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Nemcakova I, Litvinec A, Mandys V, Potocky S, Plencner M, Doubkova M, Nanka O, Olejnickova V, Sankova B, Bartos M, Ukraintsev E, Babčenko O, Bacakova L, Kromka A, Rezek B, Sedmera D. Coating Ti6Al4V implants with nanocrystalline diamond functionalized with BMP-7 promotes extracellular matrix mineralization in vitro and faster osseointegration in vivo. Sci Rep 2022; 12:5264. [PMID: 35347219 PMCID: PMC8960880 DOI: 10.1038/s41598-022-09183-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/18/2022] [Indexed: 02/06/2023] Open
Abstract
The present study investigates the effect of an oxidized nanocrystalline diamond (O-NCD) coating functionalized with bone morphogenetic protein 7 (BMP-7) on human osteoblast maturation and extracellular matrix mineralization in vitro and on new bone formation in vivo. The chemical structure and the morphology of the NCD coating and the adhesion, thickness and morphology of the superimposed BMP-7 layer have also been assessed. The material analysis proved synthesis of a conformal diamond coating with a fine nanostructured morphology on the Ti6Al4V samples. The homogeneous nanostructured layer of BMP-7 on the NCD coating created by a physisorption method was confirmed by AFM. The osteogenic maturation of hFOB 1.19 cells in vitro was only slightly enhanced by the O-NCD coating alone without any increase in the mineralization of the matrix. Functionalization of the coating with BMP-7 resulted in more pronounced cell osteogenic maturation and increased extracellular matrix mineralization. Similar results were obtained in vivo from micro-CT and histological analyses of rabbit distal femurs with screws implanted for 4 or 12 weeks. While the O-NCD-coated implants alone promoted greater thickness of newly-formed bone in direct contact with the implant surface than the bare material, a further increase was induced by BMP-7. It can be therefore concluded that O-NCD coating functionalized with BMP-7 is a promising surface modification of metallic bone implants in order to improve their osseointegration.
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Affiliation(s)
- Ivana Nemcakova
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4, Czech Republic
| | - Andrej Litvinec
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4, Czech Republic
| | - Vaclav Mandys
- Department of Pathology, Charles University, Third Faculty of Medicine, Ruska 2411, 100 00, Prague 10, Czech Republic
| | - Stepan Potocky
- Institute of Physics, Czech Academy of Sciences, Cukrovarnicka 10, 162 00, Prague 6, Czech Republic
| | - Martin Plencner
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4, Czech Republic
| | - Martina Doubkova
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4, Czech Republic.
| | - Ondrej Nanka
- Institute of Anatomy, Charles University, First Faculty of Medicine, U Nemocnice 3, 128 00, Prague 2, Czech Republic
| | - Veronika Olejnickova
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4, Czech Republic.,Institute of Anatomy, Charles University, First Faculty of Medicine, U Nemocnice 3, 128 00, Prague 2, Czech Republic
| | - Barbora Sankova
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4, Czech Republic.,Institute of Anatomy, Charles University, First Faculty of Medicine, U Nemocnice 3, 128 00, Prague 2, Czech Republic
| | - Martin Bartos
- Institute of Dental Medicine, Charles University, First Faculty of Medicine, U Nemocnice 2, 1280 00, Prague 2, Czech Republic
| | - Egor Ukraintsev
- Faculty of Electrical Engineering, Czech Technical University in Prague, Technicka 2, 166 27, Prague 6, Czech Republic
| | - Oleg Babčenko
- Faculty of Electrical Engineering, Czech Technical University in Prague, Technicka 2, 166 27, Prague 6, Czech Republic
| | - Lucie Bacakova
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4, Czech Republic
| | - Alexander Kromka
- Institute of Physics, Czech Academy of Sciences, Cukrovarnicka 10, 162 00, Prague 6, Czech Republic
| | - Bohuslav Rezek
- Faculty of Electrical Engineering, Czech Technical University in Prague, Technicka 2, 166 27, Prague 6, Czech Republic
| | - David Sedmera
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4, Czech Republic. .,Institute of Anatomy, Charles University, First Faculty of Medicine, U Nemocnice 3, 128 00, Prague 2, Czech Republic.
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Cellular responses to deproteinized bovine bone mineral biofunctionalized with bone-conditioned medium. Clin Oral Investig 2020; 25:2159-2173. [PMID: 32870390 PMCID: PMC7966141 DOI: 10.1007/s00784-020-03528-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/13/2020] [Indexed: 01/30/2023]
Abstract
OBJECTIVES The aim of the study was to investigate whether the osteoinductive properties of bone-conditioned medium (BCM) harvested from cortical bone chips within a clinically relevant short-term period can enhance the biologic characteristics of deproteinized bovine bone mineral (DBBM) in vitro. MATERIALS AND METHODS To assess the biofunctionalization of DBBM, the adhesive, proliferative, and differentiation properties of mesenchymal stromal ST2, pre-osteoblastic MC3T3-E1, and primary bone-derived cells grown on BCM-coated DBBM were examined by crystal violet staining of adherent cells, BrdU ELISA, and qRT-PCR, respectively. RESULTS BCM extracted within 20 min or 24 h in either Ringer's solution (BCM-RS) or RS mixed with autologous serum (BCM-RS + S) increased the adhesive properties of all three cell types seeded on DBBM. The 20-min BCM-RS preparation appeared more potent than the 24-h preparation. BCM-RS made within 20 min or 24 h had strong pro-proliferative effects on all cell types grown on DBBM. RS + S alone exhibited a considerable pro-proliferative effect, suggesting an impact of the serum on cellular growth. DBBM coated with BCM-RS or BCM-RS + S, made within 20 min or 24 h each, caused a significant induction of osteogenic differentiation marker expression with a higher potency of the BCM-RS + S. Finally, a strong additive effect of fresh bone chips combined with BCM-coated DBBM on the osteogenic differentiation of the three cell types was observed. CONCLUSIONS Altogether, the data strongly support the biofunctionalization of DBBM with BCM extracted within a clinically relevant time window of 20 min. CLINICAL RELEVANCE Pre-activation of non-osteoinductive biomaterials with BCM, prepared from autologous bone chips during a guided bone regeneration (GBR) procedure, bears the potential of an optimal treatment modality for bone defects in daily practice.
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Hung CC, Fu E, Chiu HC, Liang HC. Bone formation following sinus grafting with an alloplastic biphasic calcium phosphate in Lanyu Taiwanese mini-pigs. J Periodontol 2019; 91:93-101. [PMID: 31350789 DOI: 10.1002/jper.17-0748] [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: 12/24/2017] [Revised: 06/03/2019] [Accepted: 06/11/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND To evaluate the new bone formation after grafting with a synthetic biphasic calcium phosphate in sinuses with minimal bone height, the alloplastic and xenograft materials were compared after grafting into Lanyu Taiwanese mini-pig sinuses via split-mouth design. METHODS In six mini-pigs, synthetic hydroxyapatite/tricalcium phosphate (HA/TCP) particles were inserted into one of the sinus cavities using the extra-oral approach, where deproteinized bovine bone mineral (DBBM) particles were placed contralaterally. Fluorescent bony labels of Alizarin and Calcein green were delivered at weeks 4 and 8, respectively. Animals were sacrificed at week 12 and the augmented tissues were evaluated by cone-beam computed tomography, microcomputed tomography, and histology. RESULTS By radiographic examination, the mean thicknesses of sinus cortexes for DBBM and HA/TCP groups were similar (0.35 versus 0.38 cm) and the mean volumes augmented were also indifferent (1.29 versus 1.64 cm3 ). The distributions of bones, residual particles, and non-mineralized tissues in augmented masses between groups were undistinguishable. Under microscopy, however, macroporosities of osteons were filled with HA/TCP residual particles, whereas the newly formed bones lay on top of DBBM particle surfaces. Although the mineral deposition rates between groups were indifferent, the mean labeled surface in the HA/TCP group was significantly greater than those in the DBBM group at week 4 (35.16% versus 14.00% for HA/TCP and DBBM, respectively) but less than that at week 8 (19.33% versus 39.16%, respectively). CONCLUSION Sinus augmentation with synthetic HA/TCP and DBBM exhibited similar effectiveness in new bone formation.
