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Takafuji K, Oyamada Y, Hatakeyama W, Kihara H, Shimazaki N, Fukutoku A, Satoh H, Kondo H. Quantitative analysis of change in bone volume 5 years after sinus floor elevation using plate-shaped bone substitutes: a prospective observational study. Int J Implant Dent 2024; 10:9. [PMID: 38372934 PMCID: PMC10876503 DOI: 10.1186/s40729-023-00501-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 09/09/2023] [Indexed: 02/20/2024] Open
Abstract
PURPOSE Tricalcium phosphate (TCP) has osteoconductive ability and reportedly offers similar clinical results as autogenous bone grafts in dental implant treatment. However, few reports quantify temporal changes in augmented bone volume after sinus augmentation. We aimed to establish a three-dimensional (3D) quantification method to assess bone volume after sinus augmentation and to evaluate biocompatibility of the TCP plate. METHODS Maxillary sinus floor augmentation was performed employing the lateral window technique, and plate-shaped β-TCP (TCP plate) was used instead of granular bone grafting materials. After lifting the sinus membrane, the TCP plate was inserted and supported by dental implants or micro-screws. The changes in bone volumes in the maxillary sinus before and after surgery were recorded using cone-beam computed tomography, saved as Digital Imaging and Communications in Medicine-formatted files, and transformed to Standard Triangle Language (STL)-formatted files. Pre- and post-operative STL data of bone volume were superimposed, and the augmented bone volume was calculated. Moreover, changes in bone volumes, TCP plate resorption rates, and bone heights surrounding the implants were three dimensionally quantified. RESULTS Fifteen implants in nine subjects were included in this study. TCP plates secured long-term space making, with results similar to those of granular bone substitutes. Newly formed bone was identified around the implant without bone graft material. TCP plate was absorbed and gradually disappeared. CONCLUSIONS A novel 3D quantification method was established to evaluate changes in bone volume. Clinical application of TCP plate in sinus augmentation could be a better procedure in terms of prognosis and safety.
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Affiliation(s)
- Kyoko Takafuji
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
- Department of Fixed Prosthodontics and Oral Implantology, Aichi Gakuin University, Nagoya, Japan
| | - Yutaro Oyamada
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Wataru Hatakeyama
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Nobuko Shimazaki
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Akihiro Fukutoku
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hiroaki Satoh
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan.
- Department of Fixed Prosthodontics and Oral Implantology, Aichi Gakuin University, Nagoya, Japan.
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Lee W, Prat D, Chao W, Farber DC, Wang C, Wapner KL. The Efficiency of Highly Porous β-Tricalcium Phosphate With Bone Marrow Aspirate Concentrate in Midfoot Joint Arthrodesis. Foot Ankle Spec 2023:19386400231213177. [PMID: 38018529 DOI: 10.1177/19386400231213177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Nonunion is one of the most common and devastating complications following midfoot joint arthrodesis. Many different types of bone grafts and bone substitutes have been used to promote osseous fusion. However, there is no consensus on the gold standard bone grafting material and whether biologic materials should be used alone or in combination. The purpose of this study is to investigate the efficiency of highly porous β-tricalcium phosphate (β-TCP) with bone marrow aspirate concentrate (BMAC) in midfoot joint arthrodesis. METHODS This retrospective comparative study included patients who underwent midfoot joint arthrodesis using compression screws. Patients were classified into 2 groups: arthrodesis with highly porous β-TCP and BMAC (group A) and arthrodesis without them (group B). The osseous union rate was compared between the 2 groups. A total of 44 patients (46 feet) including 89 joints were included in this study. RESULTS There was a significant difference in the union rate between the 2 groups: 91.5% (43/47 joints) in arthrodesis with highly porous β-TCP and BMAC (group A) and 76.2% (32/42 joints) in arthrodesis without highly porous β-TCP and BMAC (group B; P = .048). CONCLUSION This study investigated the efficiency of highly porous β-TCP and BMAC to promote bony healing in midfoot joint arthrodesis. A significantly higher union rate was shown when arthrodesis was performed with highly porous β-TCP and BMAC, compared with arthrodesis performed without them. We suggest that highly porous β-TCP and BMAC can be a viable and effective adjunct to the fixation in midfoot joint arthrodesis. LEVEL OF EVIDENCE Level III: Retrospective comparative analysis.
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Affiliation(s)
- Wonyong Lee
- Division of Foot & Ankle Surgery, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Orthopaedic Surgery, Guthrie Medical Group, Sayre, Pennsylvania
| | - Dan Prat
- Division of Foot & Ankle Surgery, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Wen Chao
- Division of Foot & Ankle Surgery, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel C Farber
- Division of Foot & Ankle Surgery, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Carol Wang
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Keith L Wapner
- Division of Foot & Ankle Surgery, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
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Čandrlić M, Tomas M, Matijević M, Kačarević ŽP, Bićanić M, Udiljak Ž, Butorac Prpić I, Miškulin I, Čandrlić S, Včev A. Regeneration of Buccal Wall Defects after Tooth Extraction with Biphasic Calcium Phosphate in Injectable Form vs. Bovine Xenograft: A Randomized Controlled Clinical Trial. Dent J (Basel) 2023; 11:223. [PMID: 37754343 PMCID: PMC10528832 DOI: 10.3390/dj11090223] [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: 07/28/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
Bone healing after tooth extraction may be affected by defects of the alveolus buccal wall, such as fenestrations and dehiscences. Therefore, to minimize dimensional changes it is advisable to perform alveolar ridge preservation after tooth extractions. Different biomaterials are used for this purpose. The aim of this study was to investigate the qualitative and quantitative histological changes in human biopsies taken after 6 months of healing of extraction sockets with buccal wall defects. For this purpose, the defects of 36 patients (18 per group) were treated with injectable biphasic calcium phosphate (I-BCP) or bovine xenograft (BX) after extraction. After six months of healing, biopsies were taken and proceeded to the histology laboratory. No evidence of an inflammatory response of the tissue was observed in the biopsies of either group, and the newly formed bone (NB) was in close contact with the remaining biomaterial (BM). The histomorphometric results showed that there was no statistically significant difference between the groups in the mean percentage of NB (p = 0.854), BM (p = 0.129), and soft tissue (p = 0.094). To conclude, both biomaterials exhibited osteoconductivity and biocompatibility and achieved satisfactory bone regeneration of buccal wall defects after tooth extraction.
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Affiliation(s)
- Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Marko Matijević
- Community Healthcare Center of Osijek-Baranja County, 31 000 Osijek, Croatia;
| | - Željka Perić Kačarević
- Department of Anatomy, Histology, Embriology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia;
- Botiss Biomaterials GmbH, 15806 Zossen, Germany
| | - Marijana Bićanić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Žarko Udiljak
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Ivana Butorac Prpić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Ivan Miškulin
- Department of Public Health, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Slavko Čandrlić
- Department of Interdisciplinary Areas, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31 000 Osijek, Croatia;
| | - Aleksandar Včev
- Department of Pathophysiology, Physiology and Immunology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia
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Choi YJ, Chang HJ, Kim MJ, Lee JH, Lee BK. Efficacy of pure beta tricalcium phosphate graft in dentoalveolar surgery: a retrospective evaluation based on serial radiographic images. Maxillofac Plast Reconstr Surg 2023; 45:25. [PMID: 37495896 PMCID: PMC10371935 DOI: 10.1186/s40902-023-00390-w] [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: 02/16/2023] [Accepted: 06/01/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The use of beta-tricalcium phosphate (beta-TCP) in dental surgery is limited owing to its rapid absorption compared to mixed formulations of hydroxyapatite. However, newly developed pure beta-TCP crystals have demonstrated slow absorption; hence, they last longer within the defect and act as a scaffold until new bone formation. The oral environment is unique and can prove unfavorable for bone grafts due to the high infection rate in the oral cavity and the fragile condition of the oral mucosa. The aim of this study was to evaluate the feasibility of using pure beta-TCP bone grafts in various dental treatments. METHODS Panoramic X-ray images of 25 patients who underwent bone grafting during dental surgery were analyzed. A specially treated pure beta-TCP crystal, Neo Bone® (Neo Bone®, SN Biologics Co., Ltd, Seoul, Korea), was used in this study. The bone density at the graft site was compared with that of the surrounding bone using the ImageJ software (Wayne Rasband, NIH USA). RESULTS Six months after surgery, the bone graft density was similar to that of the surrounding bone in 20 patients and increased in 5 patients. No adverse effects, such as infection, dehiscence, or graft failure, were observed. CONCLUSION The newly developed pure beta-TCP crystal was slowly absorbed and served as support until new bone formation at the defect site, thus demonstrating its potential for use in various oral conditions requiring bone grafting.
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Affiliation(s)
- Young-Jin Choi
- Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, South Korea
| | - Hoon-Je Chang
- Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, South Korea
| | - Min Jae Kim
- Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, South Korea
| | - Jee-Ho Lee
- Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, South Korea
| | - Bu-Kyu Lee
- Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, South Korea.
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Aragoneses Lamas JM, Sánchez MG, González LC, Suárez García A, Aragoneses Sánchez J. Vertical Bone Gain after Sinus Lift Procedures with Beta-Tricalcium Phosphate and Simultaneous Implant Placement-A Cross-Sectional Study. ACTA ACUST UNITED AC 2020; 56:medicina56110609. [PMID: 33202885 PMCID: PMC7697819 DOI: 10.3390/medicina56110609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/01/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The objective of this cross-sectional study was to evaluate the vertical bone gain achieved after the sinus lift procedure with beta-tricalcium phosphate (β-TCP) used as a bone substitute and simultaneous implant placement. METHODS One hundred and twenty-eight sinus lift procedures (utilizing a synthetic ceramic containing 99.9% tricalcium phosphate as a bone substitute) and simultaneous implant placements were performed on 119 patients. The lateral window approach surgical protocol for maxillary sinus lift was performed on the patients. The implants were evaluated using cone-beam computed tomography (CBCT) at 6 months following placement. The vertical bone gain was considered a primary variable, while implant length, diameter, and location were considered secondary variables. RESULTS The ANOVA results showed no statistical difference in vertical bone gain with implant parameters like implant length, width, and position. Pearsons correlation revealed a statistically significant positive correlation with vertical bone gain and implant length and diameter. A further multivariate linear regression analysis was performed and it observed statistically significant associations between the variables in the study after adjusting for confounding factors. CONCLUSIONS This study concluded that there was vertical bone gain with the usage of β-TCP in maxillary sinus lift surgical procedure with immediate implant placement and that implant variables like length and diameter had a significant influence on the average bone gain values. The implant position did not have a statistically significant influence but there was considerable variation in the bone gain between first, second premolar, and molar regions.
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Affiliation(s)
- Juan Manuel Aragoneses Lamas
- Department of Dental Research, Federico Henriquez y Carvajal University, Santo Domingo 10106, Dominican Republic; (J.M.A.L.); (J.A.S.)
| | | | - Leví Cuadrado González
- Department of Implantology and Regeneration, Universidad de Vic-Universidad Central de Cataluña, 08500 Barcelona, Spain;
| | - Ana Suárez García
- Department of Pre-clinical Dentistry, Universidad Europea de Madrid, 28670 Madrid, Spain;
| | - Javier Aragoneses Sánchez
- Department of Dental Research, Federico Henriquez y Carvajal University, Santo Domingo 10106, Dominican Republic; (J.M.A.L.); (J.A.S.)
