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Trompet D, Melis S, Chagin AS, Maes C. Skeletal stem and progenitor cells in bone development and repair. J Bone Miner Res 2024; 39:633-654. [PMID: 38696703 DOI: 10.1093/jbmr/zjae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 05/04/2024]
Abstract
Bone development, growth, and repair are complex processes involving various cell types and interactions, with central roles played by skeletal stem and progenitor cells. Recent research brought new insights into the skeletal precursor populations that mediate intramembranous and endochondral bone development. Later in life, many of the cellular and molecular mechanisms determining development are reactivated upon fracture, with powerful trauma-induced signaling cues triggering a variety of postnatal skeletal stem/progenitor cells (SSPCs) residing near the bone defect. Interestingly, in this injury context, the current evidence suggests that the fates of both SSPCs and differentiated skeletal cells can be considerably flexible and dynamic, and that multiple cell sources can be activated to operate as functional progenitors generating chondrocytes and/or osteoblasts. The combined implementation of in vivo lineage tracing, cell surface marker-based cell selection, single-cell molecular analyses, and high-resolution in situ imaging has strongly improved our insights into the diversity and roles of developmental and reparative stem/progenitor subsets, while also unveiling the complexity of their dynamics, hierarchies, and relationships. Albeit incompletely understood at present, findings supporting lineage flexibility and possibly plasticity among sources of osteogenic cells challenge the classical dogma of a single primitive, self-renewing, multipotent stem cell driving bone tissue formation and regeneration from the apex of a hierarchical and strictly unidirectional differentiation tree. We here review the state of the field and the newest discoveries in the origin, identity, and fates of skeletal progenitor cells during bone development and growth, discuss the contributions of adult SSPC populations to fracture repair, and reflect on the dynamism and relationships among skeletal precursors and differentiated cell lineages. Further research directed at unraveling the heterogeneity and capacities of SSPCs, as well as the regulatory cues determining their fate and functioning, will offer vital new options for clinical translation toward compromised fracture healing and bone regenerative medicine.
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Affiliation(s)
- Dana Trompet
- Laboratory of Skeletal Cell Biology and Physiology (SCEBP), Skeletal Biology and Engineering Research Center (SBE), Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, 40530 Gothenburg, Sweden
- Department of Physiology and Pharmacology, Karolinska Institute, 17177 Stockholm, Sweden
| | - Seppe Melis
- Laboratory of Skeletal Cell Biology and Physiology (SCEBP), Skeletal Biology and Engineering Research Center (SBE), Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Andrei S Chagin
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, 40530 Gothenburg, Sweden
- Department of Physiology and Pharmacology, Karolinska Institute, 17177 Stockholm, Sweden
| | - Christa Maes
- Laboratory of Skeletal Cell Biology and Physiology (SCEBP), Skeletal Biology and Engineering Research Center (SBE), Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
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Yang X, Wu L, Li C, Li S, Hou W, Hao Y, Lu Y, Li L. Synergistic Amelioration of Osseointegration and Osteoimmunomodulation with a Microarc Oxidation-Treated Three-Dimensionally Printed Ti-24Nb-4Zr-8Sn Scaffold via Surface Activity and Low Elastic Modulus. ACS APPLIED MATERIALS & INTERFACES 2024; 16:3171-3186. [PMID: 38205810 DOI: 10.1021/acsami.3c16459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Biomaterial scaffolds, including bone substitutes, have evolved from being primarily a biologically passive structural element to one in which material properties such as surface topography and chemistry actively direct bone regeneration by influencing stem cells and the immune microenvironment. Ti-6Al-4V(Ti6Al4V) implants, with a significantly higher elastic modulus than human bone, may lead to stress shielding, necessitating improved stability at the bone-titanium alloy implant interface. Ti-24Nb-4Zr-8Sn (Ti2448), a low elastic modulus β-type titanium alloy devoid of potentially toxic elements, was utilized in this study. We employed 3D printing technology to fabricate a porous scaffold structure to further decrease the structural stiffness of the implant to approximate that of cancellous bone. Microarc oxidation (MAO) surface modification technology is then employed to create a microporous structure and a hydrophilic oxide ceramic layer on the surface and interior of the scaffold. In vitro studies demonstrated that MAO treatment enhances the proliferation, adhesion, and osteogenesis capabilities on the scaffold surface. The chemical composition of the MAO-Ti2448 oxide layer is found to enhance the transcription and expression of osteogenic genes in bone mesenchymal stem cells (BMSCs), potentially related to the enrichment of Nb2O5 and SnO2 in the oxide layer. The MAO-Ti2448 scaffold, with its synergistic surface activity and low stiffness, significantly activates the anti-inflammatory macrophage phenotype, creating an immune microenvironment that promotes the osteogenic differentiation of BMSCs. In vivo experiments in a rabbit model demonstrated a significant improvement in the quantity and quality of the newly formed bone trabeculae within the scaffold under the contact osteogenesis pattern with a matched elastic modulus. These trabeculae exhibit robust connections to the external structure of the scaffold, accelerating the formation of an interlocking structure between the bone and implant and providing higher implantation stability. These findings suggest that the MAO-Ti2448 scaffold has significant potential as a bone defect repair material by regulating osteoimmunomodulation and osteogenesis to enhance osseointegration. This study demonstrates an optional strategy that combines the mechanism of reducing the elastic modulus with surface modification treatment, thereby extending the application scope of β-type titanium alloy.
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Affiliation(s)
- Xinyue Yang
- Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110055, P.R. China
| | - Lijun Wu
- Engineering Research Center of High Entropy Alloy Materials (Liaoning Province), School of Materials Science and Engineering, Dalian University of Technology, Dalian 116024, P.R. China
| | - Cheng Li
- Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110055, P.R. China
| | - Shujun Li
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P.R. China
| | - Wentao Hou
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P.R. China
| | - Yulin Hao
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, P.R. China
| | - Yiping Lu
- Engineering Research Center of High Entropy Alloy Materials (Liaoning Province), School of Materials Science and Engineering, Dalian University of Technology, Dalian 116024, P.R. China
| | - Lei Li
- Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110055, P.R. China
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Hong CC, Harrison WD, Clough T, Calder J. Association of Periprosthetic Fibula Fracture With Knotless Suture Button (TightRope) Fixation for Ankle Syndesmosis in Elite Athletes. Orthop J Sports Med 2023; 11:23259671231206185. [PMID: 37927967 PMCID: PMC10625313 DOI: 10.1177/23259671231206185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/22/2023] [Indexed: 11/07/2023] Open
Abstract
Background Suture button fixation is frequently used to stabilize the distal tibiofibular syndesmosis in athletes sustaining an isolated ligamentous syndesmosis injury. Purpose To report on a series of periprosthetic fibula fractures adjacent to the lateral suture button after a subsequent unrelated ankle injury or progressive stress injury after initial ankle syndesmosis stabilization using the knotless TightRope (Arthrex). Study Design Case series; Level of evidence, 4. Methods Eight elite athletes with periprosthetic fibula fractures and stress injuries around the lateral suture buttons were evaluated. In all athletes, the knotless TightRope had been used to stabilize an isolated ligamentous ankle syndesmotic injury, after which all patients recovered and returned to professional sports at their preinjury level. The athletes subsequently developed an acute fibula fracture or a fibula stress fracture related to the 3.7-mm drill hole in the fibula adjacent to the lateral suture buttons after a mean of 14.1 months (range, 5-29 months). The management of these complications was analyzed. Results Five athletes sustained a periprosthetic fibula fracture in the form of undisplaced spiral Weber B injuries after a subsequent, unrelated injury. Poor healing response was noted with initial nonoperative treatment for the first 2 athletes, and surgical intervention was performed with successful union of the fracture and return to sports. The subsequent 3 athletes had early surgery with uneventful recovery. Another 3 athletes developed stress injuries adjacent to the fibula suture button without a history of acute trauma. In 2 of the 3 athletes, the position of lateral suture buttons was in the anterior third of the fibula. Initial nonoperative management yielded poor healing response, and subsequent surgical intervention was required to enable healing and return to sports. Conclusion Nonoperative management of fractures adjacent to the fibula suture button of a knotless TightRope may lead to a delay in union. Therefore, early surgical intervention should be considered in elite athletes, whose return-to-sports time is critical. Care is needed to ensure that the fibula hole for the suture button is centrally located because the eccentric placement of the fibula hole in the anterior third of the fibula may contribute to the development of a stress reaction or stress fracture. Surgical intervention for a periprosthetic fibula stress fracture leads to satisfactory resolution of symptoms.
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Affiliation(s)
- Choon Chiet Hong
- Fortius Clinic (FIFA Medical Centre of Excellence), London, UK
- Department of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore
- Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Tim Clough
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - James Calder
- Fortius Clinic (FIFA Medical Centre of Excellence), London, UK
- Department of Bioengineering, Imperial College London, London, UK
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Alonso-Fernández I, Haugen HJ, López-Peña M, González-Cantalapiedra A, Muñoz F. Use of 3D-printed polylactic acid/bioceramic composite scaffolds for bone tissue engineering in preclinical in vivo studies: A systematic review. Acta Biomater 2023; 168:1-21. [PMID: 37454707 DOI: 10.1016/j.actbio.2023.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023]
Abstract
3D-printed composite scaffolds have emerged as an alternative to deal with existing limitations when facing bone reconstruction. The aim of the study was to systematically review the feasibility of using PLA/bioceramic composite scaffolds manufactured by 3D-printing technologies as bone grafting materials in preclinical in vivo studies. Electronic databases were searched using specific search terms, and thirteen manuscripts were selected after screening. The synthesis of the scaffolds was carried out using mainly extrusion-based techniques. Likewise, hydroxyapatite was the most used bioceramic for synthesizing composites with a PLA matrix. Among the selected studies, seven were conducted in rats and six in rabbits, but the high variability that exists regarding the experimental process made it difficult to compare them. Regarding the results, PLA/Bioceramic composite scaffolds have shown to be biocompatible and mechanically resistant. Preclinical studies elucidated the ability of the scaffolds to be used as bone grafts, allowing bone growing without adverse reactions. In conclusion, PLA/Bioceramics scaffolds have been demonstrated to be a promising alternative for treating bone defects. Nevertheless, more care should be taken when designing and performing in vivo trials, since the lack of standardization of the processes, which prevents the comparison of the results and reduces the quality of the information. STATEMENT OF SIGNIFICANCE: 3D-printed polylactic acid/bioceramic composite scaffolds have emerged as an alternative to deal with existing limitations when facing bone reconstruction. Since preclinical in vivo studies with animal models represent a mandatory step for clinical translation, the present manuscript analyzed and discussed not only those aspects related to the selection of the bioceramic material, the synthesis of the implants and their characterization. But provides a new approach to understand how the design and perform of clinical trials, as well as the selection of the analysis methods, may affect the obtained results, by covering authors' knowledgebase from veterinary medicine to biomaterial science. Thus, this study aims to systematically review the feasibility of using polylactic acid/bioceramic scaffolds as grafting materials in preclinical trials.
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Affiliation(s)
- Iván Alonso-Fernández
- Anatomy, Animal Production and Veterinary Clinical Sciences Department, Veterinary Faculty, Universidade de Santiago de Compostela, Campus Universitario s/n, 27002 Lugo, Spain.
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Mónica López-Peña
- Anatomy, Animal Production and Veterinary Clinical Sciences Department, Veterinary Faculty, Universidade de Santiago de Compostela, Campus Universitario s/n, 27002 Lugo, Spain
| | - Antonio González-Cantalapiedra
- Anatomy, Animal Production and Veterinary Clinical Sciences Department, Veterinary Faculty, Universidade de Santiago de Compostela, Campus Universitario s/n, 27002 Lugo, Spain
| | - Fernando Muñoz
- Anatomy, Animal Production and Veterinary Clinical Sciences Department, Veterinary Faculty, Universidade de Santiago de Compostela, Campus Universitario s/n, 27002 Lugo, Spain
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Ferro F, Azzolin F, Spelat R, Bevilacqua L, Maglione M. Considering the Value of 3D Cultures for Enhancing the Understanding of Adhesion, Proliferation, and Osteogenesis on Titanium Dental Implants. Biomolecules 2023; 13:1048. [PMID: 37509084 PMCID: PMC10377630 DOI: 10.3390/biom13071048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Individuals with pathologic conditions and restorative deficiencies might benefit from a combinatorial approach encompassing stem cells and dental implants; however, due to the various surface textures and coatings, the influence of titanium dental implants on cells exhibits extensive, wide variations. Three-dimensional (3D) cultures of stem cells on whole dental implants are superior in testing implant properties and were used to examine their capabilities thoroughly. MATERIALS AND METHODS The surface micro-topography of five titanium dental implants manufactured by sandblasting with titanium, aluminum, corundum, or laser sintered and laser machined was compared in this study. After characterization, including particle size distribution and roughness, the adhesion, proliferation, and viability of adipose-derived stem cells (ADSCs) cultured on the whole-body implants were tested at three time points (one to seven days). Finally, the capacity of the implant to induce ADSCs' spontaneous osteoblastic differentiation was examined at the same time points, assessing the gene expression of collagen type 1 (coll-I), osteonectin (osn), alkaline phosphatase (alp), and osteocalcin (osc). RESULTS Laser-treated (Laser Mach and Laser Sint) implants exhibited the highest adhesion degree; however, limited proliferation was observed, except for Laser Sint implants, while viability differences were seen throughout the three time points, except for Ti Blast implants. Sandblasted surfaces (Al Blast, Cor Blast, and Ti Blast) outpaced the laser-treated ones, inducing higher amounts of coll-I, osn, and alp, but not osc. Among the sandblasted surfaces, Ti Blast showed moderate roughness and the highest superficial texture density, favoring the most significant spontaneous differentiation relative to all the other implant surfaces. CONCLUSIONS The results indicate that 3D cultures of stem cells on whole-body titanium dental implants is a practical and physiologically appropriate way to test the biological characteristics of the implants, revealing peculiar differences in ADSCs' adhesion, proliferation, and activity toward osteogenic commitment in the absence of specific osteoinductive cues. In addition, the 3D method would allow researchers to test various implant surfaces more thoroughly. Integrating with preconditioned stem cells would inspire a more substantial combinatorial approach to promote a quicker recovery for patients with restorative impairments.