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Affiliation(s)
- Chao-Chien Hung
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan
| | - Earl Fu
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan.,Department of Dentistry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Hsien-Chung Chiu
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan
| | - Huang-Chien Liang
- Department of Materials Engineering, Ming Chi University of Technology, New Taipei City, Taiwan
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Thoma DS, Bienz SP, Payer M, Hüsler J, Schmidlin PR, Hämmerle CHF, Jakse N, Jung RE. Randomized clinical study using xenograft blocks loaded with bone morphogenetic protein‐2 or autogenous bone blocks for ridge augmentation – A three‐dimensional analysis. Clin Oral Implants Res 2019; 30:872-881. [DOI: 10.1111/clr.13492] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/15/2019] [Accepted: 05/18/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science University of Zurich Zurich Switzerland
| | - Stefan P. Bienz
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science University of Zurich Zurich Switzerland
| | - Michael Payer
- Department of Oral Surgery and Radiology, School of Dentistry Medical University Graz Graz Austria
| | - Jürg Hüsler
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science University of Zurich Zurich Switzerland
| | - Patrick R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology University of Zurich Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science University of Zurich Zurich Switzerland
| | - Norbert Jakse
- Department of Oral Surgery and Radiology, School of Dentistry Medical University Graz Graz Austria
| | - Ronald E. Jung
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science University of Zurich Zurich Switzerland
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Donos N, Dereka X, Calciolari E. The use of bioactive factors to enhance bone regeneration: A narrative review. J Clin Periodontol 2019; 46 Suppl 21:124-161. [DOI: 10.1111/jcpe.13048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
| | - Xanthippi Dereka
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
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Jin HY, Teng MH, Wang D, Li X, Liang JY, Wang WX, Jiang S, Zhao BD. Modified Disk-Up Sinus Reamer for Sinus Floor Elevation and Simultaneous Implant Placement: An Animal Study with Miniature Pigs. J INVEST SURG 2019; 33:520-529. [PMID: 30644766 DOI: 10.1080/08941939.2018.1545881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: The disk-up sinus reamer (DSR) is a modified instrument used to elevate the maxillary sinus floor. This study aimed to compare the effects of modified DSR sinus floor elevation (DSFE) with osteotome sinus floor elevation (OSFE), both with simultaneous implant placement. Methods: Twelve miniature pigs were treated with DSFE on one side and OSFE on the other. Implants 9 mm in length were placed in six pigs without grafting, while implants 11 mm in length were placed in the other six pigs with grafting. After submerged healing for 3 months, vertical bone gain (VBG), general and histological observation, and bone contact ratio (BCR) were analyzed. Results: The mean maxillary residual bone height (RBH) when implants were placed was 6.45 ± 0.36 mm. In the no-grafting group, DSFE and OSFE had a similar VBG after 3 months. The grafting group with DSFE recorded a significantly higher VBG (VBG0: 7.83 ± 0.44 mm, VBG1: 7.54 ± 0.40 mm) than the graft group with OSFE (VBG0: 5.45 ± 0.56 mm, VBG1: 4.34 ± 2.15 mm) (p < 0.05). One implant became loose and the sinus mucosa of three pigs appeared metallic in color on the control side (OSFE). Conclusions: The effect of OSFE and DSFE is similar when there is no need for grafting. DSFE seems a better alternative method for sinus floor elevation with grafting when more VBG is needed.
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Affiliation(s)
- Hang-Ying Jin
- Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - Min-Hua Teng
- Affiliated Hospital of Qingdao University, Qingdao, China
| | - Duode Wang
- Qingdao Jimo People's hospital, Jimo, China
| | - Xin Li
- Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jia-Yue Liang
- Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - Wen-Xue Wang
- Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - Shuai Jiang
- Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - Bao-Dong Zhao
- Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
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Impact of Inorganic Xenograft on Bone Healing and Osseointegration: An Experimental Study in Rabbits. IMPLANT DENT 2018; 26:875-881. [PMID: 29095789 DOI: 10.1097/id.0000000000000694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate if an inorganic graft applied before implant insertion interferes with osseointegration. MATERIALS AND METHODS The bilateral mandibular incisors of 12 rabbits were extracted. One of the sockets was randomly filled with an inorganic xenogenic bone graft, whereas the remaining socket was allowed to heal naturally and served as a control. After 60 days, titanium implants were inserted into healing areas. The animals were killed 60 days after. Bone depositions were marked with fluorochrome oxytetracycline, alizarin, and calcein and evaluated using confocal laser scanning microscopy. Bone-to-implant contact (BIC) and bone area (BA) within the limits of the implant threads were analyzed. Data were compared statically by paired t tests, one-way ANOVA, and Bonferroni post hoc tests (α = 0.05). RESULTS No differences between the control and experimental groups in bone deposition for each marker, in either the BIC or BA analysis were observed. The bone deposition marked by alizarin (14-21 days) was the highest, followed by oxytetracycline (0 and 7 days) and calcein (45 and 52 days) in both groups (P < 0.05). CONCLUSION The bone healing or the course of osseointegration was not impaired by the use of an inorganic xenogenic graft before insertion of a titanium implant.
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Susin C, Lee J, Fiorini T, Freitas RM, Chiu H, Prasad HS, Buxton AN, Wikesjö UME. Sinus augmentation using rh
BMP
‐2/
ACS
in a mini‐pig model: Influence of an adjunctive ceramic bone biomaterial. J Clin Periodontol 2018; 45:1005-1013. [DOI: 10.1111/jcpe.12921] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 02/23/2018] [Accepted: 05/08/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Tiago Fiorini
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Rubens Moreno Freitas
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Hsien‐Chung Chiu
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Hari S. Prasad
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Amanda N. Buxton
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Ulf ME Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
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Thoma DS, Payer M, Jakse N, Bienz SP, Hüsler J, Schmidlin PR, Jung UW, Hämmerle CH, Jung RE. Randomized, controlled clinical two-centre study using xenogeneic block grafts loaded with recombinant human bone morphogenetic protein-2 or autogenous bone blocks for lateral ridge augmentation. J Clin Periodontol 2017; 45:265-276. [DOI: 10.1111/jcpe.12841] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Michael Payer
- Department of Oral Surgery and Radiology; School of Dentistry; Medical University Graz; Graz Austria
| | - Norbert Jakse
- Department of Oral Surgery and Radiology; School of Dentistry; Medical University Graz; Graz Austria
| | - Stefan P. Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Jürg Hüsler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Patrick R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Ui-Won Jung
- Department of Periodontology; Research Institute for Periodontal Regeneration; Yonsei University College of Dentistry; Seoul Korea
| | - Christoph H.F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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Ozaki M, Takayama T, Yamamoto T, Ozawa Y, Nagao M, Tanabe N, Nakajima A, Suzuki N, Maeno M, Yamano S, Sato S. A collagen membrane containing osteogenic protein-1 facilitates bone regeneration in a rat mandibular bone defect. Arch Oral Biol 2017; 84:19-28. [PMID: 28938197 DOI: 10.1016/j.archoralbio.2017.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 08/31/2017] [Accepted: 09/07/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Osteogenic protein-1 (OP-1) has shown osteoinductive activities and is useful for clinical treatments, including bone regeneration. Regenerative procedures using a bioabsorbable collagen membrane (BCM) are well established in periodontal and implant dentistry. We evaluated the subsequent effects of the BCM in combination with OP-1 on bone regeneration in a rat mandibular circular critical-sized bone defect in vivo. DESIGN We used 8 rats that received surgery in both sides of the mandible, and created the total 16 defects which were divided into 4 groups: Group 1; no treatment, as a control, Group 2; BCM alone, Group 3; BCM containing low dose 0.5μg of OP-1 (L-OP-1), and Group 4; BCM containing high dose 2.0μg of OP-1 (H-OP-1). Newly formed bone was evaluated by micro computed tomography (micro-CT) and histological analyses at 8 weeks postoperatively. In quantitative and qualitative micro-CT analyses of the volume of new bone formation, bone density, and percentage of new bone area was evaluated. RESULTS BCM with rhOP-1 significantly increased and accelerated bone volume, bone mineral density, and percentage of new bone area compared to control and BCM alone at 8 weeks after surgery; these enhancements in bone regeneration in the OP-1-treated groups were dose-dependent. CONCLUSIONS OP-1 delivered with a BCM may have effective osteoinductive potency and be a good combination for bone regeneration. The use of such a combination device for osteogenesis may result in safer and more predictable bone regenerative outcomes in the future.
