rhBMPs, and their combinations with the common scaffolds used for bone regeneration techniques. The results of clinical studies and animal trials were especially emphasized. The statements from the literature were compared with authors' own clinical data.The potential to reconstruct these large bone defects with a growth factor thus limiting or even avoiding a secondary harvest site is exciting and it represents a new frontier in the field of surgery. This study data confirm how there are excellent documents about the possible combination of using substitute materials and growth factor for treating large and minor craniofacial bone defects.
修复萎缩的牙槽嵴对颌面外科医生来说是一个巨大的挑战。目前有多种治疗方法,包括引导骨再生、骨块移植和骨牵张成骨术,这些方法都是安全的。最近,食品和药物管理局批准了重组人骨形态发生蛋白(rhBMPs)的使用,为临床医生提供了一种额外的治疗方法,用于重建局部和大面积颌骨缺损。目前,已经有几位患者成功地接受了骨移植和 rhBMP-2 的联合治疗,临床和影像学检查随访结果表明,这种治疗方法是可预测且安全的。在这项研究中,我们使用 Medline、Medpilot 和 Cochrane 系统评价数据库进行了文献回顾。研究集中在过去 20 年(2000-2020 年)发表的手稿和综述上。使用的关键词是富血小板血浆、rhBMPs 及其与用于骨再生技术的常见支架的组合。特别强调了临床研究和动物试验的结果。将文献中的陈述与作者自己的临床数据进行了比较。有生长因子的情况下,有潜力重建这些大的骨缺损,从而限制甚至避免二次取骨部位,这令人兴奋,这代表了手术领域的一个新前沿。本研究数据证实了有大量关于替代材料和生长因子联合治疗大、小颅面骨缺损的文献。