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Heitzer M, Zhao Q, Greven J, Winnand P, Zhang X, Bläsius FM, Buhl EM, Wolf M, Neuss S, Hildebrand F, Hölzle F, Modabber A. Evaluation of in vitro biocompatibility of human pulp stem cells with allogeneic, alloplastic, and xenogeneic grafts under the influence of extracellular vesicles. Sci Rep 2023; 13:12475. [PMID: 37528137 PMCID: PMC10394079 DOI: 10.1038/s41598-023-39410-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023] Open
Abstract
Therapies using dental pulp stem cells (DPSCs) or stem cell-derived extracellular vesicles (EVs) have shown promising applications for bone tissue engineering. This in vitro experiment evaluated the joint osteogenic capability of DPSCs and EVs on alloplastic (maxresorp), allogeneic (maxgraft), and xenogeneic (cerabone) bone grafts. We hypothesize that osteogenic differentiation and the proliferation of human DPSCs vary between bone grafts and are favorable under the influence of EVs. DPSCs were obtained from human wisdom teeth, and EVs derived from DPSCs were isolated from cell culture medium. DPSCs were seeded on alloplastic, allogeneic, and xenogeneic bone graft substitutes for control, and the same scaffolds were administered with EVs in further groups. The cellular uptake of EVs into DPSC cells was assessed by confocal laser scanning microscopy. Cell vitality staining and calcein acetoxymethyl ester staining were used to evaluate cell attachment and proliferation. Cell morphology was determined using scanning electron microscopy, and osteogenic differentiation was explored by alkaline phosphatase and Alizarin red staining. Within the limitations of an in vitro study without pathologies, the results suggest that especially the use of xenogeneic bone graft substitutes with DPSCS and EVs may represent a promising treatment approach for alveolar bone defects.
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Affiliation(s)
- Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Qun Zhao
- Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, NRW, Germany.
| | - Johannes Greven
- Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, NRW, Germany
| | - Philipp Winnand
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Xing Zhang
- Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, NRW, Germany
| | - Felix Marius Bläsius
- Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, NRW, Germany
| | - Eva Miriam Buhl
- Institute of Pathology, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, NRW, Germany
| | - Michael Wolf
- Department of Orthodontics, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, NRW, Germany
| | - Sabine Neuss
- Institute of Pathology, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, NRW, Germany
- BioInterface Group, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstraße 20, 52074, Aachen, NRW, Germany
| | - Frank Hildebrand
- Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, NRW, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Heitzer M, Modabber A, Zhang X, Winnand P, Zhao Q, Bläsius FM, Buhl EM, Wolf M, Neuss S, Hölzle F, Hildebrand F, Greven J. In vitro comparison of the osteogenic capability of human pulp stem cells on alloplastic, allogeneic, and xenogeneic bone scaffolds. BMC Oral Health 2023; 23:56. [PMID: 36721114 PMCID: PMC9890824 DOI: 10.1186/s12903-023-02726-4] [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: 09/22/2022] [Accepted: 01/10/2023] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND A rigorous search for alternatives to autogenous bone grafts to avoid invasiveness at the donor site in the treatment of maxillomandibular bone defects. Researchers have used alloplastic, allogeneic, and xenogeneic bone graft substitutes in clinical studies with varying degrees of success, although their in vitro effects on stem cells remain unclear. Dental pulp stem cells (DPSCs) can potentially enhance the bone regeneration of bone graft substitutes. The present in vitro study investigates the osteogenic capability of DPSCs on alloplastic (biphasic calcium phosphate [BCP]), allogeneic (freeze-dried bone allografts [FDBAs]), and xenogeneic (deproteinized bovine bone mineral [DBBM]) bone grafts. METHODS Human DPSCs were seeded on 0.5 mg/ml, 1 mg/ml, and 2 mg/ml of BCP, FDBA, and DBBM to evaluate the optimal cell growth and cytotoxicity. Scaffolds and cell morphologies were analyzed by scanning electron microscopy (SEM). Calcein AM and cytoskeleton staining were performed to determine cell attachment and proliferation. Alkaline phosphatase (ALP) and osteogenesis-related genes expressions was used to investigate initial osteogenic differentiation. RESULTS Cytotoxicity assays showed that most viable DPSCs were present at a scaffold concentration of 0.5 mg/ml. The DPSCs on the DBBM scaffold demonstrated a significantly higher proliferation rate of 214.25 ± 16.17 (p < 0.001) cells, enhancing ALP activity level and upregulating of osteogenesis-related genes compared with other two scaffolds. CONCLUSION DBBP scaffold led to extremely high cell viability, but also promoted proliferation, attachment, and enhanced the osteogenic differentiation capacity of DPSCs, which hold great potential for bone regeneration treatment; however, further studies are necessary.
