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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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Tee BC, Sun Z. Xenogeneic mesenchymal stem cell transplantation for mandibular defect regeneration. Xenotransplantation 2020; 27:e12625. [PMID: 32629548 DOI: 10.1111/xen.12625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/18/2020] [Accepted: 06/06/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND It is commonly accepted that xenogeneic stem cell transplantation for tissue engineering is faced with host immune rejection. Using a rat critical-size mandibular defect model, this study examined whether the immune rejection can be evaded by diminishing T-cell immunity. METHODS To examine donor cell survival and host immune reaction, pig bone marrow-derived mesenchymal stem cells (BM-MSCs) were labeled with CM-DiI, loaded onto gelatin sponge (5 × 106 cells/scaffold), and transplanted into 5-mm mandibular defects of immunocompetent and T cell-deficient athymic rats. To examine the effects of xenogeneic BM-MSCs on bone regeneration, athymic rats undergone the same surgeries were terminated at post-operative weeks 1, 3, and 6. Control rats underwent the same jaw surgery without BM-MSC transplantation. RESULTS The density of CM-DiI-labeled BM-MSCs decreased with time in both strains of rats. Although it was substantially higher in athymic rats than in immunocompetent rats at post-operative day 1, by day 3-7 the density became comparable between the two strains of rats. Apoptosis reflected by cleaved Caspase-3 staining was low in both strains. Stronger infiltration of neutrophils, macrophages, B cells and CD8+ T cells was found in MSC-treated animals. In athymic rats, infiltration of neutrophils and macrophages was strong, but it occurred later than that in immunocompetent rats. While bone volume fraction significantly increased with time (P < .001), no difference was found between MSC-treated and control groups. CONCLUSIONS Even in hosts with deficient T-cell immunity, xenogeneic BM-MSC transplantation into mandibular critical-sized defects still faces challenges from host innate immunity, which compromises their regenerative efficacy.
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Affiliation(s)
- Boon Ching Tee
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Zongyang Sun
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, USA
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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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Liu S, Tian L, Ding M, Liu Y, Li G, Chen J, Ding Y. The effect of extracapsular injuries on growth and development of the mandible condyle: an experimental study in growing dogs. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:e131-e145. [PMID: 27527388 DOI: 10.1016/j.oooo.2016.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 05/02/2016] [Accepted: 05/29/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the effects of condylar extracapsular injuries on the development of the mandibular condyle and try to find a way to treat condylar hyperplasia by electively using such injuries to restrict the overdeveloped mandibular condyle. STUDY DESIGN Sixty 6-month-old beagle puppies were divided randomly into five groups: blank control; unilateral fracture to the condylar neck; unilateral fracture to the condylar neck treated with rigid internal fixation; unilateral periosteum injury; unilateral decortication of the condylar neck. Computed tomography, 99 mTc single-photon emission computed tomography, and tetracycline-calcein double-labeling were performed after surgery. The puppies were sacrificed 12 and 24 weeks after surgery. Morphologic analyses and examination of growth activity were done. RESULTS Unilateral fracture of the condylar neck without fixation caused local morphologic changes during the early postoperative period, but compensatory growth of the condyle altered such changes after healing. The other types of injury failed to inhibit the growth of the condyle and the mandible, whereas functional deviation of the chin was found after unilateral fracture of the condylar neck with or without fixation. CONCLUSIONS The four types of extracapsular injury described here failed to inhibit the growth of the mandibular condyle and could not be selected as alternatives to treat condylar hyperplasia.
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Affiliation(s)
- Siying Liu
- State Key Laboratory of Military Stomatology, Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Lei Tian
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Mingchao Ding
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Yanpu Liu
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Guiyu Li
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Jinwu Chen
- State Key Laboratory of Military Stomatology, Department of Radiology, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Yin Ding
- State Key Laboratory of Military Stomatology, Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, PR China.
