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Inada N, Ohata T, Maruno H, Morii T, Hosogane N, Ichimura S. Optimal timing for intermittent administration of parathyroid hormone (1-34) for distraction osteogenesis in rabbits. J Orthop Surg Res 2022; 17:130. [PMID: 35241115 PMCID: PMC8895655 DOI: 10.1186/s13018-022-03019-2] [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: 10/29/2021] [Accepted: 02/16/2022] [Indexed: 12/01/2022] Open
Abstract
Background To date, the usefulness of parathyroid hormone [PTH (1–34)] in distraction osteogenesis has been reported in several studies. We aimed to determine the optimal timing of PTH (1–34) administration in a rabbit distraction osteogenesis model. Methods The lower hind leg of a Japanese white rabbit was externally fixed, and tibial osteotomy was performed. One week after the osteotomy, bone lengthening was carried out at 0.375 mm/12 h for 2 weeks. After 5 weeks, the lower leg bone was collected. Bone mineral density (BMD), peripheral quantitative computed tomography (pQCT), micro-computed tomography (micro-CT), and mechanical tests were performed on the distracted callus. The rabbits were divided into three groups according to the timing of PTH (1–34) administration: 4 weeks during the distraction and consolidation phases (group D + C), 2 weeks of the distraction phase (group D), and the first 2 weeks of the consolidation phase (group C). A control group (group N) was administered saline for 4 weeks during the distraction and consolidation phases. Furthermore, to obtain histological findings, lower leg bones were collected from each rabbit at 2, 3, and 4 weeks after osteotomy, and tissue sections of the distracted callus were examined histologically. Results The BMD was highest in group C and was significantly higher than group D. In pQCT, the total cross-sectional area was significantly higher in groups D + C, D, and C than group N, and the cortical bone area was highest in group C and was significantly higher than group D. In micro-CT, group C had the highest bone mass and number of trabeculae. Regarding the mechanical test, group C had the highest callus failure strength, and this value was significantly higher compared to group N. There was no significant difference between groups D and N. The histological findings revealed that the distracted callus mainly consisted of endochondral ossification in the distraction phase. In the consolidation phase, the chondrocytes were almost absent, and intramembranous ossification was the main type of ossification. Conclusion We found that the optimal timing of PTH (1–34) administration is during the consolidation phase, which is mainly characterized by intramembranous ossification.
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Affiliation(s)
- Narisaku Inada
- Department of Orthopedic Surgery, School of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Tetsuya Ohata
- Department of Orthopedic Surgery, School of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hideto Maruno
- Department of Orthopedic Surgery, School of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Takeshi Morii
- Department of Orthopedic Surgery, School of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Naobumi Hosogane
- Department of Orthopedic Surgery, School of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Shoichi Ichimura
- Department of Orthopedic Surgery, School of Medicine, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
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Application of Autologous Human Bone Marrow-Derived Mesenchymal Stem Cells in Distraction Osteogenesis for the Treatment of Bilateral Mandibular Hypoplasia. J Craniofac Surg 2018; 29:1629-1632. [DOI: 10.1097/scs.0000000000004614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Kiernan CH, Wolvius EB, Brama PA, Farrell E. The Immune Response to Allogeneic Differentiated Mesenchymal Stem Cells in the Context of Bone Tissue Engineering. TISSUE ENGINEERING PART B-REVIEWS 2018; 24:75-83. [DOI: 10.1089/ten.teb.2017.0175] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Caoimhe H. Kiernan
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Eppo B. Wolvius
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - Pieter A.J. Brama
- School of Veterinary Medicine, Veterinary Science Centre, University College Dublin, Dublin, Ireland
| | - Eric Farrell
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC, University Medical Center Rotterdam, The Netherlands
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Martins M, Ribeiro D, Martins A, Reis RL, Neves NM. Extracellular Vesicles Derived from Osteogenically Induced Human Bone Marrow Mesenchymal Stem Cells Can Modulate Lineage Commitment. Stem Cell Reports 2016; 6:284-91. [PMID: 26923821 PMCID: PMC4788762 DOI: 10.1016/j.stemcr.2016.01.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/04/2016] [Accepted: 01/04/2016] [Indexed: 12/29/2022] Open
Abstract
The effective osteogenic commitment of human bone marrow mesenchymal stem cells (hBMSCs) is critical for bone regenerative therapies. Extracellular vesicles (EVs) derived from hBMSCs have a regenerative potential that has been increasingly recognized. Herein, the osteoinductive potential of osteogenically induced hBMSC-EVs was examined. hBMSCs secreted negatively charged nanosized vesicles (∼35 nm) with EV-related surface markers. The yield of EVs over 7 days was dependent on an osteogenic stimulus (standard chemical cocktail or RUNX2 cationic-lipid transfection). These EVs were used to sequentially stimulate homotypic uncommitted cells during 7 days, matching the seeding density of EV parent cells, culture time, and stimuli. Osteogenically committed hBMSC-EVs induced an osteogenic phenotype characterized by marked early induction of BMP2, SP7, SPP1, BGLAP/IBSP, and alkaline phosphatase. Both EV groups outperformed the currently used osteoinductive strategies. These data show that naturally secreted EVs can guide the osteogenic commitment of hBMSCs in the absence of other chemical or genetic osteoinductors. hBMSC-EV secretion during culture is osteogenic stimulus dependent Osteogenically induced hBMSC-EVs are early osteoinductors Osteogenically induced hBMSC-EVs outperform currently used osteoinductive strategies
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Affiliation(s)
- Margarida Martins
- 3B's Research Group-Biomaterials, Biodegradable and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Barco, 4805-017 Guimarães, Portugal; ICVS/3B's PT Government Associated Laboratory, Braga/Guimarães, Portugal
| | - Diana Ribeiro
- 3B's Research Group-Biomaterials, Biodegradable and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Barco, 4805-017 Guimarães, Portugal; ICVS/3B's PT Government Associated Laboratory, Braga/Guimarães, Portugal
| | - Albino Martins
- 3B's Research Group-Biomaterials, Biodegradable and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Barco, 4805-017 Guimarães, Portugal; ICVS/3B's PT Government Associated Laboratory, Braga/Guimarães, Portugal
| | - Rui Luís Reis
- 3B's Research Group-Biomaterials, Biodegradable and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Barco, 4805-017 Guimarães, Portugal; ICVS/3B's PT Government Associated Laboratory, Braga/Guimarães, Portugal
| | - Nuno Meleiro Neves
- 3B's Research Group-Biomaterials, Biodegradable and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Barco, 4805-017 Guimarães, Portugal; ICVS/3B's PT Government Associated Laboratory, Braga/Guimarães, Portugal.
