Department of Plastic and Reconstructive Surgery, School of Medicine CHA University, CHA Bundang Medical Center, Seongnam, Republic of Korea.
J Craniofac Surg. 2022 May 1;33(3):962-968. doi: 10.1097/SCS.0000000000008072. Epub 2021 Sep 10.
Decellularized allogeneic bone chips act as scaffolds for bone tissue regeneration. Owing to their lack of osteogenic potentials compared to autologous bone graft, decellularized bone scaffolds (DBSs) have applied only to small partial bone defects in clinical settings. Furthermore, only decellularized cancellous bone chips have been limitedly used for the purpose of bone regeneration. The cortical bone has less porosity and less osteogenic materials such as bone morphogenetic proteins in comparison with cancellous bone. In this study, we tried to accelerate new bone formation within the decellularized cortical bone scaffold using a vascular pedicle as an in vivo bioreactor.Forty DBSs were divided into 4 groups with different conditionings (DBS+ demineralized bone matrix [DBM], DBS+DBM+me+mesenchymal stem cells, DBS+DBM+vascular pedicle, and DBS+DBM+vascular pedicle+mesenchymal stem cells) and implanted into the back of 5 rabbits. Half of the DBSs were examined at 8 weeks and the other half at 16 weeks to determine vascularization level and osteogenesis within each group. New bone formation and bone-forming cells related to osteogenesis were observed via histological staining. Inclusion of the vascular pedicle resulted in larger areas of bone regeneration. With time, osteon structures became more prominent in groups containing the vascular pedicle.In summary, vascularized DBSs combined with a vascular pedicle have shown promising results for bone regeneration, thereby representing potential therapeutic alternatives for autologous bone grafts or bone tissue free transfer in large or segmental bone defects. In addition, demineralized whole cortical bone matrix along with vascular pedicle and various bone inductive materials, such as DBM and recombinant human bone morphogenetic protein-2, may be an additional new option of an ideal osteoinductive system.
脱细胞同种异体骨屑作为骨组织再生的支架。由于与自体骨移植物相比缺乏成骨潜力，脱细胞骨支架（DBS）仅在临床环境中应用于小的局部骨缺损。此外，仅脱细胞松质骨屑被有限地用于骨再生目的。皮质骨的孔隙率较低，并且与松质骨相比，成骨材料（例如骨形态发生蛋白）较少。在这项研究中，我们试图使用血管蒂作为体内生物反应器来加速脱细胞皮质骨支架内的新骨形成。
将 40 个 DBS 分为 4 组，每组具有不同的条件（DBS+脱矿质骨基质[DBM]，DBS+DBM+me+间充质干细胞，DBS+DBM+血管蒂和 DBS+DBM+血管蒂+间充质干细胞），并植入 5 只兔子的背部。一半的 DBS 在 8 周和另一半在 16 周进行检查，以确定每组内的血管化水平和成骨情况。通过组织学染色观察新骨形成和与成骨相关的成骨细胞。包含血管蒂会导致更大的骨再生区域。随着时间的推移，在包含血管蒂的组中，骨单位结构变得更加明显。
总之，血管化 DBS 与血管蒂结合使用已显示出对骨再生的有前途的结果，从而为自体骨移植物或大或节段性骨缺损的骨组织无转移提供了潜在的治疗替代方法。此外，脱矿质全皮质骨基质与血管蒂以及各种骨诱导材料（例如 DBM 和重组人骨形态发生蛋白-2）的组合可能是理想的诱导成骨系统的另一种新选择。
