- Email: [email protected]
In vitro indirect responses of osteoblasts to polycaprolactone-ceramics scaffolds
218 an earlier stage when compared to the conventional method. The resulting 3D computer model (Catia) was used for 3D printing of a gypsum mold (Z250 3D Systems Z-corp) and the nylon construct (EOS Formiga P110, Oceanz) that is integrated to improve collar stiffness. The mould was used to fabricate a silicon inlay. Due to the improved fit of the neck collar, patient adherence to wear the collar was greatly improved when compared to the gypsum mould approach. Conclusions: Our approach resulted in early implementation of neck collar treatment of hypertrophic neck scars. Moreover, the personalised manufacturing approach improved patient adherence to wear the collar on a daily base. Our findings suggest that personalised manufacturing of neck collars could augment therapy in patients with hypertrophic burn scars. http://dx.doi.org/10.1016/j.ijom.2017.02.737 In vivo evaluation of microporous silk sponges with modified pulp for bone tissue engineering T. Thai ∗ , T. Nuntanaranont, S. Kamolmatyakul, J. Meesane Prince of Songkla University, Songkhla, Thailand Background: Bone resorption following tooth extraction interferes dental implant replacement. Alveolar bone augmentation routinely facilitate to replace dental implant in a desired position.1 Objective: To evaluate bone formation improved by microporous silk sponges with modified pulp (MS-MP) in animal experiments for alveolar bone augmentation. Methods: The microporous silk sponges (MS) were fabricated then coated with modified pulp. The 18 bi-circular defects in rabbit calvaria were used for experiments. They were divided in two groups randomly: MS-MP and MS. They were sacrificed at two, four, eight weeks postoperatively. The scanning electron microscopy, clinical healing, microcomputed tomography, histology were used to evaluate the sponges and their bone formation in vivo. Findings: The MS-MP were fabricated in proper pore size and highly internal connective porosity for bone regeneration. All rabbits were good healing without any infection. MS-MP group enhanced more new bone and thicker than MS group. The forming bone of MS-MP group was mature faster than MS group. Conclusion: The MS-MP showed good biocompatible and osteoconductive properties in animal experiments. The MS-MP may a novel biomaterial for alveolar bone augmentation.
Reference 1. Jensen, S. S., & Terheyden, H. (2009). Bone augmentation procedures in localised defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials. Int J Oral Maxillofac Implants, 24, 218–236.
http://dx.doi.org/10.1016/j.ijom.2017.02.738
Correction of facial deformity with bespoke patient-specific polyetheretherketone implant: in-house manufacturing to virtual planning and navigational technology M. Thomas ∗ , C. Frezzini, R. Keat, N. Lee Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom Background: Polyetheretherketone (PEEK) is a semi-crystalline linear aromatic polymer with properties that makes it a suitable material for craniofacial reconstruction. PEEK is versatile and is an alternative to the current implantable material available for craniofacial reconstruction. The advances in computer-aided design/computer-aided manufacturing (CAD/CAM) technology have made the implants accurate and reproducible. Objectives: Case series to take you through the journey from making the PEEK implants in-house to using navigational technology. Methods: 21 patients underwent reconstruction of facial deformity between 2012 and 2015 (19 were posttraumatic and 3 were congenital defects. Age ranged from 17 to 50 years. Results: We performed 22 reconstructions (11 zygomatic, 8 orbital and 1 mandibular), of which 7 were manufactured with in-house techniques and 15 were manufactured using CAD/CAM technology. Navigation technology was used for placement of five orbital implants. Two implants manufactured using in-house technique required removal. Conclusions: PEEK is a versatile material for craniofacial reconstruction. The in-house technique manufacturing technique had multiple steps and the needed adjustments for an accurate fit. The use of CAD/CAM for patient specific implants and use of navigation has given us accurate reproducible results. The multisegmented interlocking plates provided added advantage of additional stability with minimal fixation and ease of insertion. http://dx.doi.org/10.1016/j.ijom.2017.02.739 In vitro indirect responses of osteoblasts to polycaprolactoneceramics scaffolds N. Thuaksuban ∗ , T. Luntheng, N. Monmaturapoj Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand Background: Polycaprolactone (PCL)-ceramics scaffolds are successfully fabricated using melt stretching and compression molding (MSCM) technique. It processing allows any surgeon to instantly build three-dimensional scaffolds on the chair side of surgical operations. Objectives: To evaluate effects of calcium and phosphate ions released from the scaffolds on osteoblast cells. Methods: The groups of scaffolds included A; PCL-20% biphasic calcium phosphate (BCP) (%wt), B; PCL-30%BCP, C; PCL-20% tricalcium phosphate (TCP) and D; PCL-30% TCP. Indirect effects of calcium and phosphate ions released from those scaffolds on proliferation and differentiation of MC3T3-E1 osteoblast cell lines were assessed using enzyme-linked immunosorbent assay and mineralised matrix Alizarin red staining (AR) over 21 days. Findings: The cell proliferation in all groups decreased on day 7 relating to the maximum releasing of phosphate ion, whilst, an increase of proliferation thereafter would relate to the releasing
