Reconstruction of parietal bone defects with adiposederived mesenchymal stem cells: experimental study

Purpose: This study assessed the regeneration potential of mesenchymal stem cells (MSC) from adipose tissue associated with platelet-rich plasma (PRP) in bone regeneration. Methods: Thirty Wistar rats (Rattus norvegicus albinos) were divided into five groups (according to the grafting material and time to euthanasia): (1) autograft - 14 days (control), (2) autograft - 28 days (control), (3) MSC + PRP - 14 days, (4) MSC + PRP + papaverine - 14 days and (5) MSC + PRP + papaverine - 28 days. After euthanasia, the graft was removed and histological slides were prepared. They were assessed by a blinded pathologist using a previously published histological scale as parameter. Results: There was some degree of neoformed bone trabeculae (NBT) in 93.3% of the samples, as well as osteoblastic activity (OA). The autograft groups (14 and 28 days) had higher levels in the formation of bone trabeculae. Nonparametric data were analyzed using the Wilcoxon-Mann-Whitney test and proved not to be statistically significant at p 0.05. Conclusions: Experimental parietal bone reconstruction, combining MSC, PRP and papaverine presented regeneration in all groups with no significant difference among them.(AU)

Os parietale partitum: Exploring the prevalence of this trait in four contemporary populations.

Os parietale partitum is a variable segmentation of the parietal bone. This manifests as a parietal division in the anteroposterior or superoinferior planes that is separated by an unusual suture and can be complete or incomplete. The existence of parietal divisions was observed and documented more than 260 years ago. The main objectives of this paper are to record the incidence of this rare trait in four modern populations with no previous records of it and provide a review of the literature. Four contemporary skeletal collections from Crete (Greece), Limassol (Cyprus), Coimbra (Portugal) and Salvador (Brazil) were assessed by the authors of this paper for non-metric cranial traits. Out of 711 skulls, only three cases of parietal division were found and all three originated from the Cypriot collection. These three cases were anatomically analyzed, showing that all three cases were adult females and showed unilateral expression of the trait. Two skulls showed superoinferior division, and the third case showed anteroposterior division. Numerous other cranial non-metric traits were found in these three skulls. Based on the cemetery archives, there seems to be no genetic link between the individuals bearing this trait. Further genetic analysis is suggested in order to verify this conclusion.

Perioperative complications associated with intracranial procedures in patients with nonsyndromic single-suture craniosynostosis.

Within the diagnosis "craniosynostosis," there is a subset of patients who present with isolated, nonsyndromic, single-suture involvement. This study evaluates perioperative complications in this specific subset of patients over 4 decades at a single institution. To do so, we performed a retrospective review on consecutive patients undergoing correction of single-suture synostosis from May 1977 to January 2013 at a tertiary pediatric craniofacial center. Demographic information, operative details, and perioperative course were collected. Complications were categorized as either major or minor. A χ(2) test and Fisher exact test were used to compare all categorical variables. Continuous variables were analyzed using Wilcoxon rank-sum and Kruskal-Wallis tests.Seven hundred forty-six patients underwent surgical correction of nonsyndromic craniosynostosis. Of these, there were 307 (41.2%) sagittal, 201 (26.9%) metopic, and 238 (31.9%) unicoronal. Thirty-four patients had complications (4.6%). Eight were considered major (1.1%), including one postoperative mortality in a patient with hypoplastic left-sided heart syndrome. Minor complications occurred in 26 patients (3.5%) and included subgaleal hematoma (n = 3), seroma (n = 4), and superficial wound infection (n = 5). Metopic and sagittal suture involvement was significantly associated with a higher complication rate (P = 0.04). A child with isolated single suture synostosis and any comorbidity had a significantly greater risk of any complication (P < 0.001; odds ratio, 3.8) and specifically an increased risk of major complication (P = 0.031; odds ratio, 6.0). Subclassification of patients by time period yielded no statistically significant changes in perioperative morbidity. To conclude, these data allow us to counsel families more accurately with regard to morbidity and mortality and may potentially serve as a benchmark for future quality improvement work.

