Standardized and axially vascularized calcium phosphate-based implants for segmental mandibular defects: A promising proof of concept

• DOI: 10.1016/j.actbio.2022.09.071
• Publication Date: 2022-10-06T17:23:20Z
• Authors: Arnaud Paré; Baptiste Charbonnier; Joëlle Veziers; Caroline Vignes; Maeva Dutilleul; Gonzague De Pinieux; Boris Laure; Adeline Bossard; Annaëlle Saucet-Z...; Gwenola Touzot-Jo...; Pierre Weiss; Pierre Corre; Olivier Gauthier; David Marchat
• Keywords: Calcium Phosphates; [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology; Sheep; Tissue Engineering; Tissue Scaffolds; Additive manufacturing; 610; Segmental mandibulectomy; Mandible; Bone regeneration; 3. Good health; Calcium phosphates; Humans; Animals; Surgical model; [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology

The reconstruction of massive segmental mandibular bone defects (SMDs) remains challenging even today; the current gold standard in human clinics being vascularized transplantation (VBT). As alternative to this onerous approach, tissue engineering strategies have been widely investigated. However, they displayed limited clinical success, particularly failing address essential problem quick vascularization implant. Although routinely used clinics, insertion intrinsic bioengineered constructs for rapid formation a feeding angiosome uncommon. In clinically relevant model (sheep), custom calcium phosphate-based bioceramic soaked with autologous marrow and perfused by an arteriovenous loop was tested regenerate SMD compared VBT (clinical standard). Animals did not support well treatment, study aborted 2 weeks after surgery due ethical animal welfare considerations. regeneration successful construct. Implants were osseointegrated only 3 months implantation totally entrapped lamellar 12 months; healthy yellow filled remaining space. STATEMENT OF SIGNIFICANCE: Regenerative medicine struggles generation large functional volume. Among them are restore. care, based on free flaps, still displays technical drawbacks (e.g., donor site morbidity). Modern technologies 3D printing, digital chain) combined surgical techniques provide pre-clinical proof concept, investigating benefits such strategy bone-related regenerative field. Results proved that synthetic-biologics-free approach is able critical size defect 15 cm3 preclinical model, mimicking real life scenarii defect, full physiological months.