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The Human Mesenchymal Stromal Cell-Derived Osteocyte Capacity to Modulate Dendritic Cell Functions Is Strictly Dependent on the Culture System. J Immunol Res 2015; 2015:526195. [PMID: 26247040 PMCID: PMC4515297 DOI: 10.1155/2015/526195] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 06/23/2015] [Accepted: 06/24/2015] [Indexed: 01/14/2023] Open
Abstract
In vitro differentiation of mesenchymal stromal cells (MSC) into osteocytes (human differentiated osteogenic cells, hDOC) before implantation has been proposed to optimize bone regeneration. However, a deep characterization of the immunological properties of DOC, including their effect on dendritic cell (DC) function, is not available. DOC can be used either as cellular suspension (detached, Det-DOC) or as adherent cells implanted on scaffolds (adherent, Adh-DOC). By mimicking in vitro these two different routes of administration, we show that both Det-DOC and Adh-DOC can modulate DC functions. Specifically, the weak downregulation of CD80 and CD86 caused by Det-DOC on DC surface results in a weak modulation of DC functions, which indeed retain a high capacity to induce T-cell proliferation and to generate CD4+CD25+Foxp3+ T cells. Moreover, Det-DOC enhance the DC capacity to differentiate CD4+CD161+CD196+ Th17-cells by upregulating IL-6 secretion. Conversely, Adh-DOC strongly suppress DC functions by a profound downregulation of CD80 and CD86 on DC as well as by the inhibition of TGF-β production. In conclusion, we demonstrate that different types of DOC cell preparation may have a different impact on the modulation of the host immune system. This finding may have relevant implications for the design of cell-based tissue-engineering strategies.
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Dehghan MM, Baghaban Eslaminejad M, Motallebizadeh N, Ashrafi Halan J, Tagiyar L, Soroori S, Nikmahzar A, Pedram M, Shahverdi A, Kazemi Mehrjerdi H, Izadi S. Transplantation of Autologous Bone Marrow Mesenchymal Stem Cells with Platelet-Rich Plasma Accelerate Distraction Osteogenesis in A Canine Model. CELL JOURNAL 2015. [PMID: 26199903 PMCID: PMC4503838 DOI: 10.22074/cellj.2016.3724] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective Distraction osteogenesis (DO) is a surgical procedure used to generate large
volumes of new bone for limb lengthening.
Materials and Methods In this animal experimental study, a 30% lengthening of the left
tibia (mean distraction distance: 60.8 mm) was performed in ten adult male dogs by callus
distraction after osteotomy and application of an Ilizarov fixator. Distraction was started on
postoperative day seven with a distraction rate of 0.5 mm twice per day and carried out at
a rate of 1.5 mm per day until the end of the study. Autologous bone marrow mesenchymal stem cells (BM-MSCs) and platelet-rich plasma (PRP) as the treatment group (n=5)
or PRP alone (control group, n=5) were injected into the distracted callus at the middle
and end of the distraction period. At the end of the consolidation period, the dogs were
sacrificed after which computerized tomography (CT) and histomorphometric evaluations
were performed.
Results Radiographic evaluationsrevealed that the amount and quality of callus formations were significantly higher in the treatment group (P<0.05). As measured by
CT scan, the healing parametersin dogs of the treatment group were significantly
greater (P<0.05). New bone formation in the treatment group was significantly higher
(P<0.05).
Conclusion The present study showed that the transplantation of BM-MSCs positively
affects early bony consolidation in DO. The use of MSCs might allow a shortened period
of consolidation and therefore permit earlier device removal.
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Affiliation(s)
- Mohammad Mehdi Dehghan
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Mohamadreza Baghaban Eslaminejad
- Department of Stem Cells and Developmental Biology at Cell Sciences Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | | | - Javad Ashrafi Halan
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Tabriz University, Tabriz, Iran
| | - Leila Tagiyar
- Department of Stem Cells and Developmental Biology at Cell Sciences Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Sarang Soroori
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Agbibi Nikmahzar
- Department of Stem Cells and Developmental Biology at Cell Sciences Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Mirsepehr Pedram
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Abdolhossein Shahverdi
- Department of Stem Cells and Developmental Biology at Cell Sciences Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Hossein Kazemi Mehrjerdi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Sadra Izadi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
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Ohata T, Maruno H, Ichimura S. Changes over time in callus formation caused by intermittently administering PTH in rabbit distraction osteogenesis models. J Orthop Surg Res 2015; 10:88. [PMID: 26037517 PMCID: PMC4464237 DOI: 10.1186/s13018-015-0228-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 05/20/2015] [Indexed: 11/13/2022] Open
Abstract
Background Changes over time in the callus during intermittent administration of parathyroid hormone (PTH) were studied in rabbit distraction osteogenesis models. Method Models of distraction osteogenesis in Japanese white rabbits were created, and distraction osteogenesis (total length: 10.5 mm) was performed for 2 weeks. Simultaneously with the start of distraction, 30 rabbits received 4 weeks of subcutaneous administration of 30 μg/kg of PTH(1–34), teriparatide, (P-group: n = 15) or saline (N-group: n = 15) every other day. The tibias of five rabbits were dissected at 6, 8, and 10 weeks after surgery to perform bone mineral density (BMD), peripheral quantitative computed tomography (pQCT), and mechanical testing. Results The mean BMD had no significant differences over time at 6, 8, and 10 weeks after surgery between the P-group and the N-group. On pQCT, the P-group had significant increases in total bone cross-sectional area of the callus compared to the N-group at 8 and 10 weeks after surgery. On mechanical testing, the P-group’s absorption energy had not changed at 6 weeks after surgery compared to the N-group, but it had significantly increased at 8 weeks. At 10 weeks after surgery, the N-group’s absorption energy rapidly increased, and the difference between the two groups disappeared. Conclusion The intermittent administration of PTH(1–34), teriparatide, for 4 weeks every other day from the start of distraction had the potential to shorten the callus maturation period in the rabbit distraction osteogenesis models.
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Affiliation(s)
- Tetsuya Ohata
- Kyorin University, School of Medicine, 6-20-2 Sinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Hideto Maruno
- Kyorin University, School of Medicine, 6-20-2 Sinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Shoichi Ichimura
- Kyorin University, School of Medicine, 6-20-2 Sinkawa, Mitaka, Tokyo, 181-8611, Japan.
