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

口腔颌面部疾病治疗后骨缺损的修复是一个难题，目前已采用多种方法进行治疗。近年来，许多带蒂骨瓣已被用于修复，但供区有限。许多作者已经提出了血管化或游离骨膜的成骨能力，但关于骨膜成骨的几个结论已经显示出来。本研究旨在探讨带血管蒂骨膜瓣复合去端胶原和重组人骨形态发生蛋白-2（rhBMP-2）的成骨作用，以及在骨膜瓣内填充基质以增强骨膜的成骨能力。2例用骨膜卷起移植于腹部皮下。骨膜成骨的组织学、X线观察及分子生物学检测 ...更多信息 术后3、5天及1、3、5、7、9周取材，X线片显示rhBMP-2组新骨形成量明显多于去端胶原组。但在这两种情况下，在术后5至9周观察到新骨的重塑。组织学观察显示，去端胶原组在术后2周内形成膜性骨化，而rhBMP-2组既有软骨内骨化又有膜性骨化。去端胶原的骨形成速度快于rhBMP-2。在分子生物学检查中，由于仅切除骨膜取材困难，无法显示重复性结果。将rhBMP-2/PLGA（rhBMP-2/poly（DL-lactide-co-glycolide））胶囊植入大鼠皮下的实验表明，rhBMP-2在大鼠皮肤外的作用是诱导间充质细胞向成骨细胞分化。少

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