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Wang P, Ma Y, Wang Y, Zhou M, Liu J, Rui Y, Wu Y, Zhou T. A Novel Method to Assess Healing of Segmental Bone Defects using the Induced Membrane Technique. Orthop Surg 2024; 16:1991-1998. [PMID: 38946673 PMCID: PMC11293926 DOI: 10.1111/os.14157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 07/02/2024] Open
Abstract
OBJECTIVE Clinical concerns exist regarding the quality of bony consolidation in the context of the induced membrane technique. This study evaluates the clinical process of bone grafting in the second stage of induced membrane bone union in patients with tibial bone defects to infer the possibility of non-union and establish a reliable and effective evaluation method combined with computed tomography (CT) to assess fracture healing. METHODS Patients with tibial bone defects who underwent the induced membrane technique at our hospital between February 2017 and February 2020 were retrospectively analyzed. The Hounsfield unit (HU) values of the patients were evaluated at different times during the second stage of bone grafting. Bone healing at the boundary value of the 120 HU output threshold (-1024 HU-3071 HU) was directionally selected, and the changes in the growth volume of union (new bone volume [selected according to HU value]/bone defect volume) were compared with analyzing individual class bone union. Method 1 involved X-rays revealing that at least three of the four cortices were continuous and at least 2 mm thick, with the patient being pain free. For Method 2, new bone volume (selected according to HU value/bone defect volume) at the stage was compared with analyzing individual class healing. Receiver operating characteristic curve analysis was used for Methods 1 and 2. RESULTS A total of 42 patients with a segmental bone defect with a mean age of 40.5 years (40.5 ± 8.3 years) were included. The relationship between bone graft volume and time variation was analyzed by single factor repeated variable analysis (F = 6.477, p = 0.016). Further, curve regression analysis showed that the change in bone graft volume over time presented a logarithmic curve pattern (Y = 0.563 + 0.086 × ln(X), Ra2 = 0.608, p = 0.041). ROC curve analysis showed that Method 2 is superior to Method 1 (AUC: 86.3% vs. 68.3%, p < 0.05). CONCLUSION The induced membrane technique could be used to treat traumatic long bone defects, with fewer complications and a higher healing rate. The proposed imaging grading of HU (new bone volume/bone defect volume) can be used as a reference for the quality of bony consolidation with the induced membrane technique.
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Affiliation(s)
- Peng Wang
- Department of Orthopedics SurgeryWuxi No. 9 People's Hospital Affiliated to Soochow University (Wuxi Ninth People's Hospital)WuxiChina
| | - Yunhong Ma
- Department of Orthopedics SurgeryWuxi No. 9 People's Hospital Affiliated to Soochow University (Wuxi Ninth People's Hospital)WuxiChina
| | - Yapeng Wang
- Department of Orthopedics SurgeryWuxi No. 9 People's Hospital Affiliated to Soochow University (Wuxi Ninth People's Hospital)WuxiChina
| | - Ming Zhou
- Department of Orthopedics SurgeryWuxi No. 9 People's Hospital Affiliated to Soochow University (Wuxi Ninth People's Hospital)WuxiChina
| | - Jun Liu
- Department of Orthopedics SurgeryWuxi No. 9 People's Hospital Affiliated to Soochow University (Wuxi Ninth People's Hospital)WuxiChina
| | - Yongjun Rui
- Department of Orthopedics SurgeryWuxi No. 9 People's Hospital Affiliated to Soochow University (Wuxi Ninth People's Hospital)WuxiChina
| | - Yongwei Wu
- Department of Orthopedics SurgeryWuxi No. 9 People's Hospital Affiliated to Soochow University (Wuxi Ninth People's Hospital)WuxiChina
| | - Tong Zhou
- Wuxi Ninth People's Hospital; Shanghai Blackflame Medical Technology Co., Ltd. FireplusShanghaiChina
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Shimizu S, Koizumi H, Shibahara I, Kumabe T. Excessive Heat Generation by Power-Driven Craniotomy Tools: A Possible Cause of Autologous Bone Flap Resorption Observed in an Ex Vivo Simulation. World Neurosurg 2024; 187:e914-e919. [PMID: 38734170 DOI: 10.1016/j.wneu.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Bone flap resorption is an issue after autologous cranioplasty. Critical temperatures above 50°C generated by power-driven craniotomy tools may lead to thermal osteonecrosis, a possible factor in resorption. This ex vivo study examined whether the tools produced excessive heat resulting in bone flap resorption. METHODS Using swine scapulae maintained at body temperature, burr holes, straight and curved cuts, and wire-pass holes were made with power-driven craniotomy tools. Drilling was at the conventional feed rate (FR) plus irrigation (FR-I+), at a high FR plus irrigation (hFR-I+), and at high FR without irrigation (hFR-I-). The temperature in each trial was recorded by an infrared thermographic camera. RESULTS With FR-I+, the maximum temperature at the burr holes, the cuts, and the wire-pass holes was 69.0°C, 56.7°C, and 46.2°C, respectively. With hFR-I+, these temperatures were 53.1°C, 52.1°C, and 46.0°C, with hFR-I- they were 56.0°C, 66.5°C, and 50.0°C; hFR-I- burr hole- and cutting procedures resulted in the highest incidence of bone temperatures above 50°C followed by FR-I+, and hFR-I+. At the site of wire-pass holes, only hFR-I- drilling produced this temperature. CONCLUSIONS Except during prolonged procedures in thick bones, most drilling with irrigation did not reach the critical temperature. Drilling without irrigation risked generating the critical temperature. Knowing those characteristics may be a help to perform craniotomy with less thermal bone damage.
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Affiliation(s)
- Satoru Shimizu
- Department of Neurosurgery, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
| | - Hiroyuki Koizumi
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Ichiyo Shibahara
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Toshihiro Kumabe
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
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Lin C, Yang YS, Ma H, Chen Z, Chen D, John AA, Xie J, Gao G, Shim JH. Engineering a targeted and safe bone anabolic gene therapy to treat osteoporosis in alveolar bone loss. Mol Ther 2024:S1525-0016(24)00426-X. [PMID: 38937970 DOI: 10.1016/j.ymthe.2024.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 06/04/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024] Open
Abstract
Alveolar bone loss in elderly populations is highly prevalent and increases the risk of tooth loss, gum disease susceptibility, and facial deformity. Unfortunately, there are very limited treatment options available. Here, we developed a bone-targeted gene therapy that reverses alveolar bone loss in patients with osteoporosis by targeting the adaptor protein Schnurri-3 (SHN3). SHN3 is a promising therapeutic target for alveolar bone regeneration, because SHN3 expression is elevated in the mandible tissues of humans and mice with osteoporosis while deletion of SHN3 in mice greatly increases alveolar bone and tooth dentin mass. We used a bone-targeted recombinant adeno-associated virus (rAAV) carrying an artificial microRNA (miRNA) that silences SHN3 expression to restore alveolar bone loss in mouse models of both postmenopausal and senile osteoporosis by enhancing WNT signaling and osteoblast function. In addition, rAAV-mediated silencing of SHN3 enhanced bone formation and collagen production of human skeletal organoids in xenograft mice. Finally, rAAV expression in the mandible was tightly controlled via liver- and heart-specific miRNA-mediated repression or via a vibration-inducible mechanism. Collectively, our results demonstrate that AAV-based bone anabolic gene therapy is a promising strategy to treat alveolar bone loss in osteoporosis.
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Affiliation(s)
- Chujiao Lin
- Department of Medicine/Division of Rheumatology, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Yeon-Suk Yang
- Department of Medicine/Division of Rheumatology, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Hong Ma
- Department of Microbiology and Physiological Systems, UMass Chan Medical School, Worcester, MA 01655, USA; Horae Gene Therapy Center, Umass Chan Medical School, Worcester, MA 01655, USA; Viral Vector Core, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Zhihao Chen
- Department of Medicine/Division of Rheumatology, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Dong Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Aijaz Ahmad John
- Department of Medicine/Division of Rheumatology, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Jun Xie
- Department of Microbiology and Physiological Systems, UMass Chan Medical School, Worcester, MA 01655, USA; Horae Gene Therapy Center, Umass Chan Medical School, Worcester, MA 01655, USA; Viral Vector Core, UMass Chan Medical School, Worcester, MA 01655, USA
| | - Guangping Gao
- Department of Microbiology and Physiological Systems, UMass Chan Medical School, Worcester, MA 01655, USA; Horae Gene Therapy Center, Umass Chan Medical School, Worcester, MA 01655, USA; Viral Vector Core, UMass Chan Medical School, Worcester, MA 01655, USA; Li Weibo Institute for Rare Diseases Research, UMass Chan Medical School, Worcester, MA 01655, USA.
| | - Jae-Hyuck Shim
- Department of Medicine/Division of Rheumatology, UMass Chan Medical School, Worcester, MA 01655, USA; Horae Gene Therapy Center, Umass Chan Medical School, Worcester, MA 01655, USA; Li Weibo Institute for Rare Diseases Research, UMass Chan Medical School, Worcester, MA 01655, USA.
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Kamalakar A, Tobin B, Kaimari S, Robinson MH, Toma AI, Cha T, Chihab S, Moriarity I, Gautam S, Bhattaram P, Abramowicz S, Drissi H, García AJ, Wood LB, Goudy SL. Delivery of A Jagged1-PEG-MAL hydrogel with Pediatric Human Bone Cells Regenerates Critically-Sized Craniofacial Bone Defects. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.10.06.561291. [PMID: 37873448 PMCID: PMC10592619 DOI: 10.1101/2023.10.06.561291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Treatments for congenital and acquired craniofacial (CF) bone abnormalities are limited and expensive. Current reconstructive methods include surgical correction of injuries, short-term bone stabilization, and long-term use of bone grafting solutions, including implantation of (i) allografts which are prone to implant failure or infection, (ii) autografts which are limited in supply. Current bone regenerative approaches have consistently relied on BMP2 application with or without addition of stem cells. BMP2 treatment can lead to severe bony overgrowth or uncontrolled inflammation, which can accelerate further bone loss. Bone marrow-derived mesenchymal stem cell-based treatments, which do not have the side effects of BMP2, are not currently FDA approved, and are time and resource intensive. There is a critical need for novel bone regenerative therapies to treat CF bone loss that have minimal side effects, are easily available, and are affordable. In this study we investigated novel bone regenerative therapies downstream of JAGGED1 (JAG1). We previously demonstrated that JAG1 induces murine cranial neural crest (CNC) cells towards osteoblast commitment via a NOTCH non-canonical pathway involving JAK2-STAT5 (1) and that JAG1 delivery with CNC cells elicits bone regeneration in vivo. In this study, we hypothesize that delivery of JAG1 and induction of its downstream NOTCH non-canonical signaling in pediatric human osteoblasts constitute an effective bone regenerative treatment in an in vivo murine bone loss model of a critically-sized cranial defect. Using this CF defect model in vivo, we delivered JAG1 with pediatric human bone-derived osteoblast-like (HBO) cells to demonstrate the osteo-inductive properties of JAG1 in human cells and in vitro we utilized the HBO cells to identify the downstream non-canonical JAG1 signaling intermediates as effective bone regenerative treatments. In vitro, we identified an important mechanism by which JAG1 induces pediatric osteoblast commitment and bone formation involving the phosphorylation of p70 S6K. This discovery enables potential new treatment avenues involving the delivery of tethered JAG1 and the downstream activators of p70 S6K as powerful bone regenerative therapies in pediatric CF bone loss.