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Affiliation(s)
- Manami Ozaki
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, Tokyo, Japan
| | - Tadahiro Takayama
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan; Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan.
| | - Takanobu Yamamoto
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, Tokyo, Japan
| | - Yasumasa Ozawa
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, Tokyo, Japan
| | - Mayu Nagao
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan
| | - Natsuko Tanabe
- Department of Biochemistry, Nihon University School of Dentistry, Tokyo, Japan; Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Akira Nakajima
- Department of Orthodontics, Nihon University School of Dentistry, Tokyo, Japan; Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Naoto Suzuki
- Department of Biochemistry, Nihon University School of Dentistry, Tokyo, Japan; Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Masao Maeno
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan; Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Seiichi Yamano
- Department of Prosthodontics, New York University College of Dentistry, NY, U.S.A
| | - Shuichi Sato
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan; Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
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Susin C, Fiorini T, Lee J, de Freitas RM, Chiu HC, Prasad HS, Buxton AN, Wikesjö UME. Sinus augmentation using a mini-pig model: Effect of ceramic and allogeneic bone biomaterials. J Clin Periodontol 2017. [PMID: 28644556 DOI: 10.1111/jcpe.12766] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Present clinical practice broadly relies on off-the-shelf allogeneic, xenogeneic or synthetic bone biomaterials in support of sinus augmentation. Also, recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support clinically relevant bone formation when used to augment the maxillary sinus. OBJECTIVES To evaluate local bone formation/dental implant osseointegration following implantation of two particulate bone biomaterials using the mini-pig sinus augmentation model. METHODS Nine adult Göttingen mini-pigs were used for evaluation of a biphasic ceramic (15%/85% HA/ß-TCP) and an allogeneic mineralized bone biomaterial. Treatments randomized to contralateral sinus sites included sham-surgery (control) and biomaterials. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each sinus site. The animals were euthanized at 8 weeks for histologic analysis. RESULTS Execution of the surgical protocol and healing was unremarkable. Limited infraorbital swelling was observed until suture removal. The biphasic ceramic and allogeneic bone biomaterials produced significantly increased bone formation (5.2 ± 1.9 mm and 4.9 ± 1.6 mm vs. 2.6 ± 0.5 mm, p < 0.05) and osseointegration (18.0 ± 6.0% and 25.1 ± 18.2% vs. 10.1 ± 8.0%, p < 0.05) over the sham-surgery control. No significant differences were observed between biomaterials. CONCLUSIONS Implantation of biphasic ceramic or allogeneic bone biomaterials enhances bone formation in the mini-pig maxillary sinus, however, dental implant bone support is incomplete resulting in overall limited osseointegration.
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Affiliation(s)
- Cristiano Susin
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Tiago Fiorini
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Jaebum Lee
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Rubens Moreno de Freitas
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Hsien-Chung Chiu
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Hari S Prasad
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Amanda N Buxton
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Ulf M E Wikesjö
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
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13
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Lustosa RM, Macedo DDV, Iwaki LCV, Tolentino EDS, Hasse PN, Marson GBDO, Iwaki Filho L. Continuity resection of the mandible after ameloblastoma - feasibility of oral rehabilitation with rhBMP-2 associated to bovine xenograft followed by implant installation. J Craniomaxillofac Surg 2015; 43:1553-60. [PMID: 26190695 DOI: 10.1016/j.jcms.2015.06.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 06/02/2015] [Accepted: 06/18/2015] [Indexed: 11/26/2022] Open
Abstract
Recombinant human morphogenetic protein (rhBMP) is a graft alternative for extensive mandibular reconstruction after tumor resections. However, the feasibility of rhBMP-2 to receive osseointegrated implants and prosthetic rehabilitation has been rarely reported. This study reports on a case of an extensive solid ameloblastoma along the mandibular body. The treatment consisted of resection followed by off-label use of rhBMP type 2 associated with bovine bone xenograft. Eleven months postoperatively, the patient was prosthetically rehabilitated with dental implants, without evidence of resorption or complications. The literature on mandibular reconstructions using rhBMP and their feasibility for future osseointegrated implant placement was also reviewed. Based on the presented case, the association between rhBMP-2 and a bovine bone xenograft could be considered a feasible option for the reconstruction and rehabilitation of large mandibular defects after tumor resection. According to the literature, the use of rhBMP as a graft material is encouraging, with good clinical outcome. However, there are no long-term studies demonstrating success and survival rates of implants placed in these grafts. Future investigations will be required to ascertain the long-term survival of implants in areas grafted with rhBMP. Also, there is a lack of information regarding the prosthetic rehabilitation of these patients.
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Affiliation(s)
| | | | | | | | | | | | - Liogi Iwaki Filho
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
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In vivo comparison of hard tissue regeneration with ovine mesenchymal stem cells processed with either the FICOLL method or the BMAC method. J Craniomaxillofac Surg 2015; 43:1177-83. [PMID: 26138380 DOI: 10.1016/j.jcms.2015.05.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 05/21/2015] [Accepted: 05/26/2015] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The aim of this work was to analyse the suitability of mesenchymal stem cell isolation by FICOLL density centrifugation and the closed bone marrow aspirate concentrate (BMAC) system for sinus augmentation with bovine bone mineral (BBM) in the sheep model. METHODS 16 sheep underwent sinus augmentation with BBM and MSCs; they were divided between two groups with survival points of 8 and 16 weeks. For the FICOLL control arm three, and for the BMAC test arm, five augmentations were performed for each time point. The derived cell numbers were counted; a colony forming unit (CFU) assay was performed; the pluripotency of the MSCs was proved; histological and histomorphometrical analysis were performed. RESULTS The approach of using BBM and MSCs in combination with fibrin adhesive was sufficient for new bone formation as the FICOLL experiment indicated. However, due to significantly lower cell numbers isolated using the BMAC in sheep, less new bone was formed in the test arm. CONCLUSIONS The BMAC system is well suited for human MSC isolation but it needs to be optimized to fit sheep cell characteristics if it is to be used in this animal model.
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Brockmeyer P, Kramer K, Krohn S, Kauffmann P, Mauth C, Dard M, Schliephake H, Gruber RM. Influence of synthetic polyethylene glycol hydrogels on new bone formation during mandibular augmentation procedures in Goettingen minipigs. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:194. [PMID: 26032116 DOI: 10.1007/s10856-015-5526-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 05/28/2015] [Indexed: 06/04/2023]
Abstract
Polyethylene glycol hydrogels (PEG) have been used as slow release carrier for osteoinductive growth factors in order to achieve a retarded delivery. However, there have been concerns about negative effects on bone regeneration. This study aims to test whether PEG hydrogels themselves affect new bone formation (NBF), when used as a carrier during mandibular augmentation procedures. In a randomized split-mouth design, bilateral mandibular bone defects were surgically created in 12 Goettingen minipigs, and subsequently augmented, using PEG hydrogel on one side of the mandible. The contralateral sides, without PEG, served as controls. After 4 and 12 weeks, bone formation was evaluated in six animals each. A comparison of the data, using a three-way analysis of variance (ANOVA), revealed a significant effect of the healing time and the region of the graft on the distribution and enhancement of NBF (P < .0001, respectively). Although a 0.3% (95%-CI [-5.5; 4.8]) lower volume density of newly formed bone could be observed over all PEG hydrogel sections, in contrast to the contralateral controls, the analysis revealed no clinically significant effects of the PEG hydrogel treatment on the total level (P = 0.90), and the distribution of NBF (P = 0.54). In conclusion, PEG hydrogels do not affect NBF when used as a carrier for osteoinductive growth factors during mandibular augmentation procedures.
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Affiliation(s)
- Phillipp Brockmeyer
- Department of Oral and Maxillofacial Surgery, University Medical Centre Goettingen, Robert-Koch-Str. 40, 37075, Gōttingen, Germany,
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Pilipchuk SP, Plonka AB, Monje A, Taut AD, Lanis A, Kang B, Giannobile WV. Tissue engineering for bone regeneration and osseointegration in the oral cavity. Dent Mater 2015; 31:317-38. [PMID: 25701146 DOI: 10.1016/j.dental.2015.01.006] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 12/19/2014] [Accepted: 01/11/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The focus of this review is to summarize recent advances on regenerative technologies (scaffolding matrices, cell/gene therapy and biologic drug delivery) to promote reconstruction of tooth and dental implant-associated bone defects. METHODS An overview of scaffolds developed for application in bone regeneration is presented with an emphasis on identifying the primary criteria required for optimized scaffold design for the purpose of regenerating physiologically functional osseous tissues. Growth factors and other biologics with clinical potential for osteogenesis are examined, with a comprehensive assessment of pre-clinical and clinical studies. Potential novel improvements to current matrix-based delivery platforms for increased control of growth factor spatiotemporal release kinetics are highlighting including recent advancements in stem cell and gene therapy. RESULTS An analysis of existing scaffold materials, their strategic design for tissue regeneration, and use of growth factors for improved bone formation in oral regenerative therapies results in the identification of current limitations and required improvements to continue moving the field of bone tissue engineering forward into the clinical arena. SIGNIFICANCE Development of optimized scaffolding matrices for the predictable regeneration of structurally and physiologically functional osseous tissues is still an elusive goal. The introduction of growth factor biologics and cells has the potential to improve the biomimetic properties and regenerative potential of scaffold-based delivery platforms for next-generation patient-specific treatments with greater clinical outcome predictability.
