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Mosaddad SA, Hussain A, Tebyaniyan H. Exploring the Use of Animal Models in Craniofacial Regenerative Medicine: A Narrative Review. TISSUE ENGINEERING. PART B, REVIEWS 2024; 30:29-59. [PMID: 37432898 DOI: 10.1089/ten.teb.2023.0038] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
The craniofacial region contains skin, bones, cartilage, the temporomandibular joint (TMJ), teeth, periodontal tissues, mucosa, salivary glands, muscles, nerves, and blood vessels. Applying tissue engineering therapeutically helps replace lost tissues after trauma or cancer. Despite recent advances, it remains essential to standardize and validate the most appropriate animal models to effectively translate preclinical data to clinical situations. Therefore, this review focused on applying various animal models in craniofacial tissue engineering and regeneration. This research was based on PubMed, Scopus, and Google Scholar data available until January 2023. This study included only English-language publications describing animal models' application in craniofacial tissue engineering (in vivo and review studies). Study selection was based on evaluating titles, abstracts, and full texts. The total number of initial studies was 6454. Following the screening process, 295 articles remained on the final list. Numerous in vivo studies have shown that small and large animal models can benefit clinical conditions by assessing the efficacy and safety of new therapeutic interventions, devices, and biomaterials in animals with similar diseases/defects to humans. Different species' anatomical, physiologic, and biological features must be considered in developing innovative, reproducible, and discriminative experimental models to select an appropriate animal model for a specific tissue defect. As a result, understanding the parallels between human and veterinary medicine can benefit both fields.
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Affiliation(s)
- Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmed Hussain
- School of Dentistry, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran
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2
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Weber M, Wehrhan F, Deschner J, Sander J, Ries J, Möst T, Bozec A, Gölz L, Kesting M, Lutz R. The Special Developmental Biology of Craniofacial Tissues Enables the Understanding of Oral and Maxillofacial Physiology and Diseases. Int J Mol Sci 2021; 22:ijms22031315. [PMID: 33525669 PMCID: PMC7866214 DOI: 10.3390/ijms22031315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 11/21/2022] Open
Abstract
Maxillofacial hard tissues have several differences compared to bones of other localizations of the human body. These could be due to the different embryological development of the jaw bones compared to the extracranial skeleton. In particular, the immigration of neuroectodermally differentiated cells of the cranial neural crest (CNC) plays an important role. These cells differ from the mesenchymal structures of the extracranial skeleton. In the ontogenesis of the jaw bones, the development via the intermediate stage of the pharyngeal arches is another special developmental feature. The aim of this review was to illustrate how the development of maxillofacial hard tissues occurs via the cranial neural crest and pharyngeal arches, and what significance this could have for relevant pathologies in maxillofacial surgery, dentistry and orthodontic therapy. The pathogenesis of various growth anomalies and certain syndromes will also be discussed.
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Affiliation(s)
- Manuel Weber
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
- Correspondence: ; Tel.: +49-9131-854-3749
| | - Falk Wehrhan
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
- Private Office for Maxillofacial Surgery, 91781 Weißenburg, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University of Mainz, 55131 Mainz, Germany;
| | - Janina Sander
- Private Office for Oral Surgery, 96049 Bamberg, Germany;
| | - Jutta Ries
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
| | - Tobias Möst
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
| | - Aline Bozec
- Department of Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Lina Gölz
- Department of Orthodontics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
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Rode C, Wyrwa R, Weisser J, Schnabelrauch M, Vučak M, Grom S, Reinauer F, Stetter A, Schlegel KA, Lutz R. A Novel Resorbable Composite Material Containing Poly(ester-co-urethane) and Precipitated Calcium Carbonate Spherulites for Bone Augmentation-Development and Preclinical Pilot Trials. Molecules 2020; 26:E102. [PMID: 33379374 PMCID: PMC7795954 DOI: 10.3390/molecules26010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/24/2022] Open
Abstract
Polyurethanes have the potential to impart cell-relevant properties like excellent biocompatibility, high and interconnecting porosity and controlled degradability into biomaterials in a relatively simple way. In this context, a biodegradable composite material made of an isocyanate-terminated co-oligoester prepolymer and precipitated calcium carbonated spherulites (up to 60% w/w) was synthesized and investigated with regard to an application as bone substitute in dental and orthodontic application. After foaming the composite material, a predominantly interconnecting porous structure is obtained, which can be easily machined. The compressive strength of the foamed composites increases with raising calcium carbonate content and decreasing calcium carbonate particle size. When stored in an aqueous medium, there is a decrease in pressure stability of the composite, but this decrease is smaller the higher the proportion of the calcium carbonate component is. In vitro cytocompatibility studies of the foamed composites on MC3T3-E1 pre-osteoblasts revealed an excellent cytocompatibility. The in vitro degradation behaviour of foamed composite is characterised by a continuous loss of mass, which is slower with higher calcium carbonate contents. In a first pre-clinical pilot trial the foamed composite bone substitute material (fcm) was successfully evaluated in a model of vertical augmentation in an established animal model on the calvaria and on the lateral mandible of pigs.
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Affiliation(s)
- Claudia Rode
- Biomaterials Department, INNOVENT e. V., Prüssingstrasse 27B, 07745 Jena, Germany; (C.R.); (R.W.); (J.W.)
| | - Ralf Wyrwa
- Biomaterials Department, INNOVENT e. V., Prüssingstrasse 27B, 07745 Jena, Germany; (C.R.); (R.W.); (J.W.)
| | - Juergen Weisser
- Biomaterials Department, INNOVENT e. V., Prüssingstrasse 27B, 07745 Jena, Germany; (C.R.); (R.W.); (J.W.)
| | - Matthias Schnabelrauch
- Biomaterials Department, INNOVENT e. V., Prüssingstrasse 27B, 07745 Jena, Germany; (C.R.); (R.W.); (J.W.)
| | - Marijan Vučak
- Schaefer Kalk GmbH & Co. KG, Louise-Seher-Straße 6, 65582 Diez, Germany;
| | - Stefanie Grom
- Karl Leibinger Medizintechnik GmbH & Co. KG, a Company of the KLS Martin Group, Kolbinger Straße 10, 78570 Mühlheim an der Donau, Germany; (S.G.); (F.R.)