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Affiliation(s)
- Archana Kamalakar
- Department of Pediatric Otolaryngology, Emory University, Atlanta, GA, USA
| | - Brendan Tobin
- Parker H. Petit Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, GA, USA
- School of Chemistry and Biomolecular Engineering, Georgia Tech College of Engineering, Atlanta, GA, USA
| | - Sundus Kaimari
- Department of Pediatric Otolaryngology, Emory University, Atlanta, GA, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - M. Hope Robinson
- Department of Pediatric Otolaryngology, Emory University, Atlanta, GA, USA
| | - Afra I. Toma
- Department of Pediatric Otolaryngology, Emory University, Atlanta, GA, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Timothy Cha
- Department of Pediatric Otolaryngology, Emory University, Atlanta, GA, USA
| | - Samir Chihab
- Department of Orthopedics, Emory University, Atlanta, GA, USA
| | - Irica Moriarity
- Neuroscience Program in College of Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Surabhi Gautam
- Department of Orthopedics, Emory University, Atlanta, GA, USA
| | - Pallavi Bhattaram
- Department of Orthopedics, Emory University, Atlanta, GA, USA
- The Atlanta Veterans Affairs Medical Center Atlanta, GA, USA
| | - Shelly Abramowicz
- Department of Pediatric Otolaryngology, Emory University, Atlanta, GA, USA
- Department of Surgery, Division of Oral and Maxillofacial Surgery, Emory University, Atlanta, GA, USA
| | - Hicham Drissi
- Department of Cell biology, Emory University, Atlanta, GA, USA
- Department of Orthopedics, Emory University, Atlanta, GA, USA
- The Atlanta Veterans Affairs Medical Center Atlanta, GA, USA
| | - Andrés J. García
- Parker H. Petit Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, GA, USA
- George W. Woodruff School of Mechanical Engineering, Georgia Tech College of Engineering, Atlanta, GA, USA
| | - Levi B. Wood
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Parker H. Petit Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, GA, USA
- George W. Woodruff School of Mechanical Engineering, Georgia Tech College of Engineering, Atlanta, GA, USA
| | - Steven L. Goudy
- Department of Pediatric Otolaryngology, Emory University, Atlanta, GA, USA
- Department of Pediatric Otolaryngology, Children’s Healthcare of Atlanta, Atlanta, GA, USA
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Dastgir R, Coffey J, Quereshy H, Baur DA, Quereshy FA. Nonvascularized bone grafts: how successful are they in reconstruction of segmental mandibular defects? Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:e63-e72. [PMID: 38155011 DOI: 10.1016/j.oooo.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/29/2023] [Accepted: 10/22/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE Segmental mandibular defects can occur due to various etiologies, including trauma and tumor resection. Reconstruction should provide adequate support for subsequent dental rehabilitation and allow for proper occlusion. Nonvascularized bone grafts have been used for reconstructing mandibular defects in cases where vascularized grafts were not feasible. The objective of this study was to assess the success rate of these grafts in reconstruction of segmental defects of various sizes in the mandible. STUDY DESIGN Fifty patients were included in this retrospective chart review. Length of the grafts varied from 3 to 20 cm and patients were followed up from 4 to 80 months. Fifteen grafts were harvested from anterior iliac crest, 23 from posterior iliac crest, 9 grafts were a combination of either with costochondral graft, and 3 were solely allografts. Bone morphogenetic protein was utilized in 41 cases as an adjunct. RESULTS Success was defined as continuity of bone clinically and radiographically at a 4-month follow-up. Nonvascularized bone grafting was successful in 90% of cases. Complications were observed in 34% of cases, of which the most common were infection followed by wound dehiscence. CONCLUSIONS Our study demonstrated substantial success rate with nonvascularized bone grafts in reconstruction of segmental mandibular defects.
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Affiliation(s)
- Ramtin Dastgir
- Research Fellow, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, Cleveland, OH, USA
| | - Joshua Coffey
- Private Practice, Midwest Oral Surgery, St. Louis, MO, USA
| | - Humzah Quereshy
- Resident, Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Dale A Baur
- Professor and Chair, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, Cleveland, OH, USA
| | - Faisal A Quereshy
- Professor and Program Director, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, Cleveland, OH, USA.
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De Lauretis A, Øvrebø Ø, Romandini M, Lyngstadaas SP, Rossi F, Haugen HJ. From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2308848. [PMID: 38380549 PMCID: PMC11077667 DOI: 10.1002/advs.202308848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/23/2024] [Indexed: 02/22/2024]
Abstract
Periodontitis is a dysbiosis-driven inflammatory disease affecting the tooth-supporting tissues, characterized by their progressive resorption, which can ultimately lead to tooth loss. A step-wise therapeutic approach is employed for periodontitis. After an initial behavioral and non-surgical phase, intra-bony or furcation defects may be amenable to regenerative procedures. This review discusses the regenerative technologies employed for periodontal regeneration, highlighting the current limitations and future research areas. The search, performed on the MEDLINE database, has identified the available biomaterials, including biologicals (autologous platelet concentrates, hydrogels), bone grafts (pure or putty), and membranes. Biologicals and bone grafts have been critically analyzed in terms of composition, mechanism of action, and clinical applications. Although a certain degree of periodontal regeneration is predictable in intra-bony and class II furcation defects, complete defect closure is hardly achieved. Moreover, treating class III furcation defects remains challenging. The key properties required for functional regeneration are discussed, and none of the commercially available biomaterials possess all the ideal characteristics. Therefore, research is needed to promote the advancement of more effective and targeted regenerative therapies for periodontitis. Lastly, improving the design and reporting of clinical studies is suggested by strictly adhering to the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.
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Affiliation(s)
- Angela De Lauretis
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Øystein Øvrebø
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Mario Romandini
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
| | - Ståle Petter Lyngstadaas
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
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Wei Y, Pan H, Yang J, Zeng C, Wan W, Chen S. Aligned cryogel fibers incorporated 3D printed scaffold effectively facilitates bone regeneration by enhancing cell recruitment and function. SCIENCE ADVANCES 2024; 10:eadk6722. [PMID: 38324693 PMCID: PMC10849600 DOI: 10.1126/sciadv.adk6722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/05/2024] [Indexed: 02/09/2024]
Abstract
Reconstructing extensive cranial defects represents a persistent clinical challenge. Here, we reported a hybrid three-dimensional (3D) printed scaffold with modification of QK peptide and KP peptide for effectively promoting endogenous cranial bone regeneration. The hybrid 3D printed scaffold consists of vertically aligned cryogel fibers that guide and promote cell penetration into the defect area in the early stages of bone repair. Then, the conjugated QK peptide and KP peptide further regulate the function of the recruited cells to promote vascularization and osteogenic differentiation in the defect area. The regenerated bone volume and surface coverage of the dual peptide-modified hybrid scaffold were significantly higher than the positive control group. In addition, the dual peptide-modified hybrid scaffold demonstrated sustained enhancement of bone regeneration and avoidance of bone resorption compared to the collagen sponge group. We expect that the design of dual peptide-modified hybrid scaffold will provide a promising strategy for bone regeneration.
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Affiliation(s)
- Yuxuan Wei
- Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery, the Third Affiliated Hospital of Southern Medical University. Guangzhou, Guangdong 510630, China
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang 325000, China
| | - Hao Pan
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang 325000, China
- Department of Orthopaedic Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Jianqiu Yang
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang 325000, China
- Department of Orthopaedic Surgery, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006 China
| | - Canjun Zeng
- Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery, the Third Affiliated Hospital of Southern Medical University. Guangzhou, Guangdong 510630, China
| | - Wenbing Wan
- Department of Orthopaedic Surgery, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006 China
| | - Shixuan Chen
- Zhejiang Engineering Research Center for Tissue Repair Materials, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang 325000, China
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Han Z, Xiong J, Jin X, Dai Q, Han M, Wu H, Yang J, Tang H, He L. Advances in reparative materials for infectious bone defects and their applications in maxillofacial regions. J Mater Chem B 2024; 12:842-871. [PMID: 38173410 DOI: 10.1039/d3tb02069j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Infectious bone defects are characterized by the partial loss or destruction of bone tissue resulting from bacterial contaminations subsequent to diseases or external injuries. Traditional bone transplantation and clinical methods are insufficient in meeting the treatment demands for such diseases. As a result, researchers have increasingly focused on the development of more sophisticated biomaterials for improved therapeutic outcomes in recent years. This review endeavors to investigate specific reparative materials utilized for the treatment of infectious bone defects, particularly those present in the maxillofacial region, with a focus on biomaterials capable of releasing therapeutic substances, functional contact biomaterials, and novel physical therapy materials. These biomaterials operate via heightened antibacterial or osteogenic properties in order to eliminate bacteria and/or stimulate bone cells regeneration in the defect, ultimately fostering the reconstitution of maxillofacial bone tissue. Based upon some successful applications of new concept materials in bone repair of other parts, we also explore their future prospects and potential uses in maxillofacial bone repair later in this review. We highlight that the exploration of advanced biomaterials holds promise in establishing a solid foundation for the development of more biocompatible, effective, and personalized treatments for reconstructing infectious maxillofacial defects.
