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Zhu H, Blahnová VH, Perale G, Xiao J, Betge F, Boniolo F, Filová E, Lyngstadaas SP, Haugen HJ. Xeno-Hybrid Bone Graft Releasing Biomimetic Proteins Promotes Osteogenic Differentiation of hMSCs. Front Cell Dev Biol 2020; 8:619111. [PMID: 33415112 PMCID: PMC7784409 DOI: 10.3389/fcell.2020.619111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/30/2020] [Indexed: 01/04/2023] Open
Abstract
Bone defect is a noteworthy health problem and is the second most transplanted tissue after blood. Numerous bone grafts are designed and applied in clinics. Limitations, however, from different aspects still exist, including limited supply, mechanical strength, and bioactivity. In this study, two biomimetic peptides (P2 and P6) are incorporated into a composite bioactive xeno hybrid bone graft named SmartBonePep®, with the aim to increase the bioactivity of the bone graft. The results, which include cytotoxicity, proliferation rate, confocal microscopy, gene expression, and protein qualification, successfully prove that the SmartBonePep® has multi-modal biological effects on human mesenchymal stem cells from bone marrow. The effective physical entrapment of P6 into a composite xeno-hybrid bone graft, withstanding manufacturing processes including exposure to strong organic solvents and ethylene oxide sterilization, increases the osteogenic potential of the stem cells as well as cell attachment and proliferation. P2 and P6 both show a strong biological potential and may be future candidates for enhancing the clinical performance of bone grafts.
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Affiliation(s)
- Hao Zhu
- Department of Orthopedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Veronika Hefka Blahnová
- Department of Tissue Engineering, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia
- Department of Biophysics, Second Faculty of Medicine, Charles University, Prague, Czechia
| | - Giuseppe Perale
- Industrie Biomediche Insubri S.A., Mezzovico-Vira, Switzerland
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria
- Faculty of Biomedical Sciences, University of Southern Switzerland, Lugano, Switzerland
| | - Jun Xiao
- Department of Orthopedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Felice Betge
- Industrie Biomediche Insubri S.A., Mezzovico-Vira, Switzerland
| | - Fabio Boniolo
- Helmholtz Zentrum München Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), Neuherberg, Germany
| | - Eva Filová
- Department of Tissue Engineering, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia
- Department of Biophysics, Second Faculty of Medicine, Charles University, Prague, Czechia
| | - Ståle Petter Lyngstadaas
- Corticalis AS, Oslo, Norway
- Department of Biomaterials, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Håvard Jostein Haugen
- Corticalis AS, Oslo, Norway
- Department of Biomaterials, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Abstract
Some treatment options available to repair bone defects are the use of autogenous and allogeneic bone grafts. The drawback of the first one is the donor site’s limitation and the need for a second operation on the same patient. In the allograft method, the problems are associated with transmitted diseases and high susceptibility to rejection. As an alternative to biological grafts, polymers can be used in bone repair. Some polymers used in the orthopedic field are poly(methyl methacrylate), poly(ether-ether-ketone), and ultra-high molecular weight polyethylene (UHMWPE). UHMWPE has drawn much attention since it combines low friction coefficient and high wear and impact resistance. However, UHMWPE is a bioinert material, which means that it does not interact with the bone tissue. UHMWPE composites and nanocomposites with hydroxyapatite (HA) are widely studied in the literature to mitigate these issues. HA is the main component of the inorganic phase in the natural bone, and the addition of this bioactive filler to the polymeric matrix aims to mimic bone composition. This brief review discusses some polymers used in orthopedic applications, focusing on the UHMWPE/HA composites as a potential bone substitute.
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203
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Safety and Efficacy Results of BonoFill First-in-Human, Phase I/IIa Clinical Trial for the Maxillofacial Indication of Sinus Augmentation and Mandibular Bone Void Filling. J Oral Maxillofac Surg 2020; 79:787-798.e2. [PMID: 33434518 DOI: 10.1016/j.joms.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE The gold standard for bone regeneration of bone deficiencies is still an autologous bone graft, which has considerable disadvantages; namely, the need for a second major surgery and the limited volume of bone available for harvesting. BonoFill (BF) is a novel, tissue-engineered, bone graft with intrinsic osteoinductive, osteoconductive, and osteogenic properties, consisting of the patient's own adipose tissue-derived mesenchymal stem cells, attached to hydroxyapatite particles. Here, we present the safety and efficacy results of BF first-in-human clinical study for maxillofacial bone tissue regeneration. MATERIALS AND METHODS Eleven eligible male and female subjects, aged 49-65 years, were enrolled into the clinical study in 2 clinical indications: Bone augmentation and bone void grafting in the jaws. Clinical follow-up was performed throughout a period of 6 months after BF treatment and included clinical examination, blood tests, CT scans, and biopsies collected from the transplantation site to assess chronic bone infection, changes in complete blood count, and adequate bone augmentation for implant placement. RESULTS The study results demonstrated that BF promoted adequate bone tissue regeneration without complications. Per our evaluation, there were no incidents of chronic bone infection, or significant changes in complete blood count, and the patients reported overall good health for the duration of the study. At trial end, in the sinus augmentation indication, the BF treated sites residual bone was augmented at an average of 6.36 mm (Δ new bone, n = 10) and the total bone height at the treated area was on average 11.44 mm (n = 10). In the indication of filling of bone voids, the patient's average residual bone height of 2.91 mm was 15.76 mm (n = 1) at trial end. CONCLUSIONS BF treatment was shown to be safe and resulted in newly generated bone, which provided adequate bone height for placement of dental implants. Thus, BF is a promising novel autologous bone graft for bone tissue repair.
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204
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Han SH, Cha M, Jin YZ, Lee KM, Lee JH. BMP-2 and hMSC dual delivery onto 3D printed PLA-Biogel scaffold for critical-size bone defect regeneration in rabbit tibia. Biomed Mater 2020; 16:015019. [DOI: 10.1088/1748-605x/aba879] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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205
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Velasco-Ortega E, Valente NA, Iezzi G, Petrini M, Derchi G, Barone A. Maxillary sinus augmentation with three different biomaterials: Histological, histomorphometric, clinical, and patient-reported outcomes from a randomized controlled trial. Clin Implant Dent Relat Res 2020; 23:86-95. [PMID: 33295137 DOI: 10.1111/cid.12964] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/16/2020] [Accepted: 10/30/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Lateral maxillary sinus augmentation (MSA) is a predictable bone regeneration technique in case of atrophy of the posterior-upper maxilla. Aimed at obtaining quantity and quality of bone suitable for receiving osseointegrated implants, its success is largely due to the skill of the surgeon, but also to the characteristics of the biomaterial used. METHODS Twenty-four patients needing MSA were included in the study. The patients were randomly allocated to three different groups: anorganic bovine bone mineral as control, tricalcium phosphate with or without hyaluronic acid (HA) as test groups. Nine months after MSA, bone biopsies were harvested for the histomorphometric analysis. Secondary outcomes were mean bone gain, intraoperative and postoperative complications, implant insertion torque, implant failure, and patient-reported outcome measures. RESULTS Although the percentage of new bone was not statistically different between the three groups (P = .191), the percentages of residual biomaterial was significantly higher (P < .000) and nonmineralized tissue significantly lower (P < .000) in the control than in the test groups. Test groups did not differ significantly from each other for all histomorphometric parameters. The implant insertion torque was significantly higher in the control group (P < .0005). The rest of the secondary outcomes were not significantly different between the groups. CONCLUSION MSA is a safe and predictable procedure in terms of histological, clinical, and PROAMs, regardless of the biomaterial used. The addition of HA did not influence the outcomes.
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Affiliation(s)
| | - Nicola Alberto Valente
- Department of Stomatology, Faculty of Dentistry, University of Seville, Seville, Spain.,Formerly, Unit of Oral Surgery and Implantology, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Science, University G. d'Annunzio of Chieti, Chieti, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Science, University G. d'Annunzio of Chieti, Chieti, Italy
| | - Giacomo Derchi
- Department of Surgical, Medical, Molecular and of the Critical Needs Pathologies, University-Hospital of Pisa, Complex Unit of Stomatology and Oral Surgery, Pisa, Italy
| | - Antonio Barone
- Formerly, Unit of Oral Surgery and Implantology, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland.,Department of Surgical, Medical, Molecular and of the Critical Needs Pathologies, University-Hospital of Pisa, Complex Unit of Stomatology and Oral Surgery, Pisa, Italy
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206
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Immobilizing magnesium ions on 3D printed porous tantalum scaffolds with polydopamine for improved vascularization and osteogenesis. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 117:111303. [DOI: 10.1016/j.msec.2020.111303] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/10/2020] [Accepted: 07/19/2020] [Indexed: 12/15/2022]
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207
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Rajendan AK, Arisaka Y, Yui N, Iseki S. Polyrotaxanes as emerging biomaterials for tissue engineering applications: a brief review. Inflamm Regen 2020; 40:27. [PMID: 33292785 PMCID: PMC7657355 DOI: 10.1186/s41232-020-00136-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/07/2020] [Indexed: 02/06/2023] Open
Abstract
The field of tissue engineering and regeneration constantly explores the possibility of utilizing various biomaterials' properties to achieve effective and uneventful tissue repairs. Polyrotaxanes (PRXs) are supramolecular assemblies, which possess interesting mechanical property at a molecular scale termed as molecular mobility. This molecular mobility could be utilized to stimulate various cellular mechanosignaling elements, thereby altering the cellular functions. Apart from this, the versatile nature of PRXs such as the ability to form complex with growth factors and peptides, numerous sites for chemical modifications, and processability into different forms makes them interesting candidates for applications towards tissue engineering. This literature briefly reviews the concepts of PRXs and molecular mobility, the versatile nature of PRXs, and its emerging utility towards certain tissue engineering applications.
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Affiliation(s)
- Arun Kumar Rajendan
- Section of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yoshinori Arisaka
- Department of Organic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda, Tokyo, 101-0062, Japan
| | - Nobuhiko Yui
- Department of Organic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda, Tokyo, 101-0062, Japan
| | - Sachiko Iseki
- Section of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
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208
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Coelho CC, Padrão T, Costa L, Pinto MT, Costa PC, Domingues VF, Quadros PA, Monteiro FJ, Sousa SR. The antibacterial and angiogenic effect of magnesium oxide in a hydroxyapatite bone substitute. Sci Rep 2020; 10:19098. [PMID: 33154428 PMCID: PMC7645747 DOI: 10.1038/s41598-020-76063-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/06/2020] [Indexed: 11/25/2022] Open
Abstract
Bone graft infections are serious complications in orthopaedics and the growing resistance to antibiotics is increasing the need for antibacterial strategies. The use of magnesium oxide (MgO) is an interesting alternative since it possesses broad-spectrum antibacterial activity. Additionally, magnesium ions also play a role in bone regeneration, which makes MgO more appealing than other metal oxides. Therefore, a bone substitute composed of hydroxyapatite and MgO (HAp/MgO) spherical granules was developed using different sintering heat-treatment cycles to optimize its features. Depending on the sintering temperature, HAp/MgO spherical granules exhibited distinct surface topographies, mechanical strength and degradation profiles, that influenced the in vitro antibacterial activity and cytocompatibility. A proper balance between antibacterial activity and cytocompatibility was achieved with HAp/MgO spherical granules sintered at 1100 ºC. The presence of MgO in these granules was able to significantly reduce bacterial proliferation and simultaneously provide a suitable environment for osteoblasts growth. The angiogenic and inflammation potentials were also assessed using the in vivo chicken embryo chorioallantoic membrane (CAM) model and the spherical granules containing MgO stimulated angiogenesis without increasing inflammation. The outcomes of this study evidence a dual effect of MgO for bone regenerative applications making this material a promising antibacterial bone substitute.