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Affiliation(s)
- Federico Ferro
- Department of Medical and Biological Sciences, University of Udine, 33100 Udine, Italy
| | - Federico Azzolin
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
| | - Renza Spelat
- Neurobiology Sector, International School for Advanced Studies (SISSA), 34136 Trieste, Italy
| | - Lorenzo Bevilacqua
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
| | - Michele Maglione
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
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Ihejirika-Lomedico R, Patel K, Buchalter DB, Kirby DJ, Mehta D, Dankert JF, Muiños-López E, Ihejirika Y, Leucht P. Non-psychoactive Cannabidiol Prevents Osteoporosis in an Animal Model and Increases Cell Viability, Proliferation, and Osteogenic Gene Expression in Human Skeletal Stem and Progenitor Cells. Calcif Tissue Int 2023; 112:716-726. [PMID: 37093268 DOI: 10.1007/s00223-023-01083-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
Cannabidiol (CBD), the non-psychoactive component of the Cannabis sativa plant, is marketed as a potential therapeutic agent and has been studied for its roles in reducing inflammation and managing neuropathic pain. Some studies have reported that CB1 and CB2 receptor activation can attenuate and reverse bone loss in experimental animal models. Despite this, little is known about the impact of CBD on fracture healing. We investigated the effects of CBD in vitro using human osteoprogenitor cells and in vivo via murine femur fracture and osteoporosis models. In vitro mesenchymal stem cells were treated with increasing concentrations of crystalized pharmaceutical grade CBD or vehicle solution. Cell viability and proliferation were significantly increased in cells treated with CBD compared to vehicle control. Osteocalcin expression was also significantly higher in the CBD-treated human stem cells compared to vehicle control. In vivo the effect of CBD on bone mineral density and fracture healing in mice was examined using a two-phase experimental approach. Fluoxetine was used for pharmacologic induction of osteoporosis and surgical oophorectomy (OVX) was used for hormonal induction of osteoporosis. X-ray and microCT analysis showed that CBD prevented both fluoxetine- and OVX-induced osteoporosis. We found that while OVX resulted in delayed bone healing in control mice, CBD-pretreated mice exhibited normal bone healing. Collectively these in vitro and in vivo findings suggest that CBD exerts cell-specific effects which can be exploited to enhance bone metabolism. These findings also indicate that CBD usage in an osteoporotic population may positively impact bone morphology, warranting further research.
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Affiliation(s)
- Rivka Ihejirika-Lomedico
- Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Grossman School of Medicine, 550 First Avenue, MSB 251A, New York, NY, 10016, USA
| | - Karan Patel
- Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Grossman School of Medicine, 550 First Avenue, MSB 251A, New York, NY, 10016, USA
| | - Daniel B Buchalter
- Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Grossman School of Medicine, 550 First Avenue, MSB 251A, New York, NY, 10016, USA
| | - David J Kirby
- Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Grossman School of Medicine, 550 First Avenue, MSB 251A, New York, NY, 10016, USA
| | - Devan Mehta
- Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Grossman School of Medicine, 550 First Avenue, MSB 251A, New York, NY, 10016, USA
| | - John F Dankert
- Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Grossman School of Medicine, 550 First Avenue, MSB 251A, New York, NY, 10016, USA
| | - Emma Muiños-López
- Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Grossman School of Medicine, 550 First Avenue, MSB 251A, New York, NY, 10016, USA
| | - Yael Ihejirika
- Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Grossman School of Medicine, 550 First Avenue, MSB 251A, New York, NY, 10016, USA
| | - Philipp Leucht
- Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Grossman School of Medicine, 550 First Avenue, MSB 251A, New York, NY, 10016, USA.
- Department of Cell Biology, NYU Grossman School of Medicine, 550 First Avenue, MSB 251A, New York, NY, 10016, USA.
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7
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Babayi M, Ashtiani MN, Emamian A, Ramezanpour H, Yousefi H, Mahdavi M. Peri-implant cell differentiation in delayed and immediately-loaded dental implant: A mechanobiological simulation. Arch Oral Biol 2023; 151:105702. [PMID: 37086495 DOI: 10.1016/j.archoralbio.2023.105702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/15/2023] [Accepted: 04/15/2023] [Indexed: 04/24/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect of immediate versus delayed dental implant placement strategies on cell differentiation in a dental callus. DESIGN The implant was placed in the mandible with two nearby teeth using an idealized two-dimensional finite element model. Eight weeks after surgery, the mechanobiological modeling of healing was used to estimate cell differentiation. It was assumed that the callus was initially filled by mesenchymal cells. The model then transformed mechanical stimuli received by the callus from loadings in terms of distortional and dilatational strains into predictions of the cellular phenotypes, including fibroblasts, chondrocytes, and osteoblasts, or whether they would remain unchanged or die. RESULTS The results demonstrated that delayed loading led to greater bone formation than immediate loading. Osteoblast colonies were observed in the base of threads in the immediately-loaded implant, whereas the delayed loading caused distant bone formation from the surrounding bone side towards the implant. The osteoblasts were differentiated from both intramembranous and endochondral mechanisms of ossification. After eight weeks, approximately 61 % of the callus was ossified in the delayed placement model compared to 35 % in the immediate placement model, resulting in a greater amount of fibrocartilaginous tissue on the bone side of the callus. CONCLUSIONS Immediate and delayed loading models generated different results. In the delayed strategy, bone cells were supplied appropriately during the first few weeks following surgery, whereas the immediate loading caused fibrocartilaginous tissue differentiation. In the form of distant osseointegration, the secondary stability of the dental implant was higher and faster due to the delayed placement.
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Affiliation(s)
- Masumeh Babayi
- Department of Biomedical Engineering, Sahand University of Technology, Tabriz, Islamic Republic of Iran
| | - Mohammed N Ashtiani
- Faculty of Medical Sciences, Tarbiat Modares Unviersity, Tehran, Islamic Republic of Iran.
| | - Amirhossein Emamian
- Department of Biomedical Engineering, Sahand University of Technology, Tabriz, Islamic Republic of Iran; Research and Development Department, Avita Dental System, Tehran, Islamic Republic of Iran
| | - Hosseinali Ramezanpour
- Research and Development Department, Avita Dental System, Tehran, Islamic Republic of Iran
| | - Hashem Yousefi
- Research and Development Department, Avita Dental System, Tehran, Islamic Republic of Iran
| | - Majid Mahdavi
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Islamic Republic of Iran
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Leclerc K, Remark LH, Ramsukh M, Josephson AM, Palma L, Parente PEL, Sambon M, Lee S, Lopez EM, Morgani SM, Leucht P. Hox genes are crucial regulators of periosteal stem cell identity. Development 2023; 150:dev201391. [PMID: 36912250 PMCID: PMC10112919 DOI: 10.1242/dev.201391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/20/2023] [Indexed: 03/14/2023]
Abstract
Periosteal stem and progenitor cells (PSPCs) are major contributors to bone maintenance and repair. Deciphering the molecular mechanisms that regulate their function is crucial for the successful generation and application of future therapeutics. Here, we pinpoint Hox transcription factors as necessary and sufficient for periosteal stem cell function. Hox genes are transcriptionally enriched in periosteal stem cells and their overexpression in more committed progenitors drives reprogramming to a naïve, self-renewing stem cell-like state. Crucially, individual Hox family members are expressed in a location-specific manner and their stem cell-promoting activity is only observed when the Hox gene is matched to the anatomical origin of the PSPC, demonstrating a role for the embryonic Hox code in adult stem cells. Finally, we demonstrate that Hoxa10 overexpression partially restores the age-related decline in fracture repair. Together, our data highlight the importance of Hox genes as key regulators of PSPC identity in skeletal homeostasis and repair.
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Affiliation(s)
- Kevin Leclerc
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
| | - Lindsey H. Remark
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
- Department of Cell Biology, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
| | - Malissa Ramsukh
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
| | - Anne Marie Josephson
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
- Department of Cell Biology, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
| | - Laura Palma
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
| | - Paulo E. L. Parente
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
| | - Margaux Sambon
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
| | - Sooyeon Lee
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
- Institute of Comparative Molecular Endocrinology, Ulm University, Ulm 89081, Germany
| | - Emma Muiños Lopez
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
- Cell Therapy Area, Clínica Universidad de Navarra, Pamplona 31008, Spain
| | - Sophie M. Morgani
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
| | - Philipp Leucht
- Department of Orthopedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
- Department of Cell Biology, NYU Robert I. Grossman School of Medicine, New York, NY 10016, USA
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9
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Mehta D, Dankert J, Yim N, Leclerc K, Leucht P. Rosiglitazone induces adipogenesis of both marrow and periosteum derived mesenchymal stem cells during endochondral fracture healing. J Orthop Sci 2023; 28:460-467. [PMID: 34879982 PMCID: PMC9167886 DOI: 10.1016/j.jos.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/21/2021] [Accepted: 11/10/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) afflicts about six percent of the global population, and these patients suffer from a two-fold increased fracture risk. Thiazolidinediones (TZDs), including rosiglitazone, are commonly used medications in T2DM because they have a low incidence of monotherapy failure. It is known that rosiglitazone is associated with secondary osteoporosis, further increasing the fracture risk in an already susceptible population. However, it is not yet understood how rosiglitazone impacts endochondral bone healing after fracture. The aim of this study is to elucidate how rosiglitazone treatment impacts endochondral fracture healing, and how rosiglitazone influences the differentiation of skeletal stem and progenitor cells from the bone marrow and the periosteum. METHODS An in-vivo mouse femur fracture model was employed to evaluate differences in fracture healing between mice treated with and without rosiglitazone chow. Fracture healing was assessed with histology and micro computed tomography (μCT). In-vitro assays utilized isolated mouse bone marrow stromal cells and periosteal cells to investigate how rosiglitazone impacts the osteogenic capability and adipogenicity of these cells. RESULTS The in-vivo mouse femur fracture model showed that fracture callus in mice treated with rosiglitazone had significantly more adipose content than those of control mice that did not receive rosiglitazone. In addition, μCT analysis showed that rosiglitazone treated mice had significantly greater bone volume, but overall greater porosity when compared to control mice. In-vitro experimentation showed significantly less osteogenesis and more adipogenesis in bone marrow derived progenitor cells that were cultured in osteogenic media. In addition, rosiglitazone treatment alone caused significant increases in adipogenesis in both bone marrow and periosteum derived cells. CONCLUSION Rosiglitazone impairs endochondral fracture healing in mice by increasing adipogenesis and decreasing osteogenesis of both bone marrow and periosteum derived skeletal progenitor cells.
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Affiliation(s)
- Devan Mehta
- NYU Grossman School of Medicine - NYU Langone Orthopedic Hospital, Department of Orthopedic Surgery, New York, NY, USA.
| | - John Dankert
- NYU Grossman School of Medicine - NYU Langone Orthopedic Hospital, Department of Orthopedic Surgery, New York, NY, USA.
| | - Nury Yim
- NYU Grossman School of Medicine - NYU Langone Orthopedic Hospital, Department of Orthopedic Surgery, New York, NY, USA.
| | - Kevin Leclerc
- NYU Grossman School of Medicine - NYU Langone Orthopedic Hospital, Department of Orthopedic Surgery, New York, NY, USA.
| | - Philipp Leucht
- NYU Grossman School of Medicine - NYU Langone Orthopedic Hospital, Department of Orthopedic Surgery, New York, NY, USA.