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Kitasato S, Tanaka T, Chazono M, Komaki H, Kakuta A, Inagaki N, Akiyama S, Marumo K. Local application of alendronate controls bone formation and β-tricalcium phosphate resorption induced by recombinant human bone morphogenetic protein-2. J Biomed Mater Res A 2019; 108:528-536. [PMID: 31702866 DOI: 10.1002/jbm.a.36833] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/28/2019] [Accepted: 11/01/2019] [Indexed: 12/22/2022]
Abstract
This study examined the ability of local alendronate (ALN) administration to control β-tricalcium phosphate (β-TCP) resorption as well as the induction of bone formation by recombinant human bone morphogenetic protein-2 (rhBMP-2). A 15-mm critical-sized bone defect was created in the diaphysis of rabbit ulnae. Nine female rabbits (4 to 5 months-old) were divided into 3 groups. Group 1 (n = 6 ulnae) animals received implants consisting of β-TCP granules and 25 μg of rhBMP-2 in 6.5% collagen gel. Group 2 (6 ulnae) and Group 3 (6 ulnae) animals received the same implants, but with 10-6 M and 10-3 M ALN-treated TCP granules, respectively. Two weeks postsurgery, tartrate-resistant acid phosphatase-positive cell counts, new bone formation, and residual β-TCP were evaluated. This study showed that a high dose of ALN strongly reduced osteoclastic resorption of β-TCP induced by rhBMP-2, resulting in decreased bone formation. In contrast, a low dose of ALN slightly reduced the bone resorptive effect but increased bone formation. These results suggest that osteoclast-mediated resorption plays an important role in bone formation and a coupling-like phenomenon could occur in the β-TCP-implanted area, and that administration of a low dose of ALN may solve clinical bone resorptive problems induced by rhBMP-2.
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Affiliation(s)
- Seiichiro Kitasato
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Takaaki Tanaka
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan.,Department of Orthopaedic Surgery, NHO Utsunomiya National Hospital, Tochigi, Japan
| | - Masaaki Chazono
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan.,Department of Orthopaedic Surgery, NHO Utsunomiya National Hospital, Tochigi, Japan
| | - Hirokazu Komaki
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Atsuhito Kakuta
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Naoya Inagaki
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Shoshi Akiyama
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Keishi Marumo
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
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Rony L, Aguado E, Pascaretti-Grizon F, Hubert L, Chappard D. Hyaluronic Acid Stimulates Osseointegration of β-TCP in Young and Old Ewes. Calcif Tissue Int 2019; 105:487-496. [PMID: 31321456 DOI: 10.1007/s00223-019-00589-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
Abstract
Cross-linked hyaluronic acid (HyAR) increases the local concentration of growth factors. We compared β-TCP osseointegration in old and young ewes with/without HyAR addition. A blind tunnel was drilled on the medial femoral condyle of each knee in nine young and nine old ewes and was filled with β-TCP, β-TCP + HyAR or left unfilled. Double labeling with calcein allowed histodynamic analysis. Ewes were sacrificed at 84 days and the knees were harvested. MicroCT provided histomorphometric parameters: trabecular bone volume, residual volume of biomaterial. Histodynamic parameters were: mineralization rate, mineralized surfaces, bone formation rate. A non-parametric ANOVA and post hoc test analyzed differences between subgroups. Osseointegration of β-TCP was similar in the aged/young grafted groups. Trabecular bone volume was significantly increased versus ungrafted animals (p < 0.001). There were no significant difference for bone volume, residual volume of biomaterial and histodynamic parameters when a single parameter was considered but additional effects of β-TCP and HyAR were evidenced by 3D analysis. Addition of HyAR to ß-TCP does not significantly increase bone volume but tends to increase histodynamic parameters. However, considering the reduction of osteoblastic activity in aged animals, β-TCP, and HyAR boosts osteoblastic activity. HyAR leads to an equivalent response between young and old animals.
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Affiliation(s)
- L Rony
- Groupe Etudes Remodelage Osseux et BioMatériaux, GEROM- LabCom NextBone, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, SFR 42-08, 49933, Angers Cedex, France
- Département de Chirurgie Osseuse, CHU d'Angers, 49033, Angers Cédex, France
| | - E Aguado
- Groupe Etudes Remodelage Osseux et BioMatériaux, GEROM- LabCom NextBone, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, SFR 42-08, 49933, Angers Cedex, France
- ONIRIS, Ecole Vétérinaire de Nantes, 44307, Nantes Cedex 3, France
| | - F Pascaretti-Grizon
- Groupe Etudes Remodelage Osseux et BioMatériaux, GEROM- LabCom NextBone, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, SFR 42-08, 49933, Angers Cedex, France
| | - L Hubert
- Groupe Etudes Remodelage Osseux et BioMatériaux, GEROM- LabCom NextBone, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, SFR 42-08, 49933, Angers Cedex, France
- Département de Chirurgie Osseuse, CHU d'Angers, 49033, Angers Cédex, France
| | - D Chappard
- Groupe Etudes Remodelage Osseux et BioMatériaux, GEROM- LabCom NextBone, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, SFR 42-08, 49933, Angers Cedex, France.
- Département de Chirurgie Osseuse, CHU d'Angers, 49033, Angers Cédex, France.
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Loin J, Kün-Darbois JD, Guillaume B, Badja S, Libouban H, Chappard D. Maxillary sinus floor elevation using Beta-Tricalcium-Phosphate (beta-TCP) or natural bone: same inflammatory response. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:97. [PMID: 31440845 DOI: 10.1007/s10856-019-6299-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023]
Abstract
Sinus elevation is a common procedure to increase bone volume in the atrophic maxilla to allow placement of dental implants. Autogenous bone is the gold standard but is limited in quantity and causes morbidity at the donor site. β-TCP is a synthetic biomaterial commonly used in that purpose. It appears to induce a poor inflammatory response. This study aimed to evaluate the degree of edema of the sinus mucosa after sinus lift surgery according to the type of biomaterial. Forty sinuses (20 patients) were included retrospectively and divided into 2 groups according to the biomaterial that was used: synthetic biomaterial (BTCP group), natural bone (BONE group). A control group (CTRL group) was constituted by the non-grafted maxillary sinuses. Twelve measurements per sinus were realized on pre- and post-operative computed tomography and averaged to provide the sinus membrane thickness value (SM.Th). SM.Th was thicker post-operatively in the BTCP and BONE groups in comparison with the CTRL group and in comparison with pre-operative measurements. No difference was found post operatively between the BTCP and BONE groups. We found that a synthetic biomaterial (β-TCP) induced the same degree of edema, and thus of inflammation, as natural bone. It constitutes therefore an interesting alternative to autogenous bone for maxillary sinus lifts.
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Affiliation(s)
- Justine Loin
- Service de Chirurgie Maxillo-faciale et stomatologie, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex, France
| | - Jean-Daniel Kün-Darbois
- Service de Chirurgie Maxillo-faciale et stomatologie, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex, France.
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France.
| | - Bernard Guillaume
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
- Centre Français d'Implantologie CFI, 6 rue de Rome, 75008, Paris, France
| | - Smail Badja
- Service de Chirurgie Maxillo-faciale et stomatologie, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex, France
| | - Hélène Libouban
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
| | - Daniel Chappard
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
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Human macrophages and osteoclasts resorb β-tricalcium phosphate in vitro but not mouse macrophages. Micron 2019; 125:102730. [PMID: 31415983 DOI: 10.1016/j.micron.2019.102730] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/12/2019] [Accepted: 07/29/2019] [Indexed: 11/22/2022]
Abstract
β-TCP is a resorbable bony biomaterial but its biodegradation mechanisms in vivo remains unclear. Osteoclast can resorb β-TCP but a role for macrophages has also been suggested by in vivo studies. However no in vitro study has clearly evidenced the action of macrophages in the resorption process. We prepared flat β-TCP tablets with a smooth surface to investigate the in vitro capability of murine (RAW 264.7) and human macrophage cells (PBMCs) to resorb the biomaterial. In parallel, these cells were differentiated into multinucleated osteoclasts with M-CSF and RANK-L. The action of these cells was evaluated by scanning electron microscopy and Raman microspectroscopy after a 21 day culture on the tablets. Human macrophages and osteoclasts derived from PBMCs appeared able to resorb β-TCP by forming resorption pits at the surface of the flat tablets. RAW macrophages were unable to resorb β-TCP but they exhibited this possibility when they have been differentiated into osteoclasts. These cells can engulf β-TCP grains in their cytoplasm as evidenced by light and TEM microscopy with production of carbonic anhydrase (revealed by the immunogold technique in TEM). The resorbed areas were characterized by severe degradation of the grains showing speckled and stick-like aspects indicating a chemical corrosion. The effect was maximal at the grain boundaries which have a slightly different chemical composition. Changes in the Raman spectrum were observed between the resorbed and un-resorbed β-TCP suggesting crystal modifications. In contrast, un-differentiated murine macrophages were not able to chemically attack β-TCP and no resorption pit was observed. RAW cell is not a representative model of the macrophage-biomaterial interactions that occur in human. This in vitro study evidences that both human osteoclasts and macrophages represent active cell populations capable to resorb β-TCP.
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Mendoza-Azpur G, Olaechea A, Padial-Molina M, Gutiérrez-Garrido L, O'Valle F, Mesa F, Galindo-Moreno P. Composite Alloplastic Biomaterial vs. Autologous Platelet-Rich Fibrin in Ridge Preservation. J Clin Med 2019; 8:E223. [PMID: 30744095 PMCID: PMC6406621 DOI: 10.3390/jcm8020223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/05/2019] [Accepted: 02/08/2019] [Indexed: 01/17/2023] Open
Abstract
AIM The aim of this study was to examine the clinical and histological differences of using a combination of alloplastic beta triphasic calcium phosphate (β-TCP) and a cross-linked collagen membrane versus autologous platelet-rich fibrin (PRF-L) in ridge preservation after dental extraction. MATERIAL AND METHODS Fifty-one patients were included in this observational case-series study. Dental extractions were performed, after which 25 patients were grafted with β-TCP and 26 with PRF-L. After four months of healing, clinical, radiological, histomorphometric and histological evaluations were performed. RESULTS A significantly higher percentage of mineralized tissue was observed in samples from the PRF-L grafted areas. Cellularity was higher in PRF-L grafted areas (osteocytes in newly formed bone per mm² = 123.25 (5.12) vs. 84.02 (26.53) for PRF-L and β-TCP, respectively, p = 0.01). However, sockets grafted with PRF-L showed a higher reduction in the bucco-lingual dimension after four months of healing (2.19 (0.80) vs. 1.16 (0.55) mm, p < 0.001), as well as a higher alteration in the final position of the mid muco-gingival junction (1.73 (1.34) vs. 0.88 (0.88) mm, p < 0.01). CONCLUSION PRF-L concentrate accelerates wound healing in post-extraction sockets in terms of new mineralized tissue component. However, the use of β-TCP biomaterial appears to be superior to maintain bucco-lingual volume and the final position of the muco-gingival junction.
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Affiliation(s)
- Gerardo Mendoza-Azpur
- Department of Periodontology, School of Dentistry, Cientifica del Sur University, 15067 Lima, Peru.
| | - Allinson Olaechea
- Department of Periodontology, School of Dentistry, Cientifica del Sur University, 15067 Lima, Peru.
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain.
| | - Lourdes Gutiérrez-Garrido
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain.
| | - Francisco O'Valle
- Department of Pathology & Institute of Biopathology and Regenerative Medicine (IBIMER, CIBM), University of Granada, 18071 Granada, Spain.
| | - Francisco Mesa
- Department of Periodontology, School of Dentistry, University of Granada, 18071 Granada, Spain.
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain.
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11
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Beger B, Blatt S, Pabst AM, Hansen T, Goetz H, Al-Nawas B, Ziebart T. Biofunctionalization of synthetic bone substitutes with angiogenic stem cells: Influence on regeneration of critical-size bone defects in an in vivo murine model. J Craniomaxillofac Surg 2018; 46:1601-1608. [PMID: 30196861 DOI: 10.1016/j.jcms.2018.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 05/23/2018] [Accepted: 06/01/2018] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the influence of human bone marrow-derived endothelial progenitor cells (EPC) on vascularization and bone regeneration in combination with a bone-substitute material (BSM) in a critical-size bone defect in a murine model. Critical-size bone defects were performed and the defects were filled according to the group membership. MATERIALS AND METHODS Eighteen rats were randomized in two experimental groups: BSM (BoneCeramic) with/without EPC biofunctionalization, and a control group without BSM and EPC. Calvaria bone defects were performed and the defects were filled according to the group membership. After 8 weeks, qualitative tissue response of newly formed bone mass was analyzed by histology, cone beam CT (CBCT) and micro-CT (μCT) scans. Occurrence of tumor masses due to EPC vascularization in peripheral organs was investigated microscopically in histological slides of liver and kidney. RESULTS The combination of EPC and BSM showed smaller bone defects in the CT scans and the histological evaluation as the single use of BSM without EPC by trend (p = 0.067). Further, a higher amount of blood vessels could be found in histological slices of BSM in combination with EPC. No inflammatory response or tumor formation could be found. CONCLUSION These findings confirm the biocompatibility of the used BSM and provide evidence that the combination of BSM with EPC might be effective for bone vascularization and regeneration. Using EPC in augmentation sites might overall lead to faster and better bone regeneration and should be further investigated in future studies.
