Three-Dimensional Cone Beam Computed Tomography Volumetric Outcomes of rhBMP-2/Demineralized Bone Matrix versus Iliac Crest Bone Graft for Alveolar Cleft Reconstruction
| Autor: | Mark M. Urata, Luke Sanborn, Jeffrey A. Hammoudeh, Sheila Nazarian, Leia Yen, Daniel Yen, Fan Liang, Thomas Imahiyerobo, Breanna Jedrzejewski, Stephen L.-K. Yen |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Cone beam computed tomography Time Factors Radiography Bone Matrix Bone Morphogenetic Protein 2 Dentistry Human bone Transplantation Autologous Iliac crest Ilium 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Transforming Growth Factor beta Iliac bone Humans Medicine Prospective Studies Orthodontics Alveolar Bone Grafting business.industry Demineralized bone matrix Follow up studies 030206 dentistry Cone-Beam Computed Tomography Recombinant Proteins Cleft Palate Transplantation Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Female Surgery business Follow-Up Studies |
| Zdroj: | Plastic and Reconstructive Surgery. 140:767-774 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000003686 |
| Popis: | Recent studies indicate that recombinant human bone morphogenetic protein-2 (rhBMP-2) in a demineralized bone matrix scaffold is a comparable alternative to iliac bone autograft in the setting of secondary alveolar cleft repair. Postreconstruction occlusal radiographs demonstrate improved bone stock when rhBMP-2/demineralized bone matrix (DBM) scaffold is used but lack the capacity to evaluate bone growth in three dimensions. This study uses cone beam computed tomography to provide the first clinical evaluation of volumetric and density comparisons between these two treatment modalities.A prospective study was conducted with 31 patients and 36 repairs of the alveolar cleft over a 2-year period. Twenty-one repairs used rhBMP-2/DBM scaffold and 14 repairs used iliac bone grafting. Postoperatively, occlusal radiographs were obtained at 3 months to evaluate bone fill; cone beam computed tomographic images were obtained at 6 to 9 months to compare volumetric and density data.At 3 months, postoperative occlusal radiographs demonstrated that 67 percent of patients receiving rhBMP-2/DBM scaffold had complete bone fill of the alveolus, versus 56 percent of patients in the autologous group. In contrast, cone beam computed tomographic data showed 31.6 percent (95 percent CI, 24.2 to 38.5 percent) fill in the rhBMP-2 group compared with 32.5 percent (95 percent CI, 22.1 to 42.9 percent) in the autologous population. Density analysis demonstrated identical average values between the groups (1.38 g/cc).These data demonstrate comparable bone regrowth and density values following secondary alveolar cleft repair using rhBMP-2/DBM scaffold versus autologous iliac bone graft. Cone beam computed tomography provides a more nuanced understanding of true bone regeneration within the alveolar cleft that may contribute to the information provided by occlusal radiographs alone.Therapeutic, II. |
| Databáze: | OpenAIRE |
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