Mandibular Defect Model Research Articles

A Mini-Pig Mandibular Defect Model for Evaluation of Craniomaxillofacial Bone Regeneration.

Craniomaxillofacial bone defects represent a clinical challenge in the fields of maxillofacial surgery and (implant) dentistry. Regeneration of these bone defects requires the application of bone graft materials that facilitate new bone formation in a safe, reliable, and predictive manner. In addition to autologous bone graft, several types of (synthetic) bone substitute materials have become clinically available, and still major efforts are focused on improving such bone substitute materials by optimizing their properties. Given the regulatory necessity to evaluate the performance of new bone substitute materials for craniomaxillofacial bone regeneration in a large animal model with similarity to human bone before clinical application, we here describe a mini-pig mandibular bone defect model that allows for the creation of multiple (critical-size) bone defects within the mandibular body of a single animal. As examples of bone substitute materials, we utilize both the clinically used BioOss granules and an experimental calcium phosphate cement for filling the created defects. Regarding the latter, its advantages are the injectable application within the defect site, in which the material rapidly sets, and the tailorable degradation properties via the inclusion of hydrolytically degrading polymeric particles. For both bone substitute materials, we show the suitability of the bone defect model to assess bone regeneration via histology and micro-computed tomography. Impact statement Given the regulatory necessity to evaluate the performance of new bone substitute materials for craniomaxillofacial bone regeneration in a large animal model with similarity to the human bone before clinical application, we here describe a mini-pig mandibular bone defect model that allows for the creation of multiple (critical-size) bone defects within the mandibular body of a single animal that can be used for the evaluation of the bone regenerative capacity of new bone grafting materials as well as tissue-engineered products for alveolar bone regeneration.

Repair of a Rat Mandibular Bone Defect by Hypertrophic Cartilage Grafts Engineered From Human Fractionated Adipose Tissue.

Background: Devitalized bone matrix (DBM) is currently the gold standard alternative to autologous bone grafting in maxillofacial surgery. However, it fully relies on its osteoconductive properties and therefore requires defects with healthy bone surrounding. Fractionated human adipose tissue, when differentiated into hypertrophic cartilage in vitro, was proven reproducibly osteogenic in vivo, by recapitulating endochondral ossification (ECO). Both types of bone substitutes were thus compared in an orthotopic, preclinical mandibular defect model in rat. Methods: Human adipose tissue samples were collected and cultured in vitro to generate disks of hypertrophic cartilage. After hypertrophic induction, eight samples from two donors were implanted into a mandible defect in rats, in parallel to Bio-Oss® DBM granules. After 12 weeks, the mandible samples were harvested and evaluated by Micro-CT and histology. Results: Micro-CT demonstrated reproducible ECO and complete restoration of the mandibular geometry with adipose-based disks, with continuous bone inside and around the defect, part of which was of human (donor) origin. In the Bio-Oss® group, instead, osteoconduction from the border of the defect was observed but no direct connection of the granules with the surrounding bone was evidenced. Adipose-based grafts generated significantly higher mineralized tissue volume (0.57 ± 0.10 vs. 0.38 ± 0.07, n = 4, p = 0.03) and newly formed bone (18.9 ± 3.4% of surface area with bone tissue vs. 3 ± 0.7%, p < 0.01) than Bio-Oss®. Conclusion: Our results provide a proof-of-concept that adipose-based hypertrophic cartilage grafts outperform clinical standard biomaterials in maxillofacial surgery.

Patient-Specific Bioimplants and Reconstruction Plates for Mandibular Defects: Production Workflow and In Vivo Large Animal Model Study.

