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Clem DS, McClain PK, McGuire MK, Richardson CR, Santarelli GA, Schallhorn RA, Scheyer ET, Gunsolley JC, Morelli T. Harvest graft substitute for soft tissue volume augmentation around existing implants: A randomized, controlled and blinded multicenter trial. J Periodontol 2024; 95:740-748. [PMID: 38071454 DOI: 10.1002/jper.23-0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/15/2023] [Accepted: 10/27/2023] [Indexed: 08/24/2024]
Abstract
BACKGROUND Using a single-blind, randomized, controlled, multicenter, practice-based clinical trial, a volume-stable collagen matrix (VCMX) was compared with connective tissue graft (CTG) for soft tissue augmentation around existing dental implants. METHODS Sixty patients (31 VCMX and 31 CTG) were included. The primary outcome was a soft tissue thickness change 3 mm below the gingival margin (GM). Secondary outcomes included clinical measures, such as keratinized tissue widths (KTw), probing pocket depths, and pink esthetic scores, and patient-reported outcomes (PRO). RESULTS There were no significant differences between test and control patient demographics or clinical measures throughout the 1-year study. VCMX "grafts" were by design larger than CTG, and surgery time was less (27% less, p = 0.0005). Three millimeters below the GM (primary endpoint), tissue thickness increase was noninferior for VCMX compared with CTG (0.93 ± 0.80 mm vs. 1.10 ± 0.51 mm, respectively), inferior (by 0.25 mm) at 1 mm, and noninferior at 5 mm. Postoperative pain was significantly less for VCMX patients (p < 0.0001), but all other PRO measures, including esthetics and satisfaction, improved similarly for both therapies. CONCLUSIONS Given the inclusion criteria for this study, namely soft tissue augmentation around existing implants with some evidence of KTw and minimal recession, VCMX provided soft tissue thickness and volume increases similar (noninferior) to CTG. Clinical measures and PRO were similar between therapies-site sensitivity and esthetics improved similarly for both therapies-but surgery time and pain following surgery were significantly less for VCMX.
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Affiliation(s)
- Donald S Clem
- The McGuire Institute (iMc - practice-based clinical research network) Houston, Houston, Texas, USA
- University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Pamela K McClain
- The McGuire Institute (iMc - practice-based clinical research network) Houston, Houston, Texas, USA
- Private Practice Aurora, Aurora, Colorado, USA
| | - Michael K McGuire
- The McGuire Institute (iMc - practice-based clinical research network) Houston, Houston, Texas, USA
- Private Practice Houston, Houston, Texas, USA
| | - Chris R Richardson
- The McGuire Institute (iMc - practice-based clinical research network) Houston, Houston, Texas, USA
- Private Practice Richmond, Richmond, Virginia, USA
| | - Greg A Santarelli
- The McGuire Institute (iMc - practice-based clinical research network) Houston, Houston, Texas, USA
- Private Practice Kenosha, Kenosha, Wisconsin, USA
| | - Rachel A Schallhorn
- The McGuire Institute (iMc - practice-based clinical research network) Houston, Houston, Texas, USA
- Private Practice Aurora, Aurora, Colorado, USA
| | - E Todd Scheyer
- The McGuire Institute (iMc - practice-based clinical research network) Houston, Houston, Texas, USA
- Private Practice Houston, Houston, Texas, USA
| | - John C Gunsolley
- The McGuire Institute (iMc - practice-based clinical research network) Houston, Houston, Texas, USA
- School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Thiago Morelli
- The McGuire Institute (iMc - practice-based clinical research network) Houston, Houston, Texas, USA
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Rahimnejad M, Makkar H, Dal-Fabbro R, Malda J, Sriram G, Bottino MC. Biofabrication Strategies for Oral Soft Tissue Regeneration. Adv Healthc Mater 2024; 13:e2304537. [PMID: 38529835 PMCID: PMC11254569 DOI: 10.1002/adhm.202304537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/01/2024] [Indexed: 03/27/2024]
Abstract
Gingival recession, a prevalent condition affecting the gum tissues, is characterized by the exposure of tooth root surfaces due to the displacement of the gingival margin. This review explores conventional treatments, highlighting their limitations and the quest for innovative alternatives. Importantly, it emphasizes the critical considerations in gingival tissue engineering leveraging on cells, biomaterials, and signaling factors. Successful tissue-engineered gingival constructs hinge on strategic choices such as cell sources, scaffold design, mechanical properties, and growth factor delivery. Unveiling advancements in recent biofabrication technologies like 3D bioprinting, electrospinning, and microfluidic organ-on-chip systems, this review elucidates their precise control over cell arrangement, biomaterials, and signaling cues. These technologies empower the recapitulation of microphysiological features, enabling the development of gingival constructs that closely emulate the anatomical, physiological, and functional characteristics of native gingival tissues. The review explores diverse engineering strategies aiming at the biofabrication of realistic tissue-engineered gingival grafts. Further, the parallels between the skin and gingival tissues are highlighted, exploring the potential transfer of biofabrication approaches from skin tissue regeneration to gingival tissue engineering. To conclude, the exploration of innovative biofabrication technologies for gingival tissues and inspiration drawn from skin tissue engineering look forward to a transformative era in regenerative dentistry with improved clinical outcomes.
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Affiliation(s)
- Maedeh Rahimnejad
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Hardik Makkar
- Faculty of Dentistry, National University of Singapore, Singapore
| | - Renan Dal-Fabbro
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Jos Malda
- Regenerative Medicine Center Utrecht, Utrecht, The Netherlands
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gopu Sriram
- Faculty of Dentistry, National University of Singapore, Singapore
- NUS Centre for Additive Manufacturing (AM.NUS), National University of Singapore, Singapore
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Marco C. Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
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3
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Sun TC, Chang TK. Soft tissue management around dental implant in esthetic zone - the current concepts and novel techniques. J Dent Sci 2024; 19:1348-1358. [PMID: 39035283 PMCID: PMC11259688 DOI: 10.1016/j.jds.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/02/2024] [Indexed: 07/23/2024] Open
Abstract
It has been said, 'Bone sets the tone, but tissue is the issue.' In the field of implantology, while significant breakthroughs have been achieved in hard tissue regeneration, clinicians find it more challenging to handle soft tissue complications around dental implants. Successfully managing soft tissue around dental implants requires clinicians to have comprehensive knowledge of proper implant placement, prosthetic design and tissue management, and a high level of surgical skills for soft tissue augmentation and grafting. Autogenous gingival grafts can be utilized in various clinical situations, providing surgeons with great potential and freedom to enhance the quality and quantity of peri-implant soft tissue. Emerging trends, such as digital tools for treatment planning, minimally invasive surgical approaches, and innovative biomaterials, can also contribute to a more pleasing outcome. By elucidating these multifaceted considerations, this review will serve as a valuable resource for clinicians aiming to achieve functional and aesthetic excellence in implant-based oral rehabilitation.
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Affiliation(s)
- Teresa Chanting Sun
- Department of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan
| | - Tsung-Kai Chang
- Department of Prosthodontics, Mackay Memorial Hospital, Taipei, Taiwan
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Bienz SP, Gadzo N, Zuercher AN, Wiedemeier D, Jung RE, Thoma DS. Clinical and histological wound healing patterns of collagen-based substitutes: An experimental randomized controlled trial in standardized palatal defects in humans. J Clin Periodontol 2024; 51:319-329. [PMID: 38017650 DOI: 10.1111/jcpe.13903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 11/30/2023]
Abstract
AIM To evaluate the progression of wound healing of standardized palatal defects in groups using three different collagen-based wound dressings and a control group, in terms of wound closure, pain perception and descriptive histology. MATERIALS AND METHODS Twenty participants were enrolled in this experimental study, in whom four palatal defects were created. The defects (6 mm diameter, 3 mm depth) were randomly assigned to one of four treatment modalities: C (control), MG (Mucograft®), MD (mucoderm®) and FG (Fibro-Gide®). Photographs were taken, and pain assessment was performed before and after treatment and at 5, 7, 9, 12, 14 and 16 days after surgery. All participants wore a palatal splint for a duration of 16 days. RESULTS All groups achieved complete wound closure at 14 days. The percentage of the remaining open wound on day 7 amounted to 49.3% (C; interquartile range [IQR]: 22.6), 70.1% (FG; IQR: 20.7), 56.8% (MD; IQR: 26.3) and 62.2% (MG; IQR: 34.4). Statistically significant differences were found between FG and C (p =.01) and between MD and FG (p =.04). None of the participants rated pain higher than 4 out of 10 during the entire study period. CONCLUSIONS Collagen-based wound dressings provide coverage of open defects, albeit without acceleration of wound closure or reduction of pain. FG (which is not intended for open oral wounds) showed slower wound closure compared to C and MD.
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Affiliation(s)
- Stefan P Bienz
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Naida Gadzo
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Anina N Zuercher
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Daniel Wiedemeier
- Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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Webb CWB, D'Costa K, Tawagi E, Antonyshyn JA, Hofer OPS, Santerre JP. Electrospun methacrylated natural/synthetic composite membranes for gingival tissue engineering. Acta Biomater 2024; 173:336-350. [PMID: 37989435 DOI: 10.1016/j.actbio.2023.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
New functional materials for engineering gingival tissue are still in the early stages of development. Materials for such applications must maintain volume and have advantageous mechanical and biological characteristics for tissue regeneration, to be an alternative to autografts, which are the current benchmark of care. In this work, methacrylated gelatin (GelMa) was photocrosslinked with synthetic immunomodulatory methacrylated divinyl urethanes and defined monomers to generate composite scaffolds. Using a factorial design, with the synthetic monomers of a degradable polar/hydrophobic/ionic polyurethane (D-PHI) and GelMa, composite materials were electrospun with polycarbonate urethane (PCNU) and light-cured in-flight. The materials had significantly different relative hydrophilicities, with unique biodegradation profiles associated with specific formulations, thereby providing good guidance to achieving desired mechanical characteristics and scaffold resorption for gingival tissue regeneration. In accelerated esterase/collagenase degradation models, the new materials exhibited an initial rapid weight loss followed by a more gradual rate of degradation. The degradation profile allowed for the early infiltration of human adipose-derived stromal/stem cells, while still enabling the graft's structural integrity to be maintained. In conclusion, the materials provide a promising candidate platform for the regeneration of oral soft tissues, addressing the requirement of viable tissue infiltration while maintaining volume and mechanical integrity. STATEMENT OF SIGNIFICANCE: There is a need for the development of more functional and efficacious materials for the treatment of gingival recession. To address significant limitations in current material formulations, we sought to investigate the development of methacrylated gelatin (GelMa) and oligo-urethane/methacrylate monomer composite materials. A factorial design was used to electrospin four new formulations containing four to five monomers. Synthetic immunomodulatory monomers were crosslinked with GelMa and electrospun with a polycarbonate urethane resulting in unique mechanical properties, and resorption rates which align with the original design criteria for gingival tissue engineering. The materials may have applications in tissue engineering and can be readily manufactured. The findings of this work may help better direct the efforts of tissue engineering and material manufacturing.
