Experimental study of bone formation using vascularized periosteum and development of artificial periosteum

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Various procedures have been used to treat the difficult problems of reconstruction of bone defect following the treatment of oral and maxillofacial diseases. Recently, many pedicled flaps with bone have been used for the reconstruction, but donor sites are limited. Many authors have presented the osteogenetic capacity of vascularized, or free, periosteum, but several conclusions about bone formation by the periosteum have been showed. The purposes of this study were (1) to evaluate the osteogenesis of vascularized periosteal flap combined with atelocollagen and recombinant human bone morphogenetic protein-2 (rhBMP-2) and (2) to develop the matrix filled inside that to increase the osteogenetic capacity of periosteum.Vascularized periosteal flap of tibia of rats was elevated and atelocollagen of rhBMP-2 was rolled up by the periosteum and grafted in abdominal subcutaneous area. Histological and radiographic observations of bone formation and molecular biological examination of perioste … More um were made at 3 and 5 days and 1, 3, 5, 7 and 9 Weeks.Radiologic findings indicated that a greater amount of new bone was seen in case of rhBMP-2 implantation than that of atelocollagen. But in both cases remodeling of new bone was observed between 5 and 9 weeks after surgery. Histologic observation showed that in case of atelocollagen bone was formed with membranous ossification during 2 weeks after surgery, although in case of rhBMP-2 both endochondral and membranous ossification were seen. The rate of bone formation in case of atelocollagen was faster than that of rhBMP-2. In molecular biological examination, reproducible result could not be shown, because it was difficult to resect only periosteum for sample. The experiment of implantation of rhBMP-2/PLGA capsules (rhBMP-2 with poly (DL-lactide-co-glycolide)) to subcutaneous area of rats indicated that the role of rhBMP-2 in the extraskeletal site of rats was to induce the differentiation of mesenchymal cells into the osteoblasts. Less