51
|
Abdel-Rahman FH, Salem AS, El-Shinnawi UM, Hammouda NI, El-Kenawy MH, Maria OM. Efficacy of Autogenous Platelet-Rich Fibrin Vs Slowly Resorbable Collagen Membrane With Immediate Implants in the Esthetic Zone. J ORAL IMPLANTOL 2021; 47:342-351. [PMID: 32870251 DOI: 10.1563/aaid-joi-d-20-00124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Fakhreldin H Abdel-Rahman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ahmed S Salem
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Una M El-Shinnawi
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Nelly I Hammouda
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mohamed H El-Kenawy
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ola M Maria
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
52
|
In Vivo Biological Evaluation of Biodegradable Nanofibrous Membranes Incorporated with Antibiofilm Compounds. Polymers (Basel) 2021; 13:polym13152457. [PMID: 34372057 PMCID: PMC8347157 DOI: 10.3390/polym13152457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 12/20/2022] Open
Abstract
Guided bone regeneration involves excluding non-osteogenic cells from the surrounding soft tissues and allowing osteogenic cells originating from native bone to inhabit the defect. The aim of this work was to fabricate, analyze antibiofilm activity and evaluate in vivo biological response of poly (lactic-co-glycolic acid) (PLGA) electrospun membranes incorporated with tea tree oil and furan-2(5H)-one. Samples were exposed to Streptococcus mutans culture and after 48 h incubation, biofilm was evaluated by colony forming units (CFU/mL) followed by scanning electron microscopy. Additionally, seventy-five Balb-C mice were divided into five experimental groups for subcutaneous implantation: tea tree oil loaded PLGA electrospun fiber membrane, furanone loaded PLGA electrospun fiber membrane, neat PLGA electrospun fiber membrane, a commercially available PLGA membrane –Pratix® and Sham (no-membrane implantation). Post implantation period of each experimental group (1, 3 and 9 weeks), samples were collected and processed for by histological descriptive and semiquantitative evaluation. Results showed a significant reduction of bacterial attachment on tea tree oil and furan-2(5H)-one incorporated membranes. Macrophage counts were significant found in all the materials implanted, although giant cells were predominantly associated with electrospun fiber membranes. The incorporation of antibiofilm compounds in nanofibers membranes did not incite inflammatory response significantly different in comparison with pure PLGA electrospun membranes, indicating its potential for development of novel functionalized membranes targeting the inhibition of bacterial biofilms on membrane-grafting materials.
Collapse
|
53
|
Vidal-Gutiérrez X, Prado-Prone G, Rodil SE, Velasquillo C, Clemente I, Silva-Bermudez P, Almaguer-Flores A. Bismuth subsalicylate incorporated in polycaprolactone-gelatin membranes by electrospinning to prevent bacterial colonization. Biomed Mater 2021; 16. [PMID: 34038883 DOI: 10.1088/1748-605x/ac058d] [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: 12/04/2020] [Accepted: 05/26/2021] [Indexed: 01/23/2023]
Abstract
Periodontitis is a chronic, multifactorial, inflammatory disease characterized by the progressive destruction of the periodontal tissues. Guided tissue regeneration (GTR), involving the use of barrier membranes, is one of the most successful clinical procedures for periodontal therapy. Nevertheless, rapid degradation of the membranes and membrane-related infections are considered two of the major reasons for GTR clinical failure. Recently, integration of non-antibiotic, antimicrobial materials to the membranes has emerged as a novel strategy to face the bacterial infection challenge, without increasing bacterial resistance. In this sense, bismuth subsalicylate (BSS) is a non-antibiotic, metal-based antimicrobial agent effective against different bacterial strains, that has been long safely used in medical treatments. Thus, the aim of the present work was to fabricate fibrillar, non-rapidly bioresorbable, antibacterial GTR membranes composed of polycaprolactone (PCL), gelatin (Gel), and BSS as the antibacterial agent. PCL-G-BSS membranes with three different BSS concentrations (2 wt./v%, 4 wt./v%, and 6 wt./v%) were developed by electrospinning and their morphology, composition, water wettability, mechanical properties, Bi release and degradation rate were characterized. The Cytotoxicity of the membranes was studiedin vitrousing human osteoblasts (hFOB) and gingival fibroblasts (HGF-1), and their antibacterial activity was tested againstAggregatibacter actinomycetemcomitans, Escherichia coli, Porphyromonas gingivalisandStaphylococcus aureus.The membranes obtained exhibited adequate mechanical properties for clinical application, and appropriate degradation rates for allowing periodontal defects regeneration. The hFOB and HGF-1 cells displayed adequate viability when in contact with the lixiviated products from the membranes, and, in general, displayed antibacterial activity against the four bacteria strains tested. Thus, the PCL-G-BSS membranes showed to be appropriate as potential barrier membranes for periodontal GTR treatments.
Collapse
Affiliation(s)
- Ximena Vidal-Gutiérrez
- Posgrado en Ciencias Médicas, Odontológicas y de la Salud, Ciencias Odontológicas, Facultad de Odontología, División de Estudios de Posgrado e Investigación, Universidad Nacional Autónoma de México, Circuito exterior s/n, Ciudad Universitaria, CDMX C.P. 04510, México.,Laboratorio de Biointerfases, Facultad de Odontología, División de Estudios de Posgrado e Investigación, Universidad Nacional Autónoma de México, Circuito exterior s/n, Ciudad Universitaria, CDMX C.P. 04510, México.,Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilco No. 289 Col. Arenal de Guadalupe, CDMX C.P. 14389, México
| | - Gina Prado-Prone
- Laboratorio de Biointerfases, Facultad de Odontología, División de Estudios de Posgrado e Investigación, Universidad Nacional Autónoma de México, Circuito exterior s/n, Ciudad Universitaria, CDMX C.P. 04510, México.,Laboratorio de Biotecnología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México Xochimilco No. 289 Col. Arenal de Guadalupe, CDMX C.P. 14389, México
| | - Sandra E Rodil
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Circuito exterior s/n, Ciudad Universitaria, CDMX C.P. 04510, México
| | - Cristina Velasquillo
- Laboratorio de Biotecnología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México Xochimilco No. 289 Col. Arenal de Guadalupe, CDMX C.P. 14389, México
| | - Ibarra Clemente
- Dirección General, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México Xochimilco No. 289 Col. Arenal de Guadalupe, CDMX C.P. 14389, México
| | - Phaedra Silva-Bermudez
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilco No. 289 Col. Arenal de Guadalupe, CDMX C.P. 14389, México
| | - Argelia Almaguer-Flores
- Laboratorio de Biointerfases, Facultad de Odontología, División de Estudios de Posgrado e Investigación, Universidad Nacional Autónoma de México, Circuito exterior s/n, Ciudad Universitaria, CDMX C.P. 04510, México
| |
Collapse
|
54
|
Feher B, Apaza Alccayhuaman KA, Strauss FJ, Lee JS, Tangl S, Kuchler U, Gruber R. Osteoconductive properties of upside-down bilayer collagen membranes in rat calvarial defects. Int J Implant Dent 2021; 7:50. [PMID: 34095987 PMCID: PMC8180471 DOI: 10.1186/s40729-021-00333-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/19/2021] [Indexed: 02/07/2023] Open
Abstract
Background Bilayer collagen membranes are routinely used in guided bone/tissue regeneration to serve as osteoconductive scaffolds and prevent the invasion of soft tissues. It is recommended to place the membranes with their dense layer towards the soft tissue and their porous layer towards the bony defect area. However, evidence supporting this recommendation is lacking. This study aimed to determine whether the alignment of bilayer collagen membranes has an effect on bone regeneration. Methods In two groups of ten male Sprague-Dawley rats each, a 5-mm calvarial defect was created. Thereafter, the defect was randomly covered with a bilayer, resorbable, pure type I and III collagen membrane placed either regularly or upside-down (i.e., dense layer towards bone defect). After 4 weeks of healing, micro-computed tomography (μCT), histology, and histomorphometry of the inner cylindrical region of interest (4.5 mm in diameter) were performed to assess new bone formation and the consolidation of the collagen membrane in the defect area. Results Quantitative μCT showed similar bone volume (median 8.0 mm3, interquartile range 7.0–10.0 vs. 6.2 mm3, 4.3–9.4, p = 0.06) and trabecular thickness (0.21 mm, 0.19–0.23 vs. 0.18 mm, 0.17–0.20, p = 0.03) between upside-down and regular placement, both leading to an almost complete bony coverage. Histomorphometry showed comparable new bone areas between the upside-down and regularly placed membranes, 3.9 mm2 (2.7–5.4) vs. 3.8 mm2 (2.2–4.0, p = 0.31), respectively. Both treatment groups revealed the same regeneration patterns and spatial distribution of bone with and without collagen fibers, as well as residual collagen fibers. Conclusions Our data support the osteoconductive properties of collagen membranes and suggest that bone regeneration is facilitated regardless of membrane layer alignment. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-021-00333-y.
Collapse
Affiliation(s)
- Balazs Feher
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Karol Ali Apaza Alccayhuaman
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Franz Josef Strauss
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Stefan Tangl
- Core Facility Hard Tissue and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Ulrike Kuchler
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria. .,Austrian Cluster for Tissue Regeneration, Vienna, Austria. .,Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| |
Collapse
|
55
|
Wei Y, Deng Y, Ma S, Ran M, Jia Y, Meng J, Han F, Gou J, Yin T, He H, Wang Y, Zhang Y, Tang X. Local drug delivery systems as therapeutic strategies against periodontitis: A systematic review. J Control Release 2021; 333:269-282. [PMID: 33798664 DOI: 10.1016/j.jconrel.2021.03.041] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/27/2021] [Accepted: 03/27/2021] [Indexed: 12/14/2022]
Abstract
Periodontitis is a chronic inflammation of the soft tissue surrounding and supporting the teeth, which causes periodontal structural damage, alveolar bone resorption, and even tooth loss. Its prevalence is very high, with nearly 60% of the global population affected. Hence, periodontitis is an important public health concern, and the development of effective healing treatments for oral diseases is a major target of the health sciences. Currently, the application of local drug delivery systems (LDDS) as an adjunctive therapy to scaling and root planning (SRP) in periodontitis is a promising strategy, giving higher efficacy and fewer side effects by controlling drug release. The cornerstone of successful periodontitis therapy is to select an appropriate bioactive agent and route of administration. In this context, this review highlights applications of LDDS with different properties in the treatment of periodontitis with or without systemic diseases, in order to reveal existing challenges and future research directions.