A major challenge with extensive craniomaxillofacial bone reconstruction is the limited donor-site availability to reconstruct defects predictably and accurately according to the anatomical shape of the patient. Here, patient-specific composite bioimplants, consisting of cross-linked poly(trimethylene carbonate) (PTMC) networks and β-tricalcium phosphate (β-TCP), are tested in vivo in twelve Göttingen minipigs in a large mandibular continuity defect model. The 25mm defects are supported by patient-specific titanium reconstruction plates and receive either osteoconductive composite bioimplants (PTMC+TCP), neat polymer network bioimplants (PTMC), autologous bone segments (positive control), or are left empty (negative control). Postoperatively, defects treated with bioimplants show evident ossification at 24 weeks. Histopathologic evaluation reveals that neat PTMC bioimplant surfaces are largely covered with fibrous tissue, while in the PTMC+TCP bioimplants, bone attached directly to the implant surface shows good osteoconduction and histological signs of osteoinductivity. However, PTMC+TCP bioimplants are associated with high incidence of necrosis and infection, possibly due to rapid resorption and/or particle size of the used β-TCP. The study highlights the importance of testing bone regeneration implants in a clinically relevant large animal model and at the in situ reconstruction site, since results on small animal models and studies in nonloadbearing areas do not translate directly.

The W9 peptide inhibits osteoclastogenesis and osteoclast activity by downregulating osteoclast autophagy and promoting osteoclast apoptosis.

The W9 peptide has been shown to act as a receptor activator for nuclear factor-κB ligand (RANKL) antagonist and tumor necrosis factor (TNF)-α antagonist, which can promote bone formation and inhibit bone resorption. Studies on the W9 peptide at the cellular level have mainly focused on osteoblasts, and little research on the mechanism by which the W9 peptide regulates osteoclasts has been reported, which was the aim of this work. In this study, a rat mandibular defect model was established in vivo and implanted with hydrogel containing the W9 peptide for 2weeks and 4weeks, and histochemical staining was used to evaluate the formation of new bone and the changes in osteoclasts. RAW264.7 cells were cultured in vitro for osteoclast induction, and different concentrations of W9 peptide were added. Tartrate resistant acid phosphatase staining, monodansylcadaverine staining, TdT-mediated dUTP Nick-End Labeling assay, real-time PCR and Western blot were used to detect osteoclast differentiation, autophagy and apoptosis. Our results showed that the W9 peptide could reduce osteoclastogenesis and osteoclast activity induced by RANKL, and these effects were partly due to the inhibition of osteoclast autophagy. On the other hand, the W9 peptide could promote mature osteoclast apoptosis, in which autophagy might play an antagonistic role. Taken together, these results suggest that the W9 peptide inhibits osteoclastogenesis and osteoclast activity by downregulating osteoclast autophagy and promoting osteoclast apoptosis. Our results will benefit the development and application of new small molecule peptides for the treatment of bone resorption diseases.

Immunomodulatory effects of tricalcium silicate-based cements on osteogenesis

Although the effects of tricalcium silicate-based cements (TSCs) on osteogenesis have been extensively investigated, their immunomodulatory role on bone regeneration remains elusive. The present study investigated how TSCs modulate bone regeneration by inducing macrophage polarization. The ex vivo part of the study evaluated the effects of two TSCs on mouse bone marrow-derived macrophages (mBMDMs), and on the osteogenic potential of mouse bone marrow mesenchymal stromal cells (mBMMSCs) that had been co-cultured with TSC-exposed mBMDMs. The in vivo part of the study utilized a rat mandibular defect model to investigate the osteogenic effects of the TSCs on healing of bone defects. Immunofluorescence and immunohistochemistry were used to identify polarization of the macrophages adjacent to bone defects and their cytokine secretion in vivo. The TSCs induced mBMDMs to polarize into the M2 phenotype ex vivo. Osteogenic differentiation of mBMMSCs was enhanced when these cells were co-cultured with mBMDMs that had been exposed to either TSC at non-cytotoxic concentrations. In vivo observations of more profuse new bone formation, presence of defect-adjacent macrophages with M2 phenotype and expression of osteogenesis-related cytokines are indicative of the immunomodulatory role played by TSCs on bone regeneration. This is achieved via induction of macrophage polarization into the M2 phenotype.