| | - Frank Reinauer
- Karl Leibinger Medizintechnik GmbH & Co. KG, a Company of the KLS Martin Group, Kolbinger Straße 10, 78570 Mühlheim an der Donau, Germany; (S.G.); (F.R.)
| | - Adrian Stetter
- Clinic for Oral and Maxillofacial Surgery, Universitätsklinikum Erlangen, Glückstrasse 11, 91054 Erlangen, Germany; (A.S.); (K.A.S.); (R.L.)
| | - Karl Andreas Schlegel
- Clinic for Oral and Maxillofacial Surgery, Universitätsklinikum Erlangen, Glückstrasse 11, 91054 Erlangen, Germany; (A.S.); (K.A.S.); (R.L.)
| | - Rainer Lutz
- Clinic for Oral and Maxillofacial Surgery, Universitätsklinikum Erlangen, Glückstrasse 11, 91054 Erlangen, Germany; (A.S.); (K.A.S.); (R.L.)
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Moest T, Schlegel KA, Kesting M, Fenner M, Lutz R, Beck DM, Nkenke E, von Wilmowsky C. A new standardized critical size bone defect model in the pig forehead for comparative testing of bone regeneration materials. Clin Oral Investig 2019; 24:1651-1661. [PMID: 31414271 DOI: 10.1007/s00784-019-03020-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: 01/10/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The preclinical study aimed to establish a standardized preclinical model to investigate osseous graft consolidation in defect configurations of limited regenerative capacity. MATERIAL AND METHODS Critical size defects (CSD) were prepared and titanium tubes inserted for defect separation from local bone in the forehead area of 18 pigs. Defects were filled with demineralized bovine bone mineral (DBBM) or served as empty controls and were covered with a resorbable collagen membrane (CM) or left untreated. Six randomly selected pigs were sacrificed after 4, 8 and 12 weeks. Specimens were histologically and histomorphometrically analysed focusing on newly formed bone (NFB), demineralized bovine bone mineral (DBBM) and soft tissue (ST) proportions. RESULTS Four weeks after defect preparation, no statistically significant difference concerning NFB quantity could be detected within the groups. Defects covered with the CM showed lower amounts of DBBM. After 6 and 12 weeks, defects augmented with DBBM in combination with a CM (8 weeks: 43.12 ± 4.31; 12 weeks: 43.05 ± 3.01) showed a statistically significant higher NFB rate compared to empty control defects covered with 8 weeks: 7.66 ± 0.59; 12 weeks or without a CM; 8 weeks: 8.62 ± 2.66; 12 weeks: 18.40 ± 2.40. CM application showed no significant impact on osseous defect regeneration or soft tissue formation. Superior NFB could be detected for basal aspect for several evaluation time points. CONCLUSIONS The modification of CSD with titanium tubes represents a suitable model to imitate a one-wall defect regeneration situation. CLINICAL RELEVANCE The established model represents a promising method to evaluate graft consolidation in one-wall defect configuration.
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Affiliation(s)
- Tobias Moest
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany.
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
| | - Matthias Fenner
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
| | - Daniele Machado Beck
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
| | - Emeka Nkenke
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Vienna, Austria
| | - Cornelius von Wilmowsky
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Glueckstraße 11, 91054, Erlangen, Germany
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Rogala P, Uklejewski R, Winiecki M, Dąbrowski M, Gołańczyk J, Patalas A. First Biomimetic Fixation for Resurfacing Arthroplasty: Investigation in Swine of a Prototype Partial Knee Endoprosthesis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6952649. [PMID: 31355275 PMCID: PMC6634287 DOI: 10.1155/2019/6952649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 04/10/2019] [Accepted: 05/21/2019] [Indexed: 02/05/2023]
Abstract
Resurfacing hip and knee endoprostheses are generally embedded in shallow, prepared areas in the bone and secured with cement. Massive cement penetration into periarticular bone, although it provides sufficient primary fixation, leads to the progressive weakening of peri-implant bone and results in failures. The aim of this paper was to investigate in an animal model the first biomimetic fixation of components of resurfacing arthroplasty endoprostheses by means of the innovative multispiked connecting scaffold (MSC-Scaffold). The partial resurfacing knee arthroplasty (RKA) endoprosthesis working prototype with the MSC-Scaffold was designed for biomimetic fixation investigations using reverse engineering methods and manufactured by selective laser melting. After Ca-P surface modification of bone contacting surfaces of the MSC-Scaffold, the working prototypes were implanted in 10 swines. Radiological, histopathological, and micro-CT examinations were performed on retrieved bone-implant specimens. Clinical examination confirmed very good stability (4 in 5-point Likert scale) of the operated knee joints. Radiological examinations showed good implant fixation (radiolucency less than 2 mm) without any signs of migration. Spaces between the MSC-Scaffold spikes were penetrated by bone tissue. The histological sections showed newly formed trabecular bone tissue between the spikes, and the trabeculae of periscaffold bone were seen in contact with the spikes. The micro-CT results showed the highest percentage of bone tissue ingrowths into the MSC-Scaffold at a distance of 2.5÷3.0 mm from the spikes bases. The first biomimetic fixation for resurfacing arthroplasty was successfully verified in 10 swines investigations using RKA endoprosthesis working prototypes. The performed research shows that the MSC-Scaffold allows for cementless and biomimetic fixation of resurfacing endoprosthesis components in periarticular cancellous bone.