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Affiliation(s)
- Catarina C Coelho
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal. .,INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal. .,FEUP - Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, s/n, 4200-465, Porto, Portugal. .,FLUIDINOVA, S.A., Rua Engenheiro Frederico Ulrich, 2650, 4470-605, Maia, Portugal.
| | - Tatiana Padrão
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,ISEP - Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072, Porto, Portugal
| | - Laura Costa
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,FEUP - Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, s/n, 4200-465, Porto, Portugal
| | - Marta T Pinto
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,IPATIMUP - Instituto de Patologia e Imunologia Molecular, Universidade do Porto, Rua Júlio Amaral de Carvalho, 45, 4200-135, Porto, Portugal
| | - Paulo C Costa
- UCIBIO/REQUIMTE, MEDTECH, Laboratório de Tecnologia Farmacêutica, Departamento de Ciências do Medicamento, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Valentina F Domingues
- REQUIMTE/LAQV/GRAQ, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072, Porto, Portugal
| | - Paulo A Quadros
- FLUIDINOVA, S.A., Rua Engenheiro Frederico Ulrich, 2650, 4470-605, Maia, Portugal
| | - Fernando J Monteiro
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,FEUP - Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, s/n, 4200-465, Porto, Portugal
| | - Susana R Sousa
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,ISEP - Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072, Porto, Portugal
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209
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Kamboj N, Kazantseva J, Rahmani R, Rodríguez MA, Hussainova I. Selective laser sintered bio-inspired silicon-wollastonite scaffolds for bone tissue engineering. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 116:111223. [DOI: 10.1016/j.msec.2020.111223] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/15/2020] [Accepted: 06/19/2020] [Indexed: 10/24/2022]
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210
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Martinez-Marquez D, Delmar Y, Sun S, Stewart RA. Exploring Macroporosity of Additively Manufactured Titanium Metamaterials for Bone Regeneration with Quality by Design: A Systematic Literature Review. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E4794. [PMID: 33121025 PMCID: PMC7662257 DOI: 10.3390/ma13214794] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 12/14/2022]
Abstract
Additive manufacturing facilitates the design of porous metal implants with detailed internal architecture. A rationally designed porous structure can provide to biocompatible titanium alloys biomimetic mechanical and biological properties for bone regeneration. However, increased porosity results in decreased material strength. The porosity and pore sizes that are ideal for porous implants are still controversial in the literature, complicating the justification of a design decision. Recently, metallic porous biomaterials have been proposed for load-bearing applications beyond surface coatings. This recent science lacks standards, but the Quality by Design (QbD) system can assist the design process in a systematic way. This study used the QbD system to explore the Quality Target Product Profile and Ideal Quality Attributes of additively manufactured titanium porous scaffolds for bone regeneration with a biomimetic approach. For this purpose, a total of 807 experimental results extracted from 50 different studies were benchmarked against proposed target values based on bone properties, governmental regulations, and scientific research relevant to bone implants. The scaffold properties such as unit cell geometry, pore size, porosity, compressive strength, and fatigue strength were studied. The results of this study may help future research to effectively direct the design process under the QbD system.
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Affiliation(s)
| | | | | | - Rodney A. Stewart
- School of Engineering and Built Environment, Griffith University, Gold Coast, QLD 4222, Australia; (D.M.-M.); (Y.D.); (S.S.)
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211
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Kuchler U, Heimel P, Stähli A, Josef Strauss F, Luza B, Gruber R. Impact of DBBM Fragments on the Porosity of the Calvarial Bone: A Pilot Study on Mice. MATERIALS 2020; 13:ma13214748. [PMID: 33114211 PMCID: PMC7660694 DOI: 10.3390/ma13214748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/17/2020] [Accepted: 10/20/2020] [Indexed: 12/27/2022]
Abstract
Deproteinized bovine bone mineral (DBBM) is brittle and can break into fragments. Here, we examined whether DBBM fragments have an impact on mice calvarial bone during bone augmentation. DBBM was either randomly crushed (DBBM fragments) or left undisturbed (DBBM granules). Then, DBBM fragments or original DBBM granules were placed onto calvarial bone in 20 BALB/c mice. Following random allocation, ten mice received DBBM fragments and ten mice received original DBBM granules. After fourteen days of healing, micro computed tomography (micro-CT) and histological analysis of the augmented sites were performed. The primary outcome was the porosity of the calvarial bone. The micro-CT analysis revealed that DBBM fragments failed to significantly change the porosity of the calvarial bone as compared with original DBBM granules, despite the slightly higher bone resorption in the DBBM fragment group, 10.3% (CI 6.3–11.6) versus 6.1% (CI 4.1–7.8, p = 0.355), respectively. The cortical bone volume was not altered by DBBM fragments as compared with original DBBM granules, i.e., 79.0% (CI 78.9–81.2) versus 81.5% (CI 80.1–83.3, p = 0.357), respectively. The DBBM fragment group revealed similar bone thickness values as compared with the DBBM granules group, i.e., 0.26 mm (CI 0.23–0.29) versus 0.25 mm (CI 0.22–0.27, p = 0.641), respectively. The histological evaluation supported the micro-CT observations, displaying minor signs of porosity and resorption. The particle-size distribution analysis confirmed a shift towards smaller particle sizes in the DBBM fragment group. These findings suggest that DBBM fragments behave similarly to original DBBM granules in terms of bone morphological changes at augmented sites.
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Affiliation(s)
- Ulrike Kuchler
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria;
| | - Patrick Heimel
- Core Facility Hard Tissue and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (P.H.); (B.L.)
- Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, 1090 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1090 Vienna, Austria
| | - Alexandra Stähli
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (A.S.); (F.J.S.)
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Franz Josef Strauss
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (A.S.); (F.J.S.)
- Department of Conservative Dentistry, School of Dentistry, University of Chile, Santiago 8380544, Chile
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
| | - Bernadette Luza
- Core Facility Hard Tissue and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (P.H.); (B.L.)
- Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, 1090 Vienna, Austria
| | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria; (A.S.); (F.J.S.)
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Correspondence: ; Tel.: +43-699-107-18-472
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Biomimetic Aspects of Oral and Dentofacial Regeneration. Biomimetics (Basel) 2020; 5:biomimetics5040051. [PMID: 33053903 PMCID: PMC7709662 DOI: 10.3390/biomimetics5040051] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/09/2020] [Accepted: 10/10/2020] [Indexed: 12/12/2022] Open
Abstract
Biomimetic materials for hard and soft tissues have advanced in the fields of tissue engineering and regenerative medicine in dentistry. To examine these recent advances, we searched Medline (OVID) with the key terms “biomimetics”, “biomaterials”, and “biomimicry” combined with MeSH terms for “dentistry” and limited the date of publication between 2010–2020. Over 500 articles were obtained under clinical trials, randomized clinical trials, metanalysis, and systematic reviews developed in the past 10 years in three major areas of dentistry: restorative, orofacial surgery, and periodontics. Clinical studies and systematic reviews along with hand-searched preclinical studies as potential therapies have been included. They support the proof-of-concept that novel treatments are in the pipeline towards ground-breaking clinical therapies for orofacial bone regeneration, tooth regeneration, repair of the oral mucosa, periodontal tissue engineering, and dental implants. Biomimicry enhances the clinical outcomes and calls for an interdisciplinary approach integrating medicine, bioengineering, biotechnology, and computational sciences to advance the current research to clinics. We conclude that dentistry has come a long way apropos of regenerative medicine; still, there are vast avenues to endeavour, seeking inspiration from other facets in biomedical research.
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Chun J, Jung J, Lee JH, Oh SH, Kwon YD. Osteogenic differentiation and inflammatory response of recombinant human bone morphogenetic protein-2 in human maxillary sinus membrane-derived cells. Exp Ther Med 2020; 20:81. [PMID: 32968438 PMCID: PMC7500044 DOI: 10.3892/etm.2020.9208] [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: 12/26/2019] [Accepted: 06/02/2020] [Indexed: 12/14/2022] Open
Abstract
The aim of the present study was to investigate the osteogenic potential of human maxillary sinus membrane (hMSM)-derived cells, and the role of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the inflammatory response of hMSM-derived cells and gingival fibroblasts following sinus floor elevation procedure (SFE). hMSM-derived cells from the samples were isolated, subcultured, and analyzed using immunohistochemical staining and flow cytometry. The hMSM-derived cells obtained from passage 6 were used for Alizarin Red staining and quantitative reverse transcription-quantitative PCR to observe its osteogenic activity and inflammatory reaction upon supplementation with rhBMP-2. The hMSM-derived cells were shown to be heterogeneous, as indicated by their positive expression of human mesenchymal stem cell markers (STRO-1, high mobility group AT-hook 2, CD44, CD105 and OCT-3/4), fibroblast cell marker (fibroblast-specific protein 1) and epithelial cell marker (epithelial cell adhesion molecule). Calcium nodules were found to be more notably evident in the rhBMP-2 group, following osteogenic differentiation. The gene expression of osteogenic markers was significantly upregulated in the cells supplemented with rhBMP-2. Supplementation with rhBMP-2 also enhanced the expression of inflammatory markers in hMSM-derived cells and gingival fibroblasts; however, NF-κB and TNF-α expression was not significantly increased compared with the control in the hMSM-derived cells. hMSM contains mesenchymal stem cells (MSCs) capable of differentiating into osteogenic cells. The supplementation of rhBMP-2 enhanced osteogenic differentiation and induced an inflammatory response which was greater in gingival fibroblasts compared with hMSM-derived cells. In summary, the hMSM is a potential contributor to the osteogenic process following SFE, and the use of rhBMP-2 may increase the inflammatory response accordingly. The gingival tissue may be responsible for the increased inflammatory response by rhBMP-2 and postoperative complications.
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Affiliation(s)
- Jeewan Chun
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Junho Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jae-Hyung Lee
- Department of Maxillofacial Regenerative Medicine, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Sang-Hwan Oh
- Department of Dental Hygiene, College of Medical Science, Konyang University, Daejeon 35365, Republic of Korea
| | - Yong-Dae Kwon
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea
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Al-Sowayan B, Alammari F, Alshareeda A. Preparing the Bone Tissue Regeneration Ground by Exosomes: From Diagnosis to Therapy. Molecules 2020; 25:E4205. [PMID: 32937850 PMCID: PMC7570455 DOI: 10.3390/molecules25184205] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 12/14/2022] Open
Abstract
Bone tissue engineering employs acellular scaffolds or scaffolds, along with cells and growth factors, to provide the mechanical support needed, as well as serve as a delivery vehicle for bioactive molecules to the injury sites. As tissue engineering continues to evolve, it has integrated two emerging fields: stem cells and nanotechnology. A paracrine factor that is found to be responsible for the major regenerative effect in stem cell transplantation is an extracellular vesicle called an 'exosome'. Recent advances in nanotechnology have allowed the 'exosome' to be distinguished from other extracellular vesicles and be polymerized into a well-defined concept. Scientists are now investigating exosome uses in clinical applications. For bone-related diseases, exosomes are being explored as biomarkers for different bone pathologies. They are also being explored as a therapeutic agent where progenitor cell-derived exosomes are used to regenerate damaged bone tissue. In addition, exosomes are being tested as immune modulators for bone tissue inflammation, and finally as a delivery vehicle for therapeutic agents. This review discusses recently published literature on the clinical utilization of exosomes in bone-related applications and the correlated advantages. A particular focus will be placed on the potential utilization of regenerative cell-derived exosomes as a natural biomaterial for tissue regeneration.
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Affiliation(s)
- Batla Al-Sowayan
- Stem Cells and Regenerative Medicine Unit, Cell Therapy & Cancer Research Department, King Abdullah International Medical Research Center/King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia;
| | | | - Alaa Alshareeda
- Stem Cells and Regenerative Medicine Unit, Cell Therapy & Cancer Research Department, King Abdullah International Medical Research Center/King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia;
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215
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Ferracini R, Bistolfi A, Guidotti C, Artiaco S, Battista A, Battiston B, Perale G. Bone Loss in Distal Radial Fractures Treated with A Composite Xenohybrid Bone Substitute: A Two Years Follow-Up Retrospective Study. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E4040. [PMID: 32933036 PMCID: PMC7558122 DOI: 10.3390/ma13184040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/28/2020] [Accepted: 09/04/2020] [Indexed: 11/30/2022]
Abstract
(1) Background: Recently, surgical treatment of distal radius fractures has increased exponentially. Many locking plates' fixation systems have been developed allowing a more stable reduction and early mobilization. Sometimes, open reduction and fixation of distal radius fractures may leave a residual bone loss requiring grafting. This retrospective study reports clinical and radiologic outcomes of distal radius fractures treated with xenohybrid bone grafting in order to assess (i) the safety of the investigated bone graft; (ii) its radiological integration and biomechanical performances, and (iii) clinical outcomes of the patients; (2) Methods: We performed a retrospective study on a cohort of 19 patients. Preoperative X-ray and CT scan were performed. The mean clinical and radiographical follow-up was two years. Safety of the xenohybrid bone graft was constantly evaluated. Clinical results were assessed through the DASH score and Mayo wrist score; (3) Results: No adverse reactions, infections, and local or general complication were related to the use of xenohybrid bone graft. The radiolucency of the xenografts suggested progressive osteointegration. No evidence of bone graft resorption was detected. All the patients reached consolidation with good to excellent clinical results; and (4) Conclusions: Clinical and radiological data demonstrated that xenohybrid bone grafting promotes new bone formation and healing in osteopenic areas caused by fracture reduction.
