1
|
Şen E, Özkan N, Önger ME, Kaplan S. Effects of NGF and Photobiomodulation Therapy on Crush Nerve Injury and Fracture Healing: A Stereological and Histopathological Study in an Animal Model. Craniomaxillofac Trauma Reconstr 2023; 16:281-291. [PMID: 38047151 PMCID: PMC10693267 DOI: 10.1177/19433875221138175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Study Design A stereological and histopathological study in an animal model. Objective This study explores the effects of the nerve growth factor and photobiomodulation therapy on the damaged nerve tissue and fracture healing. Methods A total of 24 rabbits were divided into 4 groups: control group (n = 5), nerve growth factor (NGF) group (n = 7), photobiomodulation (PBMT) group (n = 6), and nerve growth factor and photobiomodulation therapy (NGF+PBMT) group (n = 6). The vertical fracture was performed between the mental foramen and the first premolar, and the mental nerve was crushed for 30 seconds with a standard serrated clamp with a force of approximately 50 N in all groups. The control group received an isotonic solution (.02 mL, .09% NaCl) to the operation site locally. The NGF group received 1 μg human NGF-β/.9% .2 mL NaCl solution for 7 days locally. The PBMT group received PBMT treatment (GaAlAs laser, 810 nm, .3 W, 18 J/cm2) every 48 hours for 14 sessions following the surgery. The NGF+PBMT group received both NGF and PBMT treatment as described above. After 28 days, the bone tissues and mental nerves from all groups were harvested and histologically and stereologically analyzed. Results According to the stereological results, the volume of the new vessel and the volume of the new bone were significantly higher in the PBMT group than in other groups (P < .001). According to the histopathological examinations, higher myelinated axons were observed in experimental groups than in the control group. Conclusions As a result, PBMT has beneficial effects on bone regeneration. Based on the light microscopic evaluation, more regenerated axon populations were observed in the NGF group than in the PBMT and PBMT + NGF groups in terms of myelinated axon content.
Collapse
Affiliation(s)
- Esengül Şen
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Turkey
| | - Nilüfer Özkan
- Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Turkey
| | - Mehmet Emin Önger
- Associate Professor, Department of Histology and Embryology, Faculty of Medicine, Ondokuz Mayis University, Turkey
| | - Süleyman Kaplan
- Professor, Department of Histology and Embryology, Faculty of Medicine, Ondokuz Mayis University, Turkey
| |
Collapse
|
2
|
Wang XD, Li SY, Zhang SJ, Gupta A, Zhang CP, Wang L. The neural system regulates bone homeostasis via mesenchymal stem cells: a translational approach. Am J Cancer Res 2020; 10:4839-4850. [PMID: 32308753 PMCID: PMC7163440 DOI: 10.7150/thno.43771] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/12/2020] [Indexed: 12/11/2022] Open
Abstract
Large bone reconstruction is a major clinical issue associated with several challenges, and autograft is the main method for reconstructing large defects of maxillofacial bone. However, postoperative osteoporosis of the bone graft, even with sufficient vascularization, remains a primary problem. Therefore, better understanding of the mechanisms and clinical translation of bone homeostasis is required. Neuronal innervation of the bone is an emerging research topic, especially with regards to the role of peripheral nerves in regulating bone homeostasis. Moreover, sensory and autonomic nerves regulate this process via different types of neurotransmitters, but the specific mechanism is still elusive. In this review article, the current understanding of the interaction between the peripheral nerve and the skeleton system is summarized, with a particular focus on bone marrow mesenchymal stem cells (BMMSCs), except for osteoblasts and osteoclasts. The novel application of nerve-based bone regeneration via BMMSCs may provide a new strategy in tissue engineering and clinical treatment of osteoporosis and bone disorders.
