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A New Osteogenic Membrane to Enhance Bone Healing: At the Crossroads between the Periosteum, the Induced Membrane, and the Diamond Concept. Bioengineering (Basel) 2023; 10:bioengineering10020143. [PMID: 36829637 PMCID: PMC9952848 DOI: 10.3390/bioengineering10020143] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/25/2023] Open
Abstract
The lack of viability of massive bone allografts for critical-size bone defect treatment remains a challenge in orthopedic surgery. The literature has reviewed the advantages of a multi-combined treatment with the synergy of an osteoconductive extracellular matrix (ECM), osteogenic stem cells, and growth factors (GFs). Questions are still open about the need for ECM components, the influence of the decellularization process on the latter, the related potential loss of function, and the necessity of using pre-differentiated cells. In order to fill in this gap, a bone allograft surrounded by an osteogenic membrane made of a decellularized collagen matrix from human fascia lata and seeded with periosteal mesenchymal stem cells (PMSCs) was analyzed in terms of de-/recellularization, osteogenic properties, PMSC self-differentiation, and angiogenic potential. While the decellularization processes altered the ECM content differently, the main GF content was decreased in soft tissues but relatively increased in hard bone tissues. The spontaneous osteogenic differentiation was necessarily obtained through contact with a mineralized bone matrix. Trying to deepen the knowledge on the complex matrix-cell interplay could further propel these tissue engineering concepts and lead us to provide the biological elements that allow bone integration in vivo.
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Manon J, Evrard R, Maistriaux L, Fievé L, Heller U, Magnin D, Boisson J, Kadlub N, Schubert T, Lengelé B, Behets C, Cornu O. Periosteum and fascia lata: Are they so different? Front Bioeng Biotechnol 2022; 10:944828. [DOI: 10.3389/fbioe.2022.944828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: The human fascia lata (HFL) is used widely in reconstructive surgery in indications other than fracture repair. The goal of this study was to compare microscopic, molecular, and mechanical properties of HFL and periosteum (HP) from a bone tissue engineering perspective.Material and Methods: Cadaveric HP and HFL (N = 4 each) microscopic morphology was characterized using histology and immunohistochemistry (IHC), and the extracellular matrix (ECM) ultrastructure assessed by means of scanning electron microscopy (SEM). DNA, collagen, elastin, glycosaminoglycans, major histocompatibility complex Type 1, and bone morphogenetic protein (BMP) contents were quantified. HP (N = 6) and HFL (N = 11) were submitted to stretch tests.Results: Histology and IHC highlighted similarities (Type I collagen fibers and two-layer organization) but also differences (fiber thickness and compaction and cell type) between both tissues, as confirmed using SEM. The collagen content was statistically higher in HFL than HP (735 vs. 160.2 μg/mg dry weight, respectively, p < 0.0001). On the contrary, DNA content was lower in HFL than HP (404.75 vs. 1,102.2 μg/mg dry weight, respectively, p = 0.0032), as was the immunogenic potential (p = 0.0033). BMP-2 and BMP-7 contents did not differ between both tissues (p = 0.132 and p = 0.699, respectively). HFL supported a significantly higher tension stress than HP.Conclusion: HP and HFL display morphological differences, despite their similar molecular ECM components. The stronger stretching resistance of HFL can specifically be explained by its higher collagen content. However, HFL contains many fewer cells and is less immunogenic than HP, as latter is rich in periosteal stem cells. In conclusion, HFL is likely suitable to replace HP architecture to confer a guide for bone consolidation, with an absence of osteogenicity. This study could pave the way to a bio-engineered periosteum built from HFL.
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Chen X, Yu B, Wang Z, Li Q, Dai C, Wei J. Progress of Periosteal Osteogenesis: The Prospect of In Vivo Bioreactor. Orthop Surg 2022; 14:1930-1939. [PMID: 35794789 PMCID: PMC9483074 DOI: 10.1111/os.13325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/25/2022] [Accepted: 05/14/2022] [Indexed: 12/14/2022] Open
Abstract
Repairing large segment bone defects is still a clinical challenge. Bone tissue prefabrication shows great translational potentials and has been gradually accepted clinically. Existing bone reconstruction strategies, including autologous periosteal graft, allogeneic periosteal transplantation, xenogeneic periosteal transplantation, and periosteal cell tissue engineering, are all clinically valuable treatments and have made significant progress in research. Herein, we reviewed the research progress of these techniques and briefly explained the relationship among in vivo microenvironment, mechanical force, and periosteum osteogenesis. Moreover, we also highlighted the importance of the critical role of periosteum in osteogenesis and explained current challenges and future perspective.