Collapse
Affiliation(s)
- Ying Wei
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Yaxin Deng
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Shuting Ma
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Meixin Ran
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Yannan Jia
- Affiliated Hospital of Inner Mongolia University for the Nationalities, Tongliao 028000, Neimenggu, China
| | - Jia Meng
- Liaoning Institute of Basic Medicine, Shenyang 110016, Liaoning, China
| | - Fei Han
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China.
| | - Jingxin Gou
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Tian Yin
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Haibing He
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Yanjiao Wang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Yu Zhang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China.
| | - Xing Tang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| |
Collapse
|
56
|
Evaluation of Guided Bone Regeneration in Critical Defects Using Bovine and Porcine Collagen Membranes: Histomorphometric and Immunohistochemical Analyses. Int J Biomater 2021; 2021:8828194. [PMID: 33859694 PMCID: PMC8024098 DOI: 10.1155/2021/8828194] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/08/2020] [Accepted: 03/10/2021] [Indexed: 12/03/2022] Open
Abstract
Guided bone regeneration (GBR) is a technique used to facilitate bone regeneration, which uses a biocompatible membrane acting as a physical barrier to prevent the adjacent connective tissue from invading the bone defect. The aim of this study was to evaluate and compare the effectiveness of bovine and porcine collagenous membranes as barriers to connective tissue invasion during the repair of critical bone defects in rat calvaria, using histological, histometric, and immunohistochemical analyses. For this study, 72 rats were divided into three groups: clot group (CG), bovine collagen group (BCG), and porcine collagen group (PCG). Analyses were performed on days 7, 15, 30, and 60. The histological results showed that the PCG exhibited bone neoformation starting from day 7, and after 30 days of repair, the surgical defect was completely filled in some animals. For the BCG, there was little bone neoformation activity in the initial periods, and from day 30 onwards, there was an increase in bone neoformation, with a greater increase on day 60. The data obtained in the histometric analysis reveal that, on day 30, the neoformed bone area did not vary greatly between the PCG and the BCG, though both varied from the CG. By day 60, the PCG presented a greater area of neoformation than the BCG. These results were corroborated by the immunohistochemistry results. In view of the results obtained, it can be concluded that all membranes studied in this research promoted GBR.
Collapse
|
57
|
Shaikh MS, Zafar MS, Pisani F, Lone MA, Malik YR. Critical features of periodontal flaps with regard to blood clot stability: A review. J Oral Biosci 2021; 63:111-119. [PMID: 33684521 DOI: 10.1016/j.job.2021.02.007] [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: 01/07/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Wound healing is a multifactorial procedure involving different cell types and biological mediators. The principles of wound healing are also applicable to periodontal tissues. The formation and stability of blood clots play a vital role in successful healing of wounds in periodontal tissues. The aim of the present review was to highlight the vital factors of periodontal flaps associated with blood clot stability. HIGHLIGHT The data on periodontal regeneration and wound healing have evolved greatly in light of several factors, including space for blood clots and blood clot stabilization. In periodontal osseous defects, the stability of blood clots seems critical to wound healing. If mechanical forces can be managed by wound stabilization, the gingival flap-tooth root interface may show connective tissue repair. However, compromised adhesion is susceptible to mechanical forces and can cause wound breakage and epithelialization. CONCLUSION The presence of a thick blood clot may hinder the plasmatic circulation between the recipient bed and graft during the initial stage of healing, which is critical in cases of mucogingival surgery. Root conditioning can also determine the healing consequence by enhancing blood clot adhesion.
Collapse
Affiliation(s)
- Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Madina Munawwarra, 41311, Saudi Arabia; Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, 44000, Pakistan.
| | - Flavio Pisani
- College of Medicine and Dentistry, MClinDent in Periodontology, Birmingham, B4 6BN, UK
| | - Mohid Abrar Lone
- Department of Oral Pathology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Yasser Riaz Malik
- Department of Community Dentistry, Sir Syed College of Medical Sciences for Girls, Karachi, 74200, Pakistan; Department of Preventive Dentistry (Dental Public Health), College of Dentistry, University of Hail, Hail, Saudi Arabia
| |
Collapse
|
58
|
Yu H, Zhu H. The management of a complicated crown-root fracture incorporating modified crown-lengthening surgery. Br Dent J 2021; 230:217-222. [PMID: 33637921 DOI: 10.1038/s41415-021-2653-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 08/07/2020] [Indexed: 01/11/2023]
Abstract
Anterior teeth with subgingival fractures require a multidisciplinary management approach with regards to biological, functional and aesthetic factors. This case report emphasises the use of a minimally invasive technique combined with a sequence of therapies to treat a complicated crown-root fracture and reviews the critical factors to ensure predictable outcomes. Endodontic treatment was undertaken due to exposure of the pulp in a complicated crown-root fracture of the maxillary right central incisor. Extrusion of the fractured fragment was performed to expose the fracture margin under the alveolar bone. Modified crown-lengthening surgery was used to reconstruct the biologic width. The traumatised tooth was restored with a glass fibre post and resin core, which fit the biological requirements. Finally, an all-ceramic crown fulfilled biomimetic aesthetics. This multidisciplinary approach achieved a good long-term prognosis with regards to periodontal and periapical healing.
Collapse
Affiliation(s)
- Haojie Yu
- The Affiliated Stomatology Hospital, Zhejiang University, School of Medicine, China; Key Laboratory of Oral, Biomedical Research of Zhejiang Province, Zhejiang, University School of Stomatology, Yan'an Road 395, Hangzhou, 310006, China.
| | - Haihua Zhu
- The Affiliated Stomatology Hospital, Zhejiang University, School of Medicine, China; Key Laboratory of Oral, Biomedical Research of Zhejiang Province, Zhejiang, University School of Stomatology, Yan'an Road 395, Hangzhou, 310006, China
| |
Collapse
|
59
|
Guo X, Lin N, Lu S, Zhang F, Zuo B. Preparation and Biocompatibility Characterization of Silk Fibroin 3D Scaffolds. ACS APPLIED BIO MATERIALS 2021; 4:1369-1380. [PMID: 35014488 DOI: 10.1021/acsabm.0c01239] [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] [Indexed: 01/04/2023]
Abstract
In this paper, three different mass fractions of sodium carbonate were used for degumming to obtain different degrees of damaged silk fibroin fibers, which were then treated with formic acid to shrink and bond them into 3D scaffolds. The structure and performance of silk fibroin fibers and silk fibroin 3D scaffolds were characterized by scanning electron microscopy, infrared spectroscopy, X-ray diffraction, a differential thermal scanner, a universal materials testing machine, and laser confocal microscopy, and the degradation performance was tested by protease degradation. The results showed that an excessive mass fraction of sodium carbonate would cause partial hydrolysis of fibroin fibers, decrease the mechanical properties of fibroin fiber, increase the surface roughness of fibroin fibers, and make mouse embryonic fibroblasts easier to adhere and grow. Silk fibroin fibers were slightly dissolved, shrunk, and dispersed in formic acid. The mass fraction of sodium carbonate can adjust the enzymatic degradation rate of the silk fibroin 3D scaffolds. With the extension of the degradation time, minerals will be deposited on the surface of the scaffolds. The results show that the silk fibroin 3D scaffolds have biocompatibility, mechanical properties, and degradability, which provides a good material for a barrier biofilm in the future.
Collapse
|
60
|
Imber JC, Bosshardt DD, Stähli A, Saulacic N, Deschner J, Sculean A. Pre-clinical evaluation of the effect of a volume-stable collagen matrix on periodontal regeneration in two-wall intrabony defects. J Clin Periodontol 2021; 48:560-569. [PMID: 33471389 DOI: 10.1111/jcpe.13426] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/28/2020] [Accepted: 01/10/2021] [Indexed: 01/07/2023]
Abstract
AIM To histologically evaluate the effect of a new collagen matrix on periodontal regeneration. MATERIALS AND METHODS Two-wall intrabony defects were surgically created bilaterally distally to the maxillary first and third pre-molars in beagle dogs. The defects were randomly allocated to open flap debridement either with (test) or without (control) a volume-stable collagen matrix (VCMX). After 12 weeks, the dogs were euthanized, and the specimens histologically processed. Descriptive, histomorphometrical (vertical gain of periodontal tissues) and statistical analyses were then performed. RESULTS Healing was uneventful in most cases. Residual VCMX was still present and showed integration into new bone, new periodontal ligament, connective tissue and, in some specimens, into new cementum. Periodontal regeneration occurred to a varying extent in both groups. New continuous cementum and new bone formation were statistically significantly greater in the test group (4.12 mm and 3.28 mm, respectively) than in the control group (1.54 mm and 2.47 mm, respectively) (p = .009 and p = .037, respectively). The junctional epithelium was longer in the control group (2.21 mm) than in the test group (1.49 mm, p = .16). CONCLUSION The present results have for the first time provided histologic evidence for the potential of this novel VCMX to facilitate periodontal regeneration thus warranting further pre-clinical and clinical testing.
Collapse
Affiliation(s)
- Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Dieter Daniel Bosshardt
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University Hospital, University of Bern, Bern, Switzerland
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
61
|
Upadhyay H, Bhattacharya HS, Agarwal MC, Manjunath RGS, Agarwal A, Upadhyay H. Different Regenerative Responses of Two Platelet Concentrates in the Treatment of Human Periodontal Infrabony Defects: A Clinico-Radiographic Study. Contemp Clin Dent 2020; 11:217-222. [PMID: 33776346 PMCID: PMC7989751 DOI: 10.4103/ccd.ccd_7_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/28/2020] [Accepted: 07/03/2020] [Indexed: 01/01/2023] Open
Abstract
Background: Platelet concentrates usage in the treatment of intrabony defects has been improved due to advancement of research. Many generation of platelet concentrates were used, but research regarding advanced platelet-rich fibrin (A-PRF) regarding periodontal treatment is scanty. Aim: The purpose of the study was to evaluate and compare PRF and A-PRF in the treatment of human periodontal infrabony defects (IBDs) both clinically and radiographically. Materials and Methods: Twenty-eight patients having IBDs were divided into Group A (PRF) and Group B (A-PRF). Clinical parameters such as plaque index, gingival index, probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline and 3 and 6 months and radiographic examination at baseline and 6 months were also recorded to evaluate defect fill, resolution, and change in the alveolar crest height. Then, all the data were tabulated in a Microsoft Excel sheet and subjected to statistical analysis. Mean and standard deviations of the clinical and radiographic parameters were calculated, and unpaired t-test was performed to assess intergroup comparison at different time intervals. Results: Intragroup comparison showed statistically significant improvement in PPD and CAL at 3 and 6 months while statistically significant improvement was observed in mean defect fill and resolution in Group B. Conclusion: Individually, both the materials have shown promising results. However, statistically, PRF group (Group A) showed better treatment outcome in terms of bone fill and A-PRF group (Group B) in terms of soft tissue healing.
