Use of rhBMP2 with bone grafts in pediatric jaw resection cases

Objectives: The efficacy of rhBMP2 with bone grafts (rhBMP2-BG) in promoting adequate bone formation within critical size defects is documented. However, the efficacy in treating jaw resection (including segmental) has not been documented in human pediatric (<10 years) cases.

Methods: In this retrospective analysis, 4 jaw discontinuities that were treated with rhBMP2-BG were included. Three cases involved resection of mandible as treatment for aggressive cysts. Fourth case was with defect in mandible caused by an extensive fibro-osseous lesion. In all cases, reconstructions were carried with split rib graft along with rhBMP2 (as per manufacturer’s recommendation) with absorbable collagen sponge. The cyst cases were reconstructed three months after resection while the fourth case was reconstructed immediately.

Results: In both type of reconstructions, the defect was bridged successfully with adequate qualitative and quantitative parameters as revealed by imaging studies at the 6th month follow up. However, it was observed that immediate delivery yielded better quality and quantity of bone regeneration in segmental mandibular defects comparatively. The results of both the surgeries will be presented and discussed with clinical as well as radiographical evidences at the end of the sixth month period.

Conclusion: This presentation is the first to describe use of rhBMP2-BG in pediatric jaw resection cases. It appears that immediate reconstruction yields better quality and quantity of bone. More systematic studies with large sample are needed to identify the mechanism of this difference in efficacy between the immediate and delayed in cases with jaw resection treated with rhBMP2-BG.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Use of rhBMP2 with bone grafts in pediatric jaw resection cases
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