Radiation-Induced Impairment of Bone Healing Can Be Overcome by Recombinant Human Bone Morphogenetic Protein-2

Würzler, K. K.; DeWeese, Theodore L.; Sebald, W.; Reddi, A. Hari

doi:10.1097/00001665-199803000-00009

Cited by 75 publications

(64 citation statements)

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“…New bone was formed on BMP-2-treated hydroxyapatite disks implanted into a subperiosteal pocket in rabbits radiated pre-operatively with a fractionated dose of 20 Gy (Howard et al, 1998). Despite these encouraging findings, 3-mm rat calvarial defects preoperatively treated with a 12-Gy radiation dose, and subsequently with BMP-2, had successful bone regeneration, but incomplete healing of the defect (Wurzler et al, 1998). In rat mandibular defects treated with a fractionated 45-Gy radiation dose, followed by transplantation of demineralized bone powder, only 39% of defects had more than 50% bone fill (Lorente et al, 1992).…”

Section: (53) Craniofacial Bone Regeneration After Ablative Cancer Smentioning

confidence: 99%

Craniofacial Tissue Engineering by Stem Cells

et al. 2006

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Craniofacial tissue engineering promises the regeneration or de novo formation of dental, oral, and craniofacial structures lost to congenital anomalies, trauma, and diseases. Virtually all craniofacial structures are derivatives of mesenchymal cells. Mesenchymal stem cells are the offspring of mesenchymal cells following asymmetrical division, and reside in various craniofacial structures in the adult. Cells with characteristics of adult stem cells have been isolated from the dental pulp, the deciduous tooth, and the periodontium. Several craniofacial structures-such as the mandibular condyle, calvarial bone, cranial suture, and subcutaneous adipose tissue-have been engineered from mesenchymal stem cells, growth factor, and/or gene therapy approaches. As a departure from the reliance of current clinical practice on durable materials such as amalgam, composites, and metallic alloys, biological therapies utilize mesenchymal stem cells, delivered or internally recruited, to generate craniofacial structures in temporary scaffolding biomaterials. Craniofacial tissue engineering is likely to be realized in the foreseeable future, and represents an opportunity that dentistry cannot afford to miss.

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Section: (53) Craniofacial Bone Regeneration After Ablative Cancer Smentioning

confidence: 99%

Craniofacial Tissue Engineering by Stem Cells

et al. 2006

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“…Because prior studies have demonstrated that exogenously delivered BMP-2 can overcome radiation-induced impairment of bone formation both in vitro and in vivo [26,27,56], our negative findings are confounding and perhaps illustrate that further investigation into our polymeric BMP-2 gene delivery system is warranted. Gene transfer by viral vectors represents a very ubiquitous approach in gene therapy studies, the most common vectors being adenoassociated viruses, retroviruses, and lentiviruses [32].…”

Section: Discussionmentioning

confidence: 86%

Gene Therapy to Enhance Allograft Incorporation After Host Tissue Irradiation

Santoni

Turner

Wheeler³

et al. 2008

Clin Orthop Relat Res

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Structural bone allografts are used to reconstruct large skeletal defects after tumor surgery. Although allograft-related complications are declining, the use of perioperative radiation therapy is associated with a poorer outcome. Recently, BMP-2 levels in the host bed were reportedly diminished after exposure to radiation doses consistent with those used perioperatively to treat musculoskeletal sarcoma. Reintroduction of this osteogenic protein may circumvent the deleterious effects of preoperative radiation on allograft incorporation. We introduced a novel polymeric BMP-2 gene delivery system into the host-allograft junctions at the time of transplantation in an ovine tibial defect model with or without preoperative exposure to 50 Gy radiation. After 4 months, we noted no radiographic or histologic improvements in allograft incorporation after preoperative radiation and BMP-2 reintroduction; however, 50 Gy radiation was associated with increased porosity in the interface regions and poorer radiographic healing. We identified no BMP2-expressing cells or protein in the interface at the study end point, suggesting the polymeric gene delivery system was unable to promote extended expression of the protein or induce a healing response. Although gene therapy may hold promise as a novel technique to improve allograft incorporation, our data do not support that contention with the current approach.

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“…[16] The most heavily studied bone morphogenetic proteins are BMP-2 and BMP-7. [17] BMPs are currently being used to promote osteogenesis in a wide variety of clinical settings where bone growth is critical. Therefore, it is worthwhile to include autogenous cancellous bone, a rich source of BMPs, in bone graft implants.…”

Section: Discussionmentioning

confidence: 99%

Mandibular defect reconstruction utilizing preoperative 3D modeling, plate pre-bending and a novel triad graft: a case report

Wagner¹,

Wagner²,

Wagner³

2017

SDS

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The reconstruction of boney defects of the mandible are a challenge in surgical therapy despite advances in bone grafting. This case study details a 30-year-old female who sustained a gunshot wound to the mandible leaving a 5 cm boney defect. This defect was reconstructed utilizing preoperative three-dimensional (3D) planning, an accurately pre-bent reconstruction plate, and a novel "triad" construct of autogenous bone graft, demineralized bone matrix, and an osteoprotective membrane. This reconstruction workflow allowed maintenance of the contour of the mandible and bone regeneration while also acting as a barrier to other tissues. This new technique reduced operative donor site morbidity and decreased surgical time dramatically, allowing the patient to be discharged the same day. The patient has a 5-year follow-up with panorex film and a biopsy of the graft area showing normal cortical bone. This case report illustrates the combination of advanced technology and novel products which can decrease operating time, decrease anesthesia time, increase precision, and most importantly decrease patient morbidity. Key words:3-dimensional prototyping, osteoprotective membrane, acellular dermal matrix, demineralized bone matrix putty, bone morphogenetic proteins, osteopromotion, pre-bending, reconstruction plate ABSTRACTArticle history:

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Radiation-Induced Impairment of Bone Healing Can Be Overcome by Recombinant Human Bone Morphogenetic Protein-2

Cited by 75 publications

References 0 publications

Craniofacial Tissue Engineering by Stem Cells

Craniofacial Tissue Engineering by Stem Cells

Gene Therapy to Enhance Allograft Incorporation After Host Tissue Irradiation

Mandibular defect reconstruction utilizing preoperative 3D modeling, plate pre-bending and a novel triad graft: a case report

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