Al Maruf D S Abdullah, Cheng Kai, Xin Hai, Cheung Veronica K Y, Foley Matthew, Wise Innes K, Lewin Will, Froggatt Catriona, Wykes James, Parthasarathi Krishnan, Leinkram David, Howes Dale, Suchowerska Natalka, McKenzie David R, Gupta Ruta, Crook Jeremy M, Clark Jonathan R
Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia.
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia.
Bioengineering (Basel). 2023 Oct 21;10(10):1233. doi: 10.3390/bioengineering10101233.
Autologous bone replacement remains the preferred treatment for segmental defects of the mandible; however, it cannot replicate complex facial geometry and causes donor site morbidity. Bone tissue engineering has the potential to overcome these limitations. Various commercially available calcium phosphate-based bone substitutes (Novabone, BioOss, and Zengro) are commonly used in dentistry for small bone defects around teeth and implants. However, their role in ectopic bone formation, which can later be applied as vascularized graft in a bone defect, is yet to be explored. Here, we compare the above-mentioned bone substitutes with autologous bone with the aim of selecting one for future studies of segmental mandibular repair. Six female sheep, aged 7-8 years, were implanted with 40 mm long four-chambered polyether ether ketone (PEEK) bioreactors prepared using additive manufacturing followed by plasma immersion ion implantation (PIII) to improve hydrophilicity and bioactivity. Each bioreactor was wrapped with vascularized scapular periosteum and the chambers were filled with autologous bone graft, Novabone, BioOss, and Zengro, respectively. The bioreactors were implanted within a subscapular muscle pocket for either 8 weeks (two sheep), 10 weeks (two sheep), or 12 weeks (two sheep), after which they were removed and assessed by microCT and routine histology. Moderate bone formation was observed in autologous bone grafts, while low bone formation was observed in the BioOss and Zengro chambers. No bone formation was observed in the Novabone chambers. Although the BioOss and Zengro chambers contained relatively small amounts of bone, endochondral ossification and retained hydroxyapatite suggest their potential in new bone formation in an ectopic site if a consistent supply of progenitor cells and/or growth factors can be ensured over a longer duration.
自体骨移植仍然是下颌骨节段性缺损的首选治疗方法；然而，它无法复制复杂的面部几何形状，并且会导致供体部位出现并发症。骨组织工程有潜力克服这些局限性。各种市售的磷酸钙基骨替代物（Novabone、BioOss和Zengro）通常用于牙科治疗牙齿和种植体周围的小骨缺损。然而，它们在异位骨形成中的作用（可在以后作为血管化移植物应用于骨缺损）尚未得到探索。在此，我们将上述骨替代物与自体骨进行比较，目的是选择一种用于未来下颌骨节段性修复的研究。选用6只7 - 8岁的雌性绵羊，植入采用增材制造制备的40毫米长的四腔聚醚醚酮（PEEK）生物反应器，随后进行等离子体浸没离子注入（PIII）以提高亲水性和生物活性。每个生物反应器用带血管的肩胛骨骨膜包裹，各腔分别填充自体骨移植材料、Novabone、BioOss和Zengro。将生物反应器植入肩胛下肌袋内8周（两只绵羊）、10周（两只绵羊）或12周（两只绵羊），之后取出并通过显微CT和常规组织学进行评估。在自体骨移植材料中观察到中等程度的骨形成，而在BioOss和Zengro腔中观察到低水平的骨形成。在Novaboneone腔腔中未观察到骨形成。尽管BioOss和Zengro腔中含有相对少量的骨，但软骨内成骨和残留的羟基磷灰石表明，如果能在更长时间内确保祖细胞和/或生长因子的持续供应，它们在异位部位形成新骨方面具有潜力。