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Experimental comparison of the effects of locally administered zoledronic acid and alendronate on the rate of mandibular distraction osteogenesis in dogs. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:35-42. [DOI: 10.1016/j.oooo.2012.09.086] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 07/08/2012] [Accepted: 09/16/2012] [Indexed: 11/18/2022]
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Okabe YT, Kondo T, Mishima K, Hayase Y, Kato K, Mizuno M, Ishiguro N, Kitoh H. Biodistribution of locally or systemically transplantedosteoblast-like cells. Bone Joint Res 2014; 3:76-81. [PMID: 24652780 PMCID: PMC3963507 DOI: 10.1302/2046-3758.33.2000257] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Objectives In order to ensure safety of the cell-based therapy for bone
regeneration, we examined in vivo biodistribution
of locally or systemically transplanted osteoblast-like cells generated
from bone marrow (BM) derived mononuclear cells. Methods BM cells obtained from a total of 13 Sprague-Dawley (SD) green
fluorescent protein transgenic (GFP-Tg) rats were culture-expanded
in an osteogenic differentiation medium for three weeks. Osteoblast-like
cells were then locally transplanted with collagen scaffolds to
the rat model of segmental bone defect. Donor cells were also intravenously infused
to the normal Sprague-Dawley (SD) rats for systemic biodistribution.
The flow cytometric and histological analyses were performed for
cellular tracking after transplantation. Results Locally transplanted donor cells remained within the vicinity
of the transplantation site without migrating to other organs. Systemically
administered large amounts of osteoblast-like cells were cleared
from various organ tissues within three days of transplantation
and did not show any adverse effects in the transplanted rats. Conclusions We demonstrated a precise assessment of donor cell biodistribution
that further augments prospective utility of regenerative cell therapy.
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Affiliation(s)
- Y T Okabe
- Nagoya University Hospital, Centerfor Advanced Medicine and Clinical Research, 65 Tsurumai, Showa-ku, Nagoya, Aichi466-8550, Japan
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Yang JH, Kim HJ, Kim SE, Yun YP, Bae JH, Kim SJ, Choi KH, Song HR. The effect of bone morphogenic protein-2-coated tri-calcium phosphate/hydroxyapatite on new bone formation in a rat model of femoral distraction osteogenesis. Cytotherapy 2011; 14:315-26. [PMID: 22122301 DOI: 10.3109/14653249.2011.630728] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AIMS Distraction osteogenesis (DO) is an increasingly popular technique used to stimulate new bone formation to treat orthopedic disorders resulting from bone defects and deficits. Because of various possible complications that can occur during the long consolidation period, the development of procedures to accelerate regenerated ossification is clearly desirable. The purpose of this study was to evaluate the effect of single insertions of bone morphogenic protein-2 (BMP-2), delivered by tri-calcium phosphate (TCP)/hydroxyapatite (HA), administered at osteotomy sites, on the rate of new bone formation during DO in a rat model. METHODS Thirty-six male Sprague-Dawley rats, aged 12 weeks and weighing a mean (± standard deviation) of 401 ± 14 g, were used in this study. The animals were randomized into three groups of 12 rats each. Group I served as a control, group II was treated with only TCP/HA, and group III was treated with recombinant human (rh) BMP-2-coated TCP/HA. Materials were inserted into the medullary canal at the femoral osteotomy site at the end of the lengthening period. After a 7-day latent phase, distraction was commenced on day 0 at a rate of 0.50 mm every 6 h for 5 days (2 mm daily), resulting in a total of 10 mm of lengthening by day 5. At two different time-points [at 4 weeks (day 33) and 8 weeks (day 61) after cessation of distraction], the progress of bone formation was determined with microcomputed tomography (micro-CT), histology and real-time polymerase chain reaction (PCR). The mean and standard deviation of the values obtained from the experiment were computed and statistical analyses performed using anova. Statistical significance was established at P < 0.05. Results. Radiographically, all group III rat femurs exhibited bridging callus formation 8 weeks after cessation of distraction, whereas group II rat femurs demonstrated non-bridging callus formation. None of the group I rat femurs showed callus in the central zone of the distraction gap. For micro-CT, bone formation and remodeling of the distraction regeneration with beta-TCP/HA coated with rhBMP-2 had greater values than the control sides at all time-points. Two-dimensional quantitative analysis of the distraction regeneration showed that the bone volume of group III had higher values than groups I and II at 4 weeks (P < 0.05). This difference was also evident at 8 weeks. With hematoxylin and eosin (H&E) staining, the control group (group I) did not show any bone tissue at the distraction site. In group II at 4 weeks, abundant fibrous tissue surrounding the particles was visible with some areas of woven bone. At 8 weeks, the woven bone covered the particles but not the whole circumference. In group III at 4 weeks, much of the woven bone surrounded the particle with some fibrocartilagenous materials. At 8 weeks, woven bone covering the whole circumference of the particles was visible. CONCLUSIONS Application of rhBMP-2, at the end of the rather rapid distraction period, as a single bolus significantly increased the osteogenic process, while beta-TCP/HA behaved effectively as a sustained delivery system for this osteoinductive protein.
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Affiliation(s)
- Jae-Hyuk Yang
- Department of Orthopaedic Surgery, Seoul Veterans Hospital, Seoul, Korea
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Küçük D, Ay S, Kara MI, Avunduk MC, Gümus C. Comparison of local and systemic alendronate on distraction osteogenesis. Int J Oral Maxillofac Surg 2011; 40:1395-400. [PMID: 21945486 DOI: 10.1016/j.ijom.2011.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Revised: 08/19/2011] [Accepted: 08/31/2011] [Indexed: 11/25/2022]
Abstract
This study compared the effect of systemic and local administration of alendronate on distraction osteogenesis in rabbit mandibles. Thirty New Zealand white rabbits were allocated to 3 groups: 10 rabbits for systemic alendronate; 9 for local alendronate; and 11 as controls. After a 5 day latency period, distraction was performed at a rate of 0.8mm/day for 9 days via a custom-made distractor. Animals were killed at the end of the consolidation period of 28 days. The distracted mandibles were harvested and evaluated by plain radiography, computed tomography (CT), dual energy X-ray absorptiometry (DEXA), and histomorphometry. Histologically, comparing the systemic and local alendronate groups, there were no statistically significant differences in the bone healing parameters, but each group showed a statistically superior effect over the control group (p<0.05). Quantitative CT evaluation showed a significant difference mean in the density of the regeneration between experimental and control groups. There was a significant increase in mean bone mineral density in the experimental groups compared with the control group. Histologic, CT, and DEXA analysis demonstrated that using systemic and local alendronate may be effective in accelerating new bone formation in the distraction gap in rabbit mandibles.
