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Saulacic N, Lang NP, Corluka S, Mendaña MP, Muñoz Guzón FM. Vertical Alveolar Ridge Regeneration by Means of Periosteal Activation-A Proof-of-Principle Study. J Clin Periodontol 2024. [PMID: 39148400 DOI: 10.1111/jcpe.14057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 07/22/2024] [Accepted: 07/30/2024] [Indexed: 08/17/2024]
Abstract
AIM To assess the possibility of vertical alveolar ridge augmentation by means of activation of the periosteum. MATERIALS AND METHODS Six adult male Beagle dogs were used for the study. All premolars and first molars were extracted, and one vertical saucer-shaped bony defect was created on each side of the mandible. After 3 months of healing, full-thickness muco-periosteal flaps were elevated, and one distraction device was placed on each side of the mandible. The distraction plate was left submerged, and the activation mechanism connected to the distraction rod was exposed intra-orally. The protocol of periosteal activation (PP: periosteal 'pumping') was initiated after a latency of 7 days. The alternation of activation and relaxation at the rate of 0.35 mm/12 h during 5 days was followed by the sole activation of 0.35 mm/12 h for 5 days (PP group). Devices were left inactivated on the contralateral control side of the mandible (C group). All animals were euthanized after 8 weeks of consolidation. Samples were analysed histologically and by means of micro-CT. RESULTS New mature lamellar bone was formed over the pristine bone in all groups. More intensive signs of bone modelling and remodelling were observed in the PP group compared to the C group. Mean new bone, bone marrow, connective tissue and total volumetric densities were greater in the PP group (p < 0.001, p = 0.001, p = 0.003 and p < 0.001, respectively). No differences were observed in the relative area parameters. Total tissue volume and bone volume were higher in the PP group (p = 0.031 and p = 0.076, respectively), while the bone mineral densities were higher in the C group (p = 0.041 and p = 0.003, respectively). Trabecular number, trabecular thickness and trabecular separation values were similar between the two groups. CONCLUSIONS Regeneration of vertical alveolar bone ridge defects may be enhanced by activation of the periosteum, without the application of bone grafting materials.
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Affiliation(s)
- Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Niklaus P Lang
- Department of Cranio-Maxillofacial Surgery, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Slavko Corluka
- Tissue Engineering for Orthopaedics and Mechanobiology, Bone and Joint Program, Department for BioMedical Research (DBMR), Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Maria Permuy Mendaña
- Department of Veterinary Clinical Sciences, Faculty of Veterinary, University of Santiago de Compostela, Lugo, Spain
- Ibonelab SL, Lugo, Spain
| | - Fernando M Muñoz Guzón
- Department of Veterinary Clinical Sciences, Faculty of Veterinary, University of Santiago de Compostela, Lugo, Spain
- Ibonelab SL, Lugo, Spain
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Xing DL, Zhu YQ, Sun W, Fang X, Zhuang ZW, Qiu L, Chen XL. Use of carbon dioxide fractional laser in the management of lower limb ischemia in patients with diabetes: a case report : CO 2 fractional laser in the treatment of diabetic foot. J Int Med Res 2024; 52:3000605241253759. [PMID: 38853406 PMCID: PMC11163927 DOI: 10.1177/03000605241253759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/23/2024] [Indexed: 06/11/2024] Open
Abstract
Treatment of lower limb ischemia in patients with diabetes is challenging because of the location of the ulcers and the complexity of their pathogenesis. Carbon dioxide fractional laser (CO2FL) therapy in conjunction with tibial periosteum distraction could become a substitute for conventional methods. We herein describe a patient diagnosed with ischemic diabetic foot with a complex ulcer in the upper third of the tibia. Laser irradiation (Deep FX mode with 30 mJ of energy and 10% density) was applied to the entire region of skin below the knee after surface anesthesia, and this treatment was performed twice a week until the ulcer healed. Computed tomography angiography showed successful establishment of a blood supply to the back of the right foot after treatment. Skin grafting was successfully performed, with only a few wounds remaining on the foot 8 months after treatment. The pain score was significantly decreased at the last follow-up. No complications occurred. This case report provides guidance for the performance of CO2FL, a fast, easy, accurate treatment in patients with diabetes. CO2FL can target lower limb arterial occlusive disease accompanied by refractory ulcers, addressing the underlying vascular occlusion and dysfunction as well as promoting microcirculation and wound healing.
