Efficacy of rhBMP-2 in Cleft Lip and Palate Defects: Systematic Review and Meta-analysis
- 69 Downloads
The aim of this study was to analyze the efficacy of using rhBMP-2 (recombinant human morphogenetic protein-2) in the treatment of patients with cleft lip and palate defects (CLPD). Seven databases were screened: PubMed (Medline), Lilacs, Ibecs, Web of Science, BBO, Scopus, and The Cochrane Library. Clinical trials that evaluated the use of bioactive treatment with rhBMP-2 in the treatment of patients with CLPD were included. Statistical analyses were performed by comparing the standardized mean difference of bone formation volume and bone filling percentage (p = 0.05). Ten studies compared the use of rhBMP-2 and iliac crest bone graft (ICBG). The global analysis for bone formation volume and bone filling percentage showed that bioactive materials were similar to ICBG with a standardized mean difference of respectively 0.07 (95% CI − 0.41 to 0.56) and 0.24 (95% CI − 0.32 to 0.80). The available literature suggested that use of rhBMP-2 presented similar bone formation results to those of ICBG in secondary alveolar bone grafting for patients with CLPD.
KeywordsBone transplantation Cleft palate Bone morphogenetic protein Review
This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001 and DOCFIX #88887.195037/2018-00. The present research was also supported by the Fundação de Amparo à Pesquisa do Rio Grande do Sul (Pronex FAPERGS #16.0471-4) and by National Council of Technological and Scientific Development (CNPq - grant Technological Development).
WLOR, TMS, and AFS designed the study. WLOR and TMS prepared the first draft of the paper. WLOR was responsible for statistical analysis of the data. WLOR, ADG, and EP prepared the final draft of the manuscript. All authors revised the paper critically for intellectual content and approved the final version. All authors agree to be accountable for the work and to ensure that any questions relating to the accuracy and integrity of the paper are investigated and properly resolved.
Compliance with Ethical Standards
Conflict of interest
Wellington Luiz de Oliveira da Rosa, Tiago Machado da Silva, Arthur Dias Galarça, Evandro Piva, and Adriana Fernandes da Silva have no conflicts of interest related to this work.
Research Involving Human and Animal Participants
There were no human or animal studies conducted by the authors who were described in this review.
The study is with secondary data from other papers. Informed consent was obtained from all individual participants in each included study for whom identifying information is included in this article.
- 2.Vecchiatini R, Mobilio N, Raimondi F et al (2009) Implant-prosthetic rehabilitation for a patient with monolateral cleft lip and palate: a clinical report. Quintessence Int 40:445–447Google Scholar
- 4.van Hout WMMT, van der Molen ABM, Breugem CC et al (2011) Reconstruction of the alveolar cleft: can growth factor-aided tissue engineering replace autologous bone grafting? A literature review and systematic review of results obtained with bone morphogenetic protein-2. Clin Oral Invest 15:297–303. https://doi.org/10.1007/s00784-011-0547-6 CrossRefGoogle Scholar
- 16.Alonso N, Risso GH, Denadai R, Raposo-Amaral CE (2014) Effect of maxillary alveolar reconstruction on nasal symmetry of cleft lip and palate patients: a study comparing iliac crest bone graft and recombinant human bone morphogenetic protein-2. J Plast Reconstr Aesthetic Surg 67:1201–1208. https://doi.org/10.1016/j.bjps.2014.05.014 CrossRefGoogle Scholar
- 25.da Rosa WL de O, da Silva TM, da Silva AF, Piva E (2017) Bioactive treatments in bone grafts for implant-based rehabilitation: systematic review and meta-analysis. Clin Implant Dent Relat Res 1–10. https://doi.org/10.1111/cid.12552
- 30.Clokie CML, SÃ¡ndor GKB (2008) Reconstruction of 10 major mandibular defects using bioimplants containing BMP-7. J Can Dent Assoc 74:67–72Google Scholar
- 32.Hammoudeh JA, Fahradyan A, Gould DJ et al (2017) A comparative analysis of recombinant human bone morphogenetic protein-2 with a demineralized bone matrix versus iliac crest bone graft for secondary alveolar bone grafts in patients with cleft lip and palate: review of 501 cases. Plast Reconstr Surg 140:318–325. https://doi.org/10.1097/PRS.0000000000003519 CrossRefGoogle Scholar
- 33.Liang F, Yen SLK, Imahiyerobo T et al (2017) Three-dimensional cone beam computed tomography volumetric outcomes of rhBMP-2/demineralized bone matrix versus iliac crest bone graft for alveolar cleft reconstruction. Plast Reconstr Surg 140:767–774. https://doi.org/10.1097/PRS.0000000000003686 CrossRefGoogle Scholar
- 34.Alonso N, Tanikawa DYS, Freitas R da S, et al (2010) Evaluation of maxillary alveolar reconstruction using a resorbable collagen sponge with recombinant human bone morphogenetic protein-2 in cleft lip and palate patients. Tissue Eng C Methods 16:1183–1189. https://doi.org/10.1089/ten.tec.2009.0824 CrossRefGoogle Scholar
- 36.Zhang H, Sucato DJ, Welch RD (2005) Recombinant human bone morphogenic protein-2-enhanced anterior spine fusion without bone encroachment into the spinal canal: a histomorphometric study in a thoracoscopically instrumented porcine model. Spine 30:512–518. https://doi.org/10.1097/01.brs.0000154651.62088.e3 CrossRefGoogle Scholar
- 42.Shields LBE, Raque GH, Glassman SD et al (2006) Adverse effects associated with high-dose recombinant human bone morphogenetic protein-2 use in anterior. Cervical Spine Fusion 31:542–547Google Scholar