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10
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Measurement of bone damage caused by quasi-static compressive loading-unloading to explore dental implants stability: Simultaneous use of in-vitro tests, μ-CT images, and digital volume correlation. J Mech Behav Biomed Mater 2023; 138:105566. [PMID: 36435034 DOI: 10.1016/j.jmbbm.2022.105566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
Primary stability of dental implants is the initial mechanical engagement of the implant with its adjacent bone. Implantation and the subsequent loading may cause mechanical damage in the peripheral bone, which ultimately reduces the stability of the implant. This study aimed at evaluating primary stability of dental implants through applying stepwise compressive displacement-controlled, loading-unloading cycles to obtain overall stiffness and dissipated energy of the bone-implant structure; and quantifying induced plastic strains in surrounding bone using digital volume correlation (DVC) method, through comparing μCT images in different loading steps. To this end, dental implants were inserted into the cylindrical trabecular bones, then the bone-implant structure was undergone step-wise loading-unloading cycles, and μCT images were taken in some particular steps, then comparison was made between undeformed and deformed configurations using DVC to quantify plastic strain within the trabecular bone. Comparing stiffness reduction and dissipated energy values in different loading steps, obtained from the force-displacement curve in each loading step, revealed that the maximum displacement of 0.16 mm can be deemed as a safe threshold above which damages in peri-implant bone started to increase considerably (p < 0.05). In addition, it was found here that peri-implant bone strain linearly increased with decreasing bone-implant stiffness (p < 0.05). Moreover, strain concentration in peri-implant bone region showed that the plastic strain in trabecular bone spread up to a distance of about 2.5 mm away from the implant surface. Research of this kind can be used to optimize the design of dental implants, with the ultimate goal of improving their stability, also to validate in-silico models, e.g., micro-finite element models, which can help gain a deeper understanding of bone-implant construct behavior.
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11
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Moran MM, Ko FC, Mesner LD, Calabrese GM, Al-Barghouthi BM, Farber CR, Sumner DR. Intramembranous bone regeneration in diversity outbred mice is heritable. Bone 2022; 164:116524. [PMID: 36028119 PMCID: PMC9798271 DOI: 10.1016/j.bone.2022.116524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 12/31/2022]
Abstract
There are over one million cases of failed bone repair in the U.S. annually, resulting in substantial patient morbidity and societal costs. Multiple candidate genes affecting bone traits such as bone mineral density have been identified in human subjects and animal models using genome-wide association studies (GWAS). This approach for understanding the genetic factors affecting bone repair is impractical in human subjects but could be performed in a model organism if there is sufficient variability and heritability in the bone regeneration response. Diversity Outbred (DO) mice, which have significant genetic diversity and have been used to examine multiple intact bone traits, would be an excellent possibility. Thus, we sought to evaluate the phenotypic distribution of bone regeneration, sex effects and heritability of intramembranous bone regeneration on day 7 following femoral marrow ablation in 47 12-week old DO mice (23 males, 24 females). Compared to a previous study using 4 inbred mouse strains, we found similar levels of variability in the amount of regenerated bone (coefficient of variation of 86 % v. 88 %) with approximately the same degree of heritability (0.42 v. 0.49). There was a trend toward more bone regeneration in males than females. The amount of regenerated bone was either weakly or not correlated with bone mass at intact sites, suggesting that the genetic factors responsible for bone regeneration and intact bone phenotypes are at least partially independent. In conclusion, we demonstrate that DO mice exhibit variation and heritability of intramembranous bone regeneration that will be suitable for future GWAS.
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Affiliation(s)
- Meghan M Moran
- Department of Anatomy & Cell Biology, Rush University Medical Center, Chicago, IL, USA; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
| | - Frank C Ko
- Department of Anatomy & Cell Biology, Rush University Medical Center, Chicago, IL, USA; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Larry D Mesner
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Gina M Calabrese
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Basel M Al-Barghouthi
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Charles R Farber
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, VA, USA; Departments of Public Health Sciences and Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - D Rick Sumner
- Department of Anatomy & Cell Biology, Rush University Medical Center, Chicago, IL, USA; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
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12
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Ferro F, Azzolin F, Spelat R, Bevilacqua L, Maglione M. Assessing the Efficacy of Whole-Body Titanium Dental Implant Surface Modifications in Inducing Adhesion, Proliferation, and Osteogenesis in Human Adipose Tissue Stem Cells. J Funct Biomater 2022; 13:jfb13040206. [PMID: 36412847 PMCID: PMC9680380 DOI: 10.3390/jfb13040206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/13/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although the influence of titanium implants' micro-surface properties on titanium discs has been extensively investigated, the research has not taken into consideration their whole-body effect, which may be considered possible using a combinatorial approach. METHODS Five titanium dental implants with a similar moderate roughness and different surface textures were thoroughly characterized. The cell adhesion and proliferation were assessed after adipose-tissue-derived stem cells (ADSCs) were seeded on whole-body implants. The implants' inductive properties were assessed by evaluating the osteoblastic gene expression. RESULTS The surface micro-topography was analyzed, showing that hydroxyapatite (HA)-blasted and bland acid etching implants had the highest roughness and a lower number of surface particles. Cell adhesion was observed after 24 h on all the implants, with the highest score registered for the HA-blasted and bland acid etching implants. Cell proliferation was observed only on the laser-treated and double-acid-etched surfaces. The ADSCs expressed collagen type I, osteonectin, and alkaline phosphatase on all the implant surfaces, with high levels on the HA-treated surfaces, which also triggered osteocalcin expression on day seven. CONCLUSIONS The findings of this study show that the morphology and treatment of whole titanium dental implants, primarily HA-treated and bland acid etching implants, impact the adherence and activity of ADSCs in osteogenic differentiation in the absence of specific osteo-inductive signals.
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Affiliation(s)
- Federico Ferro
- Department of Medical and Biological Sciences, University of Udine, 33100 Udine, Italy
- Correspondence:
| | - Federico Azzolin
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
| | - Renza Spelat
- Neurobiology Sector, International School for Advanced Studies (SISSA), 34136 Trieste, Italy
| | - Lorenzo Bevilacqua
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
| | - Michele Maglione
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
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13
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Zhang K, Liu X, Tang Y, Liu Z, Yi Q, Wang L, Geng B, Xia Y. Fluid Shear Stress Promotes Osteoblast Proliferation and Suppresses Mitochondrial-Mediated Osteoblast Apoptosis Through the miR-214-3p-ATF4 Signaling Axis. Physiol Res 2022. [DOI: 10.33549/physiolres.934917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
MicroRNAs (miRNAs) play vital roles in bone metabolism and participate in the mechanically induced bone alterations. The underlying molecular mechanisms by which fluid shear stress (FSS) regulate the proliferative and apoptotic phenotypic changes of osteoblasts remain elusive. The study aimed to investigate the regulatory effects of FSS on osteoblast proliferative and apoptotic phenotypes and the roles of miR-214-3p-ATF4 (activating transcription factor 4) signaling axis in the mechanomodulation processes. FSS promoted the proliferative activity of osteoblasts and suppressed mitochondrial-mediated osteoblast apoptosis. FSS decreased miR-214-3p expression and increased ATF4 expression in MC3T3-E1 osteoblasts. MiR-214-3p inhibited osteoblast proliferative activity and promoted mitochondrial-mediated osteoblast apoptosis. Overexpression of miR-214-3p attenuated FSS-enhanced osteoblast proliferation and FSS-suppressed mitochondrial-mediated osteoblast apoptosis. We validated that ATF4 acted as a target gene of miR-214-3p. Moreover, miR-214 3p regulated osteoblast proliferation and apoptosis through targeting ATF4. Taken together, our study proved that FSS could suppress mitochondrial-mediated osteoblast apoptosis and promote osteoblast proliferation through the miR-214-3p-ATF4 signaling axis.
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Affiliation(s)
- K Zhang
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou Gansu, China, Orthopaedics Key Laboratory of Gansu Province, Lanzhou Gansu, China
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14
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Xu G, Liu H, Zhang L. Characterization of Changes in Subchondral Bone Tissue Density of the Ankle Joint in Taekwondo Players. Front Bioeng Biotechnol 2022; 10:872258. [PMID: 35600898 PMCID: PMC9114634 DOI: 10.3389/fbioe.2022.872258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background: It has been found that ankle joint impingement can cause articular cartilage injury, and the change of subchondral bone density and distribution under long-term stress loading can reflect the stress interaction of the articular surface and the difference in bone remodeling degree and predict the location of cartilage injury. Objective: To investigate the bone density distribution pattern of ankle joint subchondral bone under mechanical stress loading of Taekwondo, the volume proportion of bone tissue with different bone densities, and the distribution characteristics of bone remodeling position. Study design: A controlled laboratory study. Methods: Computed tomography data were collected from the feet of 10 normal subjects (control group) and 10 high-level Taekwondo athletes. First, the distribution pattern of the high-density area of the articular surface was determined by computed tomography osteoabsorptiometry and the nine-grid anatomical region localization method. Second, the percentage of bone volume (%BTV) and the distribution trend of bone tissue were measured. Result: In the present study, it was found that there were high-density areas in the 1st, 2nd, 3rd, 4th, 6th, 7th, and 9th regions of the distal tibia of Taekwondo athletes, and the distribution track was consistent with the high-density areas of the talar dome surface (1st, 2nd, 3rd, 4th, 6th, 7th, and 9th regions). In Taekwondo athletes, the percentage of bone tissue volume in the distal tibia and talus with high and moderate bone density was significantly higher than that in the control group (p < 0.05). Conclusion: The impact stress, ground reaction force, intra-articular stress, lower limb movement technology, lower limb muscle, and tendon stress caused by Taekwondo lead to special pressure distribution patterns and bone tissue remodeling in the ankle.
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15
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Lopez EM, Leclerc K, Ramsukh M, Parente PE, Patel K, Aranda CJ, Josephson AM, Remark LH, Kirby DJ, Buchalter DB, Hadi T, Morgani SM, Ramkhelawon B, Leucht P. Modulating the systemic and local adaptive immune response after fracture improves bone regeneration during aging. Bone 2022; 157:116324. [PMID: 34998981 PMCID: PMC9016796 DOI: 10.1016/j.bone.2021.116324] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 01/04/2023]
Abstract
Tissue injury leads to the well-orchestrated mobilization of systemic and local innate and adaptive immune cells. During aging, immune cell recruitment is dysregulated, resulting in an aberrant inflammatory response that is detrimental for successful healing. Here, we precisely define the systemic and local immune cell response after femur fracture in young and aging mice and identify increased toll-like receptor signaling as a potential culprit for the abnormal immune cell recruitment observed in aging animals. Myd88, an upstream regulator of TLR-signaling lies at the core of this aging phenotype, and local treatment of femur fractures with a Myd88 antagonist in middle-aged mice reverses the aging phenotype of impaired fracture healing, thus offering a promising therapeutic target that could overcome the negative impact of aging on bone regeneration.
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Affiliation(s)
- Emma Muiños Lopez
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Kevin Leclerc
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Malissa Ramsukh
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Paulo El Parente
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Karan Patel
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Carlos J Aranda
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Anna M Josephson
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Lindsey H Remark
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America; Department of Cell Biology, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - David J Kirby
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Daniel B Buchalter
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Tarik Hadi
- Department of Surgery, Division of Endovascular Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Sophie M Morgani
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Bhama Ramkhelawon
- Department of Surgery, Division of Endovascular Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America; Department of Cell Biology, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America
| | - Philipp Leucht
- Department of Orthopaedic Surgery, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America; Department of Cell Biology, NYU Robert I. Grossman School of Medicine, New York, NY, United States of America.
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16
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Tian Y, Sadowsky SJ, Brunski JB, Yuan X, Helms JA. Effects of masticatory loading on bone remodeling around teeth vs. implants: insights from a preclinical model. Clin Oral Implants Res 2022; 33:342-352. [PMID: 35051302 DOI: 10.1111/clr.13894] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 12/10/2021] [Accepted: 12/19/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Teeth connect to bone via a periodontal ligament whereas implants connect to bone directly. Consequently, masticatory loads are distributed differently to periodontal versus peri-implant bone. Our objective was to determine how masticatory loading of an implant versus a tooth affected peri-implant versus periodontal bone remodeling. Our hypothesis was that strains produced by functional loading of an implant would be elevated compared to the strains around teeth, and that this would stimulate a greater degree of bone turnover around implants versus in periodontal bone. MATERIALS AND METHODS Sixty skeletally mature mice were divided into two groups. In the Implant group, maxillary first molars (mxM1) were extracted, and after socket healing, titanium alloy implants were positioned sub-occlusally. After osseointegration, implants were exposed, resin crowns were placed, and masticatory loading was initiated. In a Control group the dentition was left intact. Responses of peri-implant and periodontal bone were measured using micro-CT, histology, bone remodeling assays, and quantitative histomorphometry while bone strains were estimated using finite element (FE) analyses. CONCLUSIONS When a submerged osseointegrated implant is exposed to masticatory forces peri-implant strains are elevated, and peri-implant bone undergoes significant remodeling that culminates in new bone accrual. The accumulation of new bone functions to reduce both peri-implant strains and bone remodeling activities, equivalent to those observed around the intact dentition.