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Affiliation(s)
- Dan-Lei Xing
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yuan-Qiang Zhu
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wei Sun
- Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiao Fang
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhi-Wei Zhuang
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Le Qiu
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xu-Lin Chen
- Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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Saulacic N, Katagiri H, Fujioka-Kobayashi M, Ferrari SL, Gerbaix MC. Alternated activation with relaxation of periosteum stimulates bone modeling and remodeling. Sci Rep 2024; 14:11136. [PMID: 38750119 PMCID: PMC11096315 DOI: 10.1038/s41598-024-61902-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/10/2024] [Indexed: 05/18/2024] Open
Abstract
Gradual elevation of the periosteum from the original bone surface, based on the principle of distraction osteogenesis, induces endogenous hard and soft tissue formation. This study aimed to assess the impact of alternating protocols of activation with relaxation (periosteal pumping) on bone modeling and remodeling. One hundred and sixty-two adult male Wistar rats were used in this study. Four test groups with different pumping protocols were created based on the relaxation applied. Two control groups underwent an activation period without relaxation or only a single activation. One group was sham-operated. Periosteal pumping without period of activation induced gene expression in bone and bone remodeling, and following activation period enhanced bone modeling. Four test groups and control group with activation period equaled the values of bone modeling at the end-consolidation period, showing significant downregulation of Sost in the bone and periosteum compared to that in the sham group (p < 0.001 and p < 0.001, respectively). When all test groups were pooled together, plate elevation from the bony surface increased bone remodeling on day 45 of the observation period (p = 0.003). Furthermore, bone modeling was significantly affected by plate elevation on days 17 and 45 (p = 0.047 and p = 0.005, respectively) and by pumping protocol on day 31 (p = 0.042). Periosteal pumping was beneficial for increasing bone repair when the periosteum remained in contact with the underlaying bony surface during the manipulation period. Following periosteal elevation, periosteal pumping accelerated bone formation from the bony surface by the modeling process.
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Affiliation(s)
- Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern, Switzerland.
| | - Hiroki Katagiri
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern, Switzerland
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Masako Fujioka-Kobayashi
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern, Switzerland
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Serge L Ferrari
- Service of Bone Diseases, Department Medicine, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Maude C Gerbaix
- Service of Bone Diseases, Department Medicine, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland
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Pumping the Periosteum: A Feasibility Study: Periosteal Distraction Osteogenesis in a Rat Model. Ann Plast Surg 2022; 89:218-224. [PMID: 35276708 DOI: 10.1097/sap.0000000000003108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Gradual elevation of periosteum from the bone surface is known to promote the adaptation of soft tissues and the formation of hard tissues. The aim of our study was to estimate the benefit of periosteal distraction osteogenesis (PDO) on de novo bone formation in a rat model. MATERIALS AND METHODS After device placement, animals were allowed for a latency period of 7 days. Animals in the PDO group were subjected to distraction at a rate of 0.1 mm/d for 10 days. In the periosteal pumping (PP) group, the animals were subjected to distraction at a rate of 0.1 mm/d. The direction of distraction was alternated every 2 days. The animals were euthanized at 17, 31, and 45 days after surgery, and the samples were analyzed histologically and by microcomputed tomography. RESULTS In both groups, the new bone was characterized as primary woven bone that was located at the leading edge of bone apposition. Bone volumes significantly increased throughout the observation period both in the PP group (P = 0.018) and in the PDO group (P < 0.001). The new bone was denser and more mature in the PP group than in the PDO group, and the difference was significant at the 31-day time point (P = 0.024). However, the volume of the new bone was higher in the PDO at the 45-day time point (P < 0.001). CONCLUSIONS We propose that the PP may be applied to enhance the osteogenic capacity of periosteum without plate elevation. Because this is only a proof-of-principle study, the alternated protocol of periosteal distraction warrants evaluation in the future studies.