Collapse
|
3
|
Yao Y, Du Y, Gu X, Guang MK, Huang B, Gong P. [Local injection of exogenous nerve growth factor improves early bone maturation of implants]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 36:128-132. [PMID: 29779271 PMCID: PMC7030349 DOI: 10.7518/hxkq.2018.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 01/30/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the effects of nerve growth factor (NGF) in the osteogenic action of implants and the maturation and reconstruction changes in bone tissues in the early stage of osseointegration. METHODS The mouse implant model was established by placing titanium in the femoral head of the mouse and locally injecting NGF in the implant zone. On 1, 2 and 4 weeks after operation, stain samples were collected from animals using hematoxylin-eosin (HE) staining and Masson staining. The effect of NGF on the bone maturation was compared at different time points of early stage osseointegration. RESULTS The results of HE and Masson staining indicated that the local injection of external NGF can up-regulate bone mass, amount of bone trabecula, and bone maturity in the mouse model. The mature bone rate in treatment group of 1 week and 4 weeks after operation were significantly higher than those in the control group (P<0.05). CONCLUSIONS NGF can shorten the period of bone maturation.
Collapse
Affiliation(s)
- Yang Yao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yu Du
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xia Gu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Meng-Kai Guang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bo Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ping Gong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| |
Collapse
|
4
|
Zhao YH, Zhang SJ, Yang ZH, Liu XC, Lei DL, Li J, Wang L. Relationship of distraction rate with inferior alveolar nerve degeneration-regeneration shift. Neural Regen Res 2018; 13:360-365. [PMID: 29557389 PMCID: PMC5879911 DOI: 10.4103/1673-5374.226426] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Distraction osteogenesis is an important technique for the treatment of maxillofacial abnormities and defects. However, distraction osteogenesis may cause the injury of the inferior alveolar nerve. The relationship between distraction rate and nerve degeneration-regeneration shift remains poorly understood. In this study, 24 rabbits were randomly divided into four groups. To establish the rabbit mandibular distraction osteogenesis model, the mandibles of rabbits in distraction osteogenesis groups were subjected to continuous osteogenesis distraction at a rate of 1.0, 1.5 and 2.0 mm/d, respectively, by controlling rounds of screwing each day in the distractors. In the sham group, mandible osteotomy was performed without distraction. Pin-prick test with a 10 g blunt pin on the labium, histological and histomorphometric analyses with methylene blue staining, Bodian's silver staining, transmission electron microscopy and myelinated fiber density of inferior alveolar nerve cross-sections were performed to assess inferior alveolar nerve conditions. At 28 days after model establishment, in the pin-prick test, the inferior alveolar nerve showed no response in the labium to a pin pricks in the 2 mm/d group, indicating a severe dysfunction. Histological and histomorphometric analyses indicated that the inferior alveolar nerve suffered more degeneration and injuries at a high distraction rate (2 mm/d). Importantly, the nerve regeneration, indicated by newborn Schwann cells and axons, was more abundant in 1.0 and 1.5 mm/d groups than in 2.0 mm/d group. We concluded that the distraction rate was strongly associated with the inferior alveolar nerve function, and the distraction rates of 1.0 and 1.5 mm/d had regenerative effects on the inferior alveolar nerve. This study provides an experimental basis for the relationship between distraction rate and nerve degeneration-regeneration shift during distraction osteogenesis, and may facilitate reducing nerve complications during distraction osteogenesis.