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Affiliation(s)
- C W Brian Webb
- Faculty of Dentistry, University of Toronto, 124 Edward St, M5G 1X3, Canada; Institute of Biomedical Engineering, University of Toronto, 164 College St Room 407, M5S 3G9, Canada
| | - Katya D'Costa
- Institute of Biomedical Engineering, University of Toronto, 164 College St Room 407, M5S 3G9, Canada
| | - Eric Tawagi
- Institute of Biomedical Engineering, University of Toronto, 164 College St Room 407, M5S 3G9, Canada
| | - Jeremy A Antonyshyn
- Institute of Biomedical Engineering, University of Toronto, 164 College St Room 407, M5S 3G9, Canada
| | - O P Stefan Hofer
- Division of Plastic and Reconstructive Surgery, University of Toronto, 149 College Street 5th Floor, M5T 1P5, Canada; Department of Surgery and Surgical Oncology, University Health Network, 190 Elizabeth St 1st Floor, M5G 2C4, Canada
| | - J Paul Santerre
- Faculty of Dentistry, University of Toronto, 124 Edward St, M5G 1X3, Canada; Institute of Biomedical Engineering, University of Toronto, 164 College St Room 407, M5S 3G9, Canada.
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Tian Z, Zhao Z, Rausch MA, Behm C, Shokoohi-Tabrizi HA, Andrukhov O, Rausch-Fan X. In Vitro Investigation of Gelatin/Polycaprolactone Nanofibers in Modulating Human Gingival Mesenchymal Stromal Cells. MATERIALS (BASEL, SWITZERLAND) 2023; 16:7508. [PMID: 38138649 PMCID: PMC10744501 DOI: 10.3390/ma16247508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023]
Abstract
The aesthetic constancy and functional stability of periodontium largely depend on the presence of healthy mucogingival tissue. Soft tissue management is crucial to the success of periodontal surgery. Recently, synthetic substitute materials have been proposed to be used for soft tissue augmentation, but the tissue compatibility of these materials needs to be further investigated. This study aims to assess the in vitro responses of human gingival mesenchymal stromal cells (hG-MSCs) cultured on a Gelatin/Polycaprolactone prototype (GPP) and volume-stable collagen matrix (VSCM). hG-MSCs were cultured onto the GPP, VSCM, or plastic for 3, 7, and 14 days. The proliferation and/or viability were measured by cell counting kit-8 assay and resazurin-based toxicity assay. Cell morphology and adhesion were evaluated by microscopy. The gene expression of collagen type I, alpha1 (COL1A1), α-smooth muscle actin (α-SMA), fibroblast growth factor (FGF-2), vascular endothelial growth factor A (VEGF-A), transforming growth factor beta-1 (TGF-β1), focal adhesion kinase (FAK), integrin beta-1 (ITG-β1), and interleukin 8 (IL-8) was investigated by RT-qPCR. The levels of VEGF-A, TGF-β1, and IL-8 proteins in conditioned media were tested by ELISA. GPP improved both cell proliferation and viability compared to VSCM. The cells grown on GPP exhibited a distinct morphology and attachment performance. COL1A1, α-SMA, VEGF-A, FGF-2, and FAK were positively modulated in hG-MSCs on GPP at different investigation times. GPP increased the gene expression of TGF-β1 but had no effect on protein production. The level of ITG-β1 had no significant changes in cells seeded on GPP at 7 days. At 3 days, notable differences in VEGF-A, TGF-β1, and α-SMA expression levels were observed between cells seeded on GPP and those on VSCM. Meanwhile, GPP showed higher COL1A1 expression compared to VSCM after 14 days, whereas VSCM demonstrated a more significant upregulation in the production of IL-8. Taken together, our data suggest that GPP electrospun nanofibers have great potential as substitutes for soft tissue regeneration in successful periodontal surgery.
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Affiliation(s)
- Zhiwei Tian
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Wien, Austria; (Z.T.); (Z.Z.); (M.A.R.); (C.B.)
| | - Zhongqi Zhao
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Wien, Austria; (Z.T.); (Z.Z.); (M.A.R.); (C.B.)
| | - Marco Aoqi Rausch
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Wien, Austria; (Z.T.); (Z.Z.); (M.A.R.); (C.B.)
- Clinical Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Wien, Austria
| | - Christian Behm
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Wien, Austria; (Z.T.); (Z.Z.); (M.A.R.); (C.B.)
| | - Hassan Ali Shokoohi-Tabrizi
- Core Facility Applied Physics, Laser and CAD/CAM Technology, University Clinic of Dentistry, Medical University of Vienna, 1090 Wien, Austria;
| | - Oleh Andrukhov
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Wien, Austria; (Z.T.); (Z.Z.); (M.A.R.); (C.B.)
| | - Xiaohui Rausch-Fan
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Wien, Austria;
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Wien, Austria
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Michels R, Magrin GL, Cruz ACC, Magini RS, Benfatti CAM. Functionalization of a Volume-Stable Collagen Matrix Using Liquid Platelet-Rich Fibrin: A Case Report Presenting a New Approach for Root Coverage. Case Rep Dent 2023; 2023:3929269. [PMID: 37006702 PMCID: PMC10060066 DOI: 10.1155/2023/3929269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/29/2023] [Accepted: 02/04/2023] [Indexed: 04/04/2023] Open
Abstract
This case report presents a novel approach for root coverage of multiple gingival recessions with a volume-stable collagen matrix functionalized with injectable platelet-rich fibrin (i-PRF). A patient with multiple gingival recessions in the anterior maxilla was submitted to root coverage by coronally advanced flap with split-full-split incisions. Blood collection was performed before surgery and i-PRF was obtained after centrifugation (relative centrifugal force (RCF) 400 g, 2700 rpm, 3 minutes). A volume-stable collagen matrix was soaked with i-PRF and applied as a substitute for autogenous connective tissue graft. A mean root coverage of 83% was observed after a 12-month follow-up period, and only slight modifications were detected in a 30-month follow-up consultation. The association of a volume-stable collagen matrix with i-PRF successfully treated multiple gingival recessions with reduced morbidity since a connective tissue collection was avoided.
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Affiliation(s)
- Roberta Michels
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Gabriel Leonardo Magrin
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - ACC Cruz
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - RS Magini
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Cesar Augusto Magalhães Benfatti
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
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Tavelli L, Barootchi S, Rodriguez MV, Mancini L, Majzoub J, Travan S, Sugai J, Chan H, Kripfgans O, Wang H, Giannobile WV. Recombinant human platelet-derived growth factor improves root coverage of a collagen matrix for multiple adjacent gingival recessions: A triple-blinded, randomized, placebo-controlled trial. J Clin Periodontol 2022; 49:1169-1184. [PMID: 35871600 PMCID: PMC9796054 DOI: 10.1111/jcpe.13706] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 07/10/2022] [Accepted: 07/16/2022] [Indexed: 12/30/2022]
Abstract
AIM To evaluate the efficacy of recombinant human platelet-derived growth factor (rhPDGF)-BB combined with a cross-linked collagen matrix (CCM) for the treatment of multiple adjacent gingival recession type 1 defects (MAGRs) in combination with the coronally advanced flap (CAF). MATERIALS AND METHODS Thirty patients were enrolled in this triple-blind, randomized, placebo-controlled trial and treated with either CAF + CCM + rhPDGF, or CAF + CCM + saline. The primary outcome was mean root coverage (mRC) at 6 months. Complete root coverage, gain in gingival thickness (GT), keratinized tissue width, volumetric and ultrasonographic changes, and patient-reported outcome measures were also assessed. Mixed-modelling regression analyses were used for statistical comparisons. RESULTS At 6 months, the mRC of the CCM + rhPDGF and CCM alone groups were 88.25% and 77.72%, respectively (p = .02). A significant gain in GT was consistently observed for both treatment arms, and more so for the patients receiving the matrix containing rhPDGF through time (0.51 vs. 0.80 mm, on average, p = .01). The rhPDGF + CCM treated patients presented greater volume gain, higher soft tissue thickness, and a superior aesthetic score. CONCLUSION rhPDGF enhances the clinical, volumetric, and aesthetic outcomes of MAGRs above the results achieved with CAF + CCM alone (ClinicalTrials.gov NCT04462237).
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Affiliation(s)
- Lorenzo Tavelli
- Department of Oral Medicine, Infection, and Immunity, Division of PeriodontologyHarvard School of Dental MedicineBostonMassachusettsUSA,Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA,Center for clinical Research and evidence synthesis In oral TissuE RegeneratION (CRITERION)BostonMassachusettsUSA
| | - Shayan Barootchi
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA,Center for clinical Research and evidence synthesis In oral TissuE RegeneratION (CRITERION)BostonMassachusettsUSA
| | - Maria Vera Rodriguez
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA,Postgraduate Periodontics, Division of PeriodonticsColumbia University College of Dental MedicineNew YorkNew YorkUSA
| | - Leonardo Mancini
- Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly
| | - Jad Majzoub
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Suncica Travan
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Jim Sugai
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Hsun‐Liang Chan
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Oliver Kripfgans
- Biointerfaces Institute and Department of Biomedical EngineeringCollege of EngineeringAnn ArborMichiganUSA,Department of RadiologyUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Hom‐Lay Wang
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - William V. Giannobile
- Department of Oral Medicine, Infection, and Immunity, Division of PeriodontologyHarvard School of Dental MedicineBostonMassachusettsUSA,Center for clinical Research and evidence synthesis In oral TissuE RegeneratION (CRITERION)BostonMassachusettsUSA
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Lee CT, Lange M, Jureidini A, Bittner N, Schulze-Späte U. Clinical and patient-reported outcomes after recession coverage using modified vestibular incision subperiosteal tunnel access with a volume-stable collagen matrix as compared to a coronally advanced flap with a subepithelial connective tissue graft. J Periodontal Implant Sci 2022; 52:466-478. [PMID: 36468471 PMCID: PMC9807852 DOI: 10.5051/jpis.2105760288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/27/2022] [Accepted: 06/02/2022] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Coronally advanced split-or full-thickness (CAST or CAFT) flaps in combination with subepithelial connective tissue grafts (SCTGs) are commonly used in root-coverage procedures despite postoperative pain and bleeding from the graft donor site. Therefore, the modified vestibular incision subperiosteal tunnel access procedure (VISTAX) uses a novel collagen matrix (VCMX) instead of autogenous tissue to address the limitations associated with autogenous tissue grafting. This retrospective study compared the clinical outcomes of VISTAX to the results obtained after using a CAST or CAFT flap in combination with SCTG for root coverage. METHODS Patients with single or multiple adjacent recession I/II defects were included, with 10 subjects each in the VISTAX, CAFT, and CAST groups. Defect coverage, keratinized tissue width, esthetic scores, and patients' perceived pain and dentinal hypersensitivity (visual analogue scale [VAS]) were assessed at baseline, 3 months, and 6 months. RESULTS All surgical techniques significantly reduced gingival recession (P<0.0001). Defect coverage, esthetic appearance, and the reduction in dentinal hypersensitivity were comparable. However, the VAS scores for pain were significantly lower in the VISTAX group than in the CAFT and CAST groups, which had similar scores (P<0.05). Furthermore, the clinical results of VISTAX and CAFT/CAST generally remained stable at 6 months. CONCLUSIONS The clinical outcomes of VISTAX, CAFT, and CAST were comparable. However, patients perceived significantly less pain after VISTAX, indicating a potentially higher patient acceptance of the procedure. A prospective trial with a longer follow-up period and a larger sample size should therefore evaluate VISTAX further.
