A research report submitted to the School of Oral Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Dentistry in the branch Maxillofacial and Oral Surgery.
Johannesburg 2014 / The reconstruction of osseous mandibular defects remains a significant challenge. The use of autologous bone for mandibular reconstruction is associated with numerous limitations, and alternatives to autologous bone would provide significant benefits for patients. The aim of this study was to evaluate and compare binary application of recombinant human bone morphogenetic protein 7 (rhBMP-7) and recombinant human transforming growth factor (rhTGF-3) to solo application of recombinant human bone morphogenetic protein 7 (rhBMP-7) in full-thickness mandibular defects in the non-human primate Papio ursinus. In four baboons, a 2.5cm segmental defect was created in the mandible and stabilized with a 2.7mm titanium reconstruction plate. Two defects were implanted with rhBMP-7 solo, and the other two with binary application rhBMP-7 and rhTGF-3 at a ratio of 20:1. All four baboons were euthanazed at 180 days post implantation. All four specimens were radiographed prior to sectioning. Tissue processing and histomorphometry were done on the undecalcified sections prepared from the harvested mandible specimens. In all defects bone regeneration re-established bony continuity at six months. The mean area of the regenerate was 336 ± 107.5 mm2 (range 229-444.7) in the solo specimens, and 312 ± 63.5mm2 (range 249-376.6) in the binary specimens. Radiographic examination confirmed complete bone healing in all defects but variable restitution of defect volume. The regenerated bone had a trabecular pattern consistent with mature mandibular bone and the defect interfaces were indiscernible. Due to the small sample size no performance advantage could be identified between the two treatment groups. These results confirm that successful bone regeneration by tissue induction in surgically created mandibular defects can be achieved with osteogenic proteins of the transforming growth factor- superfamily.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/17346 |
| Date | 27 March 2015 |
| Creators | Vafaei, Nika |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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