Bone Morphogenetic Protein-Induced Repair of the Premaxillary Cleft

Herford, Alan S.; Boyne, Philip J.; Rawson, Rick; Williams, Roland P.

doi:10.1016/j.joms.2007.06.670

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 11 , Pages 2136-2141, November 2007

Bone Morphogenetic Protein-Induced Repair of the Premaxillary Cleft

Alan S. Herford, DDS, MD
- Chairman, Department of Oral and Maxillofacial Surgery, Loma Linda University Medical Center, Loma Linda, CA.
- Address correspondence and reprint requests to Dr Herford: Department of Oral and Maxillofacial Surgery, Loma Linda University Medical Center, 11092 Anderson Street, Loma Linda, CA 92350
Philip J. Boyne, DMD, MS, DSc(hon)
- Professor Emeritus, Department of Oral and Maxillofacial Surgery, Loma Linda University Medical Center, Loma Linda, CA.
Rick Rawson, DDS, MS
- Former Chief Resident, Department of Oral and Maxillofacial Surgery, Loma Linda University Medical Center, Loma Linda, CA.
Roland P. Williams, DDS
- Research Intern, Department of Oral and Maxillofacial Surgery, Loma Linda University Medical Center, Loma Linda, CA.

Purpose

The purpose of this study is to evaluate the bony regeneration of premaxillary clefts in humans using recombinant human bone morphogenetic protein type 2 in a collagen sponge carrier.

Patients and Methods

Twelve patients with unilateral clefted premaxillas were evaluated preoperatively and 4 months postoperatively. Ten patients were repaired with recombinant human bone morphogenetic protein type 2 while 2 others were grafted with anterior iliac crest particulate marrow cancellous bone. Computed tomographic studies were used to evaluate preoperative alveolar cleft volumes, postoperative bone bridge volumes, and preoperative and postoperative volume ratios.

Results

A preoperative and postoperative volume ratio for patients repaired with recombinant human bone morphogenetic protein type 2 ranged from 24.1% to 90.6% with a mean of 71.7%. Patients who were grafted with particulate marrow cancellous bone had similar preoperative and postoperative volume ratios ranging from 71.3% to 84.9% with a mean of 78.1%.

Conclusions

Clefts of the anterior maxilla can have complete osseous regeneration induced by recombinant human bone morphogenetic protein type 2 as an effective alternative to conventional anterior iliac particulate marrow cancellous bone grafts.