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At least 19 recordsLinked to original sources

Sutural distraction osteogenesis (SDO) versus osteotomy distraction osteogenesis (ODO) for midfacial advancement: a new technique and primary clinical report.

A new technique of osteotomy distraction osteogenesis (ODO) and sutural distraction osteogenesis (SDO) by the use of bone-borne traction hooks is presented. The technique of osteotomy plus distraction osteogenesis is suitable for adult patients. The technique of sutural distraction osteogenesis is suitable for young patients, ages 6 through 12 years. The distraction system consists of a face-bow, orthodontic elastics, and bone-borne traction hooks. The bone-borne traction hooks are made of titanium, with two traction hooks running laterally or downwardly. When a Le Fort III osteotomy is needed, bone-borne traction hooks are inserted through the nostrils into a bone hole drilled at the lateral-inferior pyriform aperture. When no osteotomy is needed, only the bone-borne traction hooks are placed. Heavy elastics were used in the technique of osteotomy distraction osteogenesis for Le Fort III osteotomy adult patients, whereas light forces and thus light elastics were used for younger patients. Three adult patients and four children were treated by osteotomy distraction and sutural distraction, respectively. All seven patients with midfacial hypoplasia established a harmonious facial profile and normal occlusal relationships. Radiographic examination showed balanced advancement of the midfacial skeleton. It is suggested that the treatment of midfacial hypoplasia in children by the technique of sutural distraction osteogenesis is to be preferred because of its simplicity and relative noninvasiveness. Thus, the authors suggest that midfacial hypoplasia should be treated at a younger age by this technique, potentially eliminating the need for a Le Fort III osteotomy at an older age.

Adolescent↗

Subperiosteal implantation of octacalcium phosphate (OCP) stimulates both chondrogenesis and osteogenesis in the tibia, but only osteogenesis in the parietal bone of a rat.

BACKGROUND: It is not known whether long bones and calvaria have distinct biological characteristics. Octacalcium phosphate (OCP), which is a precursor phase of the hydroxyapatite, has been reported to stimulate bone formation if implanted in the subperiosteal region of mouse calvaria. The present study was designed to investigate how the long bone and the calvarium respond to OCP implantation and to compare their biological characteristics. METHODS: The synthetic OCP was implanted into the subperiosteal region of rat tibiae and parietal bones being mixed with bovine type I collagen treated by pepsin (Atelocollagen). The biological response was examined histologically and immunohistochemically for collagen matrix phenotypes of types I and II to identify bone and cartilage formation. RESULTS: Both chondrogenesis and osteogenesis were initiated in the tibia 1 week after implantation of OCP and most of the cartilage was replaced by bone at week 2. However, the parietal bone did not show osteogenesis responding to OCP implantation until week 3, and no cartilage formation was associated with the osteogenesis. CONCLUSIONS: The present study demonstrated the distinct characteristics of biological response to OCP implantation between the long bone and the calvarium in terms of whether or not cartilage formation is involved in the stimulated osteogenesis by OCP, and in terms of timing of the stimulated chondrogenesis and/or osteogenesis, i.e., the parietal bone takes more time to respond to OCP implantation than the tibia.

Animals↗

[Osteogenesis imperfecta cystica (Fairbank)--a special form of osteogenesis imperfecta congenita (Vrolik) (author's transl)].

Two patients, aged 13 and 19 years, with osteogenesis imperfecta congenita (Vrolik) have been seen at the rehabilitation centre at Neckargemund. The younger patient showed the typical appearances of osteogenesis imperfecta cystica (Fairbank), while the older patient failed to show these changes in the skeleton. Contrary to the frequently expressed view that patients with osteogenesis imperfecta congenita always die in the perinatal period, they may survive for a considerable length of time. The change of osteogenesis imperfecta congenita (Vrolik) into osteogensis imperfecta cystica (Fairbank) has been described as a sequence in the occasional survivors by Spranger, but is not a necessary condition for survival. Osteogenesis imperfecta cystica should be regarded as an extremely rare special type of Vrolik's disease.

Adolescent↗

Regional differences of dura osteoinduction: squamous dura induces osteogenesis, sutural dura induces chondrogenesis and osteogenesis.

