Compósito prototipado 3D na reconstrução de falha crítica em rádio de coelhos (Oryctolagus cuniculus)
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Data
2019-01-14
Autores
Sprada, Arícia Gomes [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A proposta deste estudo foi utilizar a tecnologia de impressoras 3D para obtenção de substitutos ósseos para reconstrução de falhas segmentares críticas em rádio de coelhos. Foram utilizados 60 coelhos da raça Nova Zelândia nos quais realizou-se ostectomia segmental de 1,5 cm no rádio direito. Os animais foram divididos em três grupos, onde o grupo controle (GI n = 20) foi submetido à ostectomia e não recebeu nenhum tratamento. O grupo enxerto (GII n = 20) foi submetido à ostectomia e reconstrução da falha óssea por meio de enxerto autólogo proveniente da asa do ílio. O grupo implante (GIII n = 20) foi submetido à reconstrução óssea pela implantação de próteses impressas por impressora 3D constituídas de ácido polilático (PLLA) e hidroxiapatita (HA). Os implantes foram preparados com base na imagem de tomografia computadorizada obtidas do membro do próprio animal. Os animais foram avaliados clinicamente nos momentos pós-operatório 7, 15, 30, 60 e 90 dias. Radiografias em duas projeções foram efetuadas nos dias 15, 30, 60 e 90 após a cirurgia, de acordo com os subgrupos T1, T2, T3 e T4, respectivamente. Ao final das avaliações radiográficas, os animais foram submetidos à eutanásia e o segmento ósseo de interesse encaminhado para análise histopatológica. Clinicamente, o grupo enxerto (grupo II) apresentou menor claudicação, edema, dor e complicações nas feridas cirúrgicas quando comparado aos grupos controle e grupo implante. Nas avaliações radiográficas a reação periosteal, formação de calo ósseo e ponte óssea também foram superiores no grupo II quando comparado aos outros grupos. No estudo histopatológico fibrose, osteogênese e condrogênese foi similar em todos os grupos. No entanto, a presença de congestão, hemorragia e inflamação foram maiores no grupo implante. Esses resultados sugerem que os implantes impressos apresentam boas propriedades biomecânicas que em estudos futuros podem ser associados às propriedades biológicas do enxerto ósseo criando-se um novo implante que apresente características osteocondutivas e osteogênicas, como por exemplo, a associação de PLLA, HA e células vivas.
The purpose of this study was to use the 3D printing technology to obtain a bone substitute for reconstruction of critical segmental bone failures of 1.5cm in rabbits’ radio. The animals were divided into 3 groups: Group I (n=20) or control group, Group II (n=20) or graft group and Group III (n=20) or implant group. On group I, the rabbits were submitted to ostectomy receiving no treatment. On group II, the bone defect was treated with autologous graft from the ilium crest. On group III, reconstruction occurred using a three-dimensional printed hydroxyapatite and Poly-Llactic acid (PLLA) implant. The implants were prepared using 3D imaging based on the computed tomography obtained from each animal. Clinical evaluation were conducted postoperatively on day 7, 15, 30, 60 e 90. Radiographs in two projections were taken on days 15, 30, 60 and 90 postoperative, according to the subgroups T1, T2, T3 and T4, respectively. After radiographic evaluation, the animals were submitted to euthanasia and the bone segment was referred for histopathological analysis. Clinically, group II presented less lameness, edema, pain and complications on the surgical wound when compared to the control and implant groups. On radiographic evaluation, periosteal reaction, bone callus formation and bone bridge were also superior in group II when compared to the others groups. Histopathological study showed that fibrosis, osteogenesis and chondrogenesis were similar in all groups. However, the presence of congestion, hemorrhage and inflammation were higher in the implant group. These results indicate that biomechanical capacity of the implant and biological properties of the graft bone should be associated by creating a new implant that presents osteoconductive and osteogenic characteristics, such as a bone substitute printed using PLLA and hydroxyapatite enriched with living cells.
The purpose of this study was to use the 3D printing technology to obtain a bone substitute for reconstruction of critical segmental bone failures of 1.5cm in rabbits’ radio. The animals were divided into 3 groups: Group I (n=20) or control group, Group II (n=20) or graft group and Group III (n=20) or implant group. On group I, the rabbits were submitted to ostectomy receiving no treatment. On group II, the bone defect was treated with autologous graft from the ilium crest. On group III, reconstruction occurred using a three-dimensional printed hydroxyapatite and Poly-Llactic acid (PLLA) implant. The implants were prepared using 3D imaging based on the computed tomography obtained from each animal. Clinical evaluation were conducted postoperatively on day 7, 15, 30, 60 e 90. Radiographs in two projections were taken on days 15, 30, 60 and 90 postoperative, according to the subgroups T1, T2, T3 and T4, respectively. After radiographic evaluation, the animals were submitted to euthanasia and the bone segment was referred for histopathological analysis. Clinically, group II presented less lameness, edema, pain and complications on the surgical wound when compared to the control and implant groups. On radiographic evaluation, periosteal reaction, bone callus formation and bone bridge were also superior in group II when compared to the others groups. Histopathological study showed that fibrosis, osteogenesis and chondrogenesis were similar in all groups. However, the presence of congestion, hemorrhage and inflammation were higher in the implant group. These results indicate that biomechanical capacity of the implant and biological properties of the graft bone should be associated by creating a new implant that presents osteoconductive and osteogenic characteristics, such as a bone substitute printed using PLLA and hydroxyapatite enriched with living cells.
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Palavras-chave
Ácido Polilático, Defeito ósseo segmental, Enxerto ósseo, Hidroxiapatita, Impressão 3D