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Affiliation(s)
- Ziyi Han
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Jingdi Xiong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Xiaohan Jin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Qinyue Dai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Mingyue Han
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Hongkun Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Jiaojiao Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Haiqin Tang
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Libang He
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
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Zhou Y, Hu J, Li B, Xia J, Zhang T, Xiong Z. Towards the Clinical Translation of 3D PLGA/β-TCP/Mg Composite Scaffold for Cranial Bone Regeneration. MATERIALS (BASEL, SWITZERLAND) 2024; 17:352. [PMID: 38255520 PMCID: PMC10817297 DOI: 10.3390/ma17020352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024]
Abstract
Recent years have witnessed the rapid development of 3D porous scaffolds with excellent biocompatibility, tunable porosity, and pore interconnectivity, sufficient mechanical strength, controlled biodegradability, and favorable osteogenesis for improved results in cranioplasty. However, clinical translation of these scaffolds has lagged far behind, mainly because of the absence of a series of biological evaluations. Herein, we designed and fabricated a composite 3D porous scaffold composed of poly (lactic-co-glycolic) acid (PLGA), β-tricalcium phosphate (β-TCP), and Mg using the low-temperature deposition manufacturing (LDM) technique. The LDM-engineered scaffolds possessed highly porous and interconnected microstructures with a porosity of 63%. Meanwhile, the scaffolds exhibited mechanical properties close to that of cancellous bone, as confirmed by the compression tests. It was also found that the original composition of scaffolds could be maintained throughout the fabrication process. Particularly, two important biologic evaluations designed for non-active medical devices, i.e., local effects after implantation and subchronic systemic toxicity tests, were conducted to evaluate the local and systemic toxicity of the scaffolds. Additionally, the scaffolds exhibited significant higher mRNA levels of osteogenic genes compared to control scaffolds, as confirmed by an in vitro osteogenic differentiation test of MC3T3-E1 cells. Finally, we demonstrated the improved cranial bone regeneration performance of the scaffolds in a rabbit model. We envision that our investigation could pave the way for translating the LDM-engineered composite scaffolds into clinical products for cranial bone regeneration.
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Affiliation(s)
- Yongsen Zhou
- Biomanufacturing Center, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China; (Y.Z.); (B.L.); (J.X.); (T.Z.)
- Biomanufacturing and Rapid Forming Technology Key Laboratory of Beijing, Beijing 100084, China
- Biomanufacturing and Engineering Living Systems, Innovation International Talents Base (111 Base), Beijing 100084, China
| | - Jingqi Hu
- National Engineering Research Center of Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing 100084, China;
| | - Binhan Li
- Biomanufacturing Center, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China; (Y.Z.); (B.L.); (J.X.); (T.Z.)
- Biomanufacturing and Rapid Forming Technology Key Laboratory of Beijing, Beijing 100084, China
- Biomanufacturing and Engineering Living Systems, Innovation International Talents Base (111 Base), Beijing 100084, China
| | - Jingjing Xia
- Biomanufacturing Center, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China; (Y.Z.); (B.L.); (J.X.); (T.Z.)
- Biomanufacturing and Rapid Forming Technology Key Laboratory of Beijing, Beijing 100084, China
- Biomanufacturing and Engineering Living Systems, Innovation International Talents Base (111 Base), Beijing 100084, China
| | - Ting Zhang
- Biomanufacturing Center, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China; (Y.Z.); (B.L.); (J.X.); (T.Z.)
- Biomanufacturing and Rapid Forming Technology Key Laboratory of Beijing, Beijing 100084, China
- Biomanufacturing and Engineering Living Systems, Innovation International Talents Base (111 Base), Beijing 100084, China
| | - Zhuo Xiong
- Biomanufacturing Center, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China; (Y.Z.); (B.L.); (J.X.); (T.Z.)
- Biomanufacturing and Rapid Forming Technology Key Laboratory of Beijing, Beijing 100084, China
- Biomanufacturing and Engineering Living Systems, Innovation International Talents Base (111 Base), Beijing 100084, China
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10
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Abdulaziz D, Anastasiou AD, Panagiotopoulou V, Raif EM, Giannoudis PV, Jha A. Physiologically engineered porous titanium/brushite scaffolds for critical-size bone defects: A design and manufacturing study. J Mech Behav Biomed Mater 2023; 148:106223. [PMID: 37976684 DOI: 10.1016/j.jmbbm.2023.106223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
Repairing critical-size bone defects still represents a critical clinical challenge in the field of trauma surgery. This study focuses on a physiological design and manufacturing of porous composite scaffold (titanium Ti with 10 % mole iron doped brushite DCPD-Fe3+) which can mimic the biomechanical properties of natural cortical bone, specifically for the purpose of repairing critical-size defects. To achieve this, the principle of design of experiments (DOE) was applied for investigating the impact of sintering temperature, mineral ratio, and volume fraction of porosity on the mechanical properties of the fabricated scaffolds. The fabricated scaffolds had open porosity up to 60 %, with pore size approximately between 100 μm and 850 μm. The stiffness of the porous composite scaffolds varied between 3.30 GPa and 20.50 GPa, while the compressive strength ranged from approximately 130 MPa-165 MPa at sintering temperatures equal to or exceeding 1000 °C. Scaffolds with higher porosity and mineral content demonstrated lower stiffness values, resembling natural bone. Numerical simulation was employed by Ansys Workbench to investigate the stress and strain distribution of a critical size defect in mid-shaft femur which was designed to be replaced with the fabricated scaffold. The fabricated scaffolds showed flexible biomechanical behaviour at the bone/scaffold interface, generating lower stress levels and indicating a better match with the femoral shaft stiffness. The experimental and numerical findings demonstrated promising applications for manufacturing a patient-specific bone scaffold for critical and potentially large defects for reducing stress shielding and minimizing non-union risk.
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Affiliation(s)
- Dina Abdulaziz
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, UK.
| | - Antonios D Anastasiou
- Department of Chemical Engineering, University of Manchester, Manchester, M1 3AL, UK
| | | | - El Mostafa Raif
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, LS2 9JT, UK
| | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Animesh Jha
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, UK
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11
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Bello SA, Cruz-Lebrón J, Rodríguez-Rivera OA, Nicolau E. Bioactive Scaffolds as a Promising Alternative for Enhancing Critical-Size Bone Defect Regeneration in the Craniomaxillofacial Region. ACS APPLIED BIO MATERIALS 2023; 6:4465-4503. [PMID: 37877225 DOI: 10.1021/acsabm.3c00432] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Reconstruction of critical-size bone defects (CSDs) in the craniomaxillofacial (CMF) region remains challenging. Scaffold-based bone-engineered constructs have been proposed as an alternative to the classical treatments made with autografts and allografts. Scaffolds, a key component of engineered constructs, have been traditionally viewed as biologically passive temporary replacements of deficient bone lacking intrinsic cues to promote osteogenesis. Nowadays, scaffolds are functionalized, giving rise to bioactive scaffolds promoting bone regeneration more effectively than conventional counterparts. This review focuses on the three approaches most used to bioactivate scaffolds: (1) conferring microarchitectural designs or surface nanotopography; (2) loading bioactive molecules; and (3) seeding stem cells on scaffolds, providing relevant examples of in vivo (preclinical and clinical) studies where these methods are employed to enhance CSDs healing in the CMF region. From these, adding bioactive molecules (specifically bone morphogenetic proteins or BMPs) to scaffolds has been the most explored to bioactivate scaffolds. Nevertheless, the downsides of grafting BMP-loaded scaffolds in patients have limited its successful translation into clinics. Despite these drawbacks, scaffolds containing safer, cheaper, and more effective bioactive molecules, combined with stem cells and topographical cues, remain a promising alternative for clinical use to treat CSDs in the CMF complex replacing autografts and allografts.
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Affiliation(s)
- Samir A Bello
- Department of Chemistry, University of Puerto Rico, Rio Piedras Campus, PO Box 23346, San Juan, Puerto Rico 00931, United States
- Molecular Sciences Research Center, University of Puerto Rico, 1390 Ponce De León Ave, Suite 1-7, San Juan, Puerto Rico 00926, United States
| | - Junellie Cruz-Lebrón
- Department of Chemistry, University of Puerto Rico, Rio Piedras Campus, PO Box 23346, San Juan, Puerto Rico 00931, United States
- Molecular Sciences Research Center, University of Puerto Rico, 1390 Ponce De León Ave, Suite 1-7, San Juan, Puerto Rico 00926, United States
| | - Osvaldo A Rodríguez-Rivera
- Department of Chemistry, University of Puerto Rico, Rio Piedras Campus, PO Box 23346, San Juan, Puerto Rico 00931, United States
- Molecular Sciences Research Center, University of Puerto Rico, 1390 Ponce De León Ave, Suite 1-7, San Juan, Puerto Rico 00926, United States
| | - Eduardo Nicolau
- Department of Chemistry, University of Puerto Rico, Rio Piedras Campus, PO Box 23346, San Juan, Puerto Rico 00931, United States
- Molecular Sciences Research Center, University of Puerto Rico, 1390 Ponce De León Ave, Suite 1-7, San Juan, Puerto Rico 00926, United States
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12
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Fan J, Zhang X, Kang M, Lee CS, Kim L, Hadaya D, Aghaloo TL, Lee M. Complementary modulation of BMP signaling improves bone healing efficiency. Biomaterials 2023; 302:122335. [PMID: 37748419 PMCID: PMC10805245 DOI: 10.1016/j.biomaterials.2023.122335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/30/2023] [Accepted: 09/19/2023] [Indexed: 09/27/2023]
Abstract
The bone morphogenetic protein (BMP) signaling pathway plays a crucial role in bone development and regeneration. While BMP-2 is widely used as an alternative to autograft, its clinical application has raised concerns about adverse side effects and deteriorated bone quality. Therefore, there is a need to develop more sophisticated approaches to regulate BMP signaling and promote bone regeneration. Here, we present a novel complementary strategy that targets both BMP antagonist noggin and agonist Trb3 to enhance bone defect repair without the application of exogenous BMP-2. In vitro studies showed that overexpression of Trb3 with simultaneous noggin suppression significantly promotes osteogenic differentiation of mesenchymal stem cells. This was accompanied by increased BMP/Smad signaling. We also developed sterosome nanocarriers, a non-phospholipid liposomal system, to achieve non-viral mediated noggin suppression and Trb3 overexpression. The gene-loaded sterosomes were integrated onto an apatite-coated polymer scaffold for in vivo calvarial defect implantation, resulting in robust bone healing compared to BMP-2 treatments. Our work provides a promising alternative for high-quality bone formation by regulating expression of BMP agonists and antagonists.
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Affiliation(s)
- Jiabing Fan
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, 90095, USA; Department of Pharmaceutical Sciences, School of Pharmacy and Health Professions, University of Maryland Eastern Shore, Princess Anne, MD, 21853, USA
| | - Xiao Zhang
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, 90095, USA
| | - Minjee Kang
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, 90095, USA
| | - Chung-Sung Lee
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, 90095, USA; Department of Pharmaceutical Engineering, Soonchunhyang University, Asan, Chungcheongnam-do, 31538, Republic of Korea
| | - Lauren Kim
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, 90095, USA
| | - Danny Hadaya
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, CA, 90095, USA
| | - Tara L Aghaloo
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, CA, 90095, USA.
| | - Min Lee
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, 90095, USA; Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA.
