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Tamilarasan M, Nivetha R, Prabhahar CS, Umayal M, Arun Jaikumar R, Naidu NM. Evaluation of Primary and Secondary Stability of Endosseous Dental Implants With and Without the Use of Platelet-Rich Fibrin: A Clinical Study. Cureus 2024; 16:e62918. [PMID: 39040770 PMCID: PMC11262779 DOI: 10.7759/cureus.62918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND This clinical study investigates platelet-rich fibrin's (PRF) impact on dental implant stability, addressing global oral health challenges and limitations of traditional methods. Emphasizing osseointegration's pivotal role, the study explores PRF's potential in enhancing implant stability, assessing it through resonance frequency analysis (RFA) and implant stability quotient (ISQ). The hypothesis suggests PRF may improve both primary and secondary stability, aiming to uncover clinical benefits in dental implant procedures Materials and methods: The study involved 24 subjects from the Department of Periodontics outpatient clinics with a meticulously designed methodology. This included a pre-surgical protocol with oral prophylaxis, impressions, and cone-beam computed tomography (CBCT) analysis. PRF preparation utilized a minimally invasive venipuncture technique. Implant placement followed a two-stage surgical protocol, assessing primary stability with MEGA ISQ (Ostell). Post-surgery, patients received instructions and underwent recall for secondary stability after three months. Clinical parameters such as plaque index (PI), gingival index (GI), implant probing pocket depth (IPPD), sulcus bleeding index (SBI), and implant stability (IS) were systematically recorded. Robust statistical analyses, using IBM SPSS Statistics for Windows v20.0 (IBM Corp., Armonk, USA) software, incorporated Mann-Whitney U and Wilcoxon signed-rank tests for group and within-time point comparisons, with a significance level of p<0.05. This comprehensive study yields nuanced insights into the impact of PRF and implant procedures on key clinical parameters, contributing significantly to the field. RESULTS This study compared dental implants with and without PRF in 24 patients. Both groups showed significant improvements in the PI, GI, and SBI. The PRF group exhibited higher IS in the third and sixth months, while IPPD was lower in the PRF group in the sixth month. CONCLUSION The findings of the study highlight a positive impact on implant stability contributing to better implant outcomes.
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Affiliation(s)
- M Tamilarasan
- Department of Periodontics, Best Dental Science College, Madurai, IND
| | - R Nivetha
- Department of Periodontics, Best Dental Science College, Madurai, IND
| | - C S Prabhahar
- Department of Periodontics, Best Dental Science College, Madurai, IND
| | - M Umayal
- Department of Periodontics, Best Dental Science College, Madurai, IND
| | - R Arun Jaikumar
- Department of Prosthodontics, Best Dental Science College, Madurai, IND
| | - N Madhulika Naidu
- Department of Oral Medicine and Radiology, Best Dental Science College, Madurai, IND
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Ivanovski S, Lee RSB, Fernandez-Medina T, Pinto N, Andrade C, Quirynen M. Impact of autologous platelet concentrates on the osseointegration of dental implants. Periodontol 2000 2024. [PMID: 38647020 DOI: 10.1111/prd.12563] [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: 11/10/2023] [Revised: 02/06/2024] [Accepted: 03/04/2024] [Indexed: 04/25/2024]
Abstract
Osseointegration is defined as the direct deposition of bone onto biomaterial devices, most commonly composed from titanium, for the purpose of anchoring dental prostheses. The use of autologous platelet concentrates (APC) has the potential to enhance this process by modifying the interface between the host and the surface of the titanium implant. The rationale is to modify the implant surface and implant-bone interface via "biomimicry," a process whereby the deposition of the host's own proteins and extracellular matrix enhances the biocompatibility of the implant and hence accelerates the osteogenic healing process. This review of the available evidence reporting on the effect of APC on osseointegration explores in vitro laboratory studies of the interaction of APC with different implant surfaces, as well as the in vivo and clinical effects of APC on osseointegration in animal and human studies. The inherent variability associated with using autologous products, namely the unique composition of each individual's blood plasma, as well as the great variety in APC protocols, combination of biomaterials, and clinical/therapeutic application, makes it is difficult to make any firm conclusions about the in vivo and clinical effects of APC on osseointegration. The available evidence suggests that the clinical benefits of adding PRP and the liquid form of L-PRF (liquid fibrinogen) to any implant surface appear to be limited. The application of L-PRF membranes in the osteotomy site, however, may produce positive clinical effects at the early stage of healing (up to 6 weeks), by promoting early implant stability and reducing marginal bone loss, although no positive longer term effects were observed. Careful interpretation and cautious conclusions should be drawn from these findings as there were various limitations in methodology. Future studies should focus on better understanding of the influence of APCs on the biomaterial surface and designing controlled preclinical and clinical studies using standardized APC preparation and application protocols.
