Clinical Oral Investigations

, Volume 22, Issue 3, pp 1223–1234 | Cite as

Experimental variation of the level and the ratio of angiogenic and osteogenic signaling affects the spatiotemporal expression of bone-specific markers and organization of bone formation in ectopic sites

  • Norman Moser
  • Jan Goldstein
  • Phillip Kauffmann
  • Matthias Epple
  • Henning SchliephakeEmail author
Original Article



The aim of the present study was to test the hypothesis that the ratio of angiogenic and osteogenic signaling affects ectopic bone formation when delivered in different amounts.

Materials and methods

Porous composite PDLLA/CaCO3 scaffolds were loaded with rhBMP2 and rhVEGF in different dosage combinations and implanted into the gluteal muscles of 120 adult male Wistar rats. Bone formation and expression of alkaline phosphatase and Runx2 were quantified by histomorphometry. Spatial distribution across the scaffolds was assessed by using a grid that discriminated between the periphery and center of the scaffolds.


The evaluation showed that the combined delivery of bone morphogenetic protein BMP2 and VEGF in different dosage combinations did not enhance the overall quantity of ectopic bone formation compared to the delivery of BMP2 alone. The addition of VEGF generally upregulated Runx2 after 4 weeks, which may have retarded terminal osteogenic differentiation. However, slow combined delivery of 1.5–2.0 μg BMP2 combined with 50 ng VEGF165 over a period of 5 weeks supported a more even distribution of bone formation across the implanted scaffolds whereas higher amounts of VEGF did not elicit this effect.


The findings suggest that structural organization rather than the quantity of ectopic bone formation is affected by the dosage and the ratio of BMP2 and VEGF levels at the observed intervals.

Clinical relevance

The development of carriers for dual growth factor delivery has to take into account the necessity to carefully balance the ratio of growth release.


Bone morphogenetic protein Vascular endothelial growth factor Osteogenesis Runx2 Alkaline phosphatase 



The authors greatly value the help of Mrs. Jutta Schulz and Dr. Behrens during the laboratory experiments and the support of Dr. Sven. Backhaus and Dr. Thomas Annen during the preparation of the scaffolds. They also wish to thank Mrs. Kant and Mrs. Schäfer for their valuable help in histologic processing.

Author contribution

N. Moser performed the animal experiments, scanned the histologic specimens, and co-authored the manuscript. J. Goldstein performed the histomorphometric evaluation of bone formation. P. Kaufmann scanned the histologic specimens, collected the data, and co-authored the manuscript. M. Epple fabricated the scaffolds. H. Schliephake performed the morphometry of immunohistochemical staining and co-authored the manuscript.


This work has been funded by a grant from the Federal Ministry of Education and Research (BMBF) (No. 13N10003).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial SurgeryGeorge Augusta UniversityGöttingenGermany
  2. 2.Inorganic Chemistry and Center for Nanointegration Duisburg-Essen (CeNIDE)University of Duisburg-EssenEssenGermany

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