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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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Chen X, Yu B, Wang Z, Li Q, Dai C, Wei J. Progress of Periosteal Osteogenesis: The Prospect of In Vivo Bioreactor. Orthop Surg 2022; 14:1930-1939. [PMID: 35794789 PMCID: PMC9483074 DOI: 10.1111/os.13325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/25/2022] [Accepted: 05/14/2022] [Indexed: 12/14/2022] Open
Abstract
Repairing large segment bone defects is still a clinical challenge. Bone tissue prefabrication shows great translational potentials and has been gradually accepted clinically. Existing bone reconstruction strategies, including autologous periosteal graft, allogeneic periosteal transplantation, xenogeneic periosteal transplantation, and periosteal cell tissue engineering, are all clinically valuable treatments and have made significant progress in research. Herein, we reviewed the research progress of these techniques and briefly explained the relationship among in vivo microenvironment, mechanical force, and periosteum osteogenesis. Moreover, we also highlighted the importance of the critical role of periosteum in osteogenesis and explained current challenges and future perspective.
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Affiliation(s)
- Xiaoxue Chen
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
| | - Baofu Yu
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
| | - Zi Wang
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
| | - Chuanchang Dai
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
| | - Jiao Wei
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
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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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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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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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He Z, Liu Y, Liu X, Sun Y, Zhao Q, Liu L, Zhu Z, Luo E. Smart Porous Scaffold Promotes Peri-Implant Osteogenesis under the Periosteum. ACS Biomater Sci Eng 2020; 6:6321-6330. [PMID: 33449673 DOI: 10.1021/acsbiomaterials.0c00956] [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] [Indexed: 02/08/2023]
Abstract
Background: Adequate peri-implant bone mass and bone quality are essential factors to ensure the initial stability of the implant and success of implant operation. In clinical settings, the lack of bone mass often restricts the implant operation. In this study, we fabricated a smart porous scaffold with a shape memory function and investigated whether it could promote peri-implant osteogenesis under the periosteum. Methods: A porous shape memory polymer (SMP) scaffold was fabricated and its shape memory function, mechanical properties, and degradation rate were tested in vitro. Moreover, the scaffold was implanted in the mandible of rabbits to evaluate its efficacy to promote peri-implant osteogenesis in the periosteum and enhance the initial stability of the implant. Histological, micro-CT, and biomechanical analyses were carried out for further verification. Results: The SMP scaffold has a good shape memory function and biocompatibility in vitro. In vivo experiments demonstrated that the SMP scaffold could recover to its original shape after implantation to create a small gap in the periosteum. After 12 weeks, the scaffold was gradually replaced by a newly formed bone, and the stability of the implant increased when it implanted with the scaffold. Conclusion: The present study indicates that the SMP scaffolds have a good shape memory function and could enhance peri-implant bone formation under the periosteum. The SMP scaffold provides a clinical potential candidate for bone tissue engineering under the periosteum.
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Affiliation(s)
- Ze He
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Yao Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Xian Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Yue Sun
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Qiucheng Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Linan Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Zhaokun Zhu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - En Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
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Bone-borne accelerated sutural expansion: A microcomputed tomography study in rabbits. Am J Orthod Dentofacial Orthop 2018; 154:260-269. [PMID: 30075928 DOI: 10.1016/j.ajodo.2017.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 10/29/2017] [Accepted: 11/21/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION In this study, we evaluated the effect of bone-borne accelerated expansion protocols on sutural separation and sutural bone modeling using a microcomputed tomography system. We also determined the optimum instant sutural expansion possible without disruption of bone modeling. METHODS Sixteen New Zealand white rabbits, 20 to 24 weeks old, were randomly divided into 4 experimental groups. Modified hyrax expanders were placed across their interfrontal sutures and secured with miniscrew implants located bilaterally in the frontal bone. The hyrax appliances were activated as follows: group 1 (control), 0.5-mm per day expansion for 12 days; group 2, 1-mm instant expansion followed by 0.5 mm per day for 10 days; group 3, 2.5-mm instant expansion followed by 0.5 mm per day for 7 days, and group 4, 4-mm instant expansion followed by 0.5 mm per day for 4 days. After 6 weeks of retention, sutural separation and sutural bone modeling were assessed by microcomputed tomography and quantified. Statistical analysis was performed using Kruskal Wallis and Mann-Whitney U tests and the Spearman rho correlation (P <0.05). RESULTS Median amounts of sutural separation ranged from 2.84 to 4.41 mm for groups 1 and 4, respectively. Median bone volume fraction ranged from 59.96% to 69.15% for groups 4 and 3, respectively. A significant correlation (r = 0.970; P <0.01) was observed between the amounts of instant expansion and sutural separation. CONCLUSIONS Pending histologic verifications, our findings suggest that the protocol involving 2.5 mm of instant expansion followed by 0.5 mm per day for 7 days is optimal for accelerated sutural expansion. When 4 mm of instant expansion was used, the sutural bone volume fraction was decreased.
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