Calvarial Bone Graft Harvest: Techniques, Considerations, and Morbidity

Frodel, John L.; Marentette, Lawrence J.; Quatela, Vito C.; Weinstein, Gregory S.

doi:10.1001/archotol.1993.01880130019002

Cited by 115 publications

(63 citation statements)

References 22 publications

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“…The filtered solution was then centrifuged. The pellet was removed and washed twice in PBS 5 mM ethylenediaminetetraacetic acid (EDTA) before a red blood cell lysis buffer (155 mM NH 4 Cl, 10 mM KHCO 3 , and 0.1 mM EDTA) was added. After three additional PBS washes and centrifugations, trypan blue staining was used to count the number of viable hSVF cells.…”

Section: Isolation Of Svf From Human Lipoaspiratementioning

confidence: 99%

“…1 However, the disadvantages associated with bone graft harvests are significant, including limited endogenous supply, prolonged surgical times, and harvest complications. [1][2][3][4] Cell sources such as bone marrow mesenchymal stem cells (BMSCs) and adipose-derived stem cells (ASCs) have generated significant interest for their tissue engineering potential. [5][6][7] However, the limitations associated with these conventional stem cell sources are also significant.…”

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confidence: 99%

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Human Perivascular Stem Cells Show Enhanced Osteogenesis and Vasculogenesis with Nel-Like Molecule I Protein

Askarinam¹,

James

Zara

et al. 2013

Tissue Engineering Part A

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An ideal mesenchymal stem cell (MSC) source for bone tissue engineering has yet to be identified. Such an MSC population would be easily harvested in abundance, with minimal morbidity and with high purity. Our laboratories have identified perivascular stem cells (PSCs) as a candidate cell source. PSCs are readily isolatable through fluorescent-activated cell sorting from adipose tissue and have been previously shown to be indistinguishable from MSCs in the phenotype and differentiation potential. PSCs consist of two distinct cell populations: (1) pericytes (CD146 + , CD34 -, and CD45 -), which surround capillaries and microvessels, and (2) adventitial cells (CD146 -, CD34 + , and CD45 -), found within the tunica adventitia of large arteries and veins. We previously demonstrated the osteogenic potential of pericytes by examining pericytes derived from the human fetal pancreas, and illustrated their in vivo trophic and angiogenic effects. In the present study, we used an intramuscular ectopic bone model to develop the translational potential of our original findings using PSCs (as a combination of pericytes and adventitial cells) from human white adipose tissue. We evaluated human PSC (hPSC)-mediated bone formation and vascularization in vivo. We also examined the effects of hPSCs when combined with the novel craniosynostosis-associated protein, Nel-like molecule I (NELL-1). Implants consisting of the demineralized bone matrix putty combined with NELL-1 (3 mg/mL), hPSC (2.5 · 10 5 cells), or hPSC + NELL-1, were inserted in the bicep femoris of SCID mice. Bone growth was evaluated using microcomputed tomography, histology, and immunohistochemistry over 4 weeks. Results demonstrated the osteogenic potential of hPSCs and the additive effect of hPSC + NELL-1 on bone formation and vasculogenesis. Comparable osteogenesis was observed with NELL-1 as compared to the more commonly used bone morphogenetic protein-2. Next, hPSCs induced greater implant vascularization than the unsorted stromal vascular fraction from patientmatched samples. Finally, we observed an additive effect on implant vascularization with hPSC + NELL-1 by histomorphometry and immunohistochemistry, accompanied by in vitro elaboration of vasculogenic growth factors. These findings hold significant implications for the cell/protein combination therapy hPSC + NELL-1 in the development of strategies for vascularized bone regeneration.

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Section: Isolation Of Svf From Human Lipoaspiratementioning

confidence: 99%

mentioning

confidence: 99%

Human Perivascular Stem Cells Show Enhanced Osteogenesis and Vasculogenesis with Nel-Like Molecule I Protein

Askarinam¹,

James

Zara

et al. 2013

Tissue Engineering Part A

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“…The quest for beauty, for an aesthetic and harmonious smile, makes individuals increasingly seek out the dentist for the restoration of occlusal function and esthetics Frodel et al, 1993;Iturriaga & Ruiz;Nyström et al;Orsini et al;Prolo;Ramalho-Ferreira et al). Coupled to this, with increasing life expectancy of the population, there was .…”

Section: Discussionmentioning

confidence: 99%

Particularities in the Surgical Technique of Calvaria Graft

Ferreira

Faverani

Jardim

et al. 2012

Int. J. Odontostomat.