Enhancement of jaw bone regeneration via ERK1/2 activation using dedifferentiated fat cells

Background aimsMesenchymal stem/stromal cells (MSCs) are multipotent and self-renewing cells that are extensively used in tissue engineering. Adipose tissues are known to be the source of two types of MSCs; namely, adipose tissue–derived MSCs (ASCs) and dedifferentiated fat (DFAT) cells. Although ASCs are sometimes transplanted for clinical cytotherapy, the effects of DFAT cell transplantation on mandibular bone healing remain unclear. MethodsThe authors assessed whether DFAT cells have osteogenerative potential compared with ASCs in rats in vitro. In addition, to elucidate the ability of DFAT cells to regenerate the jaw bone, the authors examined the effects of DFAT cells on new bone formation in a mandibular defect model in (i) 30-week-old rats and (ii) ovariectomy-induced osteoporotic rats in vivo. ResultsOsteoblast differentiation with bone morphogenetic protein 2 (BMP-2) or osteogenesis-induced medium upregulated the osteogenesis-related molecules in DFAT cells compared with those in ASCs. BMP-2 activated the phosphorylation signaling pathways of ERK1/2 and Smad2 in DFAT cells, but minor Smad1/5/9 activation was noted in ASCs. The transplantation of DFAT cells into normal or ovariectomy-induced osteoporotic rats with mandibular defects promoted new bone formation compared with that seen with ASCs. ConclusionsDFAT cells promoted osteoblast differentiation and new bone formation through ERK1/2 and Smad2 signaling pathways in vitro. The transplantation of DFAT cells promoted new mandibular bone formation in vivo compared with that seen with ASCs. These results suggest that transplantation of ERK1/2-activated DFAT cells shorten the mandibular bone healing process in cytotherapy.

Human amnion-derived mesenchymal stem cells promote osteogenic differentiation of lipopolysaccharide-induced human bone marrow mesenchymal stem cells via ANRIL/miR-125a/APC axis

Background and aimPeriodontitis is a chronic inflammatory disease inducing the absorption of alveolar bone and leading to tooth loss. Human amnion-derived mesenchymal stem cells (HAMSCs) have been used for studying inflammatory processes. This study aimed to explore the role of long noncoding RNA (lncRNA) antisense noncoding RNA in the INK4 locus (ANRIL) in HAMSC-driven osteogenesis in lipopolysaccharide (LPS)-induced human bone marrow mesenchymal stem cells (HBMSCs).MethodsThe cells were incubated with a co-culture system. Reactive oxygen species (ROS) level and superoxide dismutase (SOD) activity were used to detect the oxidative stress level. Flow cytometry was performed to determine cell proliferation. The alkaline phosphatase (ALP) activity, Alizarin red assay, cell transfection, and rat mandibular defect model were used to evaluate the osteogenic differentiation. Quantitative real-time reverse transcription–polymerase chain reaction (RT-PCR), Western blot analysis, dual-luciferase reporter assay, and immunofluorescence staining were used to evaluate the molecular mechanisms.ResultsThis study showed that HAMSCs promoted the osteogenesis of LPS-induced HBMSCs, while the ANRIL level in HBMSCs decreased during co-culture. ANRIL had no significant influence on the proliferation of LPS-induced HBMSCs. However, its overexpression inhibited the HAMSC-driven osteogenesis in vivo and in vitro, whereas its knockdown reversed these effects. Mechanistically, this study found that downregulating ANRIL led to the overexpression of microRNA-125a (miR-125a), and further contributed to the competitive binding of miR-125a and adenomatous polyposis coli (APC), thus significantly activating the Wnt/β-catenin pathway.ConclusionThe study indicated that HAMSCs promoted the osteogenic differentiation of LPS-induced HBMSCs via the ANRIL/miR-125a/APC axis, and offered a novel approach for periodontitis therapy.