Dura plays an important role in calvarial morphogenesis. However, precisely what that role is remains unclear. We present here in vivo evidence that dura without other central nervous system components induces both chondrogenesis and osteogenesis. The mechanism is, at least in part, by proximate tissue interaction. The objectives of this experiment were to answer the following: (1) Can dura actually induce osteogenesis without the influence of the underlying brain? (2) What are the requirements of this dura-induced heterotopic osteogenesis? (3) What are the differences between dura underlying sutures and dura underlying the squamous portions of the cranial bones? Dura underlying the metopic, sagittal, and lambdoidal sutures and dura underlying the flat portions of frontal and parietal bones were obtained from neonatal Lewis rats and transplanted into the posterior thoraces of adult Lewis recipients. In group I, dura underlying the metopic, sagittal, and lambdoidal sutures (n = 20) and dura underlying the flat portions of frontal and parietal bones (n = 20) were transplanted individually into separate epitheliomesenchymal pockets. Group II animals had dura underlying the metopic, sagittal, and lambdoidal sutures (n = 10) and dura underlying the flat portions of frontal and parietal bones (n = 10) transplanted individually into surgically created mesenchymal pockets by placing the dura grafts between panniculus carnosus and latissimus dorsi muscles. The animals were sacrificed at 2-week intervals. Light microscopy, special histochemical analysis, immunohistochemistry, and electron microscopy were performed. Bone formation was seen in 15 of the 18 animals (83 percent) in group I. No bone or cartilage formation was seen in group II. Chondrogenesis was seen in 4 animals receiving dura underlying the metopic, sagittal, and lambdoidal sutures in group I. Cellular hyperproliferation was seen at 2 weeks when dura was transplanted close to the hair follicles. These cells had a high nucleus-to-cytoplasm ratio and were positive for transforming growth factor beta. This hyperproliferation was followed by production and accumulation of Alcian blue-positive extracellular matrix that resisted digestion by hyaluronidase. Cellularly active cartilage was seen at 6 weeks. There was no chondrogenesis in animals receiving dura underlying the flat portions of frontal and parietal bones in group I. Electron microscopy demonstrated the presence of proteoglycan-like ground substance and type II collagen in the inner layer of sutural dura and the predominance of dense type I collagen in the squamous dura and the external layer of the sutural dura. The important findings of this experiment are that (1) heterotopically transplanted neonatal dura can induce osteogenesis, (2) this heterotopic osteoinduction by dura requires epitheliomesenchymal interaction, and (3) separating dura into sutural dura and squamous dura, chondrogenesis occasionally occurred in addition to osteogenesis with the former, while only membranous ossification occurred with the latter, indicating intrinsic differences within the dura mater. This dural heterogeneity is supported by direct ultrastructural data.

Animals↗

BMP-induced osteogenesis on the surface of hydroxyapatite with geometrically feasible and nonfeasible structures: topology of osteogenesis.

Bone morphogenetic protein (BMP) is known to require a suitable carrier to induce ectopic bone formation in vivo. Hydroxyapatite ceramics have been reported to be effective in some forms but ineffective in others as a carrier of BMP-induced bone formation. In this study we compare three geometrically different forms of hydroxyapatite to examine their functions as carriers of BMP-induced bone formation. A fraction containing all the active BMPs (BMP cocktail) was partially purified from a 4M guanidine extract from bovine bone by a three-step chromatographic procedure. The BMP cocktail was combined with each of three forms of hydroxyapatite--solid particles (SPHAP), porous particles (PPHAP), and coral-replicated porous tablets (coral-HAP)--and implanted subcutaneously into rats. Both the PPHAP and coral-HAP systems induced osteogenesis 2 weeks after implantation, as evidenced by morphological and biochemical observations. Details of the osteogenetic process were followed by double-fluorescence labeling in the coral-HAP system to confirm bone formation on the surface of hydroxyapatite. However, there was no evidence of osteogenesis or chondrogenesis in the SPHAP system. The results indicate that the geometry of the interconnected porous structure in PPHAP and coral-HAP create spaces for vasculature that lead to osteogenesis while the smooth structure and close contact of particles in SPHAP inhibit vascular formation and proliferation of mesenchymal cells, preventing bone and cartilage formation. It was concluded that the geometrical structure in hydroxyapatite ceramics that induces vasculature is crucial as a carrier for BMP-induced bone formation.

Alkaline Phosphatase↗

[Osteogenesis imperfecta--lower limb in osteogenesis imperfecta].

The author of this paper asses lower extremity in 141 children with osteogenesis imperfecta, treated in University Children Hospital in Krakow in years 1988-2002: number of fractures, presence of the deformation, radiological findings, possibility of walking. Only 3 from this group did not suffer from lower extremity long bone fractures. In remaining patients, the number of fractures was 4 on average with type I and IV, and 46 fractures in children with type III osteogenesis imperfecta in each patient. Perinatal fractures appeared in 26 children with type II or III oi. In remaining, first fracture happened at the age of 23 months on average. 21% of the children had never walked before, and the rest of them started pionisation at the age of 20 months on average. Lower extremities deformations appeared in 113 children (80%). We assessed typical deformity pattern, based on clinical and radiological findings: varisation of femur and antecurvation of the tibia. The movement limitations in hips or knees was found in 29 children. Radiological changes in growth cartilage, so-called "popcorn calcification" were found in 15 children with type III of osteogenesis imperfecta.

