Initial Experience With rhBMP‐2 Delivered in a Compressive Resistant Matrix for Mandibular Reconstruction in 5 Dogs

Boudrieau, Randy J.

doi:10.1111/j.1532-950x.2014.12171.x

Cited by 21 publications

(21 citation statements)

References 79 publications

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“…[3][4][5] Recent advances in the bone-tissue engineering field have allowed the fabrication of CaP scaffolds representing an accurate replica of a specific bone defect 6,7 by using three-dimensional (3D) printing 7,8 Incorporation of growth factors or osteogenic cells to the bioceramic scaffolds improves bone regeneration by providing additional osteoinductive or osteogenic properties, respectively, to the scaffold. 4,7 Among all of the growth factors, recombinant human bone morphogenic protein-2 (rhBMP-2) has been reported to be one of the most extensively used growth factors in both human 9 and veterinary 10,11 orthopedic surgery because of its powerful osteoinductive properties.…”

Section: Introductionmentioning

confidence: 99%

Use of three‐dimensionally printed β‐tricalcium phosphate synthetic bone graft combined with recombinant human bone morphogenic protein‐2 to treat a severe radial atrophic nonunion in a Yorkshire terrier

et al. 2020

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Objective: To describe a novel surgical approach to treat a critical-sized bone defect due to severe, radial atrophic nonunion in a miniature dog. Study design: Case report Animal: A 1-year-old Yorkshire terrier with a critical-sized left radial defect after failed internal fixation of a transverse radial fracture. Methods: Computed tomographic (CT) images of the radius were imported for three-dimensional (3D) printing of a custom-designed synthetic 3D-printed β-tricalcium phosphate (β-TCP) scaffold. The radius was exposed, and the β-TCP scaffold was press-fitted in the bone gap underneath the plate. Recombinant human bone morphogenic protein-2 (RhBMP-2) collagen sponges were squeezed to soak the scaffold with growth factor and then placed on both sides of the synthetic graft. Two additional cortical screws were also placed prior to routine closure of the surgical site. Results: Radiographic examination was consistent with complete healing of the radius defect 4 months after surgery. The bone plate was removed 10 months after surgery. According to CT examination 18 months after surgery, there was no evidence of the synthetic graft; instead, complete corticalization of the affected area was noted. Complete functional recovery was observed until the last clinical follow-up 36 months postoperatively. Conclusion: Screw fixation and use of a 3D-printed ceramic scaffold augmented with rhBMP-2 resulted in excellent bone regeneration of the nonunion and full recovery of a miniature breed dog. Clinical significance: The therapeutic approach used in this dog could be considered as an option for treatment of large-bone defects in veterinary orthopedics, especially for defects affecting the distal radius of miniature dogs.

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Section: Introductionmentioning

confidence: 99%

Use of three‐dimensionally printed β‐tricalcium phosphate synthetic bone graft combined with recombinant human bone morphogenic protein‐2 to treat a severe radial atrophic nonunion in a Yorkshire terrier

et al. 2020

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“…Reconstruction of mandibular segmental defects is a challenge in human medicine [1][2][3] as well as in veterinary practice. [4][5][6][7][8][9][10] Mandibular bone loss in dogs may be associated with trauma, ballistic projectiles, 8,9,11,12 severe periodontal disease, [12][13][14] and mandibulectomy performed due to tumor or other diseases. 6,7,9,10,13 The general goals of the treatment are reestablishing bone continuity, obtaining appropriate dental occlusion, and restoring functional aspects.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7][8][9][10] Mandibular bone loss in dogs may be associated with trauma, ballistic projectiles, 8,9,11,12 severe periodontal disease, [12][13][14] and mandibulectomy performed due to tumor or other diseases. 6,7,9,10,13 The general goals of the treatment are reestablishing bone continuity, obtaining appropriate dental occlusion, and restoring functional aspects. 2,6,15,16 Bone plates and screws are the most frequent alloplastic implants used for mandibular reconstruction.…”

Section: Introductionmentioning

confidence: 99%

“…2,6,15,16 Bone plates and screws are the most frequent alloplastic implants used for mandibular reconstruction. 3,6,[8][9][10]16 In general, reconstruction plates are rigid implants used on the ventral aspect of the mandible in order to stabilize the remaining segments to preserve the facial contour and occlusion as well as to stabilize bone grafts in a suitable position when used. 2,17 A new design is the locking reconstruction plate that locks the screw to the plate to create an additional stability.…”