Collapse
Affiliation(s)
- Himani Upadhyay
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Hirak S Bhattacharya
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Manvi Chandra Agarwal
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - R G Shiva Manjunath
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Ashutosh Agarwal
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Himanshu Upadhyay
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| |
Collapse
|
62
|
Aoki H, Bizenjima T, Seshima F, Sato M, Irokawa D, Yoshikawa K, Yoshida W, Imamura K, Matsugami D, Kitamura Y, Kita D, Sugito H, Tomita S, Saito A. Periodontal surgery using rhFGF-2 with deproteinized bovine bone mineral or rhFGF-2 alone: 2-year follow-up of a randomized controlled trial. J Clin Periodontol 2020; 48:91-99. [PMID: 33030228 PMCID: PMC7984167 DOI: 10.1111/jcpe.13385] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 12/11/2022]
Abstract
AIM To compare outcomes of rhFGF-2 + DBBM therapy with rhFGF-2 alone in the treatment of intrabony defects. This study provides 2-year follow-up results from the previous randomized controlled trial. MATERIALS AND METHODS Defects were randomly allocated to receive rhFGF-2 + DBBM (test) or rhFGF-2 (control). Treated sites were re-evaluated at 2 years postoperatively, using original clinical and patient-centred measures. RESULTS Thirty-eight sites were available for re-evaluation. At 2 years, both groups showed a significant improvement in clinical attachment level (CAL) from baseline. A gain in CAL of 3.4 ± 1.3 mm in the test group and 3.1 ± 1.5 mm in the control group was found. No significant inter-group difference was noted. Both groups showed a progressive increase in radiographic bone fill (RBF). The test treatment yielded greater RBF (56%) compared with the control group (41%). The control treatment performed better in contained defects in terms of CAL and RBF. There was no significant difference in patient-reported outcomes between groups. CONCLUSIONS At 2-year follow-up, the test and cotrol treatments were similarly effective in improving CAL, whereas the test treatment achieved a significantly greater RBF. In both treatments, favourable clinical, radiographic, and patient-reported outcomes can be sustained for at least 2 years. TRIAL REGISTRATION The University Hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) 000025257.
Collapse
Affiliation(s)
- Hideto Aoki
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | | | - Fumi Seshima
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Masahiro Sato
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Daisuke Irokawa
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Kouki Yoshikawa
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Wataru Yoshida
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Daisuke Matsugami
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Yurie Kitamura
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Daichi Kita
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Hiroki Sugito
- Department of Dental Hygiene, Tokyo Dental Junior College, Tokyo, Japan
| | - Sachiyo Tomita
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| |
Collapse
|
63
|
Picciolo G, Peditto M, Irrera N, Pallio G, Altavilla D, Vaccaro M, Picciolo G, Scarfone A, Squadrito F, Oteri G. Preclinical and Clinical Applications of Biomaterials in the Enhancement of Wound Healing in Oral Surgery: An Overview of the Available Reviews. Pharmaceutics 2020; 12:E1018. [PMID: 33114407 PMCID: PMC7692581 DOI: 10.3390/pharmaceutics12111018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023] Open
Abstract
Oral surgery has undergone dramatic developments in recent years due to the use of biomaterials. The aim of the present review is to provide a general overview of the current biomaterials used in oral surgery and to comprehensively outline their impact on post-operative wound healing. A search in Medline was performed, including hand searching. Combinations of searching terms and several criteria were applied for study identification, selection, and inclusion. The literature was searched for reviews published up to July 2020. Reviews evaluating the clinical and histological effects of biomaterials on post-operative wound healing in oral surgical procedures were included. Review selection was performed by two independent reviewers. Disagreements were resolved by a third reviewer, and 41 reviews were included in the final selection. The selected papers covered a wide range of biomaterials such as stem cells, bone grafts, and growth factors. Bioengineering and biomaterials development represent one of the most promising perspectives for the future of oral surgery. In particular, stem cells and growth factors are polarizing the focus of this ever-evolving field, continuously improving standard surgical techniques, and granting access to new approaches.
Collapse
Affiliation(s)
- Giacomo Picciolo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
| | - Matteo Peditto
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Giovanni Pallio
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Domenica Altavilla
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Mario Vaccaro
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Giuseppe Picciolo
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Alessandro Scarfone
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
| | - Francesco Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98125 Messina, Italy; (N.I.); (G.P.); (M.V.); (A.S.)
- SunNutraPharma, Academic Spin-Off Company of the University of Messina, Via C. Valeria, 98125 Messina, Italy;
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via C. Valeria, 98125 Messina, Italy; (G.P.); (M.P.); (D.A.); (G.O.)
| |
Collapse
|
64
|
Which substances loaded onto collagen scaffolds influence oral tissue regeneration?-an overview of the last 15 years. Clin Oral Investig 2020; 24:3363-3394. [PMID: 32827278 DOI: 10.1007/s00784-020-03520-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/10/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Collagen scaffolds are widely used for guided bone or tissue regeneration. Aiming to enhance their regenerative properties, studies have loaded various substances onto these scaffolds. This review aims to provide an overview of existing literature which conducted in vitro, in vivo, and clinical testing of drug-loaded collagen scaffolds and analyze their outcome of promoting oral regeneration. MATERIALS AND METHODS PubMed, Scopus, and Ovid Medline® were systematically searched for publications from 2005 to 2019. Journal articles assessing the effect of substances on oral hard or soft tissue regeneration, while using collagen carriers, were screened and qualitatively analyzed. Studies were grouped according to their used substance type-biological medical products, pharmaceuticals, and tissue-, cell-, and matrix-derived products. RESULTS A total of 77 publications, applying 36 different substances, were included. Collagen scaffolds were demonstrating favorable adsorption behavior and release kinetics which could even be modified. BMP-2 was investigated most frequently, showing positive effects on oral tissue regeneration. BMP-9 showed comparable results at lower concentrations. Also, FGF2 enhanced bone and periodontal healing. Antibiotics improved the scaffold's anti-microbial activity and reduced the penetrability for bacteria. CONCLUSION Growth factors showed promising results for oral tissue regeneration, while other substances were investigated less frequently. Found effects of investigated substances as well as adsorption and release properties of collagen scaffolds should be considered for further investigation. CLINICAL RELEVANCE Collagen scaffolds are reliable carriers for any of the applied substances. BMP-2, BMP-9, and FGF2 showed enhanced bone and periodontal healing. Antibiotics improved anti-microbial properties of the scaffolds.
Collapse
|
65
|
Nagai K, Ideguchi H, Kajikawa T, Li X, Chavakis T, Cheng J, Messersmith PB, Heber-Katz E, Hajishengallis G. An injectable hydrogel-formulated inhibitor of prolyl-4-hydroxylase promotes T regulatory cell recruitment and enhances alveolar bone regeneration during resolution of experimental periodontitis. FASEB J 2020; 34:13726-13740. [PMID: 32812255 DOI: 10.1096/fj.202001248r] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 12/16/2022]
Abstract
The hypoxia-inducible factor 1α (HIF-1α) is critically involved in tissue regeneration. Hence, the pharmacological prevention of HIF-1α degradation by prolyl hydroxylase (PHD) under normoxic conditions is emerging as a promising option in regenerative medicine. Using a mouse model of ligature-induced periodontitis and resolution, we tested the ability of an injectable hydrogel-formulated PHD inhibitor, 1,4-dihydrophenonthrolin-4-one-3-carboxylic acid (1,4-DPCA/hydrogel), to promote regeneration of alveolar bone lost owing to experimental periodontitis. Mice injected subcutaneously with 1,4-DPCA/hydrogel at the onset of periodontitis resolution displayed significantly increased gingival HIF-1α protein levels and bone regeneration, as compared to mice treated with vehicle control. The 1,4-DPCA/hydrogel-induced increase in bone regeneration was associated with elevated expression of osteogenic genes, decreased expression of pro-inflammatory cytokine genes, and increased abundance of FOXP3+ T regulatory (Treg) cells in the periodontal tissue. The enhancing effect of 1,4-DPCA/hydrogel on Treg cell accumulation and bone regeneration was reversed by AMD3100, an antagonist of the chemokine receptor CXCR4 that mediates Treg cell recruitment. In conclusion, the administration of 1,4-DPCA/hydrogel at the onset of periodontitis resolution promotes CXCR4-dependent accumulation of Treg cells and alveolar bone regeneration, suggesting a novel approach for regaining bone lost due to periodontitis.
Collapse
Affiliation(s)
- Kosuke Nagai
- Laboratory of Innate Immunity and Inflammation, Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Institute of Clinical Chemistry and Laboratory Medicine, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Hidetaka Ideguchi
- Laboratory of Innate Immunity and Inflammation, Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tetsuhiro Kajikawa
- Laboratory of Innate Immunity and Inflammation, Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Xiaofei Li
- Laboratory of Innate Immunity and Inflammation, Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Triantafyllos Chavakis
- Institute of Clinical Chemistry and Laboratory Medicine, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Jing Cheng
- Department of Bioengineering, University of California, Berkeley, Berkeley, CA, USA.,Department of Materials Science and Engineering, University of California, Berkeley, Berkeley, CA, USA.,Formulation Group in R&D, Alcon, Duluth, GA, USA
| | - Phillip B Messersmith
- Department of Bioengineering, University of California, Berkeley, Berkeley, CA, USA.,Department of Materials Science and Engineering, University of California, Berkeley, Berkeley, CA, USA
| | - Ellen Heber-Katz
- Laboratory of Regenerative Medicine, Lankenau Institute for Medical Research, Wynnewood, PA, USA
| | - George Hajishengallis
- Laboratory of Innate Immunity and Inflammation, Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
66
|
Abdelaziz D, Hefnawy A, Al-Wakeel E, El-Fallal A, El-Sherbiny IM. New biodegradable nanoparticles-in-nanofibers based membranes for guided periodontal tissue and bone regeneration with enhanced antibacterial activity. J Adv Res 2020; 28:51-62. [PMID: 33364045 PMCID: PMC7753955 DOI: 10.1016/j.jare.2020.06.014] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/12/2020] [Accepted: 06/17/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction Guided tissue regeneration (GTR) and guided bone regeneration (GBR) are commonly used surgical procedures for the repair of damaged periodontal tissues. These procedures include the use of a membrane as barrier to prevent soft tissue ingrowth and to create space for slowly regenerating periodontium and bone. Recent approaches involve the use of membranes/scaffolds based on resorbable materials. These materials provide the advantage of dissolving by time without the need of surgical intervention to remove the scaffolds. Objectives This study aimed at preparing a new series of nanofibrous scaffolds for GTR/GBR applications with enhanced mechanical properties, cell adhesion, biocompatibility and antibacterial properties. Methods Electrospun nanofibrous scaffolds based on polylactic acid/cellulose acetate (PLA/CA) or poly(caprolactone) (PCL) polymers were prepared and characterized. Different concentrations of green-synthesized silver nanoparticles, AgNPs (1-2% w/v) and hydroxyapatite nanoparticles, HANPs (10-20% w/v) were incorporated into the scaffolds to enhance the antibacterial and bone regeneration activity. Results In-vitro studies showed that addition of HANPs improved the cell viability by around 50% for both types of nanofibrous scaffolds. The tensile properties were also improved through addition of 10% HANPs but deteriorated upon increasing the concentration to 20%. AgNPs significantly improved the antibacterial activity with 40 mm inhibition zone after 32 days. Additionally, the nanofibrous scaffolds showed a desirable degradation profile with losing around 40-70% of its mass in 8 weeks. Conclusions The obtained results show that the developed nanofibrous membranes are promising scaffolds for both GTR and GBR applications.
Collapse
Affiliation(s)
- Dina Abdelaziz
- Center for Materials Science (CMS), Zewail City of Science and Technology, 6th of October, Giza 12578, Egypt.,Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, Egypt
| | - Amr Hefnawy
- Center for Materials Science (CMS), Zewail City of Science and Technology, 6th of October, Giza 12578, Egypt
| | - Essam Al-Wakeel
- Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, Egypt
| | - Abeer El-Fallal
- Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, Egypt.,Department of Dental Biomaterials, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Egypt
| | - Ibrahim M El-Sherbiny
- Center for Materials Science (CMS), Zewail City of Science and Technology, 6th of October, Giza 12578, Egypt
| |
Collapse
|
67
|
Paolantonio M, Di Tullio M, Giraudi M, Romano L, Secondi L, Paolantonio G, Graziani F, Pilloni A, De Ninis P, Femminella B. Periodontal regeneration by leukocyte and platelet-rich fibrin with autogenous bone graft versus enamel matrix derivative with autogenous bone graft in the treatment of periodontal intrabony defects: A randomized non-inferiority trial. J Periodontol 2020; 91:1595-1608. [PMID: 32294244 DOI: 10.1002/jper.19-0533] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Aim of the present study was to ascertain if a combination of leukocyte and platelet-rich fibrin (L-PRF) + autogenous bone graft (ABG) may be a clinically "non-inferior" treatment modality as compared with the association of enamel matrix derivative (EMD) with ABG in the management of intrabony defects (IBDs). METHODS A total of forty-four patients, exhibiting at least one unfavorable intraosseous defect, were treated by L-PRF associated with ABG (22 patients; test group) or EMD+ABG (control group) in each defect. At baseline and 12 months, a complete clinical and radiographic examination was done. Pre- and post-therapy clinical (probing pocket depth [PPD], clinical attachment level [CAL], gingival recession [GR]) and radiographic (defect Bone level [(DBL)] parameters for the different treatments were compared. To guarantee the test treatment's efficacy 1mm was chosen as non-inferiority margin; for clinical relevance, a second non-inferiority margin = 0.5 mm was set. RESULTS Clinical and radiographic parameters significantly improved 12 months after surgery in both test and control sites, without inter-groups differences for each measurement. The control group - test group differences for the parameters CAL gain -0.248 mm (-0.618 to 0.122), PPD Reduction -0.397 mm (-0.810 to 0.015), GR Change 0.059 mm (-0.300 to 0.418), DBL Gain -0.250 mm (-0.746 to 0.246) were all within the non-inferiority margin of 0.5 mm. CONCLUSION Our results suggest that the L-PRF+ABG combined treatment of non-contained IBDs produces non-inferior results in terms of CAL gain, PPD reduction, GR increase and DBL gain in comparison with the EMD+ABG combination.
Collapse
Affiliation(s)
- Michele Paolantonio
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Marcella Di Tullio
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Marta Giraudi
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Luigi Romano
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Lorenzo Secondi
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Giulia Paolantonio
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University of Pisa, Pisa, Italy
| | - Andrea Pilloni
- Department of Oral and Maxillofacial Sciences, Section of Periodontics, Sapienza University of Rome, Rome, Italy
| | - Paolo De Ninis
- "Luisa D'Annunzio" Institute for High Culture, Pescara, Italy
| | - Beatrice Femminella
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University, Chieti-Pescara, Italy
| |
Collapse
|
68
|
Liu X, He X, Jin D, Wu S, Wang H, Yin M, Aldalbahi A, El-Newehy M, Mo X, Wu J. A biodegradable multifunctional nanofibrous membrane for periodontal tissue regeneration. Acta Biomater 2020; 108:207-222. [PMID: 32251784 DOI: 10.1016/j.actbio.2020.03.044] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 01/14/2023]
Abstract
Biomaterial-based membranes represent a promising therapeutic option for periodontal diseases. Although conventional periodontal membranes function greatly in preventing the ingrowth of both fibroblasts and epithelial cells as well as connective tissues, they are not capable of promoting periodontal tissue regeneration. Here, we report a multifunctional periodontal membrane prepared by electrospinning biodegradable polymers with magnesium oxide nanoparticles (nMgO). nMgO is a light metal-based nanoparticle with high antibacterial capacity and can be fully resorbed in the body. Our results showed that incorporating nMgO into poly(L-lactic acid) (PLA)/gelatin significantly improved the overall properties of membranes, including elevated tensile strength to maintain structural stability and adjusted degradation rate to fit the time window of periodontal regeneration. Acidic degradation products of PLA were neutralized by alkaline ions from nMgO hydrolysis, ameliorating pH microenvironment beneficial for cell proliferation. In vitro studies demonstrated considerable antibacterial and osteogenic properties of nMgO-incorporated membranes that are highly valuable for periodontal regeneration. Further investigations in a rat periodontal defect model revealed that nMgO-incorporated membranes effectively guided periodontal tissue regeneration. Taken together, our data indicate that nMgO-incorporated membranes might be a promising therapeutic option for periodontal regeneration. STATEMENT OF SIGNIFICANCE: Traditional clinical treatments of periodontal diseases largely focus on the management of the pathologic processes, which cannot effectively regenerate the lost periodontal tissue. GTR, a classic method for periodontal regeneration, has shown promise in clinical practice. However, the current membranes might not fully fulfill the criteria of ideal membranes. Here, we report bioabsorbable nMgO-incorporated nanofibrous membranes prepared by electrospinning to provide an alternative for the clinical practice of GTR. The membranes not only function greatly as physical barriers but also exhibit high antibacterial and osteoinductive properties. We therefore believe that this study will inspire more practice work on the development of effective GTR membranes for periodontal regeneration.
Collapse
Affiliation(s)
- Xuezhe Liu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, PR China
| | - Xi He
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, PR China
| | - Dawei Jin
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, PR China
| | - Shuting Wu
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, PR China
| | - Hongsheng Wang
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, PR China
| | - Meng Yin
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, PR China
| | - Ali Aldalbahi
- Department of Chemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohamed El-Newehy
- Department of Chemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Xiumei Mo
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, PR China.
| | - Jinglei Wu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, PR China; Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, PR China.
| |
Collapse
|
69
|
Abe GL, Sasaki JI, Katata C, Kohno T, Tsuboi R, Kitagawa H, Imazato S. Fabrication of novel poly(lactic acid/caprolactone) bilayer membrane for GBR application. Dent Mater 2020; 36:626-634. [DOI: 10.1016/j.dental.2020.03.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/03/2020] [Accepted: 03/12/2020] [Indexed: 12/11/2022]
|
70
|
Potentials of sandwich-like chitosan/polycaprolactone/gelatin scaffolds for guided tissue regeneration membrane. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 109:110618. [DOI: 10.1016/j.msec.2019.110618] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 11/29/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022]
|
71
|
Abdal-Wahab M, Abdel Ghaffar KA, Ezzatt OM, Hassan AAA, El Ansary MMS, Gamal AY. Regenerative potential of cultured gingival fibroblasts in treatment of periodontal intrabony defects (randomized clinical and biochemical trial). J Periodontal Res 2020; 55:441-452. [PMID: 32080858 DOI: 10.1111/jre.12728] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 11/22/2019] [Accepted: 12/11/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Defective cellular elements constitute an important challenge to achieve predictable periodontal regeneration. In an attempt to improve the cellularity of periodontal defects, gingival fibroblasts were implanted without their associated extracellular elements in periodontal defects to expose them to periodontal tissue mediators. In order to investigate the regenerative potential of gingival fibroblasts translocated into periodontal defects, the present study was designed to clinically and biochemically investigate the use of gingival fibroblasts (GF) and their associated mesenchymal stem cells (GMSC) in the treatment of intrabony periodontal defects. METHODS A total of 20 subjects were randomly divided into two groups (n = 20). Group I: ten patients were included with ten intrabony periodontal defects that received β-calcium triphosphate (β-TCP) followed by collagen membrane defect coverage, while group II: (10 patients) ten periodontal defects received cultured gingival fibroblasts (GF) on the β-TCP scaffold and covered by a collagen membrane. The clinical evaluation was carried out at the beginning and at 6 months. Gingival crevicular fluid (GCF) samples were collected directly from the test sites for the quantitative measurement of PDGF-BB and BMP-2 using the ELISA kit at 1, 7, 14, and 21 days after surgery. RESULTS Group II reported a significantly greater reduction in vertical pocket depth (VPD) and CAL gain compared with group I after 6 months. Radiographic bone gain was statistically higher in group II compared with group I. A significantly higher concentration of PDGF-BB was observed in group II on days 1, 3, and 7 compared with group I. CONCLUSIONS Translocation of gingival fibroblasts from gingival tissue to periodontal defects could be a promising option that increases cellular elements with regeneration potential. The concept of total isolation of gingival fibroblasts using occlusive membranes must be re-evaluated.
Collapse
Affiliation(s)
- Mahetab Abdal-Wahab
- Department of Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | | | - Ola M Ezzatt
- Department of Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | | | | | - Ahmed Y Gamal
- Department of Periodontology, Faculty of Dentistry, Nahda University, Cairo, Egypt
| |
Collapse
|
72
|
Bebel A, Rochette J. Guided Tissue Regeneration Therapy With Bone Augmentation in a Lingual, Infrabony Osseous Defect of a Mandibular Canine. J Vet Dent 2020; 36:266-276. [PMID: 32066323 DOI: 10.1177/0898756420905125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This case report describes the use of canine demineralized freeze-dried membrane allograft and cancellous bone graft material to treat an infrabony osseous defect along the lingual aspect of a left mandibular canine in a 10-year-old miniature dachshund. Postoperative examination 6 and 12 months postoperatively showed osseous integration at the infrabony defect and improvement in periodontal probing measurements.
Collapse
Affiliation(s)
| | - Judy Rochette
- West Coast Veterinary Dental Services, Vancouver, British Columbia, Canada
| |
Collapse
|
73
|
Shaikh MS, Ullah R, Lone MA, Matabdin H, Khan F, Zafar MS. Periodontal regeneration: a bibliometric analysis of the most influential studies. Regen Med 2020; 14:1121-1136. [PMID: 31957597 DOI: 10.2217/rme-2019-0019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Aim: The aim of the present study is to identify the most influential research articles and their main characteristics in the specialty of periodontal regeneration. Materials & methods: The Web of Science database advance search was performed in the subject category of 'Dentistry, Oral surgery and medicine' from January 2004 to October 2018 to retrieve citations data. Results: The majority of the articles were published in journals dedicated to the specialty of periodontology. Among the top-cited articles most emphasized study types were randomized control trials (n = 25) and reviews (n = 20). Conclusion: The present bibliometric analysis provides comprehensive information regarding the contributions made in the advancement of regenerative periodontal research. The authors from developed countries and affiliated with interdisciplinary/multicenter institutions have predominantly contributed.