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Affiliation(s)
- Ye Tian
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, California, 94305, USA
| | - Steven J Sadowsky
- University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - John B Brunski
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, California, 94305, USA
| | - Xue Yuan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, California, 94305, USA
| | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, California, 94305, USA
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17
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Li J, Ahmed A, Degrande T, De Baerdemaeker J, Al-Rasheed A, van den Beucken JJ, Jansen JA, Alghamdi HS, Walboomers XF. Histological evaluation of titanium fiber mesh-coated implants in a rabbit femoral condyle model. Dent Mater 2021; 38:613-621. [PMID: 34955235 DOI: 10.1016/j.dental.2021.12.135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/17/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study was aimed to comparatively evaluate new bone formation into the pores of a flexible titanium fiber mesh (TFM) applied on the surface of implant. METHODS Twenty-eight custom made cylindrical titanium implants (4 ×10 mm) with and without a layer of two different types of TFM (fiber diameter of 22 µm and 50 µm, volumetric porosity ~70%) were manufactured and installed bilaterally in the femoral condyles of 14 rabbits. The elastic modulus for these two TFM types was ~20 GPa and ~5 GPa respectively, whereas the solid titanium was ~110 GPa. The implants (Control, TFM-22, TFM-50) were retrieved after 14 weeks of healing and prepared for histological assessment. The percentage of the bone area (BA%), the bone-to-implant contact (BIC%) and amount were determined. RESULTS Newly formed bone into mesh porosity was observed for all three types of implants. Histomorphometric analyses revealed significantly higher (~2.5 fold) BA% values for TFM-22 implants (30.9 ± 9.5%) compared to Control implants (12.7 ± 6.0%), whereas BA% for TMF-50 did not significantly differ compared with Control implants. Furthermore, both TFM-22 and TFM-50 implants showed significantly higher BIC% values (64.9 ± 14.0%, ~2.5 fold; 47.1 ± 14.1%, ~2 fold) compared to Control (23.6 ± 17.4%). Finally, TFM-22 implants showed more and thicker trabeculae in the peri-implant region. SIGNIFICANCE This in vivo study demonstrated that implants with a flexible coating of TFM improve bone formation within the inter-fiber space and the peri-implant region.
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Affiliation(s)
- Jinmeng Li
- Regenerative Biomaterials, Radboudumc, Nijmegen, The Netherlands
| | - Abeer Ahmed
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Abdulaziz Al-Rasheed
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - John A Jansen
- Regenerative Biomaterials, Radboudumc, Nijmegen, The Netherlands
| | - Hamdan S Alghamdi
- Regenerative Biomaterials, Radboudumc, Nijmegen, The Netherlands; Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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18
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The mechanosensory and mechanotransductive processes mediated by ion channels and the impact on bone metabolism: A systematic review. Arch Biochem Biophys 2021; 711:109020. [PMID: 34461086 DOI: 10.1016/j.abb.2021.109020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 02/06/2023]
Abstract
Mechanical environments were associated with alterations in bone metabolism. Ion channels present on bone cells are indispensable for bone metabolism and can be directly or indirectly activated by mechanical stimulation. This review aimed to discuss the literature reporting the mechanical regulatory effects of ion channels on bone cells and bone tissue. An electronic search was conducted in PubMed, Embase and Web of Science. Studies about mechanically induced alteration of bone cells and bone tissue by ion channels were included. Ion channels including TRP family channels, Ca2+ release-activated Ca2+ channels (CRACs), Piezo1/2 channels, purinergic receptors, NMDA receptors, voltage-sensitive calcium channels (VSCCs), TREK2 potassium channels, calcium- and voltage-dependent big conductance potassium (BKCa) channels, small conductance, calcium-activated potassium (SKCa) channels and epithelial sodium channels (ENaCs) present on bone cells and bone tissue participate in the mechanical regulation of bone development in addition to contributing to direct or indirect mechanotransduction such as altered membrane potential and ionic flux. Physiological (beneficial) mechanical stimulation could induce the anabolism of bone cells and bone tissue through ion channels, but abnormal (harmful) mechanical stimulation could also induce the catabolism of bone cells and bone tissue through ion channels. Functional expression of ion channels is vital for the mechanotransduction of bone cells. Mechanical activation (opening) of ion channels triggers ion influx and induces the activation of intracellular modulators that can influence bone metabolism. Therefore, mechanosensitive ion channels provide new insights into therapeutic targets for the treatment of bone-related diseases such as osteopenia and aseptic implant loosening.
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Effect of Opposite Tooth Condition on Marginal Bone Loss around Submerged Dental Implants: A Retrospective Study with a 3-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010715. [PMID: 34682460 PMCID: PMC8535684 DOI: 10.3390/ijerph182010715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/28/2021] [Accepted: 10/09/2021] [Indexed: 12/31/2022]
Abstract
Background: The objective of this study was to evaluate the effects of opposite tooth conditions on change in marginal bone level (MBL) around submerged dental implants. Materials and methods: The study included healthy patients with one or two implants. Structures opposite implants were either natural teeth (NT) or fixed restorations (FRs). MBLs were measured on digital periapical radiographs at the mesial and distal aspects of each implant. Results: Sixty implants were inserted by the 3-year follow-up. Mean MBLs for NT were 0.21 ± 0.33 mm before prosthetic loading and 0.30 ± 0.41 mm 3 years later (p = 0.001). Mean MBLs with FRs were 0.36 ± 0.45 mm before loading and 0.53 ± 0.50 mm 3 years later (p < 0.001). Changes in mean MBL from the 6-month follow-up to the 1- and 3-year follow-ups were statistically significant (p < 0.01) for implants opposite NT. However, changes in mean MBL from the 6-month follow-up to the 1-year (p = 0.161) and 3-year follow-ups (p = 1.000) were not significant for implants opposite FRs. Between baseline and the 3-year follow-up, MBL change was relatively small and did not differ regarding NT and FRs. Conclusion: Bone loss was greater if submerged dental implants were opposed by FRs. MBLs around submerged implants continued to change after 3 years if NT opposed implants.
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20
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The limit of tolerable micromotion for implant osseointegration: a systematic review. Sci Rep 2021; 11:10797. [PMID: 34031476 PMCID: PMC8144379 DOI: 10.1038/s41598-021-90142-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/04/2021] [Indexed: 02/04/2023] Open
Abstract
Much research effort is being invested into the development of porous biomaterials that enhance implant osseointegration. Large micromotions at the bone-implant interface impair this osseointegration process, resulting in fibrous capsule formation and implant loosening. This systematic review compiled all the in vivo evidence available to establish if there is a universal limit of tolerable micromotion for implant osseointegration. The protocol was registered with the International Prospective Register for Systematic Reviews (ID: CRD42020196686). Pubmed, Scopus and Web of Knowledge databases were searched for studies containing terms relating to micromotion and osseointegration. The mean value of micromotion for implants that osseointegrated was 32% of the mean value for those that did not (112 ± 176 µm versus 349 ± 231 µm, p < 0.001). However, there was a large overlap in the data ranges with no universal limit apparent. Rather, many factors were found to combine to affect the overall outcome including loading time, the type of implant and the material being used. The tables provided in this review summarise these factors and will aid investigators in identifying the most relevant micromotion values for their biomaterial and implant development research.
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21
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Su K, Zhou Y, Hossaini-Zadeh M, Du J. Effects of implant buccal distance on peri-implant strain: A Micro-CT based finite element analysis. J Mech Behav Biomed Mater 2021; 116:104325. [PMID: 33485035 DOI: 10.1016/j.jmbbm.2021.104325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 01/06/2021] [Indexed: 11/27/2022]
Abstract
Bone-implant mechanics is one of the factors that contribute to implant stability and success. In this work, voxel-based finite element models were built based on the micro-CT images of human cadaveric mandible specimens before and after implant placement. The computed results show high strain at the bone-implant contact locations and the buccal and lingual bone plates. The strain concentration in the thinner buccal plates was more substantial than that in the thicker lingual plates. The average values of maximum principal strain in the buccal and lingual ROIs were in good agreement with those measured using mechanical testing coupled with micro-CT and digital volume correlation. The implant position was then virtually changed in the models to be placed lingually or buccally. The computed strain in the buccal bone decreased when the implant was placed away from the buccal plate. The strain in lingual bone also deceased when the implant was moved from the center of the alveolar socket towards the lingual or buccal plate. The results indicate that the distance from implant to the buccal plate can affect the mechanical stimuli in bone, especially in the buccal plate, which may subsequently affect the bone remodeling process and buccal bone resorption.
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Affiliation(s)
- Kangning Su
- Department of Mechanical Engineering, Pennsylvania State University, University Park, PA, USA.
| | - Yuxiao Zhou
- Department of Mechanical Engineering, Pennsylvania State University, University Park, PA, USA.
| | - Mehran Hossaini-Zadeh
- Department of Oral Maxillofacial Pathology Medicine and Surgery, Temple University, Philadelphia, PA, USA.
| | - Jing Du
- Department of Mechanical Engineering, Pennsylvania State University, University Park, PA, USA.
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de Barros e Lima Bueno R, Ponce KJ, Dias AP, Guadarrama Bello D, Brunski JB, Nanci A. Influence of Nanotopography on Early Bone Healing during Controlled Implant Loading. NANOMATERIALS 2020; 10:nano10112191. [PMID: 33153132 PMCID: PMC7693286 DOI: 10.3390/nano10112191] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022]
Abstract
Nanoscale surface modifications influence peri-implant cell fate decisions and implant loading generates local tissue deformation, both of which will invariably impact bone healing. The objective of this study is to determine how loading affects healing around implants with nanotopography. Implants with a nanoporous surface were placed in over-sized osteotomies in rat tibiae and held stable by a system that permits controlled loading. Three regimens were applied: (a) no loading, (b) one daily loading session with a force of 1.5N, and (c) two such daily sessions. At 7 days post implantation, animals were sacrificed for histomorphometric and DNA microarray analyses. Implants subjected to no loading or only one daily loading session achieved high bone-implant contact (BIC), bone-implant distance (BID) and bone formation area near the implant (BFAt) values, while those subjected to two daily loading sessions showed less BFAt and BIC and more BID. Gene expression profiles differed between all groups mainly in unidentified genes, and no modulation of genes associated with inflammatory pathways was detected. These results indicate that implants with nanotopography can achieve a high level of bone formation even under micromotion and limit the inflammatory response to the implant surface.
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Affiliation(s)
- Renan de Barros e Lima Bueno
- Laboratory for the Study of Calcified Tissues and Biomaterials, Department of Stomatology, Faculty of Dental Medicine, Université de Montréal, Montréal, QC H3C3J7, Canada; (R.d.B.e.L.B.); (K.J.P.); (A.P.D.); (D.G.B.)
| | - Katia J. Ponce
- Laboratory for the Study of Calcified Tissues and Biomaterials, Department of Stomatology, Faculty of Dental Medicine, Université de Montréal, Montréal, QC H3C3J7, Canada; (R.d.B.e.L.B.); (K.J.P.); (A.P.D.); (D.G.B.)
| | - Ana Paula Dias
- Laboratory for the Study of Calcified Tissues and Biomaterials, Department of Stomatology, Faculty of Dental Medicine, Université de Montréal, Montréal, QC H3C3J7, Canada; (R.d.B.e.L.B.); (K.J.P.); (A.P.D.); (D.G.B.)
| | - Dainelys Guadarrama Bello
- Laboratory for the Study of Calcified Tissues and Biomaterials, Department of Stomatology, Faculty of Dental Medicine, Université de Montréal, Montréal, QC H3C3J7, Canada; (R.d.B.e.L.B.); (K.J.P.); (A.P.D.); (D.G.B.)
| | - John B. Brunski
- Department of Surgery, School of Medicine, Stanford University, Stanford, CA 94305, USA;
| | - Antonio Nanci
- Laboratory for the Study of Calcified Tissues and Biomaterials, Department of Stomatology, Faculty of Dental Medicine, Université de Montréal, Montréal, QC H3C3J7, Canada; (R.d.B.e.L.B.); (K.J.P.); (A.P.D.); (D.G.B.)
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC H3C3J7, Canada
- Correspondence: ; Tel.: +1514-343-5846
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Koyuncuoglu CZ, Demir B. Comparison of Measurements of Implant Stability by Two Different Radio Frequency Analysis Systems: An In Vitro Study. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206820923251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: To compare and evaluate the implant stability quotient (ISQ) measurements by two different radio frequency analysis (RFA) machines, Osstell Mentor and PenguinRFA. Materials and Methods: Twenty bone-level implants (3.7 × 10 mm2) were placed on a bovine bone in this in vitro study. The ISQ measurements were performed with the PenguinRFA and Osstell Mentor machines using the multipeg of the Penguin system. The measurements were repeated three times for each direction and an average ISQ value was calculated. The results were averaged (mean ± SD) and the intraclass correlation coefficient (ICC) was calculated to assess the relationship between the measurements. Result: The mean ISQ values for the Osstell and Penguin machines were 77.60 + 2.11 and 78.05 + 2.04, respectively. The ICC was 0.958. The ISQ values obtained from the Osstell and Penguin machines were significantly compatible ( P < .05). Conclusion: Both of the RFA devices provided similar and reliable ISQ measurements.