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Yamauchi K, Imoto K, Odajima K, Morishima H, Shimizu Y, Nogami S, Takahashi T. A collagen membrane for periosteal expansion osteogenesis using a timed-release system in rabbit calvaria. Int J Implant Dent 2022; 8:9. [PMID: 35243561 PMCID: PMC8894520 DOI: 10.1186/s40729-022-00407-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 02/14/2022] [Indexed: 11/22/2022] Open
Abstract
Background The purpose of this study was to evaluate the effects of resorbable membranes, combined with a shape memory alloy (SMA) mesh device, on bone formation using a timed-release system for periosteal expansion osteogenesis (TIME-PEO). Materials and methods Twelve Japanese white rabbits were used in this study. An SMA device was inserted under the forehead periosteum, pushed and bent for attachment to the bone surface, and then fixed using resorbable thread. The rabbits were divided into four groups: C1 (5 weeks postoperatively without membrane), C2 (8 weeks postoperatively without membrane), E1 (5 weeks postoperatively with membrane), and E2 (8 weeks postoperatively with membrane). The rabbits were killed 5 or 8 weeks after the operation and the newly formed bone was assessed histologically and radiographically. Results SMA devices, concealed under soft tissue until the time of euthanasia, did not cause active inflammation. The mean activation height, from the original bone surface to the midpoint of the mesh, was 3.1 ± 0.6 mm. Newly formed bone was observed, and most of the subperiosteal space underneath the device was occupied by fibrous tissue. Immature bone was present at the outer surface of the original skull bone in all groups. On histomorphometric analysis, there was no significant difference in the volume of the new bone between C1 and E1 (p = 0.885), and C2 and E2 (p = 0.545). Conclusions PEO using an SMA mesh device, which is based on guided bone regeneration (in atrophic alveolar bone), shows promise as an alternative for bone augmentation, irrespective of whether a resorbable membrane is used.
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Affiliation(s)
- Kensuke Yamauchi
- Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Kazuhiro Imoto
- Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Kenji Odajima
- Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Hiromitsu Morishima
- Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Yoshinaka Shimizu
- Division of Oral Pathology, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Shinnosuke Nogami
- Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Tetsu Takahashi
- Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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Saulacic N, García-González M, Muñoz Guzon FM, Garcia Garcia A, Sadath-Marashi Z, Rohrer U, Ferrari SL. Regeneration of Craniofacial Bone Induced by Periosteal Pumping. Tissue Eng Part C Methods 2022; 28:61-72. [PMID: 35107342 DOI: 10.1089/ten.tec.2022.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A variety of surgical techniques and tissue engineering strategies utilizing osteogenic potential of the periosteum have been developed for the repair of extended bone deficiencies. The aim of the present study was to assess the impact of an alternating protocol of periosteal distraction osteogenesis (PDO) on bone regeneration in an intraoral model. Eight adult, male Beagle dogs were used for the study. Two distraction devices were placed on each side of the mandible. After a 7-day latency period, distraction devices in all animals were manipulated at the rate of 0.5 mm for a total of 8 days. The pumping protocol in two test groups proceeded twice daily by alternating activation with relaxation. In the periosteal pumping/distraction (PPDO) group, the distraction screws were activated two times (at 12 and 24 h) and then turned back (at 36 h), and in the periosteal pumping (PP) group repeatedly activated and turned back (at 12 h). In the PDO group, only activation was performed once daily (positive control). Devices were left inactivated in the negative control (NC) group. The samples were harvested after 8 weeks of consolidation period and investigated by micro-CT and histological analysis. New mature, lamellar bone was formed over the pristine bone in all groups. PPDO and PDO groups showed more new bone area (NBA) compared to the PP (p < 0.001 and p < 0.001, respectively) and to the NC group (p = 0.032 and p = 0.031, respectively). Furthermore, greater NBA was found in the PP group than the NC group (p = 0.006). PDO demonstrated higher relative connective tissue area than the PPDO group (p = 0.005) and lower relative new bone volume than the NC group (p = 0.025). Pumping protocol of periosteal distraction may successfully induce the endogenous regeneration of the mandibular bone in dogs. Impact Statement Repair of extended bone defects impose a significant challenge to oral and maxillofacial surgeons. In this article, a principle of distraction osteogenesis was applied to stimulate bone regeneration in the mandible. A periosteum-based regeneration approach may represent a valuable step toward creating a significant volume of hard and soft tissues, without need for autogenous bone harvesting or application of biomaterials.