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13
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Patel D, Tatum SA. Bone Graft Substitutes and Enhancement in Craniomaxillofacial Surgery. Facial Plast Surg 2023; 39:556-563. [PMID: 37473765 DOI: 10.1055/s-0043-1770962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
Critical-sized bone defects are a reconstructive challenge, particularly in the craniomaxillofacial (CMF) skeleton. The "gold standard" of autologous bone grafting has been the work horse of reconstruction in both congenital and acquired defects of CMF skeleton. Autologous bone has the proper balance of the protein (or organic) matrix and mineral components with no immune response. Organic and mineral adjuncts exist that offer varying degrees of osteogenic, osteoconductive, osteoinductive, and osteostimulative properties needed for treatment of critical-sized defects. In this review, we discuss the various mostly organic and mostly mineral bone graft substitutes available for autologous bone grafting. Primarily organic bone graft substitutes/enhancers, including bone morphogenic protein, platelet-rich plasma, and other growth factors, have been utilized to support de novo bone growth in setting of critical-sized bone defects. Primarily mineral options, including various calcium salt formulation (calcium sulfate/phosphate/apatite) and bioactive glasses have been long utilized for their similar composition to bone. Yet, a bone graft substitute that can supplant autologous bone grafting is still elusive. However, case-specific utilization of bone graft substitutes offers a wider array of reconstructive options.
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Affiliation(s)
- Dhruv Patel
- Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, New York
| | - Sherard A Tatum
- Department of Otolaryngology and Pediatrics, SUNY Upstate Medical University, Syracuse, New York
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14
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Patel K, Salman S, Shanti RM. Bone Allografts: Their Role in Mandibular Reconstruction. Atlas Oral Maxillofac Surg Clin North Am 2023; 31:85-90. [PMID: 37500203 DOI: 10.1016/j.cxom.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Affiliation(s)
- Ketan Patel
- North Memorial Health, 300 Oakdale Avenue N, Robbinsdale, MN 55422, USA
| | - Salam Salman
- Department of Oral and Maxillofacial Surgery, University of Florida Health - Jacksonville, 653 West 8th Street, 2nd Floor LRC Building, Jacksonville, FL 32209, USA.
| | - Rabie M Shanti
- Rutgers School of Dental Medicine, Department of Oral & Maxillofacial Surgery, 110 Bergen Street, Newark, NJ 07103, USA
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15
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Al-Rawee RY, Tawfeeq BAG, Hamodat AM, Tawfek ZS. Consequence of Synthetic Bone Substitute Used for Alveolar Cleft Graft Reconstruction (Preliminary Clinical Study). Arch Plast Surg 2023; 50:478-487. [PMID: 37808326 PMCID: PMC10556338 DOI: 10.1055/a-2113-3084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/15/2023] [Indexed: 10/10/2023] Open
Abstract
Background The outcome of alveolar grafting with synthetic bone substitute (Osteon III) in various bone defect volumes is highlighted. Methods A prospective study was accomplished on 55 patients (6-13 years of age) with unilateral alveolar bone cleft. Osteon III, consisting of hydroxyapatite and tricalcium phosphate, is used to reconstruct the defect. Alveolus defect diameter was calculated before surgery (V1), after 3 months (V2), and finally after 6 months (V3) postsurgery. In the t -test, a significant difference and correlation between V1, V2, and V3 are stated. A p- value of 0.01 is considered a significant difference between parameters. Results The degree of cleft is divided into three categories: small (9 cases), medium (20 patients), and large (26 cases).The bone volume of the clefted site is divided into three steps: volume 1: (mean 18.1091 mm 3 ); step 2: after 3 months, volume 2 resembles the amount of unhealed defect (mean 0.5109 mm 3 ); and the final bone volume assessment is made after 6 months (22.5455 mm 3 ). Both show statistically significant differences in bone volume formation. Conclusion An alloplastic bone substitute can also be used as a graft material because of its unlimited bone retrieval. Osteon III can be used to reconstruct the alveolar cleft smoothly and effectively.
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Affiliation(s)
- Rawaa Y. Al-Rawee
- Department of Oral and Maxillofacial Surgery, Al-Salam Teaching Hospital. Mosul, Iraq
| | | | | | - Zaid Salim Tawfek
- Paedo Ortho Prevention Department, Alnoor University College, Mosul, Iraq
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16
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Bianconi S, Oliveira KMC, Klein KL, Wolf J, Schaible A, Schröder K, Barker J, Marzi I, Leppik L, Henrich D. Pretreatment of Mesenchymal Stem Cells with Electrical Stimulation as a Strategy to Improve Bone Tissue Engineering Outcomes. Cells 2023; 12:2151. [PMID: 37681884 PMCID: PMC10487010 DOI: 10.3390/cells12172151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023] Open
Abstract
Electrical stimulation (EStim), whether used alone or in combination with bone tissue engineering (BTE) approaches, has been shown to promote bone healing. In our previous in vitro studies, mesenchymal stem cells (MSCs) were exposed to EStim and a sustained, long-lasting increase in osteogenic activity was observed. Based on these findings, we hypothesized that pretreating MSC with EStim, in 2D or 3D cultures, before using them to treat large bone defects would improve BTE treatments. Critical size femur defects were created in 120 Sprague-Dawley rats and treated with scaffold granules seeded with MSCs that were pre-exposed or not (control group) to EStim 1 h/day for 7 days in 2D (MSCs alone) or 3D culture (MSCs + scaffolds). Bone healing was assessed at 1, 4, and 8 weeks post-surgery. In all groups, the percentage of new bone increased, while fibrous tissue and CD68+ cell count decreased over time. However, these and other healing features, like mineral density, bending stiffness, the amount of new bone and cartilage, and the gene expression of osteogenic markers, did not significantly differ between groups. Based on these findings, it appears that the bone healing environment could counteract the long-term, pro-osteogenic effects of EStim seen in our in vitro studies. Thus, EStim seems to be more effective when administered directly and continuously at the defect site during bone healing, as indicated by our previous studies.
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Affiliation(s)
- Santiago Bianconi
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany (K.-L.K.); (J.W.); (A.S.); (I.M.); (L.L.); (D.H.)
| | - Karla M. C. Oliveira
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany (K.-L.K.); (J.W.); (A.S.); (I.M.); (L.L.); (D.H.)
| | - Kari-Leticia Klein
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany (K.-L.K.); (J.W.); (A.S.); (I.M.); (L.L.); (D.H.)
| | - Jakob Wolf
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany (K.-L.K.); (J.W.); (A.S.); (I.M.); (L.L.); (D.H.)
| | - Alexander Schaible
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany (K.-L.K.); (J.W.); (A.S.); (I.M.); (L.L.); (D.H.)
| | - Katrin Schröder
- Vascular Research Centre, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - John Barker
- Frankfurt Initiative for Regenerative Medicine, Experimental Orthopedics and Trauma Surgery, Goethe University Frankfurt, 60528 Frankfurt am Main, Germany;
| | - Ingo Marzi
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany (K.-L.K.); (J.W.); (A.S.); (I.M.); (L.L.); (D.H.)
| | - Liudmila Leppik
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany (K.-L.K.); (J.W.); (A.S.); (I.M.); (L.L.); (D.H.)
| | - Dirk Henrich
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany (K.-L.K.); (J.W.); (A.S.); (I.M.); (L.L.); (D.H.)
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17
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Wang Z, Chen T, Li X, Guo B, Liu P, Zhu Z, Xu RX. Oxygen-releasing biomaterials for regenerative medicine. J Mater Chem B 2023; 11:7300-7320. [PMID: 37427691 DOI: 10.1039/d3tb00670k] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Oxygen is critical to the survival, function and fate of mammalian cells. Oxygen tension controls cellular behavior through metabolic programming, which in turn controls tissue regeneration. A variety of biomaterials with oxygen-releasing capabilities have been developed to provide oxygen supply to ensure cell survival and differentiation for therapeutic efficacy, and to prevent hypoxia-induced tissue damage and cell death. However, controlling the oxygen release with spatial and temporal accuracy is still technically challenging. In this review, we provide a comprehensive overview of organic and inorganic materials available as oxygen sources, including hemoglobin-based oxygen carriers (HBOCs), perfluorocarbons (PFCs), photosynthetic organisms, solid and liquid peroxides, and some of the latest materials such as metal-organic frameworks (MOFs). Additionally, we introduce the corresponding carrier materials and the oxygen production methods and present state-of-the-art applications and breakthroughs of oxygen-releasing materials. Furthermore, we discuss the current challenges and the future perspectives in the field. After reviewing the recent progress and the future perspectives of oxygen-releasing materials, we predict that smart material systems that combine precise detection of oxygenation and adaptive control of oxygen delivery will be the future trend for oxygen-releasing materials in regenerative medicine.
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Affiliation(s)
- Zhaojun Wang
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou 215000, China.
| | - Tianao Chen
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui 230026, China.
- Key Laboratory of Precision Scientific Instrumentation of Anhui Higher Education Institutes, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Xin Li
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou 215000, China.
| | - Buyun Guo
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui 230026, China.
- Key Laboratory of Precision Scientific Instrumentation of Anhui Higher Education Institutes, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Peng Liu
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou 215000, China.
| | - Zhiqiang Zhu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui 230026, China.
- Key Laboratory of Precision Scientific Instrumentation of Anhui Higher Education Institutes, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Ronald X Xu
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou 215000, China.
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui 230026, China.
- Key Laboratory of Precision Scientific Instrumentation of Anhui Higher Education Institutes, University of Science and Technology of China, Hefei, Anhui 230026, China
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18
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Awad K, Ahuja N, Yacoub AS, Brotto L, Young S, Mikos A, Aswath P, Varanasi V. Revolutionizing bone regeneration: advanced biomaterials for healing compromised bone defects. FRONTIERS IN AGING 2023; 4:1217054. [PMID: 37520216 PMCID: PMC10376722 DOI: 10.3389/fragi.2023.1217054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/06/2023] [Indexed: 08/01/2023]
Abstract
In this review, we explore the application of novel biomaterial-based therapies specifically targeted towards craniofacial bone defects. The repair and regeneration of critical sized bone defects in the craniofacial region requires the use of bioactive materials to stabilize and expedite the healing process. However, the existing clinical approaches face challenges in effectively treating complex craniofacial bone defects, including issues such as oxidative stress, inflammation, and soft tissue loss. Given that a significant portion of individuals affected by traumatic bone defects in the craniofacial area belong to the aging population, there is an urgent need for innovative biomaterials to address the declining rate of new bone formation associated with age-related changes in the skeletal system. This article emphasizes the importance of semiconductor industry-derived materials as a potential solution to combat oxidative stress and address the challenges associated with aging bone. Furthermore, we discuss various material and autologous treatment approaches, as well as in vitro and in vivo models used to investigate new therapeutic strategies in the context of craniofacial bone repair. By focusing on these aspects, we aim to shed light on the potential of advanced biomaterials to overcome the limitations of current treatments and pave the way for more effective and efficient therapeutic interventions for craniofacial bone defects.
