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Romanowicz GE, Zhang L, Bolger MW, Lynch M, Kohn DH. Beyond Bone Volume: Understanding Tissue-Level Quality in Healing of Maxillary vs. Femoral Defects. Acta Biomater 2024:S1742-7061(24)00486-0. [PMID: 39214162 DOI: 10.1016/j.actbio.2024.08.042] [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: 04/04/2024] [Revised: 08/13/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
Currently, principles of tissue engineering and implantology are uniformly applied to all bone sites, disregarding inherent differences in collagen, mineral composition, and healing rates between craniofacial and long bones. These differences could potentially influence bone quality during the healing process. Evaluating bone quality during healing is crucial for understanding local mechanical properties in regeneration and implant osseointegration. However, site-specific changes in bone quality during healing remain poorly understood. In this study, we assessed newly formed bone quality in sub-critical defects in the maxilla and femur, while impairing collagen cross-linking using β-aminopropionitrile (BAPN). Our findings revealed that femoral healing bone exhibited a 73% increase in bone volume but showed significantly greater viscoelastic and collagen changes compared to surrounding bone, leading to increased deformation during long-term loading and poorer bone quality in early healing. In contrast, the healing maxilla maintained equivalent hardness and viscoelastic constants compared to surrounding bone, with minimal new bone formation and consistent bone quality. However, BAPN-impaired collagen cross-linking induced viscoelastic changes in the healing maxilla, with no further changes observed in the femur. These results challenge the conventional belief that increased bone volume correlates with enhanced tissue-level bone quality, providing crucial insights for tissue engineering and site-specific implant strategies. The observed differences in bone quality between sites underscore the need for a nuanced approach in assessing the success of regeneration and implant designs and emphasize the importance of exploring site-specific tissue engineering interventions. STATEMENT OF SIGNIFICANCE: Accurate measurement of bone quality is crucial for tissue engineering and implant therapies. Bone quality varies between craniofacial and long bones, yet it's often overlooked in the healing process. Our study is the first to comprehensively analyze bone quality during healing in both the maxilla and femur. Surprisingly, despite significant volume increase, femur healing bone had poorer quality compared to the surrounding bone. Conversely, maxilla healing bone maintained consistent quality despite minimal bone formation. Impaired collagen diminished maxillary healing bone quality, but had no further effect on femur bone quality. These findings challenge the notion that more bone volume equals better quality, offering insights for improving tissue engineering and implant strategies for different bone sites.
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Affiliation(s)
- Genevieve E Romanowicz
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, MI, USA
| | - Lizhong Zhang
- Department of Biomedical Engineering, College of Engineering, University of Michigan, MI, USA
| | - Morgan W Bolger
- Department of Biomedical Engineering, College of Engineering, University of Michigan, MI, USA
| | - Michelle Lynch
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, MI, USA
| | - David H Kohn
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, MI, USA; Department of Biomedical Engineering, College of Engineering, University of Michigan, MI, USA.
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Kunrath MF, Giraldo-Osorno PM, Mendes K, Gomes ATPC, Rosa N, Barros M, Dahlin C. Unveiling the consequences of early human saliva contamination on membranes for guided bone regeneration. J Periodontal Res 2024. [PMID: 38644743 DOI: 10.1111/jre.13266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/23/2024]
Abstract
AIMS GBR membranes have various surface properties designed to elicit positive responses in regenerative clinical procedures; dental clinicians attempt to employ techniques to prevent the direct interaction of contaminated oral fluids with these biomaterials. However, saliva is uninterruptedly exhibited in oral surgical procedures applying GBR membranes, suggesting a persistent interaction with biomaterials and the surrounding oral tissues. This fundamental study aimed to investigate potential alterations in the physical, chemical, and key biological properties of membranes for guided bone regeneration (GBR) caused by isolated early interaction with human saliva. METHODS A reproducible step-by-step protocol for collecting and interacting human saliva with membranes was developed. Subsequently, membranes were evaluated for their physicochemical properties, protein quantification, DNA, and 16S rRNA levels viability of two different cell lines at 1 and 7 days, and ALP activity. Non-interacted membranes and pure saliva of donors were applied as controls. RESULTS Qualitative morphological alterations were noticed; DNA extraction and 16S quantification revealed significantly higher values. Furthermore, the viability of HGF-1 and MC3T3-E1 cells was significantly (p < .05) reduced following saliva interaction with biodegradable membranes. Saliva contamination did not prejudice PTFE membranes significantly in any biological assay. CONCLUSIONS These outcomes demonstrated a susceptible response of biodegradable membranes to isolated early human saliva interaction, suggesting impairment of structural morphology, reduced viability to HGF-1 and MC3T3-E1, and higher absorption/adherence of DNA/16S rRNA. As a result, clinical oral procedures may need corresponding refinements.
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Affiliation(s)
- Marcel F Kunrath
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine (FMD), Universidade Católica Portuguesa, Viseu, Portugal
- Dentistry Department, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Paula Milena Giraldo-Osorno
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Karina Mendes
- Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine (FMD), Universidade Católica Portuguesa, Viseu, Portugal
| | - Ana T P C Gomes
- Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine (FMD), Universidade Católica Portuguesa, Viseu, Portugal
| | - Nuno Rosa
- Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine (FMD), Universidade Católica Portuguesa, Viseu, Portugal
| | - Marlene Barros
- Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine (FMD), Universidade Católica Portuguesa, Viseu, Portugal
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Dogan Kaplan A, Cinar IC, Gultekin BA, Avci Kupeli Z, Ozfirat EC, Yalcin S. The Effect of Different Types of Collagen Membranes on Peri-Implant Dehiscence Defects. J Craniofac Surg 2023; 34:2479-2484. [PMID: 37431934 DOI: 10.1097/scs.0000000000009536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 05/20/2023] [Indexed: 07/12/2023] Open
Abstract
AIM This experimental study aimed to compare the bone-implant contact (BIC) following guided bone regeneration with 3 bioabsorbable collagen membranes on peri-implant dehiscence defects. METHODS Forty-eight standard dehiscence defects were created in the sheep iliac bone crest, and dental implants were placed into the defects. With the guided bone regeneration technique, the autogenous graft was placed into the defect and covered with different types of membranes: Geistlich Bio-Gide, Ossix Plus, and Symbios Prehydrated were covered. One group was left without a membrane as the control group (C) by applying only an autogenous graft. After recovery periods of 3 and 6 weeks, the experimental animals were sacrificed. Histologic sections were prepared by a nondecalcified method, and BIC was examined. RESULTS There was no statistically important difference between groups in the third week ( P >0.05). A statistically significant difference between groups was found in the sixth week ( P <0.01). Bone-implant contact values of the C group were significantly lower than those of the Geistlich Bio-Gide and Ossix Plus groups ( P <0.05). There was no statistically significant difference between control and Symbios Prehydrated groups ( P >0.05). In all sections, osseointegration was observed, with no signs of inflammation, necrosis, or foreign body reaction. CONCLUSION In our study, it has been concluded that the resorbable collagen membranes used in treating peri-implant dehiscence defects might affect the BIC, and the success varies according to the type of membrane used.
