Evaluation of density, volume, height and rate of bone resorption of substitutes of autologous bone grafts for the repair of alveolar clefts in humans: A systematic review

被引:22
作者
Colorado Osorio, Catalina [1 ]
Maria Escobar, Lina [1 ]
Clara Gonzalez, Maria [1 ]
Fernamdo Gamboa, Luis [1 ]
Chambrone, Leandro [1 ,2 ]
机构
[1] Univ El Bosque, Sch Dent, Unit Integral Management Craniofacial Anomalies U, Bogota, Colombia
[2] Univ El Bosque, Sch Dent, Unit Basic Oral Invest UIBO, Bogota, Colombia
关键词
Biotechnology; Protein engineering; Biomedical engineering; Dental surgery; Dentistry; Oral medicine; Alveolar cleft; Cleft lip; Substitute bone; Cleft lip repair; Transplants transplantation; Alveolar bone grafting; Cleft primary palate; TISSUE-ENGINEERED BONE; MORPHOGENETIC PROTEIN-2; RECONSTRUCTION; LIP; HYDROXYAPATITE; OSTEOPLASTY; REDUCTION; RHBMP-2;
D O I
10.1016/j.heliyon.2020.e04646
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objective: To assess clinical studies that compare synthetic or enriched natural materials to autologous osseous grafts among individuals with cleft lip and palate to determine which would be the substitute to autologous bone graft for alveolar cleft repair in humans. Materials and methods: Randomized and controlled clinical trials on alveolar clefts treated with synthetic bone substitutes and autogenous bone grafts combined with osteoinductive factors compared with autogenous bone grafts alone (with >= 4-month follow-up and reporting clinical/radiographic data) were considered eligible. MEDLINE, EMBASE, and Central databases were searched for articles published until February 2020. Results: Of 73 eligible articles, 15 were included. Some inductive factors along with iliac crest bone decreased bone reabsorption, preserved the generated bone height/width, and reduced the required autologous bone graft volume. Bone morphogenetic protein (BMP2) as an autologous bone graft substitute, demonstrated satisfactory alveolar defect healing, by avoiding autograft use. Many materials did not yield better outcomes than did autologous grafts; however, hydroxyapatite and collagen complex, hydroxyapatite agarose composite gel, acellular dermal matrix film, fibrin glue, platelet-rich plasma, and deproteinized bovine bone showed similar bone healing outcomes, being an alternative alveolar defect treatment. Conclusions: BMP2, as an osteoinductive factor along with a synthetic matrix, yields satisfactory bone healing and avoids the need for autologous bone grafts. However, high-quality RCTs are necessary to determine the most effective and safe concentration and protocol of BMP2 utilization as a substitute for the autologous iliac crest bone grafting.
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页数:8
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