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Affiliation(s)
- Xiaoxue Chen
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
| | - Baofu Yu
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
| | - Zi Wang
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
| | - Chuanchang Dai
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
| | - Jiao Wei
- Department of Plastic and Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, Shanghai, China
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Thoma DS, Bienz SP, Figuero E, Jung RE, Sanz-Martín I. Efficacy of lateral bone augmentation performed simultaneously with dental implant placement: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:257-276. [PMID: 30675733 DOI: 10.1111/jcpe.13050] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/16/2018] [Accepted: 10/26/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To analyse the evidence regarding the efficacy of lateral bone augmentation procedures in terms of defect resolution in cases of horizontal ridge deficiencies after implant placement. MATERIALS AND METHODS Included studies met the following inclusion criteria: randomized controlled trials (RCTs) or controlled clinical trials (CCTs), re-entry procedure to assess defect resolution, minimum of 10 patients (5 per group). Meta-analyses were performed whenever possible, including subgroup analysis based on membranes and grafting materials. RESULTS Twenty-eight publications (20 short-term, 8 follow-up studies) were included. The most often used type of intervention was a xenogeneic particulated grafting material (XE) and a resorbable collagen membrane (CM). The mean defect height at baseline amounted to 5.1 mm (range 2.4-7.8) and decreased to a mean of 0.9 mm (range 0.2-2.2) at re-entry, and the mean defect resolution was 81.3% (range 56.4%-97.1%). Defect height reduction was not significantly different using CM+XE as control treatment compared to the combined data of the respective test groups [n = 11; weighted mean difference (WMD) = -0.006 mm; 95% CI, -0.61, 0.60; p = 0.985]. The absence of any lateral bone augmentation was less favourable than the conjunction of a membrane and a bone grafting material (n = 1; MD = -1.96 mm; 95% CI, -3.48, -0.44; p = 0.011). The lack of a grafting material was less favourable than the conjunction of grafting material and membrane (n = 1; MD = -2.44 mm; 95% CI, -4.53, -0.35; p = 0.022), and the addition of a membrane compared to a grafting material alone was more favourable (n = 3; WMD = 0.97 mm; 95% CI, 0.31, 1.64; p = 0.004). CONCLUSIONS Lateral bone augmentation is a successful treatment modality. For optimal defect height reduction, a barrier membrane and a grafting material should be combined.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Elena Figuero
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
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Pinotti FE, Pimentel Lopes de Oliveira GJ, Scardueli CR, Costa de Medeiros M, Stavropoulos A, Chiérici Marcantonio RA. Use of a Non-Crosslinked Collagen Membrane During Guided Bone Regeneration Does Not Interfere With the Bone Regenerative Capacity of the Periosteum. J Oral Maxillofac Surg 2018; 76:2331.e1-2331.e10. [PMID: 30092216 DOI: 10.1016/j.joms.2018.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess whether the use of a non-crosslinked porcine collagen type I and III bi-layered membrane inter-positioned between the periosteum and a bone defect would interfere with the bone regenerative capacity of the periosteum. MATERIALS AND METHODS Sixty rats, each with 1 critical-size calvarial defect (CSD; diameter, 5 mm) in the parietal bone, were randomly allocated to 1 of 3 equal-size groups after CSD creation: 1) the periosteum was excised and the flap was repositioned without interposition of a membrane (no-periosteum [NP] group); 2) the flap including the periosteum was repositioned (periosteum [P] group); and 3) a non-crosslinked collagen membrane was inter-positioned between the flap, including the periosteum, and the bone defect (membrane [M] group). Micro-computed tomography, qualitative histology, immunohistochemistry, and reverse transcription real-time quantitative polymerase chain reaction were performed at 3, 7, 15, and 30 days postoperatively. RESULTS A markedly increased radiographic residual defect length was observed in the NP group compared with the P group at 30 days. The NP group also presented a smaller radiographic bone fill area than the P group at 15 and 30 days and then the M group at 30 days. The P and M groups exhibited considerably greater expression of bone morphogenetic protein-2 and osteocalcin than the NP group at 7 days; expression of transforming growth factor-β1 was considerably greater in the NP group at 15 days. Further, the P group presented considerably higher gene expression levels of Runx2 and Jagged1 at 7 days and of alkaline phosphatase at 3 and 15 days compared with the M and NP groups. CONCLUSION Interposition of this specific non-crosslinked collagen membrane between the periosteum and the bone defect during guided bone regeneration interferes only slightly, if at all, with the bone regenerative capacity of the periosteum.