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Affiliation(s)
- Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, USA.,Columbia University College of Dental Medicine, New York, NY, USA
| | - Marlena Lange
- Section of Geriodontics, Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, Friedrich Schiller University, Jena, Germany
| | - Alain Jureidini
- Columbia University College of Dental Medicine, New York, NY, USA.,Private Office, Arlington, VA, USA
| | - Nurit Bittner
- Columbia University College of Dental Medicine, New York, NY, USA
| | - Ulrike Schulze-Späte
- Columbia University College of Dental Medicine, New York, NY, USA.,Section of Geriodontics, Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, Friedrich Schiller University, Jena, Germany
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10
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Webb BCW, Glogauer M, Santerre JP. The Structure and Function of Next-Generation Gingival Graft Substitutes-A Perspective on Multilayer Electrospun Constructs with Consideration of Vascularization. Int J Mol Sci 2022; 23:5256. [PMID: 35563649 PMCID: PMC9099797 DOI: 10.3390/ijms23095256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 12/10/2022] Open
Abstract
There is a shortage of suitable tissue-engineered solutions for gingival recession, a soft tissue defect of the oral cavity. Autologous tissue grafts lead to an increase in morbidity due to complications at the donor site. Although material substitutes are available on the market, their development is early, and work to produce more functional material substitutes is underway. The latter materials along with newly conceived tissue-engineered substitutes must maintain volumetric form over time and have advantageous mechanical and biological characteristics facilitating the regeneration of functional gingival tissue. This review conveys a comprehensive and timely perspective to provide insight towards future work in the field, by linking the structure (specifically multilayered systems) and function of electrospun material-based approaches for gingival tissue engineering and regeneration. Electrospun material composites are reviewed alongside existing commercial material substitutes', looking at current advantages and disadvantages. The importance of implementing physiologically relevant degradation profiles and mechanical properties into the design of material substitutes is presented and discussed. Further, given that the broader tissue engineering field has moved towards the use of pre-seeded scaffolds, a review of promising cell options, for generating tissue-engineered autologous gingival grafts from electrospun scaffolds is presented and their potential utility and limitations are discussed.
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Affiliation(s)
- Brian C. W. Webb
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada; (B.C.W.W.); (M.G.)
- Institute of Biomedical Engineering, University of Toronto, 164 Collage St Room 407, Toronto, ON M5S 3G9, Canada
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada; (B.C.W.W.); (M.G.)
| | - J. Paul Santerre
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada; (B.C.W.W.); (M.G.)
- Institute of Biomedical Engineering, University of Toronto, 164 Collage St Room 407, Toronto, ON M5S 3G9, Canada
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Immunohistochemical Evaluation of Periodontal Regeneration Using a Porous Collagen Scaffold. Int J Mol Sci 2021; 22:ijms222010915. [PMID: 34681574 PMCID: PMC8535773 DOI: 10.3390/ijms222010915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/03/2021] [Accepted: 10/07/2021] [Indexed: 12/17/2022] Open
Abstract
(1) Aim: To immunohistochemically evaluate the effect of a volume-stable collagen scaffold (VCMX) on periodontal regeneration. (2) Methods: In eight beagle dogs, acute two-wall intrabony defects were treated with open flap debridement either with VCMX (test) or without (control). After 12 weeks, eight defects out of four animals were processed for paraffin histology and immunohistochemistry. (3) Results: All defects (four test + four control) revealed periodontal regeneration with cementum and bone formation. VCMX remnants were integrated in bone, periodontal ligament (PDL), and cementum. No differences in immunohistochemical labeling patterns were observed between test and control sites. New bone and cementum were labeled for bone sialoprotein, while the regenerated PDL was labeled for periostin and collagen type 1. Cytokeratin-positive epithelial cell rests of Malassez were detected in 50% of the defects. The regenerated PDL demonstrated a larger blood vessel area at the test (14.48% ± 3.52%) than at control sites (8.04% ± 1.85%, p = 0.0007). The number of blood vessels was higher in the regenerated PDL (test + control) compared to the pristine one (p = 0.012). The cell proliferative index was not statistically significantly different in pristine and regenerated PDL. (4) Conclusions: The data suggest a positive effect of VCMX on angiogenesis and an equally high cell turnover in the regenerated and pristine PDL. This VCMX supported periodontal regeneration in intrabony defects.
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McGuire MK, Janakievski J, Scheyer ET, Velásquez D, Gunsolley JC, Heard RH, Morelli T. Efficacy of a harvest graft substitute for recession coverage and soft tissue volume augmentation: A randomized controlled trial. J Periodontol 2021; 93:333-342. [PMID: 34287902 DOI: 10.1002/jper.21-0131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/26/2021] [Accepted: 07/09/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The autogenous connective tissue graft (CTG) with coronally advanced flap (CTG+CAF) is the "gold standard" for recession defect coverage; however, researchers continue to pursue lower morbidity, more convenient and unlimited supply harvest graft substitutes, including those that could provide soft tissue volume augmentation. METHODS A randomized, controlled, double-masked comparison of a volume-stable collagen matrix (VCMX) versus CTG was conducted at four clinical investigation sites. Single, contralateral, within patient matched-pair, RT1 recession defects were treated with VCMX+CAF (test) and CTG+CAF (control). The primary efficacy end point was percent root coverage at 6 months. Secondary efficacy end points included clinical measures such as soft tissue volume, attachment level, and keratinized tissue width. Patient-reported outcomes included measures such as discomfort, esthetics, and overall satisfaction; 6-month end point results were followed for 1 year. RESULTS Thirty patients received control and test therapies, and all patients were available for follow-up measures. Average percent root coverage for CTG+CAF was 90.5% ± 14.87% versus 70.7% ± 28.26% for VCMX+CAF, P <0.0001. Both therapies produced significant soft tissue volume increases (84.8 ± 47.43 mm2 control versus 48.90 ± 35.58 mm2 test, P = 0.0006). The test, harvest graft substitute produced less postoperative pain and was preferred by patients at the 6-month end point. All other end point measures were not significantly different. CONCLUSIONS VCMX+CAF root coverage was inferior to CTG+CAF but produced less morbidity and was preferred by patients. Case/patient selection and surgical technique appear key to achieving successful results with the harvest graft alternative.
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Affiliation(s)
- Michael K McGuire
- The McGuire Institute (iMc - practice-based clinical research network); Private practice, Houston, TX
| | - Jim Janakievski
- iMc; Private practice, Tacoma, WA; Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA
| | - E Todd Scheyer
- The McGuire Institute (iMc - practice-based clinical research network); Private practice, Houston, TX
| | - Diego Velásquez
- iMc; Private practice, Fenton, MI, University of Michigan School of Dentistry, Ann Arbor, MI
| | - John C Gunsolley
- School of Dentistry, Virginia Commonwealth University, Richmond, VA
| | | | - Thiago Morelli
- iMc; Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Peri-implant tissue augmentation by volume-stable collagen matrix transplantation: a study of dog mandibles. Odontology 2021; 110:81-91. [PMID: 34279761 DOI: 10.1007/s10266-021-00639-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
The aim of this study was to investigate histologically the amount of peri-implant tissue augmentation after volume-stable porcine collagen matrix transplantation. Six male beagle dogs were used in the experiment. P2, P4, and M1 distal roots were extracted under general anesthesia. After 6 months, implants were placed in the same sites, and volume-stable porcine collagen matrix transplantation was performed. Impressions were taken at 1 and 2 weeks and at 1, 2, and 3 months after transplantation. The dogs were euthanized at 3 months, and their mandibles were removed and scanned using micro-computed tomography. Standard Triangulated Language data were also obtained. Using preoperative models as a reference, the data for all time points were compared, and changes in the thickness of the cross-section of the implant sites were measured. The model created at 3 months was then compared with the mandible data, and the thickness of collected peri-implant soft tissue was measured under optical microscopy. Increased thickness was found at some of the sites on the buccal side. Regarding the peri-implant soft tissue, the thickness of the measured sites on the buccal side was significantly increased at 3 months in the experimental group. Histological observations of the internal structures of the tissue in the experimental group revealed irregular collagen fibers and a remnant collagen matrix. Endogenous tissue was observed within the collagen matrix, indicating good fusion with the surrounding autologous tissue. These results suggest that volume-stable porcine collagen matrix transplantation promotes peri-implant tissue augmentation on the buccal side.
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Artzi Z, Renert U, Netanely E, Thoma DS, Vered M. Histologic composition of marginal mucosal tissue augmented by a resorbable volume-stable collagen matrix in soft tissue thickening procedures in humans: a morphometric observational study. Clin Oral Investig 2021; 26:427-435. [PMID: 34164734 DOI: 10.1007/s00784-021-04016-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/31/2021] [Indexed: 11/28/2022]
Abstract
AIM This study aims to examine the composition of lining and masticatory mucosa at the pre- and post-soft tissue augmentation procedures with a volume-stable cross-linking collagen matrix (VCMX) in humans. MATERIALS AND METHODS In 12 patients, single implant sites were augmented with a VCMX. Biopsies were obtained including masticatory (MM) and lining (LM) mucosa before augmentation and at 12 weeks post-augmentation procedures. Rete pegs density (RPD), length (RPL), and blood vessel density (BVD) were histomorphometrically analyzed at both time points. Picrosirius red staining under polarized light microscopy was used to evaluate collagen fiber organization. The effects of time and tissue type were evaluated by ANOVA with repeated measures. RESULTS Both MM and LM areas demonstrated an increase in mean RPL following augmentation, 382.6 µm ± 95.1 vs. 290.5 µm ± 79.3 and 335.6 µm ± 94.2 vs. 292.9 µm ± 77.0, respectively (p < .05). There was a significant difference in the numbers of RP per 1 mm length (RPD) between the MM (9.2 ± 1.7) and LM (6.1 ± 2.8) mucosa but not between the pre- and post-VCMX augmentation time points. The mean BVD in the LM was greater than in the MM (5.5 ± 2.4 and 6.3 ± 2.4 vs. 3.4 ± 3.3 and 3.7 ± 1.8, respectively, p < .05) but not between time points. The collagen fiber arrangements pre- and post-augmentation were not significantly different. CONCLUSION Augmentation with VCMX did not alter the composition of lining and masticatory mucosa at implant sites. CLINICAL RELEVANCE A thick soft tissue phenotype around the implant neck is an important factor to maintain peri-implant health. A non-autogenous cross-linking collagen matrix is proposed as an alternate graft substitute in soft tissue augmentation procedures in order to improve implant soft tissue phenotype.
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Affiliation(s)
- Zvi Artzi
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Uri Renert
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Erez Netanely
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland
| | - Marilena Vered
- Department of Oral Pathology and Oral Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Asparuhova MB, Stähli A, Guldener K, Sculean A. A Novel Volume-Stable Collagen Matrix Induces Changes in the Behavior of Primary Human Oral Fibroblasts, Periodontal Ligament, and Endothelial Cells. Int J Mol Sci 2021; 22:ijms22084051. [PMID: 33919968 PMCID: PMC8070954 DOI: 10.3390/ijms22084051] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 01/03/2023] Open
Abstract
The aim of the present study was to investigate the influence of a novel volume-stable collagen matrix (vCM) on early wound healing events including cellular migration and adhesion, protein adsorption and release, and the dynamics of the hemostatic system. For this purpose, we utilized transwell migration and crystal violet adhesion assays, ELISAs for quantification of adsorbed and released from the matrix growth factors, and qRT-PCR for quantification of gene expression in cells grown on the matrix. Our results demonstrated that primary human oral fibroblasts, periodontal ligament, and endothelial cells exhibited increased migration toward vCM compared to control cells that migrated in the absence of the matrix. Cellular adhesive properties on vCM were significantly increased compared to controls. Growth factors TGF-β1, PDGF-BB, FGF-2, and GDF-5 were adsorbed on vCM with great efficiency and continuously delivered in the medium after an initial burst release within hours. We observed statistically significant upregulation of genes encoding the antifibrinolytic thrombomodulin, plasminogen activator inhibitor type 1, thrombospondin 1, and thromboplastin, as well as strong downregulation of genes encoding the profibrinolytic tissue plasminogen activator, urokinase-type plasminogen activator, its receptor, and the matrix metalloproteinase 14 in cells grown on vCM. As a general trend, the stimulatory effect of the vCM on the expression of antifibrinolytic genes was synergistically enhanced by TGF-β1, PDGF-BB, or FGF-2, whereas the strong inhibitory effect of the vCM on the expression of profibrinolytic genes was reversed by PDGF-BB, FGF-2, or GDF-5. Taken together, our data strongly support the effect of the novel vCM on fibrin clot stabilization and coagulation/fibrinolysis equilibrium, thus facilitating progression to the next stages of the soft tissue healing process.