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Affiliation(s)
- Piotr Rogala
- Department of Orthopaedics and Traumatology, W. Dega University Hospital, Poznan University of Medical Sciences, 28 Czerwca 1956 Street 135/147, 61-545 Poznan, Poland
- Institute of Health Sciences, Hipolit Cegielski State College of Higher Education, Card. Stefan Wyszyński Street 38, 62-200 Gniezno, Poland
- Veterinary Surgery Department, Naramowicka Street 68, 61-619 Poznań, Poland
| | - Ryszard Uklejewski
- Institute of Health Sciences, Hipolit Cegielski State College of Higher Education, Card. Stefan Wyszyński Street 38, 62-200 Gniezno, Poland
- Department of Medical Bioengineering Fundamentals, Institute of Technology, Kazimierz Wielki University, Karol Chodkiewicz Street 30, 85-064 Bydgoszcz, Poland
- Department of Technology Design/Laboratory of Bone Implants Research and Design, Institute of Mechanical Technology, Poznan University of Technology, Piotrowo Street 3, 60-965 Poznan, Poland
| | - Mariusz Winiecki
- Department of Medical Bioengineering Fundamentals, Institute of Technology, Kazimierz Wielki University, Karol Chodkiewicz Street 30, 85-064 Bydgoszcz, Poland
- Department of Technology Design/Laboratory of Bone Implants Research and Design, Institute of Mechanical Technology, Poznan University of Technology, Piotrowo Street 3, 60-965 Poznan, Poland
| | - Mikołaj Dąbrowski
- Department of Orthopaedics and Traumatology, W. Dega University Hospital, Poznan University of Medical Sciences, 28 Czerwca 1956 Street 135/147, 61-545 Poznan, Poland
- Department of Spondyloorthopaedics and Biomechanics, W. Dega University Hospital, Poznan University of Medical Sciences, 28 Czerwca 1956 Street 135/147, 61-545 Poznan, Poland
| | - Jacek Gołańczyk
- Veterinary Surgery Department, Naramowicka Street 68, 61-619 Poznań, Poland
| | - Adam Patalas
- Department of Technology Design/Laboratory of Bone Implants Research and Design, Institute of Mechanical Technology, Poznan University of Technology, Piotrowo Street 3, 60-965 Poznan, Poland
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Lutz R, Sendlbeck C, Wahabzada H, Tudor C, Prechtl C, Schlegel KA. Periosteal elevation induces supracortical peri-implant bone formation. J Craniomaxillofac Surg 2017; 45:1170-1178. [PMID: 28606438 DOI: 10.1016/j.jcms.2017.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/12/2017] [Accepted: 05/11/2017] [Indexed: 01/27/2023] Open
Abstract
PURPOSE The aim of the study was to evaluate the possibility of supracortical peri-implant bone formation after periosteal elevation. MATERIALS AND METHODS Periosteal elevation with an elevation height of 5 or 10 mm was performed in an animal experiment with 24 female domestic pigs. For this purpose, four implants were inserted in the frontal bone of each animal. The implants protruded from the local bone by 5 or 10 mm. In the test groups, the periosteum was attached to the protruding implants. In the control groups, the implants were covered with biocompatible degradable periosteal-shielding devices. Each 8 animals were sacrificed after 20, 40 and 60 days. De novo bone formation was evaluated radiographically and histologically. RESULTS Bone formation rate was higher in the test groups compared to the control groups after 20, 40 and 60 days. After 40 and 60 days, a statistically significant higher (P < 0.01) bone formation rate was found for both elevation heights. The maximum height of the generated bone was statistically significantly higher (P < 0.01) in the test groups for both elevation heights, compared to the control groups for all time points investigated. CONCLUSION Periosteal elevation by dental implants is a treatment option for supracortical peri-implant bone formation.
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Affiliation(s)
- Rainer Lutz
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany.
| | - Christina Sendlbeck
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Hommeira Wahabzada
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Christian Tudor
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Christopher Prechtl
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Med. Dr. Med. Dent. Dr. H.C. Friedrich Wilhelm Neukam), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Östliche Stadtmauerstrasse 27, 91054, Erlangen, Germany
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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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8
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9
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Moest T, Wehrhan F, Lutz R, Schmitt CM, Neukam FW, Schlegel KA. Extra-oral defect augmentation using autologous, bovine and equine bone blocks: A preclinical histomorphometrical comparative study. J Craniomaxillofac Surg 2015; 43:559-66. [PMID: 25794644 DOI: 10.1016/j.jcms.2015.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 01/08/2015] [Accepted: 02/16/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES This study aimed to compare autologous bone (AB), bovine bone (BB), and equine bone (EB) blocks with regard to de novo bone formation, connective tissue, and residual bone substitute material portions in a standardized defect animal model. MATERIAL AND METHODS In the frontal skull of 20 pigs, 106 standardized cylindrical "critical size defects" were prepared. Defects were randomly filled with AB, BB, and EB blocks. After a healing period of 30 and 60 days, de novo bone formation, residual bone substitute material, and connective tissue portion was assessed by means of histomorphometry (Toluidine blue O staining). Mann-Whitney U-tests were used to evaluate differences between the groups. RESULTS The de novo bone formation was significantly higher in the AB group in comparison to the xenogeneic groups (p < 0.05). After 30 days, EB showed significantly (p < 0.05) more newly formed bone compared to the BB group. The soft tissue formation was significantly higher in the BB and EB group. Defects augmented with BB showed significantly (p < 0.05) higher portions of bone substitute materials compared to sides augmented with EB after 30 days. CONCLUSION In the extra-oral model, AB blocks were superior concerning de novo bone formation. No clinical advantages of EB blocks could be observed.
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Affiliation(s)
- Tobias Moest
- Department of Oral and Maxillofacial Surgery, University Erlangen - Nuremberg, Glückstraße 11, D-91054 Erlangen, Germany.