Comparison of splinted and non-splinted superstructures of three implants placed in a mandibular distal extension model with missing teeth using modal analysis

This study evaluated the effects of two types of superstructures (splinted crown and non-splinted crown) on four vibration characteristics (natural frequency, damping ratio (DAR), vectors in antiphase, maximum displacement (MDP)) by using modal analysis. These structures were fabricated on three implants placed in the mandibular free-end defect model. After placing three implants on a mandibular distal extension model with missing teeth, the three-unit splinted and non-splinted crowns were designed on the CAD software. Subsequently, the zirconia disc was milled using a milling machine to produce the superstructures (n = 5). After establishing four measurement points on each crown of the prostheses, a vibration was applied to the mandible model with an impact hammer, and the transfer function of each measurement point was identified. Using the modal analysis software, the natural frequency and damping ratios were calculated from the transfer function, modal shapes at each natural frequency were observed, and maximum displacement that takes into account the lateral force during mastication was simulated. The t-test was performed for each of the averaged values of natural frequency, maximum displacement, and damping ratio (p < 0.05). Mann-Whitney U test was performed on the average of the number of vectors in antiphase (p < 0.05). The mean natural frequency was significantly higher in the splinted crown (758.2 ± 2.8 Hz) than that in the non-splinted crown (752.8 ± 3.7 Hz) (P = 0.047). The mean damping ratio was not significantly different for the splinted (3.3 ± 0.2%) and non-splinted crowns (3.2 ± 0.3%) (P = 0.535). The average number of vectors in antiphase was significantly smaller in the non-splinted crown (4.4 ± 0.9) than in the splinted crown (10 ± 2.5) (P = 0.008). The mean value of the maximum displacement was significantly smaller in the splinted crown (6.7 ± 1.1 μm) than that in the non-splinted crown (7.3 ± 0.6 μm) (P = 0.048). Within the limitations of this study, the vibration characteristics of the superstructures differed between designs with splinted and non-splinted crowns. Crown splinting increased the rigidity and natural frequency and decreased the MDP. However, the higher number of vectors in antiphase indicated more twists in the superstructures during vibration. The non-splinted crowns showed a lower natural frequency and a greater maximum displacement; however, they comprised fewer vectors in antiphase, indicating that the twist during vibration was less than that observed with the splinted crowns. Thus, our results suggest that crown splinting reduces the deformation of the superstructure, implants, and the surrounding tissues in comparison to the deformation observed when no splinting is performed.

Xenogeneic mesenchymal stem cell transplantation for mandibular defect regeneration.

It is commonly accepted that xenogeneic stem cell transplantation for tissue engineering is faced with host immune rejection. Using a rat critical-size mandibular defect model, this study examined whether the immune rejection can be evaded by diminishing T-cell immunity. To examine donor cell survival and host immune reaction, pig bone marrow-derived mesenchymal stem cells (BM-MSCs) were labeled with CM-DiI, loaded onto gelatin sponge (5×106 cells/scaffold), and transplanted into 5-mm mandibular defects of immunocompetent and T cell-deficient athymic rats. To examine the effects of xenogeneic BM-MSCs on bone regeneration, athymic rats undergone the same surgeries were terminated at post-operative weeks 1, 3, and 6. Control rats underwent the same jaw surgery without BM-MSC transplantation. The density of CM-DiI-labeled BM-MSCs decreased with time in both strains of rats. Although it was substantially higher in athymic rats than in immunocompetent rats at post-operative day 1, by day 3-7 the density became comparable between the two strains of rats. Apoptosis reflected by cleaved Caspase-3 staining was low in both strains. Stronger infiltration of neutrophils, macrophages, B cells and CD8+ T cells was found in MSC-treated animals. In athymic rats, infiltration of neutrophils and macrophages was strong, but it occurred later than that in immunocompetent rats. While bone volume fraction significantly increased with time (P<.001), no difference was found between MSC-treated and control groups. Even in hosts with deficient T-cell immunity, xenogeneic BM-MSC transplantation into mandibular critical-sized defects still faces challenges from host innate immunity, which compromises their regenerative efficacy.

