|
1
|
Ferraz MP. Bone Grafts in Dental Medicine: An Overview of Autografts, Allografts and Synthetic Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16114117. [PMID: 37297251 DOI: 10.3390/ma16114117] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
This review provides an overview of various materials used in dentistry and oral and maxillofacial surgeries to replace or repair bone defects. The choice of material depends on factors such as tissue viability, size, shape, and defect volume. While small bone defects can regenerate naturally, extensive defects or loss or pathological fractures require surgical intervention and the use of substitute bones. Autologous bone, taken from the patient's own body, is the gold standard for bone grafting but has drawbacks such as uncertain prognosis, surgery at the donor site, and limited availability. Other alternatives for medium and small-sized defects include allografts (from human donors), xenografts (from animals), and synthetic materials with osteoconductive properties. Allografts are carefully selected and processed human bone materials, while xenografts are derived from animals and possess similar chemical composition to human bone. Synthetic materials such as ceramics and bioactive glasses are used for small defects but may lack osteoinductivity and moldability. Calcium-phosphate-based ceramics, particularly hydroxyapatite, are extensively studied and commonly used due to their compositional similarity to natural bone. Additional components, such as growth factors, autogenous bone, and therapeutic elements, can be incorporated into synthetic or xenogeneic scaffolds to enhance their osteogenic properties. This review aims to provide a comprehensive analysis of grafting materials in dentistry, discussing their properties, advantages, and disadvantages. It also highlights the challenges of analyzing in vivo and clinical studies to select the most suitable option for specific situations.
Collapse
Affiliation(s)
- Maria Pia Ferraz
- Departamento de Engenharia Metalúrgica e de Materiais, Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4099-002 Porto, Portugal
- INEB-Instituto de Engenharia Biomédica, Universidade do Porto, 4099-002 Porto, Portugal
| |
Collapse
|
|
2
|
Guastaldi FPS, Matheus HR, Faloni APDS, de Almeida-Filho E, Cominotte MA, Moretti LAC, Verzola MHA, Marcantonio E, de Almeida JM, Guastaldi AC, Cirelli JA. A new multiphase calcium phosphate graft material improves bone healing-An in vitro and in vivo analysis. J Biomed Mater Res B Appl Biomater 2022; 110:2686-2704. [PMID: 35779277 DOI: 10.1002/jbm.b.35121] [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: 02/22/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
This study aims to evaluate the potential of a novel biomaterial synthesized from amorphous calcium phosphate (ACP), octacalcium phosphate (OCP), and hydroxyapatite (HA) to repair critical-sized defects (CSD) in rabbit calvaria. In vitro analyses of cell viability, cell proliferation, formation of mineral nodules, and cell differentiation using qPCR were performed for comparing experimental calcium phosphate (ECP), deproteinized bovine bone (DBB), and beta-tricalcium phosphate (β-TCP). Bilateral CSDs were created in 45 rabbit calvaria. Six groups were evaluated: ECP, ECP + fibrin sealant (ECP + S), coagulum, autogenous bone, DBB, and β-TCP. Euthanasia was performed at 2, 4, and 8 weeks, followed by micro-computed tomography and histological and immunohistochemical analyses. Results from in vitro analyses revealed similar biocompatibility for all tested materials and a tendency for higher gene expression of some bone markers in the ECP group than in β-TCP and DBB groups at 7 days. In contrast to that in DBB and β-TCP groups, ECP displayed growing bone volume over total volume percentage (BV/TV%) with time in vivo. Histological analysis revealed a greater number of giant cells and reduced size of grafted particles in ECP during all periods of analysis. RUNX-2 expression was statistically lower in ECP than DBB at 2 and 4 weeks. Despite no statistical significance, ECP presented the highest absolute values for ALP-expression at 2, 4, and 8 weeks compared with other groups. Together, our findings indicate that a combination of the ACP, OCP, and HA phases into ECP is beneficial and promising for bone regeneration.