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Affiliation(s)
- Cenker Zeki Koyuncuoglu
- Faculty of Dentistry, Department of Periodontology, Istanbul Aydin University, Istanbul, Turkey
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24
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van Oirschot BAJA, Jansen JA, van de Ven CJJM, Geven EJW, Gossen JA. Evaluation of Collagen Membranes Coated with Testosterone and Alendronate to Improve Guided Bone Regeneration in Mandibular Bone Defects in Minipigs. J Oral Maxillofac Res 2020; 11:e4. [PMID: 33262883 PMCID: PMC7644271 DOI: 10.5037/jomr.2020.11304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/27/2020] [Indexed: 04/19/2023]
Abstract
OBJECTIVES The purpose of the present in vivo study was to evaluate whether pericard collagen membranes coated with ancillary amounts of testosterone and alendronate in a poly-lactic glycolic acid (PLGA) carrier as compared to uncoated membranes will improve early bone regeneration. MATERIAL AND METHODS In each of 16 minipigs, four standardized mandibular intraosseous defects were made bilaterally. The defects were filled with Bio-Oss® granules and covered with a non-coated or coated membrane. Membranes were spray-coated with 4 layers of PLGA containing testosterone and alendronate resulting in 20, 50 or 125 μg/cm2 of testosterone and 20 µg/cm2 alendronate (F20, F50, F125). Non-coated membranes served as controls (F0). Animals were sacrificed at 6 and 12 weeks after treatment. Qualitative and quantitative histological evaluations of bone regeneration were performed. Differences between groups were assessed by paired Student's t-test. RESULTS Light microscopical analysis showed new bone formation that was in close contact with the Bio-Oss® surface without an intervening non-mineralized tissue layer. Histomorphometric analysis of newly formed bone showed a significant 20% increase in area in the F125 coated membrane treated defects (40 [SD 10]%) compared to the F0 treated defects after 6 weeks (33 [SD 10]%, P = 0.013). At week 12, the total percentage of new bone was increased compared to week 6, but no increase in newly formed bone compared to F0 was observed. CONCLUSIONS The data from this in vivo study indicate that F125 collagen membranes coated with testosterone and alendronate resulted in superior bone formation (+24%) when normalized to control sites using uncoated membranes.
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Affiliation(s)
- Bart A J A van Oirschot
- Department of Dentistry - Biomaterials, Radboudumc, Radboud University Nijmegen, NijmegenThe Netherlands
| | - John A Jansen
- Department of Dentistry - Biomaterials, Radboudumc, Radboud University Nijmegen, NijmegenThe Netherlands
| | - Cindy J J M van de Ven
- Department of Dentistry - Biomaterials, Radboudumc, Radboud University Nijmegen, NijmegenThe Netherlands
- Osteo-Pharma BV, OssThe Netherlands
| | - Edwin J W Geven
- Department of Dentistry - Biomaterials, Radboudumc, Radboud University Nijmegen, NijmegenThe Netherlands
- Osteo-Pharma BV, OssThe Netherlands
| | - Jan A Gossen
- Department of Dentistry - Biomaterials, Radboudumc, Radboud University Nijmegen, NijmegenThe Netherlands
- Osteo-Pharma BV, OssThe Netherlands
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25
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Li Z, Arioka M, Liu Y, Aghvami M, Tulu S, Brunski JB, Helms JA. Effects of condensation and compressive strain on implant primary stability: A longitudinal, in vivo, multiscale study in mice. Bone Joint Res 2020; 9:60-70. [PMID: 32435456 PMCID: PMC7229305 DOI: 10.1302/2046-3758.92.bjr-2019-0161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Aims Surgeons and most engineers believe that bone compaction improves implant primary stability without causing undue damage to the bone itself. In this study, we developed a murine distal femoral implant model and tested this dogma. Methods Each mouse received two femoral implants, one placed into a site prepared by drilling and the other into the contralateral site prepared by drilling followed by stepwise condensation. Results Condensation significantly increased peri-implant bone density but it also produced higher strains at the interface between the bone and implant, which led to significantly more bone microdamage. Despite increased peri-implant bone density, condensation did not improve implant primary stability as measured by an in vivo lateral stability test. Ultimately, the condensed bone underwent resorption, which delayed the onset of new bone formation around the implant. Conclusion Collectively, these multiscale analyses demonstrate that condensation does not positively contribute to implant stability or to new peri-implant bone formation. Cite this article:Bone Joint Res. 2020;9(2):60–70.
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Affiliation(s)
- Zhijun Li
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, USA; Orthopedic surgeon, Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Masaki Arioka
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, USA; Assistant professor, Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yindong Liu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, USA; Oral surgeon, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Maziar Aghvami
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, USA
| | - Serdar Tulu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, USA
| | - John B Brunski
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, USA
| | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, USA
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26
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Zhou Y, Gong C, Hossaini-Zadeh M, Du J. 3D full-field strain in bone-implant and bone-tooth constructs and their morphological influential factors. J Mech Behav Biomed Mater 2020; 110:103858. [PMID: 32501222 DOI: 10.1016/j.jmbbm.2020.103858] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/08/2020] [Accepted: 05/10/2020] [Indexed: 01/20/2023]
Abstract
The biomechanics of bone-tooth and bone-implant interfaces affects the outcomes of several dental treatments, such as implant placement, because bone, tooth and periodontal ligament are living tissues that adapt to the changes in mechanical stimulations. In this work, mechanical testing coupled with micro-CT was performed on human cadaveric mandibular bone-tooth and bone-implant constructs. Using digital volume correlation, the 3D full-field strain in bone under implant loading and tooth loading was measured. Concurrently, bone morphology and bone-implant and bone-tooth contact were also measured through the analysis of micro-CT images. The results show that strain in bone increased when a tooth was replaced by a dental implant. Strain concentration was observed in peri-implant bone, as well as in the buccal bone plate, which is also the clinically-observed bone resorption area after implant placement. Decreasing implant stability measurements (resonance frequency analysis and torque test) indicated increased peri-implant strain, but their relationships may not be linear. Peri-implant bone strain linearly increased with decreasing bone-implant contact (BIC) ratio. It also linearly decreased with increasing bone-tooth/bone-implant contact ratio. The high strain in the buccal bone plate linearly increased with decreasing buccal bone plate thickness. The results of this study revealed 3D full-field strain in bone-tooth and bone-implant constructs, as well as their several morphological influential factors.
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Affiliation(s)
- Yuxiao Zhou
- Department of Mechanical Engineering, Pennsylvania State University, University Park, PA, 16802, United States.
| | - Chujie Gong
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, United States.
| | - Mehran Hossaini-Zadeh
- Department of Oral Maxillofacial Pathology, Medicine and Surgery, Temple University, Philadelphia, PA, 19140, United States.
| | - Jing Du
- Department of Mechanical Engineering, Pennsylvania State University, University Park, PA, 16802, United States.
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27
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Lee S, Remark LH, Buchalter DB, Josephson AM, Wong MZ, Litwa HP, Ihejirika R, Leclerc K, Markus D, Yim NL, Tejwani R, Bradaschia-Correa V, Leucht P. Propranolol Reverses Impaired Fracture Healing Response Observed With Selective Serotonin Reuptake Inhibitor Treatment. J Bone Miner Res 2020; 35:932-941. [PMID: 31881108 PMCID: PMC8080057 DOI: 10.1002/jbmr.3950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/16/2019] [Accepted: 12/19/2019] [Indexed: 11/07/2022]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are one of the most commonly prescribed antidepressants worldwide and recent data show significant impairment of fracture healing after treatment with the SSRI fluoxetine in mice. Here, we provide evidence that the negative effects of SSRIs can be overcome by administration of the beta-blocker propranolol at the time of fracture. First, in vitro experiments established that propranolol does not affect osteogenic differentiation. We then used a murine model of intramembranous ossification to study the potential rescue effect of propranolol on SSRI-induced impaired fracture healing. Micro-CT analysis revealed that fluoxetine treatment resulted in a smaller bony regenerate and that this decrease in bone formation can be overcome by co-treatment with propranolol. We then tested this in a clinically relevant model of endochondral ossification. Fluoxetine-treated mice with a femur fracture were treated with propranolol initiated at the time of fracture, and a battery of analyses demonstrated a reversal of the detrimental effect of fluoxetine on fracture healing in response to propranolol treatment. These experiments show for the first time to our knowledge that the negative effects of SSRIs on fracture healing can be overcome by co-treatment with a beta-blocker. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Sooyeon Lee
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Lindsey H Remark
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Daniel B Buchalter
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Anne M Josephson
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Madeleine Z Wong
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Hannah P Litwa
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Rivka Ihejirika
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Kevin Leclerc
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Danielle Markus
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Nury L Yim
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | - Ruchi Tejwani
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA
| | | | - Philipp Leucht
- Department of Orthopaedic Surgery, New York University Langone Health, New York, NY, USA.,Department of Cell Biology, Robert I. Grossman School of Medicine, New York University, New York, NY, USA
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28
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Simulation analysis of impact damage to the bone tissue surrounding a dental implant. Sci Rep 2020; 10:6927. [PMID: 32332927 PMCID: PMC7181623 DOI: 10.1038/s41598-020-63666-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 03/31/2020] [Indexed: 12/03/2022] Open
Abstract
Dental implant may suffer transient external impacts. To simulate the effect of impact forces on bone damage is very important for evaluation of damage and guiding treatment in clinics. In this study, an animal model was established by inserting an implant into the femoral condyle of New Zealand rabbit. Implant with good osseointegration was loaded with impact force. A three-dimensional finite element model was established based on the data of the animal model. Damage process to bone tissue was simulated with Abaqus 6.13 software combining dynamic mechanical properties of the femur. The characteristics of bone damage were analyzed by comparing the results of animal testing with numerical simulation data. After impact, cortical bone around the implant and trabecular at the bottom of the implant were prone to damage. The degree of damage correlated with the direction of loading and the magnitude of the impact. Lateral loading was most likely performed to damage cancellous bone. The stress wave formed by the impact force can damage the implant–bone interface and peri-implant trabeculae. The data from numerical simulations were consistent with data from animal experiments, highlighting the importance of a thorough examination and evaluation based on the patient’s medical history.
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29
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The interplay between bone healing and remodeling around dental implants. Sci Rep 2020; 10:4335. [PMID: 32152332 PMCID: PMC7063044 DOI: 10.1038/s41598-020-60735-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 02/12/2020] [Indexed: 01/08/2023] Open
Abstract
Long-term bone healing/adaptation after a dental implant treatment starts with diffusion of mesenchymal stem cells to the wounded region and their subsequent differentiation. The healing phase is followed by the bone-remodeling phase. In this work, a mechano-regulatory cellular differentiation model was used to simulate tissue healing around an immediately loaded dental implant. All tissue types were modeled as poroelastic in the healing phase. Material properties of the healing region were updated after each loading cycle for 30 cycles (days). The tissue distribution in the healed state was then used as the initial condition for the remodeling phase during which regions healed into bone adapt their apparent density with respect to a homeostatic remodeling stimulus. The short- (bone healing) and long-term (bone remodeling) effects of initial implant micromotion during the healing phase were studied. Development of soft tissue was observed both in the coronal region due to high fluid velocity, and on the vertical sides of the healing-gap due to high shear stress. In cases with small implant micromotion, tissue between the implant threads differentiated into bone during the healing phase but resorbed during remodeling. In cases with large implant micromotion, higher percentage of the healing region differentiated into soft tissue resulting in smaller volume of bone tissue available for remodeling. However, the remaining bone region developed higher density bone tissue. It was concluded that an optimal range of initial implant micromotion could be designed for a specific patient in order to achieve the desired long-term functional properties.
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Load response of an osseointegrated implant used in the treatment of unilateral transfemoral amputation: An early implant loosening case study. Clin Biomech (Bristol, Avon) 2020; 73:201-212. [PMID: 32036173 DOI: 10.1016/j.clinbiomech.2020.01.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/16/2020] [Accepted: 01/18/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Osseointegrated implants for transfemoral amputees facilitate direct load transfer between the prosthetic limb and femur; however, implant loosening is a common complication, and the associated implant-bone loads remain poorly understood. This case study aimed to use patient-specific computational modeling to evaluate bone-implant interface loading during standing and walking in a transfemoral amputee with an osseointegrated implant prior to prosthesis loosening and revision surgery. METHODS One male transfemoral amputee with an osseointegrated implant was recruited (age: 59-yrs, weight: 83 kg) and computed tomography (CT) performed on the residual limb approximately 3 months prior to implant failure. Gait analyses were performed, and the CT images used to develop a finite element model of the patient's implant and surrounding bone. Simulations of static weight bearing, and over-ground walking were then performed. FINDINGS During standing, maximum and minimum principal strains in trabecular bone adjacent to the implant were 0.26% and -0.30%, respectively. Strains generated at the instant of contralateral toe-off and contralateral heel strike during walking were substantially higher and resulted in local trabecular bone yielding. Specifically, the maximum and minimum principal strains in the thin layer of trabecular bone surrounding the distal end of the implant were 1.15% and -0.98%, respectively. INTERPRETATION Localised yielding of trabecular bone at the interface between the femur and implant in transfemoral amputee osseointegrated prosthesis recipients may present a risk of implant loosening due to periprosthetic bone fracture during walking. Rehabilitation exercises should aim to produce implant-bone loading that stimulates bone remodelling to provide effective bone conditioning prior to ambulation.