A 2-stage Approach to Craniofacial Reconstruction in an Infected Ovine Mandibular Defect Model

A 2-stage Approach to Craniofacial Reconstruction in an Infected Ovine Mandibular Defect Model

Hydroxyapatite nanowires modified polylactic acid membrane plays barrier/osteoinduction dual roles and promotes bone regeneration in a rat mandible defect model.

Periodontitis is an inflammatory disease leading to tooth loss, alveolar bone absorption and disorder of masticatory function. Guided tissue regeneration (GTR) is one of the most common strategies for regeneration of lost periodontium. During surgical process, barrier membranes, and osteoinductive/osteoconductive materials should be placed, respectively, which may increase risks of infection, bleeding, and difficulty of operation. Here, we introduced a new kind of hydroxyapatite (HAp) nanowires modified polylactic acid (PLA) membrane to achieve barrier/osteoinduction dual functions. The physicochemical property measurements suggested the two sides of the composite membrane did not change after composition. Then a rat mandibular defect model was established to investigate barrier and osteoinductive effects of this composite membrane. After implantation, effects of functional cells engraftment and osteoinduction were detected by scanning electron microscope (SEM), histomorphometric measurement, immunohistochemical staining, and Micro-CT scanning. SEM images showed HAp side engrafted more cells than PLA side. The result of immunohistochemical staining suggested HAp/PLA promoted the expression of bone-related markers. Moreover, there were more newly formed bones with better quality in HAp/PLA group. Therefore, this composite membrane would be a promising biomaterial in tissue engineering for bone regeneration due to its barrier/osteoinduction dual functions. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 3099-3110, 2018.

Effect of Multilaminate Small Intestinal Submucosa as a Barrier Membrane on Bone Formation in a Rabbit Mandible Defect Model.

A barrier membrane (BM) is essential for guided bone regeneration (GBR) procedures. Absorbable BMs based on collagen have been widely applied clinically due to their excellent biocompatibility. The extracellular matrix (ECM) provides certain advantages that can compensate for the rapid degradation and insufficient mechanical strength of pure collagen membrane due to the porous scaffold structure. Recently, small intestinal submucosa (SIS), one of the most widely used ECM materials, has drawn much attention in bone tissue engineering. In this study, we adopted multilaminate SIS (mSIS) as a BM and evaluated its in vivo and in vitro properties. mSIS exhibited a multilaminate structure with a smooth upper surface and a significantly coarser bottom layer according to microscopic observation. Tensile strength was 13.10 ± 2.56 MPa. In in vivo experiments, we selected a rabbit mandibular defect model and subcutaneous implantation to compare osteogenesis and biodegradation properties with one of the most commonly used commercial collagen membranes. mSIS was retained for up to 3 months and demonstrated longer biodegradation time than commercial collagen membrane. Quantification of bone regeneration revealed significant differences in each group. Micro-computed tomography (micro-CT) revealed that the quantity and maturity of bones in the mSIS group were significantly higher than those in the blank control group (P < 0.05) and were similar to those in a commercial collagen membrane group (P > 0.05) at 4 and 12 weeks after surgery. Hematoxylin and eosin staining revealed large amounts of mature lamellar bone at 12 weeks in mSIS and commercial collagen membrane groups. Therefore, we conclude that mSIS has potential as a future biocompatible BM in GBR procedures.