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Affiliation(s)
- Kamal Awad
- Bone Muscle Research Center, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, TX, United States
- Department of Materials Science and Engineering, College of Engineering, The University of Texas at Arlington, Arlington, TX, United States
| | - Neelam Ahuja
- Bone Muscle Research Center, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, TX, United States
| | - Ahmed S. Yacoub
- Bone Muscle Research Center, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, TX, United States
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt
| | - Leticia Brotto
- Bone Muscle Research Center, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, TX, United States
| | - Simon Young
- Katz Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Antonios Mikos
- Center for Engineering Complex Tissues, Center for Excellence in Tissue Engineering, J.W. Cox Laboratory for Biomedical Engineering, Rice University, Houston, TX, United States
| | - Pranesh Aswath
- Department of Materials Science and Engineering, College of Engineering, The University of Texas at Arlington, Arlington, TX, United States
| | - Venu Varanasi
- Bone Muscle Research Center, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, TX, United States
- Department of Materials Science and Engineering, College of Engineering, The University of Texas at Arlington, Arlington, TX, United States
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McWilliam RH, Chang W, Liu Z, Wang J, Han F, Black RA, Wu J, Luo X, Li B, Shu W. Three-dimensional biofabrication of nanosecond laser micromachined nanofibre meshes for tissue engineered scaffolds. BIOMATERIALS TRANSLATIONAL 2023; 4:104-114. [PMID: 38283921 PMCID: PMC10817787 DOI: 10.12336/biomatertransl.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/19/2023] [Accepted: 06/20/2023] [Indexed: 01/30/2024]
Abstract
There is a high demand for bespoke grafts to replace damaged or malformed bone and cartilage tissue. Three-dimensional (3D) printing offers a method of fabricating complex anatomical features of clinically relevant sizes. However, the construction of a scaffold to replicate the complex hierarchical structure of natural tissues remains challenging. This paper reports a novel biofabrication method that is capable of creating intricately designed structures of anatomically relevant dimensions. The beneficial properties of the electrospun fibre meshes can finally be realised in 3D rather than the current promising breakthroughs in two-dimensional (2D). The 3D model was created from commercially available computer-aided design software packages in order to slice the model down into many layers of slices, which were arrayed. These 2D slices with each layer of a defined pattern were laser cut, and then successfully assembled with varying thicknesses of 100 μm or 200 μm. It is demonstrated in this study that this new biofabrication technique can be used to reproduce very complex computer-aided design models into hierarchical constructs with micro and nano resolutions, where the clinically relevant sizes ranging from a simple cube of 20 mm dimension, to a more complex, 50 mm-tall human ears were created. In-vitro cell-contact studies were also carried out to investigate the biocompatibility of this hierarchal structure. The cell viability on a micromachined electrospun polylactic-co-glycolic acid fibre mesh slice, where a range of hole diameters from 200 μm to 500 μm were laser cut in an array where cell confluence values of at least 85% were found at three weeks. Cells were also seeded onto a simpler stacked construct, albeit made with micromachined poly fibre mesh, where cells can be found to migrate through the stack better with collagen as bioadhesives. This new method for biofabricating hierarchical constructs can be further developed for tissue repair applications such as maxillofacial bone injury or nose/ear cartilage replacement in the future.
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Affiliation(s)
- Ross H. McWilliam
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Wenlong Chang
- Centre for Precision Manufacturing, Design, Manufacturing & Engineering Management, University of Strathclyde, Glasgow, UK
| | - Zhao Liu
- Orthopaedic Institute, Department of Orthopaedic Surgery, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu Province, China
| | - Jiayuan Wang
- Orthopaedic Institute, Department of Orthopaedic Surgery, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu Province, China
| | - Fengxuan Han
- Orthopaedic Institute, Department of Orthopaedic Surgery, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu Province, China
| | - Richard A. Black
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Junxi Wu
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Xichun Luo
- Centre for Precision Manufacturing, Design, Manufacturing & Engineering Management, University of Strathclyde, Glasgow, UK
| | - Bin Li
- Orthopaedic Institute, Department of Orthopaedic Surgery, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu Province, China
| | - Wenmiao Shu
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
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20
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Eslami N, Heidarian Miri H, Rastegar M, Sabzevari B. Effect of Platelet-rich Plasma on the Clinical Success of Alveolar Grafts in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis. J Craniofac Surg 2023; 34:1246-1251. [PMID: 37157129 DOI: 10.1097/scs.0000000000009315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/07/2023] [Indexed: 05/10/2023] Open
Abstract
OBJECTIVES This study assessed the effect of platelet-rich plasma (PRP) on the clinical success of alveolar grafts in patients with cleft lip and palate. MATERIALS AND METHODS In this meta-analysis, a search of the literature was conducted in Medline, Scopus, ISI Web of Science, and Cochrane Central Register of Controlled Trials for randomized clinical trials using PRP or platelet-rich fibrin (PRF) along with autogenous bone for alveolar ridge grafts in patients with cleft lip and palate. The methodological quality of the studies was analyzed using Cochrane's risk of the bias assessment tool. The extracted data underwent meta-analysis using the random-effects model. RESULTS Of a total of 2256 articles retrieved, 12 met the eligibility criteria and were enrolled; out of which 6 did not undergo meta-analysis due to heterogeneous data. The percentage of defects filled by bone graft was 0.648% (95% confidence interval: -0.15 to 1.45), which was not statistically significant ( P =0.115). Subgroup analysis showed no significant difference based on the use of PRF or PRP ( P =0.28), type of cleft (unilateral/bilateral; P =0.56), or type of radiographic modality (3D/2D; P =0.190). Meta-regression analysis showed that the duration of follow-up and the difference in the mean age of patients did not have a significant effect on the results (R=0, I2: high). CONCLUSION The application of PRP/PRF in combination with autogenous bone graft did not have a significant effect on the percentage of alveolar cleft filled by a bone graft. Future clinical studies are required to further elucidate the effect of PRP in the regeneration of alveolar clefts.
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Affiliation(s)
| | - Hamid Heidarian Miri
- Department of Biostatistics, Health Sciences Research Center, School of Health, Mashhad University of Medical Sciences
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21
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Elahi A, Duncan W, Li KC, Waddell JN, Coates D. Comparison of Low and High Temperature Sintering for Processing of Bovine Bone as Block Grafts for Oral Use: A Biological and Mechanical In Vitro Study. Bioengineering (Basel) 2023; 10:bioengineering10040473. [PMID: 37106660 PMCID: PMC10136185 DOI: 10.3390/bioengineering10040473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/07/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Large oral bone defects require grafting of bone blocks rather than granules to give physically robust, biocompatible and osteoconductive regeneration. Bovine bone is widely accepted as a source of clinically appropriate xenograft material. However, the manufacturing process often results in both reduced mechanical strength and biological compatibility. The aim of this study was to assess bovine bone blocks at different sintering temperatures and measure the effects on mechanical properties and biocompatibility. Bone blocks were divided into four groups; Group 1: Control (Untreated); Group 2: Initial boil for 6 h; Group 3: Boil 6 h followed by sintering at 550 °C for 6 h; Group 4: Boil 6 h followed by sintering at 1100 °C for 6 h. Samples were assessed for their purity, crystallinity, mechanical strength, surface morphology, chemical composition, biocompatibility and clinical handling properties. Statistical analysis was performed using one-way ANOVA and post-hoc Tukey's tests for normally distributed and Friedman test for abnormally distributed quantitative data from compression tests and PrestoBlue™ metabolic activity tests. The threshold for statistical significance was set at p < 0.05. The results showed that higher temperature sintering (Group 4) removed all organic material (0.02% organic components and 0.02% residual organic components remained) and increased crystallinity (95.33%) compared to Groups 1-3. All test groups (Group 2-4) showed decreased mechanical strength (MPa: 4.21 ± 1.97, 3.07 ± 1.21, 5.14 ± 1.86, respectively) compared with raw bone (Group 1) (MPa: 23.22 ± 5.24, p <0.05), with micro-cracks seen under SEM in Groups 3 and 4. Group 4 had the highest biocompatibility (p < 0.05) with osteoblasts as compared to Group 3 at all time points in vitro. Clinical handling tests indicated that Group 4 samples could better withstand drilling and screw placement but still demonstrated brittleness compared to Group 1. Hence, bovine bone blocks sintered at 1100 °C for 6 h resulted in highly pure bone with acceptable mechanical strength and clinical handling, suggesting it is a viable option as a block grafting material.
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Affiliation(s)
- Asrar Elahi
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, North Dunedin 9016, New Zealand
| | - Warwick Duncan
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, North Dunedin 9016, New Zealand
| | - Kai-Chun Li
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, North Dunedin 9016, New Zealand
| | - John Neil Waddell
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, North Dunedin 9016, New Zealand
| | - Dawn Coates
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, North Dunedin 9016, New Zealand
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22
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Sharma VJ, Adegoke JA, Afara IO, Stok K, Poon E, Gordon CL, Wood BR, Raman J. Near-infrared spectroscopy for structural bone assessment. Bone Jt Open 2023; 4:250-261. [PMID: 37051828 PMCID: PMC10079377 DOI: 10.1302/2633-1462.44.bjo-2023-0014.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
Aims Disorders of bone integrity carry a high global disease burden, frequently requiring intervention, but there is a paucity of methods capable of noninvasive real-time assessment. Here we show that miniaturized handheld near-infrared spectroscopy (NIRS) scans, operated via a smartphone, can assess structural human bone properties in under three seconds. Methods A hand-held NIR spectrometer was used to scan bone samples from 20 patients and predict: bone volume fraction (BV/TV); and trabecular (Tb) and cortical (Ct) thickness (Th), porosity (Po), and spacing (Sp). Results NIRS scans on both the inner (trabecular) surface or outer (cortical) surface accurately identified variations in bone collagen, water, mineral, and fat content, which then accurately predicted bone volume fraction (BV/TV, inner R2 = 0.91, outer R2 = 0.83), thickness (Tb.Th, inner R2 = 0.9, outer R2 = 0.79), and cortical thickness (Ct.Th, inner and outer both R2 = 0.90). NIRS scans also had 100% classification accuracy in grading the quartile of bone thickness and quality. Conclusion We believe this is a fundamental step forward in creating an instrument capable of intraoperative real-time use. Cite this article: Bone Jt Open 2023;4(4):250–261.