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Affiliation(s)
- Aylin Dogan Kaplan
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul
| | - Ihsan Caglar Cinar
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul
| | | | - Zehra Avci Kupeli
- Department of Pathology, Faculty of Veterinary Medicine, Bursa Uludag University
| | - Eren Can Ozfirat
- Department of Surgery, Faculty of Veterinary Medicine, Bursa Uludag University, Bursa, Turkey
| | - Serdar Yalcin
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul
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Deluiz D, Delcroix GJR, Fraga SRG, D'Ippolito G, Grau-Monge C, Bonnin-Marquez A, Reiner T, Amadeu T, Tinoco EMB, Schiller PC. Viable cryopreserved human bone graft exhibit superior osteogenic properties in mandibular lateral augmentation. Sci Rep 2023; 13:1422. [PMID: 36697485 PMCID: PMC9876935 DOI: 10.1038/s41598-023-28170-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023] Open
Abstract
Lack of bone volume to place dental implants is frequently a problem in the reconstruction of edentulous patients. Even though autografts are the gold standard for jaw regeneration, morbidity associated with the harvesting site stimulates the demand for other substitutes. The aim of this study is to characterize the incorporation and the osteogenic ability of a viable cryopreserved human bone graft (VC-HBG) in the mandibular augmentation in rats. Bone chips from fresh human vertebrae cadaveric donors were processed, cryoprotected and deep-frozen at - 80 °C maintaining its cell viability. A jaw augmentation model was used in 20 athymic nude rats allocated into 2 groups to either receive the VC-HBG or an acellular graft as control (A-HBG). The assessment of the grafts' incorporation was performed at 4 and 8 weeks by micro-CT, histomorphometry and immunohistochemistry. Bone volume gain was significantly higher for the VC-HBG group at both time points. At 4 weeks, the A-HBG group presented significantly higher mineral density, but at 8 weeks, the VC-HBG group showed significantly higher values than the A-HBG. There was no statistical difference between VC-HBG and A-HBG groups at 4-weeks for remaining graft particles, while at 8 weeks, the VC-HBG group showed significantly less graft remnants. Collagen I, osteopontin and tartrate-resistant acid phosphatase expression were significantly higher in the VC-HBG group at both time points, while osteocalcin expression was significantly higher in the VC-HBG group at 8-weeks compared to the A-HBG group. This experimental research demonstrated that the VC-HBG shows positive osteogenic properties, greater bone formation, higher rate of bone remodeling and a better overall incorporation in rats' mandibles compared to the A-HBG.
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Affiliation(s)
- Daniel Deluiz
- Department of Periodontology, State University of Rio de Janeiro, Boulevard 28 de Setembro, 157 - 2º andar - sala 10, Rio de Janeiro, RJ, CEP 20551-030, Brazil. .,Department of Orthopedics, University of Miami, Miami, FL, USA.
| | - Gaëtan J-R Delcroix
- College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.,Geriatric Research Education and Clinical Center, Miami VA Healthcare System, Miami, FL, USA
| | - Samira R G Fraga
- Department of Periodontology, State University of Rio de Janeiro, Boulevard 28 de Setembro, 157 - 2º andar - sala 10, Rio de Janeiro, RJ, CEP 20551-030, Brazil
| | - Gianluca D'Ippolito
- Department of Biomedical Engineering, College of Engineering, University of Miami, Miami, FL, USA
| | - Cristina Grau-Monge
- Geriatric Research Education and Clinical Center, Miami VA Healthcare System, Miami, FL, USA
| | - Andrea Bonnin-Marquez
- Geriatric Research Education and Clinical Center, Miami VA Healthcare System, Miami, FL, USA
| | - Teresita Reiner
- Geriatric Research Education and Clinical Center, Miami VA Healthcare System, Miami, FL, USA
| | - Thaís Amadeu
- Department of Pathology and Laboratories, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Eduardo M B Tinoco
- Department of Periodontology, State University of Rio de Janeiro, Boulevard 28 de Setembro, 157 - 2º andar - sala 10, Rio de Janeiro, RJ, CEP 20551-030, Brazil
| | - Paul Christian Schiller
- Geriatric Research Education and Clinical Center, Miami VA Healthcare System, Miami, FL, USA.
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Omar O, Elgali I, Dahlin C, Thomsen P. Barrier membranes: More than the barrier effect? J Clin Periodontol 2019; 46 Suppl 21:103-123. [PMID: 30667525 PMCID: PMC6704362 DOI: 10.1111/jcpe.13068] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/21/2018] [Accepted: 01/09/2019] [Indexed: 12/13/2022]
Abstract
AIM To review the knowledge on the mechanisms controlling membrane-host interactions in guided bone regeneration (GBR) and investigate the possible role of GBR membranes as bioactive compartments in addition to their established role as barriers. MATERIALS AND METHODS A narrative review was utilized based on in vitro, in vivo and available clinical studies on the cellular and molecular mechanisms underlying GBR and the possible bioactive role of membranes. RESULTS Emerging data demonstrate that the membrane contributes bioactively to the regeneration of underlying defects. The cellular and molecular activities in the membrane are intimately linked to the promoted bone regeneration in the underlying defect. Along with the native bioactivity of GBR membranes, incorporating growth factors and cells in membranes or with graft materials may augment the regenerative processes in underlying defects. CONCLUSION In parallel with its barrier function, the membrane plays an active role in hosting and modulating the molecular activities of the membrane-associated cells during GBR. The biological events in the membrane are linked to the bone regenerative and remodelling processes in the underlying defect. Furthermore, the bone-promoting environments in the two compartments can likely be boosted by strategies targeting both material aspects of the membrane and host tissue responses.
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Affiliation(s)
- Omar Omar
- Department of BiomaterialsInstitute of Clinical SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Ibrahim Elgali
- Department of BiomaterialsInstitute of Clinical SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Christer Dahlin
- Department of BiomaterialsInstitute of Clinical SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Oral Maxillofacial Surgery/ENTNU‐Hospital OrganisationTrollhättanSweden
| | - Peter Thomsen
- Department of BiomaterialsInstitute of Clinical SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
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Influence of Cigarette Smoke Inhalation on an Autogenous Onlay Bone Graft Area in Rats with Estrogen Deficiency: A Histomorphometric and Immunohistochemistry Study. Int J Mol Sci 2019; 20:ijms20081854. [PMID: 30991651 PMCID: PMC6515394 DOI: 10.3390/ijms20081854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The present study aimed to evaluate the influence of cigarette smoke inhalation on an autogenous onlay bone graft area, either covered with a collagen membrane or not, in healthy and estrogen-deficient rats through histomorphometry and immunohistochemistry. MATERIALS AND METHODS Sixty female rats (Wistar), weighing 250-300 g, were randomly divided and allocated into groups (either exposed to cigarette smoke inhalation or not, ovariectomized and SHAM). After 15 days, the test group underwent cigarette smoke inhalation. Sixty days after exposition, autogenous bone grafting was only performed on all right hemimandibles, and the left ones underwent autogenous onlay bone grafting with the collagen membrane (BioGide®). The graft was harvested from the parietal bone and attached to the animals' jaws (right and left). They were euthanized at 21, 45, and 60 days after grafting. Histological measurements and immunohistochemical analyses were performed, and results were submitted to a statistical analysis. RESULTS The addition of a collagen membrane to the bone graft proved more efficient in preserving graft area if compared to the graft area without a collagen membrane and the one associated with cigarette smoke inhalation at 21 (p = 0.0381) and 60 days (p = 0.0192), respectively. Cigarette smoke inhalation combined with ovariectomy promoted a significant reduction of the autogenous graft area at 21 and 60 days. At 45 days, no statistically significant results were observed. In the immunohistochemical analysis, the ovariectomized and smoking subgroups, combined or not with collagen membrane, received moderate and intense immunolabeling at 21 days for Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL) (p = 0.0017 and p = 0.0381, respectively). For Osteoprotegerin (OPG), intense immunolabeling was observed in most subgroups under analysis at 60 days. CONCLUSION Smoking inhalation promoted resorption on the autogenous onlay bone graft, mainly when associated with ovariectomy. Furthermore, when associated with the collagen membrane, a lower resorption rate was observed if compared to the absence of the membrane.