PEEK‑biphasic bioceramic composites promote mandibular defect repair and upregulate BMP‑2 expression in rabbits

The present study aimed to investigate whether bone morphogenetic protein-2 (BMP-2) was involved in the repair of mandibular defects using polyether-ether-ketone biphasic bioceramic (PEEK-BBC) composites in rabbits. PEEK-BBC composites with abundant and interconnected pores were prepared by calcination and characterized by scanning electron microscope. A mandibular defect model in rabbits was established using dental grinder to produce a square hole. A total of 60 rabbits were divided into four groups: Control, sham, surgery, and PEEK. In the PEEK group, the holes were filled with the PEEK-BBC composite stents. In the surgery group, the holes were produced but not filled with the composite stents. In the sham group, only the molar grooves were exposed and grinding was not performed. Animals without any treatment served as the control group. The success rate of model establishment was 100%. At 4, 8, and 16 weeks after the model was established, samples were collected from the molding sites. Bone repair was evaluated by H&E staining and Goldner trichrome staining. Bone structures in both control and sham groups were intact. A small number of osteocytes were observed in the surgery group. However, in the PEEK group, osteocytes were already evidently present in the composites at 4 weeks after surgery. At 8 and 16 weeks, there were large numbers of osteocytes in the pores of the composites. The mRNA and protein expression levels of BMP-2 were determined by reverse transcription-quantitative polymerase chain reaction and western blotting, respectively. The mRNA and protein expression levels of BMP-2 between the control and sham groups were similar and were continuously stable. However, following defect treatment, BMP-2 mRNA and protein expression was upregulated, which was enhanced by the PEEK-BBC composites. In conclusion, PEEK-BBC composites promoted the growth of osteocytes and repaired mandibular defects in rabbits, potentially via the upregulation of BMP-2 expression.

Electron beam melting in the fabrication of three-dimensional mesh titanium mandibular prosthesis scaffold

The study was designed to fulfill effective work-flow to fabricate three-dimensional mesh titanium scaffold for mandibular reconstruction. The 3D titanium mesh scaffold was designed based on a volunteer with whole mandible defect. (1) acquisition of the CT data; (2) design with computer aided design (CAD) and finite element analysis (FEA). The pore size and intervals with the best mechanic strength was also calculated using FEA. (3) fabrication of the scaffold using electron beam melting (EBM); (4) implantation surgery. The case recovered well, without loosening and rejection. Additionally, 12 mandibular defect model beagles were used to verify the results. The model was established via tooth extraction and mandibular resection surgeries, and the scaffold was designed individually based on CT data obtained at 2 weeks after extraction operation. Then scaffolds were fabricated using 3D EBM, and the implantation surgery was performed at 2 months after extraction operation. All the animals healed well after implantation, and the grafted mandibular recovered well with time. The relevant parameters of the grafted mandibular were nearly to the native mandibular at postoperative 12 months. It is feasible to fabricate mesh titanium scaffold for repairing mandibular defects individually using reverse engineering, CAD and EBM techniques.

Antibody-Mediated Osseous Regeneration for Bone Tissue Engineering in Canine Segmental Defects

Among many applications of therapeutic monoclonal antibodies (mAbs), a unique approach for regenerative medicine has entailed antibody-mediated osseous regeneration (AMOR). In an effort to identify a clinically relevant model of craniofacial defect, the present study investigated the efficacy of mAb specific for bone morphogenetic protein- (BMP-) 2 to repair canine segmental mandibular continuity defect model. Accordingly, a 15 mm unilateral segmental defect was created in mandible and fixated with a titanium plate. Anorganic bovine bone mineral with 10% collagen (ABBM-C) was functionalized with 25 μg/mL of either chimeric anti-BMP-2 mAb or isotype-matched mAb (negative control). Recombinant human (rh) BMP-2 served as positive control. Morphometric analyses were performed on computed tomography (CT) and histologic images. Bone densities within healed defect sites at 12 weeks after surgery were 1360.81 ± 10.52 Hounsfield Unit (HU), 1044.27 ± 141.16 HU, and 839.45 ± 179.41 HU, in sites with implanted anti-BMP-2 mAb, rhBMP-2, and isotype mAb groups, respectively. Osteoid bone formation in anti-BMP-2 mAb (42.99% ± 8.67) and rhBMP-2 (48.97% ± 2.96) groups was not significantly different but was higher (p < 0.05) than in sites with isotype control mAb (26.8% ± 5.35). In view of the long-term objective of translational application of AMOR in humans, the results of the present study demonstrated the feasibility of AMOR in a large clinically relevant animal model.