| | - Falk Wehrhan
- Department of Oral and Maxillofacial Surgery, University Erlangen - Nuremberg, Glückstraße 11, D-91054 Erlangen, Germany
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, University Erlangen - Nuremberg, Glückstraße 11, D-91054 Erlangen, Germany
| | - Christian Martin Schmitt
- Department of Oral and Maxillofacial Surgery, University Erlangen - Nuremberg, Glückstraße 11, D-91054 Erlangen, Germany
| | - Friedrich Wilhelm Neukam
- Department of Oral and Maxillofacial Surgery, University Erlangen - Nuremberg, Glückstraße 11, D-91054 Erlangen, Germany
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery, University Erlangen - Nuremberg, Glückstraße 11, D-91054 Erlangen, Germany
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10
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Harrison R, Criss ZK, Feller L, Modi SP, Hardy JG, Schmidt CE, Suggs LJ, Murphy MB. Mechanical properties of α-tricalcium phosphate-based bone cements incorporating regenerative biomaterials for filling bone defects exposed to low mechanical loads. J Biomed Mater Res B Appl Biomater 2015; 104:149-57. [PMID: 25677680 DOI: 10.1002/jbm.b.33362] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 10/30/2014] [Accepted: 12/17/2014] [Indexed: 12/25/2022]
Abstract
Calcium phosphate-based cements with enhanced regenerative potential are promising biomaterials for the healing of bone defects in procedures such as percutaneous vertebroplasty. With a view to the use of such cements for low load bearing applications such as sinus augmentation or filling extraction sites. However, the inclusion of certain species into bone cement formulations has the potential to diminish the mechanical properties of the formulations and thereby reduce their prospects for clinical translation. Consequently, we have prepared α-tricalcium phosphate (α-TCP)-based bone cements including materials that we would expect to improve their regenerative potential, and describe the mechanical properties of the resulting formulations herein. Formulations incorporated α-TCP, hydroxyapatite, biopolymer-thickened wetting agents, sutures, and platelet poor plasma. The mechanical properties of the composites were composition dependent, and optimized formulations had clinically relevant mechanical properties. Such calcium phosphate-based cements have potential as replacements for cements such as those based on polymethylmethacrylate.
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Affiliation(s)
- Reed Harrison
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| | - Zachary K Criss
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| | - Lacie Feller
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| | - Shan P Modi
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| | - John G Hardy
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, 32611-6131
| | - Christine E Schmidt
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, 32611-6131
| | - Laura J Suggs
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
| | - Matthew B Murphy
- Department of Biomedical Engineering, The University of Texas at Austin, Texas, 78712
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11
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Uzbek UH, Rahman SA, Alam MK, Gillani SW. Bone Forming Potential of An-Organic Bovine Bone Graft: A Cone Beam CT study. J Clin Diagn Res 2014; 8:ZC73-6. [PMID: 25654037 DOI: 10.7860/jcdr/2014/8557.5352] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 05/14/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE An-organic bovine bone graft is a xenograft with the potential of bone formation. The aim of this study was to evaluate the bone density using cone beam computed tomography scans around functional endosseous implant in the region of both augmented maxillary sinus with the an-organic bovine bone graft and the alveolar bone over which the graft was placed to provide space for the implants. MATERIALS AND METHODS Sterile freeze dried bovine bone graft produced by National Tissue Bank, University Sains, Malaysia was used for stage-1 implant placement with maxillary sinus augmentation in a total of 19 subjects with 19 implants. The age of all subjects ranged between 40-60 years with a mean age 51±4.70. All subjects underwent a follow up CT scan using PlanmecaPromax 3D(®) Cone beam computed tomography scanner at the Radiology department, Hospital University Sains, Malaysia. The collected data was then analysed to evaluate bone density in Hounsfield Units using PlanmecaRomexis" Imaging Software 2.2(®) which is specialized accompanying software of the cone beam computed tomography machine. RESULTS There was bone formation seen at the site of the augmented sinus. A significant increase (p<0.005) in bone density was reported at the augmented site compared to the bone density of the existing alveolar bone. CONCLUSION An-organic bovine bone graft is an osteoconductive material that can be used for the purpose of maxillary sinus augmentation.
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Affiliation(s)
- Usman Haider Uzbek
- Masters Student, Department of Oral and Maxillo-facial Surgery, University Sains Malaysia , Kelantan, Malaysia
| | - Shaifulizan Ab Rahman
- Senior Lecturer, Department of Oral and Maxillo-facial Surgery, University Sains Malaysia , Kelantan, Malaysia
| | | | - Syed Wasif Gillani
- Senior Lecturer, Discipline of Pharmacy, Monash University Malaysia , Selangor, Malaysia
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12
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Bova JF, da Cunha AF, Stout RW, Bhumiratana S, Alfi DM, Eisig SB, Vunjak-Novakovic G, Lopez MJ. Bupivacaine mandibular nerve block affects intraoperative blood pressure and heart rate in a Yucatan miniature swine mandibular condylectomy model: a pilot study. J INVEST SURG 2014; 28:32-9. [PMID: 25394295 DOI: 10.3109/08941939.2014.971207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE/AIM The primary objective was to evaluate the effect of a bupivacaine mandibular nerve block on intraoperative blood pressure (BP) and heart rate (HR) in response to surgical stimulation and the need for systemic analgesics postoperatively. We hypothesized that a mandibular nerve block would decrease the need for systemic analgesics both intraoperatively and postoperatively. MATERIALS AND METHODS Fourteen adult male Yucatan pigs were purchased. Pigs were chemically restrained with ketamine, midazolam, and dexmedetomidine and anesthesia was maintained with isoflurane inhalant anesthesia. Pigs were randomized to receive a mandibular block with either bupivacaine (bupivacaine group) or saline (control group). A nerve stimulator was used for administration of the block with observation of masseter muscle twitch to indicate the injection site. Invasive BP and HR were measured with the aid of an arterial catheter in eight pigs. A rescue analgesic protocol consisting of fentanyl and lidocaine was administered if HR or BP values increased 20% from baseline. Postoperative pain was quantified with a customized ethogram. HR and BP were evaluated at base line, pre-rescue, 10 and 20 min post-rescue. RESULTS Pre-rescue mean BP was significantly increased (p = .001) for the bupivacaine group. Mean intraoperative HR was significantly lower (p = .044) in the bupivacaine versus saline group. All other parameters were not significant. CONCLUSION Addition of a mandibular nerve block to the anesthetic regimen in the miniature pig condylectomy model may improve variations in intraoperative BP and HR. This study establishes the foundation for future studies with larger animal numbers to confirm these preliminary findings.