219 profiles of calcium ion. Alkaline Phosphatase activities of groups A and D increased with time and the level of group A was significantly higher than the other groups on day 21 (P < 0.05). The levels of osteocalcin in groups A and B remarkably increased on day 21, whereas, those profiles of groups C and D were stable. Amount of AR of all groups were stable during the first 14 days, and then, remarkably increased on day 21. Conclusion: The MSCM scaffold system can be effectively used as a bone substitute. Among the groups, the PCL-20% BCP scaffolds can release the optimum ion concentrations for enhancing the entire phased of the osteoblastic differentiation. http://dx.doi.org/10.1016/j.ijom.2017.02.740 Transforming growth factor-beta 3 and recombinant human bone morphogenetic protein-7 for the regeneration of segmental mandibular defects in Papio ursinus N. Vafaei ∗ , U. Ripamonti, C. Ferretti University of the Witwatersrand, Johannesburg, South Africa Background: The reconstruction of osseous mandibular defects remains a significant challenge. The use of autologous bone for mandibular reconstruction is associated with numerous limitations, and alternatives to autologous bone would provide significant benefits for patients. Objectives: The aim of this study was to evaluate and compare binary application of recombinant human bone morphogenetic protein-7 (rhBMP-7) and recombinant human transforming growth factor-beta 3 (rhTGF-3) to solo application of rhBMP7 in full-thickness mandibular defects in the non-human primate Papio ursinus. Methods: In four baboons, a 2.5 cm segmental defect was created in the mandible and stabilised with a 2.7 mm reconstruction plate. Two defects were implanted with rhBMP-7 solo, and the other 2 with rhBMP-7 and rhTGF-3. All four baboons were euthanased at 180 days post implantation. All four specimens were radiographed prior to sectioning. Tissue processing and histomorphometry were done on the decalcified sections prepared from the harvested mandible specimens. Findings: Radiographic examination confirmed that bone regeneration re-established bony continuity at six months, confirming that clinically significant osteoinduction was achieved. The mean area of the regenerate was 336 ± 107.5 mm2 (range, 229–444.7) in the solo cases and 312 ± 63.5 mm2 (range, 249–376.6) in the binary cases. The regenerated bone had a trabecular pattern consistent with mature mandibular bone and the defect interfaces were indiscernible. Conclusion: This study confirmed that successful bone regeneration by tissue induction in surgically created mandibular defects in Papio ursinus can be achieved with osteogenic proteins of the TGF- superfamily. In this sample size no performance advantage could be identified between the two treatment groups. http://dx.doi.org/10.1016/j.ijom.2017.02.741
A three-dimensional analysis of bicycle helmets in correlation with head injuries: a pilot study G. van Baar ∗ , M. van Eijnatten, N. Liberton, T. Forouzanfar, J. Wolff Department of Oral and Maxillofacial Surgery/3D Innovationlab VU University Medical Center, Amsterdam, The Netherlands Background: In the Netherlands bicyclists continue to outnumber other road users in injuries and deaths. A helmet is not mandatory, while research has shown that the utilisation of bicycle helmets can reduce head and brain injuries by up to 88%. Objectives: To assess the feasibility of three-dimensional technology in quantifying bicycle related head injuries and helmet protection. For this it was necessary to obtain accurate conebeam computed tomography (CBCT) and multidetector computed tomography (MDCT) images of bicycle helmets of patients that had been involved in an accident. Methods: Three patients involved in a bicycle accident while wearing a helmet and of whom an MDCT scan of the skull was available were included. The patients’ helmets were scanned with CBCT and MDCT devices in order to assess the best imaging modality for helmets. The acquired helmet images were subsequently converted to STL (STereoLithography) files and imported to computer-aided design/computer-aided manufacturing (CAD/CAM) software and merged with the MDCT images of the patients’ skulls. The skull fractures and helmet damages were made visible and quantified. Findings: The MDCT device offered accurate helmet images. The merged skull and helmet images offered an excellent possibility of assessing the overall damages sustained to both skull and helmet. There were no relations between skull fractures and helmet damages. Conclusions: It was feasible to obtain accurate images of bicycle helmets with MDCT. Novel CAD technology offers possibilities of assessing the bicycle helmet damages and resulting head injuries. This technology can be used to obtain data to design an optimal helmet concept. http://dx.doi.org/10.1016/j.ijom.2017.02.742 Site-specific effects of zoledronic acid on vascularisation in jaw bone versus femur J.Y. Wang ∗ , L.W. Zheng The University of Hong Kong, Hong Kong Background: Medication-related osteonecrosis of the jaws (MRONJ) is a newly updated nomenclature after bisphosphonaterelated osteonecrosis of the jaws, which is characterised clinically as an area of exposed bone in the maxilla or the mandible that has failed to heal within a period of six to eight weeks in a patient exposed to various drugs including bisphosphonate, denosumab, and antiangiogenic agents. Although all MRONJ presented as avascular lesions, the aetiology and pathogenesis have not been fully investigated. The reason why the necrosis was found in jaw bones only remains unknown. Objectives: This study aimed to compare the effects of bisphosphonates on angiogenesis in jawbone and long bones using a Sprague-Dawley (SD)-rat model.
