Transformation of a prefabricated hydroxyapatite/osteogenic protein-1 implant into a vascularised pedicled bone flap in the human chest

Heliotis, Manolis; Lavery, K.M.; Ripamonti, Ugo; Tsiridis, Eleftherios; Silvio, L. Di

doi:10.1016/j.ijom.2005.07.013

Cited by 100 publications

(122 citation statements)

References 22 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…The advanced development of growth factor delivery strategies to ensure the sustained release of one or more cytokines and enhancement of the vascular bed have shown promising results with regards to the regeneration of large bony defects 15 . Surgeons have investigated other methods to tackle the problem of vascularity at the recipient site by rotating a pedicled muscle flap, due to its adequate and reliable blood supply, to the surgical defect to induce bone formation [16][17][18] . Muscle has the propensity to form bone; it has been shown that the inclusion of alloplastic material into skeletal muscle induces bone formation in vivo [19][20][21] .…”

Section: Introductionmentioning

confidence: 99%

A Novel Surgical Approach for the Reconstruction of Critical-Size Mandibular Defects Using Calcium Sulphate/Hydroxyapatite Cement, BMP-7 and Mesenchymal Stem Cells-Histological Assessment

Alfotawi¹,

Ayoub²,

Tanner³

et al. 2016

j biomater tissue eng

View full text Add to dashboard Cite

A novel construct has been developed to induce bone formation within a pedicle muscle flap. A critical size defect (20 × 15 mm 2 ) was created in the mandible of ten rabbits. The masseter muscle was adapted to fill the surgical defect and a combination of calcium sulphate/hydroxyapatite cement (CERAMENT™lSPINE SUPPORT), BMP-7 and rabbits' mesenchymal stromal cells (rMSCs) was injected into the muscle tissue. Bone regeneration was evaluated 3 months after surgery. Limited areas of bone formation anatomically bridged the defect, despite the new bone forming throughout the muscle and within the connective tissue surrounding the remnants of the cement. The bone was thicker in the bucco-lingual direction compared to the contra lateral (non-operated) side. Quantitative histomorphometry assessment showed that the average bone surface area was 21.2±6.0 mm 2 , this was significantly greater than that of the contra-lateral nonoperating control side. The calculated amounts of residual cement and soft tissue or spaces were 20±12% and 41±10%, respectively. The average mineral apposition rate (MAR) was 1.92 µm/day. The findings demonstrated the remarkable potential of the use of local muscle flaps for injectable bio-cement loaded with BMP and seeded with rMSCs to induce bone formation for the reconstruction of bony defects. Keywords: bone, Bioengineering, scaffolding, calcium sulphate Figure 1 Summary of the in-vitro and in-vivo research protocol. A) bone marrow aspiration from the posterior iliac crest; B) bone marrow aspirate ready for rMSCs isolation, expansion and culture; C) Cell suspension prepared for re-implantation in vivo, D) Dissection of the masseter muscle into superficial and deep layer; E) Creation of critical size defect of the ramus of the mandible; F) Adaptation of the masseter muscle into the defect and around the titanium plate; G) injection of the bio-cement; I) Osseo-induction under the effect of cement, BMP-7 and rMSCs; J) Ideal scenario of bone regeneration after 3 months.

show abstract

Section: Introductionmentioning

confidence: 99%

A Novel Surgical Approach for the Reconstruction of Critical-Size Mandibular Defects Using Calcium Sulphate/Hydroxyapatite Cement, BMP-7 and Mesenchymal Stem Cells-Histological Assessment

Alfotawi¹,

Ayoub²,

Tanner³

et al. 2016

j biomater tissue eng

View full text Add to dashboard Cite

show abstract

“…More advanced surgical techniques were advocated to overcome the problems of the limited vascularity at the surgical defects ''the recipient site'' by utilizing local skeletal muscle flap to induce bone formation due to its reliable source of adequate blood supply [11][12][13]. The muscle has the propensity to induce bone formation because of its intrinsic osteogenic potential when exposed to osteogenic stimuli including bone matrix substitutes and bone morphgenic proteins (BMP) [14].…”

Section: Introductionmentioning

confidence: 99%

Radiological assessment of bioengineered bone in a muscle flap for reconstruction of a critical-size mandibular defect

Al-Fotawei

Odell

Naudi

et al. 2015

International Journal of Oral and Maxillofacial Surgery

View full text Add to dashboard Cite

This study presents a comprehensive radiographic evaluation of bone regeneration within a pedicled muscle flap for the reconstruction of critical size mandibular defect. The surgical defect (20 mm615 mm) was created in the mandible of ten experimental rabbits. The masseter muscle was adapted to fill the surgical defect, a combination of calcium sulphate/ hydroxyapatite cement (CERAMENT TM |SPINE SUPPORT), BMP-7 and rabbit mesenchymal stromal cells (rMSCs) was injected inside the muscle tissue. Radiographic assessment was carried out on the day of surgery and at 4, 8, and 12 weeks postoperatively. At 12 weeks, the animals were sacrificed and cone beam computerized tomography (CBCT) scanning and micro-computed tomography (m-CT) were carried out. Clinically, a clear layer of bone tissue was identified closely adherent to the border of the surgical defect. Sporadic radio-opaque areas within the surgical defect were detected radiographically. In comparison with the opposite non operated control side, the estimated quantitative scoring of the radio-opacity was 46.6% 615, the mean volume of the radio-opaque areas was 63.4% 620. Areas of a bone density higher than that of the mandibular bone (+35% 625%) were detected at the borders of the surgical defect. The micro-CT analysis revealed thinner trabeculae of the regenerated bone with a more condensed trabecular pattern than the surrounding native bone. These findings suggest a rapid deposition rate of the mineralised tissue and an active remodelling process of the newly regenerated bone within the muscle flap. The novel surgical model of this study has potential clinical application; the assessment of bone regeneration using the presented radiolographic protocol is descriptive and comprehensive. The findings of this research confirm the remarkable potential of local muscle flaps as local bioreactors to induce bone formation for reconstruction of maxillofacial bony defects.

show abstract

“…10 In combination with growth factors and scaffold material, the in vivo bioreactor approach has been utilized in humans to repair large mandibular defects in pilot studies. [11][12][13] However, the introduction of growth factors to a system for use in the craniofacial region carries risks of tissue overgrowth, nerve impingement, and additional regulatory challenges. 14 To that effect, strategies utilizing in vivo bioreactors without exogenous growth factors are being explored.…”

mentioning

confidence: 99%

Autologously Generated Tissue-Engineered Bone Flaps for Reconstruction of Large Mandibular Defects in an Ovine Model

Tatara

Kretlow

Spicer

et al. 2015

Tissue Engineering Part A

View full text Add to dashboard Cite

Transformation of a prefabricated hydroxyapatite/osteogenic protein-1 implant into a vascularised pedicled bone flap in the human chest

Cited by 100 publications

References 22 publications

A Novel Surgical Approach for the Reconstruction of Critical-Size Mandibular Defects Using Calcium Sulphate/Hydroxyapatite Cement, BMP-7 and Mesenchymal Stem Cells-Histological Assessment

A Novel Surgical Approach for the Reconstruction of Critical-Size Mandibular Defects Using Calcium Sulphate/Hydroxyapatite Cement, BMP-7 and Mesenchymal Stem Cells-Histological Assessment

Radiological assessment of bioengineered bone in a muscle flap for reconstruction of a critical-size mandibular defect

Autologously Generated Tissue-Engineered Bone Flaps for Reconstruction of Large Mandibular Defects in an Ovine Model

Contact Info

Product

Resources

About