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Affiliation(s)
- Jonathan F Bova
- 1Department of Pathobiological Sciences, Louisiana State University School of Veterinary Medicine , Baton Rouge, Louisiana , USA
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13
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Mueller B, Koch D, Lutz R, Schlegel KA, Treccani L, Rezwan K. A novel one-pot process for near-net-shape fabrication of open-porous resorbable hydroxyapatite/protein composites and in vivo assessment. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 42:137-45. [PMID: 25063103 DOI: 10.1016/j.msec.2014.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 04/29/2014] [Accepted: 05/13/2014] [Indexed: 01/25/2023]
Abstract
We present a mild one-pot freeze gelation process for fabricating near-net, complex-shaped hydroxyapatite scaffolds and to directly incorporate active proteins during scaffold processing. In particular, the direct protein incorporation enables a simultaneous adjustment and control of scaffold microstructure, porosity, resorbability and enhancement of initial mechanical and handling stability. Two proteins, serum albumin and lysozyme, are selected and their effect on scaffold stability and microstructure investigated by biaxial strength tests, electron microscopy, and mercury intrusion porosimetry. The resulting hydroxyapatite/protein composites feature adjustable porosities from 50% to 70% and a mechanical strength ranging from 2 to 6 MPa comparable to that of human spongiosa without any sintering step. Scaffold degradation behaviour and protein release are assessed by in vitro studies. A preliminary in vivo assessment of scaffold biocompatibility and resorption behaviour in adult domestic pigs is discussed. After implantation, composites were resorbed up to 50% after only 4 weeks and up to 65% after 8 weeks. In addition, 14% new bone formation after 4 weeks and 37% after 8 weeks were detected. All these investigations demonstrate the outstanding suitability of the one-pot-process to create, in a customisable and reliable way, biocompatible scaffolds with sufficient mechanical strength for handling and surgical insertion, and for potential use as biodegradable bone substitutes and versatile platform for local drug delivery.
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Affiliation(s)
- Berit Mueller
- University of Bremen, Advanced Ceramics, Am Biologischen Garten 2, 28359 Bremen, Germany.
| | - Dietmar Koch
- German Aerospace Center, Ceramic Composite Structures, Pfaffenwaldring 38-40, 70569 Stuttgart, Germany.
| | - Rainer Lutz
- University of Erlangen-Nuremberg, Department of Oral and Maxillofacial Surgery, Glueckstrasse 11, 91054 Erlangen, Germany.
| | - Karl A Schlegel
- University of Erlangen-Nuremberg, Department of Oral and Maxillofacial Surgery, Glueckstrasse 11, 91054 Erlangen, Germany.
| | - Laura Treccani
- University of Bremen, Advanced Ceramics, Am Biologischen Garten 2, 28359 Bremen, Germany.
| | - Kurosch Rezwan
- University of Bremen, Advanced Ceramics, Am Biologischen Garten 2, 28359 Bremen, Germany.
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14
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Kim JH, Moon HJ, Kim TH, Jo JM, Yang SH, Naskar D, Kundu SC, Chrzanowski W, Kim HW. A novel in vivo platform for studying alveolar bone regeneration in rat. J Tissue Eng 2013; 4:2041731413517705. [PMID: 24555013 PMCID: PMC3927964 DOI: 10.1177/2041731413517705] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Accepted: 12/02/2013] [Indexed: 12/25/2022] Open
Abstract
Alveolar bone regeneration is a significant challenge in dental implantation. Novel biomaterials and tissue-engineered constructs are under extensive development and awaiting in vivo animal tests to find clinical endpoint. Here, we establish a novel in vivo model, modifying gingivoperiosteoplasty in rat for the alveolar bone regeneration. Rat premaxillary bone defects were filled with silk scaffold or remained empty during the implantation period (up to 6 weeks), and harvested samples were analyzed by micro-computed tomography and histopathology. Empty defects showed increased but limited new bone formation with increasing implantation period. In defects implanted with silk sponge, the bone formation was significantly greater than that of empty defect, indicating an effective role of silk scaffold in the defect model. The modified premaxillary defect model in rat is simple to perform, while mimicking the clinical conditions, finding usefulness for the development of biomaterials and tissue-engineered constructs targeting alveolar bone regeneration in dental implantation.
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Affiliation(s)
- Joong-Hyun Kim
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, Republic of Korea ; Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, Republic of Korea
| | - Ho-Jin Moon
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, Republic of Korea ; Department of Conservative Dentistry, Dankook University Dental College, Cheonan, Republic of Korea
| | - Tae-Hyun Kim
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, Republic of Korea ; Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, Republic of Korea
| | - Jong-Min Jo
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, Republic of Korea ; Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, Republic of Korea
| | - Sung Hee Yang
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, Republic of Korea ; Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, Republic of Korea
| | - Deboki Naskar
- Department of Biotechnology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Subhas C Kundu
- Department of Biotechnology, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Wojciech Chrzanowski
- Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, Republic of Korea ; Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Hae-Won Kim
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan, Republic of Korea ; Department of Nanobiomedical Science & BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, Republic of Korea ; Department of Biomaterials Science, Dankook University Dental College, Cheonan, Republic of Korea
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15
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Metzler P, von Wilmowsky C, Stadlinger B, Zemann W, Schlegel KA, Rosiwal S, Rupprecht S. Nano-crystalline diamond-coated titanium dental implants – A histomorphometric study in adult domestic pigs. J Craniomaxillofac Surg 2013; 41:532-8. [DOI: 10.1016/j.jcms.2012.11.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Revised: 11/13/2012] [Accepted: 11/14/2012] [Indexed: 10/27/2022] Open
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von Wilmowsky C, Moest T, Nkenke E, Stelzle F, Schlegel KA. Implants in bone: part II. Research on implant osseointegration: material testing, mechanical testing, imaging and histoanalytical methods. Oral Maxillofac Surg 2013; 18:355-72. [PMID: 23430020 DOI: 10.1007/s10006-013-0397-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 02/04/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE In order to determine whether a newly developed implant material conforms to the requirements of biocompatibility, it must undergo rigorous testing. To correctly interpret the results of studies on implant material osseointegration, it is necessary to have a sound understanding of all the testing methods. The aim of this overview is to elucidate the methods that are used for the experimental evaluation of the osseointegration of implant materials. DISCUSSION In recent decades, there has been a constant proliferation of new materials and surface modifications in the field of dental implants. This continuous development of innovative biomaterials requires a precise and detailed evaluation in terms of biocompatibility and implant healing before clinical use. The current gold standard is in vivo animal testing on well validated animal models. However, long-term outcome studies on patients have to follow to finally validate and show patient benefit. CONCLUSION No experimental set-up can provide answers for all possible research questions. However, a certain transferability of the results to humans might be possible if the experimental set-up is carefully chosen for the aspects and questions being investigated. To enhance the implant survival rate in the rising number of patients with chronic diseases which compromise wound healing and osseointegration, dental implant research on compromised animal models will further gain importance in future.