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Influence of Chromium-Cobalt-Molybdenum Alloy (ASTM F75) on Bone Ingrowth in an Experimental Animal Model. J Funct Biomater 2017; 9:jfb9010002. [PMID: 29278372 PMCID: PMC5872088 DOI: 10.3390/jfb9010002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/20/2017] [Accepted: 12/20/2017] [Indexed: 12/26/2022] Open
Abstract
Cr-Co-Mo (ASTM F75) alloy has been used in the medical environment, but its use as a rigid barrier membrane for supporting bone augmentation therapies has not been extensively investigated. In the present study, Cr-Co-Mo membranes of different heights were placed in New Zealand white, male rabbit tibiae to assess the quality and volume of new bone formation, without the use of additional factors. Animals were euthanized at 20, 30, 40, and 60 days. Bone formation was observed in all of the cases, although the tibiae implanted with the standard membranes reached an augmentation of bone volume that agreed with the density values over the timecourse. In all cases, plasmatic exudate was found under the membrane and in contact with the new bone. Histological analysis indicated the presence of a large number of chondroblasts adjacent to the inner membrane surface in the first stages, and osteoblasts and osteocytes were observed under them. The bone formation was appositional. The Cr-Co-Mo alloy provides a scaffold with an adequate microenvironment for vertical bone volume augmentation, and the physical dimensions and disposition of the membrane itself influence the new bone formation.
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Scott JK, Webb RM, Flood TR. Premaxillary Osteotomy and Guided Tissue Regeneration in Secondary Bone Grafting in Children with Bilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2017; 44:469-75. [PMID: 17760480 DOI: 10.1597/06-032.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To introduce a surgical technique for secondary alveolar bone grafting performed in conjunction with premaxillary osteotomy and guided tissue regeneration in children with bilateral clefts. This paper also looks at the outcomes of this surgery in a series of 15 consecutive patients. Methods: Secondary alveolar bone grafting (with a premaxillary osteotomy and guided tissue regeneration with a collagen membrane) is usually carried out in the mixed dentition stage. This retrospective study used patients’ medical records, radiographs, and clinical examination to assess the outcome of the surgery. Patients were followed up for an average of 3 years. Results: Bone grafting was successful in all cases. No premaxillae were lost and there was no long-term morbidity of the donor site. Radiographic assessment of the bone heights showed an average of 94% retention, 3 months postoperatively. Preliminary assessment of maxillary canine eruption is encouraging, with 79% being fully erupted in those patients who are at least 3 years post–bone grafting. Conclusion: Premaxillary osteotomy allows repositioning of the premaxilla to its optimal preplanned position and successful closure of all fistulae. We have found that use of a collagen membrane is a useful adjunct.
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Affiliation(s)
- Julia K Scott
- Department of Oral and Maxillofacial Surgery, Salibury District Hospital, Salisbury, Wiltshire, UK.
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A description of the sequence of long-term behavior of autogenous boneblock in maxillary sinus augmentation in sheep: Additional morphologic and histomorphometric evidence. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:6-13. [PMID: 29150321 DOI: 10.1016/j.oooo.2017.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/16/2017] [Accepted: 09/14/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To document the behavior of autogenous bone block in sinus lift and surgical consequences. STUDY DESIGN Twelve sinus lifts with autogenous hip bone blocks and simultaneous insertion of two implants in 6 adult female sheep. Polychrome sequential labelling and histologic and histomorphometric evaluation after 6, 16, and 26 weeks. RESULTS Augmentation material in the apical third was almost fully resorbed after 26 weeks (P = .00388). Percentage of bone tissue increased 0.5-1.0 mm from the implant in crestal region (15.3 ± 7.5% to 16.2 ± 10.1%), whereas it vanished in the apical region from 16 to 26 weeks (4.2 ± 10.4% to 0%) (P = .363). CONCLUSIONS Autogenous bone block leaves an apical thin but functionally crucial layer covering implants in a form follows function way. Denial of animal-originated biomaterials and prion diseases remain a rarely discussed issue. The use of an implant length-adapted autogenous transplant with osseoinductive advantages should be taken into consideration.
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Elgali I, Omar O, Dahlin C, Thomsen P. Guided bone regeneration: materials and biological mechanisms revisited. Eur J Oral Sci 2017; 125:315-337. [PMID: 28833567 PMCID: PMC5601292 DOI: 10.1111/eos.12364] [Citation(s) in RCA: 418] [Impact Index Per Article: 59.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Guided bone regeneration (GBR) is commonly used in combination with the installment of titanium implants. The application of a membrane to exclude non‐osteogenic tissues from interfering with bone regeneration is a key principle of GBR. Membrane materials possess a number of properties which are amenable to modification. A large number of membranes have been introduced for experimental and clinical verification. This prompts the need for an update on membrane properties and the biological outcomes, as well as a critical assessment of the biological mechanisms governing bone regeneration in defects covered by membranes. The relevant literature for this narrative review was assessed after a MEDLINE/PubMed database search. Experimental data suggest that different modifications of the physicochemical and mechanical properties of membranes may promote bone regeneration. Nevertheless, the precise role of membrane porosities for the barrier function of GBR membranes still awaits elucidation. Novel experimental findings also suggest an active role of the membrane compartment per se in promoting the regenerative processes in the underlying defect during GBR, instead of being purely a passive barrier. The optimization of membrane materials by systematically addressing both the barrier and the bioactive properties is an important strategy in this field of research.
