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Biomedical subjects

Eriko Marukawa

Publications and source records attributed to Eriko Marukawa.

4 recordsLinked to original sources

Mandibular reconstruction using a combination graft of rhBMP-2 with bone marrow cells expanded in vitro.

BACKGROUND: The aim of this study was to evaluate the efficacy of a combination graft, using recombinant human bone morphogenetic protein-2 (rhBMP-2) and culture-expanded cells derived from bone marrow, for bone regeneration in a nonhuman primate mandible. METHODS: Five Japanese monkeys were used. Three milliliters of bone marrow was obtained from the tibia and plated into culture flasks. Adherent cells were cultured until near confluence; then, the proliferated cells were transferred to a three-dimensional culture system using collagen beads as the cell carrier. The medium was supplemented with ascorbic acid, beta-glycerophosphate, and dexamethasone to promote osteoblastic differentiation. After further proliferation on beads, the cells were mixed with a collagen sponge that was impregnated with rhBMP-2 and grafted into surgically created segmental bone defects of the mandibles. Three animals received this treatment, and either culture-expanded cells alone or collagen beads without cells were implanted into the remaining two monkeys as controls. The animals were killed 24 weeks after surgery, and the results were assessed by radiographic and histologic evaluation. RESULTS: The combination graft of culture-expanded bone marrow cells with rhBMP-2 in a collagen sponge regenerated the mandibular bone completely. By contrast, the graft of culture-expanded cells alone resulted in only a small amount of bone formation, and the implantation of collagen beads alone led to no bone formation. CONCLUSION: The combination graft of rhBMP-2 and culture-expanded cells, which requires only a small amount of bone marrow, is a reliable method for the reconstruction of segmental bone defects of the mandible.

Animals↗

Distraction osteogenesis and tissue engineering--new options for enhancing the implant site.

In severe atrophy of the mandible, implant placement in original bone may not be possible. In this field, augmentation procedures have already been described and controversially discussed. By the use of distraction osteogenesis, bone augmentation without donor morbidity is obtained, while the implant-bone interface remains in original bone. Despite soft tissue expansion during the distraction process, a lack of attached gingiva may cause difficulties at the implant site. In certain cases, an additional soft tissue augmentation procedure has to be performed for a good long-term functional and esthetic rehabilitation. The connective tissue graft and the free gingival graft are recommended to be standard procedures to create a stable periimplant mucosa, but the morbidity and the size limitation of the donor site have to be taken into consideration in selected patients. Transplantation of in vitro-cultured keratinocytes could be an alternative. Distraction osteogenesis and tissue engineering of keratinocytes, as well as bone-cultivating techniques, may increasingly be valuable adjuncts to current augmentation procedures.

Adult↗

Restoration of occlusal function using osseointegrated implants in the canine mandible reconstructed by rhBMP-2.

Bone morphogenetic proteins have been found to be one of the most promising osteoinductive substances and they are expected to be utilized clinically for the reconstruction of defective mandibles. However, newly formed bone induced by recombinant human bone morphogenetic protein-2 (rhBMP-2) has not yet been proven able to withstand the masticatory force applied by oral implants. In this study, we examined the qualitative changes in an rhBMP-2-induced mandible from the functional force of osseointegrated oral implants. Segmental (30 mm) bone defects were created in the mandibles of beagles. A poly D,L-lactic coglycolic acid-coated gelatin sponge impregnated with rhBMP-2 was grafted to the resected canine mandible. The new bone was formed 8 weeks after surgery and the Brånemark system fixtures were implanted into the reconstructed mandible. After another 8 weeks, the prosthesis was placed over the oral implants. The prosthesis was maintained in occlusion with the opposing natural dentition for 0, 4, 12, 24, or 48 weeks before the animal was euthanized. The quality of regenerated bone was then evaluated histologically and the osseointegration ratio between oral implants and the bonemeasured. During the first 4 weeks, the ratio remarkably increased from 48.9% to 64.5%. After 48 weeks, the ratio approached about 74.5%. The bone loaded for 48 weeks had undergone extensive remodeling and consolidation; its quality was better and maturer than that of bone that was not loaded. These results indicated that the newly formed bone induced by rhBMP-2 was able to withstand the masticatory force applied by oral implants and had become as functionally mature as a natural bone.

Analysis of Variance↗

[Bone regeneration using bone morphogenetic protein (BMP)].

Bone morphogenetic protein (BMP) is one of the most promising osteoinductive substances and is expected to be applied clinically for bone reconstruction. BMP has restored critical-size bone defects in numerous animal experiments, but the evaluation of bone formation by BMP in primates is a prerequisite for its clinical application. We attempted to restore the mandible bone defects in primates using BMP. The implantation of BMP with the carrier completely regenerated the mandible bone defects in the young primates, and the occlusal function was restored by the dental implants inserted into the regenerated bone. Although the use of BMP alone to regenerate mandible bone defects in old monkeys produced inconclusive results, the combination grafts of BMP and bone marrow, which contained osteoprogenitor cells, were successful. Furthermore, the combination of BMP and the culture-expanded cells derived form bone marrow grafts regenerate the segmental bone defects in the mandibles of old monkeys. Thus, the implantation of BMP with the BMP-responding cells could restore large bone defects even in elderly patients.

English Abstract↗