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Soares AP, Fischer H, Aydin S, Steffen C, Schmidt-Bleek K, Rendenbach C. Uncovering the unique characteristics of the mandible to improve clinical approaches to mandibular regeneration. Front Physiol 2023; 14:1152301. [PMID: 37008011 PMCID: PMC10063818 DOI: 10.3389/fphys.2023.1152301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/07/2023] [Indexed: 03/19/2023] Open
Abstract
The mandible (lower jaw) bone is aesthetically responsible for shaping the lower face, physiologically in charge of the masticatory movements, and phonetically accountable for the articulation of different phonemes. Thus, pathologies that result in great damage to the mandible severely impact the lives of patients. Mandibular reconstruction techniques are mainly based on the use of flaps, most notably free vascularized fibula flaps. However, the mandible is a craniofacial bone with unique characteristics. Its morphogenesis, morphology, physiology, biomechanics, genetic profile, and osteoimmune environment are different from any other non-craniofacial bone. This fact is especially important to consider during mandibular reconstruction, as all these differences result in unique clinical traits of the mandible that can impact the results of jaw reconstructions. Furthermore, overall changes in the mandible and the flap post-reconstruction may be dissimilar, and the replacement process of the bone graft tissue during healing can take years, which in some cases can result in postsurgical complications. Therefore, the present review highlights the uniqueness of the jaw and how this factor can influence the outcome of its reconstruction while using an exemplary clinical case of pseudoarthrosis in a free vascularized fibula flap.
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Affiliation(s)
- Ana Prates Soares
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Berlin, Germany
- *Correspondence: Ana Prates Soares,
| | - Heilwig Fischer
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Centrum für Muskuloskeletale Chirurgie, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Sabrin Aydin
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudius Steffen
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Katharina Schmidt-Bleek
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health Centre for Regenerative Therapies (BCRT), Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Hu Y, Hao X, Liu C, Ren C, Wang S, Yan G, Meng Y, Mishina Y, Shi C, Sun H. Acvr1 deletion in osteoblasts impaired mandibular bone mass through compromised osteoblast differentiation and enhanced sRANKL-induced osteoclastogenesis. J Cell Physiol 2021; 236:4580-4591. [PMID: 33251612 PMCID: PMC8048423 DOI: 10.1002/jcp.30183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/04/2020] [Accepted: 11/16/2020] [Indexed: 12/30/2022]
Abstract
Bone morphogenetic protein (BMP) signaling is well known in bone homeostasis. However, the physiological effects of BMP signaling on mandibles are largely unknown, as the mandible has distinct functions and characteristics from other bones. In this study, we investigated the roles of BMP signaling in bone homeostasis of the mandibles by deleting BMP type I receptor Acvr1 in osteoblast lineage cells with Osterix-Cre. We found mandibular bone loss in conditional knockout mice at the ages of postnatal day 21 and 42 in an age-dependent manner. The decreased bone mass was related to compromised osteoblast differentiation together with enhanced osteoclastogenesis, which was secondary to the changes in osteoblasts in vivo. In vitro study revealed that deletion of Acvr1 in the mandibular bone marrow stromal cells (BMSCs) significantly compromised osteoblast differentiation. When wild type bone marrow macrophages were cocultured with BMSCs lacking Acvr1 both directly and indirectly, both proliferation and differentiation of osteoclasts were induced as evidenced by an increase of multinucleated cells, compared with cocultured with control BMSCs. Furthermore, we demonstrated that the increased osteoclastogenesis in vitro was at least partially due to the secretion of soluble receptor activator of nuclear factor-κB ligand (sRANKL), which is probably the reason for the mandibular bone loss in vivo. Overall, our results proposed that ACVR1 played essential roles in maintaining mandibular bone homeostasis through osteoblast differentiation and osteoblast-osteoclast communication via sRANKL.
