The objective of this study was to valuate 2 substances as potential carriers of fibroblast growth factor 1 (FGF-1) in a rat craniectomy model: gelatin sponge (Spongostan; Ferrosan A/S, Søborg, Denmark) and natural bone mineral (Bio-Oss; Geistlich Biomaterials, Wolhusen, Switzerland).Forty-eight adult male Sprague-Dawley rats were used. A 5-mm-diameter circular craniectomy was performed in the left parietal bone. Animals were divided into 6 experimental groups of 8 rats, each group receiving a different treatment: control (no substance added), Spongostan, Bio-Oss, FGF, FGF + Spongostan, and FGF + Bio-Oss. Animals were killed 12 weeks after surgery.Descriptive histology and stereology were used, the latter to measure the volumes of regenerated bone and Bio-Oss remaining in the defect. Analysis of variance was used to determine differences in bone regeneration between groups, and Mann-Whitney U test was used to compare the volume of remaining Bio-Oss particles.Histologically, the control defects behaved like critical size defects, showing incomplete bone regeneration. Only the FGF + Spongostan group achieved nearly complete bone regeneration. Bio-Oss particles seemed to reduce centripetal bone regeneration. Spongostan by itself did not interfere with spontaneous bone healing.Stereologic measurements of the volume of new bone growth, measured in cubic millimeter, were as follows: control group, 3.86 ± 1.03; Bio-Oss, 2.26 ± 1.06; Spongostan, 3.00 ± 0.81; FGF, 3.99 ± 1.85; FGF + Bio-Oss, 3.02 ± 1.88; and FGF + Spongostan, 8.93 ± 1.28. Analysis of variance showed a statistically significant difference between the FGF + Spongostan group and the other groups (P < 0.001). Comparison among the other groups did not show significant differences.Fibroblast growth factor 1 with a Spongostan carrier has shown great efficacy for bone regeneration in cranial critical size defects in rats. Bio-Oss did not produce a regenerative effect, either alone or with FGF-1.

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The authors review the historical evolution of the Le Fort I osteotomy, compiling the whole current indications and utilities of the maxillary mobilisation through this technique, the potential risks and sequelae of this surgical procedure and the evolution and improvement of this osteotomy to obtain higher stability and reliability with greater long-term outcomes.

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