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Affiliation(s)
- Felipe Eduardo Pinotti
- PhD Student, Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | | | - Cássio Rocha Scardueli
- PhD Student, Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Marcell Costa de Medeiros
- Postdoctoral Student, Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Andreas Stavropoulos
- Department Head, Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
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Bennett PM, Stewart SK, Dretzke J, Bem D, Penn-Barwell JG. Preclinical therapies to prevent or treat fracture non-union: A systematic review. PLoS One 2018; 13:e0201077. [PMID: 30067783 PMCID: PMC6070249 DOI: 10.1371/journal.pone.0201077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/08/2018] [Indexed: 12/22/2022] Open
Abstract
Background Non-union affects up to 10% of fractures and is associated with substantial morbidity. There is currently no single effective therapy for the treatment or prevention of non-union. Potential treatments are currently selected for clinical trials based on results from limited animal studies, with no attempt to compare results between therapies to determine which have the greatest potential to treat non-union. Aim The aim of this systematic review was to define the range of therapies under investigation at the preclinical stage for the prevention or treatment of fracture non-union. Additionally, through meta-analysis, it aimed to identify the most promising therapies for progression to clinical investigation. Methods MEDLINE and Embase were searched from 1St January 2004 to 10th April 2017 for controlled trials evaluating an intervention to prevent or treat fracture non-union. Data regarding the model used, study intervention and outcome measures were extracted, and risk of bias assessed. Results Of 5,171 records identified, 197 papers describing 204 therapies were included. Of these, the majority were only evaluated once (179/204, 88%), with chitosan tested most commonly (6/204, 3%). Substantial variation existed in model design, length of survival and duration of treatment, with results poorly reported. These factors, as well as a lack of consistently used objective outcome measures, precluded meta-analysis. Conclusion This review highlights the variability and poor methodological reporting of current non-union research. The authors call for a consensus on the standardisation of animal models investigating non-union, and suggest journals apply stringent criteria when considering animal work for publication.
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Affiliation(s)
- Philippa M. Bennett
- Institute of Naval Medicine, Crescent Road, Alverstoke, Hampshire, United Kingdom
- * E-mail:
| | - Sarah K. Stewart
- Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham, United Kingdom
| | - Janine Dretzke
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Danai Bem
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
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Jamuna-Thevi K, Suleiman MJ, Sabri SN. The in Vitro Degradation of PLGA/Nanoapatite/Lauric Acid Composite Membrane: A Comparative Study in Phosphate Buffer Saline and Simulated Body Fluid. ACTA ACUST UNITED AC 2017. [DOI: 10.1002/masy.201600048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- K. Jamuna-Thevi
- Advanced Materials Research Centre (AMREC); SIRIM Berhad; 09000 Kulim Kedah Malaysia
| | - Muhammed J. Suleiman
- Advanced Materials Research Centre (AMREC); SIRIM Berhad; 09000 Kulim Kedah Malaysia
| | - Siti N. Sabri
- Advanced Materials Research Centre (AMREC); SIRIM Berhad; 09000 Kulim Kedah Malaysia
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Jamuna-Thevi K, Suleiman M, Sabri S. Strength Improvement of a Functionally Graded and Layered Composite Membrane for Guided Bone Regeneration in Orthopedics. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.matpr.2016.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kim YK, Nakata H, Yamamoto M, Miyasaka M, Kasugai S, Kuroda S. Osteogenic Potential of Mouse Periosteum-Derived Cells Sorted for CD90 In Vitro and In Vivo. Stem Cells Transl Med 2015; 5:227-34. [PMID: 26718647 DOI: 10.5966/sctm.2015-0013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 08/13/2015] [Indexed: 12/19/2022] Open
Abstract
The treatment of bone defects still presents complex problems, although various techniques have been developed. The periosteum is considered a good source of osteogenic precursor cells for new bone formation. It can be collected easily in the clinical setting and is less invasive to the donor site. However, the murine skull periosteum has a poor cellular component, and growth is very slow, making it important to identify a culture method for efficient growth. In the present study, we used three-dimensional cell migration with atelocollagen and gelatin media and found that both were effective for promoting the proliferation of periosteum-derived cells. Moreover, atelocollagen medium is expected to provide an added benefit as a scaffold structure in the ambient temperature of the human body. The selection of a proper surface marker for osteogenesis is imperative for bone regeneration. CD90 is a mesenchymal stem cell marker. Periosteum-derived cells sorted with CD90 showed higher proliferative capacity and osteogenic potential than that of unsorted periosteum-derived cells in vivo and in vitro. Thus, periosteum-derived cells sorted with CD90 are expected to be a good source for bone regeneration. Significance: Periosteum-derived cells showed higher proliferative capacity and osteogenic potential. Periosteum can be collected easily in the clinical setting and is less invasive to the donor site. Thus, periosteum-derived cells can be expected to be a good source for bone regeneration.
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Affiliation(s)
- You-Kyoung Kim
- Department of Oral Implantology and Regenerative Dental Medicine, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hidemi Nakata
- Department of Oral Implantology and Regenerative Dental Medicine, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Maiko Yamamoto
- Department of Oral Implantology and Regenerative Dental Medicine, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Munemitsu Miyasaka
- Department of Oral Implantology and Regenerative Dental Medicine, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Kasugai
- Department of Oral Implantology and Regenerative Dental Medicine, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinji Kuroda
- Department of Oral Implantology and Regenerative Dental Medicine, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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