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Affiliation(s)
- Benjamin Beger
- Department of Oral- and Maxillofacial Surgery, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), University Medical Center, Augustusplatz 2, 55131, Mainz, Germany.
| | - Sebastian Blatt
- Department of Oral- and Maxillofacial Surgery, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), University Medical Center, Augustusplatz 2, 55131, Mainz, Germany
| | - Andreas Max Pabst
- Department of Oral- and Maxillofacial Surgery, (Head: Prof. Dr. Dr. R. Werkmeister), Federal Armed Forces Hospital, Rübenacherstrasse 170, 56072, Koblenz, Germany
| | - Torsten Hansen
- Institute of Pathology, (Head: Prof. Dr. T. Hansen), Clinic Lippe, Röntgenstrasse 18, 32756, Detmold, Germany
| | - Hermann Goetz
- Biomaterials in Medicine (BioAPP), (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), University Medical Center, Augustusplatz 2, 55131, Mainz, Germany
| | - Thomas Ziebart
- Department of Oral- and Maxillofacial Surgery, (Head: Univ.-Prof. Dr. Dr. A. Neff), University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
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12
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EZH1 Is Associated with TCP-Induced Bone Regeneration through Macrophage Polarization. Stem Cells Int 2018; 2018:6310560. [PMID: 30228822 PMCID: PMC6136473 DOI: 10.1155/2018/6310560] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/19/2018] [Accepted: 07/19/2018] [Indexed: 12/31/2022] Open
Abstract
Macrophages have been found to regulate the effects of biomaterials throughout the entire tissue repair process as an antigen-presenting cell. As a well-defined osteoconductive biomaterial for bone defect regeneration, tricalcium phosphate (TCP) has been found to facilitate a favourable osteoimmunomodulatory response that can shift macrophage polarization towards the M2 phenotype. In the present study, our group discovered that a histone methyltransferase enhancer of zeste1 (EZH1) was drastically downregulated in Thp1 cells stimulated by TCP, indicating that EZH1 may participate in the macrophage phenotype shifting. Furthermore, the NF-κB pathway in macrophages was significantly downregulated through stimulation of TCP, suggesting a potential interaction between EZH1 and the NF-κB pathway. Utilizing gene knock-down therapy in macrophages, it was found that depletion of EZH1 induced M2 macrophage polarization but did not downregulate NF-κB. When the NF-κB pathway was inhibited, the expression of EZH1 was significantly downregulated, suggesting that the inhibition of EZH1 may be regulated by the NF-κB pathway. These novel findings provide valuable insights into a potential gene target system that controls M2 macrophage polarization which ultimately favours a microenvironment suitable for bone repair.
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13
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Ye Y, Pang Y, Zhang Z, Wu C, Jin J, Su M, Pan J, Liu Y, Chen L, Jin K. Decellularized Periosteum-Covered Chitosan Globule Composite for Bone Regeneration in Rabbit Femur Condyle Bone Defects. Macromol Biosci 2018; 18:e1700424. [PMID: 29931763 DOI: 10.1002/mabi.201700424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 05/17/2018] [Indexed: 12/24/2022]
Abstract
Critical-sized bone defects are incapable of self-healing and are commonly seen in clinical practice. The authors explore a new treatment for this, decellularized periosteum is applied to chitosan globules (chitosan-DP globules) as a hybrid material. The efficacy of chitosan-DP globules on rabbit femoral condyle bone defects is assessed with biocompatibility, biomechanics, and osteogenic efficiency measurements, and compared with the results of chitosan globules and empty control. No difference in cytotoxicity is observed among chitosan-DP globules, chitosan globules, and the empty control. Chitosan-DP globules possesse a better surface for cell adhesion than did chitosan globules. Chitosan-DP globules demonstrate superior efficiency for osteogenesis in the defect area compared to chitosan globules as per microcomputed tomography examination and push-out testing, with relatively minor histological differences. Both chitosan globule groups show more satisfactory results than those for the empty control. The results implicate chitosan-DP globules as a promising solution for bone defects.
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Affiliation(s)
- Yiheng Ye
- Department of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.,Wenzhou Medical University, Wenzhou, 325000, China
| | - Yichuan Pang
- Department of Oral and Maxillofacial Surgery, Affiliated Shanghai 9th People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200000, China
| | - Zeng Zhang
- First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, China
| | - Congcong Wu
- First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, China
| | - Jianfeng Jin
- First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, China
| | - Mingzhen Su
- First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, China
| | - Junle Pan
- First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, China
| | - Yangbo Liu
- Department of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.,Wenzhou Medical University, Wenzhou, 325000, China
| | - Lei Chen
- Department of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.,Wenzhou Medical University, Wenzhou, 325000, China
| | - Keke Jin
- Department of Pathophysiology, Wenzhou Medical University, Wenzhou, 325000, China
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14
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Márton K, Tamás SB, Orsolya N, Béla C, Ferenc D, Péter N, Csaba DN, Lajos C, Zsombor L, Eitan M, György S. Microarchitecture of the Augmented Bone Following Sinus Elevation with an Albumin Impregnated Demineralized Freeze-Dried Bone Allograft (BoneAlbumin) versus Anorganic Bovine Bone Mineral: A Randomized Prospective Clinical, Histomorphometric, and Micro-Computed Tomography Study. MATERIALS 2018; 11:ma11020202. [PMID: 29382095 PMCID: PMC5848899 DOI: 10.3390/ma11020202] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 12/15/2022]
Abstract
Serum albumin has been identified as an endogenous protein that is integral to early bone regeneration. We hypothesized that albumin addition to allografts may result in better bone remodeling than what can be achieved with anorganic xenografts. Sinus elevations were performed at 32 sites of 18 patients with the lateral window technique. Sites either received filling with an anorganic bovine bone mineral (ABBM, BioOss, Geistlich, CH) or albumin impregnated allograft (BoneAlbumin, OrthoSera, AT). After 6-months patients received dental implants and 16 bone core biopsy samples were obtained from the ABBM filled, and 16 from the BoneAlbumin augmented sites. The biopsies were examined by histomorphometry and µCT. Percentage of the residual graft in the BoneAlbumin group was 0–12.7%, median 5.4% vs. ABBM 6.3–35.9%, median 16.9%, p < 0.05. Results of the µCT analysis showed that the microarchitecture of the augmented bone in the BoneAlbumin group resembles that of the native maxilla in morphometric parameters Trabecular Pattern Factor and Connectivity. Our data show that while ABBM successfully integrates into the newly formed bone tissue as persisting particles, BoneAlbumin is underway towards complete remodeling with new bone closely resembling that of the intact maxilla.
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Affiliation(s)
- Kivovics Márton
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40, 1088 Budapest, Hungary; (N.O.); (C.B.)
- Correspondence: ; Tel.: +36-20-360-1909
| | - Szabó Bence Tamás
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi utca 47, 1088 Budapest, Hungary; (S.B.T.); (D.-N.C.)
| | - Németh Orsolya
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40, 1088 Budapest, Hungary; (N.O.); (C.B.)
| | - Czinkóczky Béla
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40, 1088 Budapest, Hungary; (N.O.); (C.B.)
| | - Dőri Ferenc
- Department of Periodontology, Semmelweis University, Szentkirályi utca 47, 1088 Budapest, Hungary;
| | - Nagy Péter
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary;
| | - Dobó-Nagy Csaba
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi utca 47, 1088 Budapest, Hungary; (S.B.T.); (D.-N.C.)
| | - Csönge Lajos
- Petz Aladár County Hospital, West Hungarian Regional Tissue Bank, Vasvári Pál u. 2–4, 9024 Győr, Hungary;
| | - Lacza Zsombor
- Institute of Clinical Experimental Research, Semmelweis University, Tűzoltó u. 37–47, 1094 Budapest, Hungary;
| | - Mijiritsky Eitan
- Department of Oral Rehabilitation, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel;
| | - Szabó György
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária utca 52, 1085 Budapest, Hungary;
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15
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Comparative study of volumetric changes and trabecular microarchitecture in human maxillary sinus bone augmentation with bioactive glass and autogenous bone graft: a prospective and randomized assessment. Int J Oral Maxillofac Surg 2017; 47:665-671. [PMID: 29246424 DOI: 10.1016/j.ijom.2017.11.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/05/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022]
Abstract
The aim of this study was to compare the volumetric changes and the new bone microarchitecture in human maxillary sinuses augmented with bioactive glass (Biogran) alone, bioactive glass combined with autogenous bone graft (1:1), or autogenous bone graft alone. Twelve maxillary sinuses were grafted with bioactive glass (group 1), nine with bioactive glass mixed with autogenous bone graft 1:1 (group 2), and 12 with autogenous bone graft (group 3). Patients underwent cone beam computed tomography 15days after the procedure to determine the initial volume of the graft (T1) and again 6 months later (T2). Biopsies were obtained at the time of dental implant placement and were subjected to micro-computed tomography. The volumetric change was 44.2% in group 1, 37.9% in group 2, and 45.7% in group 3 (P>0.05). The trabecular microarchitecture results showed that the materials used in groups 1 and 2 were good bone substitutes. However, the addition of 50% bioactive glass to autogenous bone graft improved the microarchitecture of the graft. Furthermore, the results for volumetric changes indicated that bioactive glass, its association with autogenous bone graft in a 1:1 ratio, and autogenous bone graft alone have similar resorption.
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16
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Pascaretti-Grizon F, Guillaume B, Terranova L, Arbez B, Libouban H, Chappard D. Maxillary Sinus Lift with Beta-Tricalcium Phosphate (β-TCP) in Edentulous Patients: A Nanotomographic and Raman Study. Calcif Tissue Int 2017; 101:280-290. [PMID: 28447119 DOI: 10.1007/s00223-017-0280-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/10/2017] [Indexed: 01/06/2023]
Abstract
Sinus lift elevation restores bone mass at the maxilla in edentulate patients before the placement of dental implants. It consists of opening the lateral side of the sinus and grafting beta-tricalcium phosphate granules (β-TCP) under the olfactory membrane. Bone biopsies were obtained in five patients after 60 weeks. They were embedded undecalcified in poly(methyl methacrylate) (pMMA); blocks were analyzed by nanocomputed tomography (nanoCT); specific areas were studied by Raman microspectroscopy. Remnants of β-TCP were osseointegrated and covered with mineralized bone; osteoid tissue was also filling the inner porosity. Macrophages having engulfed numerous β-TCP grains were observed in marrow spaces. β-TCP was identified by nanoCT as osseointegrated particles and as granules in the cytoplasm of macrophages. Raman microspectroscopy permitted to compare the spectra of β-TCP and bone in different areas. The ratio of the ~820 cm-1 band of pMMA (-CH2 groups) on the ν1 phosphate band at 960 cm-1 reflected tissue hydration because water was substituted by MMA during histological processing. In bone, the ratio of the ~960 cm-1 phosphate to the amide 1 band and the ratio ν2 phosphate band by the 1240-1250 amide III band reflect the mineralization degree. Specific bands of β-TCP were found in osseointegrated β-TCP granules and in the grains phagocytized by the macrophages. The hydration degree was maximal for β-TCP phagocytized by macrophages. Raman microspectroscopy associated with nanoCT is a powerful tool in the analysis of the biomaterial degradation and osseointegration.