Three dimensionally printed bioactive ceramic scaffold osseoconduction across critical-sized mandibular defects

BackgroundVascularized bone tissue transfer, commonly used to reconstruct large mandibular defects, is challenged by long operative times, extended hospital stay, donor-site morbidity, and resulting health care. 3D-printed osseoconductive tissue-engineered scaffolds may provide an alternative solution for reconstruction of significant mandibular defects. This pilot study presents a novel 3D-printed bioactive ceramic scaffold with osseoconductive properties to treat segmental mandibular defects in a rabbit model. MethodsFull-thickness mandibulectomy defects (12 mm) were created at the mandibular body of eight adult rabbits and replaced by 3D-printed ceramic scaffold made of 100% β-tricalcium phosphate, fit to defect based on computed tomography imaging. After 8 weeks, animals were euthanized, the mandibles were retrieved, and bone regeneration was assessed. Bone growth was qualitatively assessed with histology and backscatter scanning electron microscopy, quantified both histologically and with micro computed tomography and advanced 3D image reconstruction software, and compared to unoperated mandible sections (UMSs). ResultsHistology quantified scaffold with newly formed bone area occupancy at 54.3 ± 11.7%, compared to UMS baseline bone area occupancy at 55.8 ± 4.4%, and bone area occupancy as a function of scaffold free space at 52.8 ± 13.9%. 3D volume occupancy quantified newly formed bone volume occupancy was 36.3 ± 5.9%, compared to UMS baseline bone volume occupancy at 33.4 ± 3.8%, and bone volume occupancy as a function of scaffold free space at 38.0 ± 15.4%. Conclusions3D-printed bioactive ceramic scaffolds can restore critical mandibular segmental defects to levels similar to native bone after 8 weeks in an adult rabbit, critical sized, mandibular defect model.

Multivalent ion-based in situ gelling polysaccharide hydrogel as an injectable bone graft

We prepared in situ gelling alginate (ALG)/hyaluronic acid (HA) hydrogels with a controllable gelation rate using CaSO4 as a crosslinking agent and Na2HPO4 as a crosslinking retardation agent. The ALG/HA hydrogels provided sustained release of bone morphogenetic protein-2 (BMP-2) immobilized in the hydrogels over 5 weeks. The BMP-2-immobilized ALG/HA hydrogels with different ALG/HA ratios were investigated for their in vitro osteogenic differentiation behavior of human bone marrow stem cells (hBMSCs) and in vivo bone regeneration behavior using an animal model (mandibular defect model of miniature pigs). Our findings from cell culture and animal study demonstrated that the osteogenic differentiation of hBMSCs was improved with increasing HA composition in the hydrogel. The hBMSCs/BMP-2-immobilized ALG/HA hydrogel allowed greatly enhanced osteogenic differentiation of hBMSCs (in vitro) and bone regeneration (in vivo) compared with the ALG/HA hydrogel itself and single hBMSCs- or BMP-2-immobilized hydrogel groups.

ID: 1045 Oxygen carrier containing microparticles for prolonged cell survival and effective bone regeneration