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31
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Improvement of the Corrosion Resistance of Biomedical Zr-Ti Alloys Using a Thermal Oxidation Treatment. METALS 2020. [DOI: 10.3390/met10020166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Binary Zr-Ti alloys spontaneously develop a tenacious and compact oxide layer when their fresh surface is exposed either to air or to aqueous environments. Electrochemical impedance spectroscopy (EIS) analysis of Zr-45Ti, Zr-25Ti, and Zr-5Ti exposed to simulated physiological solutions at 37 °C evidences the formation of a non-sealing bilayer oxide film that accounts for the corrosion resistance of the materials. Unfortunately, these oxide layers may undergo breakdown and stable pitting corrosion regimes at anodic potentials within the range of those experienced in the human body under stress and surgical conditions. Improved corrosion resistance has been achieved by prior treatment of these alloys using thermal oxidation in air. EIS was employed to measure the corrosion resistance of the Zr-Ti alloys in simulated physiological solutions of a wide pH range (namely 3 ≤ pH ≤ 8) at 37 °C, and the best results were obtained for the alloys pre-treated at 500 °C. The formation of the passivating oxide layers in simulated physiological solution was monitored in situ using scanning electrochemical microscopy (SECM), finding a transition from an electrochemically active surface, characteristic of the bare metal, to the heterogeneous formation of oxide layers behaving as insulating surfaces towards electron transfer reactions.
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Yu T, Gao H, Liu T, Huang Y, Wang C. Effects of immediately static loading on osteointegration and osteogenesis around 3D-printed porous implant: A histological and biomechanical study. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 108:110406. [PMID: 31924051 DOI: 10.1016/j.msec.2019.110406] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/25/2019] [Accepted: 11/06/2019] [Indexed: 11/19/2022]
Abstract
The 3D-printed porous implant is capable of achieving favorable osteointegration and osteogenesis in the absence of mechanical stimulation during the early healing period. The purpose of this study is to evaluate the impact of immediately static loading on bone osteointegration and osteogenesis around the 3D-printed porous implant. Thirty porous implants with optimal configuration were installed bilaterally into femurs of 15 rabbits. The Load group on the left side was applied the maximal initial load of 10 N offered by a diminutive and built-in loading device and the Non-load group was on the contralateral side. At 2, 4, and 8 weeks post-operatively, the explants were harvested for push-out test to measure the biological fixation strength. The quantity and quality of new bone were evaluated by the means of histological examination, Micro-CT and bone density analysis. Moreover, the animal data were integrated into finite element models to assess the biomechanics of peri-implant bone. The results indicated that the quantity, quality and biomechanical properties of the new bone increased and optimized along with the healing time. It also demonstrated that the immediately static loading increased the volume of new bone with inferior quality in 2 weeks after implantation and the adverse influence emerged gradually as time extended. Moreover, finite element results demonstrated that the early structures of new bone around porous implant were not suitable for functional loading. This study indicated the mineralization modes of distance osteogenesis and contact osteogenesis around the porous implant. Accordingly, the delay and progressive loading protocol was recommended.
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Affiliation(s)
- Ti Yu
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Hui Gao
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Ting Liu
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yuanding Huang
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Chao Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.
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33
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Li J, Jansen JA, Walboomers XF, van den Beucken JJ. Mechanical aspects of dental implants and osseointegration: A narrative review. J Mech Behav Biomed Mater 2019; 103:103574. [PMID: 32090904 DOI: 10.1016/j.jmbbm.2019.103574] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 09/23/2019] [Accepted: 11/29/2019] [Indexed: 12/28/2022]
Abstract
With the need of rapid healing and long-term stability of dental implants, the existing Ti-based implant materials do not meet completely the current expectation of patients. Low elastic modulus Ti-alloys have shown superior biocompatibility and can achieve comparable or even faster bone formation in vivo at the interface of bone and the implant. Porous structured Ti alloys have shown to allow rapid bone ingrowth through their open structure and to achieve anchorage with bone tissue by increasing the bone-implant interface area. In addition to the mechanical properties of implant materials, the design of the implant body can be used to optimize load transfer and affect the ultimate results of osseointegration. The aim of this narrative review is to define the mechanical properties of dental implants, summarize the relationship between implant stability and osseointegration, discuss the effect of metallic implant mechanical properties (e.g. stiffness and porosity) on the bone response based on existing in vitro and in vivo information, and analyze load transfer through mechanical properties of the implant body. This narrative review concluded that although several studies have presented the advantages of low elastic modulus or high porosity alloys and their effect on osseointegration, further in vivo studies, especially long-term observational studies are needed to justify these novel materials as a replacement for current Ti-based implant materials.
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Affiliation(s)
- Jinmeng Li
- Department of Biomaterials, Radboudumc, P.O. Box 9101, 6500, Nijmegen, HB, the Netherlands
| | - John A Jansen
- Department of Biomaterials, Radboudumc, P.O. Box 9101, 6500, Nijmegen, HB, the Netherlands
| | - X Frank Walboomers
- Department of Biomaterials, Radboudumc, P.O. Box 9101, 6500, Nijmegen, HB, the Netherlands
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Delgado-Ruiz RA, Calvo-Guirado JL, Romanos GE. Effects of occlusal forces on the peri-implant-bone interface stability. Periodontol 2000 2019; 81:179-193. [PMID: 31407438 DOI: 10.1111/prd.12291] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The occlusal forces and their influence on the initiation of peri-implant bone loss or their relationship with peri-implantitis have created discussion during the past 30 years given the discrepancies observed in clinical, animal, and finite element analysis studies. Beyond these contradictions, in the case of an osseointegrated implant, the occlusal forces can influence the implant-bone interface and the cells responsible for the bone remodeling in different ways that may result in the maintenance or loss of the osseointegration. This comprehensive review focuses on the information available about the forces transmitted through the implant-crown system to the implant-bone interface and the mechano-transduction phenomena responsible for the bone cells' behavior and their interactions. Knowledge of the basic molecular biology of the peri-implant bone would help clinicians to understand the complex phenomenon of occlusal forces and their effects on the implant-bone interface, and would allow better control of the negative effects of mechanical stresses, leading to therapy with fewer risks and complications.
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Affiliation(s)
- Rafael Arcesio Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Jose Luis Calvo-Guirado
- International Dentistry Research Cathedra, Faculty of Medicine and Dentistry, Universidad Catolica San Antonio De Murcia (UCAM), Murcia, Spain
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA.,Department of Oral Surgery and Implant Dentistry, Johann Wolfgang Goethe University, Frankfurt, Germany
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35
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de Barros E Lima Bueno R, Dias AP, Ponce KJ, Brunski JB, Nanci A. System for application of controlled forces on dental implants in rat maxillae: Influence of the number of load cycles on bone healing. J Biomed Mater Res B Appl Biomater 2019; 108:965-975. [PMID: 31368244 PMCID: PMC7078813 DOI: 10.1002/jbm.b.34449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/03/2019] [Accepted: 07/13/2019] [Indexed: 12/26/2022]
Abstract
Experimental studies on the effect of micromotion on bone healing around implants are frequently conducted in long bones. In order to more closely reflect the anatomical and clinical environments around dental implants, and eventually be able to experimentally address load‐management issues, we have developed a system that allows initial stabilization, protection from external forces, and controlled axial loading of implants. Screw‐shaped implants were placed on the edentulous ridge in rat maxillae. Three loading regimens were applied to validate the system; case A no loading (unloaded implant) for 14 days, case B no loading in the first 7 days followed by 7 days of a single, daily loading session (60 cycles of an axial force of 1.5 N/cycle), and case C no loading in the first 7 days followed by 7 days of two such daily loading sessions. Finite element modeling of the peri‐implant compressive and tensile strains plus histological and immunohistochemical analyses revealed that in case B any tissue damage resulting from the applied force (and related interfacial strains) did not per se disturb bone healing, however, in case C, the accumulation of damage resulting from the doubling of loading sessions severely disrupted the process. These proof‐of‐principle results validate the applicability of our system for controlled loading, and provide new evidence on the importance of the number of load cycles applied on healing of maxillary bone.
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Affiliation(s)
- Renan de Barros E Lima Bueno
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - Ana P Dias
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - Katia J Ponce
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - John B Brunski
- Department of Surgery, School of Medicine, Stanford University, Stanford, California
| | - Antonio Nanci
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
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Tassone E, Bradaschia-Correa V, Xiong X, Sastre-Perona A, Josephson AM, Khodadadi-Jamayran A, Melamed J, Bu L, Kahler DJ, Ossowski L, Leucht P, Schober M, Wilson EL. KLF4 as a rheostat of osteolysis and osteogenesis in prostate tumors in the bone. Oncogene 2019; 38:5766-5777. [PMID: 31239516 PMCID: PMC6639130 DOI: 10.1038/s41388-019-0841-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 12/19/2022]
Abstract
We previously showed that KLF4, a gene highly expressed in murine prostate stem cells, blocks the progression of indolent intraepithelial prostatic lesions into aggressive and rapidly growing tumors. Here, we show that the anti-tumorigenic effect of KLF4 extends to PC3 human prostate cancer cells growing in the bone. We compared KLF4 null cells with cells transduced with a DOX-inducible KLF4 expression system, and find KLF4 function inhibits PC3 growth in monolayer and soft agar cultures. Furthermore, KLF4 null cells proliferate rapidly, forming large, invasive, and osteolytic tumors when injected into mouse femurs, whereas KLF4 re-expression immediately after their intra-femoral inoculation blocks tumor development and preserves a normal bone architecture. KLF4 re-expression in established KLF4 null bone tumors inhibits their osteolytic effects, preventing bone fractures and inducing an osteogenic response with new bone formation. In addition to these profound biological changes, KLF4 also induces a transcriptional shift from an osteolytic program in KLF4 null cells to an osteogenic program. Importantly, bioinformatic analysis shows that genes regulated by KLF4 overlap significantly with those expressed in metastatic prostate cancer patients and in three individual cohorts with bone metastases, strengthening the clinical relevance of the findings in our xenograft model.
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Affiliation(s)
- Evelyne Tassone
- Department of Cell Biology, NYU School of Medicine, New York, NY, 10016, USA
| | - Vivian Bradaschia-Correa
- Department of Cell Biology, NYU School of Medicine, New York, NY, 10016, USA
- Department of Orthopedic Surgery, NYU School of Medicine, New York, NY, 10016, USA
| | - Xiaozhong Xiong
- Department of Cell Biology, NYU School of Medicine, New York, NY, 10016, USA
| | - Ana Sastre-Perona
- The Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, NY, 10016, USA
| | - Anne Marie Josephson
- Department of Cell Biology, NYU School of Medicine, New York, NY, 10016, USA
- Department of Orthopedic Surgery, NYU School of Medicine, New York, NY, 10016, USA
| | - Alireza Khodadadi-Jamayran
- Department of Pathology, NYU School of Medicine, New York, NY, 10016, USA
- Applied Bioinformatics Laboratories, NYU School of Medicine, New York, NY, 10016, USA
| | - Jonathan Melamed
- Department of Pathology, NYU School of Medicine, New York, NY, 10016, USA
| | - Lei Bu
- Department of Medicine, NYU School of Medicine, New York, NY, 10016, USA
| | - David J Kahler
- High Throughput Biology Laboratory, NYU School of Medicine, New York, NY, 10016, USA
| | - Liliana Ossowski
- Department of Medicine, Mt Sinai School of Medicine, New York, NY, 10029, USA
| | - Philipp Leucht
- Department of Cell Biology, NYU School of Medicine, New York, NY, 10016, USA
- Department of Orthopedic Surgery, NYU School of Medicine, New York, NY, 10016, USA
| | - Markus Schober
- Department of Cell Biology, NYU School of Medicine, New York, NY, 10016, USA.
- The Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, NY, 10016, USA.
| | - Elaine L Wilson
- Department of Cell Biology, NYU School of Medicine, New York, NY, 10016, USA.
- Department of Urology, NYU School of Medicine, New York, NY, 10016, USA.
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Wu Y, Yuan X, Perez KC, Hyman S, Wang L, Pellegrini G, Salmon B, Bellido T, Helms JA. Aberrantly elevated Wnt signaling is responsible for cementum overgrowth and dental ankylosis. Bone 2019; 122:176-183. [PMID: 30408613 PMCID: PMC6559382 DOI: 10.1016/j.bone.2018.10.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/10/2018] [Accepted: 10/23/2018] [Indexed: 02/05/2023]
Abstract
Vertebrate teeth are attached to the jawbones using a variety of methods but in mammals, a fibrous connection is the norm. This fibrous periodontal ligament (PDL) allows teeth to move in the jawbones in response to natural eruptive forces, mastication, and orthodontic tooth movement. In some disease states the PDL either calcifies or is replaced by a mineralized tissue and the result is ankylosis, where the tooth is fused to the alveolar bone. To understand how the PDL maintains this fibrous state, we examined a strain of mice in which tooth movement is arrested. DaβcatOt mice express a stabilized form of β-catenin in DMP1-positive alveolar bone osteocytes and cementocytes, which results in elevated Wnt signaling throughout the periodontium. As a consequence, there is an accrual of massive amounts of cellular cementum and alveolar bone, the PDL itself calcifies and teeth become ankylosed. These data suggest that to maintain its fibrous nature, Wnt signaling must normally be repressed in the PDL space.
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Affiliation(s)
- Yan Wu
- Orthodontic Department, Stomatology Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Chongqing Municipal Key Laboratory, Chongqing 401147, China; Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Xue Yuan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Kristy C Perez
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Sydnee Hyman
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Liao Wang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Gretel Pellegrini
- Department of Anatomy and Cell Biology, Department of Medicine, Division of Endocrinology, Indiana University School of Medicine and Roudebush Veterans Administration Medical Center, Indianapolis, IN 46022, USA
| | - Benjamin Salmon
- Paris Descartes University - Sorbonne Paris Cité, EA 2496 - Orofacial Pathologies, Imaging and Biotherapies Lab and Dental Medicine Department, Bretonneau Hospital, HUPNVS, AP-HP, Paris, France
| | - Teresita Bellido
- Department of Anatomy and Cell Biology, Department of Medicine, Division of Endocrinology, Indiana University School of Medicine and Roudebush Veterans Administration Medical Center, Indianapolis, IN 46022, USA
| | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA.
