BACKGROUND Critically sized bone defects represent a significant challenge to orthopaedic surgeons worldwide.These defects generally result from severe trauma or resection of a whole large tumour.Autologous bone graft...BACKGROUND Critically sized bone defects represent a significant challenge to orthopaedic surgeons worldwide.These defects generally result from severe trauma or resection of a whole large tumour.Autologous bone grafts are the current gold standard for the reconstruction of such defects.However,due to increased patient morbidity and the need for a second operative site,other lines of treatment should be introduced.To find alternative unconventional therapies to manage such defects,bone tissue engineering using a combination of suitable bioactive factors,cells,and biocompatible scaffolds offers a promising new approach for bone regeneration.AIM To evaluate the healing capacity of platelet-rich fibrin(PRF)membranes seeded with allogeneic mesenchymal bone marrow-derived stem cells(BMSCs)on critically sized mandibular defects in a rat model.METHODS Sixty-three Sprague Dawley rats were subjected to bilateral bone defects of critical size in the mandibles created by a 5-mm diameter trephine bur.Rats were allocated to three equal groups of 21 rats each.Group I bone defects were irrigated with normal saline and designed as negative controls.Defects of group II were grafted with PRF membranes and served as positive controls,while defects of group III were grafted with PRF membranes seeded with allogeneic BMSCs.Seven rats from each group were killed at 1,2 and 4 wk.The mandibles were dissected and prepared for routine haematoxylin and eosin(HE)staining,Masson's trichrome staining and CD68 immunohistochemical staining.RESULTS Four weeks postoperatively,the percentage area of newly formed bone was significantly higher in group III(0.88±0.02)than in groups I(0.02±0.00)and II(0.60±0.02).The amount of granulation tissue formation was lower in group III(0.12±0.02)than in groups I(0.20±0.02)and II(0.40±0.02).The number of inflammatory cells was lower in group III(0.29±0.03)than in groups I(4.82±0.08)and II(3.09±0.07).CONCLUSION Bone regenerative quality of critically sized mandibular bone defects in rats was better promoted by PRF membranes seeded with BMSCs than with PRF membranes alone.展开更多
Introduction Mandibular segmental defects result in significant cosmetic and functional deficiencies.Meanwhile,the reconstruction of both the contour and function of the mandible is a challenging task.At present,autol...Introduction Mandibular segmental defects result in significant cosmetic and functional deficiencies.Meanwhile,the reconstruction of both the contour and function of the mandible is a challenging task.At present,autologous vascularized fibula transplantation is the most common method to reconstruct a mandible with long-span defects[1].展开更多
Objective To study feasibility and value of repair of oral mandibular defects with rib composite flap pedicled with internal thoracic vessels in basic level hospitals. Methods The clinical materials in 13 cases uith m...Objective To study feasibility and value of repair of oral mandibular defects with rib composite flap pedicled with internal thoracic vessels in basic level hospitals. Methods The clinical materials in 13 cases uith mandibular defects which were repaired with rib compos-展开更多
Experiments on maxillofacial bone tissue engineering showed the promising result;however, its healing mechanisms and effectiveness had not been fully understood. The aim of this study is to compare the bone healing me...Experiments on maxillofacial bone tissue engineering showed the promising result;however, its healing mechanisms and effectiveness had not been fully understood. The aim of this study is to compare the bone healing mechanism and osteogenic capacity between bovine bone mineral loaded with hAMSC and autogenous bone graft in the reconstruction of critical size mandibular bone defect. Critical size defects were made