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Affiliation(s)
- Sophia P Pilipchuk
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, 1101 Beal Avenue, Ann Arbor, MI 48109, USA.
| | - Alexandra B Plonka
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA.
| | - Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA.
| | - Andrei D Taut
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA.
| | - Alejandro Lanis
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA.
| | - Benjamin Kang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA.
| | - William V Giannobile
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA; Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, 1101 Beal Avenue, Ann Arbor, MI 48109, USA.
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Brockmeyer P, Lange K, Hahn W, Schliephake H, Matthias Gruber R. Increase of homogenous new bone formation using osteoinductive factor rhGDF-5 during sinus floor augmentation in Goettingen Minipigs. Clin Oral Implants Res 2014; 26:1321-7. [PMID: 25039481 DOI: 10.1111/clr.12457] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to test the hypothesis that recombinant human growth and differentiation factor-5 (rhGDF-5) induces an increased and homogenous distribution of new bone formation across the entire volume of sinus floor augmentation in 12 Goettingen Minipigs. MATERIAL AND METHODS In a randomized split-mouth design, one maxillary sinus was augmented with the bone substitute β-TCP, whereas a combination of β-TCP and the osteoinductive growth factor rhGDF-5 was used on the contralateral side. To evaluate the influence of dose and time on the effectiveness of the factor, two different concentrations of rhGDF-5 (400 μg and 800 μg) and healing periods (4 and 12 weeks) were each analysed. RESULTS After 4 weeks, a homogenous gradient of bone formation could be observed for all dosage groups, with decreasing bone density from the local bone towards the sinus membrane. Both test groups, however, achieved a higher total level of bone formation compared with the control group, which was only significant in the low-dose group (P = 0.0184). After 12 weeks, the influence of the growth factor significantly depends on the region (P = 0.023). In the low-dose group, the new bone formation did not differ significantly within the examined regions of the graft (P = 0.1118), suggesting a homogeneous bone formation over the entire augmentation. The gradient of the high-dose group was similar to the control group with a decrease of local bone development. CONCLUSIONS rhGDF-5 delivered on a β-TCP scaffold material leads to an increase in homogeneous new bone formation across the entire volume of the sinus floor augmentation.
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Affiliation(s)
- Phillipp Brockmeyer
- Department of Oral and Maxillofacial Surgery, University of Goettingen, Goettingen, Germany
| | - Katharina Lange
- Department of Medical Statistics, University of Goettingen, Goettingen, Germany
| | | | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University of Goettingen, Goettingen, Germany
| | - Rudolf Matthias Gruber
- Department of Oral and Maxillofacial Surgery, University of Goettingen, Goettingen, Germany
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Gruber RM, Krohn S, Mauth C, Dard M, Molenberg A, Lange K, Perske C, Schliephake H. Mandibular reconstruction using a calcium phosphate/polyethylene glycol hydrogel carrier with BMP-2. J Clin Periodontol 2014; 41:820-6. [DOI: 10.1111/jcpe.12264] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Rudolf M. Gruber
- Department of Oral and Maxillofacial Surgery; Georgia Augusta University; Goettingen Germany
| | - Sebastian Krohn
- Department of Oral and Maxillofacial Surgery; Georgia Augusta University; Goettingen Germany
| | | | - Michel Dard
- Institut Straumann; Basel Switzerland
- Department of Periodontology and Implant Dentistry; College of Dentistry; New York University; New York NY USA
| | | | - Katharina Lange
- Department of Medical Statistics; Georgia Augusta University; Goettingen Germany
| | - Christina Perske
- Department of Pathology; Georgia Augusta University; Goettingen Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery; Georgia Augusta University; Goettingen Germany
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Oshima T, Duttenhoefer F, Xavier S, Nelson K, Sauerbier S. Can mesenchymal stem cells and novel gabapentin-lactam enhance maxillary bone formation? J Oral Maxillofac Surg 2013; 72:485-95. [PMID: 24528562 DOI: 10.1016/j.joms.2013.10.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 10/30/2013] [Accepted: 10/31/2013] [Indexed: 12/26/2022]
Abstract
PURPOSE Novel gabapentin-lactam (GBP-L) has shown its potency in enhancing new bone formation (NBF) in vitro. The objective of the present preclinical trial was to investigate the in vivo performance of GBP-L. MATERIALS AND METHODS Bilateral sinus floor augmentations in 10 adult sheep were conducted. Bovine bone mineral (BBM) and mesenchymal stem cells (MSCs) combined with novel GBP-L were placed into the test sinus of each sheep. The BBM and MSCs alone served as the control on the contralateral side. Simultaneously, 3 dental implants were inserted in each maxillary sinus. The animals were sacrificed after 8 and 16 weeks, and the amount of NBF was analyzed using histomorphometry. The osteogenic potency of the MSCs was demonstrated using the colony-forming unit and differentiation assay. Statistical evaluation was performed using the Wilcoxon signed rank test and 3-factorial nonparametric analysis of variance. RESULTS The histologic examination showed NBF in tight contact with the original bone in the control and test groups. The NBF was not significantly different between the test and control sites (P > .05). However, a highly significant difference in NBF between the apical and coronal sites in the specimens from the control and test groups was detected (P < .05). GBP-L did not alter the multipotency of the MSCs or impair NBF. CONCLUSIONS Bone formation is initiated from the residual alveolar crest and along the implant. The elected mode of GBP-L application did not induce faster NBF. Alternate forms of application (eg, slow release or systemic administration) might clarify the controversial in vitro findings.
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Affiliation(s)
- Toshiyuki Oshima
- Assistant Professor, Department of Oral and Craniomaxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany.
| | - Fabian Duttenhoefer
- Resident, Department of Oral and Craniomaxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany
| | - Samuel Xavier
- Professor, Department of Oral and Craniomaxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany; and Department of Oral and Maxillofacial Surgery, University of São Paulo Faculty of Dentistry, Ribeirão Preto, São Paulo, Brazil
| | - Katja Nelson
- Professor, Department of Oral and Craniomaxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany
| | - Sebastian Sauerbier
- Associate Professor, Department of Oral and Craniomaxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany
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Influence of Acidic Fibroblast Growth Factor on Bone Regeneration in Experimental Cranial Defects Using Spongostan and Bio-Oss as Protein Carriers. J Craniofac Surg 2013; 24:1507-14. [DOI: 10.1097/scs.0b013e31828f2469] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Mardas N, Dereka X, Donos N, Dard M. Experimental Model for Bone Regeneration in Oral and Cranio-Maxillo-Facial Surgery. J INVEST SURG 2013; 27:32-49. [DOI: 10.3109/08941939.2013.817628] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jensen SS, Aaboe M, Janner SFM, Saulacic N, Bornstein MM, Bosshardt DD, Buser D. Influence of Particle Size of Deproteinized Bovine Bone Mineral on New Bone Formation and Implant Stability after Simultaneous Sinus Floor Elevation: A Histomorphometric Study in Minipigs. Clin Implant Dent Relat Res 2013; 17:274-85. [DOI: 10.1111/cid.12101] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Simon S. Jensen
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
- Department of Oral and Maxillofacial Surgery; Copenhagen University Hospital (Rigshospitalet); Copenhagen Denmark
| | - Merete Aaboe
- Department of Oral and Maxillofacial Surgery and Oral Pathology; School of Dentistry, Health, Aarhus University; Aarhus Denmark
| | - Simone F. M. Janner
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Nikola Saulacic
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
- Department of Cranio-Maxillofacial Surgery; Bern University Hospital; Bern Switzerland
| | - Michael M. Bornstein
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Dieter D. Bosshardt
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
- Robert K. Schenk Laboratory of Oral Histology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Daniel Buser
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
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Möller B, Acil Y, Birkenfeld F, Behrens E, Terheyden H, Wiltfang J. Highly porous hydroxyapatite with and without local harvested bone in sinus floor augmentation: a histometric study in pigs. Clin Oral Implants Res 2013; 25:871-8. [DOI: 10.1111/clr.12161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Björn Möller
- Clinic of Oral and Maxillofacial Surgery; University Hospital Schleswig-Holstein; Kiel Germany
| | - Yahya Acil
- Clinic of Oral and Maxillofacial Surgery; University Hospital Schleswig-Holstein; Kiel Germany
| | - Falk Birkenfeld
- Institute of Anatomy; Christian-Albrechts University Kiel; Kiel Germany
| | - Eleonore Behrens
- Clinic of Oral and Maxillofacial Surgery; University Hospital Schleswig-Holstein; Kiel Germany
| | - Hendrik Terheyden
- Department of Oral and Maxillofacial Surgery; Red Cross Hospital; Kassel Germany
| | - Jörg Wiltfang
- Clinic of Oral and Maxillofacial Surgery; University Hospital Schleswig-Holstein; Kiel Germany
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Streckbein P, Kleis W, Buch RSR, Hansen T, Weibrich G. Bone healing with or without platelet-rich plasma around four different dental implant surfaces in beagle dogs. Clin Implant Dent Relat Res 2013; 16:479-86. [PMID: 23295126 DOI: 10.1111/cid.12026] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Surface development is one of the major aims in dental implant engineering. Additive application of substances could possibly improve the new bone formation around dental implants. The present study evaluated the bone reaction on four different implant surfaces with or without platelet-rich plasma (PRP). MATERIALS AND METHODS Four self-tapping titanium screw implants (Brånemark MK III [Nobel Biocare, Göteborg, Sweden], Osseotite [3i, Miami, FL, USA], Xive [Densply Friadent, Mannheim, Germany], and Compress [IGfZ eG, Diez, Germany]) with different surfaces were inserted in each hemimandible of 12 female beagle dogs; the implant positions and the application of PRP were randomized. After intravital fluorochrome staining, sacrifices and biopsies harvesting were performed after 6 weeks (five dogs; one dog died before) and 12 weeks (six dogs) and the respective specimens were analyzed. RESULTS The only significant difference in bone remodeling was found for the Compress implants with increased bone formation compared with the Brånemark implants at 12 weeks (sign test, p = .03). Comparing the histological and histomorphometric specimens of all other implant surfaces with respect to peri-implant bone remodeling and the resulting bone-implant contact rates (BICRs), no statistically significant differences were seen in the PRP or non-PRP groups (sign test, all p values ≥ .063). CONCLUSIONS This study found no significant differences in the BICR for roughened implant surfaces compared with machined surfaces. In this animal model, the addition of PRP did not demonstrate evidence of faster bone formation or the resulting BICR.