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Mechanical and Biological Advantages of a Tri-Oval Implant Design. J Clin Med 2019; 8:jcm8040427. [PMID: 30925746 PMCID: PMC6517945 DOI: 10.3390/jcm8040427] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 02/05/2023] Open
Abstract
Of all geometric shapes, a tri-oval one may be the strongest because of its capacity to bear large loads with neither rotation nor deformation. Here, we modified the external shape of a dental implant from circular to tri-oval, aiming to create a combination of high strain and low strain peri-implant environment that would ensure both primary implant stability and rapid osseointegration, respectively. Using in vivo mouse models, we tested the effects of this geometric alteration on implant survival and osseointegration over time. The maxima regions of tri-oval implants provided superior primary stability without increasing insertion torque. The minima regions of tri-oval implants presented low compressive strain and significantly less osteocyte apoptosis, which led to minimal bone resorption compared to the round implants. The rate of new bone accrual was also faster around the tri-oval implants. We further subjected both round and tri-oval implants to occlusal loading immediately after placement. In contrast to the round implants that exhibited a significant dip in stability that eventually led to their failure, the tri-oval implants maintained their stability throughout the osseointegration period. Collectively, these multiscale biomechanical analyses demonstrated the superior in vivo performance of the tri-oval implant design.
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Hox gene expression determines cell fate of adult periosteal stem/progenitor cells. Sci Rep 2019; 9:5043. [PMID: 30911091 PMCID: PMC6434021 DOI: 10.1038/s41598-019-41639-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/08/2019] [Indexed: 11/08/2022] Open
Abstract
Hox genes are evolutionarily conserved transcription factors that during embryonic development function as master regulators of positional identity. In postnatal life, the function of Hox proteins is less clear: Hox genes are expressed during tissue repair, but in this context their function(s) are largely unknown. Here we show that Hox genes are expressed in periosteal stem/progenitor cells in a distribution similar to that during embryonic development. Using unbiased sequencing, we established that periosteal stem/progenitor cells from distinct anatomic sites within the skeleton significantly differ in their transcriptome, and that Hox expression status best defines these differences. Lastly, we provide evidence that Hox gene expression is one potential mechanism that maintains periosteal stem/progenitor cells in a more primitive, tripotent state, while suppression of Hox genes leads to fate changes with loss of tripotency. Together, our data describe an adult role of Hox genes other than positional identity, and the modulatory role of Hox genes in fate decisions may offer potential druggable targets for the treatment of fractures, non-unions and bone defects.
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40
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Trisciuzzi R, Fracassi L, Martin HA, Monopoli Forleo D, Amat D, Santos-Ruiz L, De Palma E, Crovace AM. 41 Cases of Treatment of Cranial Cruciate Ligament Rupture with Porous TTA: Three Years of Follow Up. Vet Sci 2019; 6:vetsci6010018. [PMID: 30791613 PMCID: PMC6466427 DOI: 10.3390/vetsci6010018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/06/2019] [Accepted: 02/15/2019] [Indexed: 11/16/2022] Open
Abstract
Tibial Tuberosity Advancement (TTA) is a surgical technique based on a linear osteotomy that determines a cranial advancement of the tibial tuberosity in patients suffering from cranial cruciate ligament rupture (CCL). The aim is to neutralize the cranial tibial thrust (CTT) and to reach a 90° angle between the patellar tendon and the tibial plateau with a physiological knee extension of 135°. In our study, a Ti6AI4V ELI (Titanium Aluminium Vanadium) titanium scaffold for the Porous TTA, with excellent properties of osteointegration and osteoconduction when subjected to cyclic loading has been adopted. Based on the previous scientific work on an ovine model, the use of this type of porous scaffolds has subverted the previous models. Scaffold production technology is based on direct mechanical manufacturing called Electron Beam Melting (EBM). For this study, 41 dogs, different breeds, medium-large size, weighing between 10 and 80 kg, aged between 1 and 13 years, were enrolled. The inclusion criteria were based on clinical evaluations (different gaits), drawer test and tibial compression, LOAD score (Liverpool Osteoarthritis in Dogs questionnaire), radiographic diagnosis in sedation with a 135° positioning of the joint and baropodometric investigations (Stance Analyzer). The results show that Porous TTA is an excellent method for functional recovery of the knee joint following the partial and total rupture of the CCL.
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Affiliation(s)
- Rodrigo Trisciuzzi
- Department of Emergencies and Organ Transplantation (DETO), University of Bari, Aldo Moro, 70010 Bari, Italy.
- PHD Course of Transplantation of Tissue and Organs and Cell Therapy (DETO) University of Bari, Aldo Moro, 70126 Bari, Italy.
| | - Laura Fracassi
- Department of Emergencies and Organ Transplantation (DETO), University of Bari, Aldo Moro, 70010 Bari, Italy.
- PHD Course of Transplantation of Tissue and Organs and Cell Therapy (DETO) University of Bari, Aldo Moro, 70126 Bari, Italy.
| | | | | | - Daniel Amat
- Center for Biomedical Research in Network, Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Carlos III Health Institute, 28029 Madrid, Spain.
- Departamento de Biología Celular, Genética y Fisiología, IBIMA-Universidad de Málaga, Facultad de Ciencias, Campus de Teatinos, 29071 Málaga, Spain.
| | - Leonor Santos-Ruiz
- Center for Biomedical Research in Network, Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Carlos III Health Institute, 28029 Madrid, Spain.
- Departamento de Biología Celular, Genética y Fisiología, IBIMA-Universidad de Málaga, Facultad de Ciencias, Campus de Teatinos, 29071 Málaga, Spain.
| | - Elena De Palma
- Department of Emergencies and Organ Transplantation (DETO), University of Bari, Aldo Moro, 70010 Bari, Italy.
- PHD Course of Transplantation of Tissue and Organs and Cell Therapy (DETO) University of Bari, Aldo Moro, 70126 Bari, Italy.
| | - Alberto Maria Crovace
- Department of Emergencies and Organ Transplantation (DETO), University of Bari, Aldo Moro, 70010 Bari, Italy.
- PHD Course of Health and Veterinary Experimental Sciences, University of Perugia, 06123 Perugia, Italy.
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41
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Zhang X, Yuan X, Xu Q, Arioka M, Van Brunt LA, Shi Y, Brunski J, Helms JA. Molecular Basis for Periodontal Ligament Adaptation to In Vivo Loading. J Dent Res 2019; 98:331-338. [PMID: 30612508 DOI: 10.1177/0022034518817305] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A soft food diet leads to changes in the periodontal ligament (PDL). These changes, which have been recognized for more than a century, are ascribed to alterations in mechanical loading. While these adaptive responses have been well characterized, the molecular, cellular, and mechanical mechanisms underlying the changes have not. Here, we implicate Wnt signaling in the pathoetiology of PDL responses to underloading. We show that Wnt-responsive cells and their progeny in the PDL space exhibit a burst in proliferation in response to mastication. If an animal is fed a soft diet from the time of weaning, then this burst in Wnt-responsive cell proliferation is quelled; as a consequence, both the PDL and the surrounding alveolar bone undergo atrophy. Returning these animals to a hard food diet restores the Wnt signaling in PDL. These data provide, for the first time, a molecular mechanism underlying the adaptive response of the PDL to loading.
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Affiliation(s)
- X Zhang
- 1 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,2 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - X Yuan
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Q Xu
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA.,3 The Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - M Arioka
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA.,4 Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - L A Van Brunt
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Y Shi
- 5 Los Altos High School, Los Altos, CA, USA
| | - J Brunski
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - J A Helms
- 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
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García-Moreno S, González-Serrano J, López-Pintor R, Pardal-Peláez B, Hernández G, Martínez-González J. Implant stability using piezoelectric bone surgery compared with conventional drilling: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2018; 47:1453-1464. [DOI: 10.1016/j.ijom.2018.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 01/14/2023]
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43
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Válková L, Ševčíková J, Pávková Goldbergová M, Weiser A, Dlouhý A. Osteoarthritic process modifies expression response to NiTi alloy presence. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:146. [PMID: 30167902 DOI: 10.1007/s10856-018-6156-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 08/21/2018] [Indexed: 06/08/2023]
Abstract
Nickel-titanium alloy (nitinol, NiTi) is a biomaterial with unique thermal shape memory, superelasticity and high damping properties. Therefore NiTi has been used in medical applications. In this in vitro study, the effect of NiTi alloy (with two surface modifications - helium and hydrogen) on gene expression profile of selected interleukins (IL-1β, IL-6 and IL-8) and matrix metalloproteinases (MMP-1 and MMP-2) in human physiological osteoblasts and human osteoarthritic osteoblasts was examined to respond to a question of the different behavior of bone tissue in the implantation of metallic materials in the presence of cells affected by the osteoarthritic process. The cells were cultivated in contact with NiTi and with or without LPS (bacterial lipolysaccharide). Changes in expression of target genes were calculated by 2-ΔΔCt method. An increased gene expression of IL-1β in osteoarthritic osteoblasts, with even higher expression in cells collected directly from the metal surface was observed. In case of physiological osteoblasts, the change in expression was detected after LPS treatment in cells surrounding the disc. Higher expression levels of IL-8 were observed in osteoarthritic osteoblasts after NiTi treatment in contact with alloy, and in physiological osteoblasts without relation to location in combination of NiTi and LPS. IL-6 was slightly increased in physiological osteoblastes after application of LPS. MMP-1 expression level was obviously significantly higher in osteoarthritic osteoblasts with differences regarding the metal surface and location. MMP-2 expression was decreased in both cell lines after LPS treatment. In conclusion, results of present study show that the NiTi alloy and the treatment by LPS, especially repeated doses of LPS, change the gene expression of selected ILs and MMPs in human osteoblast cell cultures. Some of the changes were depicted solely to osteoarthritic osteoblasts.
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Affiliation(s)
- Lucie Válková
- Department of Pathological Physiology, Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
| | - Jana Ševčíková
- Department of Pathological Physiology, Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic
| | - Monika Pávková Goldbergová
- Department of Pathological Physiology, Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic.
| | - Adam Weiser
- Academy of Sciences CR, Institute of Physics of Materials, Zizkova 22, 616 62, Brno, Czech Republic
| | - Antonín Dlouhý
- Academy of Sciences CR, Institute of Physics of Materials, Zizkova 22, 616 62, Brno, Czech Republic
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44
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Ida H, Seiryu M, Takeshita N, Iwasaki M, Yokoyama Y, Tsutsumi Y, Ikeda E, Sasaki S, Miyashita S, Sasaki S, Fukunaga T, Deguchi T, Takano-Yamamoto T. Biosafety, stability, and osteogenic activity of novel implants made of Zr 70Ni 16Cu 6Al 8 bulk metallic glass for biomedical application. Acta Biomater 2018; 74:505-517. [PMID: 29772348 DOI: 10.1016/j.actbio.2018.05.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/11/2018] [Accepted: 05/12/2018] [Indexed: 01/22/2023]
Abstract
Superior mechanical and chemical properties of Zr70Ni16Cu6Al8 bulk metallic glass (BMG) demonstrate its promise as a novel biomaterial for fabrication of implants. The aim of the present study was to validate mechanical, chemical, and biological properties of Zr70Ni16Cu6Al8 BMG through comparison with titanium (Ti). Our data indicated higher tensile strength, lower Young's modulus, and reduced metal ion release of Zr70Ni16Cu6Al8 BMG compared with Ti. Biosafety of bone marrow mesenchymal cells on Zr70Ni16Cu6Al8 BMG was comparable to that of Ti. Next, screw-type implant prototypes made of Zr70Ni16Cu6Al8 BMG were fabricated and inserted into rat long bones. Zr70Ni16Cu6Al8 BMG implants indicated a higher removal-torque value and lower Periotest value compared with Ti implants. In addition, higher amounts of new bone formation and osseointegration were observed around Zr70Ni16Cu6Al8 BMG implants compared with Ti implants. Moreover, gene expression analysis displayed higher expression of osteoblast- and osteoclast-associated genes in the Zr70Ni16Cu6Al8 BMG group compared with the Ti group. Importantly, loading to implants upregulated bone formation, as well as osteoblast- and osteoclast-associated gene expression in the peri-implant area. No significant difference in concentrations of Ni, Al, Cu, and Zr in various organs was shown between in the Zr70Ni16Cu6Al8 BMG and Ti groups. Collectively, these findings suggest that Zr70Ni16Cu6Al8 BMG is suitable for fabricating novel implants with superior mechanical properties, biocompatibility, stability, and biosafety compared with Ti. STATEMENT OF SIGNIFICANCE Titanium is widely used to fabricate orthopedic and dental implants. However, Titanium has disadvantages for biomedical applications in regard to strength, elasticity, and biosafety. Recently, we developed a novel hypoeutectic Zr70Ni16Cu6Al8 BMG, which has superior mechanical and chemical properties. However, the validity of Zr70Ni16Cu6Al8 BMG for biomedical application has not been cleared. The aim of the present study was to validate the mechanical, chemical, and biological properties of Zr70Ni16Cu6Al8 BMG for biomedical applications through comparison with Titanium. The present study clarifies that Zr70Ni16Cu6Al8 BMG has good mechanical properties, corrosion resistance, and osteogenic activity, which are necessary features for biomedical applications. The present study provides for the first time the superiority of Zr70Ni16Cu6Al8 BMG implants to Titanium implants for biomedical applications.
