Bone Morophogenetic Protein Application as Grafting Materials for Bone Regeneration in Craniofacial Surgery: Current Application and Future Directions

Abstract

Rebuilding atrophied alveolar ridges can present a significant challenge for the maxillofacial surgeons. A multitude of treatment options including guided bone regeneration, onlay block grafting, and distraction osteogenesis are today available as safe procedures. The recent Food and Drug Administration approval of recombinant human bone morphogenetic proteins (rhBMPs) has given clinicians an added treatment option for reconstructing localized and large jaw defects. Currently, several patients have been successfully treated with the combination of bone graft and rhBMP-2 and the results have been documented as predictable and safe by clinical and radiologic examinations follow-up. In this study, a literature review was conducted using Medline, Medpilot, and Cochrane Database of Systematic Reviews. It was concentrated on manuscripts and overviews published in the last 20 years (2000–2020). The key terms employed were platelet-rich plasma, rhBMPs, and their combinations with the common scaffolds used for bone regeneration techniques. The results of clinical studies and animal trials were especially emphasized. The statements from the literature were compared with authors’ own clinical data. The potential to reconstruct these large bone defects with a growth factor thus limiting or even avoiding a secondary harvest site is exciting and it represents a new frontier in the field of surgery. This study data confirm how there are excellent documents about the possible combination of using substitute materials and growth factor for treating large and minor craniofacial bone defects.

Histological and Histomorphometric Analyses of Bone Regeneration in Osteoporotic Rats Using a Xenograft Material

“…In addition, there are no statistically significant differences between the use of biomaterials added with BMP and not. The study data confirm the excellent documents about the possible combination of using substitute materials and growth factor for treating large and minor craniofacial bone defects [13].…”

“…Currently, several patients have been successfully treated with the combination of bone graft and rhBMP-2 and the results have been documented as predictable and safe by clinical and radiologic examinations followup. A systematic review on the rhBMP-2 application in craniomaxillofacial reconstruction defects evaluated the real efficacy and safety of BMPs [13]. According to the results, the use of different BMPs can positively influence the surgery.…”

Does Platelet-Rich Fibrin Enhance the Early Angiogenetic Potential of Different Bone Substitute Materials? An In Vitro and In Vivo Analysis

“…In general, with recent adjustments in regulatory requirements by the Food and Drug Administration, the application of growth factors related to bone substitute materials, such as recombinant human bone morphogenetic proteins (rhBMPs) [ 25 ], platelet-derived growth factor-BB (rhPDGF) [ 26 ], and fibroblast growth factor-2 (rhFGF-2) [ 27 ], has emerged as a new frontier in the field of reconstructive surgery. Currently, there is an ongoing debate on appropriate concentrations and indications [ 28 ].…”

Dental Pulp Stem Cells on Implant Surface: An In Vitro Study

“…In particular, the key protein for bone tissue formation, the osteocalcin was already produced and released to be bound to ECM for mineralization. Also, the vasculogenesis process was carried out by cell-Myth (Maipek Manufacturer Industrial Care, Naples, Italy) devices, even if in a later stage with respect to the control [45][46][47][48][49][50][51][52][53][54][55][56][57].…”