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Affiliation(s)
- Riccardo Ferracini
- Department of Surgical Sciences and Integrated Diagnostics, University of Genova, Viale Benedetto XV n6, 16132 Genova, Italy
| | - Alessandro Bistolfi
- Department of Traumatology and Rehabilitation, C.T.O. Hospital-A.O.U. Città della Salute e della Scienza, Via Zuretti 29, 10126 Turin, Italy; (A.B.); (S.A.); (B.B.)
| | - Claudio Guidotti
- Medical School, University of Turin, 10100 Turin, Italy; (C.G.); (A.B.)
| | - Stefano Artiaco
- Department of Traumatology and Rehabilitation, C.T.O. Hospital-A.O.U. Città della Salute e della Scienza, Via Zuretti 29, 10126 Turin, Italy; (A.B.); (S.A.); (B.B.)
| | - Agnese Battista
- Medical School, University of Turin, 10100 Turin, Italy; (C.G.); (A.B.)
| | - Bruno Battiston
- Department of Traumatology and Rehabilitation, C.T.O. Hospital-A.O.U. Città della Salute e della Scienza, Via Zuretti 29, 10126 Turin, Italy; (A.B.); (S.A.); (B.B.)
| | - Giuseppe Perale
- Industrie Biomediche Insubri S.A., Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland;
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216
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Polymeri A, Anssari-Moin D, van der Horst J, Wismeijer D, Laine ML, Loos BG. Surgical treatment of peri-implantitis defects with two different xenograft granules: A randomized clinical pilot study. Clin Oral Implants Res 2020; 31:1047-1060. [PMID: 32803798 PMCID: PMC7693249 DOI: 10.1111/clr.13651] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 06/03/2020] [Accepted: 08/10/2020] [Indexed: 12/24/2022]
Abstract
Objectives To investigate whether xenograft EB (EndoBon) is non‐inferior to xenograft BO (Bio‐Oss) when used in reconstructive surgery of peri‐implant osseous defects. Materials and methods Dental patients with one implant each demonstrating peri‐implantitis were randomized to receive surgical debridement and defect fill with either BO or EB. Changes in bone level (BL) and intrabony defect depth (IDD) evaluated radiographically were the primary outcomes. The secondary outcomes included changes in probing pocket depth (PPD), bleeding on probing (BoP), and suppuration on probing (SoP). All outcomes were recorded before treatment and at 6 and 12 months post‐treatment. Results Twenty‐four patients (n = 11 BO, n = 13 EB) completed the study. Both groups demonstrated significant within‐group improvements in all clinical and radiographic parameters at 6 and 12 months (p ≤ .001). At 12 months, both groups presented with IDD reductions of 2.5–3.0 mm on average. The inter‐group differences were not statistically significant at all time points and for all the examined parameters (p > .05). While the radiographic defect fill in both groups exceeded > 1 mm and can be considered treatment success, successful treatment outcomes as defined by Consensus Reporting (no further bone loss, PPD ≤ 5 mm, no BOP, and no SoP) were identified in 2/11 (18%) BO and 0/13 (0%) EB individuals (Fisher's exact test, p = .199). Conclusions Within the limitations of this pilot study, the application of xenograft EB showed to be non‐inferior to xenograft BO when used in reconstructive surgery of peri‐implant osseous defects.
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Affiliation(s)
- Angeliki Polymeri
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - David Anssari-Moin
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Joyce van der Horst
- Department Oral Implantology and Prosthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Daniel Wismeijer
- Department Oral Implantology and Prosthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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217
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Ferreira MR, Santos GA, Biagi CA, Silva Junior WA, Zambuzzi WF. GSVA score reveals molecular signatures from transcriptomes for biomaterials comparison. J Biomed Mater Res A 2020; 109:1004-1014. [PMID: 32820608 DOI: 10.1002/jbm.a.37090] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 12/17/2022]
Abstract
Two in silico methodologies were implemented to reveal the molecular signatures of inorganic hydroxyapatite and β-TCP materials from a transcriptome database to compare biomaterials. To test this new methodology, we choose the array E-MTAB-7219, which contains the transcription profile of osteoblastic cell line seeded onto 15 different biomaterials up to 48 hr. The expansive potential of the methodology was tested from the construction of customized signatures. We present, for the first time, a methodology to compare the performance of different biomaterials using the transcriptome profile of the cell through the Gene set variation analysis (GSVA) score. To test this methodology, we implemented two methods based on MSigDB collections, using all the collections and sub-collections except the Hallmark collection, which was used in the second method. The result of this analysis provided an initial understanding of biomaterial grouping based on the cell transcriptional landscape. The comparison using GSVA score combined efforts and expand the potential to compare biomaterials using transcriptome profile. Altogether, our results provide a better understanding of the comparison of different biomaterials and suggest a possibility of the new methodology be applied to the prospection of new biomaterials.
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Affiliation(s)
- Marcel R Ferreira
- Laboratory of Bioassays and Cellular Dynamics, Department of Chemistry and Biochemistry, Institute of Biosciences, São Paulo State University, UNESP, Botucatu, São Paulo, Brazil
| | - Gerson A Santos
- Laboratory of Bioassays and Cellular Dynamics, Department of Chemistry and Biochemistry, Institute of Biosciences, São Paulo State University, UNESP, Botucatu, São Paulo, Brazil
| | - Carlos A Biagi
- Genomic Medicine Center, Department of Genetics of the Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Wilson A Silva Junior
- Genomic Medicine Center, Department of Genetics of the Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Willian F Zambuzzi
- Laboratory of Bioassays and Cellular Dynamics, Department of Chemistry and Biochemistry, Institute of Biosciences, São Paulo State University, UNESP, Botucatu, São Paulo, Brazil
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218
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Sallent I, Capella-Monsonís H, Procter P, Bozo IY, Deev RV, Zubov D, Vasyliev R, Perale G, Pertici G, Baker J, Gingras P, Bayon Y, Zeugolis DI. The Few Who Made It: Commercially and Clinically Successful Innovative Bone Grafts. Front Bioeng Biotechnol 2020; 8:952. [PMID: 32984269 PMCID: PMC7490292 DOI: 10.3389/fbioe.2020.00952] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 07/23/2020] [Indexed: 12/11/2022] Open
Abstract
Bone reconstruction techniques are mainly based on the use of tissue grafts and artificial scaffolds. The former presents well-known limitations, such as restricted graft availability and donor site morbidity, while the latter commonly results in poor graft integration and fixation in the bone, which leads to the unbalanced distribution of loads, impaired bone formation, increased pain perception, and risk of fracture, ultimately leading to recurrent surgeries. In the past decade, research efforts have been focused on the development of innovative bone substitutes that not only provide immediate mechanical support, but also ensure appropriate graft anchoring by, for example, promoting de novo bone tissue formation. From the countless studies that aimed in this direction, only few have made the big jump from the benchtop to the bedside, whilst most have perished along the challenging path of clinical translation. Herein, we describe some clinically successful cases of bone device development, including biological glues, stem cell-seeded scaffolds, and gene-functionalized bone substitutes. We also discuss the ventures that these technologies went through, the hindrances they faced and the common grounds among them, which might have been key for their success. The ultimate objective of this perspective article is to highlight the important aspects of the clinical translation of an innovative idea in the field of bone grafting, with the aim of commercially and clinically informing new research approaches in the sector.
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Affiliation(s)
- Ignacio Sallent
- Regenerative, Modular & Developmental Engineering Laboratory, National University of Ireland Galway, Galway, Ireland
- Science Foundation Ireland Centre for Research in Medical Devices (CÚRAM), National University of Ireland Galway, Galway, Ireland
| | - Héctor Capella-Monsonís
- Regenerative, Modular & Developmental Engineering Laboratory, National University of Ireland Galway, Galway, Ireland
- Science Foundation Ireland Centre for Research in Medical Devices (CÚRAM), National University of Ireland Galway, Galway, Ireland
| | - Philip Procter
- Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, Uppsala, Sweden
- GPBio Ltd., Shannon, Ireland
| | - Ilia Y. Bozo
- Histograft LLC, Moscow, Russia
- Federal Medical Biophysical Center of FMBA of Russia, Moscow, Russia
| | - Roman V. Deev
- Histograft LLC, Moscow, Russia
- I.I. Mechnikov North-Western State Medical University, Saint Petersburg, Russia
| | - Dimitri Zubov
- State Institute of Genetic & Regenerative Medicine NAMSU, Kyiv, Ukraine
- Medical Company ilaya, Kyiv, Ukraine
| | - Roman Vasyliev
- State Institute of Genetic & Regenerative Medicine NAMSU, Kyiv, Ukraine
- Medical Company ilaya, Kyiv, Ukraine
| | | | | | - Justin Baker
- Viscus Biologics LLC, Cleveland, OH, United States
| | | | - Yves Bayon
- Sofradim Production, A Medtronic Company, Trévoux, France
| | - Dimitrios I. Zeugolis
- Regenerative, Modular & Developmental Engineering Laboratory, National University of Ireland Galway, Galway, Ireland
- Science Foundation Ireland Centre for Research in Medical Devices (CÚRAM), National University of Ireland Galway, Galway, Ireland
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219
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Di Raimondo R, Sanz-Esporrín J, Sanz-Martin I, Plá R, Luengo F, Vignoletti F, Nuñez J, Sanz M. Hard and soft tissue changes after guided bone regeneration using two different barrier membranes: an experimental in vivo investigation. Clin Oral Investig 2020; 25:2213-2227. [PMID: 32851532 DOI: 10.1007/s00784-020-03537-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the contour and volumetric changes of hard and soft tissues after guided bone regeneration (GBR) using two types of barrier membranes together with a xenogeneic bone substitute in dehiscence-type defects around dental implants. MATERIAL AND METHODS In 8 Beagle dogs, after tooth extraction, two-wall chronified bone defects were developed. Then, implants were placed with a buccal dehiscence defect that was treated with GBR using randomly: (i) deproteinized bovine bone mineral (DBBM) covered by a synthetic polylactic membrane (test group), (ii) DBBM plus a porcine natural collagen membrane (positive control) and (iii) defect only covered by the synthetic membrane (negative control group). Outcomes were evaluated at 4 and 12 weeks. Micro-CT was used to evaluate the hard tissue volumetric changes and STL files from digitized cast models were used to measure the soft tissues contour linear changes. RESULTS Test and positive control groups were superior in terms of volume gain and contour changes when compared with the negative control. Soft tissue changes showed at 4 weeks statistically significant superiority for test and positive control groups compared with negative control. After 12 weeks, the results were superior for test and positive control groups but not statistically significant, although, with a lesser magnitude, the negative control group exhibited gains in both, soft and hard tissues. CONCLUSIONS Both types of membranes (collagen and synthetic) attained similar outcomes, in terms of hard tissue volume gain and soft tissue contours when used in combination with DBBM CLINICAL RELEVANCE: Synthetic membranes were a valid alternative to the "gold standard" natural collagen membrane for treating dehiscence-type defects around dental implants when used with a xenogeneic bone substitute scaffold.
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Affiliation(s)
- Riccardo Di Raimondo
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Javier Sanz-Esporrín
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Periimplant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Ignacio Sanz-Martin
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Rafael Plá
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Fernando Luengo
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Fabio Vignoletti
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Periimplant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Javier Nuñez
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain. .,ETEP (Etiology and Therapy of Periodontal and Periimplant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.