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Affiliation(s)
- Florence Pascaretti-Grizon
- GEROM Groupe Etudes Remodelage Osseux et bioMatériaux, NextBone, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, Université d'Angers, 49933, Angers Cedex, France
| | - Bernard Guillaume
- GEROM Groupe Etudes Remodelage Osseux et bioMatériaux, NextBone, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, Université d'Angers, 49933, Angers Cedex, France
- CFI, Collège Français d'Implantologie, 6, rue de Rome, 75005, Paris, France
| | - Lisa Terranova
- GEROM Groupe Etudes Remodelage Osseux et bioMatériaux, NextBone, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, Université d'Angers, 49933, Angers Cedex, France
| | - Baptiste Arbez
- GEROM Groupe Etudes Remodelage Osseux et bioMatériaux, NextBone, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, Université d'Angers, 49933, Angers Cedex, France
| | - Hélène Libouban
- GEROM Groupe Etudes Remodelage Osseux et bioMatériaux, NextBone, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, Université d'Angers, 49933, Angers Cedex, France
| | - Daniel Chappard
- GEROM Groupe Etudes Remodelage Osseux et bioMatériaux, NextBone, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, Université d'Angers, 49933, Angers Cedex, France.
- GEROM - NextBone, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France.
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17
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Arbez B, Libouban H. Behavior of macrophage and osteoblast cell lines in contact with the β-TCP biomaterial (beta-tricalcium phosphate). Morphologie 2017; 101:154-163. [PMID: 28506709 DOI: 10.1016/j.morpho.2017.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 03/29/2017] [Accepted: 03/30/2017] [Indexed: 06/07/2023]
Abstract
Beta-tricalcium phosphate (β-TCP) is a synthetic ceramic used for filling bone defects. It is a good alternative to autologous grafts since it is biocompatible, resorbable and osteoconductive. Previous in vivo studies have shown that macrophages are one of the first cells coming in contact with the biomaterial followed by osteoclasts and osteoblasts that will elaborate new bone packets. Studies have focused on osteoclast morphology and very few of them have investigated the role of macrophages. The aims of this study were to characterize (i) the biomaterial surface; (ii) the in vitro behavior of macrophages (J774.2 and Raw264.7 cells) using the description of cell morphology by scanning electron microscopy (SEM) at 7 and 14 days; (iii) the behavior of osteoblasts (SaOs-2 and MC3T3-E1 cells) seeded at the surface of the biomaterial 24, 48 and 72hours by SEM and confocal microscopy. Cell proliferation was analyzed by MTT assays. Viability and affinity of the macrophages for β-TCP were found significantly increased after 7 and 14d. MC3T3-E1 cells were anchored and stretched onto the β-TCP surface as early as 24h with a high proliferation rate (+190%) when compared to the surface of a well plate. SaOs-2 exhibited the same morphological profile at 72h. Proliferation became significantly higher compared to the plastic surface at only 72h (+129%). This study emphasises the importance of choice of the cell line used in exploring the osteoconductive and osteoinductive properties of a biomaterial. Additional studies are needed to analyze differentiation of macrophages into giant multinucleated cells and how the biomaterial surface influences osteoblast differentiation.
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Affiliation(s)
- B Arbez
- GEROM Groupe études remodelage osseux et biomatériaux, IRIS-IBS institut de biologie en santé, université d'Angers, CHU d'Angers, 49933 Angers cedex, France
| | - H Libouban
- GEROM Groupe études remodelage osseux et biomatériaux, IRIS-IBS institut de biologie en santé, université d'Angers, CHU d'Angers, 49933 Angers cedex, France.
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18
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Guillaume B. Filling bone defects with β-TCP in maxillofacial surgery: A review. Morphologie 2017; 101:113-119. [PMID: 28571762 DOI: 10.1016/j.morpho.2017.05.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/02/2017] [Accepted: 05/04/2017] [Indexed: 11/18/2022]
Abstract
Reconstruction of bone defects prior to implant placement now involves synthetic substitutes such as β-TCP because of its ability to promote bone remodeling. Its capacity to be progressively substituted by the patient's bone allows to regenerate a dense bone volume. In addition, its availability in large quantities, avoiding the morbidity observed with harvesting autogenous bone, widens the operative indications. In this paper, the main indications of β-TCP in maxillofacial surgery (dentistry, parodontology and dental implant surgery) are reviewed. They include periodontal bone disease, bone disjunction, pre-implant surgery (sinus floor elevation and lateralization of the inferior alveolar nerve).
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Affiliation(s)
- B Guillaume
- Collège Français d'Implantologie (CFI), 6, rue de Rome, 75005 Paris, France; Groupe Études Remodelage Osseux et bioMatériaux (GEROM), Institut de Biologie en Santé (IRIS-IBS), LUNAM Université, CHU d'Angers, 49933 Angers cedex, France.
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19
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Tarasenko SV, Ershova AM. [Synthetic osteoplastic materials for alveolar bone augmentation before dental implantation]. STOMATOLOGII︠A︡ 2017; 96:70-74. [PMID: 28514352 DOI: 10.17116/stomat201796270-74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study presents scientific data about surgical preparation of the alveolar bone before dental implantation by applying synthetic osteoplastic materials. The review analyzed the results of experimental and clinical studies on structural features and the efficiency of these materials, the time for replacement of new-formed bone tissue and contains comparative analysis of the efficiency of synthetic bone substitutes and other types of osteoplastic materials.
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Affiliation(s)
- S V Tarasenko
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - A M Ershova
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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20
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Zhang L, Ke J, Wang Y, Yang S, Miron RJ, Zhang Y. An in vitro
investigation of the marked impact of dendritic cell interactions with bone grafts. J Biomed Mater Res A 2017; 105:1703-1711. [PMID: 28241397 DOI: 10.1002/jbm.a.36048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 02/15/2017] [Accepted: 02/22/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Lili Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology, Wuhan University; Wuhan 430079 China
- Department of Oral Implantology; School and Hospital of Stomatology, Wuhan University; Wuhan 430079 China
| | - Jin Ke
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology, Wuhan University; Wuhan 430079 China
- Department of Oral and Maxillofacial Surgery; School and Hospital of Stomatology, Wuhan University; Wuhan 430079 China
| | - Yulan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology, Wuhan University; Wuhan 430079 China
- Department of Oral Implantology; School and Hospital of Stomatology, Wuhan University; Wuhan 430079 China
| | - Shuang Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology, Wuhan University; Wuhan 430079 China
- Department of Oral Implantology; School and Hospital of Stomatology, Wuhan University; Wuhan 430079 China
| | - Richard J. Miron
- Cell Therapy Institute, Centre for Collaborative Research; Nova Southeastern University, Fort Lauderdale; FL 33328 USA
- Department of Periodontology, College of Dental Medicine; Nova Southeastern University, Fort Lauderdale; FL 33328 USA
- Department of Periodontics and Oral Surgery; University of Ann Arbor, Ann Arbor; MI 48109 USA
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology, Wuhan University; Wuhan 430079 China
- Department of Oral Implantology; School and Hospital of Stomatology, Wuhan University; Wuhan 430079 China
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21
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Quantitative Kinetics Evaluation of Blocks Versus Granules of Biphasic Calcium Phosphate Scaffolds (HA/β-TCP 30/70) by Synchrotron Radiation X-ray Microtomography: A Human Study. IMPLANT DENT 2017; 25:6-15. [PMID: 26630463 DOI: 10.1097/id.0000000000000363] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Successful bone regeneration using both granules and blocks of biphasic calcium phosphate materials has been reported in the recent literature, in some clinical applications for maxillary sinus elevation, but the long-term kinetics of bone regeneration has still not been fully investigated. MATERIALS AND METHODS Twenty-four bilateral sinus augmentation procedures were performed and grafted with hydroxyapatite/β-tricalcium phosphate 30/70, 12 with granules and 12 with blocks. The samples were retrieved at different time points and were evaluated for bone regeneration, graft resorption, neovascularization, and morphometric parameters by computed microtomography and histology. RESULTS A large amount of newly formed bone was detected in the retrieved specimens, together with a good rate of biomaterial resorption and the formation of a homogeneous and rich net of new vessels. The morphometric values were comparable at 5/6 months from grafting but, 9 months after grafting, revealed that the block-based specimens mimicked slightly better than granule-based samples the healthy native bone of the maxillary site. CONCLUSION The scaffold morphology was confirmed to influence the long-term kinetics of bone regeneration.
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Repair of calvarial bone defects in mice using electrospun polystyrene scaffolds combined with β-TCP or gold nanoparticles. Micron 2017; 93:29-37. [DOI: 10.1016/j.micron.2016.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/04/2016] [Accepted: 11/04/2016] [Indexed: 11/22/2022]
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Do Porous Titanium Granule Grafts Affect Bone Microarchitecture at Augmented Maxillary Sinus Sites? A Pilot Split-Mouth Human Study. IMPLANT DENT 2017. [PMID: 26200164 DOI: 10.1097/id.0000000000000275] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The aim of this randomized controlled clinical study was to analyze the bone microarchitecture at augmented maxillary sinus sites by using different materials in patients to compare the effect of porous titanium granules as a sinus augmentation material with bone microstructural features. MATERIALS AND METHODS Eight subjects with bilateral atrophic posterior maxilla of residual bone height <4 mm included in this study and each patient was treated with bilateral sinus augmentation procedure using xenograft with equine origin (Apatos, Osteobiol; Tecnoss Dental) and xenograft (1 g) + porous titanium (1 g) granules (Natix; Tigran Technologies AB). Sixteen human bone biopsy samples were taken from patients receiving two-stage sinus augmentation therapy during implant installation and analyzed using microcomputerized tomography. Three-dimensional bone structural parameters were analyzed in details: tissue volume, bone volume, percentage of bone volume, bone surface and bone surface density, bone specific surface, trabecular thickness trabecular separation, trabecular number, trabecular pattern factor, structural model index, fractal dimension, and bone mineral density. RESULTS No statistically significant differences were found between groups according to bone structural parameters. CONCLUSIONS Porous titanium grafts may ensure a space for new bone formation in the granules, which may be a clinical advantage for long-term success.
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Kivovics M, Szabó BT, Németh O, Tari N, Dőri F, Nagy P, Dobó-Nagy C, Szabó G. Microarchitectural study of the augmented bone following ridge preservation with a porcine xenograft and a collagen membrane: preliminary report of a prospective clinical, histological, and micro-computed tomography analysis. Int J Oral Maxillofac Surg 2016; 46:250-260. [PMID: 27839628 DOI: 10.1016/j.ijom.2016.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 07/23/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
Abstract
Socket preservation using a combination of porcine xenograft and collagen membrane maintains the vertical and horizontal dimensions of the ridge. The aim of this study was to evaluate the microarchitecture of the grafted area by histological analysis and micro-computed tomography. Patients in the test group (group 1; nine patients) underwent socket preservation, while the sockets in the control group (group 2; eight patients) were allowed to heal without preservation. After a 6-month healing period, bone core biopsy samples were obtained and implants were placed in the augmented sites in the test group (12 biopsy samples) and the non-augmented sockets of the control group (12 biopsy samples). Analysis of the biopsy samples obtained from group 1 revealed that particles of the graft were surrounded by newly formed bone in eight cases and by granulation tissue in four cases. Micromorphometric data showed statistically significant differences in several parameters between the microarchitecture of the native bone and the newly formed bone within the augmented sites, which suggests that the xenograft particles interfere with the bony healing of the alveoli.