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45
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de Barros E Lima Bueno R, Dias AP, Ponce KJ, Wazen R, Brunski JB, Nanci A. Bone healing response in cyclically loaded implants: Comparing zero, one, and two loading sessions per day. J Mech Behav Biomed Mater 2018; 85:152-161. [PMID: 29894930 PMCID: PMC6035061 DOI: 10.1016/j.jmbbm.2018.05.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/16/2018] [Accepted: 05/30/2018] [Indexed: 01/15/2023]
Abstract
When bone implants are loaded, they are inevitably subjected to displacement relative to bone. Such micro-motion generates stress/strain states at the interface that can cause beneficial or detrimental sequels. The objective of this study is to better understand the mechanobiology of bone healing at the tissue-implant interface during repeated loading. Machined screw shaped Ti implants were placed in rat tibiae in a hole slightly bigger than the implant diameter. Implants were held stable by a specially-designed bone plate that permits controlled loading. Three loading regimens were applied, (a) zero loading, (b) one daily loading session of 60 cycles with an axial force of 1.5 N/cycle for 7 days, and (c) two such daily sessions with the same axial force also for 7 days. Finite element analysis was used to characterize the mechanobiological conditions produced by the loading sessions. After 7 days, the implants with surrounding interfacial tissue were harvested and processed for histological, histomorphometric and DNA microarray analyses. Histomorphometric analyses revealed that the group subjected to repeated loading sessions exhibited a significant decrease in bone-implant contact and increase in bone-implant distance, as compared to unloaded implants and those subjected to only one loading session. Gene expression profiles differed during osseointegration between all groups mainly with respect to inflammatory and unidentified gene categories. The results indicate that increasing the daily cyclic loading of implants induces deleterious changes in the bone healing response, most likely due to the accumulation of tissue damage and associated inflammatory reaction at the bone-implant interface.
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Affiliation(s)
- Renan de Barros E Lima Bueno
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
| | - Ana Paula Dias
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
| | - Katia J Ponce
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
| | - Rima Wazen
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
| | - John B Brunski
- Department of Surgery, School of Medicine, Stanford University, Stanford, CA, United States
| | - Antonio Nanci
- Laboratory for the Study of Calcified Tissues and Biomaterials, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada.
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46
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van Arkel RJ, Ghouse S, Milner PE, Jeffers JRT. Additive manufactured push-fit implant fixation with screw-strength pull out. J Orthop Res 2018; 36:1508-1518. [PMID: 29023901 PMCID: PMC6175131 DOI: 10.1002/jor.23771] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/01/2017] [Indexed: 02/04/2023]
Abstract
Additive manufacturing offers exciting new possibilities for improving long-term metallic implant fixation in bone through enabling open porous structures for bony ingrowth. The aim of this research was to investigate how the technology could also improve initial fixation, a precursor to successful long-term fixation. A new barbed fixation mechanism, relying on flexible struts was proposed and manufactured as a push-fit peg. The technology was optimized using a synthetic bone model and compared with conventional press-fit peg controls tested over a range of interference fits. Optimum designs, achieving maximum pull-out force, were subsequently tested in a cadaveric femoral condyle model. The barbed fixation surface provided more than double the pull-out force for less than a third of the insertion force compared to the best performing conventional press-fit peg (p < 0.001). Indeed, it provided screw-strength pull out from a push-fit device (1,124 ± 146 N). This step change in implant fixation potential offers new capabilities for low profile, minimally invasive implant design, while providing new options to simplify surgery, allowing for one-piece push-fit components with high levels of initial stability. © 2017 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res 36:1508-1518, 2018.
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Affiliation(s)
- Richard J. van Arkel
- Department of Mechanical EngineeringImperial College LondonLondonSW7 2AZUnited Kingdom
| | - Shaaz Ghouse
- Department of Mechanical EngineeringImperial College LondonLondonSW7 2AZUnited Kingdom
| | - Piers E. Milner
- Department of Mechanical EngineeringImperial College LondonLondonSW7 2AZUnited Kingdom
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47
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Liu C, Carrera R, Flamini V, Kenny L, Cabahug-Zuckerman P, George BM, Hunter D, Liu B, Singh G, Leucht P, Mann KA, Helms JA, Castillo AB. Effects of mechanical loading on cortical defect repair using a novel mechanobiological model of bone healing. Bone 2018; 108:145-155. [PMID: 29305998 PMCID: PMC8262576 DOI: 10.1016/j.bone.2017.12.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 12/20/2017] [Accepted: 12/29/2017] [Indexed: 12/30/2022]
Abstract
Mechanical loading is an important aspect of post-surgical fracture care. The timing of load application relative to the injury event may differentially regulate repair depending on the stage of healing. Here, we used a novel mechanobiological model of cortical defect repair that offers several advantages including its technical simplicity and spatially confined repair program, making effects of both physical and biological interventions more easily assessed. Using this model, we showed that daily loading (5N peak load, 2Hz, 60 cycles, 4 consecutive days) during hematoma consolidation and inflammation disrupted the injury site and activated cartilage formation on the periosteal surface adjacent to the defect. We also showed that daily loading during the matrix deposition phase enhanced both bone and cartilage formation at the defect site, while loading during the remodeling phase resulted in an enlarged woven bone regenerate. All loading regimens resulted in abundant cellular proliferation throughout the regenerate and fibrous tissue formation directly above the defect demonstrating that all phases of cortical defect healing are sensitive to physical stimulation. Stress was concentrated at the edges of the defect during exogenous loading, and finite element (FE)-modeled longitudinal strain (εzz) values along the anterior and posterior borders of the defect (~2200με) was an order of magnitude larger than strain values on the proximal and distal borders (~50-100με). It is concluded that loading during the early stages of repair may impede stabilization of the injury site important for early bone matrix deposition, whereas loading while matrix deposition and remodeling are ongoing may enhance stabilization through the formation of additional cartilage and bone.
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Affiliation(s)
- Chao Liu
- Department of Mechanical and Aerospace Engineering, New York University, Brooklyn, NY, USA; Department of Orthopaedic Surgery, New York University Langone Health, NYU Langone Orthopedic Hospital, NY, USA; Department of Veterans Affairs New York Harbor Healthcare System, New York, NY, USA
| | - Robert Carrera
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Vittoria Flamini
- Department of Mechanical and Aerospace Engineering, New York University, Brooklyn, NY, USA
| | - Lena Kenny
- Department of Orthopaedic Surgery, New York University Langone Health, NYU Langone Orthopedic Hospital, NY, USA
| | - Pamela Cabahug-Zuckerman
- Department of Mechanical and Aerospace Engineering, New York University, Brooklyn, NY, USA; Department of Orthopaedic Surgery, New York University Langone Health, NYU Langone Orthopedic Hospital, NY, USA; Department of Veterans Affairs New York Harbor Healthcare System, New York, NY, USA
| | - Benson M George
- Department of Surgery, Division of Plastic Surgery, Stanford University, Stanford, CA, USA
| | - Daniel Hunter
- Department of Surgery, Division of Plastic Surgery, Stanford University, Stanford, CA, USA
| | - Bo Liu
- Department of Surgery, Division of Plastic Surgery, Stanford University, Stanford, CA, USA
| | - Gurpreet Singh
- Department of Surgery, Division of Plastic Surgery, Stanford University, Stanford, CA, USA
| | - Philipp Leucht
- Department of Orthopaedic Surgery, New York University Langone Health, NYU Langone Orthopedic Hospital, NY, USA; Department of Cell Biology, New York University, New York, NY, USA
| | - Kenneth A Mann
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jill A Helms
- Department of Surgery, Division of Plastic Surgery, Stanford University, Stanford, CA, USA
| | - Alesha B Castillo
- Department of Mechanical and Aerospace Engineering, New York University, Brooklyn, NY, USA; Department of Orthopaedic Surgery, New York University Langone Health, NYU Langone Orthopedic Hospital, NY, USA; Department of Veterans Affairs New York Harbor Healthcare System, New York, NY, USA.
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48
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Histochemical examination on the peri-implant bone with early occlusal loading after the immediate placement into extraction sockets. Histochem Cell Biol 2018; 149:433-447. [DOI: 10.1007/s00418-018-1644-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2018] [Indexed: 01/20/2023]
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49
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Li Z, Müller R, Ruffoni D. Bone remodeling and mechanobiology around implants: Insights from small animal imaging. J Orthop Res 2018; 36:584-593. [PMID: 28975660 DOI: 10.1002/jor.23758] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 09/27/2017] [Indexed: 02/04/2023]
Abstract
Anchorage of orthopedic implants depends on the interfacial bonding between the implant and the host bone as well as on the mass and microstructure of peri-implant bone, with all these factors being continuously regulated by the biological process of bone (re)modeling. In osteoporotic bone, implant integration may be jeopardized not only by lower peri-implant bone quality but also by reduced intrinsic regeneration ability. The first aim of this review is to provide a critical overview of the influence of osteoporosis on bone regeneration post-implantation. Mechanical stimulation can trigger bone formation and inhibit bone resorption; thus, judicious administration of mechanical loading can be used as an effective non-pharmacological treatment to enhance implant anchorage. Our second aim is to report recent achievements on the application of external mechanical stimulation to improve the quantity of peri-implant bone. The review focuses on peri-implant bone changes in osteoporotic conditions and following mechanical loading, prevalently using small animals and in vivo monitoring approaches. We intend to demonstrate the necessity to reveal new biological information on peri-implant bone mechanobiology to better target implant anchorage and fracture fixation in osteoporotic conditions. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:584-593, 2018.
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Affiliation(s)
- Zihui Li
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Ralph Müller
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Davide Ruffoni
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.,Mechanics of Biological and Bioinspired Materials Laboratory, Department of Aerospaceand Mechanical Engineering, University of Liège, Liège, Belgium
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50
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Bradaschia-Correa V, Josephson AM, Egol AJ, Mizrahi MM, Leclerc K, Huo J, Cronstein BN, Leucht P. Ecto-5'-nucleotidase (CD73) regulates bone formation and remodeling during intramembranous bone repair in aging mice. Tissue Cell 2017; 49:545-551. [PMID: 28720305 PMCID: PMC5656528 DOI: 10.1016/j.tice.2017.07.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 07/03/2017] [Accepted: 07/03/2017] [Indexed: 11/19/2022]
Abstract
Ecto-5'-nucleotidase (CD73) generates adenosine, an osteoblast activator and key regulator of skeletal growth. It is unknown, however, if CD73 regulates osteogenic differentiation during fracture healing in adulthood, and in particular how CD73 activity regulates intramembranous bone repair in the elderly. Monocortical tibial defects were created in 46-52-week-old wild type (WT) and CD73 knock-out mice (CD73-/-) mice. Injury repair was analyzed at post-operative days 5, 7, 14 and 21 by micro-computed tomography (micro-CT), histomorphometry, proliferating cell nuclear antigen (PCNA) immunostaining, alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP) histochemistry. Middle-aged CD73 knock-out mice exhibited delayed bone regeneration and significantly reduced bone matrix deposition detected by histomorphometry and micro-CT. Cell proliferation, ALP activity and osteoclast number were reduced in the CD73-/- mice, suggesting a combined defect in bone formation and resorption due the absence of CD73 activity in this model of intramembranous bone repair. Results from this study demonstrate that osteoblast activation through CD73 activity is essential during bone repair in aging mice, and it may present a drugable target for future biomimetic therapeutic approaches that aim at enhancing bone formation in the elderly patients.
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Affiliation(s)
- Vivian Bradaschia-Correa
- Department of Orthopaedic Surgery, New York University Langone Medical Center - Hospital for Joint Diseases, New York, NY, USA
| | - Anne M Josephson
- Department of Orthopaedic Surgery, New York University Langone Medical Center - Hospital for Joint Diseases, New York, NY, USA
| | - Alexander J Egol
- Department of Orthopaedic Surgery, New York University Langone Medical Center - Hospital for Joint Diseases, New York, NY, USA
| | - Matthew M Mizrahi
- Department of Orthopaedic Surgery, New York University Langone Medical Center - Hospital for Joint Diseases, New York, NY, USA
| | - Kevin Leclerc
- Department of Orthopaedic Surgery, New York University Langone Medical Center - Hospital for Joint Diseases, New York, NY, USA
| | - Jason Huo
- Department of Orthopaedic Surgery, New York University Langone Medical Center - Hospital for Joint Diseases, New York, NY, USA
| | - Bruce N Cronstein
- Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Philipp Leucht
- Department of Orthopaedic Surgery, New York University Langone Medical Center - Hospital for Joint Diseases, New York, NY, USA; Department of Cell Biology, New York University School of Medicine, New York, NY, USA.
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