11.0: Thursday, March 17, 2005

The Use of Recombinant Human Bone Morphogenic Protein in Craniofacial Bone Reconstruction

Monica E. Miller, MD and Michael H. Carstens, MD.

Purpose: Evaluate the utility of human recombinant Bone Morphogenic Protein (rhBMP-2) in the reconstruction of craniofacial membranous bone defects.

Methods & Materials: From October through December of 2004 three patients with bone defects of the mandible, maxilla, and calvarium due to trauma and/or tumor resection underwent reconstruction with Infuse (rhBMP-2, Medtronic Sofamor Danek, Memphis, TN) in a collagen carrier using ceramic granules. All three patients had implantation of KLS titanium plates or absorbable mesh for support. Bone growth was documented postoperatively using computed tomography performed one month after surgery with plans for future interval CT evaluations.

Results: Computed tomography has demonstrated the regeneration of new bone at the surgical sites in all three patients. Particularly notable is the entire regeneration of bone in a hemi-mandibulectomy defect.

Conclusion: The use of rhBMP-2 has been successfully reported in the orthopedic literature for reconstructing long bone defects. However, rhBMP-2 has not been used in the reconstruction of human craniofacial defects. Our study proves that rhBMP-2 can regenerate new bone in a variety of craniofacial membranous defects providing another option for craniofacial osseous bone reconstruction.