Utilização de rhBMP-2 no preenchimento de fenda alveolar de um paciente fissurado: relato de caso clínico

Abstract

Orofacial fissures are the most prevalent anomalies of the maxillofacial complex. They are the result of poor fusion of the tissue processes that form the face, which occurs during embryonic development. To rehabilitate such patients, a multidisciplinary approach is necessary and early surgeries are used to reestablish the lip, palate and maxillary bone support. To assist the cleft patients, the graft was used, providing the closure of the fissures with autogenous grafts, which have certain drawbacks. The problems encountered with the use of this mode of grafting was the starting point for tissue engineering to develop new alternatives for rehabilitation, without the need for a new graft harvesting surgery. Bone morphogenetic proteins, such as rhBMP-2, have the ability to induce the transformation of undifferentiated mesenchymal cells into bone tissue-producing cells. It was through this ability of the morphogenetic proteins that the possibility of using them in patients with cracks was seen to promote the repair of the slits. For this reason, this paper presents a case of a 14-year-old patient, selected from the systematic care provided by the Center for Integrated Assistance to the Fissured (NAIF) of the Albert Sabin Hospital in Fortaleza Ceará, in order to show the effectiveness of the rhBMP-2 in the repair of alveolar fissures, through tomography and clinical examination and a brief review of the literature. The case showed a satisfactory bone formation in the bone defect, following the perspective observed in the review, in which the studies also indicated a good amount of bone formed when compared to the conventional modality of grafting through the autogenous graft iliac graft.