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Affiliation(s)
- Marius Heitzer
- grid.412301.50000 0000 8653 1507Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Ali Modabber
- grid.412301.50000 0000 8653 1507Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Xing Zhang
- Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Philipp Winnand
- grid.412301.50000 0000 8653 1507Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Qun Zhao
- grid.412301.50000 0000 8653 1507Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Felix Marius Bläsius
- grid.412301.50000 0000 8653 1507Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Eva Miriam Buhl
- grid.412301.50000 0000 8653 1507Institute of Pathology, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Michael Wolf
- grid.412301.50000 0000 8653 1507Department of Orthodontics, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Sabine Neuss
- grid.412301.50000 0000 8653 1507Institute of Pathology, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany ,grid.1957.a0000 0001 0728 696XHelmholtz Institute for Biomedical Engineering, BioInterface Group, RWTH Aachen University, Pauwelsstraße 20, 52074 Aachen, Germany
| | - Frank Hölzle
- grid.412301.50000 0000 8653 1507Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Frank Hildebrand
- grid.412301.50000 0000 8653 1507Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Johannes Greven
- grid.412301.50000 0000 8653 1507Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
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Möhlhenrich SC, Kniha K, Heitzer M, Magnuska Z, Hermanns-Sachweh B, Gremse F, Chhatwani S, Hölzle F, Modabber A, Danesh G. Correlations between radiological and histological findings of bone remodelling and root resorption in a rodent cleft model. Head Face Med 2022; 18:33. [DOI: 10.1186/s13005-022-00338-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/03/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The evaluation of bone remodelling and dental root resorption can be performed by histological techniques or micro-computed tomography (micro-CT). The present study aimed to evaluate the relationship between these two procedures in the context of cleft repair in a rat model.
Methods
The reconstructed maxillae and the orthodontically-moved first molar of 12 rats were analysed for correlations between the histological and radiological findings retrospectively. The alveolar cleft repairs were performed using bone autografts or (human) xenografts. Four weeks after the operation, the intervention of the first molar protraction was initiated and lasted for eight weeks. The newly formed bone and the root resorption lacunae were determined via histology. In the micro-CT analysis, the average change of bone mineral density (BMD), bone volume fraction (BV/TV), trabecular thickness and trabecular separation of the jaw, as well as the volume of the root resorptions were determined. The Pearson correlation coefficient was applied to study the associations between groups.
Results
Positive correlations were found only between the newly formed bone (histology) and BMD changes (micro-CT) in the autograft group (r = 0.812, 95% CI: 0.001 to 0.979, p = 0.05). The relationship of newly formed bone and BV/TV was similar but not statistically significant (r = 0.691, 95% CI: −0.274 to 0.963, p = 0.013). Regarding root resorption, no significant correlations were found.
Conclusions
Due to the lack of correlation between histological and radiological findings of bone remodelling and the development of root resorptions, both methods should be combined in this cleft model in rats for a comprehensive analysis.
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Möhlhenrich SC, Kniha K, Magnuska Z, Chhatwani S, Hermanns-Sachweh B, Gremse F, Hölzle F, Danesh G, Modabber A. Development of root resorption during orthodontic tooth movement after cleft repair using different grafting materials in rats. Clin Oral Investig 2022; 26:5809-5821. [PMID: 35567639 PMCID: PMC9474460 DOI: 10.1007/s00784-022-04537-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/03/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate the influence of three grafting materials for cleft repair on orthodontic tooth movement in rats. MATERIALS AND METHODS Artificial alveolar clefts were created in 21 Wistar rats and were repaired 4 weeks later using autografts, human xenografts and synthetic bone substitute (beta-tricalcium phosphate/hydroxyapatite [β-TCP/HA]). A further 4 weeks later, the first molar was moved into the reconstructed maxilla. Microfocus computed tomography (μCT) was performed six times (T0-T5) to assess the tooth movement and root resorption. After 8 weeks, the affected reconstructed jaw was resected for histopathological investigation. RESULTS Total distances reached ranged from 0.82 ± 0.72 mm (β-TCP/HA) to 0.67 ± 0.27 mm (autograft). The resorption was particularly determined at the mesiobuccal root. Descriptive tooth movement slowed and root resorption increased slightly. However, neither the radiological changes during tooth movement (µCT T1 vs. µCT T5: autograft 1.85 ± 0.39 mm3 vs. 2.38 ± 0.35 mm3, p = 0.30; human xenograft 1.75 ± 0.45 mm3 vs. 2.17 ± 0.26 mm3, p = 0.54; β-TCP/HA: 1.52 ± 0.42 mm3 vs. 1.88 ± 0.41 mm3, p = 0.60) nor the histological differences after tooth movement (human xenograft: 0.078 ± 0.05 mm2; β-TCP/HA: 0.067 ± 0.049 mm2; autograft: 0.048 ± 0.015 mm2) were statistically significant. CONCLUSION The autografts, human xenografts or synthetic bone substitute used for cleft repair seem to have a similar effect on the subsequent orthodontic tooth movement and the associated root resorptions. CLINICAL RELEVANCE Development of root resorptions seems to have a secondary role in choosing a suitable grafting material for cleft repair.
