The effects of osteoformin on mineralisation and quality of newly formed bone during mandibular distraction osteogenesis in rabbits

Application of chemical factors for acceleration of consolidation phase of the distraction osteogenesis: a scoping review

PURPOSE

This study aimed to analyze the effect of injecting chemical factors compared to conventional distraction osteogenesis (DO) treatment on the bone formation of the distracted area of the maxillofacial region in human and animal studies.

METHOD

Electronic search was done in PubMed, Scopus, Embase, and Cochrane database for studies published until September 2021. The studies' risk of bias (ROB) was assessed using the Cochrane Collaborations and NIH quality assessment tools. Meta-analyses were performed to assess the difference in the amount of bone formation and maximal load tolerance.

RESULTS

Among a total of 58 included studies, eight studies analyzed the bone formation rate of the distracted area in human models and others in animal models. Results of the human studies showed acceptable outcomes in the case of using bone morphogenic protein-2 (BMP-2), autologous bone-platelet gel, and calcium sulfate. However, using platelet reach plasma does not increase the rate of bone formation significantly. Quantitative analyses showed that both BMP-2 (SMD = 26.57; 95% CI = 18.86 to 34.28) and neuron growth factor (NGF) (SMD = 16.19; 95% CI = 9.64 to 22.75) increase the amount of bone formation. Besides, NGF increased the amount of load tolerance significantly (SMD = 30.03; 95% CI = 19.91 to 40.16). Additionally, BMP-2 has no significant impact on the post-treatment maxillary length (SMD = 9.19; 95% CI =  - 2.35 to 20.73).

CONCLUSION

Limited number of human studies with low quality used chemical factors to enhance osteogenesis and showed acceptable results. However, more studies with higher quality are required.

Comparison of the Effects of Two Different Analgesics on Bone Regeneration During Mandibular Distraction Osteogenesis

INTRODUCTION

Mandibular distraction osteogenesis (DO) is frequently used in the management of bone defects and craniofacial deformities, with analgesics commonly administered to relieve acute postoperative pain. This experimental animal study investigated the effects of 2 analgesics, acetaminophen and acemetacin, on bone regeneration after DO.

MATERIALS AND METHODS

This study was conducted with 14 mature male New Zealand rabbits (2.8-3.2 kg) randomized into 2 groups of 7. Mandibular osteotomies were performed under optimal operating conditions, and a custom-made distractor was applied to the mandible of each subject, with distraction initiated after a 5-day latency period at a rate of 1.0 mm/d (2 × 0.5 mm/d) for 10 days. Analgesics were administered via oral gavage during the latency period and for the first 5 days of the distraction period for 10 days in total, with group I receiving acetaminophen (200 mg/kg/d) and group II receiving acemetacin (5 mg/kg/d). Subjects were sacrificed and their mandibles dissected at the end of 4 weeks postoperatively. Bone mineral density (BMD) and bone mineral content (BMC) were measured using dual-energy X-ray absorptiometry (DEXA), and histomorphometric analysis was performed to evaluate the quality of newly formed bone. Paired group comparisons of non-normally distributed numerical variables were made using the Mann-Whitney U test, with a P value of <0.05 considered statistically significant.

RESULTS

No significant differences in BMC and BMD values of intact bone, newly formed bone, or bone around the pin site were observed between the 2 groups. Histometric analysis also indicated acetaminophen and acemetacin to have similar effects on bone regeneration during distraction.

CONCLUSION

Acemetacin may be an alternative to acetaminophen for treating pain associated with DO, given the similarities in the effects of the 2 analgesics on bone regeneration. However, this finding should be supported by further experimental and human studies.

Effect of Mesenchymal Stem Cell Application on the Distracted Bone Microstructure: An Experimental Study

PURPOSE

Distraction osteogenesis (DO) is a surgical technique used to regenerate bone. The aim of this study was to improve bone quality and quantity during DO by the addition of mesenchymal stem cells (MSCs).

MATERIALS AND METHODS

The study was conducted on 12 goats assigned to a study group or a control group. In the study group, DO was aided with MSCs. Bone quality was assessed using energy dispersive x-ray (EDX), a scanning electron microscope (SEM), and histology. The histologic assessment was performed by measuring trabecular bone (TB) thickness in sections stained with hematoxylin and eosin (H&E) and by measuring osteoid bone percentage in sections stained with Masson trichrome (MT).

RESULTS

EDX showed an increase in calcification in the study group (mean Ca(2+), 17.58%; standard deviation [SD], 4.9%) compared with the control group (mean Ca(2+), 14.17%; SD, 6.7%). However, the increase was not statistically significant (P = .3354). Histomorphometric analysis of the H&E samples showed an increase in TB size in the study group (mean TB, 174.7 μm; SD, 33.5 μm) compared with the control group (mean TB, 115.4 μm; SD, 19.6 μm), and the increase was highly statistically significant (P = .0039). Analysis of the MT samples showed a decrease in osteoid percentage (mean osteoid percentage, 13.4%; SD, 2%) in the study group compared with the control group (mean osteoid percentage, 27.3%; SD, 3.5%). The decrease in osteoid percentage was statistically significant (P = .0001), indicating more rapid healing in the study group compared with the control group.

CONCLUSION

MSCs improved the bone quality of distracted bone and increased the crystal density in SEM images of the study group compared with that of the control group. MSCs showed promising results in improving the quality and quantity of distracted bone.