Mandibular defect reconstruction using three-dimensional polycaprolactone scaffold in combination with platelet-rich plasma and recombinant human bone morphogenetic protein-2: de novo synthesis of bone in a single case

Tissue Eng Part A. 2009 Mar;15(3):493-9. doi: 10.1089/ten.tea.2008.0033.

Abstract

This publication describes the clinical case of a 71-year-old female patient. Using polycaprolactone (PCL) scaffold, platelet-rich plasma (PRP) and recombinant human bone morphogenetic protein-2 (rhBMP-2), a critical-sized defect in the anterior mandible was regenerated using de novo-grown bone. A bacterial infection had caused a periimplantitis in two dental implants leading to a large destruction in the anterior mandible. Both implants were removed under antibiotic prophylaxis. A PCL scaffold was prepared especially for this clinical case. In a second procedure with antibiotic prophylaxis, the bony defect was reopened. The PCL scaffold was fitted and charged with PRP and rhBMP-2 (1.2 mg). After complication-free wound healing, the radiological control demonstrated de novo-grown bone in the anterior mandible 6 months postoperatively. Dental implants were inserted in a third operation. A bone biopsy of the newly grown bone, as well as of the bordering local bone, was taken and histologically examined. The bone samples were identical and presented vital laminar bone.

MeSH terms

  • Aged
  • Bone Development / drug effects*
  • Bone Morphogenetic Protein 2
  • Bone Morphogenetic Proteins / pharmacology*
  • Dental Implants
  • Female
  • Humans
  • Intraoperative Care
  • Mandible / diagnostic imaging
  • Mandible / drug effects
  • Mandible / pathology*
  • Plastic Surgery Procedures*
  • Platelet-Rich Plasma*
  • Polyesters / pharmacology*
  • Postoperative Care
  • Recombinant Proteins / pharmacology*
  • Tissue Scaffolds*
  • Tomography, X-Ray Computed
  • Transforming Growth Factor beta / pharmacology*

Substances

  • Bone Morphogenetic Protein 2
  • Bone Morphogenetic Proteins
  • Dental Implants
  • Polyesters
  • Recombinant Proteins
  • Transforming Growth Factor beta
  • recombinant human bone morphogenetic protein-2
  • polycaprolactone