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Calvaria grafts provide good bone quantity for the reconstruction of the atrophic maxilla, and have lower morbidity and resorption rates when compared to iliac crest. The aim of this paper is to present the technique for obtaining a graft of the skull. Initially, the depth of the osteotomy is determined by a manually conducted bur, which establishes the limits of the structures of the skull (outer table, diploe and inner table), making the removal of bone blocks easier and safer. Thus, osteotomies of the blocks are made with greater security, avoiding the complications inherent to surgical technique. The case that will be presented it is from a male patient of 65 years who refused to submit to the iliac crest graft, opting for the calvaria, despite being bald, that is a contraindication for this treatment modality. A delicate suture associated with placement of titanium mesh to maintain the conformation of the patient's skull in the region of the bone defect, created after removal of the graft, provided a good cosmetic result at the donor site. The use of titanium mesh for re-anatomization of bone defects created in the grafts is well indicated for bald patients.

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“…Low incidences of resorption and infection are seen (Frodel et al, 1993) although limitations include unpredictable splitting of the inner and outer tables due to poorly developed diploe in children under the age of five (Hockley et al, 1990), a weakened donor site calculated to a mean of 36% loss of strength for a harvest area of 40mmx40mm (Laure et al, 2010), and the quantity of bone available may not be enough for large defects. Rib grafts have been previously documented in small series or case reports for cranioplasty (Munro and Guyuron, 1981;Takumi and Akimoto, 2008), with only one series reporting 13 cases since 1997 (Taggard and Menezes, 2001).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…The most common donor sites for full thickness calvarial defects are split calvarial grafts and split ribs (Tessier et al, 2005;Jackson et al, 1986). Autogenous bone provides a biological reconstruction that has the potential to grow with the patient and once revascularised has minimal long term infection risk, however limitations include donor site morbidity, limited availability of sufficient bone, difficulty in contouring grafts adequately (Frodel et al, 1993) and high incidence of resorption compared to adults (Grant et al, 2004). Biomaterials in current use include acrylics, ceramics, polyethene, polyetheretherketone (PEEK) and titanium (Cho and Gosain., 2004;Hanasono et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Titanium cranioplasty in children and adolescents

Williams

Fan

Bentley

2016

Journal of Cranio-Maxillofacial Surgery

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SUMMARYFull thickness calvarial defects present considerable challenges to reconstructive surgeons. In paediatric cases, the use of biomaterials as a substrate for cranioplasty rather than autologous bone is controversial. Alloplastic cranioplasty in adults is supported by several large case series however long term outcome of biomaterial use in paediatric cases is limited. Retrospective seven year analysis of departmental database and clinical records identified 22 patients aged under 18 who had undergone 23 custom made titanium cranioplasties by a single surgeon using the same technique.Data including patient demographics, reason for craniectomy and complications experienced following surgery was obtained. The mean age at operation was 12 years 9 months. The mean defect size was 44.3cm 2 . No significant complications related to the cranioplasty were recorded in the early post operative period or during long term review (average follow up 4 years 6 months). No cranioplasty implant required removal. This retrospective case series shows that custom made patient specific titanium cranioplasty is a viable alternative to autologous bone as a reconstructive material in paediatric patients under specific circumstances.

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Calvarial Bone Graft Harvest: Techniques, Considerations, and Morbidity

Cited by 115 publications

References 22 publications

Human Perivascular Stem Cells Show Enhanced Osteogenesis and Vasculogenesis with Nel-Like Molecule I Protein

Human Perivascular Stem Cells Show Enhanced Osteogenesis and Vasculogenesis with Nel-Like Molecule I Protein

Particularities in the Surgical Technique of Calvaria Graft

Titanium cranioplasty in children and adolescents

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