Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Cluster of Excellence, Precision Medicine in Inflammation, Christian-Albrechts-University of Kiel, Kiel, Germany.
Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
J Craniomaxillofac Surg. 2024 Nov;52(11):1259-1266. doi: 10.1016/j.jcms.2024.04.012. Epub 2024 Aug 22.
Correction of bony mandibular defects is a challenge in oral and maxillofacial surgery due to aesthetic and functional requirements. This study investigated the potential of a novel hybrid scaffold for bone regeneration and degradation assessment of the ceramic within the omentum majus over 6 months and the extent to which rhBMP-2 as a growth factor, alone or combined with a hydrogel, affects regeneration.
In this animal study, 10 Göttingen minipigs each had one scaffold implanted in the greater omentum. Five animals had scaffolds loaded with a collagen hydrogel and rhBMP-2, and the other five animals (control group) had scaffolds loaded with rhBMP-2 only. Fluorochrome injections and computed tomography (CT) were performed regularly. After 6 months, the animals were euthanized, and samples were collected for microCT and histological evaluations.
Fluorescent and light microscopic and a CT morphological density evaluation showed continuous bone growth until week 16 in both groups. Regarding the ratio of bone attachment to the Zr02 support struts, the rhBMP-2 loaded collagen hydrogel group showed with 63% a significantly higher attachment (p > 0.001) than the rhBMP-2 control group (49%).
In this study, bone growth was induced in all omentum majus specimens until post-operative week 16. Furthermore, hydrogel and rhBMP-2 together resulted in better bone-scaffold integration than rhBMP-2 alone. Further studies should investigate whether implantation of the scaffolds in the jaw after an appropriate period of bone regeneration leads to a stable situation and the desired results.
由于美学和功能要求，下颌骨缺损的矫正对口腔颌面外科来说是一个挑战。本研究旨在探讨新型混合支架在 6 个月内促进骨再生的潜力，并评估大网膜内陶瓷的降解情况，以及生长因子 rhBMP-2 单独或与水凝胶联合应用对再生的影响。
在这项动物研究中，每只 10 只哥廷根小型猪的大网膜中各植入一个支架。其中 5 只动物的支架内加载胶原水凝胶和 rhBMP-2，另 5 只动物（对照组）的支架内仅加载 rhBMP-2。定期进行荧光和光镜以及 CT 扫描。6 个月后，处死动物，采集样本进行 microCT 和组织学评估。
荧光和光镜以及 CT 形态密度评估显示，两组均在第 16 周前持续骨生长。关于附着在 Zr02 支撑柱上的骨比例，rhBMP-2 加载胶原水凝胶组的附着率为 63%，明显高于 rhBMP-2 对照组的 49%（p>0.001）。
在这项研究中，所有大网膜标本中均诱导了骨生长，直到术后第 16 周。此外，水凝胶和 rhBMP-2 联合应用比 rhBMP-2 单独应用能更好地促进骨-支架整合。进一步的研究应探讨在适当的骨再生期后将支架植入颌骨是否能导致稳定的情况和所需的结果。