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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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Gould FDH, Lammers AR, Ohlemacher J, Ballester A, Fraley L, Gross A, German RZ. The Physiologic Impact of Unilateral Recurrent Laryngeal Nerve (RLN) Lesion on Infant Oropharyngeal and Esophageal Performance. Dysphagia 2015; 30:714-22. [PMID: 26285799 PMCID: PMC4639401 DOI: 10.1007/s00455-015-9648-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 08/10/2015] [Indexed: 12/27/2022]
Abstract
Recurrent laryngeal nerve (RLN) injury in neonates, a complication of patent ductus arteriosus corrective surgery, leads to aspiration and swallowing complications. Severity of symptoms and prognosis for recovery are variable. We transected the RLN unilaterally in an infant mammalian animal model to characterize the degree and variability of dysphagia in a controlled experimental setting. We tested the hypotheses that (1) both airway protection and esophageal function would be compromised by lesion, (2) given our design, variability between multiple post-lesion trials would be minimal, and (3) variability among individuals would be minimal. Individuals' swallowing performance was assessed pre- and post-lesion using high speed VFSS. Aspiration was assessed using the Infant Mammalian Penetration-Aspiration Scale (IMPAS). Esophageal function was assessed using two measures devised for this study. Our results indicate that RLN lesion leads to increased frequency of aspiration, and increased esophageal dysfunction, with significant variation in these basic patterns at all levels. On average, aspiration worsened with time post-lesion. Within a single feeding sequence, the distribution of unsafe swallows varied. Individuals changed post-lesion either by increasing average IMPAS score, or by increasing variation in IMPAS score. Unilateral RLN transection resulted in dysphagia with both compromised airway protection and esophageal function. Despite consistent, experimentally controlled injury, significant variation in response to lesion remained. Aspiration following RLN lesion was due to more than unilateral vocal fold paralysis. We suggest that neurological variation underlies this pattern.
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Affiliation(s)
- Francois D H Gould
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, PO Box 95, Rootstown, OH, 44272, USA.
| | - Andrew R Lammers
- School of Health Sciences, Cleveland State University, Cleveland, OH, USA
| | - Jocelyn Ohlemacher
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, PO Box 95, Rootstown, OH, 44272, USA
| | - Ashley Ballester
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, PO Box 95, Rootstown, OH, 44272, USA
| | - Luke Fraley
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, PO Box 95, Rootstown, OH, 44272, USA
| | - Andrew Gross
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, PO Box 95, Rootstown, OH, 44272, USA
| | - Rebecca Z German
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, PO Box 95, Rootstown, OH, 44272, USA
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Establishing a critical-size mandibular defect model in growing pigs: characterization of spontaneous healing. J Oral Maxillofac Surg 2014; 72:1852-68. [PMID: 24815793 DOI: 10.1016/j.joms.2014.02.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/23/2014] [Accepted: 02/13/2014] [Indexed: 12/20/2022]
Abstract
PURPOSE A large animal model is desired for preclinical studies aimed at reconstructing severe mandibular skeletal defects using tissue engineering techniques. To identify the size and location requirements for a mandibular critical-size bone defect in growing pigs, the present study investigated the spontaneous healing of surgically created mandibular defects. MATERIALS AND METHODS Six 4-month-old domestic pigs were used. In pigs 1 and 2, a 3-, 5-, or 7-cm(3) subperiosteal mandibular defect was created. In pigs 3 to 6, 3- to 5-cm(3) bilateral defects were randomly created at the anterior (apical to the molars) and posterior (mandibular angle) mandibular regions. Spontaneous healing of these defects was assessed by serial computed tomography scans (postoperative week 1, 6, and 12) and histologic analyses. RESULTS In pigs 1 and 2, regardless of defect size, the anterior, but not posterior, defects had largely healed. Systematic analyses of pigs 3 to 6 revealed, first, the extent of defect regeneration from spontaneous healing was significantly less in the posterior than in the anterior defects, with about two thirds and one third of the original defect volume remaining, respectively. Second, histologically, the posterior defects had considerably less regeneration and more evident tapering of the new bone than did the anterior defects. Finally, the buccal periosteum had completely regenerated in the anterior defects, but had only partially done so in the posterior defects. Also, the buccal surface contour was moderately concave in the anterior defects, but it was severely concave in the posterior defects. CONCLUSIONS Despite robust spontaneous healing of mandibular defects in growing pigs, 5-cm(3) defects in the mandibular angle region without buccal periosteum would be a reasonable critical-size defect model relevant to mandibular defects in adolescent humans.