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Affiliation(s)
- Varun J. Sharma
- Department of Surgery, Melbourne Medical School, University of Melbourne, Melbourne, Australia
- Brian F. Buxton Department of Cardiac and Thoracic Aortic Surgery, Austin Hospital, Melbourne, Australia
- Spectromix Laboratory, Melbourne, Australia
| | - John A. Adegoke
- Spectromix Laboratory, Melbourne, Australia
- Centre for Biospectroscopy, Monash University, Melbourne, Australia
| | - Isaac O. Afara
- Spectromix Laboratory, Melbourne, Australia
- Centre for Biospectroscopy, Monash University, Melbourne, Australia
- Biomedical Spectroscopy Laboratory, Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- School of Information Technology and Electrical Engineering Faculty of Engineering, Architecture and Information Technology, Melbourne, Australia
| | - Kathryn Stok
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Australia
| | - Eric Poon
- Spectromix Laboratory, Melbourne, Australia
- Department of Medicine, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Claire L. Gordon
- Department of Medicine, Melbourne Medical School, University of Melbourne, Melbourne, Australia
- Department of Infectious Diseases, Austin Hospital, Melbourne, Australia
| | - Bayden R. Wood
- Spectromix Laboratory, Melbourne, Australia
- Centre for Biospectroscopy, Monash University, Melbourne, Australia
| | - Jaishankar Raman
- Department of Surgery, Melbourne Medical School, University of Melbourne, Melbourne, Australia
- Brian F. Buxton Department of Cardiac and Thoracic Aortic Surgery, Austin Hospital, Melbourne, Australia
- Spectromix Laboratory, Melbourne, Australia
- Correspondence should be sent to Jaishankar Raman. E-mail:
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Hu S, Wang S, He Q, Li D, Xin L, Xu C, Zhu X, Mei L, Cannon RD, Ji P, Tang H, Chen T. A Mechanically Reinforced Super Bone Glue Makes a Leap in Hard Tissue Strong Adhesion and Augmented Bone Regeneration. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2206450. [PMID: 36698294 PMCID: PMC10104643 DOI: 10.1002/advs.202206450] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/08/2023] [Indexed: 06/17/2023]
Abstract
Existing bone tissue engineering strategies aim to achieve minimize surgical trauma, stabilize the injured area, and establish a dynamic osteogenic microenvironment. The cutting-edge bone glue developed in this study satisfies these criteria. Inspired by the excellent adhesive properties of mussels, herein, a super osteogenic glue (L-DPZ) that integrates poly(vinyl alcohol), L-dopa amino acid, and zeolitic imidazolate framework-8 characterized by catechol-metal coordination is used to successfully adhere to hard tissue with a maximum adhesive strength of 10 MPa, which is much higher than those of commercial and previously reported bone glues. The stable hard tissue adhesion also enables it to adhere strongly to luxated or broken teeth, Bio-Oss (a typical bone graft material), and splice fragments from comminuted fractures of the rabbit femur. Then, it is testified that the L-DPZ hydrogels exhibit satisfactory biocompatibility, stable degradability, and osteogenic ability in vitro. Moreover, the ability to anchor Bio-Oss and sustained osteogenesis of L-DPZ result in satisfactory healing in calvarial bone defect models in rabbits, as observed by increased bone thickness and the ingrowth of new bone tissue. These results are expected to demonstrate solutions to clinical dilemmas such as comminuted bone fracture fixation, bone defect reconstruction, and teeth dislocation replantation.
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Affiliation(s)
- Shanshan Hu
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing401147P. R. China
| | - Shan Wang
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing401147P. R. China
| | - Qingqing He
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing401147P. R. China
| | - Dize Li
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing401147P. R. China
| | - Liangjing Xin
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing401147P. R. China
| | - Chuanhang Xu
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing401147P. R. China
| | - Xingyu Zhu
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing401147P. R. China
| | - Li Mei
- Department of Oral SciencesSir John Walsh Research Institute Faculty of DentistryUniversity of Otago, DunedinDunedin9054New Zealand
| | - Richard D. Cannon
- Department of Oral SciencesSir John Walsh Research Institute Faculty of DentistryUniversity of Otago, DunedinDunedin9054New Zealand
| | - Ping Ji
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing401147P. R. China
| | - Han Tang
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing401147P. R. China
| | - Tao Chen
- Stomatological Hospital of Chongqing Medical UniversityChongqing Key Laboratory of Oral Diseases and Biomedical SciencesChongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing401147P. R. China
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Ramezanzade S, Aeinehvand M, Ziaei H, Khurshid Z, Keyhan SO, Fallahi HR, Melville JC, Saeinasab M, Sefat F. Reconstruction of Critical Sized Maxillofacial Defects Using Composite Allogeneic Tissue Engineering: Systematic Review of Current Literature. Biomimetics (Basel) 2023; 8:biomimetics8020142. [PMID: 37092394 PMCID: PMC10123735 DOI: 10.3390/biomimetics8020142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 04/25/2023] Open
Abstract
The current review aimed to assess the reliability and efficacy of tissue-engineered composite grafts in the reconstruction of large maxillofacial defects resulting from trauma or a benign pathologic disease. A systematic review of the literature was conducted using PubMed/Medline, Embase, and Scopus up to March 2022. The eligibility criteria included patients who had been treated with composite allogeneic tissue engineering for immediate/delayed reconstruction of large maxillofacial defects with minimum/no bone harvesting site. In the initial search, 2614 papers were obtained, and finally, 13 papers were eligible to be included in the current study. Most included papers were case reports or case series. A total of 144 cases were enrolled in this systematic review. The mean age of the patients was 43.34 (age range: 9-89). Most studies reported a successful outcome. Bone tissue engineering for the reconstruction and regeneration of crucial-sized maxillofacial defects is an evolving science still in its infancy. In conclusion, this review paper and the current literature demonstrate the potential for using large-scale transplantable, vascularized, and customizable bone with the aim of reconstructing the large maxillofacial bony defects in short-term follow-ups.
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Affiliation(s)
- Shaqayeq Ramezanzade
- Section for Clinical Oral Microbiology, Department of Odontology Cariology and Endodontics, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Mahsa Aeinehvand
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran P.O. Box 14155-6559, Iran
| | - Heliya Ziaei
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran P.O. Box 14155-6559, Iran
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Center of Excellence for Regenerative Dentistry, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand
| | - Seied Omid Keyhan
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Isfahan P.O. Box 61355-45, Iran
| | - Hamid R Fallahi
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Isfahan P.O. Box 61355-45, Iran
| | - James C Melville
- Oral, Head & Neck Oncology and Microvascular Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Morvarid Saeinasab
- Department of Biomedical and Electronic Engineering, School of Engineering, University of Bradford, Bradford BD7 1DP, UK
| | - Farshid Sefat
- Department of Biomedical and Electronic Engineering, School of Engineering, University of Bradford, Bradford BD7 1DP, UK
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25
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Hassan M, Khaleel A, Karam SM, Al-Marzouqi AH, ur Rehman I, Mohsin S. Bacterial Inhibition and Osteogenic Potentials of Sr/Zn Co-Doped Nano-Hydroxyapatite-PLGA Composite Scaffold for Bone Tissue Engineering Applications. Polymers (Basel) 2023; 15:polym15061370. [PMID: 36987151 PMCID: PMC10057618 DOI: 10.3390/polym15061370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/08/2023] [Accepted: 02/12/2023] [Indexed: 03/12/2023] Open
Abstract
Bacterial infection associated with bone grafts is one of the major challenges that can lead to implant failure. Treatment of these infections is a costly endeavor; therefore, an ideal bone scaffold should merge both biocompatibility and antibacterial activity. Antibiotic-impregnated scaffolds may prevent bacterial colonization but exacerbate the global antibiotic resistance problem. Recent approaches combined scaffolds with metal ions that have antimicrobial properties. In our study, a unique strontium/zinc (Sr/Zn) co-doped nanohydroxyapatite (nHAp) and Poly (lactic-co-glycolic acid) -(PLGA) composite scaffold was fabricated using a chemical precipitation method with different ratios of Sr/Zn ions (1%, 2.5%, and 4%). The scaffolds’ antibacterial activity against Staphylococcus aureus were evaluated by counting bacterial colony-forming unit (CFU) numbers after direct contact with the scaffolds. The results showed a dose-dependent reduction in CFU numbers as the Zn concentration increased, with 4% Zn showing the best antibacterial properties of all the Zn-containing scaffolds. PLGA incorporation in Sr/Zn-nHAp did not affect the Zn antibacterial activity and the 4% Sr/Zn-nHAp-PLGA scaffold showed a 99.7% bacterial growth inhibition. MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) cell viability assay showed that Sr/Zn co-doping supported osteoblast cell proliferation with no apparent cytotoxicity and the highest doping percentage in the 4% Sr/Zn-nHAp-PLGA was found to be ideal for cell growth. In conclusion, these findings demonstrate the potential for a 4% Sr/Zn-nHAp-PLGA scaffold with enhanced antibacterial activity and cytocompatibility as a suitable candidate for bone regeneration.
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Affiliation(s)
- Mozan Hassan
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Abbas Khaleel
- Department of Chemistry, College of Science, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Sherif Mohamed Karam
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Ali Hassan Al-Marzouqi
- Department of Chemical and Petroleum Engineering, College of Engineering, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Ihtesham ur Rehman
- School of Medicine, University of Central Lancashire, Preston PR1 2HE, UK
| | - Sahar Mohsin
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Correspondence: ; Tel.: +971-3-713-7516
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26
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Watson E, Mikos AG. Advances in In Vitro and In Vivo Bioreactor-Based Bone Generation for Craniofacial Tissue Engineering. BME FRONTIERS 2023; 4:0004. [PMID: 37849672 PMCID: PMC10521661 DOI: 10.34133/bmef.0004] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/17/2022] [Indexed: 10/19/2023] Open
Abstract
Craniofacial reconstruction requires robust bone of specified geometry for the repair to be both functional and aesthetic. While native bone from elsewhere in the body can be harvested, shaped, and implanted within a defect, using either an in vitro or in vivo bioreactors eliminates donor site morbidity while increasing the customizability of the generated tissue. In vitro bioreactors utilize cells harvested from the patient, a scaffold, and a device to increase mass transfer of nutrients, oxygen, and waste, allowing for generation of larger viable tissues. In vivo bioreactors utilize the patient's own body as a source of cells and of nutrient transfer and involve the implantation of a scaffold with or without growth factors adjacent to vasculature, followed by the eventual transfer of vascularized, mineralized tissue to the defect site. Several different models of in vitro bioreactors exist, and several different implantation sites have been successfully utilized for in vivo tissue generation and defect repair in humans. In this review, we discuss the specifics of each bioreactor strategy, as well as the advantages and disadvantages of each and the future directions for the engineering of bony tissues for craniofacial defect repair.
