Evolution of Postoperative Edema in Alveolar Graft Performed with Bone Morphogenetic Protein (rhBMP-2)

Abstract

The facial edema was influenced by the rhBMP-2 used in alveolar graft, and trismus was proportional to the intensity of facial edema.

Alveolar bone healing accompanied by severe swelling in cleft children treated with bone morphogenetic protein-2 delivered by hydrogel

“…Recently, Leal et al has published a study regarding facial edema following alveolar cleft surgery with BMP-2 (1.5 mg/ml) in 150 patients [55]. They found maximal facial edema after 3 to 4 days, the edema was inversely proportional to age (p=0.003), more pronounced in females than in males (p=0.017) and there was a correlation between edema and reduced mouth opening (p=0.0002).…”

“…the cranium, the mandibular symphysis or the tibia [47]. Since there are donor site morbidities (pain and scarring) and risks (bleeding, infection, nerve injuries, tibial fracture and dural tear) associated with any autologous donor site, bone substitutes have been studied to avoid these risks and to reduce surgery time and hospital stay [49][50][51][52][53][54][55]. Compared to other anatomical regions craniofacial bone reconstruction after trauma or tumor surgery and in anomalies is often complicated due to the complex form of facial bones and difficulties to cover large craniofacial bone defects [41,42].…”

“…methyl methacrylate, hydroxyapatite, calcium phosphate, porous polyethylene and titanium [41,42]. Bone morphogenetic protein (BMP) is a potent osteoinductive substance and has been studied in alveolar cleft surgery [49][50][51][53][54][55] during the last decade. Monetite, an inorganic substance, has been used as a bone substitute in both animal and human studies [66,67].…”

Outcomes of Alveolar Graft With Rhbmp-2 in CLP: Influence of Cleft Type and Width, Canine Eruption, and Surgeon

“…However, despite the promising outcomes in several fields, systematic literature reviews demonstrated that, despite the adequate bone formation achieved by utilization of recombinant human bone morphogenetic protein 2 (rhBMP-2; INFUSE Bone Graft; Medtronic Sofamor Danek, Memphis, TN, USA), further research is needed (Guo et al, 2011;Van Hout et al, 2011). The greater facial edema without need of analgesic and antiinflammatory therapy was cited as a possible side effect associated with rhBMP-2 (Herford et al, 2007;Alonso et al, 2010;Carvalho, 2011;Leal et al, 2015), which indicates this protein as a viable alternative material for that purpose.…”

Alveolar Bone Graft: Clinical Profile and Risk Factors for Complications in Oral Cleft Patients

“…Sparing children from the procedure of iliac crest harvesting is in itself a compelling reason to favor rhBMP2 use (Balaji, 2009). On the other hand, recent research revealed that facial edema was influenced by the rhBMP-2 used in alveolar graft, and trismus was proportional to the intensity of facial edema (Leal et al, 2014). The ideal substitute has not been discovered yet, but the investigative search continues (Coots, 2012).…”