Continuity resection of the mandible after ameloblastoma – feasibility of oral rehabilitation with rhBMP-2 associated to bovine xenograft followed by implant installation

• Published in: Journal of cranio-maxillo-facial surgery Vol. 43; no. 8; pp. 1553 - 1560
• Main Authors: Lustosa, Romulo Maciel, Macedo, Diogo de Vasconcelos, Iwaki, Lilian Cristina Vessoni, Tolentino, Elen de Souza, Hasse, Paulo Norberto, Marson, Giordano Bruno de Oliveira, Iwaki Filho, Liogi
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.10.2015
• Subjects: Absorbable Implants; Adult; Ameloblastoma - surgery; Animals; Bone graft; Bone Morphogenetic Protein 2 - therapeutic use; Bone morphogenetic protein type 2; Bone Transplantation - methods; Cattle; Collagen; Dental Implantation, Endosseous - methods; Dental Implants; Dental Prosthesis, Implant-Supported; Dentistry; Denture, Partial; Feasibility Studies; Follow-Up Studies; Heterografts - drug effects; Heterografts - transplantation; Humans; Male; Mandibular Neoplasms - surgery; Mandibular reconstruction; Mandibular Reconstruction - methods; Membranes, Artificial; Minerals - therapeutic use; Osseointegration - drug effects; Osseointegration - physiology; Recombinant Proteins - therapeutic use; Surgery; Surgical Mesh; Transforming Growth Factor beta - therapeutic use; Xenograft; Bone morphogenetic protein type 2; Xenograft; Mandibular reconstruction; Dental implants; Bone graft
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2015.06.030

Abstract Recombinant human morphogenetic protein (rhBMP) is a graft alternative for extensive mandibular reconstruction after tumor resections. However, the feasibility of rhBMP-2 to receive osseointegrated implants and prosthetic rehabilitation has been rarely reported. This study reports on a case of an extensive solid ameloblastoma along the mandibular body. The treatment consisted of resection followed by off-label use of rhBMP type 2 associated with bovine bone xenograft. Eleven months postoperatively, the patient was prosthetically rehabilitated with dental implants, without evidence of resorption or complications. The literature on mandibular reconstructions using rhBMP and their feasibility for future osseointegrated implant placement was also reviewed. Based on the presented case, the association between rhBMP-2 and a bovine bone xenograft could be considered a feasible option for the reconstruction and rehabilitation of large mandibular defects after tumor resection. According to the literature, the use of rhBMP as a graft material is encouraging, with good clinical outcome. However, there are no long-term studies demonstrating success and survival rates of implants placed in these grafts. Future investigations will be required to ascertain the long-term survival of implants in areas grafted with rhBMP. Also, there is a lack of information regarding the prosthetic rehabilitation of these patients.