Second Department of Trauma & Orthopaedics, University of Athens Medical School, "Agia Olga" Hospital, Athens, Greece.
First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
J Craniofac Surg. 2023 Oct 1;34(7):2212-2216. doi: 10.1097/SCS.0000000000009490. Epub 2023 Jun 19.
Restoration of bone defects in the craniac vault may require the use of autografts, allografts, xenografts, or synthetic grafts. There are promising data that vitamin D may play a positive role in graft incorporation. The purpose of the present study is the evaluation of the impact of vitamin D addition to human-derived bone grafts in the healing of critical-sized bone defects in porcine skulls.
Four identical critical-sized defects were created in the calvaria of 8 adult Landrace Large White pigs. The first defect was left blank as control, the second defect was filled with human-derived bone graft, the third defect was filled with human-derived bone graft enriched with a low concentration of vitamin D (2 mg/mL), and the fourth defect was filled with human-derived bone graft enriched with a high concentration of vitamin D (10 mg/mL). The animals were sacrificed after 12 weeks. Harvested tissue specimens were qualitatively evaluated by histology. New bone formation (bone volume/tissue volume) was quantitatively measured by histomorphometry.
Signs of bone formation were evident in all bone sockets. Mean values of the bone volume/tissue volume of the 4 defects were 10.91%, 11.05%, 10.40% and 10.87% respectively, at 12 weeks. In 5 animals, high concentration of vitamin D caused a significant improvement in bone formation in relation to controls. In 3 animals, a high concentration of vitamin D was associated with decreased bone formation compared with controls. No statistical difference was observed in the graft healing among the 4 graft sites ( P > 0.05).
The results of this study have shown that the addition of vitamin D to human-derived bone grafts does not have a significant effect on bone formation and graft incorporation in critical-sized bone defects of the porcine calvaria. Further high-quality studies are needed to fully elucidate the role of vitamin D in bone formation and bone graft union.
颅穹顶骨缺损的修复可能需要使用自体移植物、同种异体移植物、异种移植物或合成移植物。有有前景的数据表明，维生素 D 可能在移植物整合中发挥积极作用。本研究的目的是评估在猪颅骨的临界尺寸骨缺损中添加维生素 D 对人源性骨移植物愈合的影响。
在 8 头成年长白猪的颅骨上创建了 4 个相同的临界尺寸的缺损。第一个缺损作为空白对照，第二个缺损填充了人源性骨移植物，第三个缺损填充了低浓度维生素 D（2 mg/mL）富集的人源性骨移植物，第四个缺损填充了高浓度维生素 D（10 mg/mL）富集的人源性骨移植物。在 12 周后，处死动物。通过组织学对收获的组织标本进行定性评估。通过组织形态计量法对新骨形成（骨体积/组织体积）进行定量测量。
所有骨槽中均有骨形成的迹象。在 12 周时，4 个缺损的骨体积/组织体积平均值分别为 10.91%、11.05%、10.40%和 10.87%。在 5 只动物中，高浓度维生素 D 导致骨形成显著改善，与对照组相比。在 3 只动物中，高浓度维生素 D 与对照组相比，骨形成减少。4 个移植物部位的移植物愈合无统计学差异（P > 0.05）。
本研究结果表明，在猪颅骨的临界尺寸骨缺损中，添加维生素 D 对人源性骨移植物的骨形成和移植物整合没有显著影响。需要进一步开展高质量的研究，以充分阐明维生素 D 在骨形成和骨移植物结合中的作用。