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Affiliation(s)
- Sašo Ivanovski
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
| | - Ryan S B Lee
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
| | - Tulio Fernandez-Medina
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
| | - Nelson Pinto
- Department of Periodontology and Implantology, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Catherine Andrade
- Department of Periodontology and Implantology, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Marc Quirynen
- Department of Oral Health Sciences, Katholieke Universiteit Leuven (Periodontology), University Hospitals Leuven, Leuven, Belgium
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Romero-Gavilán F, Cerqueira A, Anitua E, Tejero R, García-Arnáez I, Martinez-Ramos C, Ozturan S, Izquierdo R, Azkargorta M, Elortza F, Gurruchaga M, Goñi I, Suay J. Protein adsorption/desorption dynamics on Ca-enriched titanium surfaces: biological implications. J Biol Inorg Chem 2021; 26:715-726. [PMID: 34453217 PMCID: PMC8437886 DOI: 10.1007/s00775-021-01886-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 07/17/2021] [Indexed: 12/17/2022]
Abstract
Calcium ions are used in the development of biomaterials for the promotion of coagulation, bone regeneration, and implant osseointegration. Upon implantation, the time-dependent release of calcium ions from titanium implant surfaces modifies the physicochemical characteristics at the implant-tissue interface and thus, the biological responses. The aim of this study is to examine how the dynamics of protein adsorption on these surfaces change over time. Titanium discs with and without Ca were incubated with human serum for 2 min, 180 min, and 960 min. The layer of proteins attached to the surface was characterised using nLC-MS/MS. The adsorption kinetics was different between materials, revealing an increased adsorption of proteins associated with coagulation and immune responses prior to Ca release. Implant-blood contact experiments confirmed the strong coagulatory effect for Ca surfaces. We employed primary human alveolar osteoblasts and THP-1 monocytes to study the osteogenic and inflammatory responses. In agreement with the proteomic results, Ca-enriched surfaces showed a significant initial inflammation that disappeared once the calcium was released. The distinct protein adsorption/desorption dynamics found in this work demonstrated to be useful to explain the differential biological responses between the titanium and Ca-ion modified implant surfaces.
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Affiliation(s)
- Francisco Romero-Gavilán
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Campus del Ríu Sec, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain.
| | - Andreia Cerqueira
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Campus del Ríu Sec, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - Eduardo Anitua
- BTI Biotechnology Institute I+D, C/ Leonardo da Vinci 14B, 01510, Miñano, Spain.,University Institute of Regenerative Medicine and Oral Implantology (UIRMI), University of the Basque Country (UPV/EHU), C/ Jacinto Quincoces, 39, 01007, Vitoria, Spain.,Private Practice in Oral Implantology, C/Jose Maria Cagigal, 19, 01007, Vitoria, Spain
| | - Ricardo Tejero
- BTI Biotechnology Institute I+D, C/ Leonardo da Vinci 14B, 01510, Miñano, Spain.,University Institute of Regenerative Medicine and Oral Implantology (UIRMI), University of the Basque Country (UPV/EHU), C/ Jacinto Quincoces, 39, 01007, Vitoria, Spain
| | - Iñaki García-Arnáez
- Facultad de Ciencias Químicas, Universidad del País Vasco, P. M. de Lardizábal, 3, 20018, San Sebastián, Spain
| | - Cristina Martinez-Ramos
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de Valencia, Camino de Vera, s/n, 46022, Valencia, Spain
| | - Seda Ozturan
- Department of Periodontology, Faculty of Dentistry, Istanbul Medeniyet University, Istanbul, Turkey
| | - Raul Izquierdo
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Campus del Ríu Sec, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - Mikel Azkargorta
- Proteomics Platform, CIBERehd, ProteoRed-ISCIII, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), Bizkaia Science and Technology Park, 48160, Derio, Spain
| | - Félix Elortza