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Affiliation(s)
- Ibrahim Elgali
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
| | - Omar Omar
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden.,Department of Oral Maxillofacial Surgery/ENT, NU-Hospital organisation, Trollhättan, Sweden
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
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de Almeida JM, de Moraes RO, Gusman DJR, Faleiros PL, Nagata MJH, Garcia VG, Theodoro LH, Bosco AF. Influence of low-level laser therapy on the healing process of autogenous bone block grafts in the jaws of systemically nicotine-modified rats: A histomorphometric study. Arch Oral Biol 2017; 75:21-30. [DOI: 10.1016/j.archoralbio.2016.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 10/21/2016] [Accepted: 12/01/2016] [Indexed: 10/20/2022]
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12
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dos Santos RAB, Ferreira MS, Mafra CES, Holzhausen M, de Lima LAPA, Mendes Pannuti C, César Neto JB. Synthetic Parathyroid Hormone May Augment Bone Volume in Autogenous Grafts: A Study in Rats. J Periodontol 2016; 87:66-73. [DOI: 10.1902/jop.2015.140638] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Tera TDM, Nascimento RD, Prado RFD, Santamaria MP, Jardini MAN. Immunolocalization of markers for bone formation during guided bone regeneration in osteopenic rats. J Appl Oral Sci 2015; 22:541-53. [PMID: 25591022 PMCID: PMC4307769 DOI: 10.1590/1678-775720140190] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/03/2014] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this paper was to evaluate the repair of onlay autogenous bone grafts covered or not covered by an expanded polytetrafluoroethylene (e-PTFE) membrane using immunohistochemistry in rats with induced estrogen deficiency. Material and Methods Eighty female rats were randomly divided into two groups: ovariectomized (OVX) and with a simulation of the surgical procedure (SHAM). Each of these groups was again divided into groups with either placement of an autogenous bone graft alone (BG) or an autogenous bone graft associated with an e-PTFE membrane (BGM). Animals were euthanized on days 0, 7, 21, 45, and 60. The specimens were subjected to immunohistochemistry for bone sialoprotein (BSP), osteonectin (ONC), and osteocalcin (OCC). Results All groups (OVX+BG, OVX+BMG, SHAM+BG, and SHAM+BMG) showed greater bone formation, observed between 7 and 21 days, when BSP and ONC staining were more intense. At the 45-day, the bone graft showed direct bonding to the recipient bed in all specimens. The ONC and OCC showed more expressed in granulation tissue, in the membrane groups, independently of estrogen deficiency. Conclusions The expression of bone forming markers was not negatively influenced by estrogen deficiency. However, the markers could be influenced by the presence of the e-PTFE membrane.
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Affiliation(s)
- Tábata de Mello Tera
- Department of Bioscience and Oral Diagnosis, Instituto de Ciência e Tecnologia, Univ. Estadual Paulista, São José dos Campos, SP, Brazil
| | - Rodrigo Dias Nascimento
- Department of Diagnosis and Surgery, Instituto de Ciência e Tecnologia, Univ. Estadual Paulista, São José dos Campos, SP, Brazil
| | - Renata Falchete do Prado
- Department of Bioscience and Oral Diagnosis, Instituto de Ciência e Tecnologia, Univ. Estadual Paulista, São José dos Campos, SP, Brazil
| | - Mauro Pedrine Santamaria
- Department of Diagnosis and Surgery, Instituto de Ciência e Tecnologia, Univ. Estadual Paulista, São José dos Campos, SP, Brazil
| | - Maria Aparecida Neves Jardini
- Department of Diagnosis and Surgery, Instituto de Ciência e Tecnologia, Univ. Estadual Paulista, São José dos Campos, SP, Brazil
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Bone Augmentation in Rabbit Tibia Using Microfixed Cobalt-Chromium Membranes with Whole Blood and Platelet-Rich Plasma. MATERIALS 2015; 8:4843-4856. [PMID: 28793476 PMCID: PMC5455479 DOI: 10.3390/ma8084843] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 06/06/2015] [Accepted: 06/29/2015] [Indexed: 01/09/2023]
Abstract
Background: Bone augmentation is a subject of intensive investigation in regenerative bone medicine and constitutes a clinical situation in which autogenous bone grafts or synthetic materials are used to aid new bone formation. Method: Based on a non-critical defect, Co-Cr barrier membranes were placed on six adult Fauve de Bourgogne rabbits, divided into two groups: whole blood and PRP. Three densitometric controls were performed during the experiment. The animals were euthanized at 30, 45, 60, and 110 days. The presence of newly formed bone was observed. Samples for histological studies were taken from the augmentation center. Results: External and internal bone tissue augmentation was observed in almost all cases. Significant differences between PRP- and whole blood–stimulated bone augmentation were not observed. At 60 days, bones with PRP presented higher angiogenesis, which may indicate more proliferation and cellular activity. Conclusion: PRP activates the bone regeneration process under optimized conditions by stimulation of osteoblast proliferation after six weeks, when a significant difference in cellular activity was observed. Membranes could stimulate bone augmentation at the site of placement and in the surrounding areas.
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Sheikh Z, Sima C, Glogauer M. Bone Replacement Materials and Techniques Used for Achieving Vertical Alveolar Bone Augmentation. MATERIALS 2015. [PMCID: PMC5455762 DOI: 10.3390/ma8062953] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Alveolar bone augmentation in vertical dimension remains the holy grail of periodontal tissue engineering. Successful dental implant placement for restoration of edentulous sites depends on the quality and quantity of alveolar bone available in all spatial dimensions. There are several surgical techniques used alone or in combination with natural or synthetic graft materials to achieve vertical alveolar bone augmentation. While continuously improving surgical techniques combined with the use of auto- or allografts provide the most predictable clinical outcomes, their success often depends on the status of recipient tissues. The morbidity associated with donor sites for auto-grafts makes these techniques less appealing to both patients and clinicians. New developments in material sciences offer a range of synthetic replacements for natural grafts to address the shortcoming of a second surgical site and relatively high resorption rates. This narrative review focuses on existing techniques, natural tissues and synthetic biomaterials commonly used to achieve vertical bone height gain in order to successfully restore edentulous ridges with implant-supported prostheses.
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Affiliation(s)
- Zeeshan Sheikh
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Room 221, Fitzgerald Building, 150 College Street, Toronto, ON M5S 3E2, Canada; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-514-224-7490
| | - Corneliu Sima
- Department of Applied Oral Sciences, The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA; E-Mail:
| | - Michael Glogauer
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Room 221, Fitzgerald Building, 150 College Street, Toronto, ON M5S 3E2, Canada; E-Mail:
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Effect of periosteum attached to autogenous iliac block bone graft on bone resorption in rabbits. J Craniofac Surg 2015; 26:642-6. [PMID: 25933150 DOI: 10.1097/scs.0000000000001417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to evaluate the effect of the periosteum attached to an iliac block bone graft on resorption of the grafted bone. Twenty-one rabbits were used. Iliac bone was harvested with (experimental group) or without a periosteum (control group) and grafted on the rabbit calvarium and fixed with miniscrews. The animals were killed, and specimens were harvested at 1, 4, and 8 weeks after the surgery. Histologic examination and histomorphometry were done. Grafted bones were severely resorbed, and the overall shapes were changed in the control group. On the contrary, the overall shape of the grafted bone was maintained, although the grafted bone was resorbed in the experimental group. Moreover, there were no osteoclasts adjacent to the periosteum of the graft. These results suggest that the periosteum attached to grafted bone can help establish early revascularization and prevent the resorption of grafted bone.