Female↗

Extracellular signal-related kinase and bone morphogenetic protein expression during distraction osteogenesis of the mandible: in vivo evidence of a mechanotransduction mechanism for differentiation and osteogenesis by mesenchymal precursor cells.

BACKGROUND: The goal in this study was to investigate the role of extracellular signal-related kinase (ERK) 1/2, a central regulator of mesenchymal stem cell differentiation, and its temporal relationship to bone morphogenetic protein (BMP) 2/4, a potent osteogenic growth factor, during live model distraction osteogenesis. METHODS: The authors examined histomorphometric expression through the early temporal sequence for both ERK 1/2 and BMP 2/4 during gradual distraction to 5.1 mm (n = 12 net). Comparison groups (group sizes, n = 12) included an acute critical-size defect of 5.1 mm and a subcritical-size defect of 2.1 mm. RESULTS: In the group gradually distracted to 5.1 mm, immunohistochemical analysis demonstrated significant intranuclear expression of ERK 1/2 within mesenchymal precursor cells at the osteotomy edges early in distraction (postoperative days 6 and 9). ERK 1/2 became increasingly localized to hypertrophic chondrocytes within the distraction regenerate during the later stages of distraction (postoperative day 16). Adjacent sections examined for BMP 2/4 expression established a close temporal and spatial correlation with ERK 1/2. BMP 2/4 expression was initially present in the regions surrounding mesenchymal precursor cells expressing ERK 1/2, but then developed most prominently within the cytoplasm of hypertrophic chondrocytes expressing ERK 1/2 late in distraction. Comparison groups consistently demonstrated either fibrous nonunion or bony union typical in fracture healing, depending on defect size. However, even specimens with subcritical-size defects and complete bony union were consistently found to have minimal ERK 1/2 expression. CONCLUSIONS: These data provide evidence that ERK 1/2 expression is present within mesenchymal precursor cells during distraction osteogenesis and that ERK expression correlates closely with BMP 2/4 expression. The presence of ERK 1/2 expression only during gradual distraction strongly implicates the concept that mechanical strain appears to be the key upregulating factor for ERK 1/2 expression, based on comparison with fracture-healing and critical-size defect specimens.

Animals↗

Histomorphometrical analysis of new bone obtained by distraction osteogenesis and osteogenesis by periosteal distraction in rabbits.

The aim of this study was to compare histomorphometrically the new bone tissue obtained using two different distraction methods, and evaluate these two methods in terms of their advantages and disadvantages. In 36 New Zealand adult male rabbits, divided into two groups, a gradual distraction was performed using a device placed on the lateral surface of the mandibular corpus. In one group osteotomy was not performed and osteogenesis by periosteal distraction (OPD) only was used. In the other group, conventional distraction osteogenesis (DO) was performed. After a 7-day latent phase, the same distraction protocol was applied to both groups. Each group of rabbits was further divided into three sub-groups killed on the 15th, 30th and 60th days of the consolidation period, and histological analysis was performed. The mean extent of newly formed bone tissue was 14.4 mm2 in the OPD groups and 25.4 mm2 in the DO groups. When compared statistically, there were significant differences between all the DO and OPD sub-groups. The newly formed bone tissue obtained by OPD was rich in interstitial fatty tissue. These results indicate that bone tissue newly formed by OPD is not suitable for occlusal forces.

Adipose Tissue↗

[Osteogenesis imperfecta--operative treatment on lower extremities in children with osteogenesis imperfecta].

The group of 141 children with osteogenesis imperfecta was treated in Orthopaedic Department of the University Children Hospital in Krakow, Poland. In 77 (54.6%) children from this group, we operated on lower extremities. Prophylactic operations, that were intramedullary Rush rodding, we performed in 19 cases (14 femurs and 11 tibias). Sofield-Millar procedures we performed in 58 children. We operated 321 times - there are 4 operations on average in one child. Average follow-up period was 6.7 years. We operated 473 long bones: 234 femurs and 239 tibias. We did 479 osteotomies. First operations were done at the age of 9 years on average (1.5-21 years). Further operations, 3 in each patient on average, we performed in period 37 months from one to another on tibias and 49 months on femurs. In all operated children we achieved full axis correction and their activity after operation improved. In order to assess that, we used the Bleck scale. In general, before operation, 54 (70%) children did not walk, and, in contrast, after operations 53 (69%) started walking. Operative treatment of the lower extremities in children with osteogenesis imperfecta improves their clinical physical abilities, quality of life and allows increase in activities.

