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Biophysical regulation of osteotomy healing: An animal study.

ABSTRACT: BACKGROUND:Osteotomies have been performed for centuries yet there remains a remarkable lack of consensus on optimal methods for cutting bone. There is universal agreement, however, that preserving cell viability is critical. PURPOSE:To identify mechanobiological parameters influencing bone formation after osteotomy site preparation. MATERIALS AND METHODS:A murine maxillary osteotomy model was used to evaluate healing. Computational modeling characterized stress and strain distributions in the osteotomy, as well as the magnitude and distribution of heat generated by drilling. The impact of osteocyte death and bone composition were assessed using molecular and cellular assays. RESULTS:The phases of osteotomy healing in mice align closely with results in large animals; in addition, molecular analyses extended our understanding of osteoprogenitor cell proliferation, differentiation, and mineralization. Computational analyses provided insights into temperature changes caused by drilling and the mechanobiological state in the healing osteotomies, while concomitant cellular assays correlate drill speed with osteocyte apoptosis and bone resorption. Even when drilling was controlled, trabeculated, spongy (Type III) bone healed faster than densely lamellar (Type I) bone because of the abundance of Wnt responsive osteoprogenitor cells in the former. CONCLUSIONS:These data provide a mechanobiological framework for evaluating tools and technologies designed to improve osteotomy site preparation.

SUBMITTER: Wang L

PROVIDER: S-EPMC6190838 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Biophysical regulation of osteotomy healing: An animal study.

Wang Liao L Aghvami Maziar M Brunski John J Helms Jill J

Clinical implant dentistry and related research 20170613 4

<h4>Background</h4>Osteotomies have been performed for centuries yet there remains a remarkable lack of consensus on optimal methods for cutting bone. There is universal agreement, however, that preserving cell viability is critical.<h4>Purpose</h4>To identify mechanobiological parameters influencing bone formation after osteotomy site preparation.<h4>Materials and methods</h4>A murine maxillary osteotomy model was used to evaluate healing. Computational modeling characterized stress and strain ...[more]

PMID: 28608504

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Project description:ObjectivesThe purpose of this study was to investigate whether platelet-rich plasma (PRP) enhances osseous healing in conjunction with a high tibial osteotomy in dogs.Study designRandomized controlled trial.MethodsSixty-four client-owned pet dogs with naturally occurring rupture of the anterior cruciate ligament and that were to be treated with a high tibial osteotomy (tibial plateau leveling osteotomy) were randomized into the treatment or control group. Dogs in the treatment group received autologous platelet-rich plasma activated with calcium chloride and bovine thrombin to produce a well-formed PRP gel that was placed into the osteotomy at the time of surgery. Dogs in the control group received saline lavage of the osteotomy. All dogs had the osteotomy stabilized with identical titanium alloy implants and all aspects of the surgical procedure and post-operative care were identical among dogs of the two groups. Bone healing was assessed at exactly 28, 49, and 70 days after surgery with radiography and ultrasonography and with MRI at day 28. The effect of PRP on bone healing was assessed using a repeated measures analysis of covariance with radiographic and ultrasonographic data and using a t-test with the MRI data.ResultsSixty dogs completed the study. There were no significant differences in age, weight, or gender distribution between the treatment and control groups. Twenty-seven dogs were treated with PRP and 33 were in the control group. The average platelet concentration of the PRP was 1.37x106 platelets/μL (±489x103) with a leukocyte concentration of 5.45x103/μL (±3.5x103). All dogs demonstrated progressive healing over time and achieved clinically successful outcomes. Time since surgery and patient age were significant predictors of radiographic healing and time since surgery was a significant predictor of ultrasonographic assessment of healing. There was no significant effect of PRP treatment as assessed radiographically, ultrasonographically, or with MRI.ConclusionThe PRP used in this study did not hasten osseous union in dogs treated with a high tibial osteotomy.

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Biophysical regulation of osteotomy healing: An animal study.

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Biophysical regulation of osteotomy healing: An animal study.

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