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220
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Aldemir Dikici B, Claeyssens F. Basic Principles of Emulsion Templating and Its Use as an Emerging Manufacturing Method of Tissue Engineering Scaffolds. Front Bioeng Biotechnol 2020; 8:875. [PMID: 32903473 PMCID: PMC7435020 DOI: 10.3389/fbioe.2020.00875] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/08/2020] [Indexed: 12/20/2022] Open
Abstract
Tissue engineering (TE) aims to regenerate critical size defects, which cannot heal naturally, by using highly porous matrices called TE scaffolds made of biocompatible and biodegradable materials. There are various manufacturing techniques commonly used to fabricate TE scaffolds. However, in most cases, they do not provide materials with a highly interconnected pore design. Thus, emulsion templating is a promising and convenient route for the fabrication of matrices with up to 99% porosity and high interconnectivity. These matrices have been used for various application areas for decades. Although this polymer structuring technique is older than TE itself, the use of polymerised internal phase emulsions (PolyHIPEs) in TE is relatively new compared to other scaffold manufacturing techniques. It is likely because it requires a multidisciplinary background including materials science, chemistry and TE although producing emulsion templated scaffolds is practically simple. To date, a number of excellent reviews on emulsion templating have been published by the pioneers in this field in order to explain the chemistry behind this technique and potential areas of use of the emulsion templated structures. This particular review focusses on the key points of how emulsion templated scaffolds can be fabricated for different TE applications. Accordingly, we first explain the basics of emulsion templating and characteristics of PolyHIPE scaffolds. Then, we discuss the role of each ingredient in the emulsion and the impact of the compositional changes and process conditions on the characteristics of PolyHIPEs. Afterward, current fabrication methods of biocompatible PolyHIPE scaffolds and polymerisation routes are detailed, and the functionalisation strategies that can be used to improve the biological activity of PolyHIPE scaffolds are discussed. Finally, the applications of PolyHIPEs on soft and hard TE as well as in vitro models and drug delivery in the literature are summarised.
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Affiliation(s)
- Betül Aldemir Dikici
- Department of Materials Science and Engineering, Kroto Research Institute, The University of Sheffield, Sheffield, United Kingdom
- Department of Materials Science and Engineering, INSIGNEO Institute for In Silico Medicine, The University of Sheffield, Sheffield, United Kingdom
| | - Frederik Claeyssens
- Department of Materials Science and Engineering, Kroto Research Institute, The University of Sheffield, Sheffield, United Kingdom
- Department of Materials Science and Engineering, INSIGNEO Institute for In Silico Medicine, The University of Sheffield, Sheffield, United Kingdom
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221
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Karadas O, Mese G, Ozcivici E. Low magnitude high frequency vibrations expedite the osteogenesis of bone marrow stem cells on paper based 3D scaffolds. Biomed Eng Lett 2020; 10:431-441. [PMID: 32850178 PMCID: PMC7438393 DOI: 10.1007/s13534-020-00161-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/12/2020] [Accepted: 06/27/2020] [Indexed: 01/08/2023] Open
Abstract
Anabolic effects of low magnitude high frequency (LMHF) vibrations on bone tissue were consistently shown in the literature in vivo, however in vitro efforts to elucidate underlying mechanisms are generally limited to 2D cell culture studies. Three dimensional cell culture platforms better mimic the natural microenvironment and biological processes usually differ in 3D compared to 2D culture. In this study, we used laboratory grade filter paper as a scaffold material for studying the effects of LHMF vibrations on osteogenesis of bone marrow mesenchymal stem cells in a 3D system. LMHF vibrations were applied 15 min/day at 0.1 g acceleration and 90 Hz frequency for 21 days to residing cells under quiescent and osteogenic conditions. mRNA expression analysis was performed for alkaline phosphatase (ALP) and osteocalcin (OCN) genes, Alizarin red S staining was performed for mineral nodule formation and infrared spectroscopy was performed for determination of extracellular matrix composition. The highest osteocalcin expression, mineral nodule formation and the phosphate bands arising from the inorganic phase was observed for the cells incubated in osteogenic induction medium with vibration. Our results showed that filter paper can be used as a model scaffold system for studying the effects of mechanical loads on cells, and LMHF vibrations induced the osteogenic differentiation of stem cells.
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Affiliation(s)
- Ozge Karadas
- Department of Bioengineering, Rm A210, Izmir Institute of Technology, Urla, Izmir, 35430 Turkey
| | - Gulistan Mese
- Department of Molecular Biology and Genetics, Izmir Institute of Technology, Urla, Izmir, Turkey
| | - Engin Ozcivici
- Department of Bioengineering, Rm A210, Izmir Institute of Technology, Urla, Izmir, 35430 Turkey
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222
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Yue S, He H, Li B, Hou T. Hydrogel as a Biomaterial for Bone Tissue Engineering: A Review. NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E1511. [PMID: 32752105 PMCID: PMC7466535 DOI: 10.3390/nano10081511] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023]
Abstract
Severe bone damage from diseases, including extensive trauma, fractures, and bone tumors, cannot self-heal, while traditional surgical treatment may bring side effects such as infection, inflammation, and pain. As a new biomaterial with controllable mechanical properties and biocompatibility, hydrogel is widely used in bone tissue engineering (BTE) as a scaffold for growth factor transport and cell adhesion. In order to make hydrogel more suitable for the local treatment of bone diseases, hydrogel preparation methods should be combined with synthetic materials with excellent properties and advanced technologies in different fields to better control drug release in time and orientation. It is necessary to establish a complete method to evaluate the hydrogel's properties and biocompatibility with the human body. Moreover, establishment of standard animal models of bone defects helps in studying the therapeutic effect of hydrogels on bone repair, as well as to evaluate the safety and suitability of hydrogels. Thus, this review aims to systematically summarize current studies of hydrogels in BTE, including the mechanisms for promoting bone synthesis, design, and preparation; characterization and evaluation methods; as well as to explore future applications of hydrogels in BTE.
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Affiliation(s)
- Shuai Yue
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
- Key Laboratory of Environment Correlative Dietology, Huazhong Agricultural University, Ministry of Education, Wuhan 43000, China
| | - Hui He
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
- Key Laboratory of Environment Correlative Dietology, Huazhong Agricultural University, Ministry of Education, Wuhan 43000, China
| | - Bin Li
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
- Key Laboratory of Environment Correlative Dietology, Huazhong Agricultural University, Ministry of Education, Wuhan 43000, China
| | - Tao Hou
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
- Key Laboratory of Environment Correlative Dietology, Huazhong Agricultural University, Ministry of Education, Wuhan 43000, China
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223
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Simitzi C, Vlahovic M, Georgiou A, Keskin-Erdogan Z, Miller J, Day RM. Modular Orthopaedic Tissue Engineering With Implantable Microcarriers and Canine Adipose-Derived Mesenchymal Stromal Cells. Front Bioeng Biotechnol 2020; 8:816. [PMID: 32775324 PMCID: PMC7388765 DOI: 10.3389/fbioe.2020.00816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/26/2020] [Indexed: 01/14/2023] Open
Abstract
Mesenchymal stromal cells (MSC) hold significant potential for tissue engineering applications. Modular tissue engineering involves the use of cellularized "building blocks" that can be assembled via a bottom-up approach into larger tissue-like constructs. This approach emulates more closely the complexity associated hierarchical tissues compared with conventional top-down tissue engineering strategies. The current study describes the combination of biodegradable porous poly(DL-lactide-co-glycolide) (PLGA) TIPS microcarriers with canine adipose-derived MSC (cAdMSC) for use as implantable conformable building blocks in modular tissue engineering applications. Optimal conditions were identified for the attachment and proliferation of cAdMSC on the surface of the microcarriers. Culture of the cellularized microcarriers for 21 days in transwell insert plates under conditions used to induce either chondrogenic or osteogenic differentiation resulted in self-assembly of solid 3D tissue constructs. The tissue constructs exhibited phenotypic characteristics indicative of successful osteogenic or chondrogenic differentiation, as well as viscoelastic mechanical properties. This strategy paves the way to create in situ tissue engineered constructs via modular tissue engineering for therapeutic applications.
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Affiliation(s)
- Chara Simitzi
- Centre for Precision Healthcare, Applied Biomedical Engineering Group, UCL Division of Medicine, University College London, London, United Kingdom
| | - Maja Vlahovic
- Centre for Precision Healthcare, Applied Biomedical Engineering Group, UCL Division of Medicine, University College London, London, United Kingdom
| | - Alex Georgiou
- Department of Biomolecular and Sports Sciences, Coventry University, Coventry, United Kingdom
- Cell Therapy Sciences Ltd., University of Warwick Science Park, Coventry, United Kingdom
| | | | - Joanna Miller
- Cell Therapy Sciences Ltd., University of Warwick Science Park, Coventry, United Kingdom
| | - Richard M. Day
- Centre for Precision Healthcare, Applied Biomedical Engineering Group, UCL Division of Medicine, University College London, London, United Kingdom
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224
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Dashtimoghadam E, Fahimipour F, Tongas N, Tayebi L. Microfluidic fabrication of microcarriers with sequential delivery of VEGF and BMP-2 for bone regeneration. Sci Rep 2020; 10:11764. [PMID: 32678204 PMCID: PMC7366644 DOI: 10.1038/s41598-020-68221-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/26/2020] [Indexed: 12/21/2022] Open
Abstract
Wound instability and poor functional vascularization in bone tissue engineering lead to lack of tissue integration and ultimate failure of engineered grafts. In order to harness the regenerative potential of growth factors and stimulate bone healing, present study aims to design multifunctional cell therapy microcarriers with the capability of sequential delivery of essential growth factors, bone morphogenetic protein 2 (BMP-2) and vascular endothelial growth factor (VEGF). An on-chip double emulsion method was implemented to generate monodisperse VEGF encapsulated microcarriers. Bio-inspired poly(3,4-dihydroxyphenethylamine) (PDA) was then functionalized to the microcarriers surface for BMP-2 conjugation. The microcarriers were seeded with mesenchymal stem cells (MSCs) using a dynamic culture technique for cells expansion. Finally, the microcarriers were incorporated into an injectable alginate-RGD hydrogel laden with endothelial cells (ECs) for further analysis. The DNA and calcium content, as well as ALP activity of the construct were analyzed. The confocal fluorescent microscopy was employed to monitor the MSCs and tunneling structure of ECs. Eventually, the capability of developed microcarriers for bone tissue formation was examined in vivo. Microfluidic platform generated monodisperse VEGF-loaded PLGA microcarriers with size-dependent release patterns. Microcarriers generated with the on-chip technique showed more sustained VEGF release profiles compared to the conventional bulk mixing method. The PDA functionalization of microcarriers surface not only provided immobilization of BMP-2 with prolonged bioavailability, but also enhanced the attachment and proliferation of MSCs. Dynamic culturing of microcarriers showcased their great potential to boost MSCs population required for stem cell therapy of bone defects. ALP activity and calcium content analysis of MSCs-laden microcarriers loaded into injectable hydrogels revealed their capability of tunneling formation, vascular cell growth and osteogenic differentiation. The in vivo histology and real-time polymerase chain reaction analysis revealed that transplantation of MSC-laden microcarriers supports ectopic bone formation in the rat model. The presented approach to design bioactive microcarriers offer sustained sequential delivery of bone ECM chemical cues and offer an ideal stabilized 3D microenvironment for patient-specific cell therapy applications. The proposed methodology is readily expandable to integrate other cells and cytokines in a tuned spatiotemporal manner for personalized regenerative medicine.
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Affiliation(s)
| | - Farahnaz Fahimipour
- Marquette University School of Dentistry, Milwaukee, WI, USA
- Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nikita Tongas
- Marquette University School of Dentistry, Milwaukee, WI, USA
| | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, USA.
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225
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Gashtasbi F, Hasannia S, Hasannia S, Mahdi Dehghan M, Sarkarat F, Shali A. Comparative study of impact of animal source on physical, structural, and biological properties of bone xenograft. Xenotransplantation 2020; 27:e12628. [PMID: 32654298 DOI: 10.1111/xen.12628] [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: 03/23/2020] [Revised: 05/21/2020] [Accepted: 06/14/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Due to the unique features of xenografts including large supply from donors, minimal risk of human disease transmission, and the lower cost of preparation and production compared to autografts and allografts, they are considered as attractive alternatives to traditional bone grafts. The animal source accessibility and production process have a direct correlation with the cost and quality of the final product. To evaluate whether the animal source of the bone has any effect on the physicochemical and histological properties of the final xenograft, three deproteinized bone grafts were prepared from sources that are easily available in Iran, including the bovine (DBB), camel (DCB), and ostrich (DOB). METHODS In the current study, three bone substitute materials intended to serve as bone xenografts were derived from the cow, camel, and ostrich using the thermochemical processing procedure. The physicochemical properties, in vitro cytocompatibility and in vivo bone regeneration capability of the prepared deproteinized bone grafts, were assessed and compared with OCS-B as an approved product in the global market. RESULTS The physical tests confirmed the hydroxyapatite nature of the final products. SEM and BET analysis showed morphological and structural differences between the products due to differences in the animal sources. In vitro studies showed the prepared deproteinized bone was free of processing chemicals and was biocompatible with mouse fibroblast and myoblast cell lines. In vivo studies revealed that the bone formation capability of the DBB, DCB, and DOB has no significant difference with one another and with OCS-B despite their structural differences. The DCB showed the highest graft residue after two month. No signs of immunogenicity were observed in the study groups compared to the blank group. CONCLUSION DBB, DCB, and DOB may offer a favorable cell response and bone regeneration similar to those of commercial bovine bone material.
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Affiliation(s)
- Fatemeh Gashtasbi
- Nova Teb Research Laboratory, Dental Equipment and Biomaterials Incubation Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Hasannia
- Nova Teb Research Laboratory, Dental Equipment and Biomaterials Incubation Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadegh Hasannia
- Nova Teb Research Laboratory, Dental Equipment and Biomaterials Incubation Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Mahdi Dehghan
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Farzin Sarkarat
- Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Dentistry Branch of Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Abbas Shali
- Nova Teb Research Laboratory, Dental Equipment and Biomaterials Incubation Center, Tehran University of Medical Sciences, Tehran, Iran
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226
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Sánchez-Labrador L, Martín-Ares M, Ortega-Aranegui R, López-Quiles J, Martínez-González JM. Autogenous Dentin Graft in Bone Defects after Lower Third Molar Extraction: A Split-Mouth Clinical Trial. MATERIALS 2020; 13:ma13143090. [PMID: 32664303 PMCID: PMC7411779 DOI: 10.3390/ma13143090] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/04/2020] [Accepted: 07/08/2020] [Indexed: 02/08/2023]
Abstract
Various biomaterials are currently used for bone regeneration, with autogenous bone being considered the gold standard material because of its osteogenic, osteoconductive, and osteoinductive properties. In recent years, the use of autogenous dentin as a graft material has been described. This split-mouth clinical trial assesses the efficacy of autogenous dentin for the regeneration of periodontal defects caused by bone loss associated with impacted lower third molar extraction. Fifteen patients underwent bilateral extraction surgery (30 third molars) using dentin as a graft material on the test side, and leaving the control side to heal spontaneously, comparing the evolution of the defects by evaluating probing depth at three and six months post-operatively. Bone density and alveolar bone crest maintenance were also evaluated six months after surgery, and pain, inflammation, mouth opening capacity on the second and seventh days after surgery. Probing depth, radiographic bone density, and alveolar bone crest maintenance showed significant differences between the test and control sides. Autogenous dentin was found to be an effective biomaterial for bone regeneration after impacted lower third molar extraction.
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227
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Rezuc A, Saavedra C, Maass R, Poblete C, Nappe C. Histological comparison of DBBM and platelet rich fibrin for guided bone regeneration in a rabbit model. J Oral Biol Craniofac Res 2020; 10:287-293. [PMID: 32637304 DOI: 10.1016/j.jobcr.2020.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/07/2020] [Indexed: 01/07/2023] Open
Abstract
Purpose To histologically evaluate the use of bovine derived deproteinized xenograft (DBBM), leukocyte and platelet rich fibrin (L-PRF) and the combination of both in Guided Bone Regeneration (GBR) performed in non-critical size defects in rabbit. Methods A prospective experimental study was performed. Four bone defects in the tibiae of 12 rabbits were made and each of them was filled with DBBM, L-PRF, a combination of DBBM + L-PRF or was left to heal as control site. All defects were covered with a collagen membrane. Rabbits were randomly distributed in three groups and euthanatized at 3, 6 or 9 weeks. Samples were obtained and histologically analyzed to determine vital bone, connective tissue and remaining graft particles percentage. Analysis of variance, Kruskal Wallis and non-paired t-test where used to evaluate the significance of the results. Results At 3 weeks of healing, DBBM showed significantly more vital bone percentage than L-PRF (p = 0,05) and DBBM + L-PRF showed significantly less connective tissue than control (p < 0,05). All other groups showed no statistical difference between them. At 6 weeks of healing, DBBM showed significantly more vital bone percentage than L-PRF (p < 0,05), DBBM + L-PRF (p < 0,05) and control (p < 0,05) and there wasn't any other significant difference regarding to connective tissue or remaining particle percentage between groups. At t 9 weeks healing period, there weren't any significant differences between groups. Conclusions DBBM seems to enhance vital bone formation at early healing stages. The use of L-PRF alone or combined with DBBM, didn't show any histological improvement regarding to vital bone formation. The use of DBBM, alone or in conjunction with L-PRF showed a trend to reduce connective tissue percentage. The use of L-PRF combined with DBBM didn't affect the remaining particle percentage.
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Affiliation(s)
- Andres Rezuc
- Mayor University, School of Dentistry, Santiago, Chile, Av. Libertador Bernardo O'Higgins 2013, Santiago, 8320000, Santiago, Chile
| | - Christian Saavedra
- San Sebastian University, Faculty of Dentistry, Puerto Montt, Chile, Lago Panguipulli, 1390, Puerto Montt, Los Lagos, Chile
| | - Rodrigo Maass
- Diego Portales University, Faculty of Medicine, Santiago, Chile, Av. Ejército Libertador 141, Santiago, 8370007, Santiago, Chile
| | - Cristian Poblete
- Mayor University, School of Medical Technology, Santiago, Chile, Camino La Pirámide 5750, Huechuraba. 8580745. Santiago, Chile
| | - Christian Nappe
- Pontifical Catholic University of Chile, Faculty of Medicine, School of Dentistry, Av. Vicuña Mackenna 4860, Macul, 7820436, Santiago, Chile
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228
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Schickert SDL, Jansen JA, Bronkhorst EM, van den Beucken JJJP, Leeuwenburgh SCG. Stabilizing dental implants with a fiber-reinforced calcium phosphate cement: An in vitro and in vivo study. Acta Biomater 2020; 110:280-288. [PMID: 32330608 DOI: 10.1016/j.actbio.2020.03.026] [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] [Received: 01/16/2020] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 01/30/2023]
Abstract
Stabilization of dental implants by means of biomaterials such as bioceramic granules and cements is currently compromised by the poor mechanical properties of these bioceramics. Recently, our group developed a calcium phosphate cement reinforced with poly(vinyl alcohol) fibers with improved flexural strength and toughness. Herein we evaluated the capacity of these fiber-reinforced calcium phosphate cements to stabilize dental implants in vitro and in vivo using a range of mechanical and biological test methods. In vitro, filling of circumferential crestal peri‑implant bone defects with synthetic bone analogues with fiber-reinforced calcium phosphate cement demonstrated superior implant stability as compared to fiber-free calcium phosphate cement over a 12-week period. Similarly, filling of circumferential crestal peri‑implant bone defects with fiber-reinforced calcium phosphate cement effectively stabilized dental implants installed in a rabbit femoral condyle defect as assessed via both Implant Stability Quotient (ISQ) and torque-out measurements. Moreover, histological and histomorphometric evaluation demonstrated the osteocompatibility of fiber-reinforced calcium phosphate cement, as evidenced by absence of soft tissue ingrowth, direct contact between the bone and cement, and gradual degradation of the biomaterial and replacement by newly-formed bone. These data demonstrate that fiber-reinforced calcium phosphate cement stabilize dental implants during osseointegration. STATEMENT OF SIGNIFICANCE: Dental implants can be placed immediately after a tooth is removed. However, in some cases the implant might not have enough bone surrounding it and becomes loose. To solve this, bioceramics have been used to fill the implant-bone gap. However, these materials have poor mechanical properties and are often not capable to stabilize the implant. Recently, our research group developed a new bone cement that is reinforced with fibers and has, therefore, enhanced mechanical properties. In this study, we have proven that by molding this cement into the implant-bone gap, we stabilize the implant and allow for a direct connection between the implant and the surrounding bone. Using this innovative cement is therefore a safe and efficient way of stabilizing dental implants.
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229
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Othman Z, Mohren R, Cillero-Pastor B, Shen Z, Lacroix Y, Guttenplan A, Tahmasebi Birgani Z, Eijssen L, Luider T, van Rijt S, Habibovic P. Comparative proteomic analysis of human mesenchymal stromal cell behavior on calcium phosphate ceramics with different osteoinductive potential. Mater Today Bio 2020; 7:100066. [PMID: 32642640 PMCID: PMC7334494 DOI: 10.1016/j.mtbio.2020.100066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 01/13/2023] Open
Abstract
In recent years, synthetic calcium phosphate (CaP) ceramics have emerged as an alternative to bone grafts in the treatment of large critical-sized bone defects. To successfully substitute for bone grafts, materials must be osteoinductive, that is, they must induce osteogenic differentiation and subsequent bone formation in vivo. Although a set of osteoinductive CaP ceramics has been developed, the precise biological mechanism by which a material directs cells toward osteogenesis and the role of individual chemical and physical properties in this mechanism remain incompletely understood. Here, we used proteomics to compare serum protein adsorption to two CaP ceramics with different osteoinductive potential, namely an osteoinductive β-tricalcium phosphate (TCP) and a non-osteoinductive hydroxyapatite (HA). Moreover, we analyzed the protein profiles of human mesenchymal stromal cells (hMSCs) cultured on these two ceramics. The serum protein adsorption experiments in the absence of cells highlighted the proteins that are highly abundant in the serum and/or have a high affinity to CaP. The extent of adsorption was suggested to be affected by the available surface area for binding and by the ion exchange dynamics on the surface. Several proteins were uniquely expressed by hMSCs on TCP and HA surfaces. Proteins identified as enriched on TCP were involved in processes related to wound healing, cell proliferation, and the production of extracellular matrix. On the other hand, proteins that were enriched on HA were involved in processes related to protein production, translation, localization, and secretion. In addition, we performed a separate proteomics analysis on TCP, HA, and two biphasic calcium phosphates with known osteoinductive potential and performed a clustering analysis on a combination of a set of proteins found to be enriched on osteoinductive materials with a set of proteins already known to be involved in osteogenesis. This yielded two protein networks potentially involved in the process of osteoinduction – one consisting of collagen fragments and collagen-related enzymes and a second consisting of endopeptidase inhibitors and regulatory proteins. The results of this study show that protein profiling can be a useful tool to help understand the effect of biomaterial properties on the interactions between a biomaterial and a biological system. Such understanding will contribute to the design and development of improved biomaterials for (bone) regenerative therapies.
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Affiliation(s)
- Z. Othman
- MERLN Institute for Technology-Inspired Regenerative Medicine, Department of Instructive Biomaterials Engineering, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - R.J.C. Mohren
- The Maastricht Multimodal Molecular Imaging Institute (M4I), Division of Imaging Mass Spectrometry, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, the Netherlands
| | - B. Cillero-Pastor
- The Maastricht Multimodal Molecular Imaging Institute (M4I), Division of Imaging Mass Spectrometry, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, the Netherlands
| | - Z. Shen
- MERLN Institute for Technology-Inspired Regenerative Medicine, Department of Instructive Biomaterials Engineering, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Y.S.N.W. Lacroix
- MERLN Institute for Technology-Inspired Regenerative Medicine, Department of Instructive Biomaterials Engineering, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - A.P.M. Guttenplan
- MERLN Institute for Technology-Inspired Regenerative Medicine, Department of Instructive Biomaterials Engineering, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Z. Tahmasebi Birgani
- MERLN Institute for Technology-Inspired Regenerative Medicine, Department of Instructive Biomaterials Engineering, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - L. Eijssen
- Department of Bioinformatics - BiGCaT, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, the Netherlands
- Department of Psychiatry and Neuropsychology, MHeNs School for Mental Health and Neuroscience Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, the Netherlands
| | - T.M. Luider
- Laboratory of Neuro-Oncology and Clinical and Cancer Proteomics, Department of Neurology, Erasmus University Medical Center, Wytemaweg 80, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - S. van Rijt
- MERLN Institute for Technology-Inspired Regenerative Medicine, Department of Instructive Biomaterials Engineering, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - P. Habibovic
- MERLN Institute for Technology-Inspired Regenerative Medicine, Department of Instructive Biomaterials Engineering, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
- Corresponding author.