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Affiliation(s)
- Philipp Streckbein
- Department of Cranio-Maxillo-Facial Surgery, Justus Liebig University, Giessen, Germany
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Thoma DS, Martin IS, Mühlemann S, Jung RE. Systematic review of pre-clinical models assessing implant integration in locally compromised sites and/or systemically compromised animals. J Clin Periodontol 2012; 39 Suppl 12:37-62. [PMID: 22533946 DOI: 10.1111/j.1600-051x.2011.01833.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim was to systematically search the dental literature for pre-clinical models assessing implant integration in locally compromised sites (part 1) and systemically compromised animals (part 2), and to evaluate the quality of reporting of included publications. METHODS A Medline search (1966-2011) was performed, complimented by additional hand searching. The quality of reporting of the included publications was evaluated using the 20 items of the ARRIVE (Animals in Research In Vivo Experiments) guidelines. RESULTS One-hundred and seventy-six (part 1; mean ARRIVE score = 15.6 ± 2.4) and 104 (part 2; 16.2 ± 1.9) studies met the inclusion criteria. The overall mean score for all included studies amounted to 15.8 ± 2.2. Housing (38.3%), allocation of animals (37.9%), numbers analysed (50%) and adverse events (51.4%) of the ARRIVE guidelines were the least reported. Statistically significant differences in mean ARRIVE scores were found depending on the publication date (p < 0.05), with the highest score of 16.7 ± 1.6 for studies published within the last 2 years. CONCLUSIONS A large number of studies met the inclusion criteria. The ARRIVE scores revealed heterogeneity and missing information for selected items in more than 50% of the publications. The quality of reporting shifted towards better-reported pre-clinical trials within recent years.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
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Lohberger B, Payer M, Rinner B, Bartmann C, Stadelmeyer E, Traunwieser E, DeVaney T, Jakse N, Leithner A, Windhager R. Human Intraoral Harvested Mesenchymal Stem Cells: Characterization, Multilineage Differentiation Analysis, and 3-Dimensional Migration of Natural Bone Mineral and Tricalcium Phosphate Scaffolds. J Oral Maxillofac Surg 2012; 70:2309-15. [DOI: 10.1016/j.joms.2011.06.216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 06/10/2011] [Accepted: 06/17/2011] [Indexed: 01/09/2023]
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Zou D, Guo L, Lu J, Zhang X, Wei J, Liu C, Zhang Z, Jiang X. Engineering of bone using porous calcium phosphate cement and bone marrow stromal cells for maxillary sinus augmentation with simultaneous implant placement in goats. Tissue Eng Part A 2012; 18:1464-78. [PMID: 22452368 DOI: 10.1089/ten.tea.2011.0501] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to explore the effects of maxillary sinus floor elevation and simultaneous dental implantation with a tissue-engineered bone complex of calcium phosphate cement (CPC) scaffolds combined with bone marrow stromal cells (BMSCs). A large animal goat model is used with the tissue engineering method. Eighteen bilateral maxillary sinus of nine goats were randomly allocated into three groups; the CPC/BMSC complex (n=6) was used to elevate maxillary sinus floor with a simultaneous implant placement; the effects were compared with those treated with CPC alone (n=6) or autogenous bone (n=6). After a healing period of 3 months, sequential triad-color fluorescence labeling, micro-CT, as well as histological and histomorphometric analyses indicated that the tissue-engineered BMSC/CPC complex could promote earlier bone formation and mineralization, and maximally maintain the volume and height of the augmented maxillary sinus. By comparison, CPC-alone or autogenous bone achieved less bone formation and later mineralization. Besides, the average bone-implant contact value reflecting the osseointegration was 35.63%±9.42% in the BMSCs/CPC group, significantly higher than 22.47%±4.28% in the CPC-alone group or 28.26%±8.03% in the autogenous bone group. In conclusion, CPC serves as a potential substrate for BMSCs for the maxillary sinus floor augmentation and simultaneous implantation. The tissue-engineered bone might enhance the stability of implants and thus be of great significance to achieve improved quality to restore the oral function in clinic.
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Affiliation(s)
- Derong Zou
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, P. R. China
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Jensen T, Schou S, Gundersen HJG, Forman JL, Terheyden H, Holmstrup P. Bone-to-implant contact after maxillary sinus floor augmentation with Bio-Oss and autogenous bone in different ratios in mini pigs. Clin Oral Implants Res 2012; 24:635-44. [DOI: 10.1111/j.1600-0501.2012.02438.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 01/29/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Thomas Jensen
- Department of Oral and Maxillofacial Surgery; Aalborg Hospital; Aarhus University Hospital; Aalborg; Denmark
| | - Søren Schou
- Department of Oral and Maxillofacial Surgery and Oral Pathology; School of Dentistry; Aarhus University; Aarhus; Denmark
| | - Hans Jørgen G. Gundersen
- Stereology and Electron Microscopy Research Laboratory; Aarhus Hospital; Aarhus University Hospital; Aarhus; Denmark
| | - Julie Lyng Forman
- Department of Biostatistics; University of Copenhagen; Copenhagen; Denmark
| | - Hendrik Terheyden
- Department of Oral and Maxillofacial Surgery; Red Cross Hospital Kassel; Kassel; Germany
| | - Palle Holmstrup
- Departments of Periodontology; Schools of Dentistry; Universities of Copenhagen and Aarhus; Copenhagen; Denmark
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Lee J, Susin C, Rodriguez NA, de Stefano J, Prasad HS, Buxton AN, Wikesjö UME. Sinus augmentation using rhBMP-2/ACS in a mini-pig model: relative efficacy of autogenous fresh particulate iliac bone grafts. Clin Oral Implants Res 2012; 24:497-504. [DOI: 10.1111/j.1600-0501.2011.02419.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2011] [Indexed: 11/29/2022]
Affiliation(s)
- Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; Georgia Health Sciences University College of Dental Medicine; Augusta; GA; USA
| | - Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; Georgia Health Sciences University College of Dental Medicine; Augusta; GA; USA
| | - Nancy A. Rodriguez
- Laboratory Animal Services; Georgia Health Sciences University; Augusta; GA; USA
| | - Jamie de Stefano
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; Georgia Health Sciences University College of Dental Medicine; Augusta; GA; USA
| | - Hari S. Prasad
- Hard Tissue Research Laboratory; Division of Oral and Maxillofacial Pathology; University of Minnesota School of Dentistry; Minneapolis; MN; USA
| | | | - Ulf M. E. Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; Georgia Health Sciences University College of Dental Medicine; Augusta; GA; USA
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Jensen T, Schou S, Stavropoulos A, Terheyden H, Holmstrup P. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft in animals: a systematic review. Int J Oral Maxillofac Surg 2012; 41:114-20. [DOI: 10.1016/j.ijom.2011.08.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 04/18/2011] [Accepted: 08/31/2011] [Indexed: 10/16/2022]
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Jensen T, Schou S, Svendsen PA, Forman JL, Gundersen HJG, Terheyden H, Holmstrup P. Volumetric changes of the graft after maxillary sinus floor augmentation with Bio-Oss and autogenous bone in different ratios: a radiographic study in minipigs. Clin Oral Implants Res 2011; 23:902-10. [DOI: 10.1111/j.1600-0501.2011.02245.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Stavropoulos A, Becker J, Capsius B, Açil Y, Wagner W, Terheyden H. Histological evaluation of maxillary sinus floor augmentation with recombinant human growth and differentiation factor-5-coated β-tricalcium phosphate: results of a multicenter randomized clinical trial. J Clin Periodontol 2011; 38:966-74. [DOI: 10.1111/j.1600-051x.2011.01754.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sauerbier S, Rickert D, Gutwald R, Nagursky H, Oshima T, Xavier SP, Christmann J, Kurz P, Menne D, Vissink A, Raghoebar G, Schmelzeisen R, Wagner W, Koch FP. Bone marrow concentrate and bovine bone mineral for sinus floor augmentation: a controlled, randomized, single-blinded clinical and histological trial--per-protocol analysis. Tissue Eng Part A 2011; 17:2187-97. [PMID: 21529247 DOI: 10.1089/ten.tea.2010.0516] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The purpose of this work was to evaluate the potential of substituting autogenous bone (AB) by bone marrow aspirate concentrate (BMAC). Both AB and BMAC were tested in combination with a bovine bone mineral (BBM) for their ability of new bone formation (NBF) in a multicentric, randomized, controlled, clinical and histological noninferiority trial. MATERIALS AND METHODS Forty-five severely atrophied maxillary sinus from 26 patients were evaluated in a partial cross-over design. As test arm, 34 sinus of 25 patients were augmented with BBM and BMAC containing mesenchymal stem cells. Eleven control sinus from 11 patients were augmented with a mixture of 70% BBM and 30% AB. Biopsies were obtained after a 3-4-month healing period at time of implant placement and histomorphometrically analyzed for NBF. RESULTS NBF was 14.3%±1.8% for the control and nonsignificantly lower (12.6%±1.7%) for the test (90% confidence interval: -4.6 to 1.2). Values for BBM (31.3%±2.7%) were significantly higher for the test compared with control (19.3%±2.5%) (p<0.0001). Nonmineralized tissue was lower by 3.3% in the test compared with control (57.6%; p=0.137). CONCLUSIONS NBF after 3-4 months is equivalent in sinus, augmented with BMAC and BBM or a mixture of AB and BBM. This technique could be an alternative for using autografts to stimulate bone formation.