Collapse
Affiliation(s)
- Ying-Hua Zhao
- Department of Stomatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Shi-Jian Zhang
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China
| | - Zi-Hui Yang
- Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | | | - De-Lin Lei
- Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Jing Li
- Department of Stomatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Lei Wang
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai; Department of Oral Surgery, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi Province, China
| |
Collapse
|
5
|
Norepinephrine inhibits mesenchymal stem cell chemotaxis migration by increasing stromal cell-derived factor-1 secretion by vascular endothelial cells via NE/abrd3/JNK pathway. Exp Cell Res 2016; 349:214-220. [PMID: 27650061 DOI: 10.1016/j.yexcr.2016.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/11/2016] [Accepted: 09/13/2016] [Indexed: 01/14/2023]
Abstract
Mesenchymal stem cells (MSCs), which are physiologically maintained in vascular endothelial cell (VEC)-based niches, play a critical role in tissue regeneration. Our previous studies demonstrated that sympathetic denervation could promote MSC mobilization, thereby enhancing bone formation in distraction osteogenesis (DO), a self-tissue engineering for craniofacial and orthopeadic surgeries. However, the mechanisms on how sympathetic neurotransmitter norepinephrine (NE) regulates MSC migration are not well understood. Here we showed that deprivation of NE by transection of cervical sympathetic trunk (TCST) inhibited stromal cell-derived factor-1 (SDF-1) expression in the perivascular regions in rat mandibular DO. In vitro studies showed that NE treatment markedly upregulated p-JNK and therefore stimulated higher SDF-1 expression in VECs than control groups, and siRNA knockdown of the abrd3 gene abolished the NE-induced p-JNK activation. On the other hand, osteoblasts differentiated from MSCs showed an increase in SDF-1 secretion with lack of NE. Importantly, NE-treated VECs inhibited the MSC chemotaxis migration along the SDF-1 concentration gradient as demonstrated in a novel 3-chamber Transwell assay. Collectively, our study suggested that NE may increase the SDF-1 secretion by VECs via NE/abrd3/JNK pathway, thereby inhibiting the MSC chemotaxis migration from perivascular regions toward bone trabecular frontlines along the SDF-1 concentration gradient in bone regeneration.
Collapse
|
6
|
Wang L, Zhao Y, Cao J, Yang X, Lei D. Mesenchymal stem cells modified with nerve growth factor improve recovery of the inferior alveolar nerve after mandibular distraction osteogenesis in rabbits. Br J Oral Maxillofac Surg 2015; 53:279-84. [DOI: 10.1016/j.bjoms.2014.12.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 12/21/2014] [Indexed: 11/16/2022]
|
7
|
Shakib K, Tan A, Soskic V, Seifalian AM. Regenerative nanotechnology in oral and maxillofacial surgery. Br J Oral Maxillofac Surg 2014; 52:884-93. [PMID: 25218313 DOI: 10.1016/j.bjoms.2014.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 08/14/2014] [Indexed: 11/15/2022]
Abstract
Regenerative nanotechnology is at the forefront of medical research, and translational medicine is a challenge to both scientists and clinicians. Although there has been an exponential rise in the volume of research generated about it for both medical and surgical uses, key questions remain about its actual benefits. Nevertheless, some people think that therapeutics based on its principles may form the core of applied research for the future. Here we give an account of its current use in oral and maxillofacial surgery, and implications and challenges for the future.
Collapse
Affiliation(s)
- Kaveh Shakib
- Department of Oral and Maxillofacial Surgery, Royal Free London NHS Foundation Trust, London, UK; UCL Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK.
| | - Aaron Tan
- UCL Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK; UCL Medical School, University College London (UCL), London, UK
| | | | - Alexander M Seifalian
- UCL Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK; Royal Free London NHS Foundation Trust, London, UK.
| |
Collapse
|
8
|
Liu H, Wen W, Hu M, Bi W, Chen L, Liu S, Chen P, Tan X. Chitosan conduits combined with nerve growth factor microspheres repair facial nerve defects. Neural Regen Res 2014; 8:3139-47. [PMID: 25206635 PMCID: PMC4158708 DOI: 10.3969/j.issn.1673-5374.2013.33.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 06/10/2013] [Indexed: 01/09/2023] Open
Abstract
Microspheres containing nerve growth factor for sustained release were prepared by a compound method, and implanted into chitosan conduits to repair 10-mm defects on the right buccal branches of the facial nerve in rabbits. In addition, chitosan conduits combined with nerve growth factor or normal saline, as well as autologous nerve, were used as controls. At 90 days post-surgery, the muscular atrophy on the right upper lip was more evident in the nerve growth factor and normal sa-line groups than in the nerve growth factor-microspheres and autologous nerve groups. physiological analysis revealed that the nerve conduction velocity and amplitude were significantly higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. Moreover, histological observation illustrated that the di-ameter, number, alignment and myelin sheath thickness of myelinated nerves derived from rabbits were higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. These findings indicate that chitosan nerve conduits bined with microspheres for sustained release of nerve growth factor can significantly improve facial nerve defect repair in rabbits.