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Affiliation(s)
- Emma Watson
- Department of Bioengineering, Rice University, Houston, TX 77030, USA
| | - Antonios G. Mikos
- Department of Bioengineering, Rice University, Houston, TX 77030, USA
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27
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Mahnavi A, Shahriari-Khalaji M, Hosseinpour B, Ahangarian M, Aidun A, Bungau S, Hassan SSU. Evaluation of cell adhesion and osteoconductivity in bone substitutes modified by polydopamine. Front Bioeng Biotechnol 2023; 10:1057699. [PMID: 36727042 PMCID: PMC9885973 DOI: 10.3389/fbioe.2022.1057699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/30/2022] [Indexed: 01/15/2023] Open
Abstract
Bones damaged due to disease or accidents can be repaired in different ways. Tissue engineering has helped with scaffolds made of different biomaterials and various methods. Although all kinds of biomaterials can be useful, sometimes their weakness in cellular activity or osteoconductivity prevents their optimal use in the fabrication of bone scaffolds. To solve this problem, we need additional processes, such as surface modification. One of the common methods is coating with polydopamine. Polydopamine can not only cover the weakness of the scaffolds in terms of cellular properties, but it can also create or increase osteoconductivity properties. Polydopamine creates a hydrophilic layer on the surface of scaffolds due to a large number of functional groups such as amino and hydroxyl groups. This layer allows bone cells to anchor and adheres well to the surfaces. In addition, it creates a biocompatible environment for proliferation and differentiation. Besides, the polydopamine coating makes the surfaces chemically active by catechol and amine group, and as a result of their presence, osteoconductivity increases. In this mini-review, we investigated the characteristics, structure, and properties of polydopamine as a modifier of bone substitutes. Finally, we evaluated the cell adhesion and osteoconductivity of different polydopamine-modified bone scaffolds.
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Affiliation(s)
- Ali Mahnavi
- Department of Biomaterials, Faculty of Interdisciplinary Science and Technology, Tarbiat Modares University, Tehran, Iran
| | - Mina Shahriari-Khalaji
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai, China
| | | | - Mostafa Ahangarian
- Department of Biomaterials, Faculty of Interdisciplinary Science and Technology, Tarbiat Modares University, Tehran, Iran
| | - Amir Aidun
- National Cell Bank of Iran, Pasteur Institute of Iran, Tehran, Iran,Tissues and Biomaterials Research Group (TBRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran,*Correspondence: Amir Aidun, ; Simona Bungau, ; Syed Shams ul Hassan,
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania,*Correspondence: Amir Aidun, ; Simona Bungau, ; Syed Shams ul Hassan,
| | - Syed Shams ul Hassan
- Shanghai Key Laboratory for Molecular Engineering of Chiral Drugs, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China,Department of Natural Product Chemistry, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Amir Aidun, ; Simona Bungau, ; Syed Shams ul Hassan,
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28
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Reconstruction of Severely Atrophied Mandible and Simultaneous Implant Insertion with an Inverted Sandwich Technique. Case Rep Dent 2023; 2023:2973079. [PMID: 36643591 PMCID: PMC9833922 DOI: 10.1155/2023/2973079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 01/06/2023] Open
Abstract
Objectives To reconstruct and rehabilitate a severely atrophied mandible. Case presentation. A 40-year-old female patient with the chief complaint of denture instability was admitted to our care. In our opinion, the optimum reconstructive method for their severely atrophied mandible (width of 4 mm) was bone grafting with an inverted sandwich technique. 2 split-thickness autogenous calvarial grafts were attained. 4 onlay bone blocks were prepared, placed with an inverted sandwich technique, and fixed with 8 lag screws. 4 implants (Osstem, ⌀4×10 mm) were placed simultaneously, and an immediate post-operation cone beam computed tomography confirmed the proper placement of the grafts and implants. No complications were reported within 4 and 8 months following graft and implant placement. Final impressions for full dental rehabilitation were taken at the 8-month follow-up. Conclusion Split-thickness calvarial grafts and simultaneous implant placement seem to be a very efficient and promising approach for major reconstruction of the mandible. However, further studies are recommended.
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29
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Busch A, Jäger M. [Synthetic bone replacement substances]. ORTHOPADIE (HEIDELBERG, GERMANY) 2022; 51:1023-1032. [PMID: 36307604 DOI: 10.1007/s00132-022-04319-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Bone substitute materials have been successfully used for bone defects in orthopedics and trauma surgery for a long time; however, there are cases, especially in bone defects with a critical size, in which the treatment is complicated. Nowadays, multiple bone substitute materials are available. Autologous cancellous bone grafts remain the gold standard among the bone replacement materials; however, donor site morbidity and the limited availability of autologous cancellous bone represent restrictions for autologous bone grafting. Allogeneic cancellous bone grafts have also been successfully for years in the treatment of bone defects; however, infection rates of more than 10% have been described for the use of allogeneic cancellous bone. By introducing synthetic bone substitutes further alternatives are currently available to the user for the individual treatment of bone defects. The aim of this study is to demonstrate the advantages and disadvantages of various synthetic bone substitute materials.
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Affiliation(s)
- André Busch
- Lehrstuhl für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Essen, Deutschland.
- Klinik für Orthopädie, Unfall- und Wiederherstellungschirurgie Katholisches Klinikum Essen, Philippusstift, Essen, Deutschland.
| | - Marcus Jäger
- Lehrstuhl für Orthopädie und Unfallchirurgie, Universität Duisburg-Essen, Essen, Deutschland
- Klinik für Orthopädie, Unfall- und Wiederherstellungschirurgie Katholisches Klinikum Essen, Philippusstift, Essen, Deutschland
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Zhou X, Sun J, Wo K, Wei H, Lei H, Zhang J, Lu X, Mei F, Tang Q, Wang Y, Luo Z, Fan L, Chu Y, Chen L. nHA-loaded gelatin/alginate hydrogel with combined physical and bioactive features for maxillofacial bone repair. Carbohydr Polym 2022; 298:120127. [DOI: 10.1016/j.carbpol.2022.120127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022]
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31
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Idulhaq M, Mudigdo A, Utomo P, Wasita B, Warman FI. Platelet-rich fibrin as a tissue engineering material in accelerate bone healing in rat bone defects: A systematic review and meta-analysis. Ann Med Surg (Lond) 2022; 84:104869. [PMID: 36504707 PMCID: PMC9732119 DOI: 10.1016/j.amsu.2022.104869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/08/2022] [Accepted: 11/06/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Various techniques for tissue engineering have been introduced to help regenerate damaged or lost bone tissue. This study aimed to see the potential implication of platelet-rich fibrin (PRF) to accelerate the bone healing process in rat bone defects. Methods A systematic literature search was conducted from several electronic databases on subjects looking at the use of PRF in rat bone defects and their results in bone regeneration. Specific results compared PRF vs. other methods, PRF vs. control, and PRV vs. combination PRF and other methods. Science Direct, PubMed, and Cochrane Library were the main information sources. The Cochrane Collaboration method is employed to assess the risk of bias. Results A total of 483 rats were used in the twelve studies, and this meta-analysis showed that the PRF vs. other methods pooled odds ratio (OR) obtained was 0.92 (95% CI 0.42-2.04; p = 0.29; I2 = 18%), PRF versus control OR obtained 9.45 (95% CI 4.68-19.08; P = 0.01; I2 = 0%), the combination of PRF compared to PRF alone OR obtained 0.12 (95% CI 0.03-0.41; p = 0.01; I2 = 0%). Discussion Platelet-rich fibrin accelerates the bone healing process in rat bone defects compared to physiologically. Platelet-rich fibrin combined with other methods can stimulate rat bone defects than utilization of platelet-rich fibrin only. The small number of articles assessed may cause limitations in sensitivity tests. This study was registered in the research registry (reviewregistry1341).
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Affiliation(s)
- Mujaddid Idulhaq
- Doctorate Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia,Department of Orthopedic & Traumatology Faculty of Medicine, Universitas Sebelas MaretRSUD Dr. Moewardi / RSO Prof Dr. R Soeharso, Surakarta, Indonesia,Corresponding author.Doctorate Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia.
| | - Ambar Mudigdo
- Department of Pathology Anatomy, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Pamudji Utomo
- Department of Orthopedic & Traumatology Faculty of Medicine, Universitas Sebelas MaretRSUD Dr. Moewardi / RSO Prof Dr. R Soeharso, Surakarta, Indonesia
| | - Brian Wasita
- Department of Pathology Anatomy, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Fanny Indra Warman
- Department of Orthopedic & Traumatology Faculty of Medicine, Universitas Sebelas MaretRSUD Dr. Moewardi / RSO Prof Dr. R Soeharso, Surakarta, Indonesia
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iPSC-neural crest derived cells embedded in 3D printable bio-ink promote cranial bone defect repair. Sci Rep 2022; 12:18701. [PMID: 36333414 PMCID: PMC9636385 DOI: 10.1038/s41598-022-22502-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Cranial bone loss presents a major clinical challenge and new regenerative approaches to address craniofacial reconstruction are in great demand. Induced pluripotent stem cell (iPSC) differentiation is a powerful tool to generate mesenchymal stromal cells (MSCs). Prior research demonstrated the potential of bone marrow-derived MSCs (BM-MSCs) and iPSC-derived mesenchymal progenitor cells via the neural crest (NCC-MPCs) or mesodermal lineages (iMSCs) to be promising cell source for bone regeneration. Overexpression of human recombinant bone morphogenetic protein (BMP)6 efficiently stimulates bone formation. The study aimed to evaluate the potential of iPSC-derived cells via neural crest or mesoderm overexpressing BMP6 and embedded in 3D printable bio-ink to generate viable bone graft alternatives for cranial reconstruction. Cell viability, osteogenic potential of cells, and bio-ink (Ink-Bone or GelXa) combinations were investigated in vitro using bioluminescent imaging. The osteogenic potential of bio-ink-cell constructs were evaluated in osteogenic media or nucleofected with BMP6 using qRT-PCR and in vitro μCT. For in vivo testing, two 2 mm circular defects were created in the frontal and parietal bones of NOD/SCID mice and treated with Ink-Bone, Ink-Bone + BM-MSC-BMP6, Ink-Bone + iMSC-BMP6, Ink-Bone + iNCC-MPC-BMP6, or left untreated. For follow-up, µCT was performed at weeks 0, 4, and 8 weeks. At the time of sacrifice (week 8), histological and immunofluorescent analyses were performed. Both bio-inks supported cell survival and promoted osteogenic differentiation of iNCC-MPCs and BM-MSCs in vitro. At 4 weeks, cell viability of both BM-MSCs and iNCC-MPCs were increased in Ink-Bone compared to GelXA. The combination of Ink-Bone with iNCC-MPC-BMP6 resulted in an increased bone volume in the frontal bone compared to the other groups at 4 weeks post-surgery. At 8 weeks, both iNCC-MPC-BMP6 and iMSC-MSC-BMP6 resulted in an increased bone volume and partial bone bridging between the implant and host bone compared to the other groups. The results of this study show the potential of NCC-MPC-incorporated bio-ink to regenerate frontal cranial defects. Therefore, this bio-ink-cell combination should be further investigated for its therapeutic potential in large animal models with larger cranial defects, allowing for 3D printing of the cell-incorporated material.