- Proteomics Platform, CIBERehd, ProteoRed-ISCIII, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), Bizkaia Science and Technology Park, 48160, Derio, Spain
| | - Mariló Gurruchaga
- Facultad de Ciencias Químicas, Universidad del País Vasco, P. M. de Lardizábal, 3, 20018, San Sebastián, Spain
| | - Isabel Goñi
- Facultad de Ciencias Químicas, Universidad del País Vasco, P. M. de Lardizábal, 3, 20018, San Sebastián, Spain
| | - Julio Suay
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Campus del Ríu Sec, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
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Anitua E, Cerqueira A, Romero-Gavilán F, García-Arnáez I, Martinez-Ramos C, Ozturan S, Azkargorta M, Elortza F, Gurruchaga M, Goñi I, Suay J, Tejero R. Influence of calcium ion-modified implant surfaces in protein adsorption and implant integration. Int J Implant Dent 2021; 7:32. [PMID: 33880662 PMCID: PMC8058122 DOI: 10.1186/s40729-021-00314-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/01/2021] [Indexed: 12/26/2022] Open
Abstract
Background Calcium (Ca) is a well-known element in bone metabolism and blood coagulation. Here, we investigate the link between the protein adsorption pattern and the in vivo responses of surfaces modified with calcium ions (Ca-ion) as compared to standard titanium implant surfaces (control). We used LC–MS/MS to identify the proteins adhered to the surfaces after incubation with human serum and performed bilateral surgeries in the medial section of the femoral condyles of 18 New Zealand white rabbits to test osseointegration at 2 and 8 weeks post-implantation (n=9). Results Ca-ion surfaces adsorbed 181.42 times more FA10 and 3.85 times less FA12 (p<0.001), which are factors of the common and the intrinsic coagulation pathways respectively. We also detected differences in A1AT, PLMN, FA12, KNG1, HEP2, LYSC, PIP, SAMP, VTNC, SAA4, and CFAH (p<0.01). At 2 and 8 weeks post-implantation, the mean bone implant contact (BIC) with Ca-ion surfaces was respectively 1.52 and 1.25 times higher, and the mean bone volume density (BVD) was respectively 1.35 and 1.13 times higher. Differences were statistically significant for BIC at 2 and 8 weeks and for BVD at 2 weeks (p<0.05). Conclusions The strong thrombogenic protein adsorption pattern at Ca-ion surfaces correlated with significantly higher levels of implant osseointegration. More effective implant surfaces combined with smaller implants enable less invasive surgeries, shorter healing times, and overall lower intervention costs, especially in cases of low quantity or quality of bone. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-021-00314-1.
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Affiliation(s)
- Eduardo Anitua
- University Institute of Regenerative Medicine and Oral Implantology (UIRMI), University of the Basque Country (UPV-EHU), C/ Jacinto Quincoces, 39, 01007, Vitoria, Spain
| | - Andreia Cerqueira
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - Francisco Romero-Gavilán
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - Iñaki García-Arnáez
- Faculty of Chemical Sciences, University of the Basque Country (UPV-EHU), P.M. de Lardizábal, 3, 20018, San Sebastián, Spain
| | - Cristina Martinez-Ramos
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de Valencia, Camino de Vera, s/n, 46022, Valencia, Spain
| | - Seda Ozturan
- Department of Periodontology, Faculty of Dentistry, Istambul Medeniyet University, Istanbul, Turkey
| | - Mikel Azkargorta
- Proteomics Platform, CIC bioGUNE, CIBERehd, ProteoRed-ISCIII, Bizkaia Science and Technology Park, 48160, Derio, Spain
| | - Félix Elortza
- Proteomics Platform, CIC bioGUNE, CIBERehd, ProteoRed-ISCIII, Bizkaia Science and Technology Park, 48160, Derio, Spain
| | - Mariló Gurruchaga
- Faculty of Chemical Sciences, University of the Basque Country (UPV-EHU), P.M. de Lardizábal, 3, 20018, San Sebastián, Spain
| | - Isabel Goñi
- Faculty of Chemical Sciences, University of the Basque Country (UPV-EHU), P.M. de Lardizábal, 3, 20018, San Sebastián, Spain
| | - Julio Suay
- Department of Industrial Systems Engineering and Design, Universitat Jaume I, Av. Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - Ricardo Tejero
- University Institute of Regenerative Medicine and Oral Implantology (UIRMI), University of the Basque Country (UPV-EHU), C/ Jacinto Quincoces, 39, 01007, Vitoria, Spain.