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Affiliation(s)
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Zuzanna Magnuska
- Institute for Experimental Molecular Imaging, Department of Nanomedicine and Theragnostic, RWTH Aachen University, Forckenbeckstraße 55, 52074, Aachen, Germany
| | - Sachin Chhatwani
- Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
| | | | - Felix Gremse
- Institute for Experimental Molecular Imaging, Department of Nanomedicine and Theragnostic, RWTH Aachen University, Forckenbeckstraße 55, 52074, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Gholamreza Danesh
- Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Evaluation of different grafting materials for alveolar cleft repair in the context of orthodontic tooth movement in rats. Sci Rep 2021; 11:13586. [PMID: 34193933 PMCID: PMC8245488 DOI: 10.1038/s41598-021-93033-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/09/2021] [Indexed: 12/05/2022] Open
Abstract
To minimize the postoperative risks posed by grafting autologous transplants for cleft repair, efforts are being made to improve grafting materials for use as potential alternatives. The aim of this study was to compare the bone graft quality of different bone substitutes including the gold standard autografts during the healing processes after cleft repair in the context of orthodontic treatment. In 21 Wistar rats, a complete, continuity-interrupting cleft was created. After 4 weeks, cleft repair was performed using autografts from the hips’ ischial tuberosity, human xenografts, or synthetic bone substitutes [beta-tricalcium phosphate (β-TCP)/hydroxyapatite (HA)]. After another 4 weeks, the first molar movement was initiated in the reconstructed jaw for 8 weeks. The bone remodeling was analyzed in vivo using micro-computed tomography (bone mineral density and bone volume fraction) and histology (new bone formation). All the grafting materials were statistically different in bone morphology, which changed during the treatment period. The β-TCP/HA substitute demonstrated less resorption compared to the autologous and xenogeneic/human bone, and the autografts led to a stronger reaction in the surrounding bone. Histologically, the highest level of new bone formation was found in the human xenografts, and the lowest was found in the β-TCP/HA substitute. The differences between the two bone groups and the synthetic materials were statistically significant. Autografts were confirmed to be the gold standard in cleft repair with regard to graft integration. However, parts of the human xenograft seemed comparable to the autografts. Thus, this substitute could perhaps be used as an alternative after additional tissue-engineered modification.
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Heitzer M, Möhlhenrich SC, Kniha K, Tolba R, Jockenhoevel S, Hölzle F, Modabber A. Microvascular anastomosis techniques using the medical adhesive VIVO and expandable micro-stents in a rat carotid artery model. Ann Anat 2021; 238:151782. [PMID: 34144156 DOI: 10.1016/j.aanat.2021.151782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sutured anastomosis remains the gold standard in microvascular surgery. The procedure is not free of complications and is a time-consuming operation requiring a high level of experience. The aim of this study was to develop new methods for a stable, faster, and safer anastomosis using a novel biodegradable adhesive, VIVO, and a custom-made microvascular stent. METHODS The VIVO medical adhesive was used for a total of 30 anastomoses in rats in the right carotid artery: 15 anastomoses were performed with a temporary intraluminal catheter, VIVO, and reduced sutures (VIVO + TC). A further 15 anastomoses were performed with nitinol stents, VIVO, and reduced sutures (VIVO + SM). Sutured anastomoses served as controls (C) and were performed on the left carotid arteries of the 30 rats. Operation and bleeding times were assessed, and patency was evaluated by Doppler flowmetry and indocyanine green (ICG) angiography. Subsequently, the anastomoses were evaluated histopathological. RESULTS The overall patency was recorded as 100% in all groups. No thrombosis or circulatory disturbance was found. Compared to C and VIVO + SM, VIVO + TC proved to be significantly less traumatic, less demanding, and time-saving. The sealing properties of VIVO lead to shorter bleeding times and less oozing. In contrast, VIVO + SM proved to be the most technically demanding and time-consuming procedure. CONCLUSION The success of a microvascular sutured anastomosis is determined by a short ischemic interval. Compared to sutured anastomosis, VIVO + TC showed ease of use as well as shorter time taken for anastomosis, less trauma, and lower blood loss. More long-term studies on the functions, biological interactions, and survival rates of glue-based anastomoses need to be initiated.
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Affiliation(s)
- Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - Stephan Christian Möhlhenrich
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - René Tolba
- Institute of Laboratory Animal Science and Experimental Surgery of RWTH-Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Stefan Jockenhoevel
- Department of Biohybrid and Medical Textiles (BioTex), AME-Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, 52074 Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
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