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Affiliation(s)
- Yue Hu
- Department of Oral Pathology, Hospital of StomatologyJilin UniversityChangchunChina
- Key Laboratory of Tooth Development and Bone Remodeling of Jilin ProvinceChangchunChina
| | - Xinqing Hao
- Department of Oral Pathology, Hospital of StomatologyJilin UniversityChangchunChina
- Key Laboratory of Tooth Development and Bone Remodeling of Jilin ProvinceChangchunChina
| | - Cangwei Liu
- Department of Oral Pathology, School and Hospital of StomatologyChina Medical UniversityShenyangChina
| | - Chunxia Ren
- Department of Oral Pathology, Hospital of StomatologyJilin UniversityChangchunChina
- Key Laboratory of Tooth Development and Bone Remodeling of Jilin ProvinceChangchunChina
| | - Shuangshuang Wang
- Department of Oral Pathology, School and Hospital of StomatologyChina Medical UniversityShenyangChina
| | - Guangxing Yan
- Department of Oral Pathology, Hospital of StomatologyJilin UniversityChangchunChina
- Key Laboratory of Tooth Development and Bone Remodeling of Jilin ProvinceChangchunChina
| | - Yuan Meng
- Department of Oral Pathology, School and Hospital of StomatologyChina Medical UniversityShenyangChina
| | - Yuji Mishina
- Department of Biologic and Materials Sciences, School of DentistryUniversity of MichiganAnn ArborMichiganUSA
| | - Ce Shi
- Department of Oral Pathology, Hospital of StomatologyJilin UniversityChangchunChina
- Key Laboratory of Tooth Development and Bone Remodeling of Jilin ProvinceChangchunChina
| | - Hongchen Sun
- Department of Oral Pathology, Hospital of StomatologyJilin UniversityChangchunChina
- Key Laboratory of Tooth Development and Bone Remodeling of Jilin ProvinceChangchunChina
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Massotti FP, Gomes FV, Mayer L, de Oliveira MG, Baraldi CE, Ponzoni D, Puricelli E. Histomorphometric assessment of the influence of low-level laser therapy on peri-implant tissue healing in the rabbit mandible. Photomed Laser Surg 2017; 33:123-8. [PMID: 25751666 DOI: 10.1089/pho.2014.3792] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was to demonstrate the effect of low-level laser therapy (LLLT) on the peri-implant bone healing process in the rabbit mandible. BACKGROUND DATA LLLT has been shown to accelerate tissue repair and osseointegration of implants placed into the rabbit tibia. However, the beneficial effects of LLLT have never been tested in the rabbit mandible, which would more closely mimic the human situation. MATERIALS AND METHODS Twenty-four male New Zealand rabbits were randomly divided into four groups of six animals each. All animals had their left mandibular incisors extracted, followed by immediate insertion of a titanium dental implant in the fresh socket. Three groups received LLLT [aluminum-gallium-arsenide (AlGaAs), λ=830nm, 50 mW, continuous wave (CW)] at three different energy densities per treatment session (E-5, 5 J/cm(2); E-10, 10 J/cm(2); and E-20, 20 J/cm(2)). Irradiation was performed every 48 h for 13 days, totaling seven sessions. One group received sham treatment (controls). Histological sections were obtained from each of the 24 mandibles dissected, without first decalcifying the specimens, and were stained with hematoxylin and eosin and Picrosirius red for histomorphometric evaluation. Bone-to-implant contact (BIC), bone formation area, and collagen fiber area were assessed by light microscopy. RESULTS Significant differences were found between group E-20 and all other groups (p<0.05). Histomorphometric evaluation showed significantly higher BIC and significantly more collagen fibers in group E-20. CONCLUSIONS Photobiostimulation with LLLT at an energy density of 20 J/cm(2) per session had a significant positive effect on new bone formation around dental implants inserted in the rabbit mandible.
