Grants We Funded

Abstract
Bone morphogenetic protein-2 (BMP-2) is a commercially available protein that causes the formation of bone, avoiding the need for bone graft from a donor site such as the hip bone. Its increased usage has led to controversy, creating an urgent situation where we need to better understand the effects of using BMP-2 in the body. This is especially critical for children requiring bone reconstruction, as the small size of the patient both decreases the available amount of bone graft and increases the risk of donor site problems. BMP 2 potentially solves these problems, but it may also affect growth. Cleft lip-palate are part of the group of diseases known as orofacial clefts, which are the most common birth defects in the United States, estimated at 1 in 590 live births. The soft tissues of the cleft lip- palate are repaired during infancy, but the cleft in the bone extends from the gum (alveolus) to the upper jaw (maxilla), creating multiple segments of the upper jaw that collapse towards each other, preventing a normal conversational smile. This can be repaired by alveolar bone grafting (ABG), commonly using hip bone graft. A previous surgeon at our center performed almost 200 alveolar bone repairs using BMP-2 instead of hip bone graft. As far as we know, this is the largest series of its kind. By comparing his patients treated with BMP-2 to those he treated without BMP-2, we will determine the optimal age ranges, cleft types, techniques, or other clinical indications to use BMP-2 instead of traditional bone graft. Pediatric bone reconstruction, such as reconstructing the skull or facial skeleton, is one of the most difficult aspects of plastic surgery, as there is a limited amount of bone available in a small child. This study has the potential to clarify the risks and benefits of BMP-2 not only for alveolar clefts, but also on its effects in the growing skeleton in general, which may change how plastic surgeons treat pediatric bone problems.

Biography
Dr. Alexander Y. Lin was raised in New York City, and graduated from Stanford University with a bachelor’s in Psychology, and a master’s in Statistics. He received his M.D. from Johns Hopkins School of Medicine. He then completed surgical residency in General Surgery and Plastic and Reconstructive Surgery at University of California San Francisco (UCSF), including a two-year research fellowship at Massachusetts General Hospital in vascular immunobiology. He completed his fellowship in Craniofacial and Pediatric Plastic Surgery at Children’s Hospital of Pittsburgh (CHP) of University of Pittsburgh Medical Center (UPMC). At Saint Louis University (SLU), he is the Alan A. and Edith L. Wolff Endowed Chair in Craniofacial, Maxillofacial, and Pediatric Plastic Surgery, Associate Professor of Surgery and Orthodontics, and a board member on the Board of Advisors for SLU MEDLaunch, their medical incubator for innovation. <br /> Pediatric Plastic Surgery treats the things that make us uniquely human: our faces, our speech (from our palate), and our ability to use our hands. Without these normal human functions, children cannot interact with others and develop normally. His goal is to give these children the opportunity to live as normal a life as possible. He is the co-founder and surgical director for the 3D Printing Center of Excellence at Cardinal Glennon. His surgery, research, and inventions, focus on improving the lives of children and their families.