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The influence of rifamycin decontamination on incorporation of autologous onlay bone grafts in rats: A histometric and immunohistochemical evaluation. Arch Oral Biol 2015; 60:724-9. [DOI: 10.1016/j.archoralbio.2014.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 12/03/2014] [Accepted: 12/12/2014] [Indexed: 11/20/2022]
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Gealh WC, Pereira CCS, Luvizuto ER, Garcia-Júnior IR, Antoniali C, Okamoto R. Healing Process of Autogenous Bone Graft in Spontaneously Hypertensive Rats Treated With Losartan: An Immunohistochemical and Histomorphometric Study. J Oral Maxillofac Surg 2014; 72:2569-81. [DOI: 10.1016/j.joms.2014.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 07/02/2014] [Accepted: 07/02/2014] [Indexed: 12/29/2022]
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Bae SY, Park JC, Shin HS, Lee YK, Choi SH, Jung UW. Tomographic and histometric analysis of autogenous bone block and synthetic hydroxyapatite block grafts without rigid fixation on rabbit calvaria. J Periodontal Implant Sci 2014; 44:251-8. [PMID: 25368814 PMCID: PMC4216402 DOI: 10.5051/jpis.2014.44.5.251] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 10/03/2014] [Indexed: 11/17/2022] Open
Affiliation(s)
- Soo-Yong Bae
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jung-Chul Park
- Department of Periodontology, Dankook University College of Dentistry, Cheonan, Korea
| | - Hyun-Seung Shin
- Department of Periodontology, Dankook University College of Dentistry, Cheonan, Korea
| | - Yong-Keun Lee
- Research Center for Oral Disease Regulation of the Aged, Chosun University School of Dentistry, Gwangju, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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TERA TDM, PRADO RFD, DE MARCO AC, SANTAMARIA MP, JARDINI MAN. The RANK/ RANKL/ OPG interaction in the repair of autogenous bone grafts in female rats with estrogen deficiency. Braz Oral Res 2014; 28:S1806-83242014000100261. [DOI: 10.1590/1807-3107bor-2014.vol28.0054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 06/24/2014] [Indexed: 11/22/2022] Open
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Yang JW, Park HJ, Yoo KH, Chung K, Jung S, Oh HK, Kim HS, Kook MS. A comparison study between periosteum and resorbable collagen membrane on iliac block bone graft resorption in the rabbit calvarium. Head Face Med 2014; 10:15. [PMID: 24886656 PMCID: PMC4024311 DOI: 10.1186/1746-160x-10-15] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 05/05/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the different resorption patterns between resorbable membrane barrier and periosteum after iliac block bone grafting radiographically and histologically. METHODS Eighteen mature male rabbits weighing from 2.0 to 2.5 kg were used. The recipient site was the rabbit skull, and autogenous iliac bone was used as the grafting material. The harvested iliac block bones were divided in the following groups: autogenous iliac block bone with preservation of the periosteum (the periosteum group), autogenous iliac block bone covered with a resorbable collagen membrane (Biomesh®, Samyang Co, Korea) after removing the periosteum (the collagen membrane group), and autogenous iliac block bones with removal of the periosteum (the control group). In each experimental group, periosteum or resorbable collagen membrane of the donor site was fixed directed to the periosteum of the recipient site. The specimens were examined macroscopically, radiographically, histologically, and histomorphometrically at every 2, 4, and 8 weeks. RESULTS All groups presented excellent bone graft healing state without inflammation, dehiscence, or displacement. The radiolucency increased from mild to moderate in all groups over the experiment. The mean thickness of the upper end of the cortical iliac bone graft was statistically significantly different between the control group and the periosteum group, between the four-week and eight-week control group, and between the four- week and eight-week periosteum group (p & 0.05). CONCLUSION This study suggests that both the periosteum and the resorbable collagen membrane may help to prevent soft tissue infiltration into the bone graft and to reduce bone graft resorption compared to block graft alone.
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Affiliation(s)
- Ji-Woong Yang
- Department of Oral and Maxillofacial Surgery, Chonnam National University School of Dentistry, 77 Yongbong-Dong Buk-Gu 500-757, Gwang-Ju, Republic of Korea
| | - Hong-Ju Park
- Department of Oral and Maxillofacial Surgery, Chonnam National University School of Dentistry, 77 Yongbong-Dong Buk-Gu 500-757, Gwang-Ju, Republic of Korea
| | - Kil-Hwa Yoo
- Department of Oral and Maxillofacial Surgery, Chonnam National University School of Dentistry, 77 Yongbong-Dong Buk-Gu 500-757, Gwang-Ju, Republic of Korea
| | - Kwang Chung
- Department of Oral and Maxillofacial Surgery, Chonnam National University School of Dentistry, 77 Yongbong-Dong Buk-Gu 500-757, Gwang-Ju, Republic of Korea
| | - Seunggon Jung
- Department of Oral and Maxillofacial Surgery, Chonnam National University School of Dentistry, 77 Yongbong-Dong Buk-Gu 500-757, Gwang-Ju, Republic of Korea
| | - Hee-Kyun Oh
- Department of Oral and Maxillofacial Surgery, Chonnam National University School of Dentistry, 77 Yongbong-Dong Buk-Gu 500-757, Gwang-Ju, Republic of Korea
| | - Hyung-Seok Kim
- Department of Forensic Medicine, Chonnam National University Medical School, Gwang-Ju, Republic of Korea
| | - Min-Suk Kook
- Department of Oral and Maxillofacial Surgery, Chonnam National University School of Dentistry, 77 Yongbong-Dong Buk-Gu 500-757, Gwang-Ju, Republic of Korea
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Koerdt S, Siebers J, Bloch W, Ristow O, Kuebler AC, Reuther T. Immunohistochemial study on the expression of von Willebrand factor (vWF) after onlay autogenous iliac grafts for lateral alveolar ridge augmentation. Head Face Med 2013; 9:40. [PMID: 24330606 PMCID: PMC3931527 DOI: 10.1186/1746-160x-9-40] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 12/03/2013] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The main problems of autogenous bone transplants are their unpredictable atrophy and their loss of structure. One key factor lies in the poor revascularization of simple onlay grafts. The the aim of this study was to evaluate the revascularization processes in autogenous bone grafts from the iliac crest to the alveolar ridge. METHODS In a sheep model, autogenous bone grafts were harvested from the iliac crest. A combination of a resorbable collagen membrane (CM) and deproteinized bovine bone material (DBBM) was used to modify the bone graft (experiment 2). This was compared with a simple onlay bone graft (control group, experiment 1). The amount of vessels in bone and connective tissue (CT), and the amount of CT were analyzed. The expression of von Willebrand factor (vWF) was compared between the two experimental groups using immunohistochemical analysis. RESULTS The ratio of the amount of vessels in bone and CT changed over time, and more vessels could be detected in bone at 12-16 weeks of graft healing. The number of vessels were significantly higher in experiment 2 than in experiment 1. More CT was found in experiment 1, whereas the amount of CT in both experiments decreased over time. CONCLUSION This study shows a more intensive and extensive revascularization in experiment 2, as significantly more vessels were detected. The decreased amount of CT in experiment 2 clarifies its clinical superiority.