Collapse
Affiliation(s)
- Huawei Liu
- Institute of Stomatology, Chinese PLA General Hospital, Beijing 100853, China
| | - Weisheng Wen
- Institute of Stomatology, Chinese PLA General Hospital, Beijing 100853, China
| | - Min Hu
- Institute of Stomatology, Chinese PLA General Hospital, Beijing 100853, China
| | - Wenting Bi
- Department of Stomatology, Second Hospital of Beijing Chaoyang District, Beijing 100026, China
| | - Lijie Chen
- Department of Stomatology, First Sanatorium of Qingdao, Jinan Military Area Command of Chinese PLA, Qingdao 266071, Shandong Province, China
| | - Sanxia Liu
- Institute of Stomatology, Chinese PLA General Hospital, Beijing 100853, China
| | - Peng Chen
- Institute of Stomatology, Chinese PLA General Hospital, Beijing 100853, China
| | - Xinying Tan
- Institute of Stomatology, Chinese PLA General Hospital, Beijing 100853, China
| |
Collapse
|
9
|
Zhang YB, Wang L, Jia S, Du ZJ, Zhao YH, Liu YP, Lei DL. Local injection of substance P increases bony formation during mandibular distraction osteogenesis in rats. Br J Oral Maxillofac Surg 2014; 52:697-702. [PMID: 25069690 DOI: 10.1016/j.bjoms.2014.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 07/07/2014] [Indexed: 11/19/2022]
Abstract
Substance P is a neuropeptide that is distributed in those sensory nerve fibres that innervate the medullary tissues of bone. It is a potent accelerator of proliferation and differentiation of osteoblasts in vitro. However, its capacity for promoting repair of mandibular defects is not known. We have investigated the osteogenic effects of local injections of substance P during mandibular distraction osteogenesis in rats. Twenty Sprague-Dawley rats were randomly assigned to 2 groups (n = 10 in each): substance P 10(-7) mmol/l in normal saline 0.2ml was injected into the experimental group, and saline alone into the controls. The mandibular distraction rate was 0.2mm every 12hours for 10 days. Daily injections of substance P or saline were given during the distraction period. Regeneration of bone was assessed quantitatively on days 15 and 29 using microcomputed tomography (microCT), and histological analysis. The rate of bony union in the group treated with substance P was significantly higher than that in the saline alone group on day 29 (p=0.001) The microCT images and quantitation showed more callus and more mature cortical bone when substance P was given than with control. Histological examination showed that cartilaginous tissues had formed in the middle of the distraction gaps in both groups. Bony bridges were seen only in the substance P group at the final time point (day 29). Injection of substance P into the gap of a rat mandible during mandibular distraction improved formation of good-quality bone and accelerated bony union.
Collapse
Affiliation(s)
- Ya-bo Zhang
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China; Department of Stomatology, No.425 Hospital of PLA, Sanya 572000, China
| | - Lei Wang
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China
| | - Sen Jia
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China
| | - Zhao-jie Du
- Department of Stomatology, No.425 Hospital of PLA, Sanya 572000, China
| | - Ying-hua Zhao
- Department of Prosthodontics, Stomatology Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Yan-pu Liu
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China.
| | - De-lin Lei
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China.
