Olli-Pekka Lappalainen1, Sakari Karhula2, Marianne Haapea3, Laura Kyllönen4, Suvi Haimi4, Susanna Miettinen4, Simo Saarakkala5, Jarkko Korpi6, Leena P Ylikontiola1, Willy S Serlo7, George K Sándor8,9. 1. Department of Oral and Maxillofacial Surgery, Oulu University Hospital and Medical Research Center, University of Oulu, Oulu, Finland. 2. Research Group of Medical Imaging, Physics and Technology, Infotech Doctoral Program, University of Oulu, Oulu, Finland. 3. Department of Diagnostic Radiology, University of Oulu, Oulu, Finland. 4. BioMediTech, Institute of Biosciences and Medical Technology, University of Tampere, Tampere, Finland. 5. Research Group of Medical Imaging, Physics and Technology, Infotech Doctoral Program, Department of Diagnostic Radiology, Medical Research Center, University of Oulu, Oulu, Finland. 6. Department of Otolaryngology, Head and Neck Surgery, Oulu University Hospital, Oulu, Finland. 7. Department of Children and Adolescents, Division of Pediatric Surgery, Oulu University Hospital, Medical Research Center, PEDEGO Research Center, University of Oulu, Oulu, Finland. 8. Department of Oral and Maxillofacial Surgery, Oulu University Hospital and Medical Research Center, University of Oulu, Oulu, Finland. george.sandor@oulu.fi. 9. BioMediTech, Institute of Biosciences and Medical Technology, University of Tampere, Tampere, Finland. george.sandor@oulu.fi.
Abstract
PURPOSE: In pediatric neurosurgery, decompressive craniectomy and correction of congenital cranial anomalies can result in major cranial defects. Corrective cranioplasty for the repair of these critical-sized defects is not only a cosmetic issue. The limited availability of suitable autogenous bone and the morbidity of donor site harvesting have driven the search for new approaches with biodegradable and bioactive materials. This study aimed to assess the healing of rabbit calvarial critical-sized defects filled with osteogenic material, either with bioactive glass scaffolds or tricalcium phosphate granules in various combinations with adipose stem cells or bone marrow stem cells, BMP-2, BMP-7, or VEGF to enhance osteogenesis. METHODS: Eighty-two bicortical full thickness critical-sized calvarial defects were operated. Five defects were left empty as negative control defects. The remaining 77 defects were filled with solid bioactive glass scaffolds or tricalcium phosphate granules seeded with adipose or bone marrow derived stem cells in combination with BMP-2, BMP-7, or VEGF. The defects were allowed to heal for 6 weeks before histologic and micro-CT analyses. RESULTS: Micro-CT examination at the 6-week post-operative time point revealed that defects filled with stem cell-seeded tricalcium phosphate granules resulted in new bone formation of 6.0 %, whereas defects with bioactive glass scaffolds with stem cells showed new bone formation of 0.5 to 1.7 %, depending on the growth factor used. CONCLUSIONS: This study suggests that tricalcium phosphate granules combined with stem cells have osteogenic potential superior to solid bioactive glass scaffolds with stem cells and growth factors.
PURPOSE: In pediatric neurosurgery, decompressive craniectomy and correction of congenital cranial anomalies can result in major cranial defects. Corrective cranioplasty for the repair of these critical-sized defects is not only a cosmetic issue. The limited availability of suitable autogenous bone and the morbidity of donor site harvesting have driven the search for new approaches with biodegradable and bioactive materials. This study aimed to assess the healing of rabbit calvarial critical-sized defects filled with osteogenic material, either with bioactive glass scaffolds or tricalcium phosphate granules in various combinations with adipose stem cells or bone marrow stem cells, BMP-2, BMP-7, or VEGF to enhance osteogenesis. METHODS: Eighty-two bicortical full thickness critical-sized calvarial defects were operated. Five defects were left empty as negative control defects. The remaining 77 defects were filled with solid bioactive glass scaffolds or tricalcium phosphate granules seeded with adipose or bone marrow derived stem cells in combination with BMP-2, BMP-7, or VEGF. The defects were allowed to heal for 6 weeks before histologic and micro-CT analyses. RESULTS: Micro-CT examination at the 6-week post-operative time point revealed that defects filled with stem cell-seeded tricalcium phosphate granules resulted in new bone formation of 6.0 %, whereas defects with bioactive glass scaffolds with stem cells showed new bone formation of 0.5 to 1.7 %, depending on the growth factor used. CONCLUSIONS: This study suggests that tricalcium phosphate granules combined with stem cells have osteogenic potential superior to solid bioactive glass scaffolds with stem cells and growth factors.
Entities:
Keywords:
Bone healing; Cranial defect; Micro-CT; Stem cells
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