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Farhan YAA, Abdelsameaa SES, Elgamily M, Awad S. Impact of Different Preparations of Tooth Graft vs Xenogeneic Bone Graft on Bone Healing: An Experimental Study. J Contemp Dent Pract 2022; 23:1163-1172. [PMID: 37073942 DOI: 10.5005/jp-journals-10024-3438] [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: 04/20/2023]
Abstract
AIM This study aims to compare the effect of demineralized xenogeneic tooth graft in its two forms, particulate and block, with bovine xenograft in the healing of a rabbit tibial bone defect model. MATERIALS AND METHODS Two monocortical bony defects were made in the right tibias of 36 rabbits, and were divided into four groups. Group I defects were left empty, while group II, III, and IV were filled with bovine xenograft, demineralized particulate tooth graft, and demineralized perforated block tooth graft, respectively for evaluation of the bone healing process. Three rabbits from each group were euthanized at 2, 4, and 6 weeks after surgery. The bone specimens were processed and stained with hematoxylin and eosin (H&E) and osteopontin (OPN) immunohistochemical staining. The results were subjected to image analysis and quantitative evaluation. RESULTS Demineralized particulate tooth graft showed the best bone healing capacity compared to all other groups at all time points tested, as it showed a large amount of the formed bone, rapid closure of the defect with a significant increase in OPN expression, and the least amount of the residual grafted particles. CONCLUSION In comparison to bovine xenograft and demineralized dentin block graft, the demineralized particulate tooth grafting material is a promising bone grafting substitute as it proved to be osteoconductive, biocompatible, and bioresorbable. CLINICAL SIGNIFICANCE Demineralized tooth grafting material can aid in the regeneration of large bone defects, leading to improvement in the filling of the bone defects which can help in oral and maxillofacial reconstruction.
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Affiliation(s)
| | | | - Mahitabe Elgamily
- Department of Oral Biology, Mansoura University, Mansoura, Egypt, Phone: +01000777402, e-mail:
| | - Sally Awad
- Department of Oral and Maxillofacial Surgery, Mansoura University, Mansoura, Egypt
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Panneerselvam E, Parameswaran A, Ramanathan M, Mukherjee B. Ramal bone graft for management of infra-orbital rim fractures with defects - Technical note and a series of 16 cases. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e581-e587. [PMID: 35452864 DOI: 10.1016/j.jormas.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/17/2022] [Indexed: 06/14/2023]
Abstract
The purpose is to describe a technique of using ramal bone graft for reconstructing defects of the infra-orbital rim (IOR), assess outcomes and complications. This was a retrospective chart review of 16 patients who underwent ramal bone grafting for IOR fractures. Outcomes evaluated were improvement in clinical findings (lid/globe malposition, tethering of facial skin and implant extrusion) and complications. Data analysis included descriptive statistics. The sample included 15 males and 1 female, with a mean age of 31.6 years. Lid malposition, globe malposition and tethering of facial skin was seen in 16, 13 and 6 patients, respectively. One patient demonstrated extrusion of implant. The mean size of bone harvested was 14 × 7 mm. All patients demonstrated improved globe position post-treatment, while 3 had residual lid retraction. Two patients demonstrated wound dehiscence in the donor site. In conclusion ramal bone graft was found to be a viable alternative for IOR reconstruction.
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Affiliation(s)
| | | | - Mrunalini Ramanathan
- Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Bipasha Mukherjee
- Oculoplasty and Orbital Surgery, Shankara Nethralaya, Chennai 600006, India
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Dellago B, Altun AA, Liska R, Baudis S. Exploring the limits of toughness enhancers for
3D
printed photopolymers as bone replacement materials. JOURNAL OF POLYMER SCIENCE 2022. [DOI: 10.1002/pol.20220378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Barbara Dellago
- Christian Doppler Laboratory for Advanced Polymers for Biomaterials and 3D Printing Vienna Austria
- Institute of Applied Synthetic Chemistry TU Wien Vienna Austria
- Austrian Cluster for Tissue Regeneration Vienna Austria
| | - Altan Alpay Altun
- Christian Doppler Laboratory for Advanced Polymers for Biomaterials and 3D Printing Vienna Austria
- Lithoz GmbH Vienna Austria
| | - Robert Liska
- Institute of Applied Synthetic Chemistry TU Wien Vienna Austria
- Austrian Cluster for Tissue Regeneration Vienna Austria
| | - Stefan Baudis
- Christian Doppler Laboratory for Advanced Polymers for Biomaterials and 3D Printing Vienna Austria
- Institute of Applied Synthetic Chemistry TU Wien Vienna Austria
- Austrian Cluster for Tissue Regeneration Vienna Austria
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Clinical Applications of Poly-Methyl-Methacrylate in Neurosurgery: The In Vivo Cranial Bone Reconstruction. J Funct Biomater 2022; 13:jfb13030156. [PMID: 36135591 PMCID: PMC9504957 DOI: 10.3390/jfb13030156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Biomaterials and biotechnology are becoming increasingly important fields in modern medicine. For cranial bone defects of various aetiologies, artificial materials, such as poly-methyl-methacrylate, are often used. We report our clinical experience with poly-methyl-methacrylate for a novel in vivo bone defect closure and artificial bone flap development in various neurosurgical operations. Methods: The experimental study included 12 patients at a single centre in 2018. They presented with cranial bone defects after various neurosurgical procedures, including tumour, traumatic brain injury and vascular pathologies. The patients underwent an in vivo bone reconstruction from poly-methyl-methacrylate, which was performed immediately after the tumour removal in the tumour group, whereas the trauma and vascular patients required a second surgery for cranial bone reconstruction due to the bone decompression. The artificial bone flap was modelled in vivo just before the skin closure. Clinical and surgical data were reviewed. Results: All patients had significant bony destruction or unusable bone flap. The tumour group included five patients with meningiomas destruction and the trauma group comprised four patients, all with severe traumatic brain injury. In the vascular group, there were three patients. The average modelling time for the artificial flap modelling was approximately 10 min. The convenient location of the bone defect enabled a relatively straightforward and fast reconstruction procedure. No deformations of flaps or other complications were encountered, except in one patient, who suffered a postoperative infection. Conclusions: Poly-methyl-methacrylate can be used as a suitable material to deliver good cranioplasty cosmesis. It offers an optimal dural covering and brain protection and allows fast intraoperative reconstruction with excellent cosmetic effect during the one-stage procedure. The observations of our study support the use of poly-methyl-methacrylate for the ad hoc reconstruction of cranial bone defects.
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Effect of Hydroxyapatite Coating by Er: YAG Pulsed Laser Deposition on the Bone Formation Efficacy by Polycaprolactone Porous Scaffold. Int J Mol Sci 2022; 23:ijms23169048. [PMID: 36012313 PMCID: PMC9409384 DOI: 10.3390/ijms23169048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/01/2022] [Accepted: 08/10/2022] [Indexed: 11/17/2022] Open
Abstract
Composite scaffolds obtained by the combination of biodegradable porous scaffolds and hydroxyapatite with bone regeneration potential are feasible materials for bone tissue engineering. However, most composite scaffolds have been fabricated by complicated procedures or under thermally harsh conditions. We have previously demonstrated that hydroxyapatite coating onto various substrates under a thermally mild condition was achieved by erbium-doped yttrium aluminum garnet (Er: YAG) pulsed laser deposition (PLD). The purpose of this study was to prepare a polycaprolactone (PCL) porous scaffold coated with the hydroxyapatite by the Er: YAG-PLD method. Hydroxyapatite coating by the Er: YAG-PLD method was confirmed by morphology, crystallographic analysis, and surface chemical characterization studies. When cultured on PCL porous scaffold coated with hydroxyapatite, rat bone marrow-derived mesenchymal stem cells adhered, spread, and proliferated well. The micro-CT and staining analyses after the implantation of scaffold into the critical-sized calvaria bone defect in rats indicate that PCL porous scaffold coated with hydroxyapatite demonstrates accelerated and widespread bone formation. In conclusion, PCL porous scaffold coated with hydroxyapatite obtained by the Er: YAG-PLD method is a promising material in bone tissue engineering.
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Cadaveric Bone Allografting for Severe Mandibular Hypoplasia With Alleviation of Upper Airway Obstruction in Goldenhar Syndrome. J Craniofac Surg 2022; 33:1857-1859. [PMID: 35762624 DOI: 10.1097/scs.0000000000008686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/19/2022] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT Severe congenital mandibular hypoplasia may cause significant upper airway obstruction, often necessitating immediate tracheostomy. Recent surgical advances have demonstrated early intervention with mandibular distraction osteogenesis over tracheostomy may yield desirable aesthetic and functional outcomes. Here we present a case of bilateral mandibular hypoplasia, severe on the right and mild on the left, secondary to Goldenhar syndrome yielding significant tongue-based upper airway obstruction that was surgically corrected with mandibular bone allograft reconstruction of the right condyle, ramus, and posterior half of the mandibular body. Postoperative polysomnography revealed significantly improved obstructive apnea and computed tomography demonstrated adequate placement of the bone allograft to overcorrect the affected hemi-mandible. To the authors' knowledge, this is the first report of immediate mandibular allografting alleviating tongue-based upper airway obstruction secondary to mandibular hypoplasia in an infant. Mandibular bone allografting may be a favorable alternative to immediate tracheostomy with delayed surgical intervention, though long-term follow up is needed to assess graft durability and maintenance of airway patency.
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Signorelli F, Giordano M, Caccavella VM, Ioannoni E, Gelormini C, Caricato A, Olivi A, Montano N. A systematic review and meta-analysis of factors involved in bone flap resorption after decompressive craniectomy. Neurosurg Rev 2022; 45:1915-1922. [PMID: 35061139 DOI: 10.1007/s10143-022-01737-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/18/2021] [Accepted: 01/11/2022] [Indexed: 02/02/2023]
Abstract
Decompressive craniectomy (DC) is effective in controlling increasing intracranial pressure determined by a wide range of conditions, mainly traumatic brain injury (TBI) and stroke, and the subsequent cranioplasty (CP) displays potential therapeutic benefit in terