Recombinant human bone morphogenetic protein 2 combined with an osteoconductive bulking agent for mandibular continuity defects in nonhuman primates.

Purpose: Recombinant human bone morphogenetic protein 2 (rhBMP-2) is an option for reconstructing mandibular continuity defects. A challenge of this technique is the need to maintain sufficient space to avoid compression of the defect. A compression-resistant matrix (CRM) provides a bulking agent that provides support during the bone formation phase.

Use of a porcine collagen matrix as an alternative to autogenous tissue for grafting oral soft tissue defects.

Purpose: Soft tissue grafting is often required to correct intraoral mucosal deficiencies. Autogenous grafts have disadvantages including an additional harvest site with its associated pain and morbidity and, sometimes, poor quality and limited amount of the graft. Porcine collagen matrices have the potential to be helpful for grafting of soft tissue defects.

Implant success in distracted bone versus autogenous bone-grafted sites.

Endosseous implants are the treatment of choice for restoring function and reconstructing most edentulous areas of the maxilla and mandible. In general, alveolar bone defects can be reconstructed by either distraction osteogenesis or autogenous bone grafting. After alveolar reconstruction, endosseous implants are used to support and retain the prosthesis for restoration of form and function.

Pivotal, randomized, parallel evaluation of recombinant human bone morphogenetic protein-2/absorbable collagen sponge and autogenous bone graft for maxillary sinus floor augmentation.

Purpose: The purpose of this prospective study was to evaluate the safety and effectiveness of recombinant human morphogenetic protein-2 (rhBMP-2) on an absorbable collagen sponge (ACS) compared with an autogenous bone graft when used for 2-stage maxillary sinus floor augmentation. The study assessed new bone formation, placement integration, and functional loading after 6 months and long term for 2 years.

Materials And Methods: A total of 160 subjects were randomized, enrolled, and followed from January 1999 to February 2004 at 21 centers in the United States.

The effects of resorbable membrane on human maxillary sinus graft: a pilot study.

Purpose: To investigate the effects of resorbable membrane on new bone formation in human maxillary sinus graft using anorganic bovine bone material histomorphometrically in a split-mouth study design.

Materials And Methods: This prospective pilot study included six patients who required bilateral sinus augmentations prior to implant treatment. Each patient was grafted with anorganic bovine bone (Bio-Oss).

Reconstruction of mandibular continuity defects with bone morphogenetic protein-2 (rhBMP-2).

Purpose: Several autogenous bone grafting techniques are available for the restoration of large continuity defects of the mandible. However, these procedures are associated with limitations involving postoperative morbidity, difficulty in ambulation, and pain. The development of a technique of surgical reconstruction not involving autogenous bone would offer new opportunities for facial bone reconstruction, particularly of the mandible.

Augmentation of the posterior maxilla by way of sinus grafting procedures: recent research and clinical observations.

This article presents some of the clinical problems with bony augmentation of the posterior maxilla using sinus lift procedures to effect alveolar bone reconstruction. The antral membrane and the bone of the antral floor have regenerative potential commensurate with other bone of the maxilla and mandible. The stem cells involved in the periosteum of the sinus floor and the mucoperiosteum of the oral cavity covering the osteotomy opening combine to form a very receptive site for grafting and surgical procedures.

Bone morphogenetic protein-induced repair of the premaxillary cleft.

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.

A method of treating the patient with postpubescent juvenile rheumatoid arthritis.

Purpose: Juvenile rheumatoid arthritis (JRA) is a perplexing and devastating disease for which establishment of a treatment protocol is difficult. The relatively low incidence and unknown cause of this disorder have made it difficult to establish when and how to intervene. Treatment protocols for the prepubescent patient (<12 years for girls and 14 years for boys), as well as for the adult, have been established.

Clinical applications of rhBMP-2 in maxillofacial surgery.

Materials And Methods: Examples of defects including mandibular continuity defects, preprosthetic atrophic alveolar ridge deficiencies, traumatic defects, and maxillary clefts were included.