Collapse
Affiliation(s)
- Muhammad S Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University Karachi, Pakistan
| | - Rizwan Ullah
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University Karachi, Pakistan
| | - Mohid A Lone
- Department of Oral Pathology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University Karachi, Pakistan
| | - Hesham Matabdin
- Department of Periodontics, Eastman Dental Institute, University College London, London, UK
| | - Fahad Khan
- Faculty of Healthcare & Medical Sciences, Anglia Ruskin University Cambridge, UK
| | - Muhammad S Zafar
- Department of Restorative Dentistry, Taibah University, Madina Munawwarra, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
| |
Collapse
|
74
|
Chang KC, Lin DJ, Wu YR, Chang CW, Chen CH, Ko CL, Chen WC. Characterization of genipin-crosslinked gelatin/hyaluronic acid-based hydrogel membranes and loaded with hinokitiol: In vitro evaluation of antibacterial activity and biocompatibility. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 105:110074. [DOI: 10.1016/j.msec.2019.110074] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/26/2019] [Accepted: 08/10/2019] [Indexed: 12/15/2022]
|
75
|
Sallum EA, Ribeiro FV, Ruiz KS, Sallum AW. Experimental and clinical studies on regenerative periodontal therapy. Periodontol 2000 2019; 79:22-55. [PMID: 30892759 DOI: 10.1111/prd.12246] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The recognition of a periodontal therapy as a regenerative procedure requires the demonstration of new cementum, periodontal ligament, and bone coronal to the base of the defect. A diversity of regenerative strategies has been evaluated, including root surface conditioning, bone grafts and bone substitute materials, guided tissue regeneration, enamel matrix proteins, growth/differentiation factors, combined therapies and, more recently, tissue-engineering approaches. The aim of this chapter of Periodontology 2000 is to review the research carried out in Latin America in the field of periodontal regeneration, focusing mainly on studies using preclinical models (animal models) and randomized controlled clinical trials. This review may help clinicians and researchers to evaluate the current status of the therapies available and to discuss the challenges that must be faced in order to achieve predictable periodontal regeneration in clinical practice.
Collapse
Affiliation(s)
- Enilson A Sallum
- Division of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Fernanda V Ribeiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, São Paulo, Brazil
| | - Karina S Ruiz
- Division of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Antonio W Sallum
- Division of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| |
Collapse
|
76
|
KESMEZ Ö. Preparation of anti-bacterial biocomposite nanofibers fabricated by electrospinning method. JOURNAL OF THE TURKISH CHEMICAL SOCIETY, SECTION A: CHEMISTRY 2019. [DOI: 10.18596/jotcsa.590621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
77
|
Effects of argon plasma treatment on the osteoconductivity of bone grafting materials. Clin Oral Investig 2019; 24:2611-2623. [PMID: 31748982 DOI: 10.1007/s00784-019-03119-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/07/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND The osteoconductive properties of bone grafting materials represent one area of research for the management of bony defects found in the fields of periodontology and oral surgery. From a physico-chemical aspect, the wettability of the graft has been demonstrated to be one of the most important factors for new bone formation. It is also well-known that argon plasma treatment (PAT) and ultraviolet irradiation (UV) may increase the surface wettability and, consequently, improve the regenerative potential of the bone grafts. Therefore, the aim of the present in vitro study was to evaluate the effect of PAT and UV treatment on the osteoconductive potential of various bone grafts. MATERIALS AND METHODS The following four frequently used bone grafts were selected for this study: synthetic hydroxyapatite (Mg-HA), biphasic calcium phosphate (BCP), cancellous and cortical xenogenic bone matrices (CaBM, CoBM). Sixty-six serially numbered disks 10 mm in diameter were used for each graft material and randomly assigned to the following three groups: test 1 (PAT), test 2 (UV), and control (no treatment). Six samples underwent topographic analysis using SEM pre- and post-treatments to evaluate changes in surface topography/characteristics. Additionally, cell adhesion and cell proliferation were evaluated at 2 and 72 h respectively following incubation in a three-dimensional culture system utilizing a bioreactor. Furthermore, the effects of PAT and UV on immune cells were assessed by measuring the viability of human macrophages at 24 h. RESULTS The topographic analysis showed different initial morphologies of the commercial biomaterials (e.g., Mg-HA and BCP showed flat morphology; BM samples were extremely porous with high roughness). The surface analysis following experimental treatments did not demonstrate topographical difference when compared with controls. Investigation of cells demonstrated that PAT treatment significantly increased cell adhesion of all 4 evaluated bone substitutes, whereas UV failed to show any statistically significant differences. The viability test revealed no differences in terms of macrophage adhesion on any of the tested surfaces. CONCLUSION Within their limitations, the present results suggest that treatment of various bone grafting materials with PAT appears to enhance the osteoconductivity of bone substitutes in the early stage by improving osteoblast adhesion without concomitantly affecting macrophage viability. CLINICAL RELEVANCE Treatment of bone grafts with PAT appears to result in faster osseointegration of the bone grafting materials and may thus favorably influence bone regeneration.
Collapse
|
78
|
Long-term Effects of Augmented Corticotomy-Assisted Orthodontics in Patients With Mandibular Anterior Alveolar Defect. J Craniofac Surg 2019; 30:e737-e740. [DOI: 10.1097/scs.0000000000005742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
79
|
Limoee M, Moradipour P, Godarzi M, Arkan E, Behbood L. Fabrication and in-vitro Investigation of Polycaprolactone - (Polyvinyl Alcohol/Collagen) Hybrid Nanofiber as Anti-Inflammatory Guided Tissue Regeneration Membrane. Curr Pharm Biotechnol 2019; 20:1122-1133. [DOI: 10.2174/1389201020666190722161004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/23/2019] [Accepted: 07/13/2019] [Indexed: 01/03/2023]
Abstract
Background:
Periodontal disease is the most common oral condition that affects the tissue
surrounding the teeth. The oral cavity is colonized by an impressive array of micro-organisms, many of
which can colonize the implants such as Guided Tissue Regeneration (GTR) often utilized in recovering
procedures that result in inflammation interfering with the bone regeneration.
Methods:
In the current study, a nano-hybrid GTR membrane is developed as a heliacal structure scaffold
with localized drug delivery function (Ibuprofen) as an anti-inflammatory agent. Polycaprolactone
(PCL) and a blend of Polyvinyl alcohol (PVA)/collagen (Col) (50/50) were electrospun by electrospinning.
Ibuprofen (Ibu) was loaded once in the PCL context and once in the hydrophilic portion
(PVA/Col).
Results:
The in vitro release behavior was investigated in each case. Chemical and physical properties
were studied for each item. Morphology investigation indicated a heliacal structure with the total average
diameter of 1266 nm consististing of porous pores with the average diameter of 256nm.
Conclusion:
The membranes indicated proper mechanical properties and appropriate biodegradation
rate as a potential GTR membrane. The controlled and sustained release of Ibu was obtained from both
PCL and PVA/COL loaded membranes. Kinetic model study indicated the following zero-order and
Higuchi models for the optimum case of PCL loaded and PVA/Col Ibu loaded scaffolds respectively.
Collapse
Affiliation(s)
- Mazdak Limoee
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Pouran Moradipour
- Nano Drug Delivery research center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahnaz Godarzi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elham Arkan
- Nano Drug Delivery research center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila Behbood
- Nano Drug Delivery research center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
80
|
Lee C, Kim S, Kim J, Namgung D, Kim K, Ku Y. Supplemental periodontal regeneration by vertical ridge augmentation around dental implants. A preclinical in vivo experimental study. Clin Oral Implants Res 2019; 30:1118-1125. [PMID: 31436866 DOI: 10.1111/clr.13525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/08/2019] [Accepted: 07/10/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the supplemental periodontal regeneration on adjacent teeth by vertical ridge augmentation around dental implants. MATERIAL AND METHODS The second premolar and the fourth premolar were extracted from both sides of the mandible in four beagle dogs. After 2 months, defects of 3 mm and 5 mm deep were formed. In the test group, vertical ridge augmentation was performed around a dental implant, and in the control group, vertical ridge augmentation was performed without implant placement. The animals were euthanized 3 months after the procedure, and radiographic and histomorphometric analyses were performed. RESULTS Overall, the test group showed better results than the control group. The presence of new cementum in the histological examination of the test group confirmed that vertical ridge augmentation with proper space maintaining could contribute to periodontal regeneration of adjacent teeth. Statistically significant difference in new bone height (%) was found in group I (5-mm defect depth and implant placement, GBR) when compared with group III (5-mm defect depth, GBR) and IV (3-mm defect depth, GBR). New bone area (%) was statistically different between groups I and IV. CONCLUSIONS In conclusion, within the limitation of this study using mandibular residual ridges after extraction of a single tooth in dogs, grafted space was maintained by dental implants better in the deep defect (5-mm depth) than the shallow defect (3-mm depth). Vertical ridge augmentation around dental implants also promoted neighboring periodontal regeneration.
Collapse
Affiliation(s)
- Changseok Lee
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Junhwan Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Dajeong Namgung
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Kyounghwa Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Young Ku
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| |
Collapse
|
81
|
Guided Bone Regeneration Using BioGlue As a Barrier Material With and Without Biphasic Calcium Phosphate. J Craniofac Surg 2019; 30:1308-1313. [PMID: 31163569 DOI: 10.1097/scs.0000000000005428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to investigate the effects of Bioglue as a mechanical barrier with or without biphasic calcium phosphate (BCP) in a rat tibia model. Sixty Sprague Dawley male rats weighing 250 ± 20 g and 10 to 12 weeks of age were studied. Unicortical defects were created on the right tibia of all rats. Subjects were randomly divided into 3 groups. BioGlue group (24 rats); BioGlue alone, Graft group (24 rats); BioGlue + BCP and Control group; unfilled and uncovered (12 rats). Animals were euthanized at 7th, 21st, and 45th days postoperatively for histological and histomorphometric analyses. BioGlue material exhibited no adverse effects until the end of observation period. Bone-healing scores did not differ statistically between Control and BioGlue group, but found to be lower in Graft group on 21st and 45th days, (P < 0.001 and P < 0.01 on the 21st day and P < 0.01 and P < 0.05 on the 45th day, respectively). New bone formation in Graft group was found to be statistically different from Control group on the 7th and 21st days (P < 0.01 and P < 0.05 respectively), whereas no statistical difference was observed between BioGlue and Control group at all times. The present analysis indicates that BioGlue functioned well as a mechanical barrier allowing new bone formation. No additional benefit of combination treatment was detected in this study design and BCP did not offer any advantage for bone regeneration, thus it can serve as only a space maintainer.