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Affiliation(s)
- Fabrício Poletto Massotti
- 1 Department of Oral and Maxillofacial Surgery, Hospital de Clínicas de Porto Alegre, School of Dentistry, Universidade Federal do Rio Grande do Sul , Porto Alegre, RS, Brazil
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REN LI, WANG ZHE, HUANG LINGWEI, YANG PENGFEI, SHANG PENG. TECHNOLOGIES FOR STRAIN ASSESSMENT FROM WHOLE BONE TO MINERALIZED OSTEOID LEVEL: A CRITICAL REVIEW. J MECH MED BIOL 2016. [DOI: 10.1142/s0219519416300027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Bone has distinctive structures and mechanical properties at the whole bone, perilacunar and mineralized osteoid levels. A systematic understanding of bone strain magnitudes at different anatomical levels and their internal interactions is the prerequisite to advances in bone mechanobiology. However, due to the intrinsic shortcomings of the strain-measuring technologies, the systematic assessment of bone strain at different anatomical levels under physiological conditions and a deep understanding of their internal interactions are still restricted. To promote technological advances and provide systematic and valuable information for mechanical engineers and bone biomechanical researchers, the most useful methods for measuring bone strain at different anatomical levels are demonstrated in this review, and suggestions for the future development of the technologies and their potential integrated applications are proposed.
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Affiliation(s)
- LI REN
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Science, Northwestern Polytechnical University, 127 Youyi Xilu, Xi'an 710072, P. R. China
| | - ZHE WANG
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Science, Northwestern Polytechnical University, 127 Youyi Xilu, Xi'an 710072, P. R. China
| | - LINGWEI HUANG
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Science, Northwestern Polytechnical University, 127 Youyi Xilu, Xi'an 710072, P. R. China
| | - PENGFEI YANG
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Science, Northwestern Polytechnical University, 127 Youyi Xilu, Xi'an 710072, P. R. China
| | - PENG SHANG
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Science, Northwestern Polytechnical University, 127 Youyi Xilu, Xi'an 710072, P. R. China
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Ren L, Yang P, Wang Z, Zhang J, Ding C, Shang P. Biomechanical and biophysical environment of bone from the macroscopic to the pericellular and molecular level. J Mech Behav Biomed Mater 2015; 50:104-22. [DOI: 10.1016/j.jmbbm.2015.04.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/12/2015] [Accepted: 04/17/2015] [Indexed: 02/06/2023]
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Weber JBB, Mayer L, Cenci RA, Baraldi CE, Ponzoni D, Gerhardt de Oliveira M. Effect of Three Different Protocols of Low-Level Laser Therapy on Thyroid Hormone Production After Dental Implant Placement in an Experimental Rabbit Model. Photomed Laser Surg 2014; 32:612-7. [DOI: 10.1089/pho.2014.3756] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Luciano Mayer
- School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Rodrigo Alberto Cenci
- School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Carlos Eduardo Baraldi
- School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Deise Ponzoni
- School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marília Gerhardt de Oliveira
- Maxillofacial Surgery Service, Hospital Cristo Redentor – Grupo Hospitalar Conceição (GHC), Porto Alegre, RS, Brazil
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Low-level laser therapy improves peri-implant bone formation: resonance frequency, electron microscopy, and stereology findings in a rabbit model. Int J Oral Maxillofac Surg 2014; 44:245-51. [PMID: 25282596 DOI: 10.1016/j.ijom.2014.09.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 06/01/2014] [Accepted: 09/11/2014] [Indexed: 12/17/2022]
Abstract
Previous studies have reported positive effects of low-level laser therapy (LLLT) on bone healing. This study evaluated the effects of LLLT on peri-implant healing in vivo. Thirty-two rabbits had their mandibular left incisors removed, followed by immediate insertion of a dental implant into the fresh socket. Animals were assigned randomly to four groups: control (non-irradiated) or LLLT at three different doses per session: 5J/cm(2), 10J/cm(2), and 20J/cm(2). A GaAlAs laser (830nm, 50mW) was applied every 48h for 13 days, starting immediately after surgery. The implant stability quotient (ISQ) was measured using resonance frequency analysis upon implant insertion and immediately after death, 30 days after the last application. Tissues were prepared for scanning electron microscopy (SEM) and stereology. Variables measured were bone-implant contact (BIC) and bone neoformation within implant threads at three different sites. The results showed better ISQ for the 20J/cm(2) group (P=0.003). BIC values were significantly higher (P<0.05) in the 20J/cm(2) group, on both SEM and stereology. Bone area values were better in the 10J/cm(2) (P=0.036) and 20J/cm(2) (P=0.016) groups compared to the control group. Under these conditions, LLLT enhanced peri-implant bone repair, improving stability, BIC, and bone neoformation. The findings support and suggest parameters for the design of clinical trials using LLLT after implant placement.
