Efficacy of Demineralized Bone Matrix for Revision Alveolar Bone Grafting in Patients Previously Treated with Bone Morphogenetic Protein 2 (BMP-2).
| Autor: | Francoisse CA; Division of Plastic Surgery, Saint Louis University, School of Medicine, St. Louis, MO, USA., Sescleifer AM; Department of General Surgery, University of Maryland School of Medicine, Baltimore, MD, USA., Okeke RI; Division of General Surgery, Saint Louis University, School of Medicine, St. Louis, MO, USA., Tyson CV; Division of Plastic Surgery, The University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, USA., Plikaitis C; Division of Plastic Surgery, Saint Louis University, School of Medicine, St. Louis, MO, USA. |
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| Jazyk: | angličtina |
| Zdroj: | The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2024 Jul; Vol. 61 (7), pp. 1179-1185. Date of Electronic Publication: 2023 Feb 27. |
| DOI: | 10.1177/10556656231159259 |
| Abstrakt: | Objective: This study investigates the effectiveness of demineralized bone matrix (DBX) to close alveolar clefts in patients previously treated with bone morphogenic protein-2 (BMP-2) who remained with bone nonunion. Design: This is an IRB-approved retrospective, single-center study. Setting: This study was conducted at a tertiary academic center. Patients/participants: We searched for all surgical encounters with the Current Procedural Terminology (CPT) code 42210 from the years 2013-2019. Included patients were diagnosed with cleft alveolus, previous BMP-2 exposure and required revision bone grafting during mixed dentition for persistent alveolar defects. Interventions: 17 patients underwent revision alveolar bone grafting (ABG) with either DBX (n = 10) or autograft (n = 7) to repair persistent bony cleft. Main Outcome Measure(s): The primary study outcome measured was alveolar bone graft revision failure described as continued alveolar nonunion. Results: The median age at revision ABG was 13.1 ± 3.3 years, with a mean follow-up time of 4.9 years (1.1-9.2 years). Patients were 53% male, 47% had a unilateral cleft lip and alveolus. 58.8% of patients were treated with DBX in the cleft, 41.2% treated with autograft from iliac crest. Overall, 11.8% (n = 2) of all revisions failed, requiring a second revision. The average time to reoperation was 2.06 years, and both were re-grafted with autograft. There was no statistically significant difference between the type of bone graft source used and the failure rate obtained ( P = .1544). Conclusions: DBX and autologous iliac crest bone grafts achieve similar alveolar union rates during revision ABG in patients treated with previous BMP-2 to the alveolar cleft. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Databáze: | MEDLINE |
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