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A Comprehensive Microstructural and Compositional Characterization of Allogenic and Xenogenic Bone: Application to Bone Grafts and Nanostructured Biomimetic Coatings. COATINGS 2020. [DOI: 10.3390/coatings10060522] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Bone grafts and bone-based materials are widely used in orthopedic surgery. However, the selection of the bone type to be used is more focused on the biological properties of bone sources than physico-chemical ones. Moreover, although biogenic sources are increasingly used for deposition of biomimetic nanostructured coatings, the influence of specific precursors used on coating’s morphology and composition has not yet been explored. Therefore, in order to fill this gap, we provided a detailed characterization of the properties of the mineral phase of the most used bone sources for allografts, xenografts and coating deposition protocols, not currently available. To this aim, several bone apatite precursors are compared in terms of composition and morphology. Significant differences are assessed for the magnesium content between female and male human donors, and in terms of Ca/P ratio, magnesium content and carbonate substitution between human bone and different animal bone sources. Prospectively, based on these data, bone from different sources can be used to obtain bone grafts having slightly different properties, depending on the clinical need. Likewise, the suitability of coating-based biomimetic films for specific clinical musculoskeletal application may depend on the type of apatite precursor used, being differently able to tune surface morphology and nanostructuration, as shown in the proof of concepts of thin film manufacturing here presented.
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231
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Zhang Y, Yu T, Peng L, Sun Q, Wei Y, Han B. Advancements in Hydrogel-Based Drug Sustained Release Systems for Bone Tissue Engineering. Front Pharmacol 2020; 11:622. [PMID: 32435200 PMCID: PMC7218105 DOI: 10.3389/fphar.2020.00622] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/20/2020] [Indexed: 12/13/2022] Open
Abstract
Bone defects caused by injury, disease, or congenital deformity remain a major health concern, and efficiently regenerating bone is a prominent clinical demand worldwide. However, bone regeneration is an intricate process that requires concerted participation of both cells and bioactive factors. Mimicking physiological bone healing procedures, the sustained release of bioactive molecules plays a vital role in creating an optimal osteogenic microenvironment and achieving promising bone repair outcomes. The utilization of biomaterial scaffolds can positively affect the osteogenesis process by integrating cells with bioactive factors in a proper way. A high water content, tunable physio-mechanical properties, and diverse synthetic strategies make hydrogels ideal cell carriers and controlled drug release reservoirs. Herein, we reviewed the current advancements in hydrogel-based drug sustained release systems that have delivered osteogenesis-inducing peptides, nucleic acids, and other bioactive molecules in bone tissue engineering (BTE).
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Affiliation(s)
- Yunfan Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Tingting Yu
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Liying Peng
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Qiannan Sun
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yan Wei
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Bing Han
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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232
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High Potential of Bacterial Adhesion on Block Bone Graft Materials. MATERIALS 2020; 13:ma13092102. [PMID: 32370084 PMCID: PMC7254222 DOI: 10.3390/ma13092102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 12/15/2022]
Abstract
Bone graft infections represent a challenge in daily clinics, resulting in increased patient discomfort and graft removal. The aim of this study was to investigate the initial adhesion of five representative pathogens on three different block bone graft materials (xenogeneic, alloplastic and allogeneic) and to assess if chlorhexidine (CHX) can effectively control the initial bacterial adhesion. Three different block bone grafting materials (Tutobone®, Endobon® and human spongiosa) were incubated with Escherichia coli, Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis and Pseudomonas aeruginosa in the presence or absence of 0.2% CHX solution. Bacterial adhesion was assessed by the direct counting of the colony-forming units (CFUs) and visualized by scanning electron microscopy (SEM). Overall, the selected bacterial species adhered successfully to all tested bone replacement scaffolds, which showed similar bacterial counts. The lg CFU values ranged from 5.29 ± 0.14 to 5.48 ± 0.72 for E. coli, from 4.37 ± 0.62 to 5.02 ± 0.48 for S. aureus, from 4.92 ± 0.34 to 4.95 ± 0.21 for S. mutans, from 4.97 ± 0.40 to 5.22 ± 0.13 for E. faecalis and from 4.23 ± 0.54 to 4.58 ± 0.26 for P. aeruginosa. CHX did not interfere with initial microbial adhesion, and yet it killed all adhered bacterial cells. Thus, CHX can be used to prevent subsequent biofilm infections.
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233
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Developments in Antibiotic-Eluting Scaffolds for the Treatment of Osteomyelitis. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10072244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Osteomyelitis is a devastating disease caused by the infection of bone tissue and is associated with significant morbidity and mortality. It is treated with antibiotic therapy and surgical debridement. A high dose of systemic antibiotics is often required due to poor bone penetration and this is often associated with unacceptable side-effects. To overcome this, local, implantable antibiotic carriers such as polymethyl methacrylate have been developed. However, this is a non-biodegradable material that requires a second surgery to be removed. Attention has therefore shifted to new antibiotic-eluting scaffolds which can be created with a range of unique properties. The purpose of this review is to assess the level of evidence that exists for these novel local treatments. Although this field is still developing, these strategies seem promising and provide hope for the future treatment of chronic osteomyelitis.
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234
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Aldemir Dikici B, Reilly GC, Claeyssens F. Boosting the Osteogenic and Angiogenic Performance of Multiscale Porous Polycaprolactone Scaffolds by In Vitro Generated Extracellular Matrix Decoration. ACS APPLIED MATERIALS & INTERFACES 2020; 12:12510-12524. [PMID: 32100541 PMCID: PMC7146758 DOI: 10.1021/acsami.9b23100] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 02/26/2020] [Indexed: 05/05/2023]
Abstract
Tissue engineering (TE)-based bone grafts are favorable alternatives to autografts and allografts. Both biochemical properties and the architectural features of TE scaffolds are crucial in their design process. Synthetic polymers are attractive biomaterials to be used in the manufacturing of TE scaffolds, due to various advantages, such as being relatively inexpensive, enabling precise reproducibility, possessing tunable mechanical/chemical properties, and ease of processing. However, such scaffolds need modifications to improve their limited interaction with biological tissues. Structurally, multiscale porosity is advantageous over single-scale porosity; therefore, in this study, we have considered two key points in the design of a bone repair material; (i) manufacture of multiscale porous scaffolds made of photocurable polycaprolactone (PCL) by a combination of emulsion templating and three-dimensional (3D) printing and (ii) decoration of these scaffolds with the in vitro generated bone-like extracellular matrix (ECM) to create biohybrid scaffolds that have improved biological performance compared to PCL-only scaffolds. Multiscale porous scaffolds were fabricated, bone cells were cultured on them, and then they were decellularized. The biological performance of these constructs was tested in vitro and in vivo. Mesenchymal progenitors were seeded on PCL-only and biohybrid scaffolds. Cells not only showed improved attachment on biohybrid scaffolds but also exhibited a significantly higher rate of cell growth and osteogenic activity. The chick chorioallantoic membrane (CAM) assay was used to explore the angiogenic potential of the biohybrid scaffolds. The CAM assay indicated that the presence of the in vitro generated ECM on polymeric scaffolds resulted in higher angiogenic potential and a high degree of tissue infiltration. This study demonstrated that multiscale porous biohybrid scaffolds present a promising approach to improve bioactivity, encourage precursors to differentiate into mature bones, and to induce angiogenesis.
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Affiliation(s)
- Betül Aldemir Dikici
- Department
of Materials Science and Engineering, Kroto Research Institute, University of Sheffield, Sheffield S3 7HQ, United Kingdom
- Department
of Materials Science and Engineering, INSIGNEO Institute for In Silico
Medicine, University of Sheffield, The Pam Liversidge Building, Sheffield S1 3JD, United Kingdom
| | - Gwendolen C. Reilly
- Department
of Materials Science and Engineering, INSIGNEO Institute for In Silico
Medicine, University of Sheffield, The Pam Liversidge Building, Sheffield S1 3JD, United Kingdom
| | - Frederik Claeyssens
- Department
of Materials Science and Engineering, Kroto Research Institute, University of Sheffield, Sheffield S3 7HQ, United Kingdom
- Department
of Materials Science and Engineering, INSIGNEO Institute for In Silico
Medicine, University of Sheffield, The Pam Liversidge Building, Sheffield S1 3JD, United Kingdom
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235
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Zhu H, Gomez M, Xiao J, Perale G, Betge F, Lyngstadaas SP, Haugen HJ. Xenohybrid Bone Graft Containing Intrinsically Disordered Proteins Shows Enhanced In Vitro Bone Formation. ACS APPLIED BIO MATERIALS 2020; 3:2263-2274. [DOI: 10.1021/acsabm.0c00064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Hao Zhu
- Department of Orthopedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, 430030 Wuhan, China
- Corticalis AS, Oslo Sciencepark, Gaustadallén 21, NO-0349 Oslo, Norway
| | - Manuel Gomez
- Corticalis AS, Oslo Sciencepark, Gaustadallén 21, NO-0349 Oslo, Norway
| | - Jun Xiao
- Department of Orthopedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, 430030 Wuhan, China
| | - Giuseppe Perale
- Industrie Biomediche Insubri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland
- Faculty of Biomedical Sciences, University of Southern Switzerland, Via G. Buffi 13, 6900 Lugano, Switzerland
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, 1200 Vienna, Austria
| | - Felice Betge
- Industrie Biomediche Insubri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland
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Mihatovic I, Schwarz F, Obreja K, Becker J, Sader R, Dard M, John G. Staged implant placement after defect regeneration using biphasic calcium phosphate materials with different surface topographies in a minipig model. Clin Oral Investig 2020; 24:3289-3298. [PMID: 31980922 DOI: 10.1007/s00784-020-03206-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/07/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the influence of biphasic calcium phosphate materials with different surface topographies on bone formation and osseointegration of titanium implants in standardized alveolar ridge defects. MATERIALS AND METHODS Standardized alveolar ridge defects (6 × 6 mm) were created in the mandible of 8 minipigs and filled with three biphasic calcium phosphate materials (BCP1-3, 90% tricalcium phosphate/10% hydroxyapatite) with different surface properties (micro- and macroporosities) as well as a bovine-derived natural bone mineral (NBM) as a control. At 12 weeks, implants were placed into the augmented defects. After further 8 weeks of healing, dissected blocks were processed for histological analysis (e.g., mineralized (MT), residual bone graft material (BS), bone-to-implant contact (BIC)). RESULTS All four biomaterials showed well-integrated graft particles and new bone formation within the defect area. MT values were comparable in all groups. BS values were highest in the NBM group (21.25 ± 13.52%) and markedly reduced in the different BCP groups, reaching statistical significance at BCP1-treated sites (9.2 ± 3.28%). All test and control groups investigated revealed comparable and statistically not significant different BIC values, ranging from 73.38 ± 20.5% (BCP2) to 84.11 ± 7.84% (BCP1), respectively. CONCLUSION All bone graft materials facilitated new bone formation and osseointegration after 12 + 8 weeks of healing.
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Affiliation(s)
- I Mihatovic
- Department of Oral Surgery and Central Admittance, University Hospital, Heichrich-Heine-University, Düsseldorf, Germany
| | - F Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany.
| | - K Obreja
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
| | - J Becker
- Department of Oral Surgery and Central Admittance, University Hospital, Heichrich-Heine-University, Düsseldorf, Germany
| | - R Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | - M Dard
- Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University, College of Dental Medicine, New York, USA
| | - G John
- Department of Oral Surgery and Central Admittance, University Hospital, Heichrich-Heine-University, Düsseldorf, Germany
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237
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Carcuac O, Abrahamsson I, Derks J, Petzold M, Berglundh T. Spontaneous progression of experimental peri-implantitis in augmented and pristine bone: A pre-clinical in vivo study. Clin Oral Implants Res 2020; 31:192-200. [PMID: 31838762 DOI: 10.1111/clr.13564] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/02/2019] [Accepted: 12/07/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To examine the progression of experimental peri-implantitis around different implants placed in augmented and pristine sites. MATERIALS AND METHODS Six labrador dogs were used. Three months after tooth extraction, four implants with different surface modifications were installed on each side of the mandible. A standard osteotomy was applied on one side, while on the contralateral side the osteotomy was modified, resulting in a gap between the implant and the bone wall. The gap was filled with a bone substitute and covered by a resorbable membrane. Three months after implant installation, implants were exposed and healing abutments were connected. Two months later, oral hygiene procedures were abandoned and a cotton ligature was placed in a submarginal position around the neck of all implants and kept in place for 4 weeks. Following ligature removal, plaque formation continued for 6 months (spontaneous progression period). Radiographs were obtained throughout the experiment, and biopsies were collected and prepared for histological evaluation at the end of the spontaneous progression period. RESULTS Differences in bone loss during the spontaneous progression period between pristine and augmented sites were small. The size and vertical dimension of the peri-implantitis lesion were larger at augmented than at pristine sites. Implants with non-modified surfaces exhibited smaller amounts of bone loss and smaller dimensions of peri-implantitis lesions than implants with modified surfaces. CONCLUSION Small differences in spontaneous progression of peri-implantitis were detected between pristine and augmented sites. Implants with modified surfaces exhibited more bone loss and larger lesions than implants with non-modified surfaces, irrespective of the type of surrounding bone.
