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Journal of Dental Research Feb 2022The clinical translation of bone tissue engineering for reconstructing large bone defects has not advanced without hurdles. The bioreactor (IVB) concept may therefore...
The clinical translation of bone tissue engineering for reconstructing large bone defects has not advanced without hurdles. The bioreactor (IVB) concept may therefore bridge between bone tissue engineering and reconstructive surgery by employing the patient body for prefabricating new prevascularized tissues. Ideally, IVB should minimize the need for exogenous growth factors/cells. Periosteal tissues are promising for IVB approaches to prefabricate tissue-engineered bone (TEB) flaps. However, the significance of preserving the periosteal vascular supply has not been adequately investigated. This study assessed muscle IVB with and without periosteal/pericranial grafts and flaps for prefabricating TEB flaps to reconstruct mandibular defects in sheep. The sheep ( = 14) were allocated into 4 groups: muscle IVB (M group; = 3), muscle + periosteal graft (MP group; = 4), muscle + periosteal flap (MVP group; = 4), and control group ( = 3). In the first surgery, alloplastic bone blocks were implanted in the brachiocephalic muscle (M) with a periosteal graft (MP) or with a vascularized periosteal flap (MVP). After 9 wk, the prefabricated TEB flaps were transplanted to reconstruct a mandibular angle defect. In the control group, the defects were reconstructed by non-prevascularized bone blocks. Computed tomography (CT) scans were performed after 13 wk and after 23 wk at termination, followed by micro-CT (µCT) and histological analyses. Both CT and µCT analysis revealed enhanced new bone formation and decreased residual biomaterial volume in the MVP group compared with control and MP groups, while the M group showed less new bone formation and more residual biomaterial. The histological analysis showed that most of the newly formed bone emerged from defect edges, but larger areas of new bone islands were found in MP and MVP groups. The MVP group showed enhanced vascularization and higher biomaterial remodeling rates. The periosteal flaps boosted the reconstructive potential of the prefabricated TEB flaps. The regenerative potential of the periosteum was manifested after the transplantation into the mechanically stimulated bony defect microenvironment.
Topics: Animals; Bone Transplantation; Humans; Mandible; Periosteum; Sheep; Surgical Flaps; Tissue Engineering
PubMed: 34514892
DOI: 10.1177/00220345211037247 -
The American Journal of Dental Science Jul 1852
PubMed: 30750990
DOI: No ID Found -
The Dental Register Feb 1862
PubMed: 33696291
DOI: No ID Found -
The Dental Register May 1864
PubMed: 33696682
DOI: No ID Found -
Plastic and Reconstructive Surgery.... Oct 2021Information about the use and donor site morbidity of periosteal free flaps in head and neck reconstruction is limited. The aim of this study was to examine potential...
Information about the use and donor site morbidity of periosteal free flaps in head and neck reconstruction is limited. The aim of this study was to examine potential periosteal free flap donor sites with respect to their dimensions, tissue and pedicle characteristics, and predicted donor site morbidity in a cadaveric model. The following cadaveric periosteal specimens with a vascular pedicle were harvested using standard surgical approaches: skull, chest wall, sternum, scapula, iliac crest, femur, and humerus. Data relating to the periosteum size and quality, vascular pedicle, surgical factors, feasibility of use, and the potential donor-site morbidity were recorded. One female (age: 78 years, height: 152 cm) and one male (age: 65 years, height: 186 cm) cadaver were used for flap harvest. The skull, chest wall, scapula, and femur were suitable in terms of the size of the periosteum harvested. The procedure to remove the periosteum from the scalp, chest wall, and scapula had the least predicted donor-site morbidity. The pedicle length and vessel caliber from the periosteal flaps were most favorable from the skull, scapula, and iliac crest. Considering all factors, the periosteum harvested from the skull and scapula were the most promising.
PubMed: 34616645
DOI: 10.1097/GOX.0000000000003846 -
Gut Mar 1981The association of finger clubbing and periostitis has been reported in primary biliary cirrhosis and, more rarely, in other forms of chronic liver disease. The...
The association of finger clubbing and periostitis has been reported in primary biliary cirrhosis and, more rarely, in other forms of chronic liver disease. The prevalence of periostitis and its relationship to finger clubbing is unknown. In this prospective study, we have determined the prevalence of periostitis and finger clubbing in 74 patients with primary biliary cirrhosis and 54 with other forms of chronic liver disease. Clubbing was present in 24% of patients with primary biliary cirrhosis, 29% with HBsAg negative chronic active hepatitis, and 23% in the group of miscellaneous liver diseases. Symmetrical periostitis affecting the tibiae and fibulae occurred in 35% of patients with primary biliary cirrhosis, 29% with chronic, active hepatitis and 40% of patients in the miscellaneous group. The distal radii and ulnae were affected in only eight patients (6%). In primary biliary cirrhosis, the presence of finger clubbing was strongly associated with periostitis (P less than 0.01), but this association was uncommon in other forms of chronic liver disease. In all forms of chronic liver disease periostitis commonly occurs in the absence of finger clubbing. Marked tenderness over the distal leg bones is a reliable sign of underlying periostitis, but this sign is present in only a third of affected patients. This study indicates that periostitis affecting the lower leg bones is common in patients with chronic liver disease, and its presence should be sought whether or not the patient has finger clubbing.