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Affiliation(s)
- Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Mario García-González
- Department of Veterinary Clinical Sciences, Faculty of Veterinary, University of Santiago de Compostela, Lugo, Spain
| | - Fernando M Muñoz Guzon
- Department of Veterinary Clinical Sciences, Faculty of Veterinary, University of Santiago de Compostela, Lugo, Spain
| | - Abel Garcia Garcia
- Department of Maxillofacial Surgery, Complejo Hospitalario Universitario de Santiago de Compostela and Oral Surgery Unit, School of Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Zahra Sadath-Marashi
- Department of Cranio-Maxillofacial Surgery, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Urs Rohrer
- ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland
| | - Serge L Ferrari
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospital and Faculty of Medicine, Genève, Switzerland
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Madi M. Induced osteogenesis using biodegradable and titanium periosteal distractors. Saudi Dent J 2021; 33:434-440. [PMID: 34803283 PMCID: PMC8589570 DOI: 10.1016/j.sdentj.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/28/2020] [Accepted: 12/22/2020] [Indexed: 10/31/2022] Open
Abstract
Background New bone formation can result from periosteal distraction. This is achieved through progressive uplifting of the periosteum by increasing the interface between it and the bone surface. Objective This study investigated the impact of gradual periosteal distraction using biodegradable materials and titanium distraction devices. Materials and methods 20 rabbits were separated into 2 groups. Distraction devices were placed in all groups after reflecting the calvarial periosteum. The device was actuated following 7 days. Group 1 got titanium device and Hydroxyapatite HA with poly-l-lactide (PLLA) device was utilized in group 2. Five animals were sacrificed from each group following 4 and 6 weeks. Newly formed bone was histologically and radiographically assessed. Results The histological observations showed that both distraction devices successfully induced osteogenesis and effectively distracted the soft tissue following 4 and six weeks. The study showed scattered bone trabeculae, with adipose tissue and multiple dome-shaped bones. Micro-computed tomography showed newly formed bone that was far less radiopaque than the initial basal bone. The connective tissue appeared as a radiolucent area that decreased gradually toward the fixation point of the device. At 6 weeks, the percentage of new bone was significantly higher than at 4 weeks for both devices. The PLLA device showed more bone than did the titanium device at both 4 and 6 weeks, but no significant difference was observed. Conclusions Both distraction devices were effective in distracting the periosteum and inducing new vascularized bone. The PLLA device induced more bone than the titanium device. Thus, the distractor composition may influence the new bone.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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García-González M, Muñoz F, González-Cantalapiedra A, López-Peña M, Saulacic N. Systematic Review and Quality Evaluation Using ARRIVE 2.0 Guidelines on Animal Models Used for Periosteal Distraction Osteogenesis. Animals (Basel) 2021; 11:1233. [PMID: 33923253 PMCID: PMC8144990 DOI: 10.3390/ani11051233] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 12/25/2022] Open
Abstract
The objective of this systematic review was to synthesize all the preclinical studies carried out in periosteal distraction osteogenesis (PDO) in order to evaluate the quality using the ARRIVE guidelines. The animal models used, and the influence of the complications, were analysed in order to establish the most appropriate models for this technique. The PRISMA statements have been followed. Bibliographic sources have been consulted manually by two reviewers. Risk of bias was evaluated using the SYRCLE tool for animal studies, and the quality of the studies with the ARRIVE 2.0 guidelines. The selection criteria established by expert researchers were applied to decide which studies should be included in the review, that resulted in twenty-four studies. Only one achieved the maximum score according to the ARRIVE 2.0 guidelines. The rabbit as an animal model has presented good results in PDO, both for calvaria and jaw. Rats have shown good results for PDO in calvaria. The minipig should not be recommended as an animal model in PDO. Despite the increase in the quality of the studies since the implementation of the ARRIVE 2.0 guidelines, it would be necessary to improve the quality of the studies to facilitate the transparency, comparison, and reproducibility of future works.
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Affiliation(s)
- Mario García-González
- Department of Veterinary Clinical Sciences, Faculty of Veterinary, Universidade de Santiago de Compostela, 27002 Lugo, Spain; (F.M.); (A.G.-C.); (M.L.-P.)
| | - Fernando Muñoz
- Department of Veterinary Clinical Sciences, Faculty of Veterinary, Universidade de Santiago de Compostela, 27002 Lugo, Spain; (F.M.); (A.G.-C.); (M.L.-P.)
| | - Antonio González-Cantalapiedra
- Department of Veterinary Clinical Sciences, Faculty of Veterinary, Universidade de Santiago de Compostela, 27002 Lugo, Spain; (F.M.); (A.G.-C.); (M.L.-P.)
| | - Mónica López-Peña
- Department of Veterinary Clinical Sciences, Faculty of Veterinary, Universidade de Santiago de Compostela, 27002 Lugo, Spain; (F.M.); (A.G.-C.); (M.L.-P.)