| |
Collapse
|
10
|
Simultaneous inferior alveolar nerve regeneration and osseointegration with a nerve growth factor-supplying implant: a preliminary study. J Oral Maxillofac Surg 2014; 73:410-23. [PMID: 25266595 DOI: 10.1016/j.joms.2014.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 06/20/2014] [Accepted: 07/01/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE Although nerve growth factor (NGF) has been proved to enhance inferior alveolar nerve (IAN) regeneration, its clinical application remains a challenging issue. This study investigated the functional regeneration of IAN injury by supplying NGF using an NGF-supplying implant and its effect on the osseointegration. MATERIALS AND METHODS In canine IAN transection-and-repair models (n = 9), NGF-supplying implants connected to osmotic pumps were installed just above the transection site. In the right IAN, NGF 300 μg in phosphate buffered saline (PBS) 2 mL was loaded in the pump and pure PBS 2 mL was loaded in the left IAN. The gross clinical finding was evaluated by wound healing, inflammation, implant exposure, and loss of fixture. To evaluate IAN regeneration, electrophysiologic (amplitude, latency, conduction velocity, and peak voltage) and histomorphometric (axon count and density, myelin thickness, and ratio of axon diameter to fiber diameter) analyses were performed. Implant stability quotient, bone-to-implant contact ratio, and new bone area were measured to assess the osseointegration of the NGF-supplying implant. RESULTS The conduction velocity (2.675 m/second) and peak voltage (1.940 μV) of the NGF group at 6 weeks were considerably higher than those of the PBS group (1.892 m/second and 1.300 μV, respectively). The same results were observed for axon count (NGF vs PBS, 4,576.107 ± 270.413 vs 3,606.972 ± 242.876), axon density (10,707.458 ± 638.835 vs 7,899.781 ± 1,063.625/mm(2)), and myelin thickness (1.670 ± 0.555 vs 1.173 ± 0.388 μm). There were no meaningful differences for the other parameters. CONCLUSIONS Supplying NGF with specially designed dental implants can be a new therapeutic approach to enable IAN regeneration and osseointegration simultaneously.
Collapse
|
11
|
Skeletal and soft tissue response to automated, continuous, curvilinear distraction osteogenesis. J Oral Maxillofac Surg 2014; 72:1773-87. [PMID: 24602810 DOI: 10.1016/j.joms.2014.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 12/30/2013] [Accepted: 01/03/2014] [Indexed: 11/21/2022]
Abstract
PURPOSE To document the bone formation and soft tissue changes in response to automated, continuous, curvilinear distraction osteogenesis (DO) at rates greater than 1 mm/day in a minipig model. MATERIALS AND METHODS Two groups of Yucatan minipigs underwent automated, continuous, curvilinear DO of the right mandible: group A, 1.5 mm/day (n = 5); and group B, 3.0 mm/day (n = 5). Each minipig underwent 12 mm of distraction followed by 24 days of fixation. The distracted and contralateral mandibles were harvested at the end of fixation. The percentage of surface area (PSA) of the regenerate occupied by bone, fibrous tissue, cartilage, and hematoma was determined using computerized histomorphometric analysis. The control groups consisted of DO wounds distracted discontinuously at 1 mm/day and the nonoperated contralateral mandible. The ipsilateral and contralateral digastric muscles were harvested and stained for proliferating cell nuclear antigen (PCNA), myogenic differentiation-1 (MyoD), and paired Box 7 protein (PAX7). RESULTS All 10 minipigs completed the distraction and fixation period. The PSA occupied by bone was similar for groups A (PSA 64.36% ± 5.87%) and B (PSA 63.83% ± 3.37%) and the control group (1 mm/day; PSA 64.89% ± 0.56%) but was less than that on the nonoperated side (PSA 84.67% ± 0.86%). The PSA occupied by cartilage and hematoma in all groups was minimal (<1.1%). The digastric muscles had no abnormal tissue or inflammation, and PAX7, MyoD, and PCNA expression had returned to the baseline levels. CONCLUSIONS The results of the present study indicate that bone formation in response to automated, continuous, and curvilinear DO at a rate of 1.5 and 3.0 mm/day is nearly identical to that with discontinuous DO at 1 mm/day. In addition, no deleterious effects were found on the digastric muscles.
