Bone Tissue Engineering in the Greater Omentum with Computer-Aided Design/Computer-Aided Manufacturing Scaffolds is Enhanced by a Periosteum Transplant

Naujokat, Hendrik; Loger, Klaas; Wagner, Juliane; Açil, Yahya; Wiltfang, Jens

doi:10.2217/rme-2020-0115

Cited by 4 publications

(5 citation statements)

References 52 publications

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“…The omentum is another highly vascularized tissue that has been used to generate tissue-engineered bone flaps. Like muscle, an omental site also requires the use of BMPs or other osteogenic growth factors [ 87 ]. Bio-Oss blocks were soaked in BMP-2 and autogenous bone marrow aspirate before implantation within pouches close to vasculature within the gastric omentum [ 88 ].…”

Section: In Vivo Bioreactorsmentioning

confidence: 99%

Advances in In Vitro and In Vivo Bioreactor-Based Bone Generation for Craniofacial Tissue Engineering

Watson

Mikos

2023

BME Front

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Craniofacial reconstruction requires robust bone of specified geometry for the repair to be both functional and aesthetic. While native bone from elsewhere in the body can be harvested, shaped, and implanted within a defect, using either an in vitro or in vivo bioreactors eliminates donor site morbidity while increasing the customizability of the generated tissue. In vitro bioreactors utilize cells harvested from the patient, a scaffold, and a device to increase mass transfer of nutrients, oxygen, and waste, allowing for generation of larger viable tissues. In vivo bioreactors utilize the patient’s own body as a source of cells and of nutrient transfer and involve the implantation of a scaffold with or without growth factors adjacent to vasculature, followed by the eventual transfer of vascularized, mineralized tissue to the defect site. Several different models of in vitro bioreactors exist, and several different implantation sites have been successfully utilized for in vivo tissue generation and defect repair in humans. In this review, we discuss the specifics of each bioreactor strategy, as well as the advantages and disadvantages of each and the future directions for the engineering of bony tissues for craniofacial defect repair.

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Section: In Vivo Bioreactorsmentioning

confidence: 99%

Advances in In Vitro and In Vivo Bioreactor-Based Bone Generation for Craniofacial Tissue Engineering

Watson

Mikos

2023

BME Front

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“…The duration for the prefabrication phase in this study was based on previous reports, which suggested an optimal duration of approximately 8 wk ( Runyan et al 2014 ; Kasper et al 2017 ; Naujokat et al 2020 ). Obviously, previous study designs were variable, but using the same duration range would allow for comparison of results.…”

Section: Discussionmentioning

confidence: 99%

“…This approach is promising for augmenting the available rib bone stock; however, it is restricted by the size of the rib periosteum and involves a relative morbidity for rib segments harvesting. The second approach has involved nonvascularized periosteal grafts transplanted into the greater omentum of minipigs (Naujokat et al 2019(Naujokat et al , 2020. Although this approach violates the anterior abdominal wall, it has reflected the versatility of transplanting periosteal grafts into a distant IVB site for customized defect-specific bone tissue regeneration.…”