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Affiliation(s)
- M Kivovics
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary.
| | - B T Szabó
- Department of Oral Diagnostics, Semmelweis University, Budapest, Hungary
| | - O Németh
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
| | - N Tari
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - F Dőri
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - P Nagy
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - C Dobó-Nagy
- Department of Oral Diagnostics, Semmelweis University, Budapest, Hungary
| | - G Szabó
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Budapest, Hungary
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Tatara AM, Shah SR, Demian N, Ho T, Shum J, van den Beucken JJJP, Jansen JA, Wong ME, Mikos AG. Reconstruction of large mandibular defects using autologous tissues generated from in vivo bioreactors. Acta Biomater 2016; 45:72-84. [PMID: 27633319 DOI: 10.1016/j.actbio.2016.09.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/05/2016] [Accepted: 09/10/2016] [Indexed: 01/20/2023]
Abstract
Reconstruction of large mandibular defects is clinically challenging due to the need for donor tissue of appropriate shape and volume to facilitate high fidelity repair. In order to generate large vascularized tissues of custom geometry, bioreactors were implanted against the rib periosteum of 3-4year-old sheep for nine weeks. Bioreactors were filled with either morcellized autologous bone, synthetic ceramic particles, or a combination thereof. Tissues generated within synthetic graft-filled bioreactors were transferred into a large right-sided mandibular angle defect as either avascular grafts (n=3) or vascularized free flaps (n=3). After twelve additional weeks, reconstructed mandibular angles were harvested and compared to contralateral control angles. Per histologic and radiologic evaluation, a greater amount of mineralized tissue was generated in bioreactors filled with autologous graft although the quality of viable bone was not significantly different between groups. Genetic analyses of soft tissue surrounding bioreactor-generated tissues demonstrated similar early and late stage osteogenic biomarker expression (Runx2 and Osteocalcin) between the bioreactors and rib periosteum. Although no significant differences between the height of reconstructed and control mandibular angles were observed, the reconstructed mandibles had decreased bone volume. There were no differences between mandibles reconstructed with bioreactor-generated tissues transferred as flaps or grafts. Tissues used for mandibular reconstruction demonstrated integration with native bone as well as evidence of remodeling. In this study, we have demonstrated that synthetic scaffolds are sufficient to generate large volumes of mineralized tissue in an in vivo bioreactor for mandibular reconstruction. STATEMENT OF SIGNIFICANCE A significant clinical challenge in craniofacial surgery is the reconstruction of large mandibular defects. In this work, we demonstrated that vascularized tissues of large volume and custom geometry can be generated from in vivo bioreactors implanted against the rib periosteum in an ovine model. The effects of different bioreactor scaffold material on tissue ingrowth were measured. To minimize donor site morbidity, tissues generated from bioreactors filled with synthetic graft were transferred as either vascularized free flaps or avascular grafts to a large mandibular defect. It was demonstrated that synthetic graft in an in vivo bioreactor is sufficient to produce free tissue bone flaps capable of integrating with native tissues when transferred to a large mandibular defect in an ovine model.
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Affiliation(s)
- Alexander M Tatara
- Department of Bioengineering, Rice University, 6500 Main Street, Houston, TX 77030, United States; Medical Scientist Training Program, Baylor College of Medicine, 1 Baylor, Houston, TX 77030, United States
| | - Sarita R Shah
- Department of Bioengineering, Rice University, 6500 Main Street, Houston, TX 77030, United States; Medical Scientist Training Program, Baylor College of Medicine, 1 Baylor, Houston, TX 77030, United States
| | - Nagi Demian
- Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at Houston, 7500 Cambridge Street, Houston, TX 77054, United States
| | - Tang Ho
- Department of Otorhinolaryngology, University of Texas Health Science Center at Houston, 6411 Fannin Street, Houston, TX 77030, United States
| | - Jonathan Shum
- Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at Houston, 7500 Cambridge Street, Houston, TX 77054, United States
| | - Jeroen J J P van den Beucken
- Department of Biomaterials, Radboud University Medical Center, Philips v Leijdenln 25, 6525 EX Nijmegen, The Netherlands
| | - John A Jansen
- Department of Biomaterials, Radboud University Medical Center, Philips v Leijdenln 25, 6525 EX Nijmegen, The Netherlands
| | - Mark E Wong
- Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at Houston, 7500 Cambridge Street, Houston, TX 77054, United States
| | - Antonios G Mikos
- Department of Bioengineering, Rice University, 6500 Main Street, Houston, TX 77030, United States.
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Bone integration behavior of hydroxyapatite/β-tricalcium phosphate graft implanted in dental alveoli: a histomorphometric and scanning electron microscopy study. IMPLANT DENT 2016; 23:710-5. [PMID: 25343320 DOI: 10.1097/id.0000000000000172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated the bone integration ability of a biphasic calcium phosphate bioceramic implanted in dental alveolus of rats. MATERIALS AND METHODS A total of 21 male rats were submitted to upper right incisor extraction and implanted with a synthetic bioceramic (Straumann Bone Ceramic). The animals were killed on 7th, 21st, and 42nd day after surgery for light and scanning electron microscopy (SEM) analysis of bone, bioceramic, and soft tissue volume as well as the quality of graft in its interface. RESULTS Light histology results showed no persistent inflammatory and foreign body reactions, a newly formed bone adhered on the ceramic surface without interposition of soft tissue, which was confirmed by SEM analysis. Histometrically, reduction/resorption, between 7 and 42 days, in the percentage of bioceramic implanted (α = 1%) left gaps for a gradual increase in vital bone formation (α = 1%) around the particles. CONCLUSIONS The bioceramic in question is biocompatible, has good bone integration, being gradually resorbed and replaced by it, featuring a viable bone substitute for grafting procedures.
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Hoornaert A, d'Arros C, Heymann MF, Layrolle P. Biocompatibility, resorption and biofunctionality of a new synthetic biodegradable membrane for guided bone regeneration. ACTA ACUST UNITED AC 2016; 11:045012. [PMID: 27509180 DOI: 10.1088/1748-6041/11/4/045012] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Membranes for guided bone regeneration (GBR) were prepared from the synthetic biodegradable polymer poly-D,L-lactic/glycolic acid (PLGA). This GBR membrane has a bi-layered structure with a dense film to prevent gingival fibroblast ingrowth and ensure mechanical function, and a micro-fibrous layer to support colonization by osteogenic cells and promote bone regeneration. Hydrolysis and biodegradation were both studied in vitro through soaking in phosphate buffered saline (PBS) and in vivo by implantation in the subcutis of rats for 4, 8, 16, 26, 48 and 52 weeks. Histology revealed an excellent colonization of the micro-fibrous layer by cells with a minimal inflammatory reaction during resorption. GBR using the synthetic PLGA membrane was evaluated on critical-size calvaria defects in rats for 4 and 8 weeks. Radiographs, micro-computed tomography and histology showed bone regeneration with the PLGA membrane, while the defects covered with a collagen membrane showed a limited amount of mineralized bone, similar to that of the defect left empty. The biofunctionality of the PLGA membranes was also compared to collagen membranes in mandible defects in rabbits, associated or not with beta-tricalcium phosphate granules. This study revealed that the bi-layered synthetic membrane made of PLGA was safer, more biocompatible, and had a greater controlled resorption rate and bone regeneration capacity than collagen membranes. This new PLGA membrane could be used in pre-implantology and peri-odontology surgery.
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Xu M, Zhai D, Xia L, Li H, Chen S, Fang B, Chang J, Wu C. Hierarchical bioceramic scaffolds with 3D-plotted macropores and mussel-inspired surface nanolayers for stimulating osteogenesis. NANOSCALE 2016; 8:13790-13803. [PMID: 27380634 DOI: 10.1039/c6nr01952h] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The hierarchical structure of biomaterials plays an important role in the process of tissue reconstruction and regeneration. 3D-plotted scaffolds have been widely used for bone tissue engineering due to their controlled macropore structure and mechanical properties. However, the lack of micro- or nano-structures on the strut surface of 3D-plotted scaffolds, especially for bioceramic scaffolds, limits their biological activity. Inspired by the adhesive versatility of mussels and the active ion-chelating capacity of polydopamine, we set out to prepare a hierarchical bioceramic scaffold with controlled macropores and mussel-inspired surface nanolayers by combining the 3D-plotting technique with the polydopamine/apatite hybrid strategy in order to synergistically accelerate the osteogenesis and angiogenesis. β-Tricalcium phosphate (TCP) scaffolds were firstly 3D-plotted and then treated in dopamine-Tris/HCl and dopamine-SBF solutions to obtain TCP-DOPA-Tris and TCP-DOPA-SBF scaffolds, respectively. It was found that polydopamine/apatite hybrid nanolayers were formed on the surface of both TCP-DOPA-Tris and TCP-DOPA-SBF scaffolds and TCP-DOPA-SBF scaffolds induced apatite mineralization for the second time during the cell culture. As compared to TCP scaffolds, both TCP-DOPA-Tris and TCP-DOPA-SBF scaffolds significantly promoted the osteogenesis of bone marrow stromal cells (BMSCs) as well as the angiogenesis of human umbilical vein endothelial cells (HUVECs), and the TCP-DOPA-SBF group presented the highest in vitro osteogenic/angiogenic activity among the three groups. Furthermore, both TCP-DOPA-Tris and TCP-DOPA-SBF scaffolds significantly improved the formation of new bone in vivo as compared to TCP scaffolds without a nanostructured surface. Our results suggest that the utilization of a mussel-inspired Ca, P-chelated polydopamine nanolayer on 3D-plotted bioceramic scaffolds is a viable and effective strategy to construct a hierarchical structure for synergistically accelerating osteogenesis.
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Affiliation(s)
- Mengchi Xu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, People's Republic of China.
| | - Dong Zhai
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, People's Republic of China.
| | - Lunguo Xia
- Center of Craniofacial Orthodontics, Department of Oral and Cranio-maxillofacial Science, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, China
| | - Hong Li
- Department of Sports Medicine, Huashan Hospital, 12 Wulumuqi Zhong Road, Shanghai 200040, People's Republic of China
| | - Shiyi Chen
- Department of Sports Medicine, Huashan Hospital, 12 Wulumuqi Zhong Road, Shanghai 200040, People's Republic of China
| | - Bing Fang
- Center of Craniofacial Orthodontics, Department of Oral and Cranio-maxillofacial Science, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, China
| | - Jiang Chang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, People's Republic of China.
| | - Chengtie Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, People's Republic of China.
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Abstract
A high number of patients have one or more missing tooth and it is estimated that one in four American subjects over the age of 74 have lost all their natural teeth. Many options exist to replace missing teeth but dental implants have become one of the most used biomaterial to replace one (or more) missing tooth over the last decades. Contemporary dental implants made with titanium have been proven safe and effective in large series of patients. This review considers the main historical facts concerned with dental implants and present the different critical factors that will ensure a good osseo-integration that will ensure a stable prosthesis anchorage.
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30
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Li D, Deng L, Yang Z, Xie X, Kang P, Tan Z. Antigen-free bovine cancellous bone loaded with recombinant human bone morphogenetic protein-2 for the repair of tibial bone defects in goat model. J Biomater Appl 2016; 30:1322-33. [PMID: 26801475 DOI: 10.1177/0885328215627796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Antigen-free bovine cancellous bone has good performances of porous network structures and mechanics with antigen extracted. To develop a bioactive scaffold for enhancing bone repair and evaluate its biological property, rhBMP-2 loaded with antigen-free bovine cancellous bone was used to treat tibial bone defect. Twenty-four healthy adult goats were chosen to establish goat defects model and randomly divided into four groups. The goats were treated with rhBMP-2/antigen-free bovine cancellous bone scaffolds (group A), autogenous cancellous bone graft (group B), porous tricalciumphosphate scaffolds (group C) and nothing (group D). Animals were evaluated with radiological and histological methods at 4, 8 and 12 weeks after surgery. The gray value of radiographs was used to evaluate the healing of the defects, which revealed that the group A had a better outcome of defect healing compared with group C at 4, 8 and 12 weeks, respectively (p < 0.05), while the difference between groups A and B was without significance at each time (p > 0.05). The newly formed bone area was calculated from histological sections, and the results indicated that the amount of new bone in group A increased significantly compared with that in group C (p < 0.05) but was similar to that in group B (p > 0.05) at 4, 8 and 12 weeks, respectively. In addition, the expression of collagen I and vascular endothelial growth factor by real-time polymerase chain reaction at 12 weeks in group A was significantly higher than that in group C (p = 0.034, p = 0.032, respectively), but no significant differences were found when compared with that in group B (p = 0.36, p = 0.54, respectively). At the same time, group C presented better results than group D on bone defects healing. Therefore, the composites of antigen-free bovine cancellous bone loaded with rhBMP-2 have a good osteoinductive activity and capacity to promote the repair of bone defects.
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Affiliation(s)
- Donghai Li
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Liqing Deng
- Department of Orthopaedics of Cheng Ban hospital, the Branch of West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Zhouyuan Yang
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xiaowei Xie
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Pengde Kang
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Zhen Tan
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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Abstract
Sinus augmentation is a routine surgical procedure in dentistry. At present, various animal models are available for the research purpose on this topic. In particular, for the first time, we have performed a morphological study on sheep sinus, using cone beam computed tomography (CBCT), to precisely define the anatomy of the ovine sinus. Then, we compared the sheep and human sinus morphological parameters, in order to uniform the research approach to the sinus augmentation procedures and to standardize this experimental model. Six fresh heads of adult female sheep were studied with CBCT and histologic examination to determine the dimensions and the organization of the ovine maxillary sinus. The comparison of the dimensional values between man and sheep shows evident differences between the two species; CBCT offers detailed information for studying normal maxillary sinus. Human and sheep maxillary sinus show anatomical differences that must be taken into account in experimental procedures.