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland;
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Imoto K, Yamauchi K, Odashima K, Nogami S, Shimizu Y, Kessler P, Lethaus B, Unuma H, Takahashi T. Periosteal expansion osteogenesis using an innovative, shape-memory polyethylene terephthalate membrane: An experimental study in rabbits. J Biomed Mater Res B Appl Biomater 2021; 109:1327-1333. [PMID: 33417286 DOI: 10.1002/jbm.b.34793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/05/2020] [Accepted: 12/27/2020] [Indexed: 11/08/2022]
Abstract
Periosteal expansion osteogenesis (PEO) results in the formation of new bone in the gap between periosteum and original bone. The purpose of this study is to evaluate the use of a polyethylene terephthalate (PET) membrane as an activation device. A dome-shaped PET membrane coated with hydroxyapatite/gelatin on the inner side was inserted between the elevated periosteum and bone at the rabbit calvaria. In the experimental group, the membrane was pushed, bent, and attached to the bone surface and fixed with a titanium screw. In control group, the membrane was only inserted and fixed with titanium screw at original shape under the periosteum. After 7 days, the screw was removed and the mesh was activated in the experimental group. Three animals per group with or without setting a latency period for activation were sacrificed at 3 and 5 weeks after surgery. Bone formation was evaluated via micro-computed tomography and determined by histomorphometric methods and histological evaluation. No PET membrane-associated complications were observed during this study. The quantitative data by the area and the occupation of newly formed bone indicated that the experimental group had a higher volume of new bone than the control group at 3 weeks after surgery. Histologically, bone formation progressed to areas adjacent to the cortical perforations; many sinusoidal vessels ran from the perforations to overlying fibrous tissue via the new bone. No bone or obvious inflammatory cells were observed over the membrane. The PET membrane has biocompatible device for PEO that induces a natural osteogenic response at the gap between the original bone and periosteum.
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Affiliation(s)
- Kazuhiro Imoto
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kensuke Yamauchi
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kenji Odashima
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Shinnosuke Nogami
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yoshinaka Shimizu
- Division of Oral Pathology, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Peter Kessler
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bernd Lethaus
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Hidero Unuma
- Graduate School of Science and Engineering, Yamagata University, Yonezawa, Japan
| | - Tetsu Takahashi
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Three-Dimensional-Printed Poly-L-Lactic Acid Scaffolds with Different Pore Sizes Influence Periosteal Distraction Osteogenesis of a Rabbit Skull. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7381391. [PMID: 32382570 PMCID: PMC7196141 DOI: 10.1155/2020/7381391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/29/2020] [Accepted: 03/17/2020] [Indexed: 12/25/2022]
Abstract
The repair of bone defects is a big challenge in reconstructive surgery. Periosteal distraction osteogenesis (PDO), as a promising technique used for bone regeneration, forms a space between the periosteum and bone cortex to regenerate the new bone merely by distracting the periosteum. In order to investigate the influence of distractor framework on the PDO, we utilized three-dimensional (3D) printing technology to fabricate three kinds of poly-L-lactic acid (PLLA) scaffolds with different pore sizes in this study. The in vitro experiments showed that the customized PLLA scaffolds had different-sized microchannels with low toxicity, good biocompatibility, and enough mechanical strength. Then, we built up an in vivo bioreactor under the skull periosteum of New Zealand white rabbits. The distractors with different pore sizes all could satisfy the demand of periosteal distraction in the animal experiments. After 8 weeks of consolidation period, the quality and quantity of the newly formed bone were improved with the increasing pore sizes of the distractors. Moreover, the newly formed bone also displayed an increasing degree of vascularization. In conclusion, 3D printing technology could promote the innovation of PDO devices and fabricate optimized scaffolds with appropriate pore sizes, shapes, and structures. It would help us regenerate more functional tissue-engineered bone and provide new ideas for further clinical application of the PDO technique.
