Purpose To evaluate bone formation after marsupialization of odontogenic keratocysts (keratocystic odontogenic tumors) of the mandible. Patients and Methods A total of 53 patients with mandibular ...odontogenic keratocysts underwent marsupialization. Clinical and radiographic examinations were done at 1, 3, and 6 months postoperatively. The bone density of the cyst site was measured on the panoramic radiographs using the Digora. The volume of the cyst was measured by injection of saline solution into the cyst cavity. Student t test and Spearman's rank correlation were used for statistical analysis. Results Healing was uneventful in all patients. The diameter of the cysts was 4.1 to 11.0 cm (average 5.4). The panoramic radiographs showed a continuous increase in bone density of the cystic area, with a 22.42% increase at 1 month, 46.07% at 3 months, and 64.69% at 6 months postoperatively compared with the preoperative values. The decrease in cyst volume was 19.05% at 1 month, 55.62% at 3 months, and 79.67% at 6 months postoperatively. The increase in bone density and decrease in cyst volume were more significant in the first 3 months than in second 3 months ( P < .01). The increase in bone density correlated inversely with the decrease in the cyst volume ( P < .01). Conclusion Bone regeneration can occur more rapidly in large mandibular odontogenic keratocysts after marsupialization with drainage by a cyst plug. After 3 months, secondary enucleation of the cyst can be performed.
Purpose The aim of this study was to construct functional tissue-engineered bone in dogs using cell sheet engineering, a new technique to gain and transfer seed cells. Materials and Methods ...Demineralized bone matrixes, prepared from homologous bone, were coated with recombinant human bone morphogenetic protein-2. Bone marrow stromal cells (BMSCs) were isolated and subcultured. Osteogenic-induced BMSCs were incubated in a temperature-responsive culture dish to form the BMSC sheet. The complex of demineralized bone matrix, recombinant human bone morphogenetic protein-2, and BMSCs wrapped with BMSC sheets was implanted around the blood vessels of the latissimus dorsi muscle in the experimental side, and the same complex without BMSC sheets was implanted around the blood vessels of the latissimus dorsi muscle on the other side as a control. At 4, 8, 12, and 16 weeks after implantation, the implants were removed for radiographic evaluation, descriptive histologic observation, and histologic quantitative analysis. Results Radiographic analysis showed that the optical density of the tissue-engineered bone on the 2 sides increased with time. However, the optical density of the experimental side was significantly greater than that of the control side at the same points. Sixteen weeks after implantation, mature lamellar bone was formed in the experimental side, with red bone marrow in the bone marrow cavity. In contrast, the control side exhibited significantly less lamellar bone. Histologic quantitative analysis showed that the experimental side exhibited significantly more bone per area compared with the control side. Conclusion BMSC sheet engineering may be useful to construct functional tissue-engineered bone.