Section: Introductionmentioning

confidence: 99%

Periosteal Flaps Enhance Prefabricated Engineered Bone Reparative Potential

et al. 2021

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The clinical translation of bone tissue engineering for reconstructing large bone defects has not advanced without hurdles. The in vivo bioreactor (IVB) concept may therefore bridge between bone tissue engineering and reconstructive surgery by employing the patient body for prefabricating new prevascularized tissues. Ideally, IVB should minimize the need for exogenous growth factors/cells. Periosteal tissues are promising for IVB approaches to prefabricate tissue-engineered bone (TEB) flaps. However, the significance of preserving the periosteal vascular supply has not been adequately investigated. This study assessed muscle IVB with and without periosteal/pericranial grafts and flaps for prefabricating TEB flaps to reconstruct mandibular defects in sheep. The sheep ( n = 14) were allocated into 4 groups: muscle IVB (M group; nM = 3), muscle + periosteal graft (MP group; nMP = 4), muscle + periosteal flap (MVP group; nMVP = 4), and control group ( nControl = 3). In the first surgery, alloplastic bone blocks were implanted in the brachiocephalic muscle (M) with a periosteal graft (MP) or with a vascularized periosteal flap (MVP). After 9 wk, the prefabricated TEB flaps were transplanted to reconstruct a mandibular angle defect. In the control group, the defects were reconstructed by non-prevascularized bone blocks. Computed tomography (CT) scans were performed after 13 wk and after 23 wk at termination, followed by micro-CT (µCT) and histological analyses. Both CT and µCT analysis revealed enhanced new bone formation and decreased residual biomaterial volume in the MVP group compared with control and MP groups, while the M group showed less new bone formation and more residual biomaterial. The histological analysis showed that most of the newly formed bone emerged from defect edges, but larger areas of new bone islands were found in MP and MVP groups. The MVP group showed enhanced vascularization and higher biomaterial remodeling rates. The periosteal flaps boosted the reconstructive potential of the prefabricated TEB flaps. The regenerative potential of the periosteum was manifested after the transplantation into the mechanically stimulated bony defect microenvironment.

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“…The scaffolds were of a cylindrical form with a height of 10 mm and a diameter of 12 mm and were additively manufactured out of zirconium-oxide and tricalcium phosphate. Immediately before implantation the scaffolds were loaded in accordance to established protocols 7,8 : One scaffold was infiltrated with a collagen gel (RatCol® Rat Tail Collagen for 3D Hydrogels, Advanced Biomatrix, San Diego, California), the other one with the same collagen gel enriched with 250 μg rhBMP-2 (E. coli derived, Creative Biomart, Shirley, New York) and wrapped by an autogenous periosteum transplant from the forehead (Figure 2).…”

Section: Methodsmentioning

confidence: 99%

“…In recent decades, many approaches to bone cultivation and ectopic endocultivation of bone flaps have been developed as an alternative approach ‐ also to reduce the morbidity of existing therapies 4–6 . The reconstruction by endocultivation using 3‐dimensional (3D)‐printed scaffolds in the greater omentum is a very promising approach in defect‐specific bone tissue regeneration 7 . This approach is based on tissue engineering strategies aiming patient‐specific bone reconstruction 8 .…”

Section: Introductionmentioning

confidence: 99%

Robot‐assisted scaffold implantation and two‐stage flap raising of the greater omentum for reconstruction of the facial skeleton: Description of a novel technique

Naujokat

Wieker

Weitkamp

et al. 2022

Robotics Computer Surgery

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Background Bone regeneration in the greater omentum is a promising strategy in facial skeleton reconstruction. This feasibility‐study aims to perform robot‐assisted scaffold implantation and second‐stage flap raising. Methods Firstly, scaffolds were implanted into the greater omentum using the da Vinci Xi surgical system or conventional technique in five miniature pigs, respectively. After 3 months a free flap including the gastrocolic vascular pedicle was harvested and procedures were evaluated. Results The average operation time was 59.2 min for open surgery and 73.8 min for robot‐assisted surgery. The average incision length of open surgery was 11.6 cm. Both techniques led to successful scaffold implantation without any complication. In all cases the scaffolds were integrated as intended and resulted in bone formation. Conclusions Current study demonstrated that the implantation of scaffolds into the greater omentum and flap harvesting using da Vinci Xi surgical system is a promising minimally‐invasive approach in regenerative surgery.

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Bone Tissue Engineering in the Greater Omentum with Computer-Aided Design/Computer-Aided Manufacturing Scaffolds is Enhanced by a Periosteum Transplant

Cited by 4 publications

References 52 publications

Advances in In Vitro and In Vivo Bioreactor-Based Bone Generation for Craniofacial Tissue Engineering

Advances in In Vitro and In Vivo Bioreactor-Based Bone Generation for Craniofacial Tissue Engineering

Periosteal Flaps Enhance Prefabricated Engineered Bone Reparative Potential

Robot‐assisted scaffold implantation and two‐stage flap raising of the greater omentum for reconstruction of the facial skeleton: Description of a novel technique

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