Abstract
ObjectiveThe present study aims to increase the concentration of genetically modified bone marrow mesenchymal stem cells (BMSCs) in the distraction osteogenesis (DO) interstitial space and induce the conversion of BMSCs to osteoblasts to improve the osteogenic efficiency in DO and shorten the treatment period.MethodsBone morphogenetic protein 1 (BMP-1) and green fluorescent protein (GFP) gene-modified cell sheets of BMSCs were constructed by tissue engineering. Thirty-six New Zealand white rabbits were randomly divided into three groups: group A (the blank control group), group B (the GFP group) with the injection of GFP gene-modified BMSC sheets into the DO gap, and group C (the BMP-1 group) with the injection of BMP-1 gene-modified BMSC sheets into the DO gap. Rabbits in all three groups were distracted for 5 days at a distraction rate of 2.0 mm/d, once/day. After distraction, the above-mentioned cell sheet suspension was injected into the distraction gap to observe osteogenesis, which was observed by gross specimen observation, micro-computed tomography (Micro-CT) scanning, and histomorphology.ResultsThe gross specimen observation showed that all animals had smooth and continuous bone cortex in the distraction region with relatively high hardness. The osteogenesis quality or hardness was ranked from the highest to the lowest, as Group C > Group B > Group A. Micro-CT and histomorphological observation revealed that group C had better maturation and bone volume of the new bone in the DO region at weeks 3 and 6 than groups B and A.ConclusionBMP-1 gene-modified BMSC sheets could effectively promote the formation of new bone during rapid DO in the mandible, compensating for the poor osteogenesis caused by rapid distraction and providing a new approach to shorten the DO treatment period in clinical practice.
Highlights
The commonly used repair methods in clinical practice include autologous bone grafting, the distraction osteogenesis (DO) technique, and individualized repair prosthesis, among which autologous bone grafting occupies a dominant position in bone defect repair
The results showed that bone marrow mesenchymal stem cell (BMSC) had a good effect on promoting new bone formation, but the osteogenic efficacy should be further improved
In group A, the new bone in the DO region was mainly the fibrous connective tissue, and the new bone tissue on the buccal side was concaved inward compared with the normal bone surface in the proximal and distal middle part, and the original osteotomy line could be clearly observed with the continuity of the bone being interrupted
Summary
Oral and maxillofacial defects and deformities caused by tumors, trauma, infection, congenital malformations, etc., seriously affect the psychological health and quality of life in patients. Due to the unique requirements of maxillofacial anatomy and oral function, the repair and reconstruction of maxillofacial deformities and defects have always been the hot spots and complex areas of concern in oral and maxillofacial surgery. The commonly used repair methods in clinical practice include autologous bone grafting, the distraction osteogenesis (DO) technique, and individualized repair prosthesis, among which autologous bone grafting occupies a dominant position in bone defect repair. Compared with other jaw defect repair methods, the DO technique has many advantages, such as relatively simple surgery, no need to open a second surgical area, and soft and hard tissues can be extended simultaneously, so it is widely adopted in the repair and reconstruction of various craniomaxillofacial defects [2, 3].
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