Results: All patients demonstrated osseous regeneration stimulated by rhBMP-2.

Conclusion: rhBMP-2 is successful in regenerating bone in a variety of maxillofacial defects.

Bone regeneration using rhBMP-2 induction in hemimandibulectomy type defects of elderly sub-human primates.

Our previous work has shown that total osseous reconstruction of large discontinuity hemimandibulectomy, critical-sized defects can be achieved easily in 8-year-old Macaca fascicularis monkeys (Boyne 1996). However the literature has indicated that animal aging decreases the BMP induction of stem cells in rats and in other rodent species. It was necessarily important that the rhBMP-2 be demonstrated in non-human primates to determine if this reduction in effectiveness also existed in the higher animals phylogenetically.

The multifocal nature of odontogenic keratocysts.

The odontogenic keratocyst, OKC, is a very aggressive intraosseos lesion with a recurrence rate of approximately 25 percent to 60 percent.' The tendency for this lesion to "return" after surgical treatment has prompted studies to obtain more information concerning the inherent nature of the lesion. The OKC lesions are usually treated with enucleation of the soft tissue lining, curettage and ostectomy of the bony margins, or with more aggressive block resection.

De novo bone induction by recombinant human bone morphogenetic protein-2 (rhBMP-2) in maxillary sinus floor augmentation.

Purpose: This phase II study was designed to evaluate 2 concentrations of recombinant human bone morphogenetic protein-2 (rhBMP-2) for safety and efficacy in inducing adequate bone for endosseous dental implant in patients requiring staged maxillary sinus floor augmentation.

Materials And Methods: Patients were treated with rhBMP-2 (via an absorbable collagen sponge [ACS]), at concentrations of 0.75 mg/mL (n = 18), 1.

Clinical, histologic, and histomorphometric evaluation of mineralized solvent-dehydrated bone allograf (Puros) in human maxillary sinus grafts.

Demineralized freeze-dried bone allografts (DFDBA) have been successfully used alone or in composite grafts for many decades. Little research has been done on the effect of retaining the mineral content of bone allografts. This study histologically and histomorphometrically evaluated a new mineralized bone allograft material placed in human atrophic maxillary sinuses.

A comparison of synovial fluid pressure after immediate versus gradual mandibular advancement in the miniature pig.

Purpose: Mandibular advancement is a commonly performed surgical procedure for the treatment of mandibular hypoplasia. With the increased use of rigid fixation, there has been a decrease in the amount of relapse but an increase in the amount of force transmitted to the condyles. Gradual advancement of the mandible by distraction osteogenesis slowly overcomes the soft-tissue envelope and may decrease the amount of force exerted on the condyles.

Distraction osteogenesis of the nasal and antral osseous floor to enhance alveolar height.

Purpose: The purpose of the study was to obtain information on the possibility of using distraction osteogenesis (DO) to increase the height of posterior atrophic maxillary alveolar ridges by distracting very small alveolar crest bone segments and, secondly, to determine if it is possible to distract the bony antral floor itself, producing new bone between the sinus membrane and the alveolar crest.

Materials And Methods: Three adult Papio anubis baboons were rendered edentulous in the posterior maxilla. Bilateral osteotomies were performed to produce a thin margin of crestal alveolar bone and in one area, a complete exposure of the antral floor.

Ankylosis of the jaw in a patient with fibrodysplasia ossificans progressiva.

A case of fibrodysplasia ossificans progressiva (FOP) is presented. This uncommon connective tissue disease tends to produce progressing ectopic osteogenesis. Because there are no reported curative procedures for TMJ ankylosis occurring in this condition, a palliative surgical approach is described.

Effect of teeth with periradicular lesions on adjacent dental implants.

Objectives: It is generally accepted that dental implants should not be placed in infected sites. However, the effect of periradicular infections of natural teeth on adjacent osseointegrated implants is less understood. The purpose of this study was to evaluate effects of periradicular lesions on osseointegration of existing implants.