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Affiliation(s)
- Cornelius von Wilmowsky
- Mund-,Kiefer- und Gesichtschirurgische Klinik Universitätsklinikum Erlangen, Glückstrasse 11, 91054, Erlangen, Germany,
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Stelzle F, Frenkel C, Riemann M, Knipfer C, Stockmann P, Nkenke E. The effect of load on heat production, thermal effects and expenditure of time during implant site preparation - an experimental ex vivo comparison between piezosurgery and conventional drilling. Clin Oral Implants Res 2012. [PMID: 23186531 DOI: 10.1111/clr.12077] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Piezoelectric surgery (PS) is meant to be a gentle osteotomy method. The aim of this study was to compare piezosurgical vs. conventional drilling methods for implant site preparation (ISP) - focusing on load-dependent thermal effect on hard tissue and the expenditure of ISP time. MATERIALS AND METHODS Three hundred and sixty ISP were performed on ex vivo pig heads using piezosurgery, spiral burs (SB) and trephine burs (TB). The load applied was increased from 0 to 1000 g in 100-g intervals. Temperature within the bone was measured with a thermocouple, and duration was recorded with a stop watch. Thermal effects were histomorphometrically analysed. Twelve ISPs per technique were performed at the lateral wall of the maxillary sinus. RESULTS PS yields the highest mean temperatures (48.6 ± 3.4°C) and thermal effects (200.7 ± 44.4 μm), both at 900-1000 g. Duration is reduced with a plus of load and significantly longer in either case for PS (P < 0.05). There is a correlation of the applied load with all other examined factors for PS and TB. Temperature and histological effects decrease for SB beyond 500 g. CONCLUSIONS PS yields significantly higher temperatures and thermal tissue alterations on load levels higher than 500 g and is significantly slower for ISP compared to SB and TB. For ISP with PS, a maximum load of 400 g should be maintained.
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Affiliation(s)
- Florian Stelzle
- Department of Oral and Maxillofacial Surgery, Erlangen University Hospital, Erlangen, Germany
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18
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Štembírek J, Kyllar M, Putnová I, Stehlík L, Buchtová M. The pig as an experimental model for clinical craniofacial research. Lab Anim 2012; 46:269-79. [PMID: 22969144 DOI: 10.1258/la.2012.012062] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The pig represents a useful, large experimental model for biomedical research. Recently, it has been used in different areas of biomedical research. The aim of this study was to review the basic anatomical structures of the head region in the pig in relation to their use in current research. Attention was focused on the areas that are frequently affected by pathological processes in humans: the oral cavity with teeth, salivary gland, orbit, nasal cavity and paranasal sinuses, maxilla, mandible and temporomandibular joint. Not all of the structures have an equal morphology in the pig and human, and these morphological dissimilarities must be taken into account before choosing the pig as an experimental model for regenerative medicine.
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Affiliation(s)
- J Štembírek
- Institute of Animal Physiology and Genetics, vvi, Academy of Sciences of Czech Republic, Brno, Czech Republic
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19
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Wehrhan F, Amann K, Molenberg A, Lutz R, Neukam FW, Schlegel KA. Critical size defect regeneration using PEG-mediated BMP-2 gene delivery and the use of cell occlusive barrier membranes - the osteopromotive principle revisited. Clin Oral Implants Res 2012; 24:910-20. [PMID: 23865504 DOI: 10.1111/j.1600-0501.2012.02489.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to investigate if osseous regeneration can be accelerated by involvement of periosteal tissue. Bone defect regeneration could be accelerated by the involvement of periosteal tissue if osteogenic cell signalling is maintained within the defect. It was questioned if local cell-mediated BMP-2 gene delivery makes a cell occlusive membrane dispensable during bone critical size defect regeneration. METHODS PEG matrix (degradation time 10 days) and PEG membrane (degradation time 120 days) were used in the pig calvarial model. Cylindrical (1 × 1 cm) critical size defects (CSD) (9 per animal; 20 animals) were filled with: (i) particulated autologous bone, covered with PEG membrane (group 1); (ii) HA/TCP, covered with PEG membrane (group 2); (iii) HA/TCP, mixed with PEG matrix (group 3); and (iv) HA/TCP mixed with BMP-2-transfected osteoblasts and PEG matrix (group 4). BMP-2/4 gene transfer: liposomal in vitro transfection of BMP-2/V5-tag fusion-protein. Quantitative histomorphometry (toluidine blue staining) after 2, 4 and 12 weeks assessed bone formation. Semiquantitative immunohistochemistry estimated the expression of BMP-2, V5-tag, Runx-2 and Sox9. RESULTS PEG matrix embedded BMP-2 expressing cells presented higher bone formation (P < 0.05) than HA/TCP + PEG matrix defect filling or PEG membrane covering (HA/TCP filling) after 12 weeks. Highest expression of BMP-2, Runx-2 and lowest expression of fibrous tissue marker Sox9 was seen in the BMP-2 group. CONCLUSION PEG matrix embedded BMP-2 expressing cells are capable to maintain osteogenic signalling and to accelerate osseous defect regeneration in absence of a cell occlusive membrane.
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Affiliation(s)
- Falk Wehrhan
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany.