Collapse
|
12
|
Shao H, Shu H, Wang C, Yuan W, Li Y. Expression of nerve growth factor and its receptor in distracted tibial nerve after limb lengthening. Anat Rec (Hoboken) 2012; 296:333-9. [PMID: 23213062 DOI: 10.1002/ar.22636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 09/24/2012] [Accepted: 10/24/2012] [Indexed: 11/09/2022]
Abstract
Despite many experimental and clinical studies conducted on distraction osteogenesis (DO) in the past decade, changes in the surrounding tissues that occur after the procedure remains poorly understood. To study the biochemical changes of recovery in nerve tissues upon DO-induced nerve injury, we prepared a rabbit model of tibia lengthening to observe the expression pattern of nerve growth factor (NGF) and low-affinity NGF receptor (p75NGFR) in the distracted tibial nerve. The distracted tibial nerve was harvested at various time points during the consolidation period of new bone formation and immunohistochemical staining was performed to detect the expression of NGF and p75NGFR. The expression levels of NGF and p75NGFR were found to be different at various times after DO. The changes in expression of these two cellular factors show similar tendencies with significantly elevated expression in Schwann cells at 7 and 14 days after distraction, but low or undetectable levels of expression at 0, 28, and 56 days. These results suggest that NGF and p75NGFR may play important roles in the adaptive process of the distracted nerve. NGF and p75NGFR are autocrine growth factors present in the distracted nerve during the early consolidation period. NGF interacts with p75NGFR to promote damage repair and reconstruction of nerves. Together, this study furthers the understanding of the relative mechanisms of nerve repair, as well as provides a further basis for the clinical application of neurotrophins.
Collapse
Affiliation(s)
- Heng Shao
- Department of Anatomy and Neurobiology, Tian Jin Medical University, Tian Jin 300070, People's Republic of China
| | | | | | | | | |
Collapse
|
13
|
Du ZJ, Wang L, Lei DL, Liu BL, Cao J, Zhang P, Ma Q. Nerve growth factor injected systemically improves the recovery of the inferior alveolar nerve in a rabbit model of mandibular distraction osteogenesis. Br J Oral Maxillofac Surg 2011; 49:557-61. [PMID: 21831488 DOI: 10.1016/j.bjoms.2011.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Accepted: 07/06/2011] [Indexed: 12/22/2022]
Abstract
Our aim was to find out if nerve growth factor (NGF) injected systemically could improve the recovery of the inferior alveolar nerve in a rabbit model of mandibular distraction osteogenesis. We used 48 New Zealand white rabbits that were treated with bilateral distraction osteogenesis at a rate of 0.5mm/12h for 10 days. Immediately postoperatively, NGF or sodium chloride 0.6 μg/day was injected intramuscularly for 20 days. At the end of distraction and after consolidation times of 1, 2, and 4 weeks, the inferior alveolar nerves were evaluated histologically and histomorphometrically. Histologically, at 2 and 4 weeks there was less myelin debris, and more regenerating axons were present, in the NGF than the control groups. The density of myelinated axons was significantly greater in groups with NGF than controls at 2 and 4 weeks (p<0.05). NGF given systemically can accelerate the recovery of the inferior alveolar nerve in rabbits after mandibular distraction osteogenesis, and is a promising treatment option for neurological complications of mandibular distraction osteogenesis.
Collapse
Affiliation(s)
- Zhao-jie Du
- Department of Oral and Maxillofacial Surgery, Fourth Military Medical University, School of Stomatology, Xi'an 710032, China.
