Autologous bone marrow aspirate concentrate repairs peri-implant bone defect

doi:10.3969/j.issn.2095-4344.2014.11.003

Abstract

Abstract:

BACKGROUND: Autologous bone marrow aspirate concentrate is often applied in patients from Department of Orthopedics and those with severe limb ischemia, but rarely applied in Department of Oral and Maxillofacial Surgery, especially in Department of Oral Implantology. The effect of autologous bone marrow aspirate concentrate on promoting peri-implant bone regeneration deserves further studies.

OBJECTIVE: To evaluate the effect of bone marrow aspirate concentrate in the repair of peri-implant bone defect.

METHODS: Bone marrow 5 mL was extracted from posterior superior iliac spine of experimental dogs and bone marrow cells were counted before and after concentration. Bone defect (4 mm × 4 mm × 4 mm) was prepared in the middle of bilateral mandibular premolar, which was randomly implanted with gelatin sponge plus bone marrow aspirate concentrate, autologous bone and gelatin sponge. At 4 and 12 weeks after surgery, bone defect specimens were histologically observed. The new bone formation rate and new bone mineral density were calculated.

RESULTS AND CONCLUSION: After centrifugation, the concentrations of nucleated cells in bone marrow aspirate concentrate were increased by (2.78±0.22) times. More colony-forming units were found after cell culture. Histological analysis showed that, significantly higher new bone formation rate and new bone mineral density occurred in gelatin sponge plus bone marrow aspirate concentrate group, compared with autologous bone group and gelatin sponge group at 4 weeks (P < 0.05). The new bone formation rate in gelatin sponge plus bone marrow aspirate concentrate group was significantly lower than that of autologous bone group, and higher than that of gelatin sponge group at 12 weeks (P < 0.05). However, the difference of new bone mineral density in the three groups was not significant (P > 0.05). Autologous bone marrow aspirate concentrate can significantly improve new bone mineral density and quantity in the pre-implant bone defect.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

全文链接：

Key words: dental implants, bone marrow, bone regeneration, gelatin sponge, absorbable

CLC Number:

R318

Yang Ying, Zhong Wei-jian, Liu Guo, Ma Guo-wu. Autologous bone marrow aspirate concentrate repairs peri-implant bone defect[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(11): 1653-1658.

Figures/Tables 3

References

[1] Buser D, Dula K, Hess D,et al. Localized ridge augmentation with autografts and barrier membranes.Periodontol 2000. 1999; 19:151-163.

[2] Laurie SW, Kaban LB, Mulliken JB,et al.Donor-site morbidity after harvesting rib and iliac bone.Plast Reconstr Surg. 1984; 73(6):933-938.

[3] Younger EM, Chapman MW. Morbidity at bone graft donor sites.J Orthop Trauma. 1989;3(3):192-195.

[4] Arrington ED, Smith WJ, Chambers HG,et al.Complications of iliac crest bone graft harvesting.Clin Orthop Relat Res. 1996; (329):300-309.

[5] Finkemeier CG. Bone-grafting and bone-graft substitutes.J Bone Joint Surg Am. 2002;84-A(3):454-464.

[6] Colnot C, Romero DM, Huang S, et al. Mechanisms of action of demineralized bone matrix in the repair of cortical bone defects.Clin Orthop Relat Res. 2005;(435):69-78.

[7] Buck BE, Malinin TI, Brown MD. Bone transplantation and human immunodeficiency virus. An estimate of risk of acquired immunodeficiency syndrome (AIDS).Clin Orthop Relat Res. 1989;(240):129-136.

[8] Buck BE, Resnick L, Shah SM,et al. Human immunodeficiency virus cultured from bone. Implications for transplantation.Clin Orthop Relat Res. 1990;(251):249-253.

[9] Hernigou P, Poignard A, Beaujean F,et al. Percutaneous autologous bone-marrow grafting for nonunions. Influence of the number and concentration of progenitor cells.J Bone Joint Surg Am. 2005;87(7):1430-1437.

[10] Quarto R, Mastrogiacomo M, Cancedda R,et al. Repair of large bone defects with the use of autologous bone marrow stromal cells.N Engl J Med. 2001;344(5):385-386.

[11] Schimming R, Schmelzeisen R.Tissue-engineered bone for maxillary sinus augmentation.J Oral Maxillofac Surg. 2004; 62(6):724-729.

[12] Marcacci M, Kon E, Moukhachev V, et al. Stem cells associated with macroporous bioceramics for long bone repair: 6- to 7-year outcome of a pilot clinical study.     Tissue Eng. 2007;13(5):947-955.

[13] Hibi H, Yamada Y, Ueda M, et al. Alveolar cleft osteoplasty using tissue-engineered osteogenic material.Int J Oral Maxillofac Surg. 2006;35(6):551-555.

[14] Lee J, Sung HM, Jang JD, et al. Successful reconstruction of 15-cm segmental defects by bone marrow stem cells and resected autogenous bone graft in central hemangioma.     J Oral Maxillofac Surg. 2010;68(1):188-194.

[15] Connolly JF, Guse R, Tiedeman J,et al. Autologous marrow injection as a substitute for operative grafting of tibial nonunions.Clin Orthop Relat Res. 1991;(266):259-270.

[16] Hernigou P, Poignard A, Beaujean F,et al. Percutaneous autologous bone-marrow grafting for nonunions. Influence of the number and concentration of progenitor cells.J Bone Joint Surg Am. 2005;87(7):1430-1437.

[17] Fortier LA, Barker JU, Strauss EJ,et al.The role of growth factors in cartilage repair.Clin Orthop Relat Res. 2011; 469(10):2706-2715.

[18] Pittenger MF, Mackay AM, Beck SC,et al. Multilineage potential of adult human mesenchymal stem cells.Science. 1999;284(5411):143-147.

[19] Chang F, Ishii T, Yanai T,et al.Repair of large full-thickness articular cartilage defects by transplantation of autologous uncultured bone-marrow-derived mononuclear cells.J Orthop Res. 2008;26(1):18-26.

[20] Tateishi-Yuyama E, Matsubara H, Murohara T,et al.Therapeutic angiogenesis for patients with limb ischaemia by autologous transplantation of bone-marrow cells: a pilot study and a randomised controlled trial.Lancet. 2002;360 (9331):427-435.

[21] Rafii S, Lyden D.Therapeutic stem and progenitor cell transplantation for organ vascularization and regeneration. Nat Med. 2003;9(6):702-712.

[22] Higashi Y, Kimura M, Hara K,et al.Autologous bone-marrow mononuclear cell implantation improves endothelium-dependent vasodilation in patients with limb ischemia.Circulation. 2004;109(10):1215-1218.

[23] Umemura T, Nishioka K, Igarashi A,et al.Autologous bone marrow mononuclear cell implantation induces angiogenesis and bone regeneration in a patient with compartment syndrome.Circ J. 2006;70(10): 1362-1364.

[24] Reyes M, Lund T, Lenvik T,et al.Purification and ex vivo expansion of postnatal human marrow mesodermal progenitor cells.Blood. 2001 ;98(9):2615-2625.

[25] Yasuhara S, Yasunaga Y, Hisatome T,et al. Efficacy of bone marrow mononuclear cells to promote bone regeneration compared with isolated CD34+ cells from the same volume of aspirate.Artif Organs. 2010;34(7):594-599.

[26] Muschler GF, Boehm C, Easley K. Aspiration to obtain osteoblast progenitor cells from human bone marrow: the influence of aspiration volume.J Bone Joint Surg Am. 1997; 79(11):1699-1709.

[27] Soltan M, Smiler DG, Gailani F. A new "platinum" standard for bone grafting: autogenous stem cells.Implant Dent. 2005; 14(4): 322-325.

[28] Hermann PC, Huber SL, Herrler T,et al.Concentration of bone marrow total nucleated cells by a point-of-care device provides a high yield and preserves their functional activity. Cell Transplant. 2008;16(10):1059-1069.

[29] Thoesen MS, Berg-Foels WS, Stokol T,et al.Use of a centrifugation-based, point-of-care device for production of canine autologous bone marrow and platelet concentrates. Am J Vet Res. 2006;67(10):1655-1661.

[30] 尹世昌,焦振华,王功国,等. 浓缩自体骨髓移植配合中药治疗骨不连临床研究[J].中国中医骨伤科杂志,2011,19(6):23-25.

[31] Jäger M, Herten M, Fochtmann U,et al.Bridging the gap: bone marrow aspiration concentrate reduces autologous bone grafting in osseous defects.J Orthop Res.2011;29(2):173-180.

[32] Jäger M, Jelinek EM, Wess KM,et al. Bone marrow concentrate: a novel strategy for bone defect treatment.Curr Stem Cell Res Ther. 2009;4(1):34-43.

[33] 张远成,刘国辉,茹长英,等.自体浓缩骨髓干细胞复合人工骨植入治疗骨不连[J].中国医药,2010,5(2):158-159.

[34] Murawski CD,Duke GL,Deyer TW,et al. Bone Marrow Aspirate Concentrate (BMAC) as a Biological Adjunct to the Surgical Treatment of Osteochondral Lesions of the Talus.Techniques Foot & Ankle Surg. 2011;10(1):18-27.

[35] Adams SB, Lewis JS Jr, Gupta AK,et al. Cannulated screw delivery of bone marrow aspirate concentrate to a stress fracture nonunion: technique tip.Foot Ankle Int. 2013; 34(5): 740-744.

[36] Smyth NA, Murawski CD, Haleem AM,et al. Establishing proof of concept: Platelet-rich plasma and bone marrow aspirate concentrate may improve cartilage repair following surgical treatment for osteochondral lesions of the talus.World J Orthop. 2012;3(7):101-108.

[37] Murawski CD, Kennedy JG. Percutaneous internal fixation of proximal fifth metatarsal jones fractures (Zones II and III) with Charlotte Carolina screw and bone marrow aspirate concentrate: an outcome study in athletes.Am J Sports Med. 2011;39(6):1295-1301.

[38] Campbell KJ, Boykin RE, Wijdicks CA,et al. Treatment of a hip capsular injury in a professional soccer player with platelet-rich plasma and bone marrow aspirate concentrate therapy.Knee Surg Sports Traumatol Arthrosc. 2013;21(7): 1684-1688.

[39] Kretlow JD, Spicer PP, Jansen JA, et al. Uncultured marrow mononuclear cells delivered within fibrin glue hydrogels to porous scaffolds enhance bone regeneration within critical-sized rat cranial defects.Tissue Eng Part A. 2010; 16(12):3555-3568.

[40] Rickert D, Sauerbier S, Nagursky H,et al. Maxillary sinus floor elevation with bovine bone mineral combined with either autogenous bone or autogenous stem cells: a prospective randomized clinical trial.Clin Oral Implants Res. 2011; 22(3): 251-258.

[41] Sauerbier S, Rickert D, Gutwald R,et al. Bone marrow concentrate and bovine bone mineral for sinus floor augmentation: a controlled, randomized, single-blinded clinical and histological trial--per-protocol analysis.Tissue Eng Part A. 2011;17(17-18):2187-2197.