Abstract
Reconstruction of a critical-sized osseous defect is challenging in maxillofacial surgery. Despite novel treatments and advances in supportive therapies, severe complications including infection, nonunion, and malunion can still occur. Here, we aimed to assess the use of a beta-tricalcium phosphate (β-TCP) scaffold loaded with high mobility group box-1 protein (HMGB-1) as a novel critical-sized bone defect treatment in rabbits. The study was performed on 15 specific pathogen-free New Zealand rabbits divided into three groups: Group A had an osseous defect filled with a β-TCP scaffold loaded with phosphate-buffered saline (PBS) (100 µL/scaffold), the defect in group B was filled with recombinant human bone morphogenetic protein 2 (rhBMP-2) (10 µg/100 µL), and the defect in group C was loaded with HMGB-1 (10 µg/100 µL). Micro-computed tomography (CT) examination demonstrated that group C (HMGB-1) showed the highest new bone volume ratio, with a mean value of 66.5%, followed by the group B (rhBMP-2) (31.0%), and group A (Control) (7.1%). Histological examination of the HMGB-1 treated group showed a vast area covered by lamellar and woven bone surrounding the β-TCP granule remnants. These results suggest that HMGB-1 could be an effective alternative molecule for bone regeneration in critical-sized mandibular bone defects.
Highlights
Reconstruction of a critical-sized osseous defect is challenging in maxillofacial surgery
Minor postoperative surgical swelling was observed in five rabbits, which lasted for 3 days, and the rabbits spontaneously recovered without any specific interference
Previous in vitro studies have suggested a direct effect of high mobility group box-1 protein (HMGB-1) on the proliferation and migration of osteoblasts[40] and a critical role for HMGB-1 in bone fracture healing[39]
Summary
Reconstruction of a critical-sized osseous defect is challenging in maxillofacial surgery. We aimed to assess the use of a beta-tricalcium phosphate (β-TCP) scaffold loaded with high mobility group box-1 protein (HMGB-1) as a novel critical-sized bone defect treatment in rabbits. Histological examination of the HMGB-1 treated group showed a vast area covered by lamellar and woven bone surrounding the β-TCP granule remnants These results suggest that HMGB-1 could be an effective alternative molecule for bone regeneration in critical-sized mandibular bone defects. Homologous and heterologous bone grafts are widely used as alternatives, but carry the risks of disease transmission, variable resorption, and potential adverse autoimmune reactions[9] Because of these limitations and the expanding need for bone reconstruction, there is great interest in the use of bone substitutes and tissue e ngineering[10]. Variable outcomes have been reported regarding the use of rhBMP-2 in the craniomaxillofacial area since its approval by the Food and Drug Administration (FDA) in 200723
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