| | | | | | | | | | | | | |
Collapse
|
14
|
Local injection of nerve growth factor via a hydrogel enhances bone formation during mandibular distraction osteogenesis. Oral Surg Oral Med Oral Pathol Oral Radiol 2011; 113:48-53. [PMID: 22677691 DOI: 10.1016/j.tripleo.2011.01.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Revised: 01/04/2011] [Accepted: 01/12/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the effects of the injectable NGF-carrying collagen/nano-hydroxyapatite/alginate hydrogel on the bone formation in a rabbit mandibular distraction osteogenesis model. STUDY DESIGN Thirty-five New Zealand white rabbits underwent bilateral madibular distraction osteogenesis at a rate of 0.75 mm/12 h for 6 days. The rabbits were divided into 4 groups: group 1 received injections of collagen/nano-hydroxyapatite/alginate hydrogel containing hNGFβ; groups 2, 3, and 4 received injections of hNGFβ, Col/nHA/Alg hydrogel, and saline, respectively. The injections were performed on both sides of the mandible at the end of the lengthening phase. All the animals were killed at a consolidation time of 14 days. RESULTS No difference in regenerate bone dimensions was observed among the 4 groups. Bone mineral density, the maximum load, and the bone volume/total volume of the new bone in the distraction gap in group 1 was significantly greater (P < .05) than in the other 3 groups. CONCLUSIONS Application of the Col/nHA/Alg hydrogel as an NGF delivery during the consolidation phase of distraction osteogenesis increased regeneration and new bone formation.
Collapse
|
15
|
Schwarz DA, Arman KG, Kakwan MS, Jamali AM, Elmeligy AA, Buchman SR. Regenerate healing outcomes in unilateral mandibular distraction osteogenesis using quantitative histomorphometry. Plast Reconstr Surg 2010; 126:795-805. [PMID: 20463629 PMCID: PMC4608224 DOI: 10.1097/prs.0b013e3181e3b351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The authors' goal was to ascertain regenerate bone-healing metrics using quantitative histomorphometry at a single consolidation period. METHODS Rats underwent either mandibular distraction osteogenesis (n = 7) or partially reduced fractures (n = 7); their contralateral mandibles were used as controls (n = 11). External fixators were secured and unilateral osteotomies performed, followed by either mandibular distraction osteogenesis (4 days' latency, then 0.3 mm every 12 hours for 8 days; 5.1 mm) or partially reduced fractures (fixed immediately postoperatively; 2.1 mm); both groups underwent 4 weeks of consolidation. After tissue processing, bone volume/tissue volume ratio, osteoid volume/tissue volume ratio, and osteocyte count per high-power field were analyzed by means of quantitative histomorphometry. RESULTS Contralateral mandibles had statistically greater bone volume/tissue volume ratio and osteocyte count per high-power field compared with both mandibular distraction osteogenesis and partially reduced fractures by almost 50 percent, whereas osteoid volume/tissue volume ratio was statistically greater in both mandibular distraction osteogenesis specimens and partially reduced fractures compared with contralateral mandibles. No statistical difference in bone volume/tissue volume ratio, osteoid volume/tissue volume ratio, or osteocyte count per high-power field was found between mandibular distraction osteogenesis specimens and partially reduced fractures. CONCLUSIONS The authors' findings demonstrate significantly decreased bone quantity and maturity in mandibular distraction osteogenesis specimens and partially reduced fractures compared with contralateral mandibles using the clinically analogous protocols. If these results are extrapolated clinically, treatment strategies may require modification to ensure reliable, predictable, and improved outcomes.
