Synergistic Enhancement of New Bone Formation by Recombinant Human Bone Morphogenetic Protein-2 and Osteoprotegerin in Trans-Sutural Distraction Osteogenesis: A Pilot Study in Dogs

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• 作者：Yusheng Yao ; MD^? ; ^{yaoyusheng700714@sina.com} ; Guijun Wang ; MD^&dagger ; ; Zhiying Wang ; MD^&Dagger ; ; Chengyue Wang ; MD^§ ; ; Haizhong Zhang ; MD ; DDS^¡Î ; Chunming Liu ; MD ; DDS^¶ ;
• 刊名：Journal of Oral and Maxillofacial Surgery
• 出版年：2011
• 出版时间：November, 2011
• 年：2011
• 卷：69
• 期：11
• 页码：e446-e455
• 全文大小：2576 K

文摘

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Purpose

The previous decade has witnessed increasing emphasis on the technique of trans-sutural distraction osteogenesis (TSDO), a new and challenging procedure to reconstruct deficiencies in craniomaxillofacial bone. The purpose of this study was to determine if locally administered recombinant human bone morphogenetic protein-2 (BMP-2)/Poly(lactic-co-glycolic acid)/Fibrin sealant and recombinant human osteoprotegerin recombinant OPG fusion protein improves osteoblastogenesis and new bone formation by TSDO.

Materials and Methods

Thirty-two dogs were divided into 4 groups: control, BMP-2, OPG, or BMP-2 plus OPG. Two dogs from each group were sacrificed at 1, 2, 4, and 6 weeks after initiating the DO protocol. Immunohistochemical, histomorphometric, and electron microscopic assessments were performed to investigate the effects of BMP-2 or OPG induced by TSDO.

Results

The animals demonstrated significant overgrowth of the maxilla (control, 19.5 ¡À 2.61 mm; BMP-2, 19.9 ¡À 1.47 mm; OPG, 18.3 ¡À 1.2 mm; BMP-2 + OPG, 20.5 ¡À 2.65 mm). Histologically, the palatine suture widened dramatically within 2 weeks after distraction. Osteoblast number, trabecular thickness, content of alkaline phosphatase, and integrated optical density of BMP-2 increased obviously in the BMP-2 + OPG group (P < .05).

Conclusions

TSDO in growing dogs is a safe, well-tolerated technology. The study found that OPG alone did not improve bone regeneration, but that it acted synergistically with BMP-2 to increase recruitment of mesenchymal stem cells and led to a significant enhancement of bone formation and healing. The temporal pattern of BMP-2 expression is consistent with a role in the regulation of mechanical and biological interventions designed to promote bone regeneration.