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Affiliation(s)
- Maria B. Asparuhova
- Dental Research Center, Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.S.); (K.G.); (A.S.)
- Correspondence:
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.S.); (K.G.); (A.S.)
| | - Kevin Guldener
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.S.); (K.G.); (A.S.)
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.S.); (K.G.); (A.S.)
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Katagiri H, El Tawil Y, Lang NP, Imber JC, Sculean A, Fujioka-Kobayashi M, Saulacic N. Collagen-Based Matrices for Osteoconduction: A Preclinical In Vivo Study. Biomedicines 2021; 9:biomedicines9020143. [PMID: 33540647 PMCID: PMC7913003 DOI: 10.3390/biomedicines9020143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/27/2021] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to evaluate the influence of additional hydroxyapatite (HA) in collagen-based matrices (CM) and membrane placement on bone formation in calvarial defects. Critical size defects in the calvaria of 16 New Zealand White Rabbits were randomly treated with CM or mineralized collagen-based matrices (mCM). Half of the sites were covered with a collagen membrane. Animals were euthanized after 12 weeks of healing. The samples were studied by micro-CT and histology. Newly formed lamellar bone was observed in all samples at the periphery of the defect. In the central areas, however, new bone composed of both woven and lamellar bone was embedded in the soft tissue. Samples treated with mCM showed more residual biomaterial and induced more small bony islands in the central areas of the defects than samples with CM. Nevertheless, a complete defect closure was not observed in any of the samples at 12 weeks. Membrane placement resulted in a decrease in bone density and height. Significant differences between the groups were revealed only between CM groups with and without membrane coverage for bone height in the central area of the defect. Neither mineralization of CM nor membrane placement improved the osteogenic capacity in this particular defect. Nevertheless, mineralisation influenced bone density without a membrane placement and bone volume underneath a membrane. CM may be used as a scaffold in bone regeneration procedures, without the need of a membrane coverage. Further preclinical studies are warrant to optimise the potential of mCM.
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Affiliation(s)
- Hiroki Katagiri
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, Faculty of Medicine, University of Berne, CH-3010 Berne, Switzerland; (H.K.); (Y.E.T.); (N.P.L.); (M.F.-K.)
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan
| | - Yacine El Tawil
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, Faculty of Medicine, University of Berne, CH-3010 Berne, Switzerland; (H.K.); (Y.E.T.); (N.P.L.); (M.F.-K.)
| | - Niklaus P. Lang
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, Faculty of Medicine, University of Berne, CH-3010 Berne, Switzerland; (H.K.); (Y.E.T.); (N.P.L.); (M.F.-K.)
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Berne, CH-3010 Berne, Switzerland; (J.-C.I.); (A.S.)
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Berne, CH-3010 Berne, Switzerland; (J.-C.I.); (A.S.)
| | - Masako Fujioka-Kobayashi
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, Faculty of Medicine, University of Berne, CH-3010 Berne, Switzerland; (H.K.); (Y.E.T.); (N.P.L.); (M.F.-K.)
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, Faculty of Medicine, University of Berne, CH-3010 Berne, Switzerland; (H.K.); (Y.E.T.); (N.P.L.); (M.F.-K.)
- Correspondence: ; Tel.: +41-31-632-8764
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Imber JC, Bosshardt DD, Stähli A, Saulacic N, Deschner J, Sculean A. Pre-clinical evaluation of the effect of a volume-stable collagen matrix on periodontal regeneration in two-wall intrabony defects. J Clin Periodontol 2021; 48:560-569. [PMID: 33471389 DOI: 10.1111/jcpe.13426] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/28/2020] [Accepted: 01/10/2021] [Indexed: 01/07/2023]
Abstract
AIM To histologically evaluate the effect of a new collagen matrix on periodontal regeneration. MATERIALS AND METHODS Two-wall intrabony defects were surgically created bilaterally distally to the maxillary first and third pre-molars in beagle dogs. The defects were randomly allocated to open flap debridement either with (test) or without (control) a volume-stable collagen matrix (VCMX). After 12 weeks, the dogs were euthanized, and the specimens histologically processed. Descriptive, histomorphometrical (vertical gain of periodontal tissues) and statistical analyses were then performed. RESULTS Healing was uneventful in most cases. Residual VCMX was still present and showed integration into new bone, new periodontal ligament, connective tissue and, in some specimens, into new cementum. Periodontal regeneration occurred to a varying extent in both groups. New continuous cementum and new bone formation were statistically significantly greater in the test group (4.12 mm and 3.28 mm, respectively) than in the control group (1.54 mm and 2.47 mm, respectively) (p = .009 and p = .037, respectively). The junctional epithelium was longer in the control group (2.21 mm) than in the test group (1.49 mm, p = .16). CONCLUSION The present results have for the first time provided histologic evidence for the potential of this novel VCMX to facilitate periodontal regeneration thus warranting further pre-clinical and clinical testing.
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Affiliation(s)
- Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Dieter Daniel Bosshardt
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University Hospital, University of Bern, Bern, Switzerland
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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De Angelis P, De Angelis S, Passarelli PC, Liguori MG, Pompa G, Papi P, Manicone PF, D'Addona A. Clinical comparison of a xenogeneic collagen matrix versus subepithelial autogenous connective tissue graft for augmentation of soft tissue around implants. Int J Oral Maxillofac Surg 2020; 50:956-963. [PMID: 33279377 DOI: 10.1016/j.ijom.2020.11.014] [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: 02/19/2020] [Revised: 11/13/2020] [Accepted: 11/18/2020] [Indexed: 11/24/2022]
Abstract
Dental implant placement is a predictable therapy for replacing teeth. Nevertheless, mechanical, biological, and aesthetic complications frequently occur. The aim of this study was to compare the clinical outcomes of a xenogeneic collagen matrix (XCM) used at the time of implant placement as an alternative to a subepithelial connective tissue graft (SCTG), for soft tissue augmentation. This was a prospective clinical trial with 12 months of follow-up. In the control group, soft tissue augmentation at the time of implant placement was performed with a SCTG, while in the test group, a XCM was employed. At 12 months postoperative, all xenografts showed no postoperative complications. In both groups, a significantly greater thickness was observed on the buccal and occlusal sides from preoperative to 3 months postoperative (P<0.05). No statistically significant difference in pink aesthetic score (P=0.379, 6 months postoperative) or marginal bone loss (P=0.449 at 3 months postoperative, P=0.778 at 6 months postoperative) was observed between the groups. Statistically significant differences in pain perceived by the patients (P<0.0001) and the time to complete the surgical procedure (P=0.0008) were detected. At 12 months after surgery, XCM provided similar clinical results in terms of soft tissue augmentation on the buccal and occlusal sides as compared with the SCTG.
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Affiliation(s)
- P De Angelis
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy.
| | | | - P C Passarelli
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - M G Liguori
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Pompa
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - P Papi
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - P F Manicone
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - A D'Addona
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
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19
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Santamaria MP, Miguel MMV, Rossato A, Bonafé ACF, Ferraz LFF, Dos Santos LM, Mathias-Santamaria IF. New Volume-Stable Collagen Matrix and Modified Coronally Advanced Flap to Treat Multiple Gingival Recessions Associated with Partially Restored Non-Carious Cervical Lesions: A Case Report. Clin Adv Periodontics 2020; 12:69-74. [PMID: 33289326 DOI: 10.1002/cap.10142] [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: 09/17/2020] [Accepted: 11/25/2020] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Gingival recession (GR) is a prevalent problem that is related to aesthetic demands and dentin hypersensitivity. Frequently, GR is associated with non-carious cervical lesion (NCCLs) forming a combined defect (CD), which requires restorative and surgical treatment. Connective tissue graft (CTG) procedures allow predictable root coverage but can result in patient discomfort and bleeding. CASE PRESENTATION This first case report describes multiple GRs associated with B+ NCCL at teeth #4 and 6 of a 27-year-old patient with a thin periodontal phenotype. The aim of this report was to evaluate the 6-month outcome of a new volume-stable collagen matrix (VCMX) combined with modified coronally advanced flap (MCAF) and partial restoration to treat CDs. After 6 months, significant improvement was observed regarding CD coverage (69.05%), recession reduction (RecRed) (2.25 mm), gingival thickness (GT) gain (0.74 mm) and keratinized tissue width (KTW) gain (0.75 mm). In addition, excellent aesthetic evaluation and patient comfort were achieved by using the biomaterial. CONCLUSION VCMX associated with MCAF and partial restoration may be an option to treat multiple recession defects plus B+ NCCLs. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Mauro Pedrine Santamaria
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Manuela Maria Viana Miguel
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Amanda Rossato
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Ana Carolina Ferreira Bonafé
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Laís Fernanda Ferreira Ferraz
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Lucio Murilo Dos Santos
- Division of Periodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
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20
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Stefanini M, Mounssif I, Barootchi S, Tavelli L, Wang HL, Zucchelli G. An exploratory clinical study evaluating safety and performance of a volume-stable collagen matrix with coronally advanced flap for single gingival recession treatment. Clin Oral Investig 2020; 24:3181-3191. [PMID: 32361892 DOI: 10.1007/s00784-019-03192-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/27/2019] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To test the safety of a new volume-stable collagen matrix (VCMX) in combination with coronally advanced flap (CAF) for the treatment of single gingival recession. MATERIAL AND METHODS Ten patients were treated for single RT1 gingival recession. Complete and mean root coverage, gingival thickness and keratinized tissue height, patient-reported outcome measures (PROMs), and safety were assessed up to 180 days. Descriptive statistics were used to analyze the clinical parameters. RESULTS VCMX resulted to be safe with no serious adverse events in all patients. At 6 months, root coverage was 96.7% with 90% of defects exhibiting complete coverage. There was an increase in mean width of keratinized tissue (KT) (0.4 ± 0.8 mm) and in gingival thickness (GT) (0.4 ± 0.34 mm); however, the difference was not statistically significant compared to baseline parameters. Pain perception and pain-killer consumption were low and decreasing further at 7 days. Esthetic satisfaction for both patients and experts revealed excellent scores. CONCLUSIONS VCMX is a safe and well-tolerated device for the treatment of single gingival recessions. In combination with CAF, it resulted in a high performance in terms of mean and complete root coverage, KT width, and GT increase. VCMX may reduce patient discomfort and post-operative morbidity. CLINICAL RELEVANCE VCMX is a safe and stable substitute for the treatment of gingival recession in conjunction with coronally advanced technique.