Adolescent↗

Growth factors in distraction osteogenesis. Immuno-histological pattern of TGF-beta1 and IGF-I in human callus induced by distraction osteogenesis.

Although growth factors have been demonstrated during bone healing, their presence has not yet been confirmed in callus distraction. Therefore, in 3 patients we searched for cytokines during callus distraction. Bone biopsies were immuno-histochemically stained for TGF-beta1, IGF-I, TGF-beta type II receptor, IGF receptor, and proliferating cell nuclear antigen (PCNA). Histologically we found immature woven bone in the middle of the callus zone and increasing calcification and lamellar bone in the re-modelling zone. Osteoblasts and fibroblast-like cells in the middle zone, and osteoblasts in all zones stained for TGF-beta and its receptor. The number of positive staining cells related to proliferous activity as assessed both by PCNA, and by bone density in radiographs. IGF-I could be detected everywhere. In conclusion, growth factors are present in bone formation and in areas of re-modelling during callotasis. Their relation to proliferous activity and radiographic density supports their involvement in osteogenesis.

Adult↗

Influence of age and gender on peri-implant osteogenesis. Age and gender on peri-implant osteogenesis.

Among the local and systemic factors affecting bone repair, great interest is focused on age and gender. The aim of this work was to perform a histomorphometric evaluation of peri-implant bone healing response in male and female rats aged 1 and 3 months. Forty Wistar rats were i.p. anesthetized with xylazine and ketamine. A c.p. Ti implant (Implant Vel, Buenos Aires-Argentina) was placed in the right tibia following the method described by Cabrini et al. (Implant Dent 1993; 2:264-267). Group I: (GI, n = 10) female rats aged 1 month; Group II: (GII, n = 10) female rats aged 3 months; Group III: (GIII, n = 10) male rats aged 1 month; Group IV: (GIV, n = 10) male rats aged 3 months. All the animals were killed by ether overdose 30 days post-implantation. The tibiae were resected, radiographed and embedded in methyl-methacrylate. Ground sections perpendicular to the longer axis of the tibia were obtained and stained with toluidine blue. Percentage of osseointegration and peri-implant bone tissue volume were evaluated. No differences in peri-implant bone tissue histology were observed among groups. No statistically significant differences in peri-implant bone volume and percentage of osseointegration were observed between GII (adult females) and GIV (adult males). Peri-implant bone volume and percentage of osseointegration were markedly greater in GIV (adult males) than in GIII (young males) (14 +/- 1 mm2 and 8 +/- 2 mm2) p < 0.01 and (49 +/- 6% and 24 +/- 9%) p < 0.01 respectively. Using this experimental model, differences in peri-implant osteogenesis (bone volume and percentage of osseointegration) associated to gender were only observed in the young rats, and differences associated to age were found between the groups of males.

Age Factors↗

[Osteogenesis imperfecta--upper limb in osteogenesis imperfecta].

The authors of this paper discuss upper extremity in children with osteogenesis imperfecta: fractures frequency, presence of the deformity, radiological data as well as ability to use the limb. Fractures of the upper extremity and shoulder ring occurred in 93 (66%) among 141 children with oi that were treated in the ward in years 1988-2002. Most of the fractures occurred in children with type III oi in Sillence classification, this was a group were deformities appeared most frequently. Generally, deformities were found in 33% of the children with oi. Typical arm deformity was posterior bending, in forearm dorsal bending. Varus elbow occurred often (11%). We found in the x-rays capitis radius dislocation (3.5%), interosseus membrane ossification (2.1%), pseudoarthrosis of the forearm bones (2.1%). The causes of the deformities and opportunities to prevent them were discussed.

Arm Injuries↗

Osteogenesis after bone and bone marrow transplantation. The ability of ceramic materials to sustain osteogenesis from transplanted bone marrow cells: preliminary studies.

The ability of four different ceramic materials to support osteogenesis when placed with bone marrow into an intermuscular site was studied. In the search for biodegradable porous ceramic materials that could be used for bone replacement and that would slowly be replaced by bone by means of "creeping substitution," the authors fabricated porous alumina, calcium aluminate, calcium hydroxyapatite, and tricalcium phosphate. Specially shaped compacts, impregnated with autologous bone marrow, were inserted into intermuscular pouches in rabbits and retrieved after 14-182 days. Newly formed bone was found within the contents of the well after 14 days and was visible at all times up to 182 days. The bone was frequently found to have adhered to the ceramic and to have penetrated the interior if the pore size was greater than 100 micron. Further investigation of the use of synthetic materials in bone replacement is warranted due to the finding that some porous ceramic material permit bony ingrowth from autologous marrow cells.

Aluminum↗