An experimental model for the study of craniofacial deformities / Modelo experimental para o estudo de deformidades craniofaciais

PURPOSE: To develop an experimental surgical model in rats for the study of craniofacial abnormalities. METHODS: Full thickness calvarial defects with 10x10-mm and 5x8-mm dimensions were created in 40 male NIS Wistar rats, body weight ranging from 320 to 420 g. The animals were equally divided into two groups. The periosteum was removed and dura mater was left intact. Animals were killed at 8 and 16 weeks postoperatively and cranial tissue samples were taken from the defects for histological analysis. RESULTS: Cranial defects remained open even after 16 weeks postoperatively. CONCLUSION: The experimental model with 5x8-mm defects in the parietal region with the removal of the periosteum and maintenance of the integrity of the dura mater are critical and might be used for the study of cranial bone defects in craniofacial abnormalities.(AU)

OBJETIVO: Desenvolver um modelo experimental em ratos para o estudo de deformidades craniofaciais. MÉTODOS: Foram realizados defeitos ósseos de espessura total com diâmetro de 5 x 8 mm e 10 x 10mm na calota craniana em 40 ratos, machos, NIS Wistar, com peso de 320 a 420 g divididos igualmente em dois grupos. O periósteo foi retirado e a dura-máter mantida intacta. Os animais foram sacrificados na 8ª e 16ª semana de pós-operatório e amostras de tecido ósseo foram extraídas para realização da análise histológica. RESULTADOS: Os defeitos cranianos permaneceram abertos mesmo após 16 semanas após a cirurgia. CONCLUSÃO: O modelo experimental com defeitos de 5x8mm na região parietal, com remoção do periósteo e manutenção da integridade da dura-máter são considerados críticos, e poderá ser utilizado para o estudo dos defeitos ósseos cranianos nas anomalias craniofaciais.(AU)

Analysis of bone variations of the occipital bone in man / Análisis de las variaciones del hueso occipital en el hombre

Inadequate ossification of the interparietal region induces the appearance of interparietal and wormian bones, also associated with genetic factors. The formation of the interparietal bone depends on the separation of the intermediate segment from the lateral plate by the transverse occipital suture, which means that this bone is formed by the medial and lateral plates. Wormian interparietal bones or epactal bones are located within the interparietal region, being single or multiple, and are located in the upper central region of the interparietal region, the sutural bones, however, are formed from additional ossification centers that can occur in near sutures. The aim of this work was to macroscopically evaluated the presence of changes in the structure of the adult human occipital bone in cadavers found in the human anatomy laboratory of the Goißs Federal University in order to determine the frequency of supernumerary bones associated with occipital and parietal bones and relate it to literature, as well as to provide images and data for ethnic studies in the Brazilian population and data that could help medical practices such as fetal position and radiographs. Our data have indicated that the frequency of the interparietal bone of 1.92 percent is among those seen in countries such as Japan, Bulgaria, Nigeria, India and Turkey, but lower than values found in pre-Hispanics Chileans; however, for the sutural bones, the frequency of this study was higher than other data obtained from Spanish and other Brazilians.

La osificación inadecuada de la región interparietal induce a la aparición de los huesos interparietal y wormiano, asociado también con factores genéticos. La formación del hueso interparietal depende de la separación del segmento intermedio desde la placa lateral por la sutura occipital transversal, lo que significa que este hueso se forma por las placas medial y lateral. Los huesos interparietales wormianos o hueso epactal se encuentram dentro de la región interparietal, siendo únicos o múltiples, y se localizan en la región central superior de la zona interparietal. Los huesos suturales, sin embargo, se forman de centros de osificación adicionales que pueden aparece cerca de estas suturas. El objetivo de este trabajo, fue evaluar macroscópicamente la presencia de variaciones en la estructura del hueso occipital en cadáveres humanos, adultos encontrados en el Laboratorio de Anatomía Humana de la Universidad Federal de Goiás, con la finalidad de determinar la frecuencia de los huesos supernumerarios asociados con los huesos parietal y occipital. Además, comparamos estos datos con los descritos enla literatura y, aportamos imágenes y datos para estudios étnicos en la población Brasileña. Estos datos pueden ayudar en las prácticas médicas como la posición fetal y radiografías. Nuestros datos indicaron que la frecuencia del hueso interparietal fue de 1,92 por ciento y se encuentra en países como Japón, Bulgaria, Nigeria, India y Turquía, pero inferior a los valores encontrados en chilenos prehispánicos. Sin embargo, para los huesos suturales, la frecuencia de este estudio fue superior a otros datos obtenidos de españoles y otros estudios realizados en individuos brasileños.

