Fogorvosi szemle, 2005 (98. évfolyam, 1-6. szám)
2005-04-01 / 2. szám
69 FOGORVOSI SZEMLE ■ 98. évf. 2. sz. 2005. ing 1-2 mm sized TCP particles in one side and autologous chin bone particles in the other (control) side. Four other patients were treated with a unilateral sinus floor augmentation using 100% TCP (no controls). Biopsies of the augmented sites were taken after 6 months. After 6 month 3.21 ±1.4 mm of new bone height was obtained after implantation of TCP particles. The average bone volume formed in the augmented sinus at the control side was 41% (32-56%) and 17% (9-27%) in the test side when all 9 patients were included (p=0.04). When only the 5 bilateral patients were included mean bone volume of the test side was 19% (13-27%) which was also significantly different from control side (p=0.009). Osteoid formation tended to be higher in the test side biopsies (1.3%) than in controls (0.3%) Indicating ongoing bone formation in the TCP material. The amount of lamellar bone at the test side was less than half the amount in the control side indicating that remodelling had only recently started in the TCP augmented side. The resorption surface however did not differ significantly between the two sides. Immunohistochemistry showed that most of the soft connective tissue cells still seen to migrate from the sinus floor bone surface between TCP particles and into the pores of particles were Runx2/Cbfa1- positive and some of these cells in contact with TCP material osteopontin- and bone sialoprotein- positive. This suggested that most of the soft connective tissue cells were osteogenic and continued to form new bone. These data indicate that this type of TCP is an acceptable bone substitute material for augmentation of the human maxillary sinus. Due to the osteoconductive but not osteoconductive properties of this material the rate of bone formation is somewhat delayed in comparison to autologous bone. Acknowledgement: The support of COSTB23 is acknowledged. E. RESEL, E. TRINIDAD, C. ALONSO-BANUELOS*, E. LAGARÓN**, E. MARTÍNEZ-SANZ1, J. VALERO, M. AMORÓS1 B. GARCILLÁN, M. LÓPEZ, C. MARTÍNEZ-ÁLVAREZ. Dpto. Anatómia y Embriológia Humana I. Facultad de Medicina. Universidad Complutense Madrid. *Servicio de Cirugía Pediátrica. Hospital U. Gregorio Maranón. ** Servicio de Cirugía Plástica. Hospital Doce de Octubre. Madrid. Spain. EXPLORING NEW POSSIBILITIES TO TREAT CLEFT PALATE Cleft palate is a congenital malformation whose treatment includes several surgical procedures throughout the patient’s life. We are trying to find an alternative method to surgery. We believe it could be possible to induce extra bone in the cleft palate edges to allow them to grow to the midline. Then, the removal of the epithelium covering these edges (medial edge epithelium -MEE-) and the subsequent apposition of the underlying tissue would permit the adherence of the cleft palate tips, thus resem; bling a normal palate. This preliminary work performed in vitro had two aims: 1) to explore the possibility of inducing new osteogenic cells from the fibroblasts located at the edges of the cleft palate, and 2) to remove the MEE as well as to achieve the subsequent adhesion of the underlying connective tissue. We used as experimental models the cleft palate presented by the TGF-ß3 null mutant mouse and small fragments of tissue obtained during surgery from the edges of human cleft palates. To reach our first objetive, we placed heparin beads soaked with BMP2 below the MEE of embryonic day 18 (E18) TGF-ß3 null mouse cleft palates and cultured these specimens during three weeks. The presence of induced osteogenic cells was identified by immunolabelling with an antibody against osteocalcin. To achieve the second aim, we removed the MEE from both E18 TGF- ß3 null mouse cleft palates and fragments from human ) cleft palates with a trypsin solution, followed by apposition of the opposing underlying tissue. Our results demonstrated that 1) the fibroblasts located at the edges of the cleft palate can be induced to form osteogenic cells, and 2) it is possible to remove the MEE covering these edges as well as to accomplish subsequent adhesion of the underlying tissue. We believe this is the first step for a future non surgical treatment for the cleft palate. Keywords: cleft palate; TGF-beta3; bone induction. Acknowledgement: This work was supported by grants from C. A. M. (08.6/0001.1/2003) and F. I. S. (PI030185) and by COST Action B23. V. DAUBIE, P. PHILIPPART*, S. HOUARD**, R. POCHET Laboratory of Histology, Université Libre de Bruxelles, Brussels, Belgium * Hôpital Bracops, Dept of Maxillo- Facial Surgery, Brussels, Belgium ** Henogen, Gosselies, Belgium CHARACTERISATION OF HUMAN BONE GRAFT MADE BY PEPGEN P-15, TISSUE FACTOR, PLATELET-RICH PLASMA AND GROUND CALVARIAN BONE Bone grafts are widely used in cranio-maxillo-facial surgery to increase skeletal jaws volume, bridge bony defect, and stabilize bone segments. In order to increase the bone graft regeneration and quality, P. Philippart implemented the use of a new mixture containing autologous grinded calvarian bone (0 < 1mm) and PepGen P- 15, a tissue-engineered bone replacement graft material, in a volumic ratio of 50%. Platelets-rich plasma (1.8 x 106 platelets/mm3 plasma) and 1pg rhTF (recombinant human Tissue Factor) were added to the mixture to make