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Kikuchi N, Yoshioka T, Taniguchi Y, Sugaya H, Arai N, Kanamori A, Yamazaki M. Optimization of leukocyte-poor platelet-rich plasma preparation: a validation study of leukocyte-poor platelet-rich plasma obtained using different preparer, storage, and activation methods. J Exp Orthop 2019; 6:24. [PMID: 31161535 PMCID: PMC6546777 DOI: 10.1186/s40634-019-0190-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/13/2019] [Indexed: 12/24/2022] Open
Abstract
Background Alternative methods of platelet-rich plasma (PRP) preparation, storage, and activation that can be stably reproduced are needed to improve PRP production. The purpose of this study was to investigate the effect of the preparer’s experience on the quality of prepared PRP, chronological changes occurring in PRP, and the effect of the activation procedures on the release of several growth factors from PRP, using PRP prepared with the PRGF-Endoret Kit. Methods Leukocyte-poor PRP samples from seventeen healthy volunteers were prepared using the PRGF-Endoret Kit and the PRGF IV System Centrifuge. The platelet and leukocyte concentrations were compared based on the preparer’s experience. The concentrations of platelets, hepatocyte growth factor (HGF), platelet-derived growth factor-BB (PDGF-BB), and insulin-like growth factor-1 (IGF-1) were determined at 0 and 60 min after PRP preparation, and compared. Concentrations of the above growth factors from PRP activated by freeze–thaw cycling and by calcium chloride (CaCl2) were also compared. Results No significant difference was observed in the platelet concentrations and leukocyte contamination rates, based on the preparer’s experience. At 60 min after PRP preparation, the platelet concentration decreased significantly, while the HGF, PDGF-BB, and IGF-1 concentrations remained unchanged. Activation with CaCl2 resulted in a significant increase in the PDGF-BB levels, although the HGF and IGF-1 concentrations remained unchanged. Conclusions The results of this study show that leukocyte-poor PRP prepared using the PRGF-Endoret Kit did not result in any qualitative difference that depended on the experience of the preparer. However, PRP preparation required standardization in terms of the time of blood count measurement. Growth factor concentrations in PRP differed according to the platelet-activation method used.
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Affiliation(s)
- Naoya Kikuchi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tomokazu Yoshioka
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. .,Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Yu Taniguchi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.,Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hisashi Sugaya
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.,Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Norihito Arai
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Akihiro Kanamori
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Rottmar M, Müller E, Guimond-Lischer S, Stephan M, Berner S, Maniura-Weber K. Assessing the osteogenic potential of zirconia and titanium surfaces with an advanced in vitro model. Dent Mater 2019; 35:74-86. [DOI: 10.1016/j.dental.2018.10.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 09/12/2018] [Accepted: 10/12/2018] [Indexed: 10/27/2022]
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Zhu W, Zhao Y, Ma Q, Wang Y, Wu Z, Weng X. 3D-printed porous titanium changed femoral head repair growth patterns: osteogenesis and vascularisation in porous titanium. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:62. [PMID: 28251470 DOI: 10.1007/s10856-017-5862-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 01/30/2017] [Indexed: 06/06/2023]
Abstract
Osteonecrosis of the femoral head (ONFH) is a major cause of morbidity, and total hip arthroplasty is both traumatic and expensive. Here, we created a gelatine scaffold embedded in uniquely shaped, 3D-printed porous titanium parts, which could attract and promote the proliferation of osteoblasts as well as bone regeneration, as the extracellular matrix (ECM) does in vivo. Interestingly, after hybridisation with platelets, the scaffold exhibited a low yet considerable rate of stable, safe and long-term growth factor release. Additionally, a novel ONFH model was constructed and verified. Scaffolds implanted in this model were found to accelerate bone repair. In conclusion, our scaffold successfully simulates the ECM and considerably accelerates bone regeneration, in which platelets play an indispensable role. We believe that platelets should be emphasised as carriers that may be employed to transport drugs, cytokines and other small molecules to target locations in vivo. In addition, this novel scaffold is a useful material for treating ONFH. An overview of the novel scaffold mimicking the extracellular environment in bone repair. a and b: A gelatine scaffold was cross-linked and freeze-dried within 3D-printed porous titanium. c: Platelets were coated onto the gelatine microscaffold after freeze-drying platelet-rich plasma. d: The microscaffold supported the migration of cells into the titanium pores and their subsequent growth, while the platelets slowly released cell factors, exerting bioactivity.
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Affiliation(s)
- Wei Zhu
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yan Zhao
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Qi Ma
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yingjie Wang
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Zhihong Wu
- Beijing Key Laboratory for Genetic Research of Bone and Joint Disease, Central Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Beijing, 100730, P.R. China.