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Zhang Y, Xia L, Zhai D, Shi M, Luo Y, Feng C, Fang B, Yin J, Chang J, Wu C. Mesoporous bioactive glass nanolayer-functionalized 3D-printed scaffolds for accelerating osteogenesis and angiogenesis. NANOSCALE 2015; 7:19207-19221. [PMID: 26525451 DOI: 10.1039/c5nr05421d] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The hierarchical microstructure, surface and interface of biomaterials are important factors influencing their bioactivity. Porous bioceramic scaffolds have been widely used for bone tissue engineering by optimizing their chemical composition and large-pore structure. However, the surface and interface of struts in bioceramic scaffolds are often ignored. The aim of this study is to incorporate hierarchical pores and bioactive components into the bioceramic scaffolds by constructing nanopores and bioactive elements on the struts of scaffolds and further improve their bone-forming activity. Mesoporous bioactive glass (MBG) modified β-tricalcium phosphate (MBG-β-TCP) scaffolds with a hierarchical pore structure and a functional strut surface (∼100 nm of MBG nanolayer) were successfully prepared via 3D printing and spin coating. The compressive strength and apatite-mineralization ability of MBG-β-TCP scaffolds were significantly enhanced as compared to β-TCP scaffolds without the MBG nanolayer. The attachment, viability, alkaline phosphatase (ALP) activity, osteogenic gene expression (Runx2, BMP2, OPN and Col I) and protein expression (OPN, Col I, VEGF, HIF-1α) of rabbit bone marrow stromal cells (rBMSCs) as well as the attachment, viability and angiogenic gene expression (VEGF and HIF-1α) of human umbilical vein endothelial cells (HUVECs) in MBG-β-TCP scaffolds were significantly upregulated compared with conventional bioactive glass (BG)-modified β-TCP (BG-β-TCP) and pure β-TCP scaffolds. Furthermore, MBG-β-TCP scaffolds significantly enhanced the formation of new bone in vivo as compared to BG-β-TCP and β-TCP scaffolds. The results suggest that application of the MBG nanolayer to modify 3D-printed bioceramic scaffolds offers a new strategy to construct hierarchically porous scaffolds with significantly improved physicochemical and biological properties, such as mechanical properties, osteogenesis, angiogenesis and protein expression for bone tissue engineering applications, in which the incorporation of nanostructures and bioactive components into the scaffold struts synergistically play a key role in the improved bone formation.
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Affiliation(s)
- Yali Zhang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, People's Republic of China.
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Gorla LFDO, Spin-Neto R, Boos FBDJ, Pereira RDS, Garcia-Junior IR, Hochuli-Vieira E. Use of autogenous bone and beta-tricalcium phosphate in maxillary sinus lifting: a prospective, randomized, volumetric computed tomography study. Int J Oral Maxillofac Surg 2015; 44:1486-91. [PMID: 26232120 DOI: 10.1016/j.ijom.2015.07.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 03/21/2015] [Accepted: 07/09/2015] [Indexed: 11/16/2022]
Abstract
The correction of bone defects can be performed using autogenous or alloplastic materials, such as beta-tricalcium phosphate (β-TCP). This study compared the changes in bone volume (CBV) after maxillary sinus lifting using autogenous bone (n = 12), autogenous bone associated with β-TCP 1:1 (ChronOS; DePuy Synthes, Paoli, CA, USA) (n = 9), and β-TCP alone (n = 11) as grafting material, by means of cone beam computed tomography (CBCT). CBV was evaluated by comparing CBCT scans obtained in the immediate postoperative period (5-7 days) and at 6 months postoperative in each group using OsiriX software (OsiriX Foundation, Geneva, Switzerland). The results showed an average resorption of 45.7 ± 18.6% for the autogenous bone group, 43.8 ± 18.4% for the autogenous bone+β-TCP group, and 38.3 ± 16.6% for the β-TCP group. All bone substitute materials tested in this study presented satisfactory results for maxillary sinus lifting procedures regarding the maintenance of graft volume during the healing phase before the insertion of implants, as assessed by means of CBCT.
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Affiliation(s)
- L F de O Gorla
- Department of Oral and Maxillofacial Surgery, Dental School at Araraquara, UNESP, Araraquara, São Paulo, Brazil
| | - R Spin-Neto
- Department of Oral Radiology, School of Dentistry, Aarhus University, Aarhus, Denmark
| | - F B D J Boos
- Department of Oral and Maxillofacial Surgery, Dental School at Araçatuba, UNESP, Araçatuba, São Paulo, Brazil
| | - R dos S Pereira
- Department of Oral and Maxillofacial Surgery, Dental School at Araçatuba, UNESP, Araçatuba, São Paulo, Brazil
| | - I R Garcia-Junior
- Department of Oral and Maxillofacial Surgery, Dental School at Araçatuba, UNESP, Araçatuba, São Paulo, Brazil
| | - E Hochuli-Vieira
- Department of Oral and Maxillofacial Surgery, Dental School at Araraquara, UNESP, Araraquara, São Paulo, Brazil.
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Chen Z, Yuen J, Crawford R, Chang J, Wu C, Xiao Y. The effect of osteoimmunomodulation on the osteogenic effects of cobalt incorporated β-tricalcium phosphate. Biomaterials 2015; 61:126-38. [PMID: 26001077 DOI: 10.1016/j.biomaterials.2015.04.044] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 04/30/2015] [Indexed: 12/26/2022]
Abstract
Osteoblast lineage cells are direct effectors of osteogenesis and are, therefore, commonly used to evaluate the in vitro osteogenic capacity of bone substitute materials. This method has served its purposes when testing novel bone biomaterials; however, inconsistent results between in vitro and in vivo studies suggest the mechanisms that govern a material's capacity to mediate osteogenesis are not well understood. The emerging field of osteoimmunology and immunomodulation has informed a paradigm shift in our view of bone biomaterials-from one of an inert to an osteoimmunomodulatory material-highlighting the importance of immune cells in materials-mediated osteogenesis. Neglecting the importance of the immune response during this process is a major shortcoming of the current evaluation protocol. In this study we evaluated a potential angiogenic bone substitute material cobalt incorporated with β-tricalcium phosphate (CCP), comparing the traditional "one cell type" approach with a "multiple cell types" approach to assess osteogenesis, the latter including the use of immune cells. We found that CCP extract by itself was sufficient to enhance osteogenic differentiation of bone marrow stem cells (BMSCs), whereas this effect was cancelled out when macrophages were involved. In response to CCP, the macrophage phenotype switched to the M1 extreme, releasing pro-inflammatory cytokines and bone catabolic factors. When the CCP materials were implanted into a rat femur condyle defect model, there was a significant increase of inflammatory markers and bone destruction, coupled with fibrous encapsulation rather than new bone formation. These findings demonstrated that the inclusion of immune cells (macrophages) in the in vitro assessment matched the in vivo tissue response, and that this method provides a more accurate indication of the essential role of immune cells when assessing materials-stimulated osteogenesis in vitro.
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Affiliation(s)
- Zetao Chen
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia; Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Jones Yuen
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Ross Crawford
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Jiang Chang
- Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia; State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Dingxi Road, Shanghai 200050, People's Republic of China
| | - Chengtie Wu
- Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia; State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Dingxi Road, Shanghai 200050, People's Republic of China.
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia; Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia.
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Terranova L, Libouban H, Mallet R, Chappard D. Analysis of β-tricalcium phosphate granules prepared with different formulations by nano-computed tomography and scanning electron microscopy. J Artif Organs 2015; 18:338-45. [DOI: 10.1007/s10047-015-0838-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/15/2015] [Indexed: 12/17/2022]
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Ndiaye M, Terranova L, Mallet R, Mabilleau G, Chappard D. Three-dimensional arrangement of β-tricalcium phosphate granules evaluated by microcomputed tomography and fractal analysis. Acta Biomater 2015; 11:404-11. [PMID: 25242650 DOI: 10.1016/j.actbio.2014.09.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 08/26/2014] [Accepted: 09/11/2014] [Indexed: 02/01/2023]
Abstract
The macrophysical properties of granular biomaterials used to fill bone defects have rarely been considered. Granules of a given biomaterial occupy three-dimensional (3-D) space when packed together and create a macroporosity suitable for the invasion of vascular and bone cells. Granules of β-tricalcium phosphate were prepared using polyurethane foam technology and increasing the amount of material powder in the slurry (10, 11, 15, 18, 21 and 25 g). After sintering, granules of 1000-2000 μm were prepared by sieving. They were analyzed morphologically by scanning electron microscopy and placed in polyethylene test tubes to produce 3-D scaffolds. Microcomputed tomography (microCT) was used to image the scaffolds and to determine porosity and fractal dimension in three dimensions. Two-dimensional sections of the microCT models were binarized and used to compute classical morphometric parameters describing porosity (interconnectivity index, strut analysis and star volumes) and fractal dimensions. In addition, two newly important fractal parameters (lacunarity and succolarity) were measured. Compression analysis of the stacks of granules was done. Porosity decreased as the amount of material in the slurry increased but non-linear relationships were observed between microarchitectural parameters describing the pores and porosity. Lacunarity increased in the series of granules but succolarity (reflecting the penetration of a fluid) was maximal in the 15-18 g groups and decreased noticeably in the 25 g group. The 3-D arrangement of biomaterial granules studied by these new fractal techniques allows the optimal formulation to be derived based on the lowest amount of material, suitable mechanical resistance during crushing and the creation of large interconnected pores.
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Chappard D, Terranova L, Mallet R, Mercier P. 3D Porous Architecture of Stacks of β-TCP Granules Compared with That of Trabecular Bone: A microCT, Vector Analysis, and Compression Study. Front Endocrinol (Lausanne) 2015; 6:161. [PMID: 26528240 PMCID: PMC4600957 DOI: 10.3389/fendo.2015.00161] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 09/28/2015] [Indexed: 01/25/2023] Open
Abstract
The 3D arrangement of porous granular biomaterials usable to fill bone defects has received little study. Granular biomaterials occupy 3D space when packed together in a manner that creates a porosity suitable for the invasion of vascular and bone cells. Granules of beta-tricalcium phosphate (β-TCP) were prepared with either 12.5 or 25 g of β-TCP powder in the same volume of slurry. When the granules were placed in a test tube, this produced 3D stacks with a high (HP) or low porosity (LP), respectively. Stacks of granules mimic the filling of a bone defect by a surgeon. The aim of this study was to compare the porosity of stacks of β-TCP granules with that of cores of trabecular bone. Biomechanical compression tests were done on the granules stacks. Bone cylinders were prepared from calf tibia plateau, constituted high-density (HD) blocks. Low-density (LD) blocks were harvested from aged cadaver tibias. Microcomputed tomography was used on the β-TCP granule stacks and the trabecular bone cores to determine porosity and specific surface. A vector-projection algorithm was used to image porosity employing a frontal plane image, which was constructed line by line from all images of a microCT stack. Stacks of HP granules had porosity (75.3 ± 0.4%) and fractal lacunarity (0.043 ± 0.007) intermediate between that of HD (respectively 69.1 ± 6.4%, p < 0.05 and 0.087 ± 0.045, p < 0.05) and LD bones (respectively 88.8 ± 1.57% and 0.037 ± 0.014), but exhibited a higher surface density (5.56 ± 0.11 mm(2)/mm(3) vs. 2.06 ± 0.26 for LD, p < 0.05). LP granular arrangements created large pores coexisting with dense areas of material. Frontal plane analysis evidenced a more regular arrangement of β-TCP granules than bone trabecule. Stacks of HP granules represent a scaffold that resembles trabecular bone in its porous microarchitecture.