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Affiliation(s)
- Dervişhan Küçük
- Dept. of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
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Affiliation(s)
- Minoru Ueda
- Department of Oral and Maxillofacial Surgery, School of Medicine
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Addition of mesenchymal stem cells to the scaffold of platelet-rich plasma is beneficial for the reduction of the consolidation period in mandibular distraction osteogenesis. J Oral Maxillofac Surg 2010; 68:1112-24. [PMID: 20223574 DOI: 10.1016/j.joms.2008.08.038] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Revised: 07/31/2008] [Accepted: 08/27/2008] [Indexed: 11/21/2022]
Abstract
PURPOSE Platelet-rich plasma (PRP) is a wonderful scaffold to induce osteogenesis. In this study, we investigated whether the combination of mesenchymal stem cells (MSC) with PRP has advantages over PRP for the reduction of consolidation period in mandibular distraction osteogenesis. MATERIALS AND METHODS After osteotomy, an external distraction device was fixed in both mandibles of 38 rabbits. After a 5-day latency period, a total of 6.3 mm was distracted for 6 days. PRP gel with or without MSC was injected into the distracted area on day 1 of the consolidation period. Healing tissues were analyzed histologically, radiologically, and mechanically on weeks 1, 2, 3, and 4 after consolidation. RESULTS In week 1, the MSC/PRP group was 34%, 20%, 21%, and 32% higher than the PRP group in the result of histomorphometry, radiodensity ratio of new bone/host bone and new bone/adjacent tooth, and microhardness test, respectively. Consolidation period was reduced by 6.6 and 5.1 days at 80% and 90% new bone/host bone ratio through regression analysis, respectively. CONCLUSION The addition of MSC in PRP scaffold significantly (P < .05) increased new bone formation, mineralization, and mechanical property compared to the PRP-only group. These results indicate that the combination therapy of MSC and PRP is more effective for reducing the consolidation period of distraction.
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Polat HB, Yeler H, Gumus C, Bulut HE, Kucuk D. Effect of oil-based calcium hydroxide (Osteoinductal) on distraction osteogenesis in rabbit mandible. ACTA ACUST UNITED AC 2009; 107:e30-6. [DOI: 10.1016/j.tripleo.2009.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Revised: 01/06/2009] [Accepted: 02/05/2009] [Indexed: 11/24/2022]
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Effects of Alendronate on Rate of Distraction in Rabbit Mandibles. J Oral Maxillofac Surg 2008; 66:2042-9. [DOI: 10.1016/j.joms.2008.06.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 03/03/2008] [Accepted: 06/16/2008] [Indexed: 11/18/2022]
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Pampu AA, Dolanmaz D, Tüz HH, Avunduk MC, Kisşnisşci RŞ. Histomorphometric Evaluation of the Effects of Zoledronic Acid on Mandibular Distraction Osteogenesis in Rabbits. J Oral Maxillofac Surg 2008; 66:905-10. [DOI: 10.1016/j.joms.2007.12.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Revised: 10/03/2007] [Accepted: 12/05/2007] [Indexed: 10/22/2022]
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Kinoshita K. Experimental Study on Rapid Maxillary Distraction Osteogenesis Using Tissue-Engineered Osteogenic Material. J Oral Maxillofac Surg 2007. [DOI: 10.1016/j.joms.2007.06.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Shao Z, Liu B, Peng Q, Liu W, Liu Y, Liu R, Xu Y, Liu L. Transplantation of osteoblast-like cells to the distracted callus in the rabbit mandible. Plast Reconstr Surg 2007; 119:500-7. [PMID: 17230082 DOI: 10.1097/01.prs.0000246374.53516.78] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The purpose of this study was to investigate whether injections of marrow-derived mesenchymal progenitor cells could be used to facilitate new bone formation during distraction osteogenesis. METHODS Fifteen New Zealand rabbits underwent bilateral osteotomy. After a 1-week latency period, bone distraction was activated at a rate of 2.0 mm/day for 5 days. The marrow-derived mesenchymal progenitor cells derived from the ilium marrow were cultured to a population of 10 in 0.5 ml and then unilaterally transplanted to the gap of distracted callus immediately after distraction had been terminated. Rabbits were killed at 2, 4, and 6 weeks after completion of bone lengthening. The distracted areas were harvested and evaluated by histologic, histomorphometric, radiographic, and scanning electron microscopic analysis. Bone mineral density in the lengthened callus was evaluated using dual-energy x-ray absorptiometry. RESULTS Radiographic evaluation indicated a significant increase in bony union of the distraction regenerate in the experimental side compared with the control side. Corresponding to the radiographic findings, the histologic examination showed an earlier and more intensive bone formation in the experimental side after 2, 4, and 6 weeks compared with the control side. Larger chondroid islands were found evident in distracted bone of the control side than in the experimental side. CONCLUSIONS The results show that transplantation of osteoblast-like cells promotes maturity of the distracted callus, as observed on the second and fourth weeks after lengthening. The method appears promising as a means of shortening the consolidation period of osteodistraction and decreasing complications during bone lengthening.
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Affiliation(s)
- Zhen Shao
- Department of Traumatic and Aesthetic Surgery, Huangsi Aesthetic Surgery Hospital, 9 Huangsi Street, Beijing 100011, People's Republic of China.
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Pampu AA, Dolanmaz D, Tüz HH, Karabacakoglu A. Experimental evaluation of the effects of zoledronic acid on regenerate bone formation and osteoporosis in mandibular distraction osteogenesis. J Oral Maxillofac Surg 2006; 64:1232-6. [PMID: 16860215 DOI: 10.1016/j.joms.2006.04.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2004] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effects of systemically administered zoledronic acid (ZA) on the bone mineral density (BMD) and bone mineral content (BMC) at mandibular distraction sites in rabbits. MATERIALS AND METHODS Eighteen New Zealand white rabbits were randomly divided into 2 groups. Bone lengthening was performed in the left portion of the mandible through distraction osteogenesis at a rate of 0.5 mm every 12 hours for 5 days. While the experimental group rabbits were administered intravenous 0.1 mg/kg ZA, control group rabbits were given only saline infusion during operation. All animals were sacrificed at the end of the consolidation period of 28 days. The mandibles of all animals were removed and both the anterior and posterior pin regions of the regenerate and regenerate region were evaluated by dual energy x-ray absorptiometry (DEXA). BMD and BMC data were statistically analyzed. RESULTS Except for 1 rabbit from the experimental group that had an infection at the external pin region, all animals showed complete clinical healing. When the values in the group receiving ZA were compared with those of the control group, it was observed that the BMD values of the anterior pin region of regenerate, regenerate region, and posterior pin region increased by 23%, 20%, and 31%, respectively; and BMC values increased by 22%, 24%, and 32%, respectively. When data of these regions were compared, both BMD and BMC were found statistically different in all regions (P < .05). CONCLUSION Results of this study showed that ZA had positive effects on new bone formation at and around the distraction gaps of the lengthened rabbit mandibles by distraction osteogenesis.
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Affiliation(s)
- A Alper Pampu
- Department of Oral and Maxillofacial Surgery, Selcuk University, Faculty of Dentistry, Konya, Turkey.
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Eyckmans J, Luyten FP. Species Specificity of Ectopic Bone Formation Using Periosteum-Derived Mesenchymal Progenitor Cells. ACTA ACUST UNITED AC 2006; 12:2203-13. [PMID: 16968161 DOI: 10.1089/ten.2006.12.2203] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To investigate novel cell-based bone-engineering approaches using rabbit as a preclinical animal model, we compared the osteogenic potential of rabbit periosteum-derived cells (RPDCs) and human periosteum-derived cells (HPDCs) in vitro and in vivo. Adherent periosteal cells from both species were expanded in vitro and subsequently treated with osteogenic medium or bone morphogenetic protein 6 (BMP6). Alkaline phosphatase (ALP) activity was measured, and alizarin red staining was performed to evaluate osteogenic differentiation. In vivo ectopic bone formation was assessed by seeding 5x10(6) periosteal cells, grown in osteogenic conditions, in a Collagraft carrier and subsequent implantation subcutaneously in athymic mice. In vitro, growth analysis indicated that RPDCs expanded faster and were smaller than HPDCs under the same culture conditions. Osteogenic medium did not affect the ALP activity of HPDCs or RPDCs. In contrast, BMP6 stimulated ALP activity in cultured RPDCs and HPDCs but at different rates. In vivo, HPDCs gave rise to extensive bone formation, whereas RPDCs failed to make bone. In vivo, cell tracking revealed that engraftment and survival of HPDCs and RPDCs after 8 weeks in the implant were limited. Some HPDCs were incorporated into the newly formed bone. RPDCs and HPDCs displayed distinct growth characteristics and osteogenic differentiation capacity in vitro and in vivo under the culture conditions used. Our data indicate potential limitations of use of the rabbit as a preclinical model for cell-based treatments for bone repair.
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Affiliation(s)
- Jeroen Eyckmans
- Laboratory for Skeletal Development and Joint Disorders, Katholieke Universiteit Leuven, Leuven, Belgium
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Qi M, Hu J, Zou S, Zhou H, Han L. Mandibular distraction osteogenesis enhanced by bone marrow mesenchymal stem cells in rats. J Craniomaxillofac Surg 2006; 34:283-9. [PMID: 16777427 DOI: 10.1016/j.jcms.2006.02.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2005] [Accepted: 02/15/2006] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE This study was to observe the effects of bone marrow mesenchymal stem cell transplantation on new bone formation in a rat mandibular osteodistraction model. MATERIAL AND METHODS Autologous bone marrow stem cells were obtained from tibiae of 40 male rats. Two weeks after cell harvest, the rats underwent right mandibular distraction and were then randomly divided into two groups (group A=20, group B=20). After distraction was complete, the stem cells were injected into the distracted gaps in group A, while the rats in group B only received physiological saline. Twenty rats (10 from each group) were sacrificed on postoperative days 27 and 55, respectively. The distracted mandibles were harvested and processed for radiographic, histological and histomorphometric analysis. RESULTS The radiodensity of the distraction zone was higher in group A than in group B at both time points. Histologically callus was found in both groups but more bone was formed in group A. Histomorphometric analysis also demonstrated that both new bone volume and thickness of the new trabeculae were significantly greater in group A than in group B. CONCLUSION The results of this study suggest that autologous bone marrow stem cell transplantation may be considered as a potential method to accelerate bone regeneration in the distraction gap, and enhance consolidation.
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Affiliation(s)
- Mengchun Qi
- Key Laboratory of Oral Biomedical Engineering, Centre of Orthognathic Surgery, West China College of Stomatology, Sichuan University, Chengdu, China
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Liu H, Kemeny DM, Heng BC, Ouyang HW, Melendez AJ, Cao T. The Immunogenicity and Immunomodulatory Function of Osteogenic Cells Differentiated from Mesenchymal Stem Cells. THE JOURNAL OF IMMUNOLOGY 2006; 176:2864-71. [PMID: 16493043 DOI: 10.4049/jimmunol.176.5.2864] [Citation(s) in RCA: 156] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Multipotent mesenchymal stem cells (MSC) are reported to be immunoprivileged as well as immunosuppressive. Hence, they are ideal candidates for allogeneic transplantation to induce regeneration of diseased tissues and organs. However, it is not known whether MSC would retain their immunoprivileged and immunomodulatory properties after differentiating into the local cell types of the transplantation site. This study sought to investigate this question with a novel New Zealand White rabbit osteogenesis model. Results showed that osteogenic cells differentiated from MSC (DOC) in vitro did not express the MHC class II molecule, were incapable of inducing allogeneic lymphocyte proliferation in mixed lymphocyte culture or generating CTL, were inhibitory in ongoing lymphocyte proliferation, and secreted anti-inflammatory cytokines (IL-10 and TGF-beta). There was a significantly higher secretion of IL-10 by DOC than that by MSC, while there was no significant difference between the TGF-beta secretion of MSC and DOC in vitro. However, after IFN-gamma treatment, TGF-beta secretion by DOC significantly decreased despite the increased production by MSC. Four weeks after local DOC implantation, despite MHC class II expression, second-set allogeneic skin rejection showed similar survival to first-set allogeneic skin rejection and DOC appeared to function as osteoblasts. In conclusion, DOC retained their immunoprivileged and immunomodulatory properties in vitro, but the latter was lost following transplantation.