| | - Xisheng Weng
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
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Anitua E, Tejero R, Pacha-Olivenza MÁ, Fernández-Calderón MC, Delgado-Rastrollo M, Zalduendo MM, Troya M, Pérez-Giraldo C, González-Martín ML. Balancing microbial and mammalian cell functions on calcium ion-modified implant surfaces. J Biomed Mater Res B Appl Biomater 2017; 106:421-432. [PMID: 28186691 DOI: 10.1002/jbm.b.33860] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/16/2017] [Accepted: 01/26/2017] [Indexed: 12/27/2022]
Abstract
Implant integration is a complex process mediated by the interaction of the implant surface with the surrounding ions, proteins, bacteria, and tissue cells. Although most implants achieve long-term bone-tissue integration, preventing pervasive implant-centered infections demands further advances, particularly in surfaces design. In this work, we analyzed classical microrough implant surfaces (only acid etched, AE; sandblasted then acid etching, SB + AE) and a new calcium-ion-modified implant surface (AE + Ca) in terms of soft- and hard-tissue integration, bacterial adhesion, and biofilm formation. We cultured on the surfaces primary oral cells from gingiva and alveolar bone, and three representative bacterial strains of the oral cavity, emulating oral conditions of natural saliva and blood plasma. With respect to gingiva and bone cells and in the presence of platelets and plasma proteins, AE + Ca surfaces yielded in average 86% higher adhesion, 44% more proliferation, and triggered 246% more synthesis of extracellular matrix biomolecules than AE-unmodified controls. Concomitantly, AE + Ca surfaces regardless of conditioning with saliva and/or blood plasma showed significantly less bacterial adhesion (67% reduction in average) and biofilm formation (40% reduction in average) than unmodified surfaces. These results highlight the importance of a calcium-rich hydrated interface to favor mammalian cell functions over microbial colonization at implant surfaces. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 421-432, 2018.
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Affiliation(s)
- Eduardo Anitua
- Private Practice in Implantology and Oral Rehabilitation, 01007, Vitoria-Gasteiz, Spain.,BTI Biotechnology Institute IMASD, 01510, Miñano, Spain
| | | | - Miguel Ángel Pacha-Olivenza
- Networking Research Centre on Bioengineering, Biomaterial and Biomedicine (CIBER-BBN), Badajoz, Spain.,Department of Applied Physics, Faculty of Science-UEx, 06006, Badajoz, Spain
| | - María Coronada Fernández-Calderón
- Networking Research Centre on Bioengineering, Biomaterial and Biomedicine (CIBER-BBN), Badajoz, Spain.,Department of Biomedical Sciences, Faculty of Medicine-UEx, 06006, Badajoz, Spain
| | - María Delgado-Rastrollo
- Networking Research Centre on Bioengineering, Biomaterial and Biomedicine (CIBER-BBN), Badajoz, Spain.,Department of Biomedical Sciences, Faculty of Medicine-UEx, 06006, Badajoz, Spain
| | | | - María Troya
- BTI Biotechnology Institute IMASD, 01510, Miñano, Spain
| | - Ciro Pérez-Giraldo
- Networking Research Centre on Bioengineering, Biomaterial and Biomedicine (CIBER-BBN), Badajoz, Spain.,Department of Biomedical Sciences, Faculty of Medicine-UEx, 06006, Badajoz, Spain
| | - María Luisa González-Martín
- Networking Research Centre on Bioengineering, Biomaterial and Biomedicine (CIBER-BBN), Badajoz, Spain.,Department of Applied Physics, Faculty of Science-UEx, 06006, Badajoz, Spain
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9
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Öncü E, Bayram B, Kantarci A, Gülsever S, Alaaddinoğlu EE. Positive effect of platelet rich fibrin on osseointegration. Med Oral Patol Oral Cir Bucal 2016; 21:e601-7. [PMID: 27475686 PMCID: PMC5005098 DOI: 10.4317/medoral.21026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 03/25/2016] [Indexed: 11/24/2022] Open
Abstract
Background Leukocyte-platelet rich fibrin (L-PRF) is a second generation platelet concentrate clinically used to accelerate tissue healing and bone regeneration. Achieving reduced implant osseointegration time could provide immediate or early loading of implants. The aim of this study was to evaluate the L-PRF-induced osseointegration and bone-implant contact (BIC) in an experimental animal model. Material and Methods Twelve 4-month-old New Zealand white rabbits were used. Following general anesthesia, 3-5 mL of blood was obtained from the central artery in rabbit ear and L-PRF was prepared. Two implant cavities (5 mm long and 3 mm in diameter) were created in each tibia with a total of four cavities in each animal. Two of these cavities were selected and covered with PRF (test group). The remaining L-PRF was used to soak the implants placed into the L-PRF covered sockets. Other cavities were left as controls. In total, 48 implants were placed. Animals were sacrificed after two, three, or four weeks. Histological samples were obtained and peri-implant tissues were histomorphometrically evaluated for bone-to-implant contact and new bone formation. Results Histomorphometric analyses of the defects revealed that the L-PRF was detectable up to the second week. Application of L-PRF increased the rate and amount of new bone formation in the experimental group compared to the control group. Bone-to-implant contact was enhanced when the surface was pre-wetted with L-PRF (p<0.01). Conclusions The results of this study demonstrated that L-PRF application may increases amount and rate of new bone formation during the early healing period and provides a faster osseointegration around implants. Key words:Dental implants, platelet rich fibrin, osseointegration, bone regeneration, matrix for growth factors.