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Affiliation(s)
- Steffen Koerdt
- Department of Oral and Maxillofacial Plastic Surgery, University of Wuerzburg, Pleicherwall 2, Wuerzburg D-97070, Germany
| | - Joerg Siebers
- Department of Oral and Maxillofacial Plastic Surgery, University of Wuerzburg, Pleicherwall 2, Wuerzburg D-97070, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sport Medicine, German Sport University, Am Sportpark Muengersdorf 6, Cologne D-50933, Germany
| | - Oliver Ristow
- Medicine & Aesthetics, Clinic for Oral, Maxillofacial and Plastical Surgery, Lenbachplatz 2a, Munich D-80333, Germany
| | - Alexander C Kuebler
- Department of Oral and Maxillofacial Plastic Surgery, University of Wuerzburg, Pleicherwall 2, Wuerzburg D-97070, Germany
| | - Tobias Reuther
- Department of Oral and Maxillofacial Plastic Surgery, University of Wuerzburg, Pleicherwall 2, Wuerzburg D-97070, Germany
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Mohd Hidzir N, Hill DJ, Taran E, Martin D, Grøndahl L. Argon plasma treatment-induced grafting of acrylic acid onto expanded poly(tetrafluoroethylene) membranes. POLYMER 2013. [DOI: 10.1016/j.polymer.2013.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rezende ML, Consolaro A, Sant'Ana AC, Damante CA, Greghi SL, Passanezi E. Demineralization of the contacting surfaces in autologous onlay bone grafts improves bone formation and bone consolidation. J Periodontol 2013; 85:e121-9. [PMID: 24171500 DOI: 10.1902/jop.2013.130298] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Autologous bone grafts are usually well consolidated after 4 to 5 months but can be incompletely interlocked with the native bone. This study investigated the effect of acid demineralization of the graft-bed interface on graft consolidation. METHODS Onlay bone grafts were performed on the calvaria of 36 guinea pigs. Half of the animals had the graft-bed contacting surfaces demineralized with 50% citric acid (pH 1.0) for 3 minutes (test group). The other half received no demineralization (control group). The bone grafts were immobilized by a resorbable membrane glued to the recipient bed with cyanoacrylate. After 7, 30, and 90 days, specimens (n = 6) were obtained for light microscopy. Data from qualitative analysis and computerized histomorphometry were statistically processed at a significance level of 5%. RESULTS Osteogenesis was not seen at the interface after 7 days. After 30 days, the test group showed 34.39% ± 13.4% of the interface area filled with mineralized tissue, compared to 17.14% ± 8.6% in the control group (P = 0.026). After 90 days, the mean percentages of mineralized tissue at the interface in the test and control specimens were 54.00% ± 11.23% and 38.65% ± 7.76% (P = 0.041), respectively. Within groups, a higher percentage of the area filled with mineralized tissue was seen at 90 days compared to 30 days (P = 0.004 for control and 0.041 for test). CONCLUSIONS Demineralization of the contacting surfaces between autologous bone graft and bone bed improved new bone formation and bone consolidation. These data need to be confirmed in humans.
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Affiliation(s)
- Maria L Rezende
- Division of Periodontics, Department of Prosthodontics, Faculty of Odontology of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
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Role of oxidative and nitrosative stress in autogenous bone grafts to the mandible using guided bone regeneration and a deproteinized bovine bone material. J Craniomaxillofac Surg 2013; 42:560-7. [PMID: 24035733 DOI: 10.1016/j.jcms.2013.07.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 06/03/2013] [Accepted: 07/31/2013] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED The aim of this study was to evaluate the role of oxidative and nitrosative stress in autogenous bone grafts to the mandible based on immunohistochemical analysis. MATERIAL AND METHODS Using a well-established sheep model autogenous bone grafts were harvested form the iliac bone. A combination of a Collagen Membrane (CM) and Deproteinized Bovine Bone Material (DBBM) was used to cover the bone graft (Experiment 2). This modification was compared with simple onlay bone grafts (Experiment 1). Immunohistochemically, the expression of specific stable degradation products of oxidative and nitrosative stress was compared between the two experimental groups. RESULTS Specific markers for oxidative and nitrosative stress showed statistically significant differences in expression in the different experimental groups. The influence of oxidative and nitrosative stress on osteoblasts (OB), osteoclasts (OC), and osteocytes (OCy) was analysed. Experiment 2 showed increased expression of markers in OB and decreased expression in OC. CONCLUSIONS Taking the result of this study and reports from the literature into consideration grafts in Experiment 2 showed less resorption and atrophy, higher activity of OB and inhibition of OC, and less expression of Reactive Oxygen and Nitrogen Species (RONS) as markers of oxidative stress within the graft. These data illustrate the improved remodelling processes in grafts using CM and DBBM.
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Immunolocalization of bone morphogenetic protein 2 during the early healing events after guided bone regeneration. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 113:533-41. [PMID: 22668432 DOI: 10.1016/j.oooo.2011.09.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Revised: 08/09/2011] [Accepted: 09/09/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the immunolocalization of bone morphogenetic protein 2 (BMP-2) after autogenous block grafting covered or not with an e-PTFE membrane. STUDY DESIGN Forty-eight rats were divided into 2 groups, autogenous block graft (B) and autogenous block graft + e-PTFE membrane (MB), and were evaluated by immunohistochemistry at baseline and 3, 7, 14, 21, and 45 days. RESULTS The largest number of positive cells in the recipient bed was observed after 3 days in both groups. At the graft border, the largest number of positive cells was seen after 7 days in group B and after 14 days in group MB. The highest proportion of staining in the graft was observed after 3 days in group B and after 21 days in group MB. CONCLUSIONS High proportions of stain were related to intense revascularization and osteogenesis. Except for the interface, BMP-2 staining occurred later in group MB than in group B in all structures analyzed.
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Dickinson DP, Coleman BG, Batrice N, Lee J, Koli K, Pennington C, Susin C, Wikesjö UME. Events of wound healing/regeneration in the canine supraalveolar periodontal defect model. J Clin Periodontol 2013; 40:527-41. [PMID: 23461721 DOI: 10.1111/jcpe.12055] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 08/28/2012] [Accepted: 12/05/2012] [Indexed: 11/28/2022]
Abstract
AIM The objective of this research was to elucidate early events in periodontal wound healing/regeneration using histological and immunohistochemical techniques. METHODS Routine critical-size, supraalveolar, periodontal defects including a space-providing titanium mesh device were created in 12 dogs. Six animals received additional autologous blood into the defect prior to wound closure. One animal from each group was killed for analysis at 2, 5, 9, 14 days, and at 4 and 8 weeks. RESULTS Both groups behaved similarly. Periodontal wound healing/regeneration progressed through three temporal phases. Early phase (2-5 days): heterogeneous clot consolidation and cell activation in the periodontal ligament (PDL) and trabecular bone was associated with PDL regeneration and formation of a pre-osteoblast population. Intermediate phase (9-14 days): cell proliferation (shown by PCNA immunostaining)/migration led to osteoid/bone, PDL and cementum formation. Late phase (4-8 weeks): primarily characterized by tissue remodelling/maturation. Fibrous connective tissue from the gingival mucosa entered the wound early, competing with regeneration. By day 14, the wound space was largely filled with regenerative and reparative tissues. CONCLUSION Activation of cellular regenerative events in periodontal wound healing/regeneration is rapid; the general framework for tissue formation is broadly outlined within 14 days. Most bone formation apparently originates from endosteally derived pre-osteoblasts; the PDL possibly acting as a supplementary source, with a primary function likely being regulatory/homeostatic. Blood accumulation at the surgical site warrants exploration; supplementation may be beneficial.
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Affiliation(s)
- Douglas P Dickinson
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Georgia Regents University College of Dental Medicine, Augusta, GA, USA.