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Affiliation(s)
- Hua Liu
- Stem Cell Laboratory, Faculty of Dentistry, National University of Singapore, Singapore
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Tsuchiya H, Uehara K, Sakurakichi K, Watanabe K, Matsubara H, Tomita K. Distraction osteogenesis after irradiation in a rabbit model. J Orthop Sci 2005; 10:627-33. [PMID: 16307189 DOI: 10.1007/s00776-005-0945-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2005] [Accepted: 07/04/2005] [Indexed: 11/29/2022]
Abstract
BACKGROUND The present study was performed to investigate the effects of preoperative irradiation on distraction osteogenesis, as little is known about how preoperative irradiation delays distraction osteogenesis. METHODS A single dose of irradiation was applied to the right rear legs of rabbits. This was followed by tibial lengthening at a rate of 0.5 mm/day, which was continued for 4 weeks. Bone regeneration was examined radiographically and histologically. RESULTS In the irradiation group, the radiographs showed little regeneration during the elongation phase. During the maturation phase, the callus appeared slowly, and its formation was spotty. Furthermore, regeneration was not completed until the fourth week of the maturation period. Histological examination at the end of distraction showed a gap in the distraction consisting of loose connective tissue, with part of the fibrous tissue oriented longitudinally. Four weeks after completion of distraction, the major part of the radiolucent region consisted of cartilage. The spotty osteogenesis was identified as enchondral ossification. Immunohistochemical examination of the regeneration area revealed that the blood vessels were extremely localized, and that the level of expression of vascular endothelial growth factor (VEGF) in the osteoblasts was high. Microangiography showed that vascularization at the distracted sites was poor. Distraction osteogenesis was decreased markedly by preoperative irradiation in terms of both rate and process. The results suggested that most of the osteoprogenitor cells were damaged immediately after irradiation. The high level of VEGF in the osteoblasts and the enchondral ossification also suggested a hypoxic state in the distracted region. CONCLUSIONS Preoperative irradiation interferes with distraction osteogenesis by inducing a state of poor angiogenesis.
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Affiliation(s)
- Hiroyuki Tsuchiya
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
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Cho BC, Kim JY, Lee JH, Chung HY, Park JW, Roh KH, Kim GU, Kwon IC, Jang KH, Lee DS, Park NW, Kim IS. The bone regenerative effect of chitosan microsphere-encapsulated growth hormone on bony consolidation in mandibular distraction osteogenesis in a dog model. J Craniofac Surg 2004; 15:299-311; discussion 312-3. [PMID: 15167253 DOI: 10.1097/00001665-200403000-00028] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this project was to study the effect of chitosan microsphere-encapsulated human growth hormone, which causes sustained release of chitosan and human growth hormone after implantation on early bony consolidation in distraction osteogenesis of a canine model. Forty-eight dogs were used for this study. An external distraction device was applied to the mandibular body after a vertical osteotomy, and the mandibular distraction was started 5 days after the operation at a rate of 1 mm/d up to a 10-mm distraction. The experimental group was divided into a control group (I), hyaluronic acid group (II), chitosan microsphere group (III), and chitosan microsphere-encapsulated human growth hormone group (IV). Normal saline was injected in group I. In group II, a 1-ml volume of hyaluronic acid solution was injected into the distracted area. In the group III, powder of chitosan microspheres and hGH were mixed with a 1-ml volume of hyaluronic acid to make an injectable form, and it was implanted into the distracted area. In group IV, powder of chitosan microsphere-encapsulated hGH was mixed with a 1-ml volume of hyaluronic acid. A total of 1-ml volume of the solution mix was implanted into the distracted area. Five dogs in each group (total of 20 dogs) were killed 3 weeks after completion of distraction. Twenty-eight dogs were killed at 6 weeks. Bone mineral density was 13.1% of the contralateral normal mandible at 3 weeks and 29.6% at 6 weeks in group I, 16.4% at 3 weeks and 40.4% at 6 weeks in group II, 16.6% at 3 weeks and 45.95% at 6 weeks in group III, and 29.6% at 3 weeks and 66.7% at 6 weeks in group IV. The mean three-point failure load was 16.1% in the control group, 34.7% in group II, 41.5% in group III, and 52.1% in group IV compared with the intact contralateral mandible, with statistical significance. In the histological findings, new bone was generated in all groups. In group IV, the formation of active woven bone was observed throughout the distracted area at 6 weeks. The amount of new bone formation in the distracted zone was in the order of group IV, group III, group II, and the control group. In conclusion, these findings suggest that chitosan microsphere-encapsulated hGH seems to be quite effective in early bone consolidation in distraction osteogenesis.
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Affiliation(s)
- Byung Chae Cho
- Department of Plastic and Reconstructive Surgery, College of Medicine, Kyungpook National University, Daegu, Korea.
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Mizumoto Y, Moseley T, Drews M, Cooper VN, Reddi AH. Acceleration of regenerate ossification during distraction osteogenesis with recombinant human bone morphogenetic protein-7. J Bone Joint Surg Am 2003; 85-A Suppl 3:124-30. [PMID: 12925619 DOI: 10.2106/00004623-200300003-00019] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Bone-lengthening can be accomplished by means of distraction osteogenesis. In the present study, we examined the effect of a single dose of recombinant human bone morphogenetic protein-7 (rhBMP-7) on the rate of new-bone formation during distraction osteogenesis in the rat. METHODS Fourteen Long-Evans rats were randomized into two groups of seven rats each. An external fixator was applied to the left femur, and a transverse osteotomy was performed. One group was treated with rhBMP-7 in an aqueous solvent, and the other group received the solvent alone and served as the control. rhBMP-7 was administered on the day of surgery by means of a single injection into the osteotomy gap. Distraction was started seven days after surgery at a rate of 0.25 mm every twelve hours. Distraction was continued for twenty days, resulting in a total of 10 mm of lengthening. The regenerate was monitored with use of radiographs and bone-mineral-density measurements at the conclusion of distraction and at two and four weeks after the cessation of distraction. The lengthened femora were harvested, and biomechanical studies were carried out to determine the stiffness and maximum torque to failure. RESULTS Radiographs showed accelerated regenerate ossification in the BMP-7 group, with a larger amount of new bone compared with the control group. The bone-mineral-density values were dramatically enhanced on Day 20 in the BMP-7 group (103.6 +/- 12.6 mg/cm (2) ) compared with the control group (26.2 +/- 15.1 mg/cm (2) ). These differences continued to be greater at two and four weeks after the cessation of distraction. Normalized values of stiffness (percent stiffness) reached 76.5% +/- 5.4% in the BMP-7 group, compared with 6.6% +/- 0.5% in the control group. The percent maximum torque at failure was 81.1% +/- 1.2% in the BMP-7 group, compared with 20.8% +/- 0.3% in the control group. CONCLUSION A single injection of rhBMP-7 at the time of osteotomy surgery stimulated the rate of regenerate ossification and increased bone-mineral density during distraction osteogenesis. The biomechanical properties of the newly formed bone were also increased by BMP-7 injection.