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Affiliation(s)
- Olivier Carcuac
- Department of Periodontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingemar Abrahamsson
- Department of Periodontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan Derks
- Department of Periodontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Max Petzold
- Centre for Applied Biostatistics, Occupational and Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tord Berglundh
- Department of Periodontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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238
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Strategies towards Orthopaedic Tissue Engineered Graft Generation: Current Scenario and Application. BIOTECHNOL BIOPROC E 2019. [DOI: 10.1007/s12257-019-0086-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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239
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Tonetti MS, Jung RE, Avila-Ortiz G, Blanco J, Cosyn J, Fickl S, Figuero E, Goldstein M, Graziani F, Madianos P, Molina A, Nart J, Salvi GE, Sanz-Martin I, Thoma D, Van Assche N, Vignoletti F. Management of the extraction socket and timing of implant placement: Consensus report and clinical recommendations of group 3 of the XV European Workshop in Periodontology. J Clin Periodontol 2019; 46 Suppl 21:183-194. [PMID: 31215112 DOI: 10.1111/jcpe.13131] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 05/03/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND The transition from a tooth requiring extraction to its replacement (with a dental implant) requires a series of clinical decisions related to timing, approach, materials, cost-effectiveness and the assessment of potential harm and patient preference. This workshop focused on the formulation of evidence-based consensus statements and clinical recommendations. METHODS Four systematic reviews covering the areas of alveolar ridge preservation/bone grafting, immediate early and delayed implant placement and alveolar bone augmentation at the time of implant placement in a healed ridge formed the basis of the deliberations. The level of evidence supporting each consensus statement and its strength was described using a modification of the GRADE tool. RESULTS The evidence base for each of the relevant topics was assessed and summarized in 23 consensus statements and 12 specific clinical recommendations. The group emphasized that the evidence base mostly relates to single tooth extraction/replacement; hence, external validity/applicability to multiple extractions requires careful consideration. The group identified six considerations that should assist clinicians in clinical decision-making: presence of infection, inability to achieve primary stability in the restoratively driven position, presence of a damaged alveolus, periodontal phenotype, aesthetic demands and systemic conditions. CONCLUSIONS A substantial and expanding evidence base is available to assist clinicians with clinical decision-making related to the transition from a tooth requiring extraction to its replacement with a dental implant. More high-quality research is needed for the development of evidence-based clinical guidelines.
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Affiliation(s)
- Maurizio S Tonetti
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.,European Research Group on Periodontology, Genova, Italy
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | | | - Juan Blanco
- Department of Surgery and Medical-Surgical Specialties (Dentistry area), Unit of Periodontology, University of Santiago de Compostela, Santiago, Spain
| | - Jan Cosyn
- Department of Dentistry, University of Ghent, Ghent, Belgium
| | - Stefan Fickl
- Division of Periodontology, University of Würzburg, Würzburg, Germany
| | - Elena Figuero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Department of Dental Clinic Specialties, Faculty of Dentistry, University Complutense, Madrid, Spain
| | - Moshe Goldstein
- Department of Periodontology, Hebrew University, Jerusalem, Israel
| | - Filippo Graziani
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Phoebus Madianos
- Department of Periodontology, Kapodistrian University, Athens, Greece
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Department of Dental Clinic Specialties, Faculty of Dentistry, University Complutense, Madrid, Spain
| | - Jose Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ignacio Sanz-Martin
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Department of Dental Clinic Specialties, Faculty of Dentistry, University Complutense, Madrid, Spain
| | - Daniel Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Nele Van Assche
- Private Practice of Periodontology and Implantology, Geel, Belgium
| | - Fabio Vignoletti
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Department of Dental Clinic Specialties, Faculty of Dentistry, University Complutense, Madrid, Spain
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Sanz M, Dahlin C, Apatzidou D, Artzi Z, Bozic D, Calciolari E, De Bruyn H, Dommisch H, Donos N, Eickholz P, Ellingsen JE, Haugen HJ, Herrera D, Lambert F, Layrolle P, Montero E, Mustafa K, Omar O, Schliephake H. Biomaterials and regenerative technologies used in bone regeneration in the craniomaxillofacial region: Consensus report of group 2 of the 15th European Workshop on Periodontology on Bone Regeneration. J Clin Periodontol 2019; 46 Suppl 21:82-91. [PMID: 31215114 DOI: 10.1111/jcpe.13123] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS To review the regenerative technologies used in bone regeneration: bone grafts, barrier membranes, bioactive factors and cell therapies. MATERIAL AND METHODS Four background review publications served to elaborate this consensus report. RESULTS AND CONCLUSIONS Biomaterials used as bone grafts must meet specific requirements: biocompatibility, porosity, osteoconductivity, osteoinductivity, surface properties, biodegradability, mechanical properties, angiogenicity, handling and manufacturing processes. Currently used biomaterials have demonstrated advantages and limitations based on the fulfilment of these requirements. Similarly, membranes for guided bone regeneration (GBR) must fulfil specific properties and potential biological mechanisms to improve their clinical applicability. Pre-clinical and clinical studies have evaluated the added effect of bone morphogenetic proteins (mainly BMP-2) and autologous platelet concentrates (APCs) when used as bioactive agents to enhance bone regeneration. Three main approaches using cell therapies to enhance bone regeneration have been evaluated: (a) "minimally manipulated" whole tissue fractions; (b) ex vivo expanded "uncommitted" stem/progenitor cells; and (c) ex vivo expanded "committed" bone-/periosteum-derived cells. Based on the evidence from clinical trials, transplantation of cells, most commonly whole bone marrow aspirates (BMA) or bone marrow aspirate concentrations (BMAC), in combination with biomaterial scaffolds has demonstrated an additional effect in sinus augmentation and horizontal ridge augmentation, and comparable bone regeneration to autogenous bone in alveolar cleft repair.
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Affiliation(s)
- Mariano Sanz
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Danae Apatzidou
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Zvi Artzi
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Darko Bozic
- Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Elena Calciolari
- Centre for Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Hugo De Bruyn
- Department Periodontology & Implantology, College of Dental Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nikos Donos
- Centre for Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Peter Eickholz
- Department of Periodontology, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Jan E Ellingsen
- Department of Prosthetics an Oral Function, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Håvard J Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - David Herrera
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - France Lambert
- Dental Biomaterials Research Unit (d-BRU), Department of Periodontology and Oral Surgery, University of Liège (ULiège), ULiège, Belgium
| | - Pierre Layrolle
- Inserm, U791, Laboratory for Osteoarticular and Dental Tissue Engineering, Faculty of Dental Surgery, University of Nantes, Nantes Cedex 1, France
| | - Eduardo Montero
- Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Kamal Mustafa
- Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Bergen, Norway
| | - Omar Omar
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, George-Augusta-University, Gottingen, Germany
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Perale G, Monjo M, Ramis JM, Øvrebø Ø, Betge F, Lyngstadaas P, Haugen HJ. Biomimetic Biomolecules in Next Generation Xeno-Hybrid Bone Graft Material Show Enhanced In Vitro Bone Cells Response. J Clin Med 2019; 8:jcm8122159. [PMID: 31817744 PMCID: PMC6947180 DOI: 10.3390/jcm8122159] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 11/27/2019] [Accepted: 12/04/2019] [Indexed: 12/18/2022] Open
Abstract
Bone defects resulting from trauma, disease, surgery or congenital malformations are a significant health problem worldwide. Consequently, bone is the second most transplanted tissue just after blood. Although bone grafts (BGs) have been used for decades to improve bone repairs, none of the currently available BGs possesses all the desirable characteristics. One way to overcome such limitations is to introduce the feature of controlled release of active bone-promoting biomolecules: however, the administration of, e.g., recombinant Bone morphogenetic proteins (BMPs) have been used in concentrations overshooting physiologically occurring concentrations and has thus raised concerns as documented side effects were recorded. Secondly, most such biomolecules are very sensitive to organic solvents and this hinders their use. Here, we present a novel xeno-hybrid bone graft, SmartBonePep®, with a new type of biomolecule (i.e., intrinsically disordered proteins, IDPs) that is both resistant to processing with organic solvent and both triggers bone cells proliferation and differentiation. SmartBonePep® is an advanced and improved modification of SmartBone®, which is a bone substitute produced by combining naturally-derived mineral bone structures with resorbable polymers and collagen fragments. Not only have we demonstrated that Intrinsically Disordered Proteins (IDPs) can be successfully and safely loaded onto a SmartBonePep®, withstanding the hefty manufacturing processes, but also made them bioavailable in a tuneable manner and proved that these biomolecules are a robust and resilient biomolecule family, being a better candidate with respect to other biomolecules for effectively producing the next generation bone grafts. Most other biomolecules which enhances bone formation, e.g., BMP, would not have tolerated the organic solvent used to produce SmartBonePep®.
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Affiliation(s)
- Giuseppe Perale
- Industrie Biomediche Insubri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland; (Ø.Ø.); (F.B.)
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, 1200 Vienna, Austria
- Correspondence:
| | - Marta Monjo
- Cell Therapy and Tissue Engineering Group, Research Institute on Health Sciences (IUNICS), University of the Balearic Islands. Ctra. Valldemossa km 7.5, 07122 Palma de Mallorca, Spain; (M.M.); (J.M.R.)
- Balearic Islands Health Research Institute (IdISBa), 07010 Palma de Mallorca, Spain
| | - Joana M. Ramis
- Cell Therapy and Tissue Engineering Group, Research Institute on Health Sciences (IUNICS), University of the Balearic Islands. Ctra. Valldemossa km 7.5, 07122 Palma de Mallorca, Spain; (M.M.); (J.M.R.)
- Balearic Islands Health Research Institute (IdISBa), 07010 Palma de Mallorca, Spain
| | - Øystein Øvrebø
- Industrie Biomediche Insubri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland; (Ø.Ø.); (F.B.)
- Corticalis AS, Oslo Sciencepark, Gaustadallen 21, 0349 Oslo, Norway; (P.L.); (H.J.H.)
| | - Felice Betge
- Industrie Biomediche Insubri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland; (Ø.Ø.); (F.B.)
| | - Petter Lyngstadaas
- Corticalis AS, Oslo Sciencepark, Gaustadallen 21, 0349 Oslo, Norway; (P.L.); (H.J.H.)
| | - Håvard J. Haugen
- Corticalis AS, Oslo Sciencepark, Gaustadallen 21, 0349 Oslo, Norway; (P.L.); (H.J.H.)
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Grottoli CF, Cingolani A, Zambon F, Ferracini R, Villa T, Perale G. Simulated Performance of a Xenohybrid Bone Graft (SmartBone ®) in the Treatment of Acetabular Prosthetic Reconstruction. J Funct Biomater 2019; 10:E53. [PMID: 31766685 PMCID: PMC6963854 DOI: 10.3390/jfb10040053] [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: 09/28/2019] [Revised: 11/15/2019] [Accepted: 11/20/2019] [Indexed: 02/06/2023] Open
Abstract
Total hip arthroplasty (THA) is a surgical procedure for the replacement of hip joints with artificial prostheses. Several approaches are currently employed in the treatment of this kind of defect. Overall, the most common method involves using a quite invasive metallic support (a Burch-Schneider ring). Moreover, valid alternatives and less invasive techniques still need to be supported by novel material development. In this work, we evaluated the performance of SmartBone®, a xenohybrid bone graft composed of a bovine bone matrix reinforced with biodegradable polymers and collagen, as an effective support in acetabular prosthesis reconstruction. Specifically, the material's mechanical properties were experimentally determined (E = ~1.25 GPa, Ef = ~0.34 GPa, and Et = ~0.49 GPa) and used for simulation of the hip joint system with a SmartBone® insert. Moreover, a comparison with a similar case treated with a Burch-Schneider ring was also conducted. It was found that it is possible to perform THA revision surgeries without the insertion of an invasive metal support and it can be nicely combined with SmartBone®'s osteointegration characteristics. The material can withstand the loads independently (σmax = ~12 MPa) or be supported by a thinner titanium plate in contact with the bone in the worst cases. This way, improved bone regeneration can be achieved.