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Expression of growth factors during the healing process of alveolar ridge augmentation procedures using autogenous bone grafts in combination with GTR and an anorganic bovine bone substitute: an immunohistochemical study in the sheep. Clin Oral Investig 2013; 18:179-88. [PMID: 23404559 DOI: 10.1007/s00784-013-0938-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 01/28/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study aims to evaluate the expression of various immunohistochemical growth factors and vascularization markers in augmentation on the mandible comparing onlay bone grafts and Guided Bone Regeneration (GBR). MATERIALS AND METHODS Using a sheep in vivo model, autogenous bone grafts were harvested from the iliac crest. A combination of a resorbable collagen membrane (CM) and a Deproteinized Bovine Bone Material (DBBM) was performed. This modification of the host side was compared with an onlay bone graft control group. Expression of different vascularization markers was compared between these groups. RESULTS The expression of revascularization markers was significantly higher within the modification of the host side using GBR and DBBM. Regarding different graft regions, a significantly higher expression within the bone graft using GBR and DBBM could be observed in staining on bone morphogenetic protein-2 (BMP-2) (5.75 vs. 3.55), vascular endothelial growth factor (VEGF) (3.08 vs. 1.64), VEGF Receptor 1 (VEGFR-1) and VEGF Receptor 2 (VEGFR-2) (4.88 vs. 2.24 and 5.06 vs. 2.74), and endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) (5.29 vs. 3.28 and 5.22 vs. 3.09; p = 0.000, all others p < 0.05), whereas the control group showed a higher rate of resorption during the surveillance period until euthanasia of sheep after 16 weeks. CONCLUSION The use of GBR and DBBM in the transplantation process of autogenous bone grafts compared with the therapeutical use of certain growth factors may enhance vascularization and lower atrophy and resorption. CLINICAL RELEVANCE The use of a combination of GBR and DBBM in augmentation procedures on the mandible shows less resorption than simple onlay bone grafts and seems to be superior in a clinical use.
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Mertens C, Decker C, Seeberger R, Hoffmann J, Sander A, Freier K. Early bone resorption after vertical bone augmentation - a comparison of calvarial and iliac grafts. Clin Oral Implants Res 2012; 24:820-5. [DOI: 10.1111/j.1600-0501.2012.02463.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Christian Mertens
- Department of Oral and Maxillofacial Surgery; University Hospital Heidelberg; Heidelberg; Germany
| | - Christian Decker
- Department of Oral and Maxillofacial Surgery; University Hospital Heidelberg; Heidelberg; Germany
| | - Robin Seeberger
- Department of Oral and Maxillofacial Surgery; University Hospital Heidelberg; Heidelberg; Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery; University Hospital Heidelberg; Heidelberg; Germany
| | - Anja Sander
- Institute of Medical Biometry and Informatics; University of Heidelberg; Heidelberg; Germany
| | - Kolja Freier
- Department of Oral and Maxillofacial Surgery; University Hospital Heidelberg; Heidelberg; Germany
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Alhag M, Farrell E, Toner M, Claffey N, Lee TC, O'Brien F. Evaluation of early healing events around mesenchymal stem cell-seeded collagen-glycosaminoglycan scaffold. An experimental study in Wistar rats. Oral Maxillofac Surg 2011; 15:31-39. [PMID: 20644972 DOI: 10.1007/s10006-010-0241-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 07/02/2010] [Indexed: 05/29/2023]
Abstract
PURPOSE Tissue engineering using cell-seeded biodegradable scaffolds offers a new bone regenerative approach that might circumvent many of the limitations of current therapeutic modalities. The aim of this experiment was to study the early healing events around mesenchymal stem cell-seeded collagen-glycosaminoglycan scaffolds. METHODS The 5-mm critical size defects were created in the calvarial bones of 41 Wistar rats. The defects were either left empty to serve as controls (n = 11), filled with cell-free scaffolds (n = 12), cell-seeded scaffolds that were maintained in standard culture medium (n = 9), or cell-seeded scaffolds that were maintained in osteoinductive factor-supplemented medium (n = 9). The animals were sacrificed at 7 days after surgery, and specimens were prepared for histological analysis. Early healing events such as host cell penetration, blood vessel in-growth, and scaffold integration were observed. The degree of inflammatory cell infiltrate was assessed. RESULTS While defects in the control group healed with a thin fibrous tissue, the collagen-glycosaminoglycan scaffold in the test groups preserved the three-dimensional form of the defects. After 7 days in vivo, the scaffold maintained its integrity and appeared populated with host cells. The cell-seeded scaffold induced more inflammatory response compared to the cell-free scaffolds. New blood vessels and areas of early bone formation were also evident in the cell-seeded scaffolds. CONCLUSIONS In conclusion, the findings show that mesenchymal stem cell-seeded collagen-glycosaminoglycan scaffolds have good tissue tolerance and exhibit an osteoinductive effect as indicated by early stage healing.
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Affiliation(s)
- Mohamed Alhag
- School of Dental Science, Trinity College, Dublin, Ireland.
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Oh KC, Cha JK, Kim CS, Choi SH, Chai JK, Jung UW. The influence of perforating the autogenous block bone and the recipient bed in dogs. Part I: a radiographic analysis. Clin Oral Implants Res 2011; 22:1298-302. [DOI: 10.1111/j.1600-0501.2010.02110.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Guided bone regeneration using a titanium-reinforced ePTFE membrane and particulate autogenous bone: the effect of smoking and membrane exposure. ACTA ACUST UNITED AC 2010; 109:825-30. [DOI: 10.1016/j.tripleo.2009.12.035] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 11/30/2009] [Accepted: 12/23/2009] [Indexed: 11/21/2022]
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He H, Huang J, Shi J, Ping F, Chen G, Dong Y. Haversian Remodeling in Guided Bone Regeneration with Calcium Alginate Film in Circular Bone Defect Model of Rabbit. ACTA ACUST UNITED AC 2009; 35:533-42. [DOI: 10.1080/10731190701586285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Adeyemo WL, Reuther T, Bloch W, Korkmaz Y, Fischer JH, Zöller JE, Kuebler AC. Influence of host periosteum and recipient bed perforation on the healing of onlay mandibular bone graft: an experimental pilot study in the sheep. Oral Maxillofac Surg 2008; 12:19-28. [PMID: 18600357 DOI: 10.1007/s10006-008-0098-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE The aim of this study was to evaluate the role of host periosteum and recipient bed perforation on the healing of an onlay graft to the mandible based on histologic and immunohistochemical analysis. MATERIALS AND METHODS Each of the 12 adult sheep used in the study received four iliac corticocancellous onlay bone grafts on the lateral surface of the mandible. In experiment 1, the block graft was placed in direct contact with the recipient bed and fixed with micro-screws, and in experiment 2, the recipient cortical bed was perforated before graft placement. The host periosteum around the graft was excised before flap replacement in experiment 3, and in experiment 4, a sheet of silicone membrane was placed between the graft and the recipient bed. The animals were euthanised at 4, 8, 12 and 16 weeks after surgery and the findings were analysed by routine microscopy (haematoxylin and eosin and tartrate-resistant acid phosphatase [TRAP] stains) and immunohistochemistry for proliferation and apoptotic markers (Ki67, caspase-3 and TUNEL stains). RESULTS After 8 weeks, full graft-host integration was seen in all the experimental groups except experiment 4. After 16 weeks, pronounced graft resorption and volume reduction was observed in experiments 1 and 2, whilst experiment 3 was characterised with extensive connective tissue infiltration and severe resorption of the graft. The number of osteoclasts expressed peaked at 4 weeks in experiments 1 and 2 and at 16 weeks in experiment 3. Immunoreactivity for Ki67 by osteoblasts lining the trabecular bone of the graft's spongiosa expressed moderate level of Ki67 at 8 weeks, and thereafter declined markedly. The strongest expression of caspase-3 on the bone surface was observed after 16 weeks. DISCUSSION AND CONCLUSION Recipient cortical bed perforation offered no advantage over non-perforated bed regarding healing and integration of a bone graft. Excision of the host overlying the periosteum was accompanied with rapid absorption of the grafts and partial or complete replacement with fibrous connective tissue. This study also demonstrated that cell death by apoptosis is a fundamental component of osteoblastic phenotypic differentiation during healing of corticocancellous bone graft.