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Liu W, Tang XJ, Zhang ZY, Yin L, Gui L. 3D-CT evaluation of mandibular morphology after mandibular outer cortex osteotomy in young miniature pigs: the role of the periosteum. J Craniomaxillofac Surg 2013; 42:763-71. [PMID: 24418019 DOI: 10.1016/j.jcms.2013.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 08/01/2013] [Accepted: 11/04/2013] [Indexed: 12/22/2022] Open
Abstract
AIM The purpose of this study was to evaluate the role of periosteum on the healing and growth of mandible after mandibular outer cortex osteotomy using three-dimensional computed tomography. METHODS Eighteen 3-month-old miniature pigs were randomized into three groups. The mandibular outer cortex osteotomy was performed on both sides in group I, and on the left side in group II. In groups I and II, the local periosteum on the left side was resected. In group III, no operation was performed. The evaluation of mandibular morphology of all the animals was performed based on multiple spiral CT data before and after surgery. RESULTS The bone defects healed well when the periosteum was preserved, whereas they healed poorly with residual bone defects when the periosteum was resected after surgery. When the periosteum was resected, the decrease in the mean thickness of the mandibular body was more than that of the contralateral side after surgery. In group I, about 66.7% of the animals exhibited mandible deviation at 24 weeks after surgery. The median point of mentum was inclined toward the side that the periosteum was preserved. In groups II and III, no mandible deviation was observed. CONCLUSION The periosteum plays an important role in bone growth and fracture healing. Mandibular outer cortex osteotomy inhibited the mandibular development and resulted in postoperative mandibular deviation in young miniature pigs. The simultaneous periosteum resection may offset the phenomenon of mandibular deviation to a certain extent.
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Affiliation(s)
- Wei Liu
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, China
| | - Xiao-Jun Tang
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, China
| | - Zhi-Yong Zhang
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, China
| | - Lin Yin
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, China
| | - Lai Gui
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, No 33, Ba-Da-Chu Road, Shi Jing Shan District, Beijing 100144, China.
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Sun Z, Tee BC, Kennedy KS, Kennedy PM, Kim DG, Mallery SR, Fields HW. Scaffold-based delivery of autologous mesenchymal stem cells for mandibular distraction osteogenesis: preliminary studies in a porcine model. PLoS One 2013; 8:e74672. [PMID: 24040314 PMCID: PMC3764039 DOI: 10.1371/journal.pone.0074672] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 08/02/2013] [Indexed: 01/12/2023] Open
Abstract
Purpose Bone regeneration through distraction osteogenesis (DO) is promising but remarkably slow. To accelerate it, autologous mesenchymal stem cells have been directly injected to the distraction site in a few recent studies. Compared to direct injection, a scaffold-based method can provide earlier cell delivery with potentially better controlled cell distribution and retention. This pilot project investigated a scaffold-based cell-delivery approach in a porcine mandibular DO model. Materials and Methods Eleven adolescent domestic pigs were used for two major sets of studies. The in-vitro set established methodologies to: aspirate bone marrow from the tibia; isolate, characterize and expand bone marrow-derived mesenchymal stem cells (BM-MSCs); enhance BM-MSC osteogenic differentiation using FGF-2; and confirm cell integration with a gelatin-based Gelfoam scaffold. The in-vivo set transplanted autologous stem cells into the mandibular distraction sites using Gelfoam scaffolds; completed a standard DO-course and assessed bone regeneration by macroscopic, radiographic and histological methods. Repeated-measure ANOVAs and t-tests were used for statistical analyses. Results From aspirated bone marrow, multi-potent, heterogeneous BM-MSCs purified from hematopoietic stem cell contamination were obtained. FGF-2 significantly enhanced pig BM-MSC osteogenic differentiation and proliferation, with 5 ng/ml determined as the optimal dosage. Pig BM-MSCs integrated readily with Gelfoam and maintained viability and proliferative ability. After integration with Gelfoam scaffolds, 2.4–5.8×107 autologous BM-MSCs (undifferentiated or differentiated) were transplanted to each experimental DO site. Among 8 evaluable DO sites included in the final analyses, the experimental DO sites demonstrated less interfragmentary mobility, more advanced gap obliteration, higher mineral content and faster mineral apposition than the control sites, and all transplanted scaffolds were completely degraded. Conclusion It is technically feasible and biologically sound to deliver autologous BM-MSCs to the distraction site immediately after osteotomy using a Gelfoam scaffold to enhance mandibular DO.
