Abstract:
:Large mandibular defects are clinically challenging to reconstruct due to the complex anatomy of the jaw and the limited availability of appropriate tissue for repair. We envision leveraging current advances in fabrication and biomaterials to create implantable devices that generate bone within the patients themselves suitable for their own specific anatomical pathology. The in vivo bioreactor strategy facilitates the generation of large autologous vascularized bony tissue of customized geometry without the addition of exogenous growth factors or cells. To translate this technology, we investigated its success in reconstructing a mandibular defect of physiologically relevant size in sheep. We fabricated and implanted 3D-printed in vivo bioreactors against rib periosteum and utilized biomaterial-based space maintenance to preserve the native anatomical mandibular structure in the defect site before reconstruction. Nine weeks after bioreactor implantation, the ovine mandibles were repaired with the autologous bony tissue generated from the in vivo bioreactors. We evaluated tissues generated in bioreactors by radiographic, histological, mechanical, and biomolecular assays and repaired mandibles by radiographic and histological assays. Biomaterial-aided mandibular reconstruction was successful in a large superior marginal defect in five of six (83%) sheep. Given that these studies utilized clinically available biomaterials, such as bone cement and ceramic particles, this strategy is designed for rapid human translation to improve outcomes in patients with large mandibular defects.
journal_name
Proc Natl Acad Sci U S Aauthors
Tatara AM,Koons GL,Watson E,Piepergerdes TC,Shah SR,Smith BT,Shum J,Melville JC,Hanna IA,Demian N,Ho T,Ratcliffe A,van den Beucken JJJP,Jansen JA,Wong ME,Mikos AGdoi
10.1073/pnas.1819246116subject
Has Abstractpub_date
2019-04-02 00:00:00pages
6954-6963issue
14eissn
0027-8424issn
1091-6490pii
1819246116journal_volume
116pub_type
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