at the mandible of 45 New Zealand white rabbits reconstructed with BBM-hAMSC, BBM alone, and ABG, respectively. At the end of first, second, and twelfth weeks, five rabbits from each experimental week were sacrificed for histology and immunohistochemistry staining. Expressions of vascular endothelial growth factor (VEGF), bone mor-phogenic proteins-2 (BMP2), Runx2 and the amount of angiogenesis were analyzed in the first and second week groups, while expressions of Runx2, osteocalcin, collagen type-I fibres, trabecular area and bone incorporation were analyzed in the twelfth week groups. The result showed that expressions of VEGF, BMP2 and Runx2 as well as the amount of angiogenesis were higher in ABG compared with BBM-hAMSC group in the first and second weeks of healing. The result of twelfth week of healing showed that expressions of Runx2 and osteocalcin as well as the thickness of collagen type-I fibres were significantly higher in BBM-hAMSC compared to ABG group, while there was no statistically difference in trabecular area and bone incorporation between BBM-hAMSC and ABG group. This study concluded that early healing activities were higher in auto-genous bone graft than in BBM-hAMSC, while osteogenic activities in the late stage of healing were higher in BBM-hAMSC compared to autogenous bone graft. It was also concluded that the osteo-genic capacity of BBM-hAMSC was comparable to autogenous bone graft in the reconstruction of critical size defect in the mandible.展开更多
Additive manufacturing has received attention for the fabrication of medical implants that have customized and complicated structures.Biodegradable Zn metals are revolutionary materials for orthopedic implants.In this...Additive manufacturing has received attention for the fabrication of medical implants that have customized and complicated structures.Biodegradable Zn metals are revolutionary materials for orthopedic implants.In this study,pure Zn porous scaffolds with diamond structures were fabricated using customized laser powder bed fusion(L-PBF)technology.First,the mechanical properties,corrosion behavior,and biocompatibility of the pure Zn porous scaffolds were characterized in vitro.The scaffolds were then implanted into the rabbit femur critical-size bone defect model for 24 weeks.The results showed that the pure Zn porous scaffolds had compressive strength and rigidity comparable to those of cancellous bone,as well as relatively suitable degradation rates for bone regeneration.A benign host response was observed using hematoxylin and eosin(HE)staining of the heart,liver,spleen,lungs,and kidneys.Moreover,the pure Zn porous scaffold showed good biocompatibility and osteogenic promotion ability in vivo.This study showed that pure Zn porous scaffolds with customized structures fabricated using L-PBF represent a promising biodegradable solution for treating large bone defects.展开更多
Ameloblastoma is the most frequent odontogenic tumor of the jaw. If not treated, ameloblastoma can gain an enormous size and cause severe facial disfigurement and functional impairment. Here we report two patients aff...Ameloblastoma is the most frequent odontogenic tumor of the jaw. If not treated, ameloblastoma can gain an enormous size and cause severe facial disfigurement and functional impairment. Here we report two patients afflicted with extensive mandibular ameloblastoma (sized in 23 cm × 18 cm × 17 cm and 15 cm × 12 cm × 10 cm, respectively). Both the patients received the same sequential treatment including radical tumor resection, simultaneous reconstruction with fibula free flap graft, vertical distraction osteogenesis on the fibula graft, placement of endosseous dental implants, and final pros-thodontic rehabilitation. It took about 15 months to finish the entire course of treatment. And after the four-year follow-up, neither soft tissue related, nor hard tissue related problems were observed. Satisfactory facial symmetry, chewing and speech functions of the patients were restored. So this sequential treatment for extensive mandibular ameloblastoma can obtain an excellent effect by the shortest time and the lowest economical cost. Furthermore, the series also can be used to reconstruct giant mandibular defects caused by different reasons.展开更多