Agujeros parientales gigantes: a propósito de un caso / Gigantic parietal holes. Based on a clinical case

Los agujeros parietales ensanchados, también llamados formina parietallia permagna o agujeros parietales gigantes, son un defecto congénito, identificados en el examen físico y confirmados imagenológicamente. Se presenta el caso de un lactante de 2 meses de edad, sin antecedentes personales a destacar, que desde el nacimiento presenta una tumefacción en el cuero cabelludo, a nivel de la fontanela lambdoidea. Se solicitan estudios imagenológicos para completar la valoración del paciente. La patología presentada motiva una serie de diagnósticos diferenciales, que deben ser recordados, los cuales pueden ser descartados fácilmente mediante la tomografía computada con reconstrucción 3D.

Enlarged parietal foramen, also called foramina parietallia permagna or giant parietal foramen, is a congenital defect identified in the physical examination and confirmed with radiological studies.The case of a two month old infant with no relevant past medical history is presented. He had a small scalp tumour, which was evident at the lamboid fontanel since birth. Imaging studies were requested to complete the evaluation of this patient. The above mentioned disease accounts for several differential diagnosis which can be early ruled out through 3D CT scan.

Efficacy of polyanionic collagen matrices for bone defect healing.

Polyanionic collagen-elastin matrices (PCEMs) possess attractive properties, such as extra negative charges, piezoelectricity, and extra RGD sites, which could make them effective in the treatment of bone defects. Although they are biocompatible with the osteogenesis process, it is unknown if PCEMs could aid in the recovery of bone defects in challenging situations. To evaluate this hypothesis, three PCEMs, differing in their negative charge density, were implanted in rat calvarial defects. Specimens harvested at 3, 7, 15, 30, and 60 days after implantation were evaluated radiographically and histologically. Two matrices were able to sustain the osteogenesis process and quickly recover the lost bone structure. The third, and most electronegative, left matrix remnants amidst the areas of new bone. The control showed bone formation limited to the boundaries of the defect. These results suggest that some PCEMs might become a useful resource in the treatment of bone defects.

Avaliaçäo da atividade osteoindutora da matriz dentinária autógena descalcificada em defeitos ósseos cirúrgicos obtidos por craniotomia e tratados pela técnica de regeneraçäo óssea guiada / Evaluation of the osteoinductive property of autogenous deminerilized dentin matrix on surgical bone defects obtained for craniotomy and treated by the guided bone regeneration technique

O propósito deste trabalho foi avaliar a atividade osteoindutora da matriz dentinária autógena descalcificada (MDAD), em defeitos ósseos cirúrgicos experimentais no osso parietal de coelho, associada à regeneraçäo óssea guiada com o uso de Membrana Amniótica Humana (MAH) e Membrana de Politetrafluoretileno (MP). Nesta pesquisa, foram empregados 72 coelhos adultos com peso médio de aproximadamente 4,5Kg e divididos em dois grupos controles, MAH e MP, e dois grupos experimentais, MAH associada à MDAD e MP associada à MDAD. Após a confecçäo do defeito ósseo, nos grupos controles, as respectivas membranas foram colocadas na superfície e no assoalho da loja cirúrgica e a cavidade foi preenchida pelo coágulo sanguineo. Nos grupos experimentais, implantou-se fatias de MDAD na periferia do defeito ósseo e colocou-se membrana na superfície e no assoalho do defeito ósseo. Em seguida, procedeu-se à sutura do periosteo sobre as membranas e da pele. Decorridos 15, 30, 45, 60, 90 e 120 dias, três coelhos de cada grupo foram sacrificados. As peças contendo os defeitos ósseos foram removidas em bloco, fixadas em formol a 10 por cento e submetidas a análise macroscópica, análise radiográfica com radiografia digital direta, sistema DIGORA, e a análise microscópica. Os resultados obtidos possibilitaram concluir que a MAH e a MP näo interferiram no processo de reparo ósseo, a MP permaneceu na regiäo de implantaçäo durante todos os períodos estudados e a MAH foi reabsorvida. As fatias de MDAD estimularam a neoformaçäo óssea de forma direta, sendo rapidamente incorporadas ao osso neoformado e reabsorvidas durante o processo de remodelaçäo óssea

The vacuum extractor: experimental demonstration of distortion of the foetal skull

Distortion of the parietal bones occurs whenever traction is applied via the vacuum extractor. This was confirmed experimentally by using a fresh mature stillborn foetus, and taking X-ray pictures of the skull with the three different of cap, and with different degrees of traction. (Summary)