Plastic Surgery Research Council
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PSRC 60th Annual Meeting

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Repair Of Critical Size Bone Defects Using Bone Marrow Stromal Cells A Histomorphometric Study In Rabbit Calvaria
Antonio C. Aloise, Ph.D, André Antonio Pelegrine, Ph.D, Lydia Masako Ferreira, Ph.D.
Federal University of Sao Paulo, Sao Paulo, Brazil.

Purpose: Therapies involving bone marrow may be helpful in the bone repair of critical defects because this tissue possesses cell populations that play an important role in bone homeostasis, namely bone marrow stromal cells (BMSCs). To date, no consensus has been reached on the best methodology for using BMSCs. Relevant literature has reported three main alternatives: (1) fresh bone marrow (“in natura”) (Pelegrine et al. 2010; Costa et al. 2011; Oliveira et al. 2012), (2) bone marrow mononuclear cell (BMMC) concentrate, also called bone marrow mononuclear fraction (BMMF) (Sakai et al. 2008; Yoshioka et al. 2011; Pelegrine et al. 2013) and (3) cultivated bone marrow mesenchymal stem cells (BM MSCs) (Quarto et al. 2001; Cerruti Filho et al. 2007).
Objectives: The aim of this study was to evaluate the bone healing observed after the use of a scaffold enriched with bone marrow mesenchymal stem cells (Group 3) and to compare it with scaffold enriched with bone marrow aspirate (Group 1), scaffold enriched with bone marrow mononuclear fraction (Group 2), and scaffold alone (control group)
Material and methods: Twenty-four rabbits were operated, and bilateral defects 12 mm in diameter were created in the animals’ parietal bones. The bilateral defects were filled with a xenograft enriched with bone marrow mesenchymal stem cells (Group 3), one of the bilateral defects was randomly covered with a barrier membrane. The rabbits were sacrificed 8 weeks after surgery, and their parietal bones were harvested and analyzed histomorphometrically. The Wilcoxon test and Friedman test for paired data were used for intra-group comparisons (with and without membrane coverage) and the Kruskal-Wallis test was used for inter-group comparisons
Results: The sides in which the defects were covered with the barrier membrane did not show improved bone healing (p > 0.05) The percentage of non-vital mineralized tissue (NVMT), represented by remaining Bio Oss® particles, was 27.79% ± 2.72% and 27.23% ± 6.8% for the defects with and without membrane coverage, respectively, whereas the percentage of vital mineralized tissue (VMT) was 28.24% ± 6.17% and 27.9% ± 5.79% for the defects with and without membrane coverage, respectively. .
Conclusions: Both methods using bone marrow mesenchymal stem cells, with and without membrane coverage, contributed to enhancing bone healing. The use of a barrier membrane seemed to have a synergistic effect on bone healing.


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