Abstract
A novel three-dimensional (3D) porous uncalcined and unsintered hydroxyapatite/poly-d/l-lactide (3D-HA/PDLLA) composite demonstrated superior biocompatibility, osteoconductivity, biodegradability, and plasticity, thereby enabling complex maxillofacial defect reconstruction. Mesenchymal stem cells (MSCs)—a type of adult stem cell—have a multipotent ability to differentiate into chondrocytes, adipocytes, and osteocytes. In a previous study, we found that CD90 (Thy-1, cluster of differentiation 90) and CD271 (low-affinity nerve growth factor receptor) double-positive cell populations from human bone marrow had high proliferative ability and differentiation capacity in vitro. In the present study, we investigated the utility of bone regeneration therapy using implantation of 3D-HA/PDLLA loaded with human MSCs (hMSCs) in mandibular critical defect rats. Microcomputed tomography (Micro-CT) indicated that implantation of a 3D-HA/PDLLA-hMSC composite scaffold improved the ability to achieve bone regeneration compared with 3D-HA/PDLLA alone. Compared to the sufficient blood supply in the mandibular defection superior side, a lack of blood supply in the inferior side caused delayed healing. The use of Villanueva Goldner staining (VG staining) revealed the gradual progression of the nucleated cells and new bone from the scaffold border into the central pores, indicating that 3D-HA/PDLLA loaded with hMSCs had good osteoconductivity and an adequate blood supply. These results further demonstrated that the 3D-HA/PDLLA-hMSC composite scaffold was an effective bone regenerative method for maxillofacial boney defect reconstruction.
Highlights
Many patients suffer from mandibular defects due to benign or malignant tumors, trauma, and dysplastic pathologies [1], which can damage chewing function, mental health, and facial esthetics in patients
To evaluate the bone regeneration after implantation, VG staining was performed with undecalcified sections of defected mandibles
Invasion of the implant by newly formed osteoid tissue was clearly observed in the two human MSCs (hMSCs) groups (Figure 6E–H) and was apparent on Micro-CT (Figure 4E–H)
Summary
Many patients suffer from mandibular defects due to benign or malignant tumors, trauma, and dysplastic pathologies [1], which can damage chewing function, mental health, and facial esthetics in patients. Felice et al [3] followed-up bone grafts in 115 patients with posterior mandibular atrophy for 2–7 years. The outcomes of those with heterologous and autogenous bone blocks were similar; heterologous blocks may be preferable because no invasive harvesting is required. An ideal scaffold mimics bone morphology and the functional properties of original bony tissue, is biodegradable and biocompatible, supports early bone regeneration, and is gradually replaced by regenerating tissue [6]. Synthetic β-tricalcium phosphate (β-TCP) has been used to reconstruct bone defects for several years, but is difficult to trim and does not wholly replace natural bone [8]. Β-TCP can only play an ideal role during oromandibular reconstruction
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