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Albulescu R, Popa AC, Enciu AM, Albulescu L, Dudau M, Popescu ID, Mihai S, Codrici E, Pop S, Lupu AR, Stan GE, Manda G, Tanase C. Comprehensive In Vitro Testing of Calcium Phosphate-Based Bioceramics with Orthopedic and Dentistry Applications. MATERIALS 2019; 12:ma12223704. [PMID: 31717621 PMCID: PMC6888321 DOI: 10.3390/ma12223704] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/29/2019] [Accepted: 11/05/2019] [Indexed: 02/07/2023]
Abstract
Recently, a large spectrum of biomaterials emerged, with emphasis on various pure, blended, or doped calcium phosphates (CaPs). Although basic cytocompatibility testing protocols are referred by International Organization for Standardization (ISO) 10993 (parts 1-22), rigorous in vitro testing using cutting-edge technologies should be carried out in order to fully understand the behavior of various biomaterials (whether in bulk or low-dimensional object form) and to better gauge their outcome when implanted. In this review, current molecular techniques are assessed for the in-depth characterization of angiogenic potential, osteogenic capability, and the modulation of oxidative stress and inflammation properties of CaPs and their cation- and/or anion-substituted derivatives. Using such techniques, mechanisms of action of these compounds can be deciphered, highlighting the signaling pathway activation, cross-talk, and modulation by microRNA expression, which in turn can safely pave the road toward a better filtering of the truly functional, application-ready innovative therapeutic bioceramic-based solutions.
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Affiliation(s)
- Radu Albulescu
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
- Department Pharmaceutical Biotechnology, National Institute for Chemical-Pharmaceutical R&D, 031299, Bucharest, Romania
| | - Adrian-Claudiu Popa
- National Institute of Materials Physics, 077125 Magurele, Romania (G.E.S.)
- Army Centre for Medical Research, 010195 Bucharest, Romania
| | - Ana-Maria Enciu
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
- Department of Cellular and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050047 Bucharest, Romania
| | - Lucian Albulescu
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Maria Dudau
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
- Department of Cellular and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050047 Bucharest, Romania
| | - Ionela Daniela Popescu
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Simona Mihai
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Elena Codrici
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Sevinci Pop
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Andreea-Roxana Lupu
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
- Cantacuzino National Medico-Military Institute for Research and Development, 050096 Bucharest, Romania
| | - George E. Stan
- National Institute of Materials Physics, 077125 Magurele, Romania (G.E.S.)
| | - Gina Manda
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
| | - Cristiana Tanase
- Victor Babes National Institute of Pathology, Biochemistry-Proteomics Department, 050096 Bucharest, Romania; (R.A.); (L.A.); (M.D.); (I.D.P.); (S.M.); (E.C.); (S.P.); (A.-R.L.); (G.M.)
- Cajal Institute, Titu Maiorescu University, 004051 Bucharest, Romania
- Correspondence:
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Pazarçeviren AE, Evis Z, Keskin D, Tezcaner A. Resorbable PCEC/gelatin-bismuth doped bioglass-graphene oxide bilayer membranes for guided bone regeneration. Biomed Mater 2019; 14:035018. [DOI: 10.1088/1748-605x/ab007b] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Hamdy RC, Bernstein M, Fragomen AT, Rozbruch SR. What's New in Limb Lengthening and Deformity Correction. J Bone Joint Surg Am 2017; 99:1408-1414. [PMID: 28816903 DOI: 10.2106/jbjs.17.00464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Reggie C Hamdy
- 1Shriners Hospital for Children, Montreal, Quebec, Canada 2Loyola University Stritch School of Medicine, Maywood, Illinois 3Hospital for Special Surgery, New York, NY
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Nakahara K, Haga-Tsujimura M, Sawada K, Mottini M, Schaller B, Saulacic N. Periosteal distraction osteogenesis versus immediate periosteal elevation in a rat model: Histological and micro-CT analysis. J Craniomaxillofac Surg 2017; 45:620-627. [PMID: 28285922 DOI: 10.1016/j.jcms.2017.01.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/25/2016] [Accepted: 01/26/2017] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The aim of the present study was to compare periosteal distraction osteogenesis (PDO) to immediate periosteal elevation (IPE) in terms of de novo bone formation. MATERIAL AND METHODS Animals of PDO Group were subjected to a 7-day latency period and a 10-day distraction period. Distraction device in IPE Group were activated for 1 mm at placement. Both groups of animals were euthanized at 17, 31 and 45-day following surgery and the samples analyzed histologically and by micro-CT. Total gap region (TG) was divided in two subregions, less than 0.5 mm (LG) and over 0.5 mm of the gap height (HG). RESULTS Bone formation in PDO Group was observed in the distal region of the distraction gap, whereas in IPE Group proximally and distally from the distraction gap. Bone volume increased in both groups in LG, HG and TG (p < 0.001), while bone mineral density only in HG (p = 0.001). More new bone was observed in PDO than in IPE Group in HG (p = 0.017) and in TG (p < 0.001), without differences found in bone mineral density. CONCLUSIONS The function of immediately elevated periosteum is limited to the distance to the underlying bone. PDO may be successfully applied to maintain the osteogenic capacity of elevated periosteum.