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Affiliation(s)
- E Öncü
- Karaciğan Mah.Ankara, cad, Necmettin Erbakan Üniversitesi, Diş Hekimliği Fakültesi Karatay, Konya- Turkey,
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11
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Abstract
Biomaterials have played an increasingly prominent role in the success of biomedical devices and in the development of tissue engineering, which seeks to unlock the regenerative potential innate to human tissues/organs in a state of deterioration and to restore or reestablish normal bodily function. Advances in our understanding of regenerative biomaterials and their roles in new tissue formation can potentially open a new frontier in the fast-growing field of regenerative medicine. Taking inspiration from the role and multi-component construction of native extracellular matrices (ECMs) for cell accommodation, the synthetic biomaterials produced today routinely incorporate biologically active components to define an artificial in vivo milieu with complex and dynamic interactions that foster and regulate stem cells, similar to the events occurring in a natural cellular microenvironment. The range and degree of biomaterial sophistication have also dramatically increased as more knowledge has accumulated through materials science, matrix biology and tissue engineering. However, achieving clinical translation and commercial success requires regenerative biomaterials to be not only efficacious and safe but also cost-effective and convenient for use and production. Utilizing biomaterials of human origin as building blocks for therapeutic purposes has provided a facilitated approach that closely mimics the critical aspects of natural tissue with regard to its physical and chemical properties for the orchestration of wound healing and tissue regeneration. In addition to directly using tissue transfers and transplants for repair, new applications of human-derived biomaterials are now focusing on the use of naturally occurring biomacromolecules, decellularized ECM scaffolds and autologous preparations rich in growth factors/non-expanded stem cells to either target acceleration/magnification of the body's own repair capacity or use nature's paradigms to create new tissues for restoration. In particular, there is increasing interest in separating ECMs into simplified functional domains and/or biopolymeric assemblies so that these components/constituents can be discretely exploited and manipulated for the production of bioscaffolds and new biomimetic biomaterials. Here, following an overview of tissue auto-/allo-transplantation, we discuss the recent trends and advances as well as the challenges and future directions in the evolution and application of human-derived biomaterials for reconstructive surgery and tissue engineering. In particular, we focus on an exploration of the structural, mechanical, biochemical and biological information present in native human tissue for bioengineering applications and to provide inspiration for the design of future biomaterials.
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Knop E, Paula LED, Fuller R. Platelet-rich plasma for osteoarthritis treatment. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 56:152-64. [PMID: 27267529 DOI: 10.1016/j.rbre.2015.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 01/11/2015] [Indexed: 12/16/2022] Open
Abstract
We conducted a comprehensive and systematic search of the literature on the use of platelet-rich plasma (PRP) in the treatment of osteoarthritis, using the Medline, Lilacs, Cochrane and SciELO databases, from May 2012 to October 2013. A total of 23 studies were selected, with nine being controlled trials and, of these, seven randomized, which included 725 patients. In this series, the group receiving PRP showed improvement in pain and joint function compared to placebo and hyaluronic acid. The response lasted up to two years and was better in milder cases. However it was found that there is no standardization in the PRP production method, neither in the number, timing, and volume of applications. Furthermore, the populations studied were not clearly described in many studies. Thus, these results should be analyzed with caution, and further studies with more standardized methods would be necessary for a more consistent conclusion about the PRP role in osteoarthritis.
