Mandibular reconstruction with a prefabricated vascularized bone graft using recombinant human osteogenic protein-1: an experimental study in miniature pigs. Part I: Prefabrication

Int J Oral Maxillofac Surg. 2001 Oct;30(5):373-9. doi: 10.1054/ijom.2001.0032.

Abstract

Osteogenic protein-1 (rhOP-1), also called bone morphogenetic protein-7 (BMP-7), is osteoinductive. It may be possible to reconstruct a mandible by local application of rhOP-1. However, in tumour patients this can be impossible due to scars or preceding radiotherapy. Usually vascularized bone grafts are indicated. The aim of this study was to prefabricate a vascularized bone graft in the latissimus dorsi muscle for microsurgical transplantation. In nine minipigs 600 microgram rhOP-1 were used with 8 ml xenogenic bone mineral (BioOss, Geistlich, Waldenburg, Germany) as a carrier and inserted into a pouch prepared in the M. latissimus dorsi. After 6, 12, and 24 weeks the grafts were harvested. The results were evaluated using computed tomography, histology, macro- and microangiography. A high yield of newly formed bone was obtained on the osteoconductive scaffold of the xenogenic bone. It was possible to create a vascularized osseous graft in the given shape of the BioOss blocks. In cross-sections, 68% of the scaffold was coated with new bone. The amount of new bone did not differ between the prefabrication times. Bone overgrowth was 2.1% of the graft volume. In conclusion, this study has shown that it can be possible to prefabricate a neomandible within a muscle graft, which then could be transferred for microvascular reconstruction of the mandible. Further research is required before this technique can be refined for clinical use.

MeSH terms

  • Animals
  • Bone Matrix / blood supply
  • Bone Matrix / transplantation*
  • Bone Morphogenetic Protein 7
  • Bone Morphogenetic Proteins / pharmacology*
  • Bone Substitutes
  • Bone Transplantation / methods*
  • Bone Transplantation / physiology
  • Female
  • Humans
  • Mandible / surgery*
  • Minerals
  • Muscle, Skeletal
  • Oral Surgical Procedures
  • Osteogenesis / drug effects*
  • Recombinant Proteins / pharmacology
  • Swine
  • Swine, Miniature
  • Tissue Engineering / methods*
  • Transforming Growth Factor beta*

Substances

  • BMP7 protein, human
  • Bio-Oss
  • Bone Morphogenetic Protein 7
  • Bone Morphogenetic Proteins
  • Bone Substitutes
  • Minerals
  • Recombinant Proteins
  • Transforming Growth Factor beta