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Klein-Nulend J, van Oers RFM, Bakker AD, Bacabac RG. Nitric oxide signaling in mechanical adaptation of bone. Osteoporos Int 2014; 25:1427-37. [PMID: 24322479 DOI: 10.1007/s00198-013-2590-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 11/24/2013] [Indexed: 01/27/2023]
Abstract
One of the most serious healthcare problems in the world is bone loss and fractures due to a lack of physical activity in elderly people as well as in bedridden patients or otherwise inactive youth. Crucial here are the osteocytes. Buried within our bones, these cells are believed to be the mechanosensors that stimulate bone formation in the presence of mechanical stimuli and bone resorption in the absence of such stimuli. Intercellular signaling is an important physiological phenomenon involved in maintaining homeostasis in all tissues. In bone, intercellular communication via chemical signals like NO plays a critical role in the dynamic process of bone remodeling. If bones are mechanically loaded, fluid flows through minute channels in the bone matrix, resulting in shear stress on the cell membrane that activates the osteocyte. Activated osteocytes produce signaling molecules like NO, which modulate the activity of the bone-forming osteoblasts and the bone-resorbing osteoclasts, thereby orchestrating bone adaptation to mechanical loading. In this review, we highlight current insights in the role of NO in the mechanical adaptation of bone mass and structure, with emphasis on its role in local bone gain and loss as well as in remodeling supervised by osteocytes. Since mechanical stimuli and NO production enhance bone strength and fracture resistance, these new insights may facilitate the development of novel osteoporosis treatments.
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Affiliation(s)
- J Klein-Nulend
- Department of Oral Cell Biology, ACTA-University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands,
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Mandibular corpus bone strains during mastication in goats (Capra hircus): A comparison of ingestive and rumination chewing. Arch Oral Biol 2011; 56:960-71. [DOI: 10.1016/j.archoralbio.2011.02.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Revised: 02/10/2011] [Accepted: 02/11/2011] [Indexed: 11/20/2022]
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de Jong WC, Korfage JAM, Langenbach GEJ. The role of masticatory muscles in the continuous loading of the mandible. J Anat 2011; 218:625-36. [PMID: 21492160 DOI: 10.1111/j.1469-7580.2011.01375.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Muscles are considered to play an important role in the ongoing daily loading of bone, especially in the masticatory apparatus. Currently, there are no measurements describing this role over longer periods of time. We made simultaneous and wireless in vivo recordings of habitual strains of the rabbit mandible and masseter muscle and digastric muscle activity up to ∼25 h. The extent to which habitually occurring bone strains were related to muscle-activity bursts in time and in amplitude is described. The data reveal the masseter muscle to load the mandible almost continuously throughout the day, either within cyclic activity bouts or with thousands of isolated muscle bursts. Mandibular strain events rarely took place without simultaneous masseter activity, whereas the digastric muscle only played a small role in loading the mandible. The average intensity of masseter-muscle activity bouts was strongly linked to the average amplitude of the concomitant bone-strain events. However, individual pairs of muscle bursts and strain events showed no relation in amplitude within cyclic loading bouts. Larger bone-strain events, presumably related to larger muscle-activity levels, had more constant principal-strain directions. Finally, muscle-to-bone force transmissions were detected to take place at frequencies up to 15 Hz. We conclude that in the ongoing habitual loading of the rabbit mandible, the masseter muscle plays an almost non-stop role. In addition, our results support the possibility that muscle activity is a source of low-amplitude, high-frequency bone loading.
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Affiliation(s)
- W C de Jong
- Department of Oral Cell Biology and Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, MOVE Research Institute, Amsterdam, The Netherlands
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