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Metzler P, von Wilmowsky C, Zimmermann R, Wiltfang J, Schlegel KA. The effect of current used bone substitution materials and platelet-rich plasma on periosteal cells by ectopic site implantation: An in-vivo pilot study. J Craniomaxillofac Surg 2012; 40:409-15. [DOI: 10.1016/j.jcms.2011.07.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 07/19/2011] [Accepted: 07/23/2011] [Indexed: 11/26/2022] Open
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Wehrhan F, Amann K, Molenberg A, Lutz R, Neukam FW, Schlegel KA. PEG matrix enables cell-mediated local BMP-2 gene delivery and increased bone formation in a porcine critical size defect model of craniofacial bone regeneration. Clin Oral Implants Res 2011; 23:805-13. [PMID: 22151397 DOI: 10.1111/j.1600-0501.2011.02223.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2011] [Indexed: 01/19/2023]
Abstract
PURPOSE This study addressed the suitability of a polyethylene glycol (PEG) matrix as scaffold for cell-mediated local BMP-2 gene transfer in a calvarial critical size defect (CSD) model. MATERIALS AND METHODS PEG matrix (degradation time 10 days) and PEG membrane (degradation time 120 days) were used in the pig calvarial model. Cylindrical (1 × 1 cm) CSD (9 per animal; 20 animals) were filled with: (i) HA/TCP, covered by PEG membrane (group 1); (ii) HA/TCP, mixed with PEG matrix (group 2); and (iii) HA/TCP mixed with BMP-2 transfected osteoblasts and PEG matrix (group 3). BMP-2/4 gene transfer: liposomal in vitro transfection of BMP-2/V5-tag fusion-protein. Quantitative histomorphometry (toluidine blue staining) after 2, 4 and 12 weeks assessed bone formation. Semiquantitative immunohistochemistry estimated the expression of BMP-2 and V5-tag. RESULTS Group 3 showed significantly higher new bone formation than groups 1, 2 at 4 (P < 0.05) and 12 (P < 0.02) weeks. BMP-2-V5-tag was detected for 4 weeks. BMP-2 expression in group 3 was higher compared to all other groups after 2 and 4 (P < 0.02) weeks. CONCLUSIONS The PEG matrix serves as scaffold for cell-mediated BMP-2 gene delivery in guided bone regeneration facilitating cell survival and protein synthesis for at least 4 weeks. Local BMP-2 gene delivery by PEG matrix-embedded cells leads to increased bone formation during critical size defect regeneration.
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Affiliation(s)
- Falk Wehrhan
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
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von Wilmowsky C, Stockmann P, Harsch I, Amann K, Metzler P, Lutz R, Moest T, Neukam FW, Schlegel KA. Diabetes mellitus negatively affects peri-implant bone formation in the diabetic domestic pig. J Clin Periodontol 2011; 38:771-9. [PMID: 21752046 DOI: 10.1111/j.1600-051x.2011.01746.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AIM Diabetes mellitus is classified as a relative contraindication for implant treatment, and higher failure rates have been seen in diabetic patients. The aim of the present study was to investigate the effect of diabetes on peri-implant bone formation in an animal model of human bone repair. MATERIALS AND METHODS Diabetes was induced by an intra-venous application of streptozotocin (90 mg/kg) in 15 domestic pigs. Implants were placed after significant histopathological changes in the hard and soft tissues were verified. The bone-implant contact (BIC), peri-implant bone mineral density (BMD), and expression of collagen type-I and osteocalcin proteins were qualitatively evaluated 4 and 12 weeks after implantation. Fifteen animals served as healthy controls. RESULTS Diabetes caused pathological changes in the soft and hard tissues. The BIC and BMD were significantly reduced in the diabetic group after 4 and 12 weeks. Collagen type-I was increased in the diabetic group at both time points, whereas osteocalcin was reduced in the diabetic group. CONCLUSIONS Poorly controlled diabetes negatively affects peri-implant bone formation and bone mineralization. These findings have to be taken into consideration for diabetic patients with an indication for implant therapy.
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Affiliation(s)
- Cornelius von Wilmowsky
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
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Schlegel KA, Prechtl C, Möst T, Seidl C, Lutz R, von Wilmowsky C. Osseointegration of SLActive implants in diabetic pigs. Clin Oral Implants Res 2011; 24:128-34. [PMID: 22111960 DOI: 10.1111/j.1600-0501.2011.02380.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Diabetes mellitus is currently classified as a relative contraindication for implant treatment because of microangiopathies with the consequence of impaired bone regeneration and higher rates of implant failure. The study aim was to investigate peri-implant bone formation in a diabetic animal model in comparison to healthy animals and to evaluate the differences between conventional (SLA(®) ) and modified (SLActive(®) ) titanium implant surfaces on osseointegration. MATERIAL AND METHODS Each six implants were placed in the calvaria of 11 diabetic and 4 healthy domestic pigs. At 30 and 90 days after implant placement, the bone-to-implant contact (BIC) and bone density (BD) were appraised. Additionally, the expression of the bone-matrix proteins collagen type I and osteocalcin was evaluated at both points in time by using immunohistochemical staining methods. RESULTS Overall, BIC was reduced in the diabetic group at 30 and 90 days. After 90 days, the SLActive(®) implants showed significantly higher BICs compared with the SLA(®) implants in diabetic animals. Peri-implant BD was higher in the SLActive(®) group at 30 and 90 days in healthy and diabetic animals. Collagen type I protein expression was higher using SLA(®) implants in diabetic pigs at 30 days. Values for osteocalcin expression were not consistent. CONCLUSIONS The results indicate the negative effect of untreated diabetes mellitus on early osseointegration of dental implants. The modified SLA(®) surface (SLActive(®) ) elicited an accelerated osseointegration of dental implants, suggesting that a better prognosis for implant treatment of diabetic patients is possible.
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Affiliation(s)
- K A Schlegel
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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von Wilmowsky C, Bauer S, Roedl S, Neukam FW, Schmuki P, Schlegel KA. The diameter of anodic TiO2 nanotubes affects bone formation and correlates with the bone morphogenetic protein-2 expression in vivo. Clin Oral Implants Res 2011; 23:359-66. [PMID: 21443609 DOI: 10.1111/j.1600-0501.2010.02139.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Recently, it has been demonstrated that the nanoscale environment is a critical factor for cellular behaviour. It has been shown that the diameter of TiO2 nanotube layers controls the cellular behaviour of cells involved in the bone-forming process in vitro. Therefore, the aim of the present study was to investigate the effects of the diameter of TiO2 nanotubes on peri-implant bone formation and the expression of bone matrix proteins in vivo. MATERIALS AND METHODS Ninety experimental implants with a nanotube diameter ranging from 15 up to 100 nm were placed in the frontal skulls of six domestic pigs, whereas untreated implants served as controls. The bone-implant contact (BIC) as well as the expression of bone morphogenetic protein (BMP)-2, collagen type-I and osteocalcin were histomorphometrically and immunohistochemically analysed after 30 days. RESULTS Evaluating the BIC, a significant higher value, could be found for the 50, 70 and 100 nm groups compared with the controls, whereas a correlation with the BMP-2 expression was present. The BMP-2 expression within the 50, 70 and 100 nm groups was statistically different compared with the control group. Significant difference was found for the osteocalcin expression in the 70 nm group. No statistical difference was found evaluating collagen type-I. SEM evaluation of the specimen surfaces revealed that the nanotube coatings do resist shearing forces evoked by implant insertion. CONCLUSION The nanotube diameter can be designed to support cellular functions of osteoblasts and osteoclasts in vivo, including differentiation and protein expression and therefore offer a powerful tool for the controlled formation of peri-implant bone around medical implant devices.
