Necessity of latency period in craniofacial distraction: Investigations with in vitro microdistractor and clinical outcomes
| Autor: | Kenneth L. Fan, James P. Bradley, David I. Hindin, Christina J. Tabit, Brian T. Andrews, Ginger C. Slack, Henry K. Kawamoto |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Bone density medicine.medical_treatment education Osteogenesis Distraction Apoptosis In Vitro Techniques Real-Time Polymerase Chain Reaction behavioral disciplines and activities Craniofacial Abnormalities Mice Imaging Three-Dimensional Osteogenesis Distraction Reaction Time medicine Animals Humans Prospective Studies Craniofacial Child Prospective cohort study Cells Cultured Cell Proliferation Osteoblasts biology business.industry Surgery Treatment Outcome Child Preschool Latency stage Tissue and Organ Harvesting Osteocalcin biology.protein Distraction osteogenesis Alkaline phosphatase Collagen Mandibular Reconstruction Tomography X-Ray Computed business Gels Microdissection psychological phenomena and processes |
| Zdroj: | Journal of Plastic, Reconstructive & Aesthetic Surgery. 68:1206-1214 |
| ISSN: | 1748-6815 |
| DOI: | 10.1016/j.bjps.2015.04.012 |
| Popis: | Summary Background To determine the need for latency period in membranous bone distraction, we performed 1) in vitro comparison of preosteoblasts suspended in a 3D microdistraction model and 2) a clinical study comparing mandibular distraction cases with/without latency. Methods In the In Vitro study, Preosteoblasts polymerized in 3D-collagen gel were placed in a microdistractor and separated into three groups: 1) distraction with latency, 2) distraction without latency, and 3) static. After 2, 4, 6, and 8 days, cell proliferation, total protein levels, alkaline phosphatase activity, and osteogenic gene expression were assessed through RT-PCR. In the clinical study, patients underwent mandibular distraction in two groups: 1) latency and 2) no latency (n = 45). The rest of the distraction protocol was identical. Outcome was based on clinical examination, radiographs at six months, and 3D CT scans. Results In the In Vitro study, The distraction without latency group compared to the latency group had delays in: proliferation, total protein count, alkaline phosphatase activity, osteogenic gene expression in CBFA-1 (fourfold vs. eighteenfold), and in osteocalcin (twofold vs. sixfold). The distraction without latency group had higher apoptotic levels during the first four days compared to the latency group (68% vs. 14%). For the clinical study, similar perioperative complications (5% vs. 6%), X-ray mineralization (93% vs. 94%), bone volume, (8.6 vs. 9.1 cc) and bone density of central distraction zone (78% vs. 81%) were observed with or without latency. Conclusions In vitro studies showed poorer results in cell survival, proliferation and osteogenic activity compared to distraction with latency; yet, clinically, there were no differences in distraction with latency versus without. |
| Databáze: | OpenAIRE |
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