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Affiliation(s)
- Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Vitale 59, Bologna, Italy.
| | - Ilham Mounssif
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Vitale 59, Bologna, Italy
| | - Shayan Barootchi
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Lorenzo Tavelli
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Giovanni Zucchelli
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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21
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Wright ME, Yu JK, Jain D, Maeda A, Yeh SCA, DaCosta RS, Lin CP, Santerre JP. Engineering functional microvessels in synthetic polyurethane random-pore scaffolds by harnessing perfusion flow. Biomaterials 2020; 256:120183. [PMID: 32622017 DOI: 10.1016/j.biomaterials.2020.120183] [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: 02/25/2020] [Revised: 06/05/2020] [Accepted: 06/06/2020] [Indexed: 12/24/2022]
Abstract
Recently reported biomaterial-based approaches toward prevascularizing tissue constructs rely on biologically or structurally complex scaffolds that are complicated to manufacture and sterilize, and challenging to customize for clinical applications. In the current work, a prevascularization method for soft tissue engineering that uses a non-patterned and non-biological scaffold is proposed. Human fibroblasts and HUVECs were seeded on an ionomeric polyurethane-based hydrogel and cultured for 14 days under medium perfusion. A flow rate of 0.05 mL/min resulted in a greater lumen density in the constructs relative to 0.005 and 0.5 mL/min, indicating the critical importance of flow magnitude in establishing microvessels. Constructs generated at 0.05 mL/min perfusion flow were implanted in a mouse subcutaneous model and intravital imaging was used to characterize host blood perfusion through the construct after 2 weeks. Engineered microvessels were functional (i.e. perfused with host blood and non-leaky) and neovascularization of the construct by host vessels was enhanced relative to non-prevascularized constructs. We report on the first strategy toward engineering functional microvessels in a tissue construct using non-bioactive, non-patterned synthetic polyurethane materials.
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Affiliation(s)
- Meghan Ee Wright
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Jonathan K Yu
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada; Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Devika Jain
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Azusa Maeda
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada
| | - Shu-Chi A Yeh
- Center for Systems Biology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ralph S DaCosta
- Princess Margaret Cancer Centre and Techna Institute, University Health Network, Toronto, Canada
| | - Charles P Lin
- Center for Systems Biology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - J Paul Santerre
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada; Faculty of Dentistry, University of Toronto, Toronto, Canada.
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22
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Prado MM, Kovalski DJ, Torrez WB, Bueno-Silva B, Feres M, de Almeida J, Porto LM. Development of a multispecies periodontal biofilm model within a stirred bioreactor. BIOFOULING 2020; 36:725-735. [PMID: 32781835 DOI: 10.1080/08927014.2020.1805600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/18/2020] [Accepted: 07/28/2020] [Indexed: 06/11/2023]
Abstract
The objective of this work was to develop a subgingival biofilm model using a stirred bioreactor. Discs of bovine teeth were adapted to a stirred bioreactor filled with a culture medium containing bacterial species associated with periodontal health or disease. After anaerobic incubation, the biofilms growing on the substratum surfaces were collected and analyzed. The mean number of Colony-forming Units (CFUs) varied, but with no difference between 3 and 7 days of biofilm formation (p > 0.05). Scanning Electron Microscopy (SEM) analysis showed a uniform biofilm layer covering the cement layer of the root surface containing bacteria with diverse morphology. In checkerboard DNA-DNA hybridization, bacterial species were identified in both biofilms. In conclusion, a subgingival biofilm model was developed using a stirred bioreactor, allowing the in vitro reproduction of complex microbial communities. This is an advanced model that may be useful to mimic complex clinical periodontal biofilms.
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Affiliation(s)
- Maick Meneguzzo Prado
- LiEB - Integrated Laboratory of Biological Engineering, Chemical and Food Engineering Department, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Davi J Kovalski
- LiEB - Integrated Laboratory of Biological Engineering, Chemical and Food Engineering Department, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | | | - Bruno Bueno-Silva
- Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Magda Feres
- Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Josiane de Almeida
- LiEB - Integrated Laboratory of Biological Engineering, Chemical and Food Engineering Department, Federal University of Santa Catarina, Florianópolis, SC, Brazil
- Faculty of Dentistry, Department of Endodontics, University of Southern Santa Catarina, Palhoça, SC, Brazil
| | - Luismar M Porto
- LiEB - Integrated Laboratory of Biological Engineering, Chemical and Food Engineering Department, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Caballé-Serrano J, Zhang S, Sculean A, Staehli A, Bosshardt DD. Tissue Integration and Degradation of a Porous Collagen-Based Scaffold Used for Soft Tissue Augmentation. MATERIALS 2020; 13:ma13102420. [PMID: 32466244 PMCID: PMC7287763 DOI: 10.3390/ma13102420] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/30/2020] [Accepted: 05/18/2020] [Indexed: 12/23/2022]
Abstract
Collagen-based scaffolds hold great potential for tissue engineering, since they closely mimic the extracellular matrix. We investigated tissue integration of an engineered porous collagen-elastin scaffold developed for soft tissue augmentation. After implantation in maxillary submucosal pouches in 6 canines, cell invasion (vimentin), extracellular matrix deposition (collagen type I) and scaffold degradation (cathepsin k, tartrate-resistant acid phosphatase (TRAP), CD86) were (immuno)-histochemically evaluated. Invasion of vimentin+ cells (scattered and blood vessels) and collagen type I deposition within the pores started at 7 days. At 15 and 30 days, vimentin+ cells were still numerous and collagen type I increasingly filled the pores. Scaffold degradation was characterized by collagen loss mainly occurring around 15 days, a time point when medium-sized multinucleated cells peaked at the scaffold margin with simultaneous labeling for cathepsin k, TRAP, and CD86. Elastin was more resistant to degradation and persisted up to 90 days in form of packages well-integrated in the newly formed soft connective tissue. In conclusion, this collagen-based scaffold maintained long-enough volume stability to allow an influx of blood vessels and vimentin+ fibroblasts producing collagen type I, that filled the scaffold pores before major biomaterial degradation and collapse occurred. Cathepsin k, TRAP and CD86 appear to be involved in scaffold degradation.
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Affiliation(s)
- Jordi Caballé-Serrano
- Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (J.C.-S.); (S.Z.)
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.S.); (A.S.)
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Sophia Zhang
- Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (J.C.-S.); (S.Z.)
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.S.); (A.S.)
| | - Alexandra Staehli
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.S.); (A.S.)
| | - Dieter D. Bosshardt
- Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (J.C.-S.); (S.Z.)
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (A.S.); (A.S.)
- Correspondence: ; Tel.: +41-316328605
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Tissue Response to a Porous Collagen Matrix Used for Soft Tissue Augmentation. MATERIALS 2019; 12:ma12223721. [PMID: 31718004 PMCID: PMC6888327 DOI: 10.3390/ma12223721] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 10/29/2019] [Accepted: 11/04/2019] [Indexed: 01/05/2023]
Abstract
A short inflammatory phase and fast ingrowth of blood vessels and mesenchymal cells are essential for tissue integration of a biomaterial. Macrophages play a key role in this process. We investigated invasion of macrophages, blood vessels, and proliferating cells into a highly porous and volume-stable collagen matrix (VCMX) used for soft tissue augmentation around teeth and dental implants. The biomaterial was implanted in submucosal pouches in the canine maxilla, and the tissue response was analyzed at six different time points. Immunohistochemistry was done for proliferating cells (PCNA), macrophages (MAC387), multinucleated giant cells (CD86), and blood vessels (TGM2). Blood rapidly filled the VCMX pores. During the first week, MAC387+ cells populated the VCMX pores, blood vessels and PCNA+ cells invaded the VCMX, and CD86+ scattered cells were observed. At 15 days, MAC387+ cells were scanty, blood vessels had completely invaded the VCMX, the number of proliferating cells peaked, and fibroblasts appeared. At 30 days, MAC387+ were absent, the numbers of proliferating and CD86+ cells had declined, while blood vessel and fibroblast numbers were high. At 90 days, residual VCMX was well-integrated in soft connective tissue. In conclusion, the VCMX elicited a short inflammatory phase followed by rapid tissue integration.
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25
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Yoo SY, Lee JS, Cha JK, Kim SK, Kim CS. Periodontal healing using a collagen matrix with periodontal ligament progenitor cells in a dehiscence defect model in beagle dogs. J Periodontal Implant Sci 2019; 49:215-227. [PMID: 31485372 PMCID: PMC6713806 DOI: 10.5051/jpis.2019.49.4.215] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/06/2019] [Accepted: 06/10/2019] [Indexed: 01/02/2023] Open
Abstract
Purpose To histologically characterize periodontal healing at 8 weeks in surgically created dehiscence defects in beagle dogs that received a collagen matrix with periodontal ligament (PDL) progenitor cells. Methods The bilateral maxillary premolars and first molars in 6 animals were used. Standardized experimental dehiscence defects were made on the buccal side of 3 premolars, and primary culturing of PDL progenitor cells was performed on the molars. Collagen matrix was used as a scaffold and a delivery system for PDL progenitor cells. The experimental sites were grafted with collagen matrix (COL), PDL progenitor cells with collagen matrix (COL/CELL), or left without any material (CTL). Histologic and histomorphometric analyses were performed after 8 weeks. Results The defect height from the cementoenamel junction to the most apical point of cementum removal did not significantly differ across the CTL, COL, and COL/CELL groups, at 4.57±0.28, 4.56±0.41, and 4.64±0.27 mm (mean ± standard deviation), respectively; the corresponding values for epithelial adhesion were 1.41±0.51, 0.85±0.29, and 0.30±0.41 mm (P<0.05), the heights of new bone regeneration were 1.32±0.44, 1.65±0.52, and 1.93±0.61 mm (P<0.05), and the cementum regeneration values were 1.15±0.42, 1.81±0.46, and 2.57±0.56 mm (P<0.05). There was significantly more new bone formation in the COL/CELL group than in the CTL group, and new cementum length was also significantly higher in the COL/CELL group. However, there were no significant differences in the width of new cementum among the groups. Conclusions PDL progenitor cells carried by a synthetic collagen matrix may enhance periodontal regeneration, including cementum and new bone formation.
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Affiliation(s)
- Seung-Yoon Yoo
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Seul-Ki Kim
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Department of Applied Life Science, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Department of Applied Life Science, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea.,Department of Mechanical Engineering, Yonsei University College of Engineering, Seoul, Korea
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26
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Malhotra N. Bioreactors Design, Types, Influencing Factors and Potential Application in Dentistry. A Literature Review. Curr Stem Cell Res Ther 2019; 14:351-366. [DOI: 10.2174/1574888x14666190111105504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/26/2018] [Accepted: 12/27/2018] [Indexed: 11/22/2022]
Abstract
Objectives:A variety of bioreactors and related approaches have been applied to dental tissues as their use has become more essential in the field of regenerative dentistry and dental tissue engineering. The review discusses the various types of bioreactors and their potential application in dentistry.Methods:Review of the literature was conducted using keywords (and MeSH) like Bioreactor, Regenerative Dentistry, Fourth Factor, Stem Cells, etc., from the journals published in English. All the searched abstracts, published in indexed journals were read and reviewed to further refine the list of included articles. Based on the relevance of abstracts pertaining to the manuscript, full-text articles were assessed.Results:Bioreactors provide a prerequisite platform to create, test, and validate the biomaterials and techniques proposed for dental tissue regeneration. Flow perfusion, rotational, spinner-flask, strain and customize-combined bioreactors have been applied for the regeneration of bone, periodontal ligament, gingiva, cementum, oral mucosa, temporomandibular joint and vascular tissues. Customized bioreactors can support cellular/biofilm growth as well as apply cyclic loading. Center of disease control & dip-flow biofilm-reactors and micro-bioreactor have been used to evaluate the biological properties of dental biomaterials, their performance assessment and interaction with biofilms. Few case reports have also applied the concept of in vivo bioreactor for the repair of musculoskeletal defects and used customdesigned bioreactor (Aastrom) to repair the defects of cleft-palate.Conclusions:Bioreactors provide a sterile simulated environment to support cellular differentiation for oro-dental regenerative applications. Also, bioreactors like, customized bioreactors for cyclic loading, biofilm reactors (CDC & drip-flow), and micro-bioreactor, can assess biological responses of dental biomaterials by simultaneously supporting cellular or biofilm growth and application of cyclic stresses.