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Affiliation(s)
- Daniel Chappard
- GEROM Groupe Etudes Remodelage Osseux et bioMatériaux – LHEA, IRIS-IBS Institut de Biologie en Santé, CHU d’Angers, L’Université Nantes Angers Le Mans, Angers, France
- Service Commun d’Imagerie et Analyses Microscopiques (SCIAM), IRIS-IBS Institut de Biologie en Santé, CHU d’Angers, L’Université Nantes Angers Le Mans, Angers, France
- *Correspondence: Daniel Chappard,
| | - Lisa Terranova
- GEROM Groupe Etudes Remodelage Osseux et bioMatériaux – LHEA, IRIS-IBS Institut de Biologie en Santé, CHU d’Angers, L’Université Nantes Angers Le Mans, Angers, France
| | - Romain Mallet
- GEROM Groupe Etudes Remodelage Osseux et bioMatériaux – LHEA, IRIS-IBS Institut de Biologie en Santé, CHU d’Angers, L’Université Nantes Angers Le Mans, Angers, France
- Service Commun d’Imagerie et Analyses Microscopiques (SCIAM), IRIS-IBS Institut de Biologie en Santé, CHU d’Angers, L’Université Nantes Angers Le Mans, Angers, France
| | - Philippe Mercier
- GEROM Groupe Etudes Remodelage Osseux et bioMatériaux – LHEA, IRIS-IBS Institut de Biologie en Santé, CHU d’Angers, L’Université Nantes Angers Le Mans, Angers, France
- Laboratoire d’Anatomie, Faculté de Médecine, Angers, France
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Tissue reactions after simultaneous alveolar ridge augmentation with biphasic calcium phosphate and implant insertion--histological and immunohistochemical evaluation in humans. Clin Oral Investig 2014; 19:1595-603. [PMID: 25511386 DOI: 10.1007/s00784-014-1385-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 12/03/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Simultaneous lateral augmentation and implant placement is considered as standard procedure in deficient edentulous ridges in oral implantology. Histological studies monitoring osteogenesis after application of alloplastic bone substitutes in humans are scarce. Bone formation upon simultaneous augmentation with biphasic calcium phosphate (BCP) and implantation was histologically investigated after 6 months in situ. The results of this secondary analysis are reported tempting to ascribe specific observations to uneventful submerged healing or compromised healing of soft tissues including occurrence of dehiscences and premature graft exposure. MATERIALS AND METHODS Histology of biopsies from lateral, crestal bone augmentations using alloplastic BCP comprising seven sites with compromised, prematurely exposed healing and six sites with uneventful submerged healing was investigated for expression of osteogenic, osteoclastogenic, and angiogenic differentiation markers. RESULTS Histology revealed alkaline phosphatase (ALP)-positive osteoblasts and immunoreactivity for osteogenic markers osteocalcin and collagen type I in biopsies with submerged healing, while inflammatory infiltrates and accumulations of multinucleated giant cells around BCP granules were observed in compromised sites. All specimens presented adequate vessel density. Multinucleated giant cells showed inconsistent staining for the osteoclast marker tartrate-resistant acid phosphatase (TRAP). CONCLUSIONS The histological findings of this study indicate an osteoconductive nature of the BCP applied. Premature exposure of the bone substitute reduced new bone formation and may bear a risk for inflammatory and foreign body reactions. CLINICAL RELEVANCE A predictable appositional bone formation in simultaneously augmented sites using BCP is linked to an uneventful healing process.
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Chen Z, Mao X, Tan L, Friis T, Wu C, Crawford R, Xiao Y. Osteoimmunomodulatory properties of magnesium scaffolds coated with β-tricalcium phosphate. Biomaterials 2014; 35:8553-65. [PMID: 25017094 DOI: 10.1016/j.biomaterials.2014.06.038] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 06/19/2014] [Indexed: 01/14/2023]
Abstract
The osteoimmunomodulatory property of bone biomaterials is a vital property determining the in vivo fate of the implants. Endowing bone biomaterials with favorable osteoimmunomodulatory properties is of great importance in triggering desired immune response and thus supports the bone healing process. Magnesium (Mg) has been recognized as a revolutionary metal for applications in orthopedics due to it being biodegradable, biocompatible, and having osteoconductive properties. However, Mg's high rate of degradation leads to an excessive inflammatory response and this has restricted its application in bone tissue engineering. In this study, β-tricalcium phosphate (β-TCP) was used to coat Mg scaffolds in an effort to modulate the detrimental osteoimmunomodulatory properties of Mg scaffolds, due to the reported favorable osteoimmunomodulatory properties of β-TCP. It was noted that macrophages switched to the M2 extreme phenotype in response to the Mg-β-TCP scaffolds, which could be due to the inhibition of the toll like receptor (TLR) signaling pathway. VEGF and BMP2 were significantly upregulated in the macrophages exposed to Mg-β-TCP scaffolds, indicating pro-osteogenic properties of macrophages in β-TCP modified Mg scaffolds. This was further demonstrated by the macrophage-mediated osteogenic differentiation of bone marrow stromal cells (BMSCs). When BMSCs were stimulated by conditioned medium from macrophages cultured on Mg-β-TCP scaffolds, osteogenic differentiation of BMSCs was significantly enhanced; whereas osteoclastogenesis was inhibited, as indicated by the downregualtion of MCSF, TRAP and inhibition of the RANKL/RANK system. These findings suggest that β-TCP coating of Mg scaffolds can modulate the scaffold's osteoimmunomodulatory properties, shift the immune microenvironment towards one that favors osteogenesis over osteoclastogenesis. Endowing bone biomaterials with favorable osteoimmunomodulatory properties can be a highly valuable strategy for the development or modification of advanced bone biomaterials.
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Affiliation(s)
- Zetao Chen
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia; Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Xueli Mao
- Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia; Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56 Ling Yuan Road West, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, 74 Zhongshan Second RD, Guangzhou 510080, China.
| | - Lili Tan
- Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang 110016, China
| | - Thor Friis
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Chengtie Wu
- Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia; State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Dingxi Road, Shanghai 200050, China
| | - Ross Crawford
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia; Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia; Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia.
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Physicochemical characteristics of bone substitutes used in oral surgery in comparison to autogenous bone. BIOMED RESEARCH INTERNATIONAL 2014; 2014:320790. [PMID: 25143936 PMCID: PMC4119630 DOI: 10.1155/2014/320790] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 06/08/2014] [Indexed: 11/17/2022]
Abstract
Bone substitutes used in oral surgery include allografts, xenografts, and synthetic materials that are frequently used to compensate bone loss or to reinforce repaired bone, but little is currently known about their physicochemical characteristics. The aim of this study was to evaluate a number of physical and chemical properties in a variety of granulated mineral-based biomaterials used in dentistry and to compare them with those of autogenous bone. Autogenous bone and eight commercial biomaterials of human, bovine, and synthetic origins were studied by high-resolution X-ray diffraction, atomic absorption spectrometry, and laser diffraction to determine their chemical composition, calcium release concentration, crystallinity, and granulation size. The highest calcium release concentration was 24. 94 mg/g for Puros and the lowest one was 2.83 mg/g for Ingenios β-TCP compared to 20.15 mg/g for natural bone. The range of particles sizes, in terms of median size D50, varied between 1.32 μm for BioOss and 902.41 μm for OsteoSponge, compared to 282.1 μm for natural bone. All samples displayed a similar hexagonal shape as bone, except Ingenios β-TCP, Macrobone, and OsteoSponge, which showed rhomboid and triclinic shapes, respectively. Commercial bone substitutes significantly differ in terms of calcium concentration, particle size, and crystallinity, which may affect their in vivo performance.
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Clinical Performance of a Highly Porous Beta-TCP as the Grafting Material for Maxillary Sinus Augmentation. IMPLANT DENT 2014; 23:357-64. [DOI: 10.1097/id.0000000000000102] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mateescu M, Rguitti E, Ponche A, Descamps M, Anselme K. Biomimetic evaluation of β tricalcium phosphate prepared by hot isostatic pressing. BIOMATTER 2014; 2:103-13. [PMID: 23507861 PMCID: PMC3549863 DOI: 10.4161/biom.21377] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Two types of completely densified β-TCP tablets were synthesized from a stoichiometric β-TCP powder. The first ones (TCP) were conventionally sintered, while the second ones (TCP-T) were sintered and treated by hot isostatic process (HIP). The HIP produced completely densified materials with relative densities greater than 99.9% and a transparent appearance of tablets. Samples were immersed in culture medium with (CM) or without serum (NCM) in static and dynamic conditions for a biomimetic evaluation. Similarly, SaOs-2 cells were cultured on samples in a static or dynamic flow perfusion system. The results of surface transformation in absence of cells showed that the dynamic condition increased the speed of calcium phosphate precipitations compared with the static condition. The morphology of precipitates was different with nature of tablets. The immersion in CM did impede this precipitation. XPS analysis of TCP-T tablets showed the presence of hydroxyapatite (HA) precipitates after incubation in NCM while octacalcium phosphate (OCP) precipitates were formed after incubation in CM. The analysis of the response of SaOs-2 cells on surfaces showed that the two types of materials are biocompatible. However, the dynamic mode of culture stimulated the differentiation of cells. Finally, it appears that the HIP treatment of TCP produces highly densified and transparent samples that display a good in vitro biocompatibility in static and dynamic culture conditions. Moreover, an interesting result of this work is the relationship between the presence of proteins in the immersion medium and the quality of precipitates formed on hipped TCP surface.
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Affiliation(s)
- Mihaela Mateescu
- Institut de Science des Matériaux de Mulhouse (IS2M), CNRS LRC7228, Mulhouse, France.
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Aguado E, Pascaretti-Grizon F, Gaudin-Audrain C, Goyenvalle E, Chappard D. β-TCP granules mixed with reticulated hyaluronic acid induce an increase in bone apposition. Biomed Mater 2013; 9:015001. [PMID: 24343316 DOI: 10.1088/1748-6041/9/1/015001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
β beta-tricalcium phosphate (β-TCP) granules are suitable for repair of bone defects. They have an osteoconductive effect shortly after implantation. However, dry granules are difficult to handle in the surgical room because of low weight and lack of cohesion. Incorporation of granules in a hydrogel could be a satisfactory solution. We have investigated the use of hyaluronic acid (HyA) as an aqueous binder of the granules. β-TCP granules were prepared by the polyurethane foam technology. Commercially available linear (LHya) and reticulated hyaluronic acid (RHyA) in aqueous solution were used to prepare a pasty mixture that can be handled more easily than granules alone. Thirteen New Zealand White rabbits (3.5-3.75 kg) were used; a 4 mm hole was drilled in each femoral condyle. After flushing, holes were filled with either LHyA, RHyA, dry β-TCP granules alone, β-TCP granules + LHyA and β-TCP granules + RHyA. Rabbits were allowed to heal for one month, sacrificed and femurs were harvested and analysed by microCT and histomorphometry. The net amount of newly formed bone was derived from measurements done after thresholding the microCT images for the material and for the material+bone. LHyA and RHyA did not result in healing of the grafted area. LHyA was rapidly eluted from the grafted zone but allowed deposition of more granules, although the amount of formed bone was not significantly higher than with β-TCP granules alone. RHyA permitted the deposition of more granules which induced significantly more bone trabeculae without inducing an inflammatory reaction. RHyA appears to be a good vehicle to implant granules of β-TCP, since HyA does not interfere with bone remodeling.