Section: Introductionmentioning

confidence: 99%

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Bridging Plate Development for Treatment of Segmental Bone Defects of the Canine Mandible

et al. 2016

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With regard to the canine mandible, a mistaken concept of application is to assume that systemic plate-bone resistance is provided by the implant so that biomechanical position could be ignored. Because the alveolar border of the mandible is a tensile zone, the plate would ideally be positioned near this area while avoiding important structures. The aim of this study was to develop 2 bridging plates for the treatment of a segmental bone defect of the canine mandible using monocortical screws to avoid damage to the tooth roots and remaining neurovascular structures. Computed tomography images of the heads of 4 dogs (rottweiler, Doberman, boxer, and miniature poodle breeds) were used as models to develop the project. The images were reconstructed in 3-dimensional (3D) format. For each dog breed, 6 mandible prototypes were produced, each with a segmental bone defect in the right mandible. The mandibular reconstruction was performed with pure titanium bridging plate and locking screws. One plate model was developed for medium- and large-breed dogs and another for small-breed dogs. Mechanical testing showed the platemandible system resists the bite forces in all dog breeds. All safety factors were greater than I in the platemandible system for medium- and large-breed dogs and greater than 10 in the plate-mandible system for small-breed dogs. Thus, bridging plates designed with differentiated geometry and monocortical locking screws showed mechanical resistance to support simulated induced bone model defects and were able to support at least 5 times the value of bite force for each evaluated dog.

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“…9 Over the past decade, a regenerative approach to mandibular reconstruction in companion dogs ABBREVIATIONS TMJ Temporomandibular joint has been reported by our group and others. 6,[10][11][12][13][14] The main goals of mandibular reconstruction in dogs are the restoration of dental occlusion, mandibular stability, and normal function, which includes physiologic mouth opening and closing and minimal lateral movement (ie, laterotrusion). 6,10,15 People undergoing mandibular reconstruction after mandibular tumor excision have superior function, aesthetics, and quality of life, compared with those who do not undergo mandibular reconstruction, [16][17][18][19][20] and our experience performing mandibular reconstruction suggests that results are similar for dogs.…”

mentioning

confidence: 99%

Kinematic analysis of mandibular motion before and after mandibulectomy and mandibular reconstruction in dogs

Arzi

Verstraete

Garcia

et al. 2019

ajvr

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OBJECTIVE To evaluate and quantify the kinematic behavior of canine mandibles before and after bilateral rostral or unilateral segmental mandibulectomy as well as after mandibular reconstruction with a locking reconstruction plate in ex vivo conditions. SAMPLE Head specimens from cadavers of 16 dogs (range in body weight, 30 to 35 kg). PROCEDURE Specimens were assigned to undergo unilateral segmental (n = 8) or bilateral rostral (8) mandibulectomy and then mandibular reconstruction by internal fixation with locking plates. Kinematic markers were attached to each specimen in a custom-built load frame. Markers were tracked in 3-D space during standardized loading conditions, and mandibular motions were quantified. Differences in mandibular range of motion among 3 experimental conditions (before mandibulectomy [ie, with mandibles intact], after mandibulectomy, and after reconstruction) were assessed by means of repeated-measures ANOVA. RESULTS Both unilateral segmental and bilateral rostral mandibulectomy resulted in significantly greater mandibular motion and instability, compared with results for intact mandibles. No significant differences in motion were detected between mandibles reconstructed after unilateral segmental mandibulectomy and intact mandibles. Similarly, the motion of mandibles reconstructed after rostral mandibulectomy was no different from that of intact mandibles, except in the lateral direction. CONCLUSIONS AND CLINICAL RELEVANCE Mandibular kinematics in head specimens from canine cadavers were significantly altered after unilateral segmental and bilateral rostral mandibulectomy. These alterations were corrected after mandibular reconstruction with locking reconstruction plates. Findings reinforced the clinical observations of the beneficial effect of reconstruction on mandibular function and the need for reconstructive surgery after mandibulectomy in dogs.

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Initial Experience With rhBMP‐2 Delivered in a Compressive Resistant Matrix for Mandibular Reconstruction in 5 Dogs

Cited by 21 publications

References 79 publications

Use of three‐dimensionally printed β‐tricalcium phosphate synthetic bone graft combined with recombinant human bone morphogenic protein‐2 to treat a severe radial atrophic nonunion in a Yorkshire terrier

Use of three‐dimensionally printed β‐tricalcium phosphate synthetic bone graft combined with recombinant human bone morphogenic protein‐2 to treat a severe radial atrophic nonunion in a Yorkshire terrier

Bridging Plate Development for Treatment of Segmental Bone Defects of the Canine Mandible

Kinematic analysis of mandibular motion before and after mandibulectomy and mandibular reconstruction in dogs

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