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Affiliation(s)
- Sebastian Sauerbier
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Freiburg, Albert-Ludwigs University, Freiburg, Germany.
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Schuckert KH, Jopp S, Osadnik M. The use of platelet rich plasma, bone morphogenetic protein-2 and different scaffolds in oral and maxillofacial surgery - literature review in comparison with own clinical experience. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2011; 2:e2. [PMID: 24421984 PMCID: PMC3886066 DOI: 10.5037/jomr.2011.2102] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 01/18/2011] [Indexed: 12/16/2022]
Abstract
Objectives The purpose of this article was to review and critically assess the use of
platelet rich plasma, recombinant human bone morphogenetic protein-2 and
different scaffolds (i.e. tricalciumphosphate, polycaprolactone,
demineralized bone matrix and anorganic bovine bone mineral) in oral and
maxillofacial surgery comparing the relevant literature and own clinical
experience. Material and Methods A literature review was conducted using MEDLINE, MEDPILOT and COCHRANE
DATABASE OF SYSTEMATIC REVIEWS. It concentrated on manuscripts and overviews
published in the last five years (2006-2010). The key terms employed were
platelet rich plasma, bone morphogenetic proteins and their combinations
with the above mentioned scaffolds. The results of clinical studies and
animal trials were especially emphasized. The statements from the literature
were compared with authors’ own clinical data. Results New publications and overviews demonstrate the advantages of platelet rich
plasma in bone regeneration. The results from the literature review were
discussed and compared with the publications detailing authors' own
experiences. Conclusions A favourable outcome concerning newly grown bone was achieved combining
platelet rich plasma in addition to optimal matrices with or without
recombinant human bone morphogenetic protein-2, depending on the clinical
case. As a consequence, the paradigm shift from transplantation of
autogenous bone to bone tissue engineering appears promising.
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Affiliation(s)
- Karl-Heinz Schuckert
- Institute Indente - Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering Hannover Germany
| | - Stefan Jopp
- Institute Indente - Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering Hannover Germany
| | - Magdalena Osadnik
- Institute Indente - Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering Hannover Germany
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Munhoz EA, Bodanezi A, Cestari TM, Taga R, de Carvalho PSP, Ferreira O. Long-term rabbits bone response to titanium implants in the presence of inorganic bovine-derived graft. J Biomater Appl 2011; 27:91-8. [PMID: 21343217 DOI: 10.1177/0885328210396946] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study evaluated bone responses to titanium implants in the presence of an inorganic graft material. The bilateral mandible incisors of 24 rabbits were surgically extracted and one of the exposed sockets, chosen at random, was filled with an inorganic xenogenic bone graft (Gen-ox®), whereas the remaining socket was left to heal naturally and served as a control. After 60 days, titanium implants were inserted in the specific areas, and on days 0, 30, 60, and 180 after the implant insertions, six animals of each group were killed. Digital periapical radiography of implant region was obtained and vertical bone height (VBH) and bone density (BD) were evaluated by digital analysis system. In the undecalcified tissue cuts, bone-to-implant contact (BIC) and bone area (BA) within the limits of the implant threads were evaluated and compared statistically by means of two-way ANOVA and Tukey's test (ρ < 0.05). No significant differences were detected in VBH and BA, either between groups or between different experimental intervals. The BD was significantly higher in the experimental group than in the control group in all the intervals tested, but there were no significant differences by interval. The BIC was statistically lower in the control group on day 0; however, a significant increase was observed on days 60 and 180 (ρ < 0.05). The use of an inorganic xenograft prior to insertion of a titanium implant did not interfere with the course of osseointegration.
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Affiliation(s)
- Etiene Andrade Munhoz
- Department of Stomatology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
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Sauerbier S, Stubbe K, Maglione M, Haberstroh J, Kuschnierz J, Oshima T, Xavier SP, Brunnberg L, Schmelzeisen R, Gutwald R. Mesenchymal stem cells and bovine bone mineral in sinus lift procedures--an experimental study in sheep. Tissue Eng Part C Methods 2011; 16:1033-9. [PMID: 20050809 DOI: 10.1089/ten.tec.2009.0734] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION New reconstructive and less invasive methods have been searched to optimize bone formation and osseointegration of dental implants in maxillary sinus augmentation. PURPOSE The aim of the presented ovine split-mouth study was to compare bovine bone mineral (BBM) alone and in combination with mesenchymal stem cells (MSCs) regarding their potential in sinus augmentation. MATERIAL AND METHODS Bilateral sinus floor augmentations were performed in six adult sheep. BBM and MSCs were placed into the test side and only BBM in the contra-lateral control side of each sheep. Animals were sacrificed after 8 and 16 weeks. Augmentation sites were analyzed by computed tomography, histology, and histomorphometry. RESULTS The initial volumes of both sides were similar and did not change significantly with time. A tight connection between the particles of BBM and the new bone was observed histologically. Bone formation was significantly (p = 0.027) faster by 49% in the test sides. CONCLUSION The combination of BBM and MSCs accelerated new bone formation in this model of maxillary sinus augmentation. This could allow early placement of implants.
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Affiliation(s)
- Sebastian Sauerbier
- Department of Oral and Maxillofacial Surgery, Albert-Ludwigs-University, Freiburg, Germany.
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Influence of rhBMP-2 on bone formation and osseointegration in different implant systems after sinus-floor elevation. An in vivo study on sheep. J Craniomaxillofac Surg 2010; 38:571-9. [DOI: 10.1016/j.jcms.2010.02.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 11/10/2009] [Accepted: 02/10/2010] [Indexed: 11/23/2022] Open
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Lee JA, Ku Y, Rhyu IC, Chung CP, Park YJ. Effects of fibrin-binding oligopeptide on osteopromotion in rabbit calvarial defects. J Periodontal Implant Sci 2010; 40:211-9. [PMID: 21072217 PMCID: PMC2967808 DOI: 10.5051/jpis.2010.40.5.211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 08/01/2010] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Fibronectin (FN) has been shown to stimulate bone regeneration in animal models. The aim of this study was to evaluate the capacity of bovine bone mineral coated with synthetic oligopeptides to enhance bone regeneration in rabbit calvarial defects. METHODS Oligopeptides including fibrin-binding sequences of FN repeats were synthesized on the basis of primary and tertiary human plasma FN structures. Peptide coated and uncoated bone minerals were implanted into 10 mm calvarial defects in New Zealand white rabbits, and the animals were sacrificed at 4 or 8 weeks after surgery. After specimens were prepared, histologic examination and histomorphometric analysis were performed. RESULTS At 4 weeks after surgery, the uncoated groups showed a limited amount of osteoid formation at the periphery of the defect and the oligopeptide coated groups showed more osteoid formation and new bone formation in the center of the defect as well as at the periphery. At 8 weeks, both sites showed increased new bone formation. However, the difference between the two sites had reduced. CONCLUSIONS Fibrin-binding synthetic oligopeptide derived from FN on deproteinized bovine bone enhanced new bone formation in rabbit calvarial defects at the early healing stage. This result suggests that these oligopeptides can be beneficial in reconstructing oral and maxillofacial deformities or in regenerating osseous bone defects.