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Affiliation(s)
- Eduardo Knop
- Rheumatology Service, Hospital das Clínicas, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
| | - Luiz Eduardo de Paula
- Rheumatology Service, Hospital das Clínicas, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Ricardo Fuller
- Rheumatology Service, Hospital das Clínicas, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil
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Mariani E, Filardo G, Canella V, Berlingeri A, Bielli A, Cattini L, Landini MP, Kon E, Marcacci M, Facchini A. Platelet-rich plasma affects bacterial growth in vitro. Cytotherapy 2015; 16:1294-304. [PMID: 25108654 DOI: 10.1016/j.jcyt.2014.06.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 05/30/2014] [Accepted: 06/17/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND AIMS Platelet-rich plasma (PRP), a blood derivative rich in platelets, is a relatively new technique used in tissue regeneration and engineering. The increased quantity of platelets makes this formulation of considerable value for their role in tissue healing and microbicidal activity. This activity was investigated against five of the most important strains involved in nosocomial infections (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae and Streptococcus faecalis) to understand the prophylactic role of pure (P)-PRP. Microbicidal proteins released from activated P-PRP platelets were also determined. METHODS The microbicidal activity of P-PRP and platelet-poor plasma (PPP) was evaluated on different concentrations of the five bacterial strains incubated for 1, 2, 4 and 18 h and plated on agar for 18-24 h. P-PRP and PPP-released microbicidal proteins were evaluated by means of multiplex bead-based immunoassays. RESULTS P-PRP and PPP inhibited bacterial growth for up to 2 h of incubation. The effect of P-PRP was significantly higher than that of PPP, mainly at the low seeding concentrations and/or shorter incubation times, depending on the bacterial strain. Chemokine (C-C motif) ligand-3, chemokine (C-C motif) ligand-5 and chemokine (C-X-C motif) ligand-1 were the molecules mostly related to Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus faecalis inhibition. Escherichia coli and Klebsiella pneumoniae were less influenced. CONCLUSIONS The present results show that P-PRP might supply an early protection against bacterial contaminations during surgical interventions because the inhibitory activity is already evident from the first hour of treatment, which suggests that physiological molecules supplied in loco might be important in the time frame needed for the activation of the innate immune response.
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Affiliation(s)
- Erminia Mariani
- Laboratory of Immunorheumatology and Tissue Regeneration/RAMSES, Rizzoli Orthopaedic Institute, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | - Giuseppe Filardo
- Laboratory of Biomechanics and Technology Innovation/NABI, 2nd Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Valentina Canella
- Laboratory of Immunorheumatology and Tissue Regeneration/RAMSES, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Andrea Berlingeri
- Operative Unit of Clinical Microbiology, St. Orsola-Malpighi University Hospital, Regional Reference Centre for Microbiological Emergencies, Bologna, Italy
| | - Alessandra Bielli
- Operative Unit of Clinical Microbiology, St. Orsola-Malpighi University Hospital, Regional Reference Centre for Microbiological Emergencies, Bologna, Italy
| | - Luca Cattini
- Laboratory of Immunorheumatology and Tissue Regeneration/RAMSES, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Maria Paola Landini
- Operative Unit of Clinical Microbiology, St. Orsola-Malpighi University Hospital, Regional Reference Centre for Microbiological Emergencies, Bologna, Italy
| | - Elizaveta Kon
- Laboratory of Biomechanics and Technology Innovation/NABI, 2nd Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Maurilio Marcacci
- Laboratory of Biomechanics and Technology Innovation/NABI, 2nd Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Andrea Facchini
- Laboratory of Immunorheumatology and Tissue Regeneration/RAMSES, Rizzoli Orthopaedic Institute, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Abstract
Pain and dysfunction related to tendinopathy are often refractory to traditional treatments and offer a unique challenge to physicians, because no gold standard treatment exists. Injectable biologics may represent a new modality in conjunction with a multifaceted treatment approach. Platelet-rich plasma (PRP) injections are not associated with the systemic or tendon degradation risks of corticosteroids or the inherent risks of surgery. Studies are promising but have not been replicated with high-powered evidence at the clinical level. Further evidence to expand understanding of the role of PRP in the treatment of tendinopathy is needed.
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Affiliation(s)
- Ken Mautner
- Departments of Physical Medicine and Rehabilitation and Orthopaedics, Emory Orthopaedics and Spine Center, 59 Executive Park Dr South, Suite 1000, Atlanta, GA 30329.