Collapse
|
82
|
Górski B, Jalowski S, Górska R, Zaremba M. Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: a 4-year follow-up of a randomized controlled trial. Clin Oral Investig 2019; 24:1183-1196. [PMID: 31324986 DOI: 10.1007/s00784-019-02982-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/20/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE (1) To assess long-term outcomes 4 years following guided tissue regeneration (GTR) of intrabony defects in patients diagnosed with aggressive periodontitis (AgP) and (2) to identify predictors of clinical attachment level (CAL) gain and bone/graft density gain. MATERIALS AND METHODS In 15 patients, two deep intrabony defects were randomly treated with xenogenic graft plus modified perforated membranes (MPM, tests) or xenogenic graft plus standard collagen membranes (CM, controls). After 4 years, clinical and radiographic outcomes were evaluated and compared with outcomes at baseline and after 1 year. RESULTS After 4 years, 14 test sites and 13 control sites were available for analysis. One tooth was lost as a result of root fracture. There were significant improvements in all evaluated parameters after 1 and 4 years in relation to baseline, but no differences were observed between tests and controls. However, some non-significant changes were found between 1 and 4 years. Regression analyses showed that recurrence of periodontitis was a significant predictor for CAL gain (p = 0.001) and bone/graft density gain (p = 0.024) from 1 to 4 years. CONCLUSIONS GTR of intrabony defects in AgP with either standard or modified CM yielded similarly successful and maintainable clinical benefits for compromised teeth 4 years following the surgery. The use of MPM showed no additional benefit. CLINICAL RELEVANCE This study demonstrates that most of the positive outcomes of GTR in AgP may be preserved over 4 years. Periodontitis recurrence might influence long-term outcomes.
Collapse
Affiliation(s)
- Bartłomiej Górski
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, Miodowa St 18, 00-246, Warsaw, Poland.
| | - Stanisław Jalowski
- Department of Dental and Maxillofacial Radiology, Medical University of Warsaw, Nowogrodzka St 59, 02-006, Warsaw, Poland
| | - Renata Górska
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, Miodowa St 18, 00-246, Warsaw, Poland
| | - Maciej Zaremba
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, Miodowa St 18, 00-246, Warsaw, Poland
| |
Collapse
|
83
|
Hemaid S, Saafan A, Hosny M, Wimmer G. Enhancement of Healing of Periodontal Intrabony Defects Using 810 nm Diode Laser and Different Advanced Treatment Modalities: A Blind Experimental Study. Open Access Maced J Med Sci 2019; 7:1847-1853. [PMID: 31316672 PMCID: PMC6614254 DOI: 10.3889/oamjms.2019.484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Low-level laser therapy (LLLT) in the early stage of bone healing was demonstrated as a positive local biostimulative effect. It was also shown that platelet-rich fibrin (PRF) and nanohydroxyapatite alloplast (NanoHA) are effective in treating periodontal intrabony defects. AIM The study aimed to evaluate the combined effects of LLLT (810 nm), PRF and NanoHA on induced intrabony periodontal defects healing. MATERIAL AND METHODS The study was conducted on 16 defects in 8 adult male rabbits (n = 16) divided into 4 groups; Control non-treated group (C), laser irradiated control group (CL), PRF+NanoHA graft (NanoHA-Graft+PRF) treated group and laser irradiated and treated group (NanoHA-Graft+PRF+L). CT radiography was made at baseline, 15 and 30 days later. The defects were induced in the form of one osseous wall defects of 10 mm height, 4 mm depth between the 1st and the 2nd molars using a tapered fissure drill coupled to a high-speed motor. Statistical analysis was done using ANOVA. RESULTS (NanoHA-Graft+PRF+L) group significantly produced bone density higher than C, CL and NanoHA-G+PRF alone. CONCLUSION The combination of LLLT+PRF+NanoHA as a treatment modality induced the best results in bone formation in the bone defect more than LLLT alone or PRF+NanoHA alone.
Collapse
Affiliation(s)
- Shrief Hemaid
- Dental Laser Applications, Department of Medical Applications of Laser, National Institute for Laser Enhanced Sciences, Cairo University, Cairo, Egypt
| | - Ali Saafan
- Dental Laser Applications, Department of Medical Applications of Laser, National Institute for Laser Enhanced Sciences, Cairo University, Cairo, Egypt
| | - Manal Hosny
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Gernot Wimmer
- Department of Oral Medicine and Periodontology, Meduni Graz, Graz, Austria
| |
Collapse
|
84
|
Mehrotra S, Chowdhary Z, Rastogi T. Evaluation and comparison of hydroxyapatite crystals with collagen fibrils bone graft alone and in combination with guided tissue regeneration membrane. J Indian Soc Periodontol 2019; 23:234-241. [PMID: 31143004 PMCID: PMC6519101 DOI: 10.4103/jisp.jisp_386_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 10/02/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The combination of collagen in bone grafts is being used because of its properties that accentuate the degree of regeneration. Furcation involvement poses challenge to the prognosis of a tooth, the use of bone grafts and a combination of grafts and membranes have proved to be beneficial in the treatment of furcation defects. Thus, the aim of the present study was to clinically evaluate and compare the effectiveness of collagen fiber bone graft with and without a membrane in the treatment of mandibular Grade II furcation defects. MATERIALS AND METHODS A clinical split-mouth randomized control trial, which included ten patients having bilateral mandibular Grade II furcation defects, was randomly assigned to Group I, treated with bone graft of hydroxyapatite with collagen fibers, and Group II, treated with bone graft of hydroxyapatite with collagen fibers and guided tissue regeneration membrane of polyglycolide and polylactide copolymer, respectively. The clinical measurements were recorded at baseline and 6 months after surgery; and plaque and gingival index were recorded at baseline and at 3 and 6 months after surgery. The data obtained was statistically evaluated. RESULTS The overall results showed that the treatment procedures demonstrated statistically significant reduction in probing pocket depth, vertical defect fill, and horizontal depth of furcation, with a gain in clinical attachment level. On comparison of both the groups, Group II showed superior results with a statistically significant difference in all parameters except in gingival recession. CONCLUSION The findings of the study demonstrated superior clinical results obtained with hydroxyapatite with collagen fibers, used in combination with polyglycolide and polylactide copolymer as compared to used alone in the treatment of Grade II furcation defects.
Collapse
Affiliation(s)
- Shalabh Mehrotra
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Zoya Chowdhary
- Department of Periodontology, Indira Gandhi Government Dental College, Jammu, Jammu and Kashmir, India
| | | |
Collapse
|
85
|
Yang Z, Gao X, Zhou M, Kuang Y, Xiang M, Li J, Song J. Effect of metformin on human periodontal ligament stem cells cultured with polydopamine‐templated hydroxyapatite. Eur J Oral Sci 2019; 127:210-221. [DOI: 10.1111/eos.12616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Zun Yang
- College of Stomatology Chongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
| | - Xiang Gao
- College of Stomatology Chongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
| | - Mengjiao Zhou
- College of Stomatology Chongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
| | - Yunchun Kuang
- College of Stomatology Chongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
| | - Mingli Xiang
- College of Stomatology Chongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
| | - Jie Li
- College of Stomatology Chongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
| | - Jinlin Song
- College of Stomatology Chongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
| |
Collapse
|
86
|
Influence of Cigarette Smoke Inhalation on an Autogenous Onlay Bone Graft Area in Rats with Estrogen Deficiency: A Histomorphometric and Immunohistochemistry Study. Int J Mol Sci 2019; 20:ijms20081854. [PMID: 30991651 PMCID: PMC6515394 DOI: 10.3390/ijms20081854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The present study aimed to evaluate the influence of cigarette smoke inhalation on an autogenous onlay bone graft area, either covered with a collagen membrane or not, in healthy and estrogen-deficient rats through histomorphometry and immunohistochemistry. MATERIALS AND METHODS Sixty female rats (Wistar), weighing 250-300 g, were randomly divided and allocated into groups (either exposed to cigarette smoke inhalation or not, ovariectomized and SHAM). After 15 days, the test group underwent cigarette smoke inhalation. Sixty days after exposition, autogenous bone grafting was only performed on all right hemimandibles, and the left ones underwent autogenous onlay bone grafting with the collagen membrane (BioGide®). The graft was harvested from the parietal bone and attached to the animals' jaws (right and left). They were euthanized at 21, 45, and 60 days after grafting. Histological measurements and immunohistochemical analyses were performed, and results were submitted to a statistical analysis. RESULTS The addition of a collagen membrane to the bone graft proved more efficient in preserving graft area if compared to the graft area without a collagen membrane and the one associated with cigarette smoke inhalation at 21 (p = 0.0381) and 60 days (p = 0.0192), respectively. Cigarette smoke inhalation combined with ovariectomy promoted a significant reduction of the autogenous graft area at 21 and 60 days. At 45 days, no statistically significant results were observed. In the immunohistochemical analysis, the ovariectomized and smoking subgroups, combined or not with collagen membrane, received moderate and intense immunolabeling at 21 days for Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL) (p = 0.0017 and p = 0.0381, respectively). For Osteoprotegerin (OPG), intense immunolabeling was observed in most subgroups under analysis at 60 days. CONCLUSION Smoking inhalation promoted resorption on the autogenous onlay bone graft, mainly when associated with ovariectomy. Furthermore, when associated with the collagen membrane, a lower resorption rate was observed if compared to the absence of the membrane.
Collapse
|
87
|
Past, Present, and Future of Regeneration Therapy in Oral and Periodontal Tissue: A Review. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9061046] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic periodontitis is the most common disease which induces oral tissue destruction. The goal of periodontal treatment is to reduce inflammation and regenerate the defects. As the structure of periodontium is composed of four types of different tissue (cementum, alveolar bone periodontal ligament, and gingiva), the regeneration should allow different cell proliferation in the separated spaces. Guided tissue regeneration (GTR) and guided bone regeneration (GBR) were introduced to prevent epithelial growth into the alveolar bone space. In the past, non-absorbable membranes with basic functions such as space maintenance were used with bone graft materials. Due to several limitations of the non-absorbable membranes, membranes of the second and third generation equipped with controlled absorbability, and a functional layer releasing growth factors or antimicrobials were introduced. Moreover, tissue engineering using biomaterials enabled faster and more stable tissue regeneration. The scaffold with three-dimensional structures manufactured by computer-aided design and manufacturing (CAD/CAM) showed high biocompatibility, and promoted cell infiltration and revascularization. In the future, using the cell sheath, pre-vascularizing and bioprinting techniques will be applied to the membrane to mimic the original tissue itself. The aim of the review was not only to understand the past and the present trends of GTR and GBR, but also to be used as a guide for a proper future of regeneration therapy in the oral region.