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Affiliation(s)
- Eric Aguado
- ONIRIS, Ecole Vétérinaire de Nantes, F-44307 Nantes Cedex 3, France. LUNAM Université, GEROM-LHEA 'Bone Remodeling and bioMaterials', IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, F-49933 ANGERS Cedex, France
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Chen Z, Wu C, Gu W, Klein T, Crawford R, Xiao Y. Osteogenic differentiation of bone marrow MSCs by β-tricalcium phosphate stimulating macrophages via BMP2 signalling pathway. Biomaterials 2013; 35:1507-18. [PMID: 24268199 DOI: 10.1016/j.biomaterials.2013.11.014] [Citation(s) in RCA: 209] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 11/03/2013] [Indexed: 02/02/2023]
Abstract
Immune reactions play important roles in determining the in vivo fate of bone substitute materials, either in new bone formation or inflammatory fibrous tissue encapsulation. The paradigm for the development of bone substitute materials has been shifted from inert to immunomodulatory materials, emphasizing the importance of immune cells in the material evaluation. Macrophages, the major effector cells in the immune reaction to implants, are indispensable for osteogenesis and their heterogeneity and plasticity render macrophages a primer target for immune system modulation. However, there are very few reports about the effects of macrophages on biomaterial-regulated osteogenesis. In this study, we used β-tricalcium phosphate (β-TCP) as a model biomaterial to investigate the role of macrophages on the material stimulated osteogenesis. The macrophage phenotype switched to M2 extreme in response to β-TCP extracts, which was related to the activation of calcium-sensing receptor (CaSR) pathway. Bone morphogenetic protein 2 (BMP2) was also significantly upregulated by the β-TCP stimulation, indicating that macrophage may participate in the β-TCP stimulated osteogenesis. Interestingly, when macrophage-conditioned β-TCP extracts were applied to bone marrow mesenchymal stem cells (BMSCs), the osteogenic differentiation of BMSCs was significantly enhanced, indicating the important role of macrophages in biomaterial-induced osteogenesis. These findings provided valuable insights into the mechanism of material-stimulated osteogenesis, and a strategy to optimize the evaluation system for the in vitro osteogenesis capacity of bone substitute materials.
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Affiliation(s)
- Zetao Chen
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Chengtie Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Dingxi Road, Shanghai 200050, People's Republic of China.
| | - Wenyi Gu
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia; Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Corner College and Cooper Rds, Brisbane, Queensland 4072, Australia
| | - Travis Klein
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Ross Crawford
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland 4059, Australia.
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de Lange GL, Overman JR, Farré-Guasch E, Korstjens CM, Hartman B, Langenbach GEJ, Van Duin MA, Klein-Nulend J. A histomorphometric and micro-computed tomography study of bone regeneration in the maxillary sinus comparing biphasic calcium phosphate and deproteinized cancellous bovine bone in a human split-mouth model. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 117:8-22. [PMID: 24182597 DOI: 10.1016/j.oooo.2013.08.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/01/2013] [Accepted: 08/09/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The gain of mineralized bone was compared between deproteinized bovine bone allograft (DBA) and biphasic calcium phosphate (BCP) for dental implant placement. STUDY DESIGN Five patients with atrophic maxillae underwent bilateral sinus elevation with DBA (Bio-Oss) and BCP (Straumann BoneCeramic). After 3 to 8 months, 32 Camlog implants were placed, and biopsies were retrieved. Bone and graft volume, degree of bone mineralization, and graft degradation gradient were determined using micro-computed tomography, and bone formation and resorption parameters were measured using histomorphometry. Implant functioning and peri-implant mucosa were evaluated up to 4 years. RESULTS Patients were prosthetically successfully restored. All but one of the implants survived, and peri-implant mucosa showed healthy appearance and stability. Bone volume, graft volume, degree of bone mineralization, and osteoclast and osteocyte numbers were similar, but BCP-grafted biopsies had relatively more osteoid than DBA-grafted biopsies. CONCLUSIONS The BCP and DBA materials showed similar osteoconductive patterns and mineralized bone, although signs of more active bone formation and remodeling were observed in BCP- than in DBA-grafted biopsies.
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Affiliation(s)
- Gert L de Lange
- Academic Center Oral Implantology Amstelveen, Amstelveen, The Netherlands
| | - Janice R Overman
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Amsterdam, The Netherlands; MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Elisabet Farré-Guasch
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Amsterdam, The Netherlands; MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Clara M Korstjens
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Amsterdam, The Netherlands; MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Bastiaan Hartman
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Amsterdam, The Netherlands; MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Geerling E J Langenbach
- Department of Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Amsterdam, The Netherlands; MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Marion A Van Duin
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Amsterdam, The Netherlands; MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Jenneke Klein-Nulend
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, and VU University Amsterdam, Amsterdam, The Netherlands; MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
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46
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Chen Z, Wu C, Yuen J, Klein T, Crawford R, Xiao Y. Influence of osteocytes in thein vitroandin vivoβ-tricalcium phosphate-stimulated osteogenesis. J Biomed Mater Res A 2013; 102:2813-23. [DOI: 10.1002/jbm.a.34954] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 09/05/2013] [Accepted: 09/06/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Zetao Chen
- Institute of Health and Biomedical Innovation, Queensland University of Technology; Brisbane, Brisbane Queensland 4059 Australia
| | - Chengtie Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure; Shanghai Institute of Ceramics, Chinese Academy of Sciences; Shanghai 200050 People's Republic of China
| | - Jones Yuen
- Institute of Health and Biomedical Innovation, Queensland University of Technology; Brisbane, Brisbane Queensland 4059 Australia
| | - Travis Klein
- Institute of Health and Biomedical Innovation, Queensland University of Technology; Brisbane, Brisbane Queensland 4059 Australia
| | - Ross Crawford
- Institute of Health and Biomedical Innovation, Queensland University of Technology; Brisbane, Brisbane Queensland 4059 Australia
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Queensland University of Technology; Brisbane, Brisbane Queensland 4059 Australia
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Soardi CM, Clozza E, Turco G, Biasotto M, Engebretson SP, Wang HL, Zaffe D. Microradiography and microcomputed tomography comparative analysis in human bone cores harvested after maxillary sinus augmentation: a pilot study. Clin Oral Implants Res 2013; 25:1161-8. [PMID: 23796003 DOI: 10.1111/clr.12225] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to compare microradiography (MR) and microcomputed tomography (μCT) analysis of bone samples following maxillary sinus augmentation at different time periods and determine the relationships between measured area and volume fractions. MATERIALS AND METHODS Lateral window sinus grafts were performed on 10 patients using a mineralized human bone allograft (MHBA). At implant placement, 5-13 months after surgery, 10 bone core biopsies were harvested. Prior to histologic sectioning, bone samples were evaluated with μCT. The morphometric parameters computed by MR and μCT were compared using Pearson's correlation and Bland and Altman analysis and included hard tissue fraction (HV/TV:%), soft tissue fraction (SV/TV:%), vital bone fraction (BV/TV:%) and residual graft fraction (GV/TV:%). RESULTS Strong positive correlation between MR and μCT was found for HV/TV and SV/TV and BV/TV [r = 0.84, 0.84 and 0.69, respectively] but weak for GV/TV [r = 0.10]. CONCLUSION μCT technology shows promising potential as an indicator of bone morphology changes; however, caution should be used in interpreting morphometric parameters, as the different methods reveal important biases.
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48
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Giuliani A, Manescu A, Larsson E, Tromba G, Luongo G, Piattelli A, Mangano F, Iezzi G, Mangano C. In vivo regenerative properties of coralline-derived (biocoral) scaffold grafts in human maxillary defects: demonstrative and comparative study with Beta-tricalcium phosphate and biphasic calcium phosphate by synchrotron radiation x-ray microtomography. Clin Implant Dent Relat Res 2013; 16:736-50. [PMID: 23350548 DOI: 10.1111/cid.12039] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In recent years, there has been interest on the fabrication of systems using particulates or block-based approach for bone tissue engineering (TE) scaffolds, possessing porous interconnected structures. In fact, these particular morphologies greatly increase the surface area for more chemical and biological reactions to take place. PURPOSE This study was designed to demonstrate the unique capability of the synchrotron radiation x-ray microtomography (micro-CT) in offering an advanced characterization of coralline-derived (Biocoral) biomaterials placed in human maxillary defects as it allows, in a nondestructive way, a complete, precise, and high-resolution three-dimensional analysis of their microstructural parameters. Moreover, the comparison between Biocoral and other biomaterials was explored to understand the mechanism of their biological behavior as bone substitute. MATERIALS AND METHODS Implant survival, bone regeneration, graft resorption, neovascularization, and morphometric parameters (including anisotropy and connectivity index of the structures) were evaluated by micro-CT in Biocoral and the other biomaterials after 6 to 7 months from implantation in human maxillary bone defects. RESULTS After the in vivo tests, a huge amount of bone was detected in the retrieved Biocoral-based samples, coupled with a good rate of biomaterial resorption and the formation of a homogeneous and rich net of new vessels. The morphometric parameters were comparable to those obtained in the biphasic calcium phosphate-based control, with the exception of the connectivity index for which this control exhibited the most well-connected structure. This last result, together with those referred to the poor performances of the β-tricalcium phosphate block-based sample, suggests that the particular scaffold morphology may play a role in the hunt the optimal scaffold structure to be implanted. CONCLUSION In this limited study, implant success rate seems not strictly dependent on the biomaterial that is used, but on the scaffold morphology. Micro-CT technique was demonstrated to play a fundamental role in advanced characterization of bone TE constructs.
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Affiliation(s)
- Alessandra Giuliani
- Dip. di Scienze Cliniche Specialistiche e Odontostomatologiche - Sezione di Biochimica, Biologia e Fisica Applicata, Università Politecnica delle Marche, Ancona, Italy
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Marchand-Libouban H, Guillaume B, Bellaiche N, Chappard D. Texture analysis of computed tomographic images in osteoporotic patients with sinus lift bone graft reconstruction. Clin Oral Investig 2012; 17:1267-72. [PMID: 22886459 DOI: 10.1007/s00784-012-0808-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 07/19/2012] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Bone implants are now widely used to replace missing teeth. Bone grafting (sinus lift) is a very useful way to increase the bone volume of the maxilla in patients with bone atrophy. There is a 6- to 9-month delay for the receiver grafted site to heal before the implants can be placed. Computed tomography is a useful method to measure the amount of remaining bone before implantation and to evaluate the quality of the receiver bone at the end of the healing period. Texture analysis is a non-invasive method useful to characterize bone microarchitecture on X-ray images. PATIENTS AND METHODS Ten patients in which a sinus lift surgery was necessary before implantation were analyzed in the present study. All had a bone reconstruction with a combination of a biomaterial (beta tricalcium phosphate) and autograft bone harvested at the chin. Computed tomographic images were obtained before grafting (t0), at mid-interval (t1, 4.2 ± 0.7 months) and before implant placement (t2, 9.2 ± 0.6 months). Texture analysis was done with the run-length method. RESULTS A significant increase of texture parameters at t1 reflected a gain of homogeneity due to the graft and the beginning of bone remodeling. At t2, some parameters remained high and corresponded to the persistence of bone trabeculae while the resorption of biomaterials was identified by other parameters which tended to return to pregraft values. CONCLUSION Texture analysis identified changes during the healing of the receiver site. CLINICAL RELEVANCE The method is known to correlate with microarchitectural changes in bone and could be a useful approach to characterized osseointegrated grafts.
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Affiliation(s)
- Hélène Marchand-Libouban
- LUNAM Université, GEROM-LHEA Bone Remodeling and Biomaterials-IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers, Cedex, France
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Lou CW, Yao CH, Chen YS, Lu CT, Chen WC, Yen KC, Lin JH. PLA
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-TCP Complex Tubes: The Mechanical Properties and Applications of Artificial Bone. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2012; 23:1701-12. [DOI: 10.1163/092050611x597762] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Ching-Wen Lou
- a Institute of Biomedical Engineering and Material Science, Central Taiwan University of Science and Technology , Taichung , 40601 , Taiwan, ROC
| | - Chun-Hsu Yao
- b Department of Biomedical Imaging and Radiological Science , China Medical University , Taichung , 40402 , Taiwan, ROC
| | - Yueh-Sheng Chen
- b Department of Biomedical Imaging and Radiological Science , China Medical University , Taichung , 40402 , Taiwan, ROC
| | - Chao-Tsang Lu
- c Institute of Life Sciences, Central Taiwan University of Science and Technology , Taichung , 40601 , Taiwan, ROC
| | - Wen-Cheng Chen
- d Advanced Medical Devices and Composite Laboratory, Department of Fiber and Composite Materials , Feng Chia University , Taichung City , 407 , Taiwan, ROC
| | - Ke-Chung Yen
- e Laboratory of Fiber Application and Manufacturing, Department of Fiber and Composite and Materials , Feng Chia University , Taichung , 40724 , Taiwan, ROC
| | - Jia-Horng Lin
- e Laboratory of Fiber Application and Manufacturing, Department of Fiber and Composite and Materials , Feng Chia University , Taichung , 40724 , Taiwan, ROC
- f School of Chinese Medicine, China Medical University , Taichung , 40402 , Taiwan, ROC
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