Collapse
Affiliation(s)
- Fernando Pozzi Semeghini Guastaldi
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, São Paulo, Brazil.,Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Henrique Rinaldi Matheus
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Ana Paula de Souza Faloni
- Department of Health Sciences, University Center of Araraquara (UNIARA), Araraquara, São Paulo, Brazil
| | - Edson de Almeida-Filho
- Department of Physical Chemistry, São Paulo State University (Unesp), Institute of Chemistry, Araraquara, São Paulo, Brazil
| | - Mariana Aline Cominotte
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, São Paulo, Brazil
| | - Livia Alves Correa Moretti
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, São Paulo, Brazil
| | | | - Elcio Marcantonio
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, São Paulo, Brazil
| | - Juliano Milanezi de Almeida
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Antonio Carlos Guastaldi
- Department of Physical Chemistry, São Paulo State University (Unesp), Institute of Chemistry, Araraquara, São Paulo, Brazil
| | - Joni Augusto Cirelli
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, São Paulo, Brazil
| |
Collapse
|
|
3
|
Salamanca E, Pan YH, Sun YS, Hsueh HW, Dorj O, Yao WL, Lin JCY, Teng NC, Watanabe I, Abe S, Wu YF, Chang WJ. Magnesium Modified β-Tricalcium Phosphate Induces Cell Osteogenic Differentiation In Vitro and Bone Regeneration In Vivo. Int J Mol Sci 2022; 23:ijms23031717. [PMID: 35163639 PMCID: PMC8836187 DOI: 10.3390/ijms23031717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 01/27/2023] Open
Abstract
In vitro, in vivo, and clinical studies have shown how the physicochemical and biological properties of β-tricalcium phosphate (β-TCP) work in bone regeneration. This study aimed to improve the properties of β-TCP by achieving optimum surface and bulk β-TCP chemical/physical properties through the hydrothermal addition of magnesium (Mg) and to later establish the biocompatibility of β-TCP/Mg for bone grafting and tissue engineering treatments. Multiple in vitro and in vivo analyses were used to complete β-TCP/Mg physicochemical and biological characterization. The addition of MgO brought about a modest rise in the number of β-TCP surface particles, indicating improvements in alkaline phosphatase (ALP) activity on day 21 (p < 0.05) and in the WST-1assay on all days (p < 0.05), with a corresponding increase in the upregulation of ALP and bone sialoprotein. SEM analyses stated that the surfaces of the β-TCP particles were not altered after the addition of Mg. Micro-CT and histomorphometric analysis from rabbit calvaria critical defects resulted in β-TCP/Mg managing to reform more new bone than the control defects and β-TCP control at 2, 6, and 8 weeks (* p ≤ 0.05, ** p ≤ 0.01, *** p ≤ 0.001, and **** p ≤ 0.0001). The hydrothermal addition of MgO to the β-TCP surfaces ameliorated its biocompatibility without altering its surface roughness resulting from the elemental composition while enhancing cell viability and proliferation, inducing more bone regeneration by osteoconduction in vivo and osteoblastic differentiation in vitro.
Collapse
Affiliation(s)
- Eisner Salamanca
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
| | - Yu-Hwa Pan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Department of General Dentistry, Chang Gung Memorial Hospital, Taipei 10507, Taiwan
- Graduate Institute of Dental & Craniofacial Science, Chang Gung University, Taoyuan 33305, Taiwan
- School of Dentistry, College of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Ying-Sui Sun
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan;
| | - Hao-Wen Hsueh
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
| | - Odontuya Dorj
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Department of Dental Technology and Hygiene, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia
| | - Wan-Ling Yao
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
| | - Jerry Chin-Yi Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental, Medicine, Boston, MA 02115, USA
| | - Nai-Chia Teng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Dental Department, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Ikki Watanabe
- Department of Gerontology, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Shinichi Abe
- Department of Anatomy, Tokyo Dental College, Tokyo 101-0061, Japan;
| | - Yi-Fan Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Correspondence: (Y.-F.W.); (W.-J.C.); Tel.: +886-2-2736-1661 (ext. 5148) (Y.-F.W.); +886-2-2736-1661 (ext. 5150) (W.-J.C.)
| | - Wei-Jen Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Dental Department, Shuang-ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Correspondence: (Y.-F.W.); (W.-J.C.); Tel.: +886-2-2736-1661 (ext. 5148) (Y.-F.W.); +886-2-2736-1661 (ext. 5150) (W.-J.C.)
| |
Collapse
|
|
4
|
Li X, Han B, Wang X, Gao X, Liang F, Qu X, Yang Z. Suppressing inflammation and enhancing osteogenesis using novel CS-EC@Ca microcapsules. J Biomed Mater Res A 2018; 106:3222-3230. [PMID: 30289606 DOI: 10.1002/jbm.a.36517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/09/2018] [Accepted: 07/25/2018] [Indexed: 12/19/2022]
Abstract
The aim of this study was to investigate the suppression of inflammation and enhancement of osteogenesis using chitosan-coated calcium hydroxide-loaded microcapsules (CS-EC@Ca microcapsules) in vivo. Circular defects were created in the mandibular bones of rabbits and filled with Ca(OH)2 , Bio-oss, or CS-EC@Ca microcapsules, and rabbits without drug implantation served as the controls. Lipopolysaccharides were injected in situ daily in all groups for 7 days. Mandibular bones were investigated at 4 and 12 weeks after surgery using micro-CT, histological observations, and real-time PCR analysis. At the postoperation, there was more substantial nascent bone in the microcapsule and Bio-oss groups than in the control group. The recovery of the rabbits in the Ca(OH)2 group was slower than the control group, as determined using micro-CT and histological staining. Osteocalcin and collagen type I production was not significantly different between the microcapsule and Bio-oss groups (p > 0.05), but the expression levels of the two molecules were significantly increased compared to the control and Ca(OH)2 groups at postoperation (p < 0.05). The mRNA transcript levels of inflammatory factors in the microcapsule group had the most reduced expression of IL-6 and TNF-α (p < 0.05). The microcapsules significantly reduced inflammation and promoted osteogenesis in this rabbit model of inflammatory bone destruction. Our findings indicate that CS-EC@Ca microcapsules hold potential for use in apical periodontitis treatment. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 3222-3230, 2018.
Collapse
Affiliation(s)
- Xiaoman Li
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Bing Han
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Xuejun Gao
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Fuxin Liang
- State Key Laboratory of Polymer Physics and Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
| | - Xiaozhong Qu
- College of Materials Science and Opto-Electronic Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhenzhong Yang
- State Key Laboratory of Polymer Physics and Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
| |
Collapse
|