rhBMP-2 with a Demineralized Bone Matrix Scaffold versus Autologous Iliac Crest Bone Graft for Alveolar Cleft Reconstruction

• DOI: 10.1097/prs.0b013e3182865dfb
• Publication Date: 2013-02-05T13:48:35Z
• Authors: Cameron S. Francis; Sheila S. Nazaria...; Michael A. Lypka; Elizabeth Rommer; Stephen Yen; Mark M. Urata; Jeffrey A. Hammoudeh
• Keywords: Iliac crest; Demineralized bone matrix; Bone grafting

Background: Secondary alveolar cleft reconstruction using autologous iliac crest bone graft is currently the standard treatment for clefts. Although effective, harvesting may result in considerable donor-site morbidity, most commonly pain and potential long-term sensory disturbances. In an effort to decrease patient a novel technique recombinant human morphogenetic protein (rhBMP)-2 encased demineralized matrix scaffold was developed as alternative autografting secondary reconstruction. Methods: A chart review conducted 55 patients who underwent over 2-year period with mean follow-up of 21 months. Of these, 36 received rhBMP-2/demineralized (including 10 previously failed repairs grafting) 19 grafting. Postoperatively, stock evaluated occlusal radiographs rated according Bergland Chelsea scales. Results: Alveolar clefts repaired were 97.2 percent successful compared 84.2 Radiographically, initial superior grafting both scales, significantly more group had coronal bridging. The postoperative intraoral infection rate following greater than scaffold. cost products offset by savings associated reduction operative time averaging 102 minutes. Conclusions: rhBMP-2 appears be viable repair. Patients are spared morbidity achieve excellent results, decreasing time, increasing operating room use. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.