Topics: Adult; Aged; Chronic Disease; Female; Humans; Liver Cirrhosis, Biliary; Liver Diseases; Male; Middle Aged; Osteoarthropathy, Secondary Hypertrophic; Periostitis; Prospective Studies
PubMed: 7227854
DOI: 10.1136/gut.22.3.203 -
Cureus Jul 2022Sclerosing osteomyelitis of Garré is a rare and very specific type of chronic osteomyelitis that mainly affects children and young adults. To date, there is no clear...
Sclerosing osteomyelitis of Garré is a rare and very specific type of chronic osteomyelitis that mainly affects children and young adults. To date, there is no clear etiology for the disease. Clinical findings and laboratory results are usually unremarkable with commonly negative blood and tissue cultures. Cortical thickening and periosteal reaction are common radiological findings. Biopsy often shows chronic non-specific inflammatory changes. It is a well-described entity in the dental literature, but to the best of our knowledge, there are no distinctive diagnostic criteria for long bones. We report a case of sclerosing osteomyelitis of Garré in a young lady involving the right tibia, for which the diagnosis was made based on clinico-radiological correlation.
PubMed: 35978744
DOI: 10.7759/cureus.26866 -
Microsurgery Mar 2022Metacarpal nonunion is a rare condition. The osteogenic capacity of periosteal free flap was investigated in five patients with metacarpal nonunion and impaired bone...
BACKGROUND
Metacarpal nonunion is a rare condition. The osteogenic capacity of periosteal free flap was investigated in five patients with metacarpal nonunion and impaired bone vascularization.
PATIENTS AND METHODS
Surgery was performed between 64 and 499 days after the initial bone osteosynthesis. The average age was 27.6 (range 16-32) years. Nonunion was caused by excessive periosteal removal in two patients, extensive open trauma in three. Four nonunions were diaphyseal, one metaphyseal. A periosteal medial femoral condyle free flap was raised on the descending genicular artery for four patients, the superomedial genicular artery for one. After osteosynthesis with a plate, the flap was wrapped around the metacarpal, overlapping the bone proximally and distally. The recipient vessel were the dorsal branch of the radial artery and a vena comitans in the anatomical snuffbox in four patients, at the base of the first webspace in one.
RESULTS
The flap size ranged from 5 × 3.5 cm to 8 × 4 cm. No postoperative complication occurred. Radiological bone union was achieved 3 to 8 months after surgery. One patient had a full range of motion, one a slight extension lag of the proximal interphalangeal joint, two moderate joint stiffness of the proximal interphalangeal or metacarpophalangeal joint (one requiring plate removal and extensor tenolysis), one severe stiffness that allowed using a hook grip which was the aim of the surgery.
CONCLUSION
In case of metacarpal nonunion with impaired bone vascularization, the periosteal medial femoral condyle free flap provides an effective and biomimetic approach to bone healing.
Topics: Adolescent; Adult; Femur; Fractures, Ununited; Free Tissue Flaps; Humans; Metacarpal Bones; Range of Motion, Articular; Young Adult
PubMed: 34636060
DOI: 10.1002/micr.30826 -
Journal of Biophotonics Aug 2019This letter describes a hybrid plug/compartment (HyPC) kinetic model to fit dynamic indocyanine green fluorescence data acquired in a porcine model of long bone...
This letter describes a hybrid plug/compartment (HyPC) kinetic model to fit dynamic indocyanine green fluorescence data acquired in a porcine model of long bone traumatic fracture. Parametric images of periosteal blood flow, endosteal blood flow, total bone blood flow and fraction of endosteal-to-periosteal flow were obtained by applying the HyPC model on a pixel-by-pixel basis. Intraoperative discrimination between healthy and damaged bone could facilitate debridement reducing post-operative complications from non-union and infection. The ability to quantify periosteal and endosteal blood flow could inform nail vs. plate-and-screw decisions to avoid further compromising cortical blood supply.
Topics: Animals; Indocyanine Green; Kinetics; Models, Biological; Optical Imaging; Orthopedic Procedures; Periosteum; Regional Blood Flow; Surgery, Computer-Assisted; Swine
PubMed: 30963727
DOI: 10.1002/jbio.201800427 -
Revue Medicale de Liege Jul 2022We report the case of a 67-year-old female patient presenting swelling of the hands and feet and pain in both legs. Clinical examination and bone scintigraphy identify...
We report the case of a 67-year-old female patient presenting swelling of the hands and feet and pain in both legs. Clinical examination and bone scintigraphy identify the triad "digital clubbing - arthritis - bilateral periostitis of the long bones", leading to a diagnosis of hypertrophic osteoarthropathy, a syndrome usually associated with pulmonary neoplasia. The thoracic CT-scan, followed by a biopsy, effectively diagnosed a right upper lobe adenocarcinoma. Surgical treatment of the neoplasia allowed the resolution of the clinical complaints and the pathological scintigraphic findings.
Topics: Adenocarcinoma; Aged; Arthritis; Female; Humans; Lung Neoplasms; Osteoarthropathy, Secondary Hypertrophic; Periostitis
PubMed: 35924493
DOI: No ID Found