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27
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Seo GY, Thoma DS, Jung UW, Lee JS. Increasing the tissue thickness at implant sites using guided bone regeneration and an additional collagen matrix: Histologic observations in beagle dogs. J Biomed Mater Res B Appl Biomater 2019; 107:741-749. [PMID: 30080303 DOI: 10.1002/jbm.b.34168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/01/2018] [Accepted: 05/08/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To histologically determine the alteration in horizontal mucosal thickness at sites that received guided bone regeneration (GBR) with additional use of collagen matrix and to assess whether bone formation is affected by adding collagen matrix at GBR sites at 8 weeks of healing. MATERIALS AND METHODS Eight weeks after bilateral extraction of maxillary premolars, standardized defects were created on buccal side of edentulous ridges in four beagle dogs. One side was randomly allocated as control (biphasic calcium phosphate plus collagen membrane; GBR only), while contralateral side was allocated as test (biphasic calcium phosphate plus collagen membrane plus an additional layer of collagen matrix). Histologic observations, histomorphometric and micro-computed tomography analyses were performed after 8 weeks. RESULTS Membrane complex comprising residual collagen membrane and adjacent dense connective tissue was observed at both control and test sites. The thickness in the histologic analysis were 1.69 ± 0.23 mm (control) and 1.76 ± 0.07 mm (test) in histologic analysis and were 2.03 ± 0.26 mm (control) and 2.14 ± 0.24 mm (test) in radiographic analysis. The thickness of the membrane complex in soft-tissue layer were 723.0 ± 241.6 μm (control) and 984.6 ± 334.4 μm (test). The percentage of new bone formation were 22.30 ± 5.92% (control) and 25.50 ± 8.08% (test). All measured outcome did not show significant differences between control and test groups. CONCLUSION The addition of collagen matrix on top of standard GBR procedure did not increase the soft tissue thickness and dense connective tissue formation at 8 weeks of healing. Bone regeneration was not affected by the addition of collagen matrix. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 741-749, 2019.
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Affiliation(s)
- Gi-Young Seo
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Daniel Stefan Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental Medicine, University of Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
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Chukkapalli SS, Lele TP. Periodontal cell mechanotransduction. Open Biol 2019; 8:rsob.180053. [PMID: 30209038 PMCID: PMC6170509 DOI: 10.1098/rsob.180053] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/16/2018] [Indexed: 01/09/2023] Open
Abstract
The periodontium is a structurally and functionally complex tissue that facilitates the anchorage of teeth in jaws. The periodontium consists of various cell types including stem cells, fibroblasts and epithelial cells. Cells of the periodontium are constantly exposed to mechanical stresses generated by biological processes such as the chewing motions of teeth, by flows generated by tongue motions and by forces generated by implants. Mechanical stresses modulate the function of cells in the periodontium, and may play a significant role in the development of periodontal disease. Here, we review the literature on the effect of mechanical forces on periodontal cells in health and disease with an emphasis on molecular and cellular mechanisms.
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Affiliation(s)
- Sasanka S Chukkapalli
- Department of Oral Biology, University of Florida, College of Dentistry, Gainesville, FL 32610, USA.,Center for Molecular Microbiology, University of Florida, College of Dentistry, Gainesville, FL 32610, USA
| | - Tanmay P Lele
- Department of Chemical Engineering, University of Florida, Gainesville, FL 32611, USA
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Herford AS, Nguyen K, Miller M, Tandon R, Signorino F. Evaluation of the Safety and Efficacy of Soft Tissue Augmentation With a Compressive-Resistant Collagen Matrix in a Nonhuman Primate Model. J Oral Maxillofac Surg 2018; 77:615-628. [PMID: 30267705 DOI: 10.1016/j.joms.2018.08.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE The purpose of the present study was to evaluate the safety and efficacy of the compression-resistant collagen-based cross-linked matrix for augmentation of maxillary and mandibular soft tissue defects in an animal model. MATERIALS AND METHODS Six rhesus macaque monkeys were subjected to soft tissue grafting in 4 sites intraorally; the anterior maxilla was subjected to hard and soft tissue grafting with implant placement. Each site was randomly assigned 1 of 3 treatments: a compressive-resistant collagen matrix membrane (CM), a subepithelial connective tissue autograft (SCTG), or sham treatment, in which a partial-thickness flap was elevated and then sutured closed with no further treatment (control). The following methods were used for data collection: in vivo evaluation by periodontal probing, ultrasound, shear modulus elasticity, polyether impressions for volumetric analysis, and in vitro analysis by histologic biopsy examinations. In vitro analysis provided by histologic measurements and evaluations was performed on nondecalcified sections. The follow-up period was 6 months. RESULTS The SCTG and CM showed favorable tissue integration. No adverse reaction to or deviation from the normal healing processes was detected. The CM integrated well in all sites, with a variable range of soft tissue volume increases. Volumetric discrepancies were appreciated in the histologic analyses and differences were found when the CM and SCTG were applied in the anterior maxilla in combination with hard tissue grafting and implant placement. Histologic evaluation showed favorable integration, no immunogenic response to the CM, and stable volumetric retention in autograft and CM sites during the experimental period. CONCLUSION The compressive-resistant CM could be a safe and efficacious alternative for soft tissue augmentation by obviating a donor site and the consequent morbidity. Although a similar performance between the CM and SCTG was observed, further studies will be necessary to estimate the clinical potentiality and describe the limits of the technique.
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Affiliation(s)
- Alan S Herford
- Professor and Chair, Department of Oral and Maxillofacial Surgery, Loma Linda University, Loma Linda, CA.
| | - Katina Nguyen
- Resident, Department of Oral and Maxillofacial Surgery, Loma Linda University, Loma Linda, CA
| | - Meagan Miller
- Resident, Department of Oral and Maxillofacial Surgery, Loma Linda University, Loma Linda, CA
| | - Rahul Tandon
- Resident, Oral and Maxillofacial Surgery, UT Southwestern Medical Center, Southwestern University, Dallas, TX
| | - Fabrizio Signorino
- Resident, Oral Surgery, Department of Dental Implants, University of Milan, Milan, Italy
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Zogakis IP, Koren E, Gorelik S, Ginsburg I, Shalish M. Effect of fixed orthodontic appliances on nonmicrobial salivary parameters. Angle Orthod 2018; 88:806-811. [PMID: 29911908 DOI: 10.2319/111317-773.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES: To examine possible changes in the levels of salivary antioxidants, C-reactive protein (CRP), cortisol, pH, proteins, and blood in patients treated with fixed orthodontic appliances. MATERIALS AND METHODS: Salivary samples from 21 orthodontic patients who met specific inclusion criteria were collected before the beginning of orthodontic treatment (T0; baseline), 1 hour after bonding (T1), and 4-6 weeks after bonding (T2). Oxidant-scavenging ability (OSA) was quantified using a luminol-dependent chemiluminescence assay. Cortisol and CRP levels were measured using immunoassay kits. pH levels and presence of proteins and blood in the samples were quantified using strip-based tests. RESULTS: A significant decrease in salivary pH was observed after bonding ( P = .013). An increase in oxidant-scavenging abilities during orthodontic treatment was detected, but the change was not statistically significant. Cortisol and CRP levels slightly increased after bonding, but the difference was small without statistical significance. Changes in the presence of proteins and blood were also insignificant. CONCLUSIONS: Exposure to fixed orthodontic appliances did not show a significant effect on salivary parameters related to inflammation or stress, with the exception of a significant but transient pH decrease after bonding.
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Volumetric and linear changes at dental implants following grafting with volume-stable three-dimensional collagen matrices or autogenous connective tissue grafts: 6-month data. Clin Oral Investig 2017; 22:1185-1195. [DOI: 10.1007/s00784-017-2210-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 09/11/2017] [Indexed: 11/28/2022]
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Zeltner M, Jung RE, Hämmerle CHF, Hüsler J, Thoma DS. Randomized controlled clinical study comparing a volume-stable collagen matrix to autogenous connective tissue grafts for soft tissue augmentation at implant sites: linear volumetric soft tissue changes up to 3 months. J Clin Periodontol 2017; 44:446-453. [PMID: 28107560 DOI: 10.1111/jcpe.12697] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2017] [Indexed: 11/28/2022]
Abstract
AIM To test whether or not the use of a volume-stable collagen matrix (VCMX) results in soft tissue volume increase at implant sites non-inferior to an autogenous subepithelial connective tissue graft (SCTG). METHODS In 20 patients, soft tissue augmentation at implant sites was performed using VCMX or SCTG. Casts obtained prior to augmentation (BL), at 30 (FU-30) and 90 days (FU-90) were digitized and transferred to stereolithography (STL) files. BL, FU-30 and FU-90 STL files were superimposed and linear volumetric changes evaluated in crestal and buccal regions of interest (ROI). Descriptive analysis was computed for both groups and a test for non-inferiority was performed. RESULTS The median linear changes from BL to FU-90 in the crestal ROI amounted to 0.175 mm (0.06; 0.51) for VCMX (p = 0.002 over time) and to 0.51 mm (0.23; 0.94) for SCTG (p = 0.129). The differences between the two groups were not significant (p = 0.287). The respective values in the buccal ROI were 0.59 mm (0.26; 1.06) for VCMX (p = 0.002) and 0.94 mm (0.66; 1.13) for SCTG (p = 0.004). The differences between the two groups were not significant (crestal: p = 0.287; buccal: p = 0.534). Non-inferiority could be concluded for VCMX compared to SCTG for both ROI. CONCLUSION VCMX and SCTG can be used for soft tissue augmentation at implant sites resulting in an at least short-term increase in volume.