目的:观察下颌阻生第三磨牙(impacted mandibular third molars,IM3Ms)拔除术后的自然转归及对邻近下颌第二磨牙(mandibular second molars,M2Ms)的影响。方法:选择下颌第三磨牙骨埋伏阻生的患者34例(51颗IM3Ms),使用超声骨刀、气动涡...目的:观察下颌阻生第三磨牙(impacted mandibular third molars,IM3Ms)拔除术后的自然转归及对邻近下颌第二磨牙(mandibular second molars,M2Ms)的影响。方法:选择下颌第三磨牙骨埋伏阻生的患者34例(51颗IM3Ms),使用超声骨刀、气动涡轮手机拔除患牙,分别于术前、术后1周及术后6个月随访,观察术后反应及M2Ms远中骨缺损情况。比较手术前后M2Ms远中骨缺损深度,并分析其影响因素。采用SPSS 29.0软件包对数据进行统计学分析。结果:术前M2Ms远中骨高度未见明显缺损,但拔除IM3Ms时,由于去骨拔牙等操作产生骨缺损。术后6个月,骨高度虽有所恢复,骨缺损率减少,但未达到术前水平。IM3Ms埋伏阻生深度是恢复率的主要影响因素。探诊深度较术前显著增加。术后24 h内患者疼痛感较重,术后1周缓解,但仍存在轻度开口受限及面部肿胀。拔除IM3Ms对患者日常生活、情绪、工作、睡眠影响较小。结论:下颌第三磨牙拔除术后,邻近第二磨牙远中骨高度部分恢复,但未达到术前水平。拔牙手术中需采取更加精细的手术技巧,以减少对邻近牙和骨组织的影响。同时,拔除IM3Ms后应给予镇痛药物,加强卫生宣教,提高患者术后舒适度。展开更多
目的采用微焦点断层扫描(Micro-CT)评价超声骨焊接技术应用过程中超声震荡产热作用下PDLLA材料对骨愈合性能的影响。方法选择SPF级雄性新西兰大白兔36只,随机分为超声骨焊接技术辅助PDLLA材料组(A组)、拧入技术辅助PDLLA材料组(B组)、...目的采用微焦点断层扫描(Micro-CT)评价超声骨焊接技术应用过程中超声震荡产热作用下PDLLA材料对骨愈合性能的影响。方法选择SPF级雄性新西兰大白兔36只,随机分为超声骨焊接技术辅助PDLLA材料组(A组)、拧入技术辅助PDLLA材料组(B组)、假手术组(C组)、空白对照组(D组),各9只。于术后4、8、12周取下颌骨标本,周围骨组织进行HE染色,观察各组植入钉周围情况。对术后4、8、12周的下颌骨大体标本拍摄Micro-CT图,使用VG Studio MAX软件进行三维重建,摆正数据样本,即颌骨颊侧造模处为轴向,动态分析植入钉体积、植入钉周围200μm环状区及骨缺损处的植入材料体积数、相对骨体积分数(BV/TV)、骨小梁厚度(Tb.Th)、骨小梁数(Tb.N)、骨小梁间隙(Tb.Sp)等骨愈合相关指标。结果HE染色结果显示,按3个时间可动态观察到A、B、C组骨缺损处骨性骨痂替代纤维性骨痂,形成类骨质,编织骨的过程符合正常骨损伤愈合的过程。Micro-CT结果显示,A、B组术后3个时间点的材料体积比较差异均无统计学意义(P>0.05);在3个时间点,4组植入钉周围200μm环状区中BV/TV、Tb.Th、Tb.N、Tb.Sp比较差异均无统计学意义(P>0.05);在骨缺损处,A、B、C组三个时间点BV/TV、Tb.Th、Tb.N、Tb.Sp比较差异无统计学意义(P>0.05);术后4周,与D组比较,A、B、C组BV/TV、Tb.Th、Tb.N、Tb.Sp差异有统计学意义(P<0.05);与C组比较,A、B组Tb.N差异有统计学意义(P<0.01)。术后8周,与D组比较,A、B、C组BV/TV、Tb.Th、Tb.N、Tb.Sp差异有统计学意义(P<0.05);术后12周,与D组比较,A、B、C组BV/TV、Tb.Th、Tb.Sp差异有统计学意义(P<0.05)。结论超声骨焊接技术其超声震荡产热作用下PDLLA材料对骨愈合性能无不良影响。展开更多
文摘BACKGROUND Critically sized bone defects represent a significant challenge to orthopaedic surgeons worldwide.These defects generally result from severe trauma or resection of a whole large tumour.Autologous bone grafts are the current gold standard for the reconstruction of such defects.However,due to increased patient morbidity and the need for a second operative site,other lines of treatment should be introduced.To find alternative unconventional therapies to manage such defects,bone tissue engineering using a combination of suitable bioactive factors,cells,and biocompatible scaffolds offers a promising new approach for bone regeneration.AIM To evaluate the healing capacity of platelet-rich fibrin(PRF)membranes seeded with allogeneic mesenchymal bone marrow-derived stem cells(BMSCs)on critically sized mandibular defects in a rat model.METHODS Sixty-three Sprague Dawley rats were subjected to bilateral bone defects of critical size in the mandibles created by a 5-mm diameter trephine bur.Rats were allocated to three equal groups of 21 rats each.Group I bone defects were irrigated with normal saline and designed as negative controls.Defects of group II were grafted with PRF membranes and served as positive controls,while defects of group III were grafted with PRF membranes seeded with allogeneic BMSCs.Seven rats from each group were killed at 1,2 and 4 wk.The mandibles were dissected and prepared for routine haematoxylin and eosin(HE)staining,Masson's trichrome staining and CD68 immunohistochemical staining.RESULTS Four weeks postoperatively,the percentage area of newly formed bone was significantly higher in group III(0.88±0.02)than in groups I(0.02±0.00)and II(0.60±0.02).The amount of granulation tissue formation was lower in group III(0.12±0.02)than in groups I(0.20±0.02)and II(0.40±0.02).The number of inflammatory cells was lower in group III(0.29±0.03)than in groups I(4.82±0.08)and II(3.09±0.07).CONCLUSION Bone regenerative quality of critically sized mandibular bone defects in rats was better promoted by PRF membranes seeded with BMSCs than with PRF membranes alone.