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Hamdy RC, Amako M, Beckman L, Kawaguchi M, Rauch F, Lauzier D, Steffen T. Effects of osteogenic protein-1 on distraction osteogenesis in rabbits. Bone 2003; 33:248-55. [PMID: 14499359 DOI: 10.1016/s8756-3282(03)00154-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this study we tested the effect of locally applied osteogenic protein 1 (OP-1) on distraction osteogenesis in rabbits. Seven days after tibial osteotomy, distraction was started at a rate of 0.25 mm per 12 h for 3 weeks. At the end of the distraction period, OP-1 was injected at the site of osteotomy. Four different dosages were tested (0, 80, 800, or 2000 microg; eight rabbits per dose group). Rabbits were sacrificed 3 weeks later, and histologic, densitometric, and biomechanical parameters were assessed. No significant differences were found between groups for any parameter. To explain why this approach was only modestly successful, the expression of BMP receptor protein in the newly formed tissue was analyzed by immunohistochemistry. Strong expression of BMP receptor IA, IB, and II was found during the early distraction phase, but not during later stages of the process. Thus, it appears that the lack of receptor protein in the target tissue impairs the effect of OP-1 given at the end of the distraction period. Possibly, OP-1 could be more useful when applied early in the distraction phase.
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Affiliation(s)
- Reggie C Hamdy
- Shriners Hospital for Children, Canadian Unit, Division of Orthopaedics, McGill University, 1529 Cedar Avenue, Montreal, Quebec, Canada H3G 1A6.
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Abstract
Distraction osteogenesis has been widely utilized to treat leg length discrepancy, deformity, nonunion, osteomyelitis, and bone loss. It has been found that most difficult conditions can be resolved with this method. This paper introduces the usefulness of distraction osteogenesis for the treatment of nonunion and bone loss after tumor excision. The procedure was found to be extremely effective for the treatment of nonunion accompanied by bone loss and infected nonunion. In particular, the Ilizarov method offers a simultaneous solution for several problems related to nonunion, such as instability, infection, deformity, bone loss, joint contracture, limb length discrepancy, and skin defects. In addition, distraction osteogenesis is safe, useful, and efficient for the treatment of bone loss even after tumor excision. Joint preservation and reconstruction by means of distraction osteogenesis is the most conservative limb-saving surgery available at present. Furthermore, distraction osteogenesis can provide natural limb regeneration.
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Affiliation(s)
- Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Japan
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Little DG, Smith NC, Williams PR, Briody JN, Bilston LE, Smith EJ, Gardiner EM, Cowell CT. Zoledronic acid prevents osteopenia and increases bone strength in a rabbit model of distraction osteogenesis. J Bone Miner Res 2003; 18:1300-7. [PMID: 12854841 DOI: 10.1359/jbmr.2003.18.7.1300] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
UNLABELLED Prolonged healing times and stress-shielding osteopenia remain problematic in distraction osteogenesis. In this study of 30 rabbits, zoledronic acid increased regenerate volume, mineralization, and tibial strength and prevented osteopenia over a 6-week period. Translation to the clinical setting, if safe, could improve outcomes in distraction osteogenesis in children. INTRODUCTION Because the external fixators for limb lengthening and reconstruction are designed to control the positions of bone fragments accurately, they also produce stress-shielding effects on the forming regenerate and surrounding bone. Osteopenia, leading to refracture and limitations on rehabilitation, are common consequences, potentially increasing morbidity and detracting from final clinical outcome. MATERIALS AND METHODS We examined the effect of zoledronic acid on distraction osteogenesis in 42 immature male NZW rabbits. The model chosen results in reliable regenerate formation and stress-shielding osteopenia. Fourteen animals received either Saline, zoledronic acid 0.1 mg/kg at surgery (ZOL), or another dose 2 weeks postoperatively (Redosed ZOL). Rabbits underwent DXA for bone mineral content and bone mineral density in regenerate and surrounding segments of operated and contralateral tibias. After death at 6 weeks, 30 pairs of tibias underwent quantitative computerized tomography (QCT) and four-point bend testing, and 12 were examined by histomorphometry. The study was powered at 0.8 to show differences of 1.3 SDs for mineral and mechanical parameters. RESULTS Osteopenia observed in tibias of the Saline group was absent in ZOL and Redosed ZOL tibias, the latter exhibiting higher bone mineral density and bone mineral content over contralateral regions (p < 0.01). Regenerate bone mineral content was higher in ZOL and Redosed ZOL versus Saline groups at 4 and 6 weeks (p < 0.01). Cross-sectional area was 49% and 59% greater at 6 weeks in ZOL and Redosed ZOL regenerates compared with the Saline group (p < 0.01). ZOL and Redosed ZOL tibias were 29% and 89% stronger by four-point bending than the Saline group (p < 0.01). Histomorphometry in the regenerate of ZOL and Redosed ZOL groups revealed higher trabecular bone volume and trabecular number compared with the Saline group (p < 0.001). CONCLUSIONS Zoledronic acid administration led to significantly greater bone area, mineral content, strength, and trabecular number with reduced stress-shielding osteopenia in this model of distraction osteogenesis. These data suggest that intraoperative and postoperative zoledronic acid administration could improve outcomes in children undergoing limb lengthening.
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Affiliation(s)
- David G Little
- Orthopaedic Research and Biotechnology, Children's Hospital at Westmead, Sydney, NSW, Australia.
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Cho BC, Moon JH, Chung HY, Park JW, Kweon IC, Kim IS. The bone regenerative effect of growth hormone on consolidation in mandibular distraction osteogenesis of a dog model. J Craniofac Surg 2003; 14:417-25. [PMID: 12826814 DOI: 10.1097/00001665-200305000-00025] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The purpose of this project was to study the effect of growth hormone on early bony consolidation in distraction osteogenesis of a dog model. Sixteen dogs were used for this study. The vertical osteotomy on the mandibular body was extended downward. An external distraction device was applied to the mandibular body and the mandibular distraction was started 5 days after the operation at a rate of 1 mm/d up to a 10-mm distraction. The experimental group was divided into a control group and growth hormone group. Dogs in the growth hormone group received a daily subcutaneous injection of 100 microg (1 IU) of recombinant human growth hormone per kilogram of body weight. The daily administration of growth hormone was performed from the day of the osteotomy through the whole distraction period to the sacrifice. Normal saline was injected in the control group. Eight dogs were allocated to each group. Two dogs in each group, a total of four dogs, were killed at 2 weeks after completion of distraction, four dogs were killed at 4 weeks, and the other eight dogs were killed at 6 weeks. The level of serum IGF-I in the growth hormone group was elevated and peaked between 8 days and 12 days after systemic administration of growth hormone. Bone mineral density was higher in the growth hormone group and lower in the control group for the whole period. Bone mechanical strength was 300% higher in the growth hormone group than in the control group. However, results were more suggestive than conclusive. On histological examination, the formation of a substantial amount of active woven bone was observed throughout the distracted zone at six weeks in the growth hormone group. In the control group, new bone was generated from the edge to the center of the distracted zone. In addition, most of the central area of the distracted zone was filled with fibrous tissue at six weeks. In conclusion, these findings suggest that growth hormone appears to be effective in early bony consolidation in distraction osteogenesis.