Collapse
Affiliation(s)
- Daniel A Schwarz
- Ann Arbor, Mich.; Toledo, Ohio; and Cairo, Egypt From the University of Michigan Medical School, the University of Toledo, and Ain Shams University
| | | | | | | | | | | |
Collapse
|
16
|
Lawler ME, Tayebaty FT, Williams WB, Troulis MJ, Kaban LB. Histomorphometric analysis of the porcine mandibular distraction wound. J Oral Maxillofac Surg 2010; 68:1543-54. [PMID: 20561467 DOI: 10.1016/j.joms.2010.02.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Accepted: 02/19/2010] [Indexed: 01/30/2023]
Abstract
PURPOSE To analyze the sequence of histomorphometric changes in the regenerate during distraction osteogenesis (DO) of the minipig mandible. MATERIALS AND METHODS A total of 16 minipigs underwent unilateral mandibular DO using a protocol of 0-day latency and a 1-mm/day rate for 12 days, and 24 days of fixation. The mandibles were harvested at mid-DO, end-DO, mid-fixation, and end-fixation. An additional 2 minipigs underwent acute lengthening, and 1 sham control was included. Serial gross examinations and plain radiographs were performed before paraffin embedding. The sections were stained with hematoxylin-eosin or hematoxylin/alcian blue/sirius red stain. Histomorphometric analysis was performed to determine the percentage of surface area (PSA) occupied by hematoma, fibrous tissue, cartilage, and bone. RESULTS All 19 minipigs survived the operation, and 17 survived the observation period; 2 were killed because of infection (mid-DO, n = 1 and end-fixation, n = 1). No device failures occurred. Of the 17 specimens, 4 were at mid-DO, 4 at end-DO, 4 at mid-fixation, and 2 at end-fixation; 2 were in the acute lengthening group, and 1 was the sham control. Hematoma was present only at mid-DO (16.61 +/- 8.07 PSA) and end-DO (1.17 +/- 2.33 PSA). Fibrous tissue decreased from mid-DO (53.12 +/- 8.59 PSA) to end-fixation (25.00 +/- 0.83 PSA). Cartilage was present in end-DO (1.72 +/- 2.71 PSA), mid-fixation (5.82 +/- 6.64 PSA), and acute lengthening (1.43 +/- 0.95 PSA). Bone increased from mid-DO (25.18 +/- 0.99 PSA) to end-fixation (64.89 +/- 0.79 PSA) and occurred earlier in the superior and middle thirds of the wounds. Periosteal bone formation predominated over endosteal bone formation early in distraction. CONCLUSION The results of the present study indicate that bone formation in this model consists of both intramembranous and endochondral components, with intramembranous osteogenesis predominating. Bone formation occurred earlier in the superior/middle portions of the wound, possibly owing to osteoinductive properties of developing tooth buds and the inferior alveolar nerve, respectively.
Collapse
Affiliation(s)
- Matthew E Lawler
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114, USA
| | | | | | | | | |
Collapse
|
17
|
Wang L, Cao J, Lei DL, Cheng XB, Zhou HZ, Hou R, Zhao YH, Cui FZ. Application of nerve growth factor by gel increases formation of bone in mandibular distraction osteogenesis in rabbits. Br J Oral Maxillofac Surg 2010; 48:515-9. [PMID: 20236741 DOI: 10.1016/j.bjoms.2009.08.042] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Accepted: 08/17/2009] [Indexed: 11/17/2022]
Abstract
The long period of bony consolidation is a concern in mandibular distraction osteogenesis (DO). We have previously shown that repeated local injections of human nerve growth factor beta (NGFβ) can appreciably improve bony consolidation in a rabbit model of DO. The present study was designed to test the effect of a single injection of human NGFβ delivered by collagen/nano-hydroxyapatite/kappa-carrageenan gels to sites of new bony formation in DO. Rabbits underwent mandibular DO at a rate of 0.75 mm/12h for 6 days. At the end of the distraction period, the following injections were given percutaneously into the callus (n=6 in each of the four groups): human NGFβ in the gel; human NGFβ in saline; the gels alone; and saline alone. Fourteen days after the end of distraction, mechanical testing, histological and histomorphometric variables of the new bone were evaluated. Histologically, the NGFβ group had more advanced consolidation than the other three groups. Both maximal load and bone volume/total volume in this group were significantly higher than in the other three (P<0.05). In conclusion, the delivery of human NGFβ in the gels results in better acceleration of new bone formation than when it is given in saline, and may be a possible way to shorten the duration of craniofacial DO.
Collapse
Affiliation(s)
- L Wang
- Department of Oral and Maxillofacial Surgery, Fourth Military Medical University, School of Stomatology, Xi'an, China
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Effects of Nerve Growth Factor Delivery Via a Gel to Inferior Alveolar Nerve in Mandibular Distraction Osteogenesis. J Craniofac Surg 2009; 20:2188-92. [DOI: 10.1097/scs.0b013e3181bf04c7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
|