基金supported in part by grants from the Clinical Research for Crossing Item of Shandong University(No.2020SDUCRCB001)the Shandong Provincial Natural Science Foundation(No.ZR2020MH180)+1 种基金the Rongxiang Regeneration Medicine Fund of Shandong University(No.2019SDRX-11)the Science and Technology Development Plan of Jinan City(No.201805041)。
文摘Introduction Mandibular segmental defects result in significant cosmetic and functional deficiencies.Meanwhile,the reconstruction of both the contour and function of the mandible is a challenging task.At present,autologous vascularized fibula transplantation is the most common method to reconstruct a mandible with long-span defects[1].
文摘Objective To study feasibility and value of repair of oral mandibular defects with rib composite flap pedicled with internal thoracic vessels in basic level hospitals. Methods The clinical materials in 13 cases uith mandibular defects which were repaired with rib compos-
文摘Experiments on maxillofacial bone tissue engineering showed the promising result;however, its healing mechanisms and effectiveness had not been fully understood. The aim of this study is to compare the bone healing mechanism and osteogenic capacity between bovine bone mineral loaded with hAMSC and autogenous bone graft in the reconstruction of critical size mandibular bone defect. Critical size defects were made at the mandible of 45 New Zealand white rabbits reconstructed with BBM-hAMSC, BBM alone, and ABG, respectively. At the end of first, second, and twelfth weeks, five rabbits from each experimental week were sacrificed for histology and immunohistochemistry staining. Expressions of vascular endothelial growth factor (VEGF), bone mor-phogenic proteins-2 (BMP2), Runx2 and the amount of angiogenesis were analyzed in the first and second week groups, while expressions of Runx2, osteocalcin, collagen type-I fibres, trabecular area and bone incorporation were analyzed in the twelfth week groups. The result showed that expressions of VEGF, BMP2 and Runx2 as well as the amount of angiogenesis were higher in ABG compared with BBM-hAMSC group in the first and second weeks of healing. The result of twelfth week of healing showed that expressions of Runx2 and osteocalcin as well as the thickness of collagen type-I fibres were significantly higher in BBM-hAMSC compared to ABG group, while there was no statistically difference in trabecular area and bone incorporation between BBM-hAMSC and ABG group. This study concluded that early healing activities were higher in auto-genous bone graft than in BBM-hAMSC, while osteogenic activities in the late stage of healing were higher in BBM-hAMSC compared to autogenous bone graft. It was also concluded that the osteo-genic capacity of BBM-hAMSC was comparable to autogenous bone graft in the reconstruction of critical size defect in the mandible.
基金supported by the National Key R&D Program of China[grant number 2018YFE0104200]the National Natural Science Foundation of China[grant numbers 51901003,51931001,52171233,51875310]+1 种基金the Beijing Natural Science Foundation[grant number L212014]the Open Project of NMPA Key Laboratory for Dental Materials[grant number PKUSS20200401].
文摘Additive manufacturing has received attention for the fabrication of medical implants that have customized and complicated structures.Biodegradable Zn metals are revolutionary materials for orthopedic implants.In this study,pure Zn porous scaffolds with diamond structures were fabricated using customized laser powder bed fusion(L-PBF)technology.First,the mechanical properties,corrosion behavior,and biocompatibility of the pure Zn porous scaffolds were characterized in vitro.The scaffolds were then implanted into the rabbit femur critical-size bone defect model for 24 weeks.The results showed that the pure Zn porous scaffolds had compressive strength and rigidity comparable to those of cancellous bone,as well as relatively suitable degradation rates for bone regeneration.A benign host response was observed using hematoxylin and eosin(HE)staining of the heart,liver,spleen,lungs,and kidneys.Moreover,the pure Zn porous scaffold showed good biocompatibility and osteogenic promotion ability in vivo.This study showed that pure Zn porous scaffolds with customized structures fabricated using L-PBF represent a promising biodegradable solution for treating large bone defects.
文摘Ameloblastoma is the most frequent odontogenic tumor of the jaw. If not treated, ameloblastoma can gain an enormous size and cause severe facial disfigurement and functional impairment. Here we report two patients afflicted with extensive mandibular ameloblastoma (sized in 23 cm × 18 cm × 17 cm and 15 cm × 12 cm × 10 cm, respectively). Both the patients received the same sequential treatment including radical tumor resection, simultaneous reconstruction with fibula free flap graft, vertical distraction osteogenesis on the fibula graft, placement of endosseous dental implants, and final pros-thodontic rehabilitation. It took about 15 months to finish the entire course of treatment. And after the four-year follow-up, neither soft tissue related, nor hard tissue related problems were observed. Satisfactory facial symmetry, chewing and speech functions of the patients were restored. So this sequential treatment for extensive mandibular ameloblastoma can obtain an excellent effect by the shortest time and the lowest economical cost. Furthermore, the series also can be used to reconstruct giant mandibular defects caused by different reasons.