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Affiliation(s)
- Byung Chae Cho
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Samduk 2-ga 50, Taegu-city 700-721, Korea.
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King GJ, Liu ZJ, Wang LL, Chiu IY, Whelan MF, Huang GJ. Effect of distraction rate and consolidation period on bone density following mandibular osteodistraction in rats. Arch Oral Biol 2003; 48:299-308. [PMID: 12663075 DOI: 10.1016/s0003-9969(03)00004-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The high cost of large animal protocols has limited the study of distraction osteogenesis (DO) in the craniofacial region. This study was designed to characterise a rat model for DO with regard to distraction rate and consolidation period. Unilateral mandibular distraction was performed on 129 male Sprague-Dawley rats using an osteotomy from the sigmoid notch to the inferior border of mandible. After a 3-day latency, 12 groups of 8-9 rats underwent distraction for 5 days at four different rates (0, 0.2, 0.4, 0.6mm per day), with three different post-osteotomy sacrifice times (10, 24, and 38 days) and four final predicted distraction lengths (0, 1, 2, and 3mm). Another four groups of rats (N=8 per group) were sacrificed 6 days post-osteotomy, resulting in distraction for 3 days with a predicted distraction length of 0, 0.6, 1.2, 1.8mm. Changes in mandibular morphology were measured from radiographs of disarticluated hemimandibles. The bone density of the regenerate and control sites was measured using microdensitometry calibrated with an epoxy stepwedge. Distraction linearly increased mandibular length, distraction gap width and the area of the distraction gap (P<0.00005). Mandibular length increased by 0.394 mm per distraction rate. Gap width and area increased by 0.67 and 5.8mm(2) per distraction rate, respectively. The increase in length represents only 39.4% of what was predicted, suggesting that compensatory alteration in condylar or mandibular morphology may have occurred. This speculation was further supported by the finding that mandibular length, measured without the condylar landmark, was 53.8% of predicted. During DO and early consolidation, the measures of bone density in the regenerates decreased compared to control for all groups. Thereafter, bone density in the regenerates generally increased in all groups until day 24 (P<0.01), obtaining levels that were comparable to the unoperated side. At both rostral and caudal sites adjacent to the osteotomies, measures of bone density were enhanced over control in all groups, with the rostral site also showing significant increases over time in the sham and the highest distraction groups (P<0.008 and P<0.014). We conclude that this rat model for mandibular distraction osteogenesis provides bone density changes that are consistent with those reported using larger animal protocols.
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Affiliation(s)
- G J King
- Department of Orthodontics, University of Washington School of Dentistry, Box 357446, Seattle, WA 98195-3446, USA.
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Cañadell J, Forriol F. Elongación ósea: aspectos clínicos y experimentales. Rev Esp Cir Ortop Traumatol (Engl Ed) 2003. [DOI: 10.1016/s1888-4415(03)76116-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Terheyden H, Wang H, Warnke P, Springer I, Erxleben A, Ludwig K, Rueger D. Acceleration of callus maturation using rhOP-1 in mandibular distraction osteogenesis in a rat model. Int J Oral Maxillofac Surg 2003. [DOI: 10.1016/s0901-5027(03)90408-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Re: Clinical Application of Injectable Calcium Sulfate on Early Bony Consolidation in Distraction Osteogenesis for the Treatment of Craniofacial Microsomia. J Craniofac Surg 2002. [DOI: 10.1097/00001665-200205000-00020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Hu J, Li J, Wang D, Buckley MJ, Agarwal S. Differences in mandibular distraction osteogenesis after corticotomy and osteotomy. Int J Oral Maxillofac Surg 2002; 31:185-9. [PMID: 12102418 PMCID: PMC4950923 DOI: 10.1054/ijom.2001.0193] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Corticotomy or osteotomy was performed on opposing sides of the mandibles in 18 goats. A custom-made distractor was used to lengthen the mandible at a rate of 1 mm/day for 10 days (total 10 mm elongation). Six goats were sacrificed respectively at 2, 4 and 8 weeks after completion of distraction. The distracted calluses were harvested and processed for radiographic, histologic, and scanning electron microscopic evaluation as well as Ca/P ratio analysis. The regenerate bone in the corticotomy side showed more bone formation and earlier mineralization than in the osteotomy side. The results of this study suggest that preservation of intramedullary vessels is beneficial to bone regeneration following mandibular osteodistraction, and that performing corticotomy may be a simple but effective way to promote the maturity of the distracted callus and shorten the time for fixation.
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Affiliation(s)
- J Hu
- Department of Oral and Maxillofacial Surgery, Huaxi School of Stomatology, Sichuan University, Chengdu, China.
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Little DG, Cornell MS, Hile MS, Briody J, Cowell CT, Bilston L. Effect of pamidronate on distraction osteogenesis and fixator-related osteoporosis. Injury 2001; 32 Suppl 4:SD14-20. [PMID: 11812473 DOI: 10.1016/s0020-1383(01)00161-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We examined the effect on bone mineral density (BMD), bone mineral content (BMC) and mechanical properties of a single 1.0 mg/kg dose of the bisphosphonate pamidronate (Novartis), in a distraction osteogenesis model in immature rabbits. Twenty rabbits underwent a tibial osteotomy. Ten rabbits received pamidronate 1.0 mg/kg via ear vein intra-operatively while 10 received saline infusions only. After a 24 h latency, all underwent distraction of 0.375 mm twice daily for 15 days. The animals were culled at 42 days. After culling, the distracted and non-distracted tibiae were examined by quantitative computer tomography (QCT). The volumetric bone mineral density (vBMD, mg/cm(3)) in the bone proximal and distal to the regenerate in the operated limb was increased by a mean of 11 and 14%, respectively, compared to controls (P<0.05). The vBMD of the regenerate bone was increased by a mean of 8% over controls (NS, P=0.17). The bone mineral content (BMC, mg) was increased by 23% (proximal and distal) (P<0.05) in the bone surrounding the lengthening and there was a 17% trend towards an increase in the regenerate (NS, P=0.3). Four-point bending analysis documented that the load to failure was increased by 32% from 436 to 574 N (P<0.01) in the pamidronate group. The modulus of elasticity was not different between the control and pamidronate groups (P=0.3), and in both groups was only approximately one-third of the intact tibiae (P<0.001). The administration of a single dose of pamidronate can improve the bone mineral density, content and mechanical properties of a bone undergoing distraction osteogenesis.
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Affiliation(s)
- D G Little
- Orthopaedic Research Unit, Royal Alexandra Hospital for Children, Locked Bag 4001, Westmead, Sydney, NSW, Australia.
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