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Affiliation(s)
- Zongyang Sun
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, Ohio, United States of America
- * E-mail:
| | - Boon Ching Tee
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, Ohio, United States of America
| | - Kelly S. Kennedy
- Division of Oral and Maxillofacial Surgery, College of Dentistry, Ohio State University, Columbus, Ohio, United States of America
| | - Patrick M. Kennedy
- Division of Oral and Maxillofacial Surgery, College of Dentistry, Ohio State University, Columbus, Ohio, United States of America
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, Ohio, United States of America
| | - Susan R. Mallery
- Division of Oral Pathology and Radiology, College of Dentistry, Ohio State University, Columbus, Ohio, United States of America
| | - Henry W. Fields
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, Ohio, United States of America
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Sun Z, Herring SW, Tee BC, Gales J. Alveolar ridge reduction after tooth extraction in adolescents: an animal study. Arch Oral Biol 2013; 58:813-25. [PMID: 23380583 PMCID: PMC3665758 DOI: 10.1016/j.archoralbio.2012.12.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 11/28/2012] [Accepted: 12/26/2012] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The mechanism for tooth extraction induced residual alveolar ridge reduction (RRR) during adolescence is poorly understood. This study investigated the alveolar bone morphology, growth, resorption and functional loading at normal and extraction sites using an adolescent pig model. DESIGN Sixteen 3-month-old pigs were divided into two groups - immediate post-extraction (IE) and 6-week post-extraction (SE). The IE group received an extraction of one deciduous mandibular molar, immediately followed by a final experiment to record masseter muscle EMGs and strains from the buccal surface of the extraction and contralateral non-extraction sites during function (mastication). The SE group was given the same tooth extraction, then kept for 6 weeks before the same final functional recording as the IE group. Both groups also received baseline (pre-extraction) EMGs and fluorescent vital stains 10 and 3 days before the final functional recording. Immediately after the final functional recording, animals were euthanized and alveolar bone specimens from extraction and contralateral non-extraction sites were collected and used to analyse alveolar bone morphology, apposition and resorption based on fluorescent and hematoxylin and eosin stained histological sections. RESULTS At control sites (IE-extraction, IE-non-extraction and SE-non-extraction), the alveolar ridges grew gingivally and buccally. Bone formation characterized the buccal surface and lingual bundle bone, whereas resorption characterized the lingual surface and buccal bundle bone. The SE-extraction sites showed three major alterations: convergence of the buccal and lingual gingival crests, loss of apposition on the lingual bundle bone, and decelerated growth at the entire buccal surface. These alterations likely resulted from redirected crestal growth as part of the socket healing process, loss of tongue pressure to the lingual side of the teeth which normally provides mechanical stimulation for dental arch expansion, and masticatory underloading during the initial post-extraction period, respectively. CONCLUSIONS These data indicate that the initial phase of RRR in adolescents is a product of modified growth, not resorption, possibly because of decreased mechanical stimulation at the extraction site.
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Affiliation(s)
- Zongyang Sun
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA.
