engleski

Ankylos implants inserted in the mandible reconstructed with iliac crest bone grafts using rhBMP-7

Bone morphogenetic protein is one of the most promising osteoinductive substances and has been expected to be applied clinically for bone reconstruction. BMP-7 has demonstrated the ability to stimulate bone regeneration in multiple skeletal sites, including the craniofacial complex. Several animal studies confirmed that the application of bone morphogenetic proteins caused a more rapid and enhanced osseointegration of simultaneously placed implants when compared to the bone substitute alone. To our knowledge, only two case reports presented clinical use of BMP-7 in maxillofacial surgery (maxillary sinus floor elevation ; Le Fort I osteotomy and advancement).We present patient with recurrent ameloblastoma treated by segmental osteotomy of the mandible. The bone defect (6 cm length) was reconstructed by autogenous iliac crest bone grafts using BMP-7. Radiographic evidence of new bone formation was seen at 9 months, postoperatively. A biopsy was taken at 9 months demonstrated viable new bone formation. A year after the reconstruction we have inserted three dental implants (Ankylos, Friadent). One implant failed, and two years after the insertion we have loaded two implants with ceramic bridge. Follow-up period is two years. To our knowledge, this is the first described case of dental implants inserted in resected mandible reconstructed by bone graft using bone morphogenetic protein. The problem of BMP-7 dosage and overgrowth of the graft should be discussed. Although this case has shown encouraging results, long-term results and the predictability of this type of reconstruction in humans are still unknown.

dental implants; Ankylos; mandible; reconstruction; iliac bone graft; BMP-7

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