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Affiliation(s)
- Marco Zeltner
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Thoma DS, Naenni N, Benic GI, Hämmerle CHF, Jung RE. Soft tissue volume augmentation at dental implant sites using a volume stable three-dimensional collagen matrix - histological outcomes of a preclinical study. J Clin Periodontol 2017; 44:185-194. [PMID: 27716970 DOI: 10.1111/jcpe.12635] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2016] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to test whether or not soft tissue augmentation with a collagen matrix (VCMX) leads to a similar increase in ridge width around dental implants compared to the use of an autogenous subepithelial connective tissue graft (SCTG). MATERIALS AND METHODS In 12 dogs, immediate dental implants were placed with simultaneous guided bone regeneration. Three months later, soft tissue volume augmentation was performed by randomly allocating three treatment modalities to these sites [VCMX, SCTG, sham-operated group (control)]. Dogs were sacrificed at 1 (n = 4), 2 (n = 4) or 6 months (n = 4). Descriptive histology and histomorphometric measurements for soft tissue thickness were performed on non-decalcified sections. RESULTS The horizontal soft tissue thickness was maximal at the most coronal level (alveolar crest) at 1 month (VCMX: 2.1 ± 1.6 mm; SCTG: 2.5 ± 1.7 mm; p = 0.877) and decreased until 6 months. At 6 months, the greatest mucosal thickness was at a level 3.5 mm below the crest (VCMX: 0.8 ± 0.3 mm; SCTG: 0.7 ± 0.2 mm) (p = 0.754). Control sites revealed no relevant soft tissue augmentation at any level and any time-point. Tissue integration for VCMX and SCTG were favourable with minimal inflammatory reactions. CONCLUSIONS Soft tissue volume augmentation at implant sites was obtained to a similar extent using VCMX and SCTG up to 2 months. Thereafter, degradation and remodelling processes were enhanced leading to a minimal increase in soft tissue thickness at 6 months for VCMX and SCTG.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Goran I Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Alaribe FN, Manoto SL, Motaung SCKM. Scaffolds from biomaterials: advantages and limitations in bone and tissue engineering. Biologia (Bratisl) 2016. [DOI: 10.1515/biolog-2016-0056] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Thoma DS, Zeltner M, Hilbe M, Hämmerle CHF, Hüsler J, Jung RE. Randomized controlled clinical study evaluating effectiveness and safety of a volume-stable collagen matrix compared to autogenous connective tissue grafts for soft tissue augmentation at implant sites. J Clin Periodontol 2016; 43:874-85. [PMID: 27310522 DOI: 10.1111/jcpe.12588] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2016] [Indexed: 11/29/2022]
Abstract
AIM To test whether or not the use of a collagen matrix (VCMX) results in short-term soft tissue volume increase at implant sites non-inferior to an autogenous subepithelial connective tissue graft (SCTG), and to evaluate safety and tissue integration of VCMX and SCTG. METHODS In 20 patients with a volume deficiency at single-tooth implant sites, soft tissue volume augmentation was performed randomly allocating VCMX or SCTG. Soft tissue thickness, patient-reported outcome measures (PROMs), and safety were assessed up to 90 days (FU-90). At FU-90 (abutment connection), tissue samples were obtained for histological analysis. Descriptive analysis was computed for both groups. Non-parametric tests were applied to test non-inferiority for the gain in soft tissue thickness at the occlusal site. RESULTS Median soft tissue thickness increased between BL and FU-90 by 1.8 mm (Q1:0.5; Q3:2.0) (VCMX) (p = 0.018) and 0.5 mm (-1.0; 2.0) (SCTG) (p = 0.395) (occlusal) and by 1.0 mm (0.5; 2.0) (VCMX) (p = 0.074) and 1.5 mm (-2.0; 2.0) (SCTG) (p = 0.563) (buccal). Non-inferiority with a non-inferiority margin of 1 mm could be demonstrated (p = 0.020); the difference between the two group medians (1.3 mm) for occlusal sites indicated no relevant, but not significant superiority of VCMX versus SCTG (primary endpoint). Pain medication consumption and pain perceived were non-significantly higher in group SCTG up to day 3. Median physical pain (OHIP-14) at day 7 was 100% higher for SCTG than for VCMX. The histological analysis revealed well-integrated grafts. CONCLUSIONS Soft tissue augmentation at implant sites resulted in a similar or higher soft tissue volume increase after 90 days for VCMX versus SCTG. PROMs did not reveal relevant differences between the two groups.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - Marco Zeltner
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Monika Hilbe
- Institute of Veterinary Pathology, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Liu C, Yamaguchi Y, Sekine S, Ni Y, Li Z, Zhu X, Dou X. Gene analysis of multiple oral bacteria by the polymerase chain reaction coupled with capillary polymer electrophoresis. J Sep Sci 2015; 39:986-92. [PMID: 26648455 DOI: 10.1002/jssc.201501087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 11/09/2015] [Accepted: 11/30/2015] [Indexed: 12/16/2022]
Abstract
Capillary polymer electrophoresis is identified as a promising technology for the analysis of DNA from bacteria, virus and cell samples. In this paper, we propose an innovative capillary polymer electrophoresis protocol for the quantification of polymerase chain reaction products. The internal standard method was modified and applied to capillary polymer electrophoresis. The precision of our modified internal standard protocol was evaluated by measuring the relative standard deviation of intermediate capillary polymer electrophoresis experiments. Results showed that the relative standard deviation was reduced from 12.4-15.1 to 0.6-2.3%. Linear regression tests were also implemented to validate our protocol. The modified internal standard method showed good linearity and robust properties. Finally, the ease of our method was illustrated by analyzing a real clinical oral sample using a one-run capillary polymer electrophoresis experiment.
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Affiliation(s)
- Chenchen Liu
- Engineering Research Center of Optical Instrument and System, University of Shanghai for Science and Technology, Shanghai, China.,Institute of Photonics and Bio-medicine (IPBM), Graduate School of Science, East China University of Science and Technology (ECUST), Shanghai, China
| | - Yoshinori Yamaguchi
- Institute of Photonics and Bio-medicine (IPBM), Graduate School of Science, East China University of Science and Technology (ECUST), Shanghai, China.,Department of Applied Physics, Graduate School of Engineering, Osaka University, Osaka, Japan
| | - Shinichi Sekine
- Division of Special Care Dentistry, Osaka University Dental Hospital, Osaka University, Osaka, Japan.,Department of Preventive Dentistry, Osaka University Graduate School of Dentistry Osaka University, Osaka, Japan
| | - Yi Ni
- Institute of Photonics and Bio-medicine (IPBM), Graduate School of Science, East China University of Science and Technology (ECUST), Shanghai, China
| | - Zhenqing Li
- Engineering Research Center of Optical Instrument and System, University of Shanghai for Science and Technology, Shanghai, China
| | - Xifang Zhu
- School of Optoelectronic Engineering, ChangZhou Institute of Technology, Changzhou, Jiangsu, China
| | - Xiaoming Dou
- Institute of Photonics and Bio-medicine (IPBM), Graduate School of Science, East China University of Science and Technology (ECUST), Shanghai, China.,School of Optoelectronic Engineering, ChangZhou Institute of Technology, Changzhou, Jiangsu, China
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Cheung JW, McCulloch CA, Santerre JP. Establishing a gingival fibroblast phenotype in a perfused degradable polyurethane scaffold: Mediation by TGF-β1, FGF-2, β1-integrin, and focal adhesion kinase. Biomaterials 2014; 35:10025-32. [DOI: 10.1016/j.biomaterials.2014.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/26/2014] [Accepted: 08/30/2014] [Indexed: 11/30/2022]
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Agis H, Collins A, Taut AD, Jin Q, Kruger L, Görlach C, Giannobile WV. Cell population kinetics of collagen scaffolds in ex vivo oral wound repair. PLoS One 2014; 9:e112680. [PMID: 25397671 PMCID: PMC4232419 DOI: 10.1371/journal.pone.0112680] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 10/09/2014] [Indexed: 01/05/2023] Open
Abstract
Biodegradable collagen scaffolds are used clinically for oral soft tissue augmentation to support wound healing. This study sought to provide a novel ex vivo model for analyzing healing kinetics and gene expression of primary human gingival fibroblasts (hGF) within collagen scaffolds. Sponge type and gel type scaffolds with and without platelet-derived growth factor-BB (PDGF) were assessed in an hGF containing matrix. Morphology was evaluated with scanning electron microscopy, and hGF metabolic activity using MTT. We quantitated the population kinetics within the scaffolds based on cell density and distance from the scaffold border of DiI-labled hGFs over a two-week observation period. Gene expression was evaluated with gene array and qPCR. The sponge type scaffolds showed a porous morphology. Absolute cell number and distance was higher in sponge type scaffolds when compared to gel type scaffolds, in particular during the first week of observation. PDGF incorporated scaffolds increased cell numbers, distance, and formazan formation in the MTT assay. Gene expression dynamics revealed the induction of key genes associated with the generation of oral tissue. DKK1, CYR61, CTGF, TGFBR1 levels were increased and integrin ITGA2 levels were decreased in the sponge type scaffolds compared to the gel type scaffold. The results suggest that this novel model of oral wound healing provides insights into population kinetics and gene expression dynamics of biodegradable scaffolds.
