Orthodontic Tooth Movement in Alveolar Cleft Repaired with a Tissue Engineering Bone: An Experimental Study in Dogs

Abstract

Tissue engineering approaches have been successfully used in repairing bone defects and have become a viable alternative to autologous bone. The aim of the present study was to investigate if a construct of porous beta-tricalcium phosphate (β-TCP) combined with osteogenically induced bone marrow stromal cells (bMSCs) could repair alveolar cleft, and allow for subsequent orthodontic tooth movement in a canine model. Twelve alveolar osteotomy surgeries in six animals were made bilaterally and randomly implanted by (1) tissue-engineered bone complex of bMSCs/β-TCP (group A, n=4), (2) β-TCP alone (group B, n=4), and (3) autologous bone obtained from iliac bone (group C, n=4). Contralateral alveolar defects were created in one animal and left untreated to serve as blank control to observe spontaneous healing of the defects. Sequential fluorescent labeling and radiographic observation was used to evaluate new bone formation and mineralization in each defect. Orthodontic tooth movement was initiated 8 weeks after surgical operation for 12 weeks, and then the dogs were sacrificed for histological and histomorphometric analysis. Results indicated that the tissue-engineered complex with bMSCs/β-TCP dramatically promoted new bone formation and mineralization and achieved a favorable height of the repaired alveolar when compared with β-TCP alone, which absorbed severely. The overall effect of the tissue-engineered bone was equivalent to autologous bone; the physiological function of the alveolar bone was restored by allowing the adjacent teeth to move into the newly formed bone in the grafted region. This study demonstrated that the tissue engineering bone from the combination of β-TCP and bMSCs is a feasible clinical approach for patients with alveolar cleft and the subsequent orthodontic tooth movement.

Efficient Bone Formation in a Swine Socket Lift Model Using <b><i>Escherichia coli-</i></b>Derived Recombinant Human Bone Morphogenetic Protein-2 Adsorbed in β-Tricalcium Phosphate

“…Regarding the biomaterial, we used β-TCP as a carrier and scaffold because it is well known to have osteoinductive or osteogenic abilities and is widely used as bone prosthetic material [Uckan et al, 2010;Zhang et al, 2011]. Our histological data, however, showed that β-TCP alone induced no new bone formation and remained in the lifted space even after 8 weeks of observation ( fig.…”

The healing of critical-size calvarial bone defects in rat with rhPDGF-BB, BMSCs, and β-TCP scaffolds

“…It has been extensively used for repairing bone defect in craniofacial and maxillary region [3,4]. As a scaffold material for bone regeneration, b-TCP possesses good biocompatibility for cell attachment, differentiation in vitro and bone formation in vivo.…”

Effect of flapless osteoperforation-assisted tooth movement on atrophic alveolar ridge: Histomorphometric and gene-enrichment analysis

“…[3][4][5] Ridge augmentation procedures have been applied to improve periodontal dimensions around the moving tooth toward the atrophic ridge, 3,4 recently in conjunction with tissue-engineering techniques. 5 However, this procedure requires invasive surgical insult and a postsurgical waiting period for graft stabilization before initiating OTM while retaining risks of graft failure and root resorption.…”

“…[3][4][5] Ridge augmentation procedures have been applied to improve periodontal dimensions around the moving tooth toward the atrophic ridge, 3,4 recently in conjunction with tissue-engineering techniques. 5 However, this procedure requires invasive surgical insult and a postsurgical waiting period for graft stabilization before initiating OTM while retaining risks of graft failure and root resorption. 3 As a minimally invasive approach, flapless decortication such as corticision, 6 piezocision, 7 piezopuncture, 8 and micro-osteoperforation 9 has been attempted to preserve periosteal blood supply and surrounding soft tissues to minimize external ridge resorption while activating internal remodeling of bone and the periodontal ligament to elicit a regional acceleratory phenomenon (RAP).…”