Reference 1. Jensen, S. S., & Terheyden, H. (2009). Bone augmentation procedures in localised defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials. Int J Oral Maxillofac Implants, 24, 218–236.
http://dx.doi.org/10.1016/j.ijom.2017.02.738
Correction of facial deformity with bespoke patient-specific polyetheretherketone implant: in-house manufacturing to virtual planning and navigational technology M. Thomas ∗ , C. Frezzini, R. Keat, N. Lee Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom Background: Polyetheretherketone (PEEK) is a semi-crystalline linear aromatic polymer with properties that makes it a suitable material for craniofacial reconstruction. PEEK is versatile and is an alternative to the current implantable material available for craniofacial reconstruction. The advances in computer-aided design/computer-aided manufacturing (CAD/CAM) technology have made the implants accurate and reproducible. Objectives: Case series to take you through the journey from making the PEEK implants in-house to using navigational technology. Methods: 21 patients underwent reconstruction of facial deformity between 2012 and 2015 (19 were posttraumatic and 3 were congenital defects. Age ranged from 17 to 50 years. Results: We performed 22 reconstructions (11 zygomatic, 8 orbital and 1 mandibular), of which 7 were manufactured with in-house techniques and 15 were manufactured using CAD/CAM technology. Navigation technology was used for placement of five orbital implants. Two implants manufactured using in-house technique required removal. Conclusions: PEEK is a versatile material for craniofacial reconstruction. The in-house technique manufacturing technique had multiple steps and the needed adjustments for an accurate fit. The use of CAD/CAM for patient specific implants and use of navigation has given us accurate reproducible results. The multisegmented interlocking plates provided added advantage of additional stability with minimal fixation and ease of insertion. http://dx.doi.org/10.1016/j.ijom.2017.02.739 In vitro indirect responses of osteoblasts to polycaprolactoneceramics scaffolds N. Thuaksuban ∗ , T. Luntheng, N. Monmaturapoj Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand Background: Polycaprolactone (PCL)-ceramics scaffolds are successfully fabricated using melt stretching and compression molding (MSCM) technique. It processing allows any surgeon to instantly build three-dimensional scaffolds on the chair side of surgical operations. Objectives: To evaluate effects of calcium and phosphate ions released from the scaffolds on osteoblast cells. Methods: The groups of scaffolds included A; PCL-20% biphasic calcium phosphate (BCP) (%wt), B; PCL-30%BCP, C; PCL-20% tricalcium phosphate (TCP) and D; PCL-30% TCP. Indirect effects of calcium and phosphate ions released from those scaffolds on proliferation and differentiation of MC3T3-E1 osteoblast cell lines were assessed using enzyme-linked immunosorbent assay and mineralised matrix Alizarin red staining (AR) over 21 days. Findings: The cell proliferation in all groups decreased on day 7 relating to the maximum releasing of phosphate ion, whilst, an increase of proliferation thereafter would relate to the releasing
219 profiles of calcium ion. Alkaline Phosphatase activities of groups A and D increased with time and the level of group A was significantly higher than the other groups on day 21 (P < 0.05). The levels of osteocalcin in groups A and B remarkably increased on day 21, whereas, those profiles of groups C and D were stable. Amount of AR of all groups were stable during the first 14 days, and then, remarkably increased on day 21. Conclusion: The MSCM scaffold system can be effectively used as a bone substitute. Among the groups, the PCL-20% BCP scaffolds can release the optimum ion concentrations for enhancing the entire phased of the osteoblastic differentiation. http://dx.doi.org/10.1016/j.ijom.2017.02.740 Transforming growth factor-beta 3 and recombinant human bone morphogenetic protein-7 for the regeneration of segmental mandibular defects in Papio ursinus N. Vafaei ∗ , U. Ripamonti, C. Ferretti University of the Witwatersrand, Johannesburg, South Africa Background: The reconstruction of osseous mandibular defects remains a significant challenge. The use of autologous bone for mandibular reconstruction is associated with numerous limitations, and alternatives to autologous bone would provide significant benefits for patients. Objectives: The