Autogenous Iliac Crest Versus rhBMP-2 for Alveolar Cleft Grafting: A 14-Year Single-Institution Experience
| Autor: | Michael A. Perrino, John J. Costandi, Sidney B. Eisig, Vincent Carrao, Kevin C. Lee |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Radiography Columbia university Bone Morphogenetic Protein 2 Iliac crest Ilium 03 medical and health sciences 0302 clinical medicine Informed consent Transforming Growth Factor beta medicine Humans Single institution Child Retrospective Studies Bone Transplantation business.industry Alveolar Bone Grafting Retrospective cohort study 030206 dentistry Patient specific Recombinant Proteins Surgery Alveolar Cleft Grafting medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Oral Surgery business |
| Zdroj: | Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 79(2) |
| ISSN: | 1531-5053 |
| Popis: | This study sought to compare radiographic outcomes and resource utilization between recombinant human bone morphogenetic protein-2 (rhBMP-2) and anterior iliac crest bone graft (AICBG) when used for secondary alveolar grafting.This is a 14-year retrospective study of patients with alveolar clefts treated at the Morgan Stanley Children's Hospital of New York-Presbyterian/Columbia University Irving Medical Center between January 2006 and January 2020. Patients who had alveolar grafting with either rhBMP-2 or AICBG were included in this study. The primary study predictor was the graft material. The study outcomes were bone height, operating room time, and the number of scrubbed personnel (surgeon and assistants). Graft survival was measured at a minimum of 6 months postoperatively. Bone height was scored according to the Bergland scale, and radiographic success was defined as Bergland types 1 or 2.The study sample included a total of 115 patients with 130 alveolar clefts. Overall, 13.0% of patients had bilateral repairs, and 17.4% were retreatments. The cumulative success rate was 89.5%. There were no differences in success between materials (rhBMP: 90.3%; AICBG: 89.1%; P = .85). Patients presenting for retreatment were more likely to receive rhBMP-2 than AICBG (48.6 vs 3.8%, P .01). After controlling for other significant confounders, the rhBMP-2 group required less personnel (P .01) and operating room time (P .01). Only 1 patient in the rhBMP-2 group was admitted, whereas all AICBG patients were admitted a minimum of 1 night.Compared with AICBG, rhBMP-2 produced a similar height of bone but required less hospital resources. The decision to use harvested ilium or rhBMP-2 is not limited by outcome data at this time. More studies will need to be performed to identify the particular advantages of each graft material. The choice of material is currently both surgeon specific and patient specific and requires thorough informed consent. |
| Databáze: | OpenAIRE |
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