| | - Lee Kneer
- Departments of Physical Medicine and Rehabilitation and Orthopaedics, Emory Orthopaedics and Spine Center, 59 Executive Park Dr South, Suite 1000, Atlanta, GA 30329
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Anitua E, Prado R, Orive G, Tejero R. Effects of calcium-modified titanium implant surfaces on platelet activation, clot formation, and osseointegration. J Biomed Mater Res A 2014; 103:969-80. [DOI: 10.1002/jbm.a.35240] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 05/14/2014] [Accepted: 05/23/2014] [Indexed: 12/26/2022]
Affiliation(s)
- Eduardo Anitua
- Private Practice in Implantology and Oral Rehabilitation in Vitoria; Spain
- Biotechnology Institute (BTI); Vitoria Spain
| | | | - Gorka Orive
- Biotechnology Institute (BTI); Vitoria Spain
| | - Ricardo Tejero
- Biotechnology Institute (BTI); Vitoria Spain
- Department of Biochemistry and Molecular Biology; University of the Basque Country (UPV-EHU); Leioa Spain
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Biodegradable electrospun nanofibers coated with platelet-rich plasma for cell adhesion and proliferation. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 40:180-8. [PMID: 24857481 DOI: 10.1016/j.msec.2014.03.065] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 03/03/2014] [Accepted: 03/23/2014] [Indexed: 12/19/2022]
Abstract
Biodegradable electrospun poly(ε-caprolactone) (PCL) scaffolds were coated with platelet-rich plasma (PRP) to improve cell adhesion and proliferation. PRP was obtained from human buffy coat, and tested on human adipose-derived mesenchymal stem cells (MSCs) to confirm cell proliferation and cytocompatibility. Then, PRP was adsorbed on the PCL scaffolds via lyophilization, which resulted in a uniform sponge-like coating of 2.85 (S.D. 0.14) mg/mg. The scaffolds were evaluated regarding mechanical properties (Young's modulus, tensile stress and tensile strain), sustained release of total protein and growth factors (PDGF-BB, TGF-β1 and VEGF), and hemocompatibility. MSC seeded on the PRP-PCL nanofibers showed an increased adhesion and proliferation compared to pristine PCL fibers. Moreover, the adsorbed PRP enabled angiogenesis features observed as neovascularization in a chicken chorioallantoic membrane (CAM) model. Overall, these results suggest that PRP-PCL scaffolds hold promise for tissue regeneration applications.
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Abstract
IMPORTANCE The promising therapeutic potential and regenerative properties of platelet-rich plasma (PRP) have rapidly led to its widespread clinical use in musculoskeletal injury and disease. Although the basic scientific rationale surrounding PRP products is compelling, the clinical application has outpaced the research. OBJECTIVE The purpose of this article is to examine the current concepts around the basic science of PRP application, different preparation systems, and clinical application of PRP in disorders in the knee. EVIDENCE ACQUISITION A systematic search of PubMed for studies that evaluated the basic science, preparation and clinical application of platelet concentrates was performed. The search used terms, including platelet-rich plasma or PRP preparation, activation, use in the knee, cartilage, ligament, and meniscus. Studies found in the initial search and related studies were reviewed. RESULTS A comprehensive review of the literature supports the potential use of PRP both nonoperatively and intraoperatively, but highlights the absence of large clinical studies and the lack of standardization between method, product, and clinical efficacy. Conclusions and Relevance. In addition to the call for more randomized, controlled clinical studies to assess the clinical effect of PRP, at this point, it is necessary to investigate PRP product composition and eventually have the ability to tailor the therapeutic product for specific indications.
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Affiliation(s)
- Kathryn B. Metcalf
- Santa Monica Orthopaedic and Sports Medicine Group, Santa Monica, CA, USA
| | - Bert R. Mandelbaum
- Santa Monica Orthopaedic and Sports Medicine Group, Santa Monica, CA, USA
| | - C. Wayne McIlwraith
- Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Tejero R, Rossbach P, Keller B, Anitua E, Reviakine I. Time-of-flight secondary ion mass spectrometry with principal component analysis of titania-blood plasma interfaces. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2013; 29:902-912. [PMID: 23095019 DOI: 10.1021/la303360f] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Treatment of osseoimplant surfaces with autologous platelet-rich plasma prepared according to the plasma rich in growth factors (PRGF-Endoret) protocol prior to implantation yields promising results in the clinic. Our objective is to understand the organization of complex interfaces between blood plasma preparations of various compositions and model titania surfaces. Here we present the results of the morphological and chemical characterization of TiO(2) surfaces incubated with four types of blood plasma preparations devoid of leukocytes and red blood cells: either enriched in platelets (PRGF-Endoret) or platelet-depleted, and either activated with CaCl(2) to induce clotting, or not. Chemical characterization was done by time-of-flight secondary ion mass spectrometry with principal component analysis (ToF-SIMS/PCA). The interface morphology was studied with scanning electron and atomic force microscopy. Immunofluorescence microscopy was used to identify platelets and infer their activation state. We observe clear differences among the four types of interfaces by ToF-SIMS/PCA. Some of these could be straightforwardly related to the differences in the sample morphology and known effects of platelet activation, but others are more subtle. Strikingly, it was possible to differentiate between these samples by ToF-SIMS/PCA of the protein species alone. This clearly indicates that the composition, orientation, and/or conformation of the proteins in these specimens depend both on the platelets' presence and on their activation. The ToF-SIMS imaging functionality furthermore provides unique insight into the distribution of phospholipid species in these samples.
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