文摘目的:对下颌第一磨牙拔除后行种植修复的病例进行回顾性研究,探索重度牙周破坏(advanced periodontal defect,APD)对拔牙后种植手术方式的影响。方法:纳入下颌第一磨牙拔除后自然愈合3~12个月行种植手术的患者176例,共179个种植位点,进行回顾性分析,记录患者年龄、性别、缺牙时间以及拔牙时是否有APD。采用多因素Logistic回归,分析拔牙前APD是否是种植时行引导性骨再生(guided bone regeneration,GBR)的风险因素。结果:对年龄、性别、缺牙时间等因素校正后,结果显示,有APD的下颌第一磨牙,种植时行GBR的风险是无APD位点的4.738倍(95%可信区间:1.650~13.609,P<0.05)。结论:APD的下颌第一磨牙拔除后,种植手术时行GBR的可能性更大。
文摘目的:观察下颌阻生第三磨牙(impacted mandibular third molars,IM3Ms)拔除术后的自然转归及对邻近下颌第二磨牙(mandibular second molars,M2Ms)的影响。方法:选择下颌第三磨牙骨埋伏阻生的患者34例(51颗IM3Ms),使用超声骨刀、气动涡轮手机拔除患牙,分别于术前、术后1周及术后6个月随访,观察术后反应及M2Ms远中骨缺损情况。比较手术前后M2Ms远中骨缺损深度,并分析其影响因素。采用SPSS 29.0软件包对数据进行统计学分析。结果:术前M2Ms远中骨高度未见明显缺损,但拔除IM3Ms时,由于去骨拔牙等操作产生骨缺损。术后6个月,骨高度虽有所恢复,骨缺损率减少,但未达到术前水平。IM3Ms埋伏阻生深度是恢复率的主要影响因素。探诊深度较术前显著增加。术后24 h内患者疼痛感较重,术后1周缓解,但仍存在轻度开口受限及面部肿胀。拔除IM3Ms对患者日常生活、情绪、工作、睡眠影响较小。结论:下颌第三磨牙拔除术后,邻近第二磨牙远中骨高度部分恢复,但未达到术前水平。拔牙手术中需采取更加精细的手术技巧,以减少对邻近牙和骨组织的影响。同时,拔除IM3Ms后应给予镇痛药物,加强卫生宣教,提高患者术后舒适度。
文摘目的采用微焦点断层扫描(Micro-CT)评价超声骨焊接技术应用过程中超声震荡产热作用下PDLLA材料对骨愈合性能的影响。方法选择SPF级雄性新西兰大白兔36只,随机分为超声骨焊接技术辅助PDLLA材料组(A组)、拧入技术辅助PDLLA材料组(B组)、假手术组(C组)、空白对照组(D组),各9只。于术后4、8、12周取下颌骨标本,周围骨组织进行HE染色,观察各组植入钉周围情况。对术后4、8、12周的下颌骨大体标本拍摄Micro-CT图,使用VG Studio MAX软件进行三维重建,摆正数据样本,即颌骨颊侧造模处为轴向,动态分析植入钉体积、植入钉周围200μm环状区及骨缺损处的植入材料体积数、相对骨体积分数(BV/TV)、骨小梁厚度(Tb.Th)、骨小梁数(Tb.N)、骨小梁间隙(Tb.Sp)等骨愈合相关指标。结果HE染色结果显示,按3个时间可动态观察到A、B、C组骨缺损处骨性骨痂替代纤维性骨痂,形成类骨质,编织骨的过程符合正常骨损伤愈合的过程。Micro-CT结果显示,A、B组术后3个时间点的材料体积比较差异均无统计学意义(P>0.05);在3个时间点,4组植入钉周围200μm环状区中BV/TV、Tb.Th、Tb.N、Tb.Sp比较差异均无统计学意义(P>0.05);在骨缺损处,A、B、C组三个时间点BV/TV、Tb.Th、Tb.N、Tb.Sp比较差异无统计学意义(P>0.05);术后4周,与D组比较,A、B、C组BV/TV、Tb.Th、Tb.N、Tb.Sp差异有统计学意义(P<0.05);与C组比较,A、B组Tb.N差异有统计学意义(P<0.01)。术后8周,与D组比较,A、B、C组BV/TV、Tb.Th、Tb.N、Tb.Sp差异有统计学意义(P<0.05);术后12周,与D组比较,A、B、C组BV/TV、Tb.Th、Tb.Sp差异有统计学意义(P<0.05)。结论超声骨焊接技术其超声震荡产热作用下PDLLA材料对骨愈合性能无不良影响。