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Affiliation(s)
| | - Alberto Cingolani
- Industrie Biomediche Insubri SA, 6805 Mezzovico-Vira, Switzerland; (C.F.G.); (A.C.)
| | - Fabio Zambon
- Politecnico di Milano, Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering “G. Natta”, 20133 Milan, Italy; (F.Z.); (T.V.)
| | - Riccardo Ferracini
- Department of Surgical Sciences and Integrated Diagnostics, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy;
- IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genova, Italy
| | - Tomaso Villa
- Politecnico di Milano, Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering “G. Natta”, 20133 Milan, Italy; (F.Z.); (T.V.)
| | - Giuseppe Perale
- Industrie Biomediche Insubri SA, 6805 Mezzovico-Vira, Switzerland; (C.F.G.); (A.C.)
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, 1200 Vienna, Austria
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243
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Abdulghani S, Mitchell GR. Biomaterials for In Situ Tissue Regeneration: A Review. Biomolecules 2019; 9:E750. [PMID: 31752393 PMCID: PMC6920773 DOI: 10.3390/biom9110750] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/15/2019] [Accepted: 11/17/2019] [Indexed: 12/11/2022] Open
Abstract
This review focuses on a somewhat unexplored strand of regenerative medicine, that is in situ tissue engineering. In this approach manufactured scaffolds are implanted in the injured region for regeneration within the patient. The scaffold is designed to attract cells to the required volume of regeneration to subsequently proliferate, differentiate, and as a consequence develop tissue within the scaffold which in time will degrade leaving just the regenerated tissue. This review highlights the wealth of information available from studies of ex-situ tissue engineering about the selection of materials for scaffolds. It is clear that there are great opportunities for the use of additive manufacturing to prepare complex personalized scaffolds and we speculate that by building on this knowledge and technology, the development of in situ tissue engineering could rapidly increase. Ex-situ tissue engineering is handicapped by the need to develop the tissue in a bioreactor where the conditions, however optimized, may not be optimum for accelerated growth and maintenance of the cell function. We identify that in both methodologies the prospect of tissue regeneration has created much promise but delivered little outside the scope of laboratory-based experiments. We propose that the design of the scaffolds and the materials selected remain at the heart of developments in this field and there is a clear need for predictive modelling which can be used in the design and optimization of materials and scaffolds.
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Affiliation(s)
- Saba Abdulghani
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-080 Marinha Grande, Portugal;
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Abstract
This review focuses on a somewhat unexplored strand of regenerative medicine, that is in situ tissue engineering. In this approach manufactured scaffolds are implanted in the injured region for regeneration within the patient. The scaffold is designed to attract cells to the required volume of regeneration to subsequently proliferate, differentiate, and as a consequence develop tissue within the scaffold which in time will degrade leaving just the regenerated tissue. This review highlights the wealth of information available from studies of ex-situ tissue engineering about the selection of materials for scaffolds. It is clear that there are great opportunities for the use of additive manufacturing to prepare complex personalized scaffolds and we speculate that by building on this knowledge and technology, the development of in situ tissue engineering could rapidly increase. Ex-situ tissue engineering is handicapped by the need to develop the tissue in a bioreactor where the conditions, however optimized, may not be optimum for accelerated growth and maintenance of the cell function. We identify that in both methodologies the prospect of tissue regeneration has created much promise but delivered little outside the scope of laboratory-based experiments. We propose that the design of the scaffolds and the materials selected remain at the heart of developments in this field and there is a clear need for predictive modelling which can be used in the design and optimization of materials and scaffolds.
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245
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Histological Evaluation of a New Beta-Tricalcium Phosphate/Hydroxyapatite/Poly (1-Lactide-Co-Caprolactone) Composite Biomaterial in the Inflammatory Process and Repair of Critical Bone Defects. Symmetry (Basel) 2019. [DOI: 10.3390/sym11111356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: The use of biomaterials is commonplace in dentistry for bone regeneration. The aim of this study was to evaluate the performance of a new alloplastic material for bone repair in critical defects and to evaluate the extent of the inflammatory process. Methods: Forty-five New Zealand rabbits were divided into five groups according to evaluation time (7, 14, 30, 60, 120 days), totaling 180 sites with six-millimeter diameter defects in their tibiae. The defects were filled with alloplastic material consisting of poly (lactide-co-caprolactone), beta-tricalcium phosphate, hydroxyapatite and nano-hydroxyapatite (BTPHP) in three different presentations: paste, block, and membrane. Comparisons were established with reference materials, such as Bio-ossTM, Bio-oss CollagenTM, and Bio-gideTM, respectively. The samples were HE-stained and evaluated for inflammatory infiltrate (scored for intensity from 0 to 3) and the presence of newly formed bone at the periphery of the defects. Results: Greater bone formation was observed for the alloplastic material and equivalent inflammatory intensity for both materials, regardless of evaluation time. At 30 days, part of the synthetic biomaterial, regardless of the presentation, was resorbed. Conclusions: We concluded that this novel alloplastic material showed osteoconductive potential, biocompatibility, low inflammatory response, and gradual resorption, thus an alternative strategy for guided bone regeneration.
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246
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Zare EN, Makvandi P, Ashtari B, Rossi F, Motahari A, Perale G. Progress in Conductive Polyaniline-Based Nanocomposites for Biomedical Applications: A Review. J Med Chem 2019; 63:1-22. [PMID: 31502840 DOI: 10.1021/acs.jmedchem.9b00803] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Inherently conducting polymers (ICPs) are a specific category of synthetic polymers with distinctive electro-optic properties, which involve conjugated chains with alternating single and double bonds. Polyaniline (PANI), as one of the most well-known ICPs, has outstanding potential applications in biomedicine because of its high electrical conductivity and biocompatibility caused by its hydrophilic nature, low-toxicity, good environmental stability, and nanostructured morphology. Some of the limitations in the use of PANI, such as its low processability and degradability, can be overcome by the preparation of its blends and nanocomposites with various (bio)polymers and nanomaterials, respectively. This review describes the state-of-the-art of biological activities and applications of conductive PANI-based nanocomposites in the biomedical fields, such as antimicrobial therapy, drug delivery, biosensors, nerve regeneration, and tissue engineering. The latest progresses in the biomedical applications of PANI-based nanocomposites are reviewed to provide a background for future research.
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Affiliation(s)
| | - Pooyan Makvandi
- Department of Medical Nanotechnology, Faculty of Advanced Technology in Medicine , Iran University of Medical Sciences , Tehran 14496-14535 , Iran.,Institute for Polymers, Composites and Biomaterials (IPCB), National Research Council (CNR) , Naples 80125 , Italy
| | - Behnaz Ashtari
- Department of Medical Nanotechnology, Faculty of Advanced Technology in Medicine , Iran University of Medical Sciences , Tehran 14496-14535 , Iran.,Shadad Ronak Commercialization Company , Pasdaran Street , Tehran , 1947 , Iran
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical Engineering , Politecnico di Milano Technical University , Milano 20133 , Italy
| | - Ahmad Motahari
- Young Researchers and Elite Club, Jahrom Branch , Islamic Azad University , Jahrom 74147-85318 , Iran
| | - Giuseppe Perale
- Biomaterials Laboratory, Institute for Mechanical Engineering and Materials Technology , University of Applied Sciences and Arts of Southern Switzerland , Manno 6928 , Switzerland.,Department of Surgical Sciences, Faculty of Medical Sciences, Orthopaedic Clinic , IRCCS A.O.U. San Martino , Genova 16132 , Italy.,Ludwig Boltzmann Institute for Experimental and Clinical Traumatology , Donaueschingenstrasse 13 , 1200 Vienna , Austria
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Synthetic Blocks for Bone Regeneration: A Systematic Review and Meta-Analysis. Int J Mol Sci 2019; 20:ijms20174221. [PMID: 31466409 PMCID: PMC6747264 DOI: 10.3390/ijms20174221] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/25/2019] [Accepted: 08/26/2019] [Indexed: 12/15/2022] Open
Abstract
This systematic review is aimed at evaluating the effectiveness of synthetic block materials for bone augmentation in preclinical in vivo studies. An electronic search was performed on Pubmed, Scopus, EMBASE. Articles selected underwent risk-of-bias assessment. The outcomes were: new bone formation and residual graft with histomorphometry, radiographic bone density, soft tissue parameters, complications. Meta-analysis was performed to compare new bone formation in test (synthetic blocks) vs. control group (autogenous blocks or spontaneous healing). The search yielded 214 articles. After screening, 39 studies were included, all performed on animal models: rabbits (n = 18 studies), dogs (n = 4), rats (n = 7), minipigs (n = 4), goats (n = 4), and sheep (n = 2). The meta-analysis on rabbit studies showed significantly higher new bone formation for synthetic blocks with respect to autogenous blocks both at four-week (mean difference (MD): 5.91%, 95% confidence intervals (CI): 1.04, 10.79%, p = 0.02) and at eight-week healing (MD: 4.44%, 95% CI: 0.71, 8.17%, p = 0.02). Other animal models evidenced a trend for better outcomes with synthetic blocks, though only based on qualitative analysis. Synthetic blocks may represent a viable resource in bone regenerative surgery for achieving new bone formation. Differences in the animal models, the design of included studies, and the bone defects treated should be considered when generalizing the results. Clinical studies are needed to confirm the effectiveness of synthetic blocks in bone augmentation procedures.
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Kattimani V, Lingamaneni KP, Yalamanchili S, Mupparapu M. Use of eggshell-derived nano-hydroxyapatite as novel bone graft substitute-A randomized controlled clinical study. J Biomater Appl 2019; 34:597-614. [PMID: 31324126 DOI: 10.1177/0885328219863311] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Vivekanand Kattimani
- 1 Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, India
| | | | - Samatha Yalamanchili
- 2 Department of Oral Medicine and Radiology, Sibar Institute of Dental Sciences, Guntur, India
| | - Muralidhar Mupparapu
- 3 Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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Cao XY, Tian N, Dong X, Cheng CK. Polylactide Composite Pins Reinforced with Bioresorbable Continuous Glass Fibers Demonstrating Bone-like Apatite Formation and Spiral Delamination Degradation. Polymers (Basel) 2019; 11:E812. [PMID: 31064109 PMCID: PMC6572480 DOI: 10.3390/polym11050812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 11/17/2022] Open
Abstract
The emergence of polylactide composites reinforced with bioresorbable silicate glass fibers has allowed for the long-term success of biodegradable polymers in load-bearing orthopedic applications. However, few studies have reported on the degradation behavior and bioactivity of such biocomposites. The aim of this work was to investigate the degradation behavior and in vitro bioactivity of a novel biocomposite pin composed of bioresorbable continuous glass fibers and poly-L-D-lactide in simulated body fluid for 78 weeks. As the materials degraded, periodic spiral delamination formed microtubes and funnel-shaped structures in the biocomposite pins. It was speculated that the direction of degradation, from both ends towards the middle of the fibers and from the surface through to the bulk of the polymer matrix, could facilitate bone healing. Following immersion in simulated body fluid, a bone-like apatite layer formed on the biocomposite pins which had a similar composition and structure to natural bone. The sheet- and needle-like apatite nanostructure was doped with sodium, magnesium, and carbonate ions, which acted to lower the Ca/P atomic ratio to less than the stoichiometric apatite and presented a calcium-deficient apatite with low crystallinity. These findings demonstrated the bioactivity of the new biocomposite pins in vitro and their excellent potential for load-bearing applications.
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Affiliation(s)
- Xiao-Yan Cao
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China.
| | - Na Tian
- Beijing Engineering Laboratory of Functional Medical Materials and Devices, Beijing Naton Technology Group Co. LTD, Beijing 100094, China.
| | - Xiang Dong
- Beijing Engineering Laboratory of Functional Medical Materials and Devices, Beijing Naton Technology Group Co. LTD, Beijing 100094, China.
| | - Cheng-Kung Cheng
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China.
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China.
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250
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Han SH, Jung SH, Lee JH. Preparation of beta-tricalcium phosphate microsphere-hyaluronic acid-based powder gel composite as a carrier for rhBMP-2 injection and evaluation using long bone segmental defect model. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2019; 30:679-693. [DOI: 10.1080/09205063.2019.1601871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Shi Huan Han
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, SMG-SNU Boramae Medical Center, Seoul, Korea
- Department of Orthopedic Surgery, YanBian University Hospital, Yanji, China
| | - Su Hyun Jung
- Research & Development Center, CG Bio Co. Ltd. Seongnam-si, Gyeonggi-do, Korea
| | - Jae Hyup Lee
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, SMG-SNU Boramae Medical Center, Seoul, Korea
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Medical Research Center, Seoul, Korea
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