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Affiliation(s)
- Ken Nakahara
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamauracho, Chuo-ku, Niigata 951-8580, Japan.
| | - Maiko Haga-Tsujimura
- Department of Histology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamauracho, Chuo-ku, Niigata 951-8580, Japan.
| | - Kosaku Sawada
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamauracho, Chuo-ku, Niigata 951-8580, Japan.
| | - Matthias Mottini
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, CH-3010 Bern, Switzerland.
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, CH-3010 Bern, Switzerland.
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, CH-3010 Bern, Switzerland.
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Periosteal Distraction Osteogenesis: An Effective Method for Bone Regeneration. BIOMED RESEARCH INTERNATIONAL 2016; 2016:2075317. [PMID: 28078283 PMCID: PMC5203878 DOI: 10.1155/2016/2075317] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 11/15/2016] [Indexed: 01/04/2023]
Abstract
The treatment of bone defects is challenging and controversial. As a new technology, periosteal distraction osteogenesis (PDO) uses the osteogenicity of periosteum, which creates an artificial space between the bone surface and periosteum to generate new bone by gradually expanding the periosteum with no need for corticotomy. Using the newly formed bone of PDO to treat bone defects is effective, which can not only avoid the occurrence of immune-related complications, but also solve the problem of insufficient donor. This review elucidates the availability of PDO in the aspects of mechanisms, devices, strategies, and measures. Moreover, we also focus on the future prospects of PDO and hope that PDO will be applied to the clinical treatment of bone defects in the future.
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Nakahara K, Haga-Tsujimura M, Sawada K, Mottini M, Schaller B, Saulacic N. Effects of collagen membrane application and cortical bone perforation on de novo bone formation in periosteal distraction: an experimental study in a rabbit calvaria. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:173-182. [PMID: 27876575 DOI: 10.1016/j.oooo.2016.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 09/14/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of the present study was to assess the impact of collagen membrane application and cortical bone perforations in periosteal distraction osteogenesis. STUDY DESIGN A total of 32 New Zealand rabbits were randomized into four experimental groups, considering two treatment modalities. Calvarial bone was perforated or left intact (P+/-). In half the animals, the distraction mesh was covered with a collagen membrane (M+/-). All animals were subjected to a 7-day latency period and a 10-day distraction period. The samples were harvested after 4-week and 8-week consolidation periods and analyzed histologically and by means of micro-computed tomography. RESULTS Primary, woven bone observed at the 4-week consolidation period was gradually replaced by lamellar bone at the 8-week consolidation period. Significant increase in bone volume was found in all groups (P < .001) and in bone mineral density in groups I (P-/M-; P < .001), III (P+/M-; P < .001), and IV (P+/M+; P = .013). Group III (P+/M-) showed significantly more new bone at the 8-week consolidation period compared with the other three groups (P = .001), with no differences observed in bone mineral density between groups at a given time-point. CONCLUSIONS In the present model, cortical bone perforations have more impact on the osteogenic process compared with the application of a collagen membrane.
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Affiliation(s)
- Ken Nakahara
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern, Switzerland; Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Maiko Haga-Tsujimura
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern, Switzerland; Department of Histology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Kosaku Sawada
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern, Switzerland; Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Matthias Mottini
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, Bern, Switzerland.
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