Department of Oral and Maxillofacial Surgery, Faculty of Medicine "Carl Gustav Carus", Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Institute for Medical Informatics and Biometry, Faculty of Medicine "Carl Gustav Carus", Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Clin Oral Investig. 2017 Nov;21(8):2521-2534. doi: 10.1007/s00784-017-2050-1. Epub 2017 Jan 18.
The clinical standard for alveolar cleft osteoplasty is augmentation with autologous bone being available in limited amounts and might be associated with donor site morbidity. The aim of the present study was the creation of tissue-engineered bone grafts and their in vivo evaluation regarding their potential to promote osteogenesis in an alveolar cleft model.
Artificial bone defects with a diameter of 3.3 mm were created surgically in the palate of 84 adult Lewis rats. Four experimental groups (n = 21) were examined: bovine hydroxyl apatite/collagen (bHA) without cells, bHA with undifferentiated mesenchymal stromal cells (MSC), bHA with osteogenically differentiated MSC. In a control group, the defect remained empty. After 6, 9 and 12 weeks, the remaining defect volume was assessed by cone beam computed tomography. Histologically, the remaining defect width and percentage of bone formation was quantified.
After 12 weeks, the remaining defect width was 60.1% for bHA, 74.7% for bHA with undifferentiated MSC and 81.8% for bHA with osteogenically differentiated MSC. For the control group, the remaining defect width measured 46.2% which was a statistically significant difference (p < 0.001).
The study design was suitable to evaluate tissue-engineered bone grafts prior to a clinical application. In this experimental set-up with the described maxillary defect, no promoting influence on bone formation of bone grafts containing bHA could be confirmed.
The creation of a sufficient tissue-engineered bone graft for alveolar cleft osteoplasty could preserve patients from donor site morbidity.
牙槽裂整复的临床标准是采用自体骨进行骨增量，然而自体骨的量有限，且可能伴有供区并发症。本研究旨在制备组织工程骨移植物，并通过体内实验评估其在牙槽裂模型中促进成骨的潜力。
在 84 只成年 Lewis 大鼠的腭部手术中创建直径为 3.3mm 的人工骨缺损。共分 4 个实验组（n=21）：无细胞牛羟磷灰石/胶原（bHA）、未分化间充质基质细胞（MSC）复合 bHA、成骨分化 MSC 复合 bHA。对照组，骨缺损保持空窗。6、9、12 周后，采用锥形束 CT 评估剩余骨缺损体积。组织学上，对剩余骨缺损宽度和骨形成百分比进行量化。
12 周后，bHA 组、未分化 MSC 复合 bHA 组和成骨分化 MSC 复合 bHA 组的剩余骨缺损宽度分别为 60.1%、74.7%和 81.8%。对照组的剩余骨缺损宽度为 46.2%，差异有统计学意义（p<0.001）。
本研究设计适用于组织工程骨移植物在临床应用前的评估。在本实验中，使用描述的上颌骨缺损模型，未证实含 bHA 的骨移植物对骨形成有促进作用。
制备充足的组织工程骨移植物进行牙槽裂整复可避免供区并发症。
