Department of Cranio-Maxillofacial Surgery, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Department of Veterinary Clinical Sciences, Faculty of Veterinary, University of Santiago de Compostela, Lugo, Spain.
Tissue Eng Part C Methods. 2022 Feb;28(2):61-72. doi: 10.1089/ten.TEC.2022.0001.
A variety of surgical techniques and tissue engineering strategies utilizing osteogenic potential of the periosteum have been developed for the repair of extended bone deficiencies. The aim of the present study was to assess the impact of an alternating protocol of periosteal distraction osteogenesis (PDO) on bone regeneration in an intraoral model. Eight adult, male Beagle dogs were used for the study. Two distraction devices were placed on each side of the mandible. After a 7-day latency period, distraction devices in all animals were manipulated at the rate of 0.5 mm for a total of 8 days. The pumping protocol in two test groups proceeded twice daily by alternating activation with relaxation. In the periosteal pumping/distraction (PPDO) group, the distraction screws were activated two times (at 12 and 24 h) and then turned back (at 36 h), and in the periosteal pumping (PP) group repeatedly activated and turned back (at 12 h). In the PDO group, only activation was performed once daily (positive control). Devices were left inactivated in the negative control (NC) group. The samples were harvested after 8 weeks of consolidation period and investigated by micro-CT and histological analysis. New mature, lamellar bone was formed over the pristine bone in all groups. PPDO and PDO groups showed more new bone area (NBA) compared to the PP ( < 0.001 and < 0.001, respectively) and to the NC group ( = 0.032 and = 0.031, respectively). Furthermore, greater NBA was found in the PP group than the NC group ( = 0.006). PDO demonstrated higher relative connective tissue area than the PPDO group ( = 0.005) and lower relative new bone volume than the NC group ( = 0.025). Pumping protocol of periosteal distraction may successfully induce the endogenous regeneration of the mandibular bone in dogs. Impact Statement Repair of extended bone defects impose a significant challenge to oral and maxillofacial surgeons. In this article, a principle of distraction osteogenesis was applied to stimulate bone regeneration in the mandible. A periosteum-based regeneration approach may represent a valuable step toward creating a significant volume of hard and soft tissues, without need for autogenous bone harvesting or application of biomaterials.
各种利用骨膜成骨潜力的外科技术和组织工程策略已被开发用于修复广泛的骨缺损。本研究旨在评估一种骨膜牵张成骨（PDO）的交替方案对口腔模型中骨再生的影响。 研究使用了 8 只成年雄性比格犬。在每侧下颌骨上放置两个牵引装置。经过 7 天的潜伏期后，所有动物的牵引装置均以 0.5mm 的速度操作，总共 8 天。在两个实验组中，通过交替激活和放松来进行每日两次的泵浦方案。在骨膜抽吸/牵张（PPDO）组中，牵张螺钉两次激活（在 12 小时和 24 小时），然后转回（在 36 小时），而在骨膜抽吸（PP）组中则反复激活和转回（在 12 小时）。在 PDO 组中，仅每天进行一次激活（阳性对照）。在阴性对照（NC）组中，装置保持不活动。在 8 周的巩固期后采集样本，并通过微 CT 和组织学分析进行研究。在所有组中，原始骨上都形成了新的成熟板层骨。与 PP 组相比，PPDO 和 PDO 组的新骨面积（NBA）更多（分别为 <0.001 和 <0.001），与 NC 组相比（分别为 =0.032 和 =0.031）。此外，PP 组的 NBA 大于 NC 组（=0.006）。PDO 组的结缔组织面积比 PPDO 组高（=0.005），而新骨体积比 NC 组低（=0.025）。骨膜牵张的泵浦方案可成功诱导犬下颌骨的内源性再生。