Collapse
|
88
|
Lin WC, Yao C, Huang TY, Cheng SJ, Tang CM. Long-term in vitro degradation behavior and biocompatibility of polycaprolactone/cobalt-substituted hydroxyapatite composite for bone tissue engineering. Dent Mater 2019; 35:751-762. [PMID: 30857736 DOI: 10.1016/j.dental.2019.02.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 02/13/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Currently, infections due to foreign-body reactions caused by bacteria or implant materials at the wound site are one of the major reasons for the failure of guided tissue regeneration (GTR) and guided bone regeneration (GBR) in clinical applications. The purpose of this study was to develop regeneration membranes with localized cobalt ion release to reduce infection and inflammation by polycaprolactone (PCL)/cobalt-substituted hydroxyapatite (CoHA). METHODS The PCL composite membrane containing 20 wt% CoHA powders was prepared by solvent casting. The surface morphology, crystal structure, chemical composition and thermal properties of PCL composite membranes were characterized. The biocompatibility, osteogenic differentiation and antibacterial properties of composite membrane were also investigated. Then, in biodegradability was assessed by immersing phosphate buffer solution (PBS) for 6 months. RESULTS Physicochemical analyses revealed that CoHA is evenly mixed in the membranes and assistance reduce the crystallinity of PCL for getting more degradation amounts than PCL membrane. Osteoblast cells culture on the membrane showed that the CoHA significantly increases cell proliferation and found the calcium deposition production increased over 90% compared with PCL after 7 days of culture. A good antibacterial effect was achieved by the addition of CoHA powder. The results were confirmed by 2.4 times reduction of proliferation of Escherichia coli (E. coli) seeded on the composite membrane after 24 h. Immersing in PBS for 6 months indicated that PCL-CoHA composite membrane has improved biodegradation and can continuously remove free radicals to reduce the inflammatory response. SIGNIFICANCE The PCL-CoHA composite membrane with suitable releasing of cobalt ion can be considered as a potential choice for bone tissue regeneration.
Collapse
Affiliation(s)
- Wei-Chun Lin
- Graduate Institute of Oral Science, Chung Shan Medical University, Taichung 40201, Taiwan.
| | - Chenmin Yao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Ting-Yun Huang
- Graduate Institute of Oral Science, Chung Shan Medical University, Taichung 40201, Taiwan.
| | - Shih-Jung Cheng
- Department of Dentistry, Chung Shan Medical University, Taiwan.
| | - Cheng-Ming Tang
- Graduate Institute of Oral Science, Chung Shan Medical University, Taichung 40201, Taiwan; Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| |
Collapse
|
89
|
Wang Y, Li H, Feng Y, Jiang P, Su J, Huang C. Dual micelles-loaded gelatin nanofibers and their application in lipopolysaccharide-induced periodontal disease. Int J Nanomedicine 2019; 14:963-976. [PMID: 30787610 PMCID: PMC6368126 DOI: 10.2147/ijn.s182073] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Combined therapies utilizing inhibitors to remove pathogens are needed to suppress lipopolysaccharide (LPS)-induced periodontal disease. We prepared a novel, multi-agent delivery scaffold for periodontal treatment. METHODS In this study, we synthesized SP600125 (a JNK inhibitor) and SB203580 (a p38 inhibitor) drug-loaded poly(ethylene glycol)-block-caprolactone copolymer via dialysis method. The physical property of micelles was characterized through dynamic light scattering and transmission electron microscopy. The cell growth and LPS-induced MMP-2 and MMP-13 expression were evaluated through CCK-8, real-time PCR and Western blot assay. The release of SP600125 and SB203580 from different scaffolds was estimated. Microcomputed tomography and histology were used for evaluating the effect of the micelles-loaded nanofibers on the treatment of class II furcation defects in dogs. RESULTS The drug was then successfully incorporated into gelatin fibers during electrospinning process. We confirmed that the micelles had spherical structure and an average particle size of 160 nm for SP600125-micelles (SP-Ms) and 150 nm for SB203580-micelles (SB-Ms). The nanofiber scaffold showed excellent encapsulation capability, in vitro drug-release behavior, and cell compatibility. Real-time PCR and Western blot assay further indicated that LPS-induced MMP-2 and MMP-13 expression was significantly inhibited by the scaffold. CONCLUSION The results suggested that the dual drug-loaded system developed in this study might become a highly effective therapy for periodontal disease.
Collapse
Affiliation(s)
- Yabing Wang
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China,
| | - Haoxuan Li
- Key Laboratory of Textile Science & Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China,
| | - Yanhuizhi Feng
- Department of Periodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
| | - Peilin Jiang
- Key Laboratory of Textile Science & Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China,
| | - Jiansheng Su
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China,
| | - Chen Huang
- Key Laboratory of Textile Science & Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China,
| |
Collapse
|
90
|
Jackson N, Assad M, Vollmer D, Stanley J, Chagnon M. Histopathological Evaluation of Orthopedic Medical Devices: The State-of-the-art in Animal Models, Imaging, and Histomorphometry Techniques. Toxicol Pathol 2019; 47:280-296. [DOI: 10.1177/0192623318821083] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Orthopedic medical devices are continuously evolving for the latest clinical indications in craniomaxillofacial, spine, trauma, joint arthroplasty, sports medicine, and soft tissue regeneration fields, with a variety of materials from new metallic alloys and ceramics to composite polymers, bioresorbables, or surface-treated implants. There is great need for qualified medical device pathologists to evaluate these next generation biomaterials, with improved biocompatibility and bioactivity for orthopedic applications, and a broad range of knowledge is required to stay abreast of this ever-changing field. Orthopedic implants require specialized imaging and processing techniques to fully evaluate the bone-implant interface, and the pathologist plays an important role in determining the proper combination of histologic processing and staining for quality slide production based on research and development trials and validation. Additionally, histomorphometry is an essential part of the analysis to quantify tissue integration and residual biomaterials. In this article, an overview of orthopedic implants and animal models, as well as pertinent insights for tissue collection, imaging, processing, and slide generation will be provided with a special focus on histopathology and histomorphometry evaluation.
Collapse
Affiliation(s)
| | - Michel Assad
- AccelLAB Inc., A Citoxlab Company, Boisbriand, Quebec, Canada
| | | | | | | |
Collapse
|
91
|
DeBaun MR, Stahl AM, Daoud AI, Pan CC, Bishop JA, Gardner MJ, Yang YP. Preclinical induced membrane model to evaluate synthetic implants for healing critical bone defects without autograft. J Orthop Res 2019; 37:60-68. [PMID: 30273977 DOI: 10.1002/jor.24153] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 09/12/2018] [Indexed: 02/04/2023]
Abstract
Critical bone defects pose a formidable orthopaedic problem in patients with bone loss. We developed a preclinical model based on the induced membrane technique using a synthetic graft to replace autograft for healing critical bone defects. Additionally, we used a novel osteoconductive scaffold coupled with a synthetic membrane to evaluate the potential for single-stage bone regeneration. Three experimental conditions were investigated in critical femoral defects in rats. Group A underwent a two-stage procedure with insertion of a polymethylmethacrylate (PMMA) spacer followed by replacement with a 3D printed polycaprolactone(PCL)/β-tricalcium phosphate (β-TCP) osteoconductive scaffold after 4 weeks. Group B received a single-stage PCL/β-TCP scaffold wrapped in a PCL-based microporous polymer film creating a synthetic membrane. Group C received a single-stage bare PCL/β-TCP scaffold. All groups were examined by serial radiographs for callus formation. After 12 weeks, the femurs were explanted and analyzed with micro-CT and histology. Mean callus scores tended to be higher in Group A. Group A showed statistically significant greater bone formation on micro-CT compared with other groups, although bone volume fraction was similar between groups. Histology results suggested extensive bone ingrowth and new bone formation within the macroporous scaffolds in all groups and cell infiltration into the microporous synthetic membrane. This study supports the use of a critical size femoral defect in rats as a suitable model for investigating modifications to the induced membrane technique without autograft harvest. Future investigations should focus on bioactive synthetic membranes coupled with growth factors for single-stage bone healing. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
Collapse
Affiliation(s)
- Malcolm R DeBaun
- Departiment of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Alexander M Stahl
- Departiment of Orthopaedic Surgery, Stanford University, Stanford, California.,Departiment of Chemistry, Stanford University, Stanford, California
| | - Adam I Daoud
- School of Medicine, Stanford University, Stanford, California
| | - Chi-Chun Pan
- Departiment of Orthopaedic Surgery, Stanford University, Stanford, California.,Departiment of Mechanical Engineering, Stanford University, Stanford, California
| | - Julius A Bishop
- Departiment of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Michael J Gardner
- Departiment of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Yunzhi P Yang
- Departiment of Orthopaedic Surgery, Stanford University, Stanford, California.,Material Science and Engineering, Stanford University, Stanford, California.,Departiment of Bioengineering, Stanford University, Stanford, California
| |
Collapse
|
92
|
Bakopoulou A, Georgopoulou Α, Grivas I, Bekiari C, Prymak O, Loza Κ, Epple M, Papadopoulos GC, Koidis P, Chatzinikolaidou Μ. Dental pulp stem cells in chitosan/gelatin scaffolds for enhanced orofacial bone regeneration. Dent Mater 2018; 35:310-327. [PMID: 30527589 DOI: 10.1016/j.dental.2018.11.025] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/19/2018] [Accepted: 11/20/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Biomimetic chitosan/gelatin (CS/Gel) scaffolds have attracted great interest in tissue engineering of several tissues. However, limited information exists regarding the potential of combining CS/Gel scaffolds with oral cells, such as dental pulp stem cells (DPSCs), to produce customized constructs targeting alveolar/orofacial bone reconstruction, which has been the aim of the present study. METHODS Two scaffold types, designated as CS/Gel-0.1 and CS/Gel-1, were fabricated using 0.1 and 1% (v/v) respectively of the crosslinker glutaraldehyde (GTA). Scaffolds (n=240) were seeded with DPSCs with/without pre-exposure to recombinant human BMP-2. In vitro assessment included DPSCs characterization (flow cytometry), evaluation of viability/proliferation (live/dead staining, metabolic-based tests), osteo/odontogenic gene expression analysis (qRT-PCR) and structural/chemical characterization (scanning electron microscopy, SEM; energy dispersive X-ray spectroscopy, EDX; X-ray powder diffraction, XRD; thermogravimetry, TG). In vivo assessment included implantation of DPSC-seeded scaffolds in immunocompromised mice, followed by histology and SEM-EDX. Statistical analysis employed one/two-way ANOVA and Tukey's post-hoc tests (significance for p<0.05). RESULTS Both scaffolds supported cell viability/proliferation over 14 days in culture, showing extensive formation of a hydroxyapatite-rich nanocrystalline calcium phosphate phase. Differential expression patterns indicated GTA concentration to significantly affect the expression of osteo/odontogenic genes, with CS/Gel-0.1 scaffolds being more effective in upregulating DSPP, IBSP and Osterix. In vivo analysis demonstrated time-dependent production of a nanocrystalline, mineralized matrix at 6, 8 and 10 weeks, being more prominent in constructs bearing rhBMP-2 pre-treated cells. The latter showed higher amounts of osteoid and fully mineralized bone, as well as empty space reduction. SIGNIFICANCE These results reveal a promising strategy for orofacial bone tissue engineering.