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Affiliation(s)
- Ju-A Lee
- Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
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Valderrama P, Jung RE, Thoma DS, Jones AA, Cochran DL. Evaluation of Parathyroid Hormone Bound to a Synthetic Matrix for Guided Bone Regeneration Around Dental Implants: A Histomorphometric Study in Dogs. J Periodontol 2010; 81:737-47. [DOI: 10.1902/jop.2010.090562] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Schuckert KH, Jopp S, Osadnik M. Modern bone regeneration instead of bone transplantation: a combination of recombinant human bone morphogenetic protein-2 and platelet-rich plasma for the vertical augmentation of the maxillary bone-a single case report. Tissue Eng Part C Methods 2010; 16:1335-46. [PMID: 20302447 DOI: 10.1089/ten.tec.2010.0020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This publication describes the clinical case of a 75-year-old woman. She suffered from total alveolar ridge atrophy due to 20 years of wearing dentures. Bone transplantation, including harvesting of the iliac crest, was rejected by another clinic due to various existing diseases and risk of blood loss on donor side. Moreover, the minimal residual alveolar ridge did not allow bone fixation using screws nor did it allow osteodistraction. Before deciding which bone tissue engineering techniques should best be employed in this surgical treatment, cardiological and internistic consultations and treatments were carried out. In addition, anesthetic preparations were made. The surgical treatment was performed implementing special bridge flap techniques to preserve the periosteum. Tricalcium phosphate blocks soaked with recombinant human bone morphogenetic protein-2 and platelet-rich plasma were implanted on the narrow alveolar ridge. They were attached by tightening the soft tissue, including the periosteum. Four months later, after complication-free wound healing and bone regeneration, six dental implants were inserted into the new alveolar ridge. The histology of all bone samples showed vital lamellar bone. Three months after implantation, a new dental structure was fixed on the implants. The patient's quality of life improved significantly with this new situation.
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Affiliation(s)
- Karl-Heinz Schuckert
- Institute Indente-Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering, Hannover, Germany.
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Derong Z, Lian G, Jiayu L, Xiuli Z, Zhiyuan Z, Xinquan J. Anatomic and histological analysis in a goat model used for maxillary sinus floor augmentation with simultaneous implant placement. Clin Oral Implants Res 2010; 21:65-70. [PMID: 20070749 DOI: 10.1111/j.1600-0501.2009.01844.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The aim of the present study was to carry out an anatomic survey on the goat maxillary sinus in order to provide accurate and definite anatomic parameters for the design of sinus floor elevation and dental implantation studies in this valuable preclinic animal model. MATERIAL AND METHODS The anatomic topographic structure of the maxillary sinuses was studied bilaterally in 10 adult goats by a gross survey as well as a histological analysis with parasagittal or coronal sections. Then following parameters were defined and measured: (1) maxillary alveolar height (MAH): vertical height from the alveolar crest to the sinus floor; (2) sinus lateral floor width (SLFW): horizontal distance from the lateral border of the anteroposterior bone crest to the sinus lateral wall; (3) infraorbital canal diameter (ICD); and (4) maxillary sinus volume (MSV): the volume occupied by water injected into the sinus. The data were presented with mean + or - SD on both sides. RESULTS The goat has a maxillary sinus similar to humans, with a slender pyramidal shape that pneumatizes the entire maxilla, and a sinus wall covered with a mucosal lining. From the maxillary sinus floor, there is an anteroposterior bone crest protruding with the infraorbital canal enveloped. It divides the maxillary sinus floor into two parts. The SLFW of the lateral part of the maxillary sinus floor becomes broader, about 5.905 + or - 1.475 mm in the third premolar site, and the MAH increases towards the posterior area, where the maxillary sinus floor is close to the related teeth roots. According to original metrical data, we also proposed a possible operation procedure for sinus floor augmentation. CONCLUSIONS There is enough space in the lateral floor of the maxillary sinus for dental implantation, and the third premolar area might be a suitable position suggested for maxillary sinus augmentation with simultaneous implant placement in a goat model.
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Affiliation(s)
- Zou Derong
- Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Susin C, Qahash M, Polimeni G, Lu PH, Prasad HS, Rohrer MD, Hall J, Wikesjö UME. Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): histological observations. J Clin Periodontol 2010; 37:574-81. [PMID: 20345394 DOI: 10.1111/j.1600-051x.2010.01554.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pre-clinical studies have shown that recombinant human bone morphogenetic protein-2 (rhBMP-2) coated onto purpose-designed titanium porous-oxide surface implants induces clinically relevant bone formation and osseointegration. The objective of this study was to examine the potential of rhBMP-7, also known as recombinant human osteogenic protein-1 (rhOP-1), coated onto titanium porous-oxide surface implants to support vertical alveolar ridge augmentation and implant osseointegration. MATERIALS AND METHODS Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in six young adult Hound Labrador mongrel dogs. The animals received implants coated with rhBMP-7 at 1.5 or 3.0 mg/ml randomized to contra-lateral jaw quadrants. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at 3, 4, 7, and 8 weeks post-surgery when they were euthanized for histological evaluation. RESULTS Without striking differences between treatments, the implant sites exhibited a swelling that gradually regressed to become hard to palpation disguising the implant contours. The histological evaluation showed robust bone formation; the newly formed bone assuming characteristics of the contiguous resident bone, bone formation (height and area) averaging 4.1+/-1.0 versus 3.6+/-1.7 mm and 3.6+/-1.9 versus 3.1+/-1.8 mm(2); and bone density 56%versus 50% for implants coated with rhBMP-7 at 1.5 and 3.0 mg/ml, respectively. Both treatments exhibited clinically relevant osseointegration, the corresponding bone-implant contact values averaging 51% and 47%. Notable peri-implant resident bone remodelling was observed for implants coated with rhBMP-7 at 3.0 mg/ml. CONCLUSIONS rhBMP-7 coated onto titanium porous-oxide surface implants induces clinically relevant local bone formation including osseointegration and vertical augmentation of the alveolar ridge, the higher concentration/dose associated with some local side effects.
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Affiliation(s)
- Cristiano Susin
- Medical College of Georgia School of Dentistry, Augusta, GA, USA.
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Abstract
Bone morphogenetic proteins (BMPs) have shown osteoinductive properties, and favorable regenerative responses to the graft materials containing BMPs have been reported. Maxillary sinus augmentation with placement of dental implants is a well-established technique for functional and aesthetic dental rehabilitation of partially or completely edentulous patients with severe maxillary atrophy, and attempts have been made to promote the bone formation using BMPs with different carriers in various animal models in sinus augmentation procedures.In this review, the summary was done on various carriers and the dosages for BMPs in sinus augmentation procedures.
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Impact of rhBMP-2 on regeneration of buccal alveolar defects during the osseointegration of transgingival inserted implants. ACTA ACUST UNITED AC 2009; 108:e3-e12. [DOI: 10.1016/j.tripleo.2009.05.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 05/07/2009] [Accepted: 05/21/2009] [Indexed: 01/20/2023]
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45
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Ruehe B, Niehues S, Heberer S, Nelson K. Miniature pigs as an animal model for implant research: bone regeneration in critical-size defects. ACTA ACUST UNITED AC 2009; 108:699-706. [PMID: 19782620 DOI: 10.1016/j.tripleo.2009.06.037] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Revised: 05/12/2009] [Accepted: 06/29/2009] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Standardized experimental investigations determining the critical-size defect (CSD) in the mandible of miniature pigs are still lacking. The aim of the present study was to obtain information about the new bone formation in created defects of varying sizes. STUDY DESIGN Marginal resection of the alveolar crest of the lower jaw was performed in 3 female miniature pigs. The animals used in the study were 3 years of age and weighed approximately 55 kg. For histologic evaluation the dental implants were harvested with the surrounding bone tissue 10 weeks after implant placement. For this, bone segments including the implants were removed from each side of the mandible. The sizes of the resected bone blocks varied, showing the following volumes: 10.1 cm(3), 4.2 cm(3), and 1.9 cm(3). Periosteal coverage of the defects was performed. Computerized tomography (CT) of the skull of the miniature pig was performed immediately after the surgical procedure as well as 6 weeks later using a 64-channel mult-slice scanner. RESULTS The CT showed that 6 weeks after obtaining the biopsies, the filling of the defects with new bone varied. The percentage of newly formed bone in relation to the size of the original defect was 57.4% for the small- and 87.2% for the middle-sized defect. The large-sized defect showed 75.5% newly formed bone compared with baseline. CONCLUSION Considering the amount of new bone formation found within this study, it is questionable if the critical defect size of 5 cm(3) stated in the literature is valid. Further research concerning the mandibular model in minipigs is required and more refinement needed to assure a standardized CSD, allowing qualitative and quantitative evaluation of bone grafts and bone graft substitutes.
