Regenerating mandibular bone using rhBMP-2: part 2 – treatment of chronic, defect non-union fractures
Identifieur interne : 001763 ( Main/Exploration ); précédent : 001762; suivant : 001764Regenerating mandibular bone using rhBMP-2: part 2 – treatment of chronic, defect non-union fractures
Auteurs : Frank J. M. Verstraete [États-Unis] ; Boaz Arzi [États-Unis] ; Daniel J. Huey [États-Unis] ; Derek D. Cissell [États-Unis] ; Kyriacos A. Athanasiou [États-Unis]Source :
- Veterinary surgery : VS [ 0161-3499 ] ; 2014.
Abstract
To describe a surgical technique utilizing a regenerative approach and internal fixation for reconstruction of critical size bone defect non-union mandibular fractures.
Case series
Dogs (n = 6) that had internal fixation of defect non-union mandibular fracture.
In 5 of the 6 cases the repair was staged and extraction of teeth performed during the first procedure. After 21-98 days (mean 27 days) a pharyngotomy intubation and temporary maxillomandibular fixation were performed. Using an extraoral approach, a locking titanium miniplate plate was contoured and secured. A compression resistant matrix (CRM) infused with rhBMP-2, was implanted in the defect. The implant was then covered with a soft tissue envelope followed by routine closure.
All dogs had healed with intact gingival covering over the mandibular fracture site defect and had immediate return to normal function and correct occlusion. Hard-tissue formation was observed clinically within 2 weeks and solid cortical bone formation within 3 months. Computed tomographic findings in one case at 3 months postoperatively demonstrated that the newly regenerated mandibular bone had 92% of the bone density and porosity compared to the contralateral side. Long-term follow-up revealed excellent outcome.
Mandibular reconstruction using internal fixation and CRM infused with rhBMP-2 is an excellent solution for the treatment of critical size defect non-union fractures in dogs.
In dogs with a mandibular critical size defect non-union fractures, reconstruction using rhBMP-2 and a CRM should be considered as a viable surgical option.
Url:
DOI: 10.1111/j.1532-950X.2014.12122.x
PubMed: 24410723
PubMed Central: 4451182
Affiliations:
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M." last="Verstraete">Frank J. M. Verstraete</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis</wicri:cityArea></affiliation></author><author><name sortKey="Arzi, Boaz" sort="Arzi, Boaz" uniqKey="Arzi B" first="Boaz" last="Arzi">Boaz Arzi</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis</wicri:cityArea></affiliation></author><author><name sortKey="Huey, Daniel J" sort="Huey, Daniel J" uniqKey="Huey D" first="Daniel J." last="Huey">Daniel J. Huey</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Biomedical Engineering, College of Engineering, University of California, Davis, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Biomedical Engineering, College of Engineering, University of California, Davis</wicri:cityArea></affiliation></author><author><name sortKey="Cissell, Derek D" sort="Cissell, Derek D" uniqKey="Cissell D" first="Derek D." last="Cissell">Derek D. Cissell</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Biomedical Engineering, College of Engineering, University of California, Davis, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Biomedical Engineering, College of Engineering, University of California, Davis</wicri:cityArea></affiliation></author><author><name sortKey="Athanasiou, Kyriacos A" sort="Athanasiou, Kyriacos A" uniqKey="Athanasiou K" first="Kyriacos A." last="Athanasiou">Kyriacos A. Athanasiou</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Biomedical Engineering, College of Engineering, University of California, Davis, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Biomedical Engineering, College of Engineering, University of California, Davis</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Department of Orthopedic Surgery, School of Medicine, University of California, Davis, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Orthopedic Surgery, School of Medicine, University of California, Davis</wicri:cityArea></affiliation></author></analytic><series><title level="j">Veterinary surgery : VS</title><idno type="ISSN">0161-3499</idno><idno type="eISSN">1532-950X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To describe a surgical technique utilizing a regenerative approach and internal fixation for reconstruction of critical size bone defect non-union mandibular fractures.</p></sec><sec id="S2"><title>Study design</title><p id="P2">Case series</p></sec><sec id="S3"><title>Animals</title><p id="P3">Dogs (n = 6) that had internal fixation of defect non-union mandibular fracture.</p></sec><sec id="S4"><title>Methods</title><p id="P4">In 5 of the 6 cases the repair was staged and extraction of teeth performed during the first procedure. After 21-98 days (mean 27 days) a pharyngotomy intubation and temporary maxillomandibular fixation were performed. Using an extraoral approach, a locking titanium miniplate plate was contoured and secured. A compression resistant matrix (CRM) infused with rhBMP-2, was implanted in the defect. The implant was then covered with a soft tissue envelope followed by routine closure.</p></sec><sec id="S5"><title>Results</title><p id="P5">All dogs had healed with intact gingival covering over the mandibular fracture site defect and had immediate return to normal function and correct occlusion. Hard-tissue formation was observed clinically within 2 weeks and solid cortical bone formation within 3 months. Computed tomographic findings in one case at 3 months postoperatively demonstrated that the newly regenerated mandibular bone had 92% of the bone density and porosity compared to the contralateral side. Long-term follow-up revealed excellent outcome.</p></sec><sec id="S6"><title>Conclusion</title><p id="P6">Mandibular reconstruction using internal fixation and CRM infused with rhBMP-2 is an excellent solution for the treatment of critical size defect non-union fractures in dogs.</p></sec><sec id="S7"><title>Clinical Relevance</title><p id="P7">In dogs with a mandibular critical size defect non-union fractures, reconstruction using rhBMP-2 and a CRM should be considered as a viable surgical option.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li></region></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Verstraete, Frank J M" sort="Verstraete, Frank J M" uniqKey="Verstraete F" first="Frank J. M." last="Verstraete">Frank J. M. Verstraete</name></region><name sortKey="Arzi, Boaz" sort="Arzi, Boaz" uniqKey="Arzi B" first="Boaz" last="Arzi">Boaz Arzi</name><name sortKey="Athanasiou, Kyriacos A" sort="Athanasiou, Kyriacos A" uniqKey="Athanasiou K" first="Kyriacos A." last="Athanasiou">Kyriacos A. Athanasiou</name><name sortKey="Athanasiou, Kyriacos A" sort="Athanasiou, Kyriacos A" uniqKey="Athanasiou K" first="Kyriacos A." last="Athanasiou">Kyriacos A. Athanasiou</name><name sortKey="Cissell, Derek D" sort="Cissell, Derek D" uniqKey="Cissell D" first="Derek D." last="Cissell">Derek D. Cissell</name><name sortKey="Huey, Daniel J" sort="Huey, Daniel J" uniqKey="Huey D" first="Daniel J." last="Huey">Daniel J. Huey</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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