Collapse
Affiliation(s)
- Athina Bakopoulou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Greece
| | - Αnthie Georgopoulou
- Department of Materials Science and Technology, University of Crete, Heraklion, Greece
| | - Ioannis Grivas
- Department of Anatomy, Histology & Embryology, School of Veterinary Medicine, Faculty of Health Sciences, A.U.Th, Greece
| | - Chryssa Bekiari
- Department of Anatomy, Histology & Embryology, School of Veterinary Medicine, Faculty of Health Sciences, A.U.Th, Greece
| | - Oleg Prymak
- Inorganic Chemistry & Center for Nanointegration Duisburg-Essen (CeNIDE), University of Duisburg-Essen, Germany
| | - Κateryna Loza
- Inorganic Chemistry & Center for Nanointegration Duisburg-Essen (CeNIDE), University of Duisburg-Essen, Germany
| | - Matthias Epple
- Inorganic Chemistry & Center for Nanointegration Duisburg-Essen (CeNIDE), University of Duisburg-Essen, Germany
| | - George C Papadopoulos
- Department of Anatomy, Histology & Embryology, School of Veterinary Medicine, Faculty of Health Sciences, A.U.Th, Greece
| | - Petros Koidis
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Greece
| | - Μaria Chatzinikolaidou
- Department of Materials Science and Technology, University of Crete, Heraklion, Greece; Institute of Electronic Structure and Laser (IESL), Foundation for Research and Technology Hellas (FORTH), Heraklion, Greece.
| |
Collapse
|
93
|
Fahmy RA, Kotry GS, Ramadan OR. Periodontal regeneration of dehisence defects using a modified perforated collagen membrane. A comparative experimental study. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.fdj.2018.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
94
|
Natale Júnior V, Souza FÁ, Vedovatto E, Nishioka RS, Poli PP, Carvalho PSPD. Preservation of Dental Sockets Filled with Composite Bovine Bone. A Single-Blind Randomized Clinical Trial. Braz Dent J 2018; 29:583-591. [DOI: 10.1590/0103-6440201802064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/22/2018] [Indexed: 01/11/2023] Open
Abstract
Abstract The purpose of this study was to evaluate the preservation of alveolar dimensions in human fresh extraction sockets filled with a composite bovine bone graft by means of design of single-blind randomized clinical trial. Forty participants had monoradicular teeth extracted (one teeth in each participant), and after were randomly divided into 2 groups: individuals whose fresh sockets were filled with the composite heterologous bone graft (Biomaterial Group), or with blood clot (Control Group). After extraction, the fresh sockets were measured at their greatest mesiodistal (MD) and bucco-lingual/palatal (BL/P) distance. Primary closure of the soft tissue was performed with a fibro-mucosal plug. After 120 post-operative days, the re-entry procedure was performed and the largest MD and BL/P measurements were again obtained to calculate the remodeling of the alveolar bone measured in percentage. In the biomaterial group, a percentage reduction of 1.62% and 3.29% in the MD and BL/P dimensions was observed 120 days after the extractions, whereas a reduction of 4.97% and 7.18% in the MD and BL/P dimensions occurred in the control group. There was a statistically significant difference (p<0.05) between the two groups for the bucco-palatal and mesiodistal measurements in the maxilla. In view of the results obtained, it can be concluded that composite bovine bone graft limited but did not impede alveolar bone remodeling.
Collapse
Affiliation(s)
- Vail Natale Júnior
- Faculdade de Medicina e Odontologia e Centro de Pesquisas Odontológicas São Leopoldo Mandic, Brazil
| | | | - Eduardo Vedovatto
- Faculdade de Medicina e Odontologia e Centro de Pesquisas Odontológicas São Leopoldo Mandic, Brazil
| | | | | | - Paulo Sérgio Perri de Carvalho
- Faculdade de Medicina e Odontologia e Centro de Pesquisas Odontológicas São Leopoldo Mandic, Brazil; Universidade Estadual Paulista, Brazil
| |
Collapse
|
95
|
|
96
|
Camps-Font O, Caro-Bonfill C, Sánchez-Garcés MÀ, Gay-Escoda C. Periodontal Regenerative Therapy for Preventing Bone Defects Distal to Mandibular Second Molars After Surgical Removal of Impacted Third Molars: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Oral Maxillofac Surg 2018; 76:2482-2514. [DOI: 10.1016/j.joms.2018.07.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/22/2018] [Accepted: 07/22/2018] [Indexed: 12/15/2022]
|
97
|
Kaczmarek B, Sionkowska A, Otrocka-Domagała I, Polkowska I. In vivo studies of novel scaffolds with tannic acid addition. Polym Degrad Stab 2018. [DOI: 10.1016/j.polymdegradstab.2018.10.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
98
|
Siddeshappa ST, Bhatnagar S, Diwan V, Parvez H. Regenerative potential of subepithelial connective tissue graft in the treatment of periodontal infrabony defects. J Indian Soc Periodontol 2018; 22:492-497. [PMID: 30631227 PMCID: PMC6305092 DOI: 10.4103/jisp.jisp_312_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 07/02/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Due to high prevalence and progression of infrabony defects lead to increase in the possibility of tooth loss. Various regenerative techniques such as guided tissue regeneration, bone grafts, and biomimetic agents have been proposed. Subepithelial connective tissue graft (SCTG) is an autogenous membrane, which contains mesenchymal cells and has osteogenic, chondrogenic, and osteoblastic activities. The present study investigates the effective application of SCTG as an autogenous barrier membrane in the treatment of periodontal infrabony defect. MATERIALS AND METHODS Ten patients in the age group of 30-45 years suffering from chronic periodontitis with clinical and radiographic evidence of vertical defects were selected for the study. Clinical parameters evaluated were gingival index, plaque index, probing pocket depth, clinical attachment level, and gingival recession. These parameters were assessed at baseline, 6 and 9 months. Radiographic parameter (defect fill) was evaluated at baseline, 6, and 9 months postoperatively. Sites were treated with PERIOGLAS® and connective tissue graft. Statistical analysis was done using paired t-test. RESULTS All the patients finished the study. A significant improvement was observed regarding clinical parameters from baseline to 9 months. The radiographic defect fill was seen in all the cases at the end of 9 months, which was statistically significant in comparison with baseline scores. CONCLUSION SCTG could be effectively used as a barrier membrane for the treatment of periodontal infrabony defects.
Collapse
Affiliation(s)
| | - Shruti Bhatnagar
- Department of Periodontology, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Vikas Diwan
- Consultant Periodontist, Balaji Wards, Jagadalpur, Bastar, India
| | - Humera Parvez
- Consultant Periodontist, Ralas Enclave Society, Dagania, Raipur, Chhattisgarh, India
| |
Collapse
|
99
|
Neto AS, Ferreira JMF. Synthetic and Marine-Derived Porous Scaffolds for Bone Tissue Engineering. MATERIALS (BASEL, SWITZERLAND) 2018; 11:E1702. [PMID: 30216991 PMCID: PMC6165145 DOI: 10.3390/ma11091702] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/27/2018] [Accepted: 08/10/2018] [Indexed: 12/19/2022]
Abstract
Bone is a vascularized and connective tissue. The cortical bone is the main part responsible for the support and protection of the remaining systems and organs of the body. The trabecular spongy bone serves as the storage of ions and bone marrow. As a dynamic tissue, bone is in a constant remodelling process to adapt to the mechanical demands and to repair small lesions that may occur. Nevertheless, due to the increased incidence of bone disorders, the need for bone grafts has been growing over the past decades and the development of an ideal bone graft with optimal properties remains a clinical challenge. This review addresses the bone properties (morphology, composition, and their repair and regeneration capacity) and puts the focus on the potential strategies for developing bone repair and regeneration materials. It describes the requirements for designing a suitable scaffold material, types of materials (polymers, ceramics, and composites), and techniques to obtain the porous structures (additive manufacturing techniques like robocasting or derived from marine skeletons) for bone tissue engineering applications. Overall, the main objective of this review is to gather the knowledge on the materials and methods used for the production of scaffolds for bone tissue engineering and to highlight the potential of natural porous structures such as marine skeletons as promising alternative bone graft substitute materials without any further mineralogical changes, or after partial or total transformation into calcium phosphate.
Collapse
Affiliation(s)
- Ana S Neto
- Department of Materials and Ceramic Engineering, CICECO, University of Aveiro, 3810-193 Aveiro, Portugal.
| | - José M F Ferreira
- Department of Materials and Ceramic Engineering, CICECO, University of Aveiro, 3810-193 Aveiro, Portugal.
| |
Collapse
|
100
|
Zohery AA, Meshri SM, Madi MI, Abd El Rehim SS, Nour ZM. Egyptian propolis compared to nanohydroxyapatite graft in the treatment of Class II furcation defects in dogs. J Periodontol 2018; 89:1340-1350. [PMID: 29802626 DOI: 10.1002/jper.17-0685] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 04/27/2018] [Accepted: 04/27/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND Complementary and alternative medicine approaches are gaining ground in everyday practice. Propolis is a bee product that has been suggested to have bone regenerative effects. This study was conducted to compare the effectiveness of Egyptian propolis with nanohydroxyapatite graft on furcation defect regeneration in mongrel dogs. METHODS A split mouth design was utilized in six clinically healthy mongrel dogs. A total of 24 Class II furcation defects were surgically created in mandibular third and fourth premolars. The defects on the right side were filled with nanohydroxyapatite graft and covered with collagen membrane, while on the left side the defects were filled with propolis and also covered with collagen membrane. The dogs were sacrificed after 1 and 3 months. Segments containing the defects were prepared for histological evaluation. RESULTS The histological evaluation after one month revealed newly formed bone in both treatment groups. However, after 3 months, the bone trabeculae appeared thinner in the collagen/nanohydroxyapatite group than in the collagen/propolis group. The histomorphometric evaluation showed a significant increase in bone height as well as bone surface area for the collagen/propolis group compared to collagen/nanohydroxyapatite group. CONCLUSIONS Both Egyptian propolis and nanohydroxyapatite graft material showed favorable periodontal regenerative effect. Propolis showed increased cellular proliferative ability that could be beneficial in reducing the healing period needed after periodontal therapy.
Collapse
Affiliation(s)
- Amr A Zohery
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Radiology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Suzanne M Meshri
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Radiology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Marwa I Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Zubaida M Nour
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University
| |
Collapse
|