dc.contributor.author |
Ferretti, Carlo
|
|
dc.contributor.author |
Ripamonti, Ugo
|
|
dc.date.accessioned |
2021-09-29T12:21:39Z |
|
dc.date.available |
2021-09-29T12:21:39Z |
|
dc.date.issued |
2020-07 |
|
dc.description.abstract |
Translating bone regeneration induced by recombinant human bone morphogenetic proteins from animal models to human patients has proven inexplicably inconsistent. This prompted us to test in 5 pediatric patients, an alternative osteoinductive morphogen, recombinant human transforming growth factor β3 (hTGF-β3), to reconstruct mandibular defects of such a size to preclude reconstruction with autologous bone. An osteoinductive implant of human demineralized bone matrix (DBM) loaded with 125 μg hTGF-β3 per gram of DBM was implanted into one defect, and 250 μg hTGF-β3 per gram of DBM in another. Thereafter in 3 patients limited amounts of particulate cortico-cancellous bone graft harvested from the posterior iliac crest were combined with 250 μg hTGF-β3 per gram of DBM. Patients were followed up for 3 to 6 years. Three patients achieved clinically significant osteoinduction, 1 patient with hTGF-β3 only, and 2 by combining hTGF-β3 with a small supplement of autologous bone. One patient with hTGF-β3 only and followed up for 5 years retains a viable reconstruction but has had sub-optimal bone regeneration. One patient had osteoinductive failure due to sepsis although the plate reconstruction remains viable. Recombinant human TGF-β3 initiates osteoinduction in humans and potentiates autologous bone graft activity allowing the reconstruction of large mandibular defects in pediatric patients. |
en_ZA |
dc.description.department |
Maxillo-Facial and Oral Surgery |
en_ZA |
dc.description.librarian |
hj2021 |
en_ZA |
dc.description.sponsorship |
The University of the Witwatersrand, Johannesburg and the National Research Foundation of South Africa. |
en_ZA |
dc.description.uri |
https://journals.lww.com/jcraniofacialsurgery/pages/default.aspx |
en_ZA |
dc.identifier.citation |
Ferretti, C. & Ripamonti, U. 2020, 'Long term follow-up of pediatric mandibular reconstruction with human transforming growth factor-β3', Journal of Craniofacial Surgery, vol. 31, no. 5, pp. 1424-1429. |
en_ZA |
dc.identifier.issn |
1049-2275 (print) |
|
dc.identifier.issn |
1536-3732 (online) |
|
dc.identifier.other |
10.1097/SCS.0000000000006568 |
|
dc.identifier.uri |
http://hdl.handle.net/2263/81999 |
|
dc.language.iso |
en |
en_ZA |
dc.publisher |
Lippincott, Williams and Wilkins |
en_ZA |
dc.rights |
© 2020 by Mutaz B. Habal, MD |
en_ZA |
dc.subject |
Human transforming growth factor β3 (hTGF-β3) |
en_ZA |
dc.subject |
Demineralized bone matrix (DBM) |
en_ZA |
dc.subject |
Bone morphogenetic proteins |
en_ZA |
dc.subject |
Human |
en_ZA |
dc.subject |
Mandible |
en_ZA |
dc.subject |
Tissue engineering |
en_ZA |
dc.subject |
Transforming growth factor- β3 (TGF-β3) |
en_ZA |
dc.title |
Long term follow-up of pediatric mandibular reconstruction with human transforming growth factor-β3 |
en_ZA |
dc.type |
Postprint Article |
en_ZA |