The organ transplantation is considered as an effective therapeutic method for organ failure. However, the shortage of donor organ and the immunological rejection are still remained as a big huddle in clinical fields. As an alternative, the tissue-engineering approach for functional organ replacement is extensively studied. The 3D porous scaffolds which guide growth and differentiation of cells are widely utilized as a vital factor with autologotic cells and growth factors for tissue engineering. However, cell necrosis in the center of 3D cell scaffold, due to the insufficient oxygen diffusion is considered as critical limitation for the formation of 3D tissues. Recently, various oxygen delivering/releasing materials have been studied to overcome this limitation. In this study, we developed a perfluorooctane (PFO)-loaded hollow microparticles (PFO-HP) which can allow sustained oxygen delivery for sufficient period, and thus provide appropriate environment for cell survival even in hypoxia. Cell (human periosteum-derived cell, hPDC) behaviors (proliferation, apoptosis, protein synthesis, etc.) in hypoxia (1% O2 and 5% CO2) were evaluated for 28 days. And osteogenic differentiation of cell [alkaline phosphatase (ALP activity), calcium deposition, immunocytochemistry, and RT-PCR (RUNX2, collagen type Ⅰ, osteocalcin, osteonectin)] after 10 days exposure in hypoxic condition was also investigated. New bone formation (histology, CT) of the cell-loaded PFO-HP and PBS-HP was also investigated using a miniature pig (mandibular defect model).

Small molecule-mediated tribbles homolog 3 promotes bone formation induced by bone morphogenetic protein-2

Although bone morphogenetic protein-2 (BMP2) has demonstrated extraordinary potential in bone formation, its clinical applications require supraphysiological milligram-level doses that increase postoperative inflammation and inappropriate adipogenesis, resulting in well-documented life-threatening cervical swelling and cyst-like bone formation. Recent promising alternative biomolecular strategies are toward promoting pro-osteogenic activity of BMP2 while simultaneously suppressing its adverse effects. Here, we demonstrated that small molecular phenamil synergized osteogenesis and bone formation with BMP2 in a rat critical size mandibular defect model. Moreover, we successfully elicited the BMP2 adverse outcomes (i.e. adipogenesis and inflammation) in the mandibular defect by applying high dose BMP2. Phenamil treatment significantly improves the quality of newly formed bone by inhibiting BMP2 induced fatty cyst-like structure and inflammatory soft-tissue swelling. The observed positive phenamil effects were associated with upregulation of tribbles homolog 3 (Trib3) that suppressed adipogenic differentiation and inflammatory responses by negatively regulating PPARγ and NF-κB transcriptional activities. Thus, use of BMP2 along with phenamil stimulation or Trib3 augmentation may be a promising strategy to improve clinical efficacy and safety of current BMP therapeutics.

Nanophase bone substitute for craniofacial load bearing application: Pilot study in the rodent.

An exploratory pilot study shows that a rodent mandibular defect model is useful in determining the biological response to a nanophase collagen/apatite composite designed as a biomimetic load-bearing bone substitute. Using a critical size defect, eight groups of rats (n = 3) were implanted with four renditions of the nanophase bone substitute (NBS) biomaterial. Each rendition was tested with and without recombinant human bone morphogenetic protein 2 (BMP2). NBS biomaterial renditions were: baseline, hyper-densified, d-ribose crosslinked, and d-ribose crosslinked and hyper-densified. Biological outcomes were assessed surgically, radiologically, and histologically. With the limited power available due to the small N's involved, some interesting hypotheses were generated that will be more fully investigated in future studies. BMP2 loaded NBS, when uncrosslinked, resulted in robust bone formation in the entire defect volume (regardless of porosity). Unloaded NBS were well tolerated but did not cause significant new bone formation in the defect volume. Densification alone had little effect on in vivo performance. Crosslinking thwarted implant uptake of BMP2 and resulted in fibrous encapsulation. It is concluded that the nanophase bone substitute is well tolerated in this bone defect model. When loaded with BMP2, implantation resulted in complete bony healing and defect closure with implant density (porosity) having little effect on bone healing or remodeling. Without BMP2 the biomaterial did not result in defect closure. Crosslinking, necessary to increase mechanical properties in an aqueous environment, disrupts osteointegration and BMP2 uptake. Alternate implant fabrication strategies will be necessary to achieve an improved balance between material strength and osteointegration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 520-532, 2018.