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Affiliation(s)
- Hermann Agis
- Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Conservative Dentistry and Periodontology, Medical University of Vienna, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Amy Collins
- Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Andrei D. Taut
- Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Qiming Jin
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Laura Kruger
- Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | | | - William V. Giannobile
- Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail:
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Thoma DS, Nänni N, Benic GI, Weber FE, Hämmerle CHF, Jung RE. Effect of platelet-derived growth factor-BB on tissue integration of cross-linked and non-cross-linked collagen matrices in a rat ectopic model. Clin Oral Implants Res 2014; 26:263-70. [PMID: 25267409 DOI: 10.1111/clr.12496] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 11/28/2022]
Abstract
AIM To test whether or not the network structure and the addition of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) to a chemically cross-linked collagen matrix (CCM)- and a non-cross-linked collagen matrix (NCCM)-influenced tissue integration, angiogenesis, and matrix degradation. MATERIALS AND METHODS Four treatment modalities were randomly assigned to four unconnected pouches in the back of 50 rats: (i) CCM-S (soaked in saline), (ii) CCM-P (plus rhPDGF-BB), (iii) NCCM-S (soaked in saline), and (iv) NCCM-P (plus rhPDGF-BB). The animals were sacrificed at 2, 4, 8, 16, and 24 weeks. Descriptive histology and histomorphometric assessments were performed thereby evaluating matrix thickness, the number of vessels (angiogenesis), and connective tissue formation. Means and standard deviations were calculated. Robust linear mixed modeling was used to test the effect of group (NCCM vs CCM), rhPDGF-BB, and time point of sacrifice (2, 4, and 8 weeks). RESULTS The thickness of NCCM groups revealed stability (range 440-570 μm) over 8 weeks, while the matrices were no longer present at 16 and 24 weeks. CCM matrices demonstrated a maximal thickness at 2 weeks (2689 ± 187 μm for CCM-S and 2693 ± 389 μm for CCM-P), a decrease of roughly 40% at 8 weeks, but were still present at 16 and 24 weeks. Vascularization of NCCM gradually increased over time with a peak (mean 17.0; SD 1.7) for NCCM-S and NCCM-P (22.0 ± 34.8) at 8 weeks. Angiogenesis in CCM was significantly more pronounced at early time points with a peak at 2 weeks (29.3 ± 16.8 for CCM-S and 30.3 ± 18.4 for CCM-P). No statistically significant effect of rhPDGF-BB was observed for any of the evaluated parameters (all P > 0.05). CONCLUSIONS The compact layer (in NCCM) delayed angiogenesis and connective tissue formation, while the spongeous cross-linked matrix of CCM facilitated early vascularization and demonstrated network presence over a longer time span.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zürich, Switzerland
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Thoma DS, Mühlemann S, Jung RE. Critical soft-tissue dimensions with dental implants and treatment concepts. Periodontol 2000 2014; 66:106-18. [DOI: 10.1111/prd.12045] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 11/30/2022]
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Vignoletti F, Nuñez J, de Sanctis F, Lopez M, Caffesse R, Sanz M. Healing of a xenogeneic collagen matrix for keratinized tissue augmentation. Clin Oral Implants Res 2014; 26:545-52. [DOI: 10.1111/clr.12441] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Fabio Vignoletti
- Department of Periodontology; Faculty of Dentistry; Complutense University of Madrid; Madrid Spain
| | - Javier Nuñez
- Department of Periodontology; Faculty of Dentistry; Complutense University of Madrid; Madrid Spain
| | - Francesco de Sanctis
- Department of Periodontology; Faculty of Dentistry; Complutense University of Madrid; Madrid Spain
| | - Monica Lopez
- School of Veterinary; University of Santiago de Compostela; Santiago de Compostela Spain
| | - Raul Caffesse
- Department of Periodontology; Faculty of Dentistry; Complutense University of Madrid; Madrid Spain
| | - Mariano Sanz
- Department of Periodontology; Faculty of Dentistry; Complutense University of Madrid; Madrid Spain
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Alminger M, Aura AM, Bohn T, Dufour C, El S, Gomes A, Karakaya S, Martínez-Cuesta M, McDougall G, Requena T, Santos C. In VitroModels for Studying Secondary Plant Metabolite Digestion and Bioaccessibility. Compr Rev Food Sci Food Saf 2014; 13:413-436. [DOI: 10.1111/1541-4337.12081] [Citation(s) in RCA: 218] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 02/28/2014] [Indexed: 12/18/2022]
Affiliation(s)
- M. Alminger
- Dept. of Chemical and Biological Engineering; Chalmers Univ. of Technology; SE 412 96 Gothenburg Sweden
| | - A.-M. Aura
- VTT Technical Research Centre of Finland; P.O.Box 1000 Tietotie 2 Espoo FI-02044 VTT Finland
| | - T. Bohn
- Environment and Agro-biotechnologies Dept; Centre de Recherche Public - Gabriel Lippmann; 4422 Belvaux Luxembourg
| | - C. Dufour
- INRA, UMR408 Safety and Quality of Plant Products F-84000 Avignon; France
- Univ. of Avignon; UMR408 Safety and Quality of Plant Products F-84000 Avignon; France
| | - S.N. El
- Engineering Faculty Dept. of Food Engineering; Ege Univ. 35100 Izmir Turkey
| | - A. Gomes
- Inst. de Biologia Experimental e Tecnológica; Apartado 12, 2781-901 Oeiras Portugal
- Inst. de Tecnologia Química e Biológica; Univ. Nova de Lisboa; Av. da República, EAN, 2781-901 Oeiras Portugal
| | - S. Karakaya
- Engineering Faculty Dept. of Food Engineering; Ege Univ. 35100 Izmir Turkey
| | - M.C. Martínez-Cuesta
- Inst. de Investigación en Ciencias de la Alimentación CIAL (CSIC-UAM); Nicolás Cabrera 9, 28049 Madrid Spain
| | - G.J. McDougall
- The James Hutton Inst., Invergowrie; DD2 5DA; Dundee United Kingdom
| | - T. Requena
- Inst. de Investigación en Ciencias de la Alimentación CIAL (CSIC-UAM); Nicolás Cabrera 9, 28049 Madrid Spain
| | - C.N. Santos
- Inst. de Biologia Experimental e Tecnológica; Apartado 12, 2781-901 Oeiras Portugal
- Inst. de Tecnologia Química e Biológica; Univ. Nova de Lisboa; Av. da República, EAN, 2781-901 Oeiras Portugal
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Mathes SH, Ruffner H, Graf-Hausner U. The use of skin models in drug development. Adv Drug Deliv Rev 2014; 69-70:81-102. [PMID: 24378581 DOI: 10.1016/j.addr.2013.12.006] [Citation(s) in RCA: 185] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 12/10/2013] [Accepted: 12/17/2013] [Indexed: 12/12/2022]
Abstract
Three dimensional (3D) tissue models of the human skin are probably the most developed and understood in vitro engineered constructs. The motivation to accomplish organotypic structures was driven by the clinics to enable transplantation of in vitro grown tissue substitutes and by the cosmetics industry as alternative test substrates in order to replace animal models. Today a huge variety of 3D human skin models exist, covering a multitude of scientific and/or technical demands. This review summarizes and discusses different approaches of skin model development and sets them into the context of drug development. Although human skin models have become indispensable for the cosmetics industry, they have not yet started their triumphal procession in pharmaceutical research and development. For drug development these tissue models may be of particular interest for a) systemically acting drugs applied on the skin, and b) drugs acting at the site of application in the case of skin diseases or disorders. Although quite a broad spectrum of models covering different aspects of the skin as a biologically acting surface exists, these are most often single stand-alone approaches. In order to enable the comprehensive application into drug development processes, the approaches have to be synchronized to allow a cross-over comparison. Besides the development of biological relevant models, other issues are not less important in the context of drug development: standardized production procedures, process automation, establishment of significant analytical methods, and data correlation. For the successful routine use of engineered human skin models in drug development, major requirements were defined. If these requirements can be accomplished in the next few years, human organotypic skin models will become indispensable for drug development, too.
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Affiliation(s)
- Stephanie H Mathes
- Institute of Chemistry and Biological Chemistry, Zurich University of Applied Sciences (ZHAW), Einsiedlerstrasse 31, 8820 Waedenswil, Switzerland
| | - Heinz Ruffner
- Developmental and Molecular Pathways (DMP), Novartis Institutes for BioMedical Research (NIBR), Fabrikstrasse 22, 4056 Basel, Switzerland
| | - Ursula Graf-Hausner
- Institute of Chemistry and Biological Chemistry, Zurich University of Applied Sciences (ZHAW), Einsiedlerstrasse 31, 8820 Waedenswil, Switzerland.
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Thoma DS, Buranawat B, Hämmerle CH, Held U, Jung RE. Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review. J Clin Periodontol 2014; 41 Suppl 15:S77-91. [DOI: 10.1111/jcpe.12220] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Borvornwut Buranawat
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Christoph H.F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ulrike Held
- Horten Centre for Patient Oriented Research and Knowledge Transfer; University Hospital Zurich; Zurich Switzerland
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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The oxidant-scavenging abilities in the oral cavity may be regulated by a collaboration among antioxidants in saliva, microorganisms, blood cells and polyphenols: a chemiluminescence-based study. PLoS One 2013; 8:e63062. [PMID: 23658797 PMCID: PMC3642077 DOI: 10.1371/journal.pone.0063062] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 03/27/2013] [Indexed: 11/24/2022] Open
Abstract
Saliva has become a central research issue in oral physiology and pathology. Over the evolution, the oral cavity has evolved the antioxidants uric acid, ascorbate reduced glutathione, plasma-derived albumin and antioxidants polyphenols from nutrients that are delivered to the oral cavity. However, blood cells extravasated from injured capillaries in gingival pathologies, or following tooth brushing and use of tooth picks, may attenuate the toxic activities of H2O2 generated by oral streptococci and by oxidants generated by activated phagocytes. Employing a highly sensitive luminol-dependent chemiluminescence, the DPPH radical and XTT assays to quantify oxidant-scavenging abilities (OSA), we show that saliva can strongly decompose both oxygen and nitrogen species. However, lipophilic antioxidant polyphenols in plants, which are poorly soluble in water and therefore not fully available as effective antioxidants, can nevertheless be solubilized either by small amounts of ethanol, whole saliva or also by salivary albumin and mucin. Plant-derived polyphenols can also act in collaboration with whole saliva, human red blood cells, platelets, and also with catalase-positive microorganisms to decompose reactive oxygen species (ROS). Furthermore, polyphenols from nutrient can avidly adhere to mucosal surfaces, are retained there for long periods and may function as a “slow- release devises” capable of affecting the redox status in the oral cavity. The OSA of saliva is due to the sum result of low molecular weight antioxidants, albumin, polyphenols from nutrients, blood elements and microbial antioxidants. Taken together, saliva and its antioxidants are considered regulators of the redox status in the oral cavity under physiological and pathological conditions.
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Saliva increases the availability of lipophilic polyphenols as antioxidants and enhances their retention in the oral cavity. Arch Oral Biol 2012; 57:1327-34. [DOI: 10.1016/j.archoralbio.2012.04.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 04/07/2012] [Accepted: 04/22/2012] [Indexed: 11/17/2022]
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Petersen A, Joly P, Bergmann C, Korus G, Duda GN. The Impact of Substrate Stiffness and Mechanical Loading on Fibroblast-Induced Scaffold Remodeling. Tissue Eng Part A 2012; 18:1804-17. [DOI: 10.1089/ten.tea.2011.0514] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Ansgar Petersen
- Julius Wolff Institute, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Center for Musculoskeletal Surgery, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Pascal Joly
- Julius Wolff Institute, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg School for Regenerative Therapies, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Camilla Bergmann
- Julius Wolff Institute, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Gabriela Korus
- Julius Wolff Institute, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Georg N. Duda
- Julius Wolff Institute, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Center for Musculoskeletal Surgery, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg School for Regenerative Therapies, Charité—Universitätsmedizin Berlin, Berlin, Germany
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Rimann M, Graf-Hausner U. Synthetic 3D multicellular systems for drug development. Curr Opin Biotechnol 2012; 23:803-9. [PMID: 22326911 DOI: 10.1016/j.copbio.2012.01.011] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 01/09/2012] [Accepted: 01/20/2012] [Indexed: 12/31/2022]
Abstract
Since the 1970s, the limitations of two dimensional (2D) cell culture and the relevance of appropriate three dimensional (3D) cell systems have become increasingly evident. Extensive effort has thus been made to move cells from a flat world to a 3D environment. While 3D cell culture technologies are meanwhile widely used in academia, 2D culture technologies are still entrenched in the (pharmaceutical) industry for most kind of cell-based efficacy and toxicology tests. However, 3D cell culture technologies will certainly become more applicable if biological relevance, reproducibility and high throughput can be assured at acceptable costs. Most recent innovations and developments clearly indicate that the transition from 2D to 3D cell culture for industrial purposes, for example, drug development is simply a question of time.
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Affiliation(s)
- Markus Rimann
- Zurich University of Applied Sciences, Institute of Chemistry and Biological Chemistry, Einsiedlerstr. 31, 8820 Wädenswil, Switzerland
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Thoma DS, Villar CC, Cochran DL, Hämmerle CHF, Jung RE. Tissue integration of collagen-based matrices: an experimental study in mice. Clin Oral Implants Res 2011; 23:1333-9. [PMID: 22093051 DOI: 10.1111/j.1600-0501.2011.02356.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To test whether or not tissue integration, biodegradation, and new blood vessel formation in two collagen-based matrices depend on the level of chemical cross-linking. MATERIAL AND METHODS Two collagen matrices with high (CM1) and low (CM2) levels of chemical cross-linking were randomly implanted in two pouches in 14 athymic nude mice. Three and 6 weeks later, the animals were euthanized. Histologic and histomorphometric measurements were performed on paraffin-embedded sections. RESULTS Both collagen matrices integrated well into the surrounding soft tissues. The level of cross-linking and duration of implantation had an effect on the formation of new blood vessels. More blood vessels (n = in absolute numbers) were found in outer compartments compared to the central compartments of the matrices, reaching 5.6 (CM2) vs. 4.3 (CM1) at 3 weeks, and 5.3 (CM2) vs. 7.3 (CM1) at 6 weeks. Similarly, connective tissue formation increased for both matrices between 3 and 6 weeks, whereas the amount of remaining collagen network gradually decreased over time being more pronounced for CM1 (-50%) compared to CM2 (-15%). CONCLUSIONS The degree of cross-linking was negatively correlated for all outcome measures resulting in improved tissue integration, superior matrix stability and enhanced angiogenic patterns for the less cross-linked collagen matrix (CM2) in this experimental study in mice.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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