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Repair of Alveolar Clefts with Recombinant Human Bone Morphogenetic Protein (rhBMP-2) in Patients with Clefts

Chin, Martin DDS; Ng, Theodore DDS; Tom, William K DDS; Carstens, Michael MD

Journal of Craniofacial Surgery: September 2005 - Volume 16 - Issue 5 - pp 778-789
doi: 10.1097/01.scs.0000166802.49021.01
Clinical Notes

This article demonstrates the feasibility of using recombinant human bone morphogenetic protein (rhBMP-2) as a substitute for autogenous iliac crest bone for repair of congenital facial clefts in humans. In this series, 50 cleft sites were repaired in 43 patients using rhBMP-2 without the use of autogenous graft tissue. Successful osseous union was achieved in 49 of the 50 sites. In one patient, the graft failed to consolidate. Severe clefts were managed by combining distraction osteogenesis and rhBMP-2. Eliminating the need to harvest autogenous iliac crest bone resulted in substantial decrease in morbidity. The constructed alveolus performed clinically as normal bone and responded to natural tooth eruption and orthodontic movement. Histology of the tissue constructed showed normal, vital bone. Although additional investigation is warranted to determine the optimum protocol for the use of this material in alveolar cleft repair, the technique should be considered as a viable treatment option in cases in which avoiding iliac crest harvesting is desirable.

San Francisco, California, USA

Address correspondence to Dr. Martin Chin, 2100 Webster Street, Suite 303, San Francisco, CA 94115; E-mail: mchin1@ix.netcom.com.

© 2005 Mutaz B. Habal, MD