aim of this study was to evaluate and compare binary application of recombinant human bone morphogenetic protein-7 (rhBMP-7) and recombinant human transforming growth factor-beta 3 (rhTGF-3) to solo application of rhBMP7 in full-thickness mandibular defects in the non-human primate Papio ursinus. Methods: In four baboons, a 2.5 cm segmental defect was created in the mandible and stabilised with a 2.7 mm reconstruction plate. Two defects were implanted with rhBMP-7 solo, and the other 2 with rhBMP-7 and rhTGF-3. All four baboons were euthanased at 180 days post implantation. All four specimens were radiographed prior to sectioning. Tissue processing and histomorphometry were done on the decalcified sections prepared from the harvested mandible specimens. Findings: Radiographic examination confirmed that bone regeneration re-established bony continuity at six months, confirming that clinically significant osteoinduction was achieved. The mean area of the regenerate was 336 ± 107.5 mm2 (range, 229–444.7) in the solo cases and 312 ± 63.5 mm2 (range, 249–376.6) in the binary cases. The regenerated bone had a trabecular pattern consistent with mature mandibular bone and the defect interfaces were indiscernible. Conclusion: This study confirmed that successful bone regeneration by tissue induction in surgically created mandibular defects in Papio ursinus can be achieved with osteogenic proteins of the TGF- superfamily. In this sample size no performance advantage could be identified between the two treatment groups. http://dx.doi.org/10.1016/j.ijom.2017.02.741
A three-dimensional analysis of bicycle helmets in correlation with head injuries: a pilot study G. van Baar ∗ , M. van Eijnatten, N. Liberton, T. Forouzanfar, J. Wolff Department of Oral and Maxillofacial Surgery/3D Innovationlab VU University Medical Center, Amsterdam, The Netherlands Background: In the Netherlands bicyclists continue to outnumber other road users in injuries and deaths. A helmet is not mandatory, while research has shown that the utilisation of bicycle helmets can reduce head and brain injuries by up to 88%. Objectives: To assess the feasibility of three-dimensional technology in quantifying bicycle related head injuries and helmet protection. For this it was necessary to obtain accurate conebeam computed tomography (CBCT) and multidetector computed tomography (MDCT) images of bicycle helmets of patients that had been involved in an accident. Methods: Three patients involved in a bicycle accident while wearing a helmet and of whom an MDCT scan of the skull was available were included. The patients’ helmets were scanned with CBCT and MDCT devices in order to assess the best imaging modality for helmets. The acquired helmet images were subsequently converted to STL (STereoLithography) files and imported to computer-aided design/computer-aided manufacturing (CAD/CAM) software and merged with the MDCT images of the patients’ skulls. The skull fractures and helmet damages were made visible and quantified. Findings: The MDCT device offered accurate helmet images. The merged skull and helmet images offered an excellent possibility of assessing the overall damages sustained to both skull and helmet. There were no relations between skull fractures and helmet damages. Conclusions: It was feasible to obtain accurate images of bicycle helmets with MDCT. Novel CAD technology offers possibilities of assessing the bicycle helmet damages and resulting head injuries. This technology can be used to obtain data to design an optimal helmet concept. http://dx.doi.org/10.1016/j.ijom.2017.02.742 Site-specific effects of zoledronic acid on vascularisation in jaw bone versus femur J.Y. Wang ∗ , L.W. Zheng The University of Hong Kong, Hong Kong Background: Medication-related osteonecrosis of the jaws (MRONJ) is a newly updated nomenclature after bisphosphonaterelated osteonecrosis of the jaws, which is characterised clinically as an area of exposed bone in the maxilla or the mandible that has failed to heal within a period of six to eight weeks in a patient exposed to various drugs including bisphosphonate, denosumab, and antiangiogenic agents. Although all MRONJ presented as avascular lesions, the aetiology and pathogenesis have not been fully investigated. The reason why the necrosis was found in jaw bones only remains unknown. Objectives: This study aimed to compare the effects of bisphosphonates on angiogenesis in jawbone and long bones using a Sprague-Dawley (SD)-rat model.