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Affiliation(s)
- Wasiu L Adeyemo
- Department of Craniomaxillofacial and Plastic Surgery, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany.
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Adeyemo WL, Reuther T, Bloch W, Korkmaz Y, Fischer JH, Zöller JE, Kuebler AC. Healing of onlay mandibular bone grafts covered with collagen membrane or bovine bone substitutes: a microscopical and immunohistochemical study in the sheep. Int J Oral Maxillofac Surg 2008; 37:651-9. [PMID: 18378427 DOI: 10.1016/j.ijom.2008.02.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Revised: 08/23/2007] [Accepted: 02/06/2008] [Indexed: 11/26/2022]
Abstract
The objective of this study was to evaluate the role of collagen membrane and Bio-Oss coverage in healing of an onlay graft to the mandible. Twelve adult sheep each received an onlay bone graft (experiment 1), bone graft+Bio-Gide (experiment 2), and bone graft+Bio-Oss/Bio-Gide (experiment 3) on the lateral surface of the mandible. The animals were euthanized at 4, 8, 12 or 16 weeks after surgery, and findings were analysed by routine microscopy and immunohistochemistry for proliferation (Ki67) and apoptotic (Caspase-3) markers. Grafts were fully incorporated in all specimens. Pronounced resorption was observed in experiment 1. Minimal loss of graft volume was seen in experiment 2 specimens without membrane displacement. A remarkable increase in the augmented region of the mandible was observed in experiment 3. A high number of osteoclasts were expressed within the grafts during the early healing period, and thereafter declined markedly. Osteoblasts within the grafts expressed a moderate level of Ki67 at 8 weeks, which thereafter declined markedly. The strongest expression of Caspase-3 on the bone surface was observed after 16 weeks. In conclusion, the effect of collagen membrane coverage on bone graft volume maintenance was dependent on membrane stability during healing. An autogenous bone graft covered with Bio-Oss particles resulted in a remarkable increase in augmented lateral surface of the mandible. The late stage of bone graft healing was associated with a high apoptotic induction pathway of osteoblasts lining the surfaces of the new bone, demonstrated by strong positive Caspase-3 immunoreactivity.
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Affiliation(s)
- W L Adeyemo
- Department of Craniomaxillofacial and Plastic Surgery, University of Cologne, Germany.
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Iezzi G, Scarano A, Mangano C, Cirotti B, Piattelli A. Histologic Results From a Human Implant Retrieved Due to Fracture 5 Years After Insertion in a Sinus Augmented With Anorganic Bovine Bone. J Periodontol 2008; 79:192-8. [DOI: 10.1902/jop.2008.070105] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Traini T, Valentini P, Iezzi G, Piattelli A. A histologic and histomorphometric evaluation of anorganic bovine bone retrieved 9 years after a sinus augmentation procedure. J Periodontol 2007; 78:955-61. [PMID: 17470032 DOI: 10.1902/jop.2007.060308] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Anorganic bovine bone (ABB) has been shown to have osteoconductive properties and no inflammatory or adverse responses as grafting materials used in sinus augmentation procedures. Despite these successful results, histologic data in humans over the long-term period are scarce. The purpose of this study was to analyze the histomorphometric data 9 years after surgery in a case of maxillary sinus augmentation using ABB. METHODS The histologic evaluation was performed in five different thin sections of the specimen, comparing histomorphometric measures for newly formed bone, marrow spaces, biomaterial particles remnants, and number of osteocytes embedded in both trabecular bone and bone tissue near the ABB. The investigation was carried out by means of scanning electron microscopy and brightfield and circularly polarized light microscopy. RESULTS We observed a mean amount of newly formed bone of 46.0% +/- 4.67%, ABB remnants of 16.0% +/- 5.89%, and marrow spaces of 38.0% +/- 8.93%. The osteocyte index was 4.43 for bone around ABB and 3.27 in the trabecular bone at a distance from the particles. CONCLUSIONS After 9 years, the tissue pattern appeared composed by residual ABB particles in close contact to the newly formed bone. The bone mineralized matrix around the ABB had collagen fibers randomly oriented and more osteocytes embedded. The results demonstrate both a high level of osteoconductivity and a "biomimetic" behavior over the long term.
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Affiliation(s)
- Tonino Traini
- Dental School, University of Chieti-Pescara, Chieti, Italy
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Abstract
BACKGROUND The advent of osseointegration and advances in biomaterials and techniques have contributed to increased application of dental implants in the restoration of partial and completely edentulous patients. Often, in these patients, soft and hard tissue defects result from a variety of causes, such as infection, trauma, and tooth loss. These create an anatomically less favorable foundation for ideal implant placement. For prosthetic-driven dental implant therapy, reconstruction of the alveolar bone through a variety of regenerative surgical procedures has become predictable; it may be necessary prior to implant placement or simultaneously at the time of implant surgery to provide a restoration with a good long-term prognosis. Regenerative procedures are used for socket preservation, sinus augmentation, and horizontal and vertical ridge augmentation. METHODS A broad overview of the published findings in the English literature related to various bone augmentation techniques is outlined. A comprehensive computer-based search was performed using various databases that include Medline and PubMed. A total of 267 papers were considered, with non-peer-reviewed articles eliminated as much as possible. RESULTS The techniques for reconstruction of bony defects that are reviewed in this paper include the use of particulate bone grafts and bone graft substitutes, barrier membranes for guided bone regeneration, autogenous and allogenic block grafts, and the application of distraction osteogenesis. CONCLUSIONS Many different techniques exist for effective bone augmentation. The approach is largely dependent on the extent of the defect and specific procedures to be performed for the implant reconstruction. It is most appropriate to use an evidenced-based approach when a treatment plan is being developed for bone augmentation cases.
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Effect of calcitonin on bone regeneration in male rats: a histomorphometric analysis. Int J Oral Maxillofac Surg 2007; 36:435-40. [PMID: 17275259 DOI: 10.1016/j.ijom.2006.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Revised: 10/23/2006] [Accepted: 12/08/2006] [Indexed: 10/23/2022]
Abstract
The aim of this study was to evaluate the effectiveness of calcitonin in promoting bone growth in surgical bone defects in rat mandibles. Fifty male rats were divided into two groups: bone defect (control) and bone defect with calcitonin (experimental). A circular bone defect 4mm in diameter was made in the mandibular bone of the rats in the angle region, and covered with a polytetrafluoroethylene barrier. The experimental group received 2 IU/kg of synthetic salmon calcitonin intramuscularly three times a week, with treatment starting immediately after surgery. The animals were killed 3, 7, 14, 21 and 28 days after the surgical procedure. The bone defects were examined histologically and by histomorphometric analysis. The Student t-test was applied to the histomorphometric data, with the level of significance set at 5%. The animals of the experimental group showed a lower level of bone formation at almost all time points than the control group, but no difference between groups was observed 28 days after surgery. The volume of newly formed bone matrix was significantly greater in the control than the experimental group at 7, 14 and 21 days, as determined by both morphologic and histomorphometric analysis. Bone repair in the calcitonin-treated animals was delayed in comparison to controls, indicating the need for further studies on male rats.
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