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Affiliation(s)
- Cornelius von Wilmowsky
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
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Stelzle F, Benner KU. An animal model for sinus floor elevation with great elevation heights. Macroscopic, microscopic, radiological and micro-CT analysis: ex vivo. Clin Oral Implants Res 2011; 21:1370-8. [PMID: 20497438 DOI: 10.1111/j.1600-0501.2010.01958.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Different animal models are used for research and training concerning sinus floor elevation. However, there is little information regarding an animal model for elevation heights of approximately 10 mm. The aim of this study was to explore the anatomical aspects of the maxillary sinus of adult pigs and to investigate the suitability of this animal as a model for sinus floor elevation training and research with great elevation heights. MATERIAL AND METHODS Thirty-four bisected heads of adult domestic pigs were examined 6 h postmortem. Direct sinus floor elevation was performed with an elevation height of 10 mm. Localization, diameters, volume and septa of the maxillary sinus were recorded on lateral X-rays and macroscopically. The thickness and structure of the maxillary sinus were investigated microscopically. The osseous microstructure of the lateral sinus wall was assessed microscopically and via micro-CT. RESULTS The maxillary sinus of the adult pig exhibits an average length of 51±6.2 mm, a height of 31±4.1 mm, a width of 19±1.6 mm and a volume of 31±7.6 cm(3) . At least one septum could be observed on the floor of each sinus. The mucosal thickness amounted to a mean of 1692±138 μm, and the lateral bony wall of the sinus to a mean of 3±0.3 mm. A laceration of the Schneiderian membrane occurred in 25% during the elevation process. CONCLUSION The maxillary sinus of adult domestic pigs is a suitable model for sinus floor elevation training and research with greater elevation heights of up to 10 mm.
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Affiliation(s)
- Florian Stelzle
- Department of Oral and Maxillofacial Surgery, Erlangen University Hospital, Erlangen, Germany.
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Luvizuto ER, Tangl S, Zanoni G, Okamoto T, Sonoda CK, Gruber R, Okamoto R. The effect of BMP-2 on the osteoconductive properties of β-tricalcium phosphate in rat calvaria defects. Biomaterials 2011; 32:3855-61. [PMID: 21376389 DOI: 10.1016/j.biomaterials.2011.01.076] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 01/31/2011] [Indexed: 11/26/2022]
Abstract
Bone formation in critical-sized calvaria defects is strongly dependent on the osteoconductive properties of grafts. It remains a matter of controversy whether biomaterials can replace autografts and whether the supplementation of biomaterials with Bone Morphogenetic Proteins (BMPs) is necessary to enhance bone formation. We examined rat calvaria critical-sized defects (5-mm-diameter) treated with β-tricalcium phosphate (TCP; Cerasorb® M), polylactic and polyglycolic acid gel (PLA/PGA; Fisiograft®) and calcium phosphate cement (CPC; Norian® CRS®), either alone or in the presence of 5 μg of BMP-2 after 45 days. Autografts and untreated defects served as controls. Bone formation was evaluated based on μCT analysis, histomorphometric analysis and fluorescence analysis. We report that TCP supported bone formation more efficiently than did autografts. Bone formation in the presence of TCP alone reached a maximal level, as BMP-2 supplementation failed to enhance bone formation. By contrast, no significant difference in bone formation was observed when PLA/PGA and CPC were compared to autografts. Moreover, the presence of BMP-2 did not substantially change the osteoconductive properties of PLA/PGA or CPC. We conclude that the osteoconductive properties of TCP are superior to those of autografts and that TCP does not require BMP-2 supplementation. Our findings also show that the decreased osteoconductive properties of PLA/PGA and CPC cannot be overcome by BMP-2 supplementation in rat calvaria defects.
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Affiliation(s)
- Eloa R Luvizuto
- Department of Oral Surgery, Medical University of Vienna, Austria
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Lutz R, Srour S, Nonhoff J, Weisel T, Damien CJ, Schlegel KA. Biofunctionalization of titanium implants with a biomimetic active peptide (P-15) promotes early osseointegration. Clin Oral Implants Res 2010; 21:726-34. [PMID: 20636727 DOI: 10.1111/j.1600-0501.2009.01904.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The early stages of peri-implant bone formation play an essential role in the osseointegration and long-term success of dental implants. By incorporating bioactive coatings, this biofunctionalization of implant surfaces may enhance the attachment of the implant to the surrounding bone and stimulate bone regeneration. MATERIAL AND METHODS To demonstrate faster osseointegration, the surfaces of dental implants were grit-blasted and acid-etched. They were then coated with hydroxyapatite (HA) and experimental implants were further coated with a biomimetic active peptide (P-15) in one of two concentrations. These biofunctionalized samples and controls with no peptide were placed in the forehead region of 12 adult pigs. Six animals were evaluated for a period of 14 or 30 days. RESULTS Histomorphometric analysis demonstrated that the implants with the high concentration of P-15 had significantly higher percentage of bone-to-implant contact (BIC) at 14 (P=0.018) and 30 (P=0.015) days compared with the other groups. Both concentrations of P-15 showed increased peri-implant bone density compared to the control group at 30 days. CONCLUSION Biofunctionalization of the implant surface with a biomimetic active peptide leads to significantly increased BIC rates at 14 and 30 days and higher peri-implant bone density at 30 days.
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Affiliation(s)
- R Lutz
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
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