Segmental Bone Reconstruction by Octacalcium Phosphate Collagen Composites with Teriparatide.

Keiko Matsui,Tadashi Kawai,Yushi Ezoe,Shinji Kamakura,Tetsu Takahashi,Toshiki Yanagisawa

doi:10.1089/ten.tea.2020.0150

Keiko Matsui, Tadashi Kawai + Show 4 more

Open Access

https://doi.org/10.1089/ten.tea.2020.0150

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Abstract

Octacalcium phosphate and collagen composite (OCPcol) demonstrated superior bone regeneration and has been commercialized recently in Japan. Teriparatide (TPTD) is a bioactive recombinant form of parathyroid hormone that is approved for osteoporosis treatment. Because mandibular bone reconstruction after segmental resection is a key clinical problem, it was examined whether single-dose local administration of OCPcol with TPTD can affect recovery after this procedure. OCPcol was prepared, and a commercially available hydroxyapatite and collagen composite (HAPcol) was used as a control. A 15 mm length segmental bone defect was made in the mandibular region of male beagle dogs. The experimental animals were divided in four groups. OCPcol treated with TPTD (OCPcol + TPTD), OCPcol, HAPcol treated with TPTD (HAPcol + TPTD), or HAPcol was implanted into the defect. The radiopaque areas of the implanted site were measured and statistically analyzed, and histological examination was performed after 6 months. The value of radiopaque area in total region of OCPcol + TPTD was highest (90.8 ± 7.3 mm2), followed in order by OCPcol (49.3 ± 21.8 mm2), HAPcol + TPTD (10.6 ± 2.3 mm2), and HAPcol (6.4 ± 2.3 mm2), and that of OCPcol + TPTD was significantly higher than that of HAPcol + TPTD or HAPcol. All segmented mandibles of OCPcol + TPTD and a part of those of OCPcol were bridged with newly formed bone, whereas no bone bridges were observed in HAPcol + TPTD or HAPcol. These results suggested that OCPcol treated with TPTD enabled bone reconstruction after segmental mandibular resection more than other three groups.Impact statementOctacalcium phosphate and collagen composite (OCPcol) is a bone regenerative material that has been recently commercialized in Japan. Teriparatide (TPTD) is a recombinant form of parathyroid hormone, and is used for the treatment of osteoporosis. It was investigated whether single-dose local administration of OCPcol with TPTD can repair a canine segmental bone defect, which was supposed to be an intractable bone defect. Compared with OCPcol, hydroxyapatite, and collagen composite (HAPcol) with TPTD, or HAPcol, because OCPcol with TPTD quickly enhanced bone regeneration and bridged the defect, it would be a candidate for the repair of intractable bone defect.

Highlights

To reconstruct large bone defects that cause functional disturbances, autologous bone grafting has been adopted as a gold standard, where bone material is collected from the patient and transplanted to the treatment site or as free flaps with bone.[3]
Postsurgical weight loss was observed in one case in the OCPcol group, they were generally well and no eating disorders and postoperative infections were observed
These results suggest that OCPcol + TPTD group would exhibit excellent bone reconstruction after segmental mandibular resection than OCPcol group, if OCPcol was implanted with a single-dose local administration of TPTD

Summary

Introduction

In the field of reconstructive surgery, the reconstruction of refractory bone defects, such as segmental bone defects that follow the resection of tumors, is a key problem.[1,2] To reconstruct large bone defects that cause functional disturbances, autologous bone grafting has been adopted as a gold standard, where bone material is collected from the patient and transplanted to the treatment site or as free flaps with bone.[3].

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