Background: Defects of the cranial vault can be a challenging and complex problem for the reconstructive surgeon. The morbidity of harvesting autogenous bone grafts, as well as complications using alloplastic materials have challenged the field of reconstructive surgery for more optimal techniques. Recombinant human bone morphogenetic protein (rhBMP-2) is an osteoinductive protein that has been shown to be effective for use in open long bone fractures, spine surgery, and augmentation of the alveolar ridge. The authors describe the use of rhBMP-2 in cranioplasty and show how this technique offers the advantages of material autogenous to the human body, while avoiding the morbidity of bone grafts, and risks associated with alloplastic material.

Methods: Seven patients aged 3 to 16 years underwent cranial vault remodeling with bone morphogenetic protein. Various characteristics of the cranial defects were recorded including dimensions, reasons for defects, and postoperative results. Infection, bone resorption, and residual defects were measured with postoperative CT scans.

Results: Seven patients were successfully treated with rhBMP-2 and evaluated using pre and post operative CT scans and clinical pictures.

Conclusions: Cranial remodeling can be successfully accomplished using bone morphogenetic protein (rhBMP-2), utilizing the advantages of autogenous material, while avoiding morbidity associated with allogenic material.