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Affiliation(s)
- Baerbel Ruehe
- Department of Oral and Maxillofacial Surgery, Charité-Campus Virchow Clinic, Berlin, Germany.
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Gutwald R, Haberstroh J, Kuschnierz J, Kister C, Lysek DA, Maglione M, Xavier SP, Oshima T, Schmelzeisen R, Sauerbier S. Mesenchymal stem cells and inorganic bovine bone mineral in sinus augmentation: comparison with augmentation by autologous bone in adult sheep. Br J Oral Maxillofac Surg 2009; 48:285-90. [PMID: 19665265 DOI: 10.1016/j.bjoms.2009.06.226] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2009] [Indexed: 02/06/2023]
Abstract
Our aim was to compare the osteogenic potential of mononuclear cells harvested from the iliac crest combined with bovine bone mineral (BBM) (experimental group) with that of autogenous cancellous bone alone (control group). We studied bilateral augmentations of the sinus floor in 6 adult sheep. BBM and mononuclear cells (MNC) were mixed and placed into one side and autogenous bone in the other side. Animals were killed after 8 and 16 weeks. Sites of augmentation were analysed radiographically and histologically. The mean (SD) augmentation volume was 3.0 (1.0) cm(3) and 2.7 (0.3) cm(3) after 8 and 16 weeks in the test group, and 2.8 (0.3) cm(3) (8 weeks) and 2.8 (1.2) cm(3) (16 weeks) in the control group, respectively. After 8 weeks, histomorphometric analysis showed 24 (3)% BBM, and 19 (11)% of newly formed bone in the test group. The control group had 20 (13%) of newly formed bone. Specimens after 16 weeks showed 29 (12%) of newly formed bone and 19 (3%) BBM in the test group. The amount of newly formed bone in the control group was 16 (6%). The results show that mononuclear cells, including mesenchymal stem cells, in combination with BBM as the biomaterial, have the potential to form bone.
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Affiliation(s)
- Ralf Gutwald
- Universitätsklinik für Zahn-, Mund- und Kieferheilkunde, Abteilung Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Hugstetter Str. 55, D-79106 Freiburg, Germany
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Mahler D, Levin L, Zigdon H, Machtei EE. The "dome phenomenon" associated with maxillary sinus augmentation. Clin Implant Dent Relat Res 2009; 11 Suppl 1:e46-51. [PMID: 19681936 DOI: 10.1111/j.1708-8208.2009.00178.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This case series is aimed to report a new phenomenon, the "dome phenomenon," which was observed in infected augmented sinuses over several years. METHODS Five patients are presented in whom sinus lift augmentation resulted in postoperative infection with inflammation and suppuration. The patients received aggressive anti-inflammatory treatment and surgical debridement of the inflamed tissue, including some grafted material performed through the lateral window of the primary procedure. RESULTS The inflammatory condition was reversed, and the site healed clinically. Radiographically, a dome-shaped, radio-opaque tissue was observed at the superior most aspect of the grafted sinus. This "dome phenomenon" was further confirmed during dental implant placement, which indicates healing potential adjacent to the maxillary sinus membrane. CONCLUSIONS The current report, as well as other studies and case series, suggests that there is great potential for healing and bone formation in the maxillary sinus membrane. The precise mechanism is not known. Further clinical and histologic studies are needed to understand the regenerative potential of the Schneiderian membrane.
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Affiliation(s)
- Dan Mahler
- Department of Periodontology, the Rambam Health Care Campus School of Graduate Dentistry, Haifa, Israel
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Bone regeneration in sinus lifts: comparing tissue-engineered bone and iliac bone. Br J Oral Maxillofac Surg 2009; 48:121-6. [PMID: 19487059 DOI: 10.1016/j.bjoms.2009.04.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2009] [Indexed: 01/30/2023]
Abstract
Lifting of the sinus floor is a standard procedure for bony augmentation that enables dental implantation. Although cultivated skin and mucosal grafts are often used in plastic and maxillofacial surgery, tissue-engineered bone has not achieved the same success. We present the clinical results of dental implants placed after the insertion of periosteum-derived, tissue-engineered bone grafts in sinus lifts. Periosteal cells were isolated from biopsy specimens of periosteum, resuspended and cultured. The cell suspension was soaked in polymer fleeces. The cell-polymer constructs were transplanted by sinus lift 8 weeks after harvesting. The patients (n=35) had either one or both sides operated on. Seventeen had a one-stage sinus lift with simultaneous implantation (54 implants). In 18 patients the implants were inserted 3 months after augmentation (64 implants). Selected cases were biopsied. A control group (41 patients: one stage=48 implants, two stage=135 implants) had augmentation with autologous bone only. They were followed up clinically and radiologically for at least 24 months. Both implants and augmentation were significantly more successful in the control group. Failure of augmentation of the tissue-engineered bone was more common after large areas had been augmented. Eleven implants were lost in the study group and only one in the control group. Lifting the sinus floor with autologous bone is more reliable than with tissue-engineered transplants. Although lamellar bone can be found in periosteum-derived, tissue-engineered transplants, the range of indications must be limited.
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Schuckert KH, Jopp S, Teoh SH. Mandibular defect reconstruction using three-dimensional polycaprolactone scaffold in combination with platelet-rich plasma and recombinant human bone morphogenetic protein-2: de novo synthesis of bone in a single case. Tissue Eng Part A 2009; 15:493-9. [PMID: 18767969 DOI: 10.1089/ten.tea.2008.0033] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This publication describes the clinical case of a 71-year-old female patient. Using polycaprolactone (PCL) scaffold, platelet-rich plasma (PRP) and recombinant human bone morphogenetic protein-2 (rhBMP-2), a critical-sized defect in the anterior mandible was regenerated using de novo-grown bone. A bacterial infection had caused a periimplantitis in two dental implants leading to a large destruction in the anterior mandible. Both implants were removed under antibiotic prophylaxis. A PCL scaffold was prepared especially for this clinical case. In a second procedure with antibiotic prophylaxis, the bony defect was reopened. The PCL scaffold was fitted and charged with PRP and rhBMP-2 (1.2 mg). After complication-free wound healing, the radiological control demonstrated de novo-grown bone in the anterior mandible 6 months postoperatively. Dental implants were inserted in a third operation. A bone biopsy of the newly grown bone, as well as of the bordering local bone, was taken and histologically examined. The bone samples were identical and presented vital laminar bone.
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Affiliation(s)
- Karl-Heinz Schuckert
- Institute Indente - Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering, Hannover, Germany.
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Histologic and histomorphometric evaluation of two bone substitute materials for bone regeneration: an experimental study in sheep. IMPLANT DENT 2009; 17:471-9. [PMID: 19077585 DOI: 10.1097/id.0b013e3181815596] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION In the past decade, there has been an increase focus on regeneration approaches as related to periodontics and implant therapies. The main objective of the present study is the evaluation of quality, density, and thickness of the newly formed bone in experimental defects treated with deproteinized bovine bone mineral (DBBM) and bioapatite-collagen. MATERIALS Fifteen identical cuboidal defects were prepared in the alveolar edentulous mandibular ridges in 10 male sheep. Defects were randomly assigned to be treated either with DBBM, Bioapatite-collagen or remained unfilled as the control group. Defects of these 3 groups were histologically examined after 6 months. RESULTS The mean percentages of bone regeneration with DBBM, Bioapatite-collagen, and control group were 51.40% +/- 3.57%, 27.66% +/- 4.18%, and 19% +/- 1%, respectively (P < 0.05). Defects filled with Bio-Oss and control defects did not show foreign body reaction, whereas Biostite particles had a reaction in 40% of the specimens. Trabecular thickness and type of new regenerated bone were also significantly different between Bio-Oss and Biostite (P < 0.05) and control group (P < 0.05). CONCLUSION The results of the present study suggest that using of DBBM particles can promote bone regeneration more effectively than Bioapatite-collagen, and both materials were more promising than the control group.
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