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Zakaria O, Madi M, Kasugai S. A novel osteogenesis technique: The expansible guided bone regeneration. J Tissue Eng 2012; 3:2041731412441194. [PMID: 22511992 PMCID: PMC3324854 DOI: 10.1177/2041731412441194] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Guided bone regeneration is a unique osteogenesis technique that requires a barrier membrane under periosteum to create space for bone regeneration. However, creating sizeable spaces is clinically not commonly feasible. A titanium plate and a thin silicone membrane were surgically layered on each calvaria of eight rabbits. Then, the periphery of the silicone membrane was fixed by a plastic ring to the underlying bone using titanium micro screws. After 1 week, a 5-mm-length titanium screw was used to elevate the titanium plate, which in turn elevated the silicone membrane together with overlying soft tissue in a rate of 1 mm/day for 5 days to create a secluded space. Animals were killed at 2 months (n = 4, group 1) and 4 months (n = 4, group 2) after the elevation. Histological and microradiographical analyses demonstrated creation of an amount of de novo bone formation (68.2 ± 22 mm(3) in group 1 and 70.3 ± 14 mm(3) in group 2) in the sizeable created spaces (207.1 ± 31 mm(3) in group 1 and 202 ± 21 mm(3) in group 2) without exposure of the device. This novel osteogenesis technique, "expansible guided bone regeneration," created a substantial in vivo incubator without applying growth factors or osteoprogenitor cells. Creating a growing space over the secluded surface allowed the development of normal biological healing process occurring on the bone surface into a regenerative process, generating bone outside the genetically determined skeletal bone. This technique is a new tissue engineering approach stimulating endogenous tissue repair without applying cells or factors exogenously.
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Affiliation(s)
- Osama Zakaria
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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Søndergaard L, Dagnæs-Hansen F, Herskin M. Welfare assessment in porcine biomedical research – Suggestion for an operational tool. Res Vet Sci 2011; 91:e1-9. [DOI: 10.1016/j.rvsc.2011.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 01/19/2011] [Accepted: 02/22/2011] [Indexed: 01/08/2023]
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Saulacic N, Hug C, Bosshardt DD, Schaller B, Buser D, Haeniwa H, Iizuka T. Relative contributions of osteogenic tissues to new bone formation in periosteal distraction osteogenesis: histological and histomorphometrical evaluation in a rat calvaria. Clin Implant Dent Relat Res 2011; 15:692-706. [PMID: 22098938 DOI: 10.1111/j.1708-8208.2011.00400.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The relative contributions of different, potential factors to new bone formation in periosteal distraction osteogenesis are unknown. PURPOSE The aim of the present study was to assess the influence of original bone and periosteum on bone formation during periosteal distraction osteogenesis in a rat calvarial model by means of histology and histomorphometry. METHODS A total of 48 rats were used for the experiment. The contribution of the periosteum was assessed by either intact or incised periosteum or an occlusive versus a perforated distraction plate. The cortical bone was either left intact or perforated. Animals were divided in eight experimental groups considering the three possible treatment modalities. All animals were subjected to a 7-day latency period, a 10-day distraction period and a 7-day consolidation period. The newly formed bone was analyzed histologically and histomorphometrically. RESULTS New, mainly woven bone was found in all groups. Differences in the maximum height of new bone were observed and depended on location. Under the distraction plate, statistically significant differences in maximum bone height were found between the group with perforations in both cortical bone and distraction plate and the group without such perforations. CONCLUSIONS If the marrow cavities were not opened, the contribution to new bone formation was dominant from the periosteum. If the bone perforations opened the marrow cavities, a significant contribution to new bone formation originated from the native bone.
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Affiliation(s)
- Nikola Saulacic
- Research assistant, Department of Cranio-Maxillofacial Surgery, University Hospital, Bern, Switzerland; research assistant, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland; postgraduate student, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland; associate professor, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland; research assistant, Department of Cranio-Maxillofacial Surgery, University Hospital, Bern, Switzerland; professor and chairman, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland; research assistant, Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan; professor and chairman, Department of Cranio-Maxillofacial Surgery, University Hospital, Bern, Switzerland
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Saulacic N, Schaller B, Iizuka T, Buser D, Hug C, Bosshardt DD. Analysis of New Bone Formation Induced by Periosteal Distraction in a Rat Calvarium Model. Clin Implant Dent Relat Res 2011; 15:283-91. [DOI: 10.1111/j.1708-8208.2011.00355.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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