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The effectiveness of using recombinant human bone morphogenetic protein-2 in the reconstruction of alveolar clefts: a
Objectives:
The purpose of this study was to examine the available evidence on the impact of using recombinant human bone morphogenetic protein-2 (rhBMP-2) in the reconstruction of alveolar clefts in terms of bone formation rate, bone volume, bone density, and postoperative complications.
Methods:
The PubMed, Embase, Web of Science, Scopus, and Cochrane databases were searched until April 2024. The outcomes included bone formation rate, bone volume, bone density, and postoperative complications. Studies comparing autologous iliac bone and rhBMP-2 for osteogenesis in patients with alveolar clefts were included.
Results:
Six studies were included. Treatment of an alveolar cleft with autologous iliac bone grafting resulted in higher bone formation, with statistically significant results after a 6-month follow-up period (MD -14.54; 95% CI -21.58 to -7.49; p < 0.0001). Furthermore, at 6 months (MD 186.60; 95% CI 33.26-339.94; p = 0.02) and 12 months (MD 188.70; 95% CI 25.13-352.27; p = 0.02), bone density was lower and the difference was statistically significant. The pooled data indicate that autologous bone graft resulted in statistically significantly higher bone volume (MD -163.09; 95% CI -313.45 to -12.74; p = 0.03). Regarding postoperative complications, no differences were found between the two groups (MD 0.67; 95% CI 0.25-1.78; p = 0.42).
Conclusion:
In this study, the application of rhBMP-2 showed no obvious advantage in the reconstruction of alveolar clefts in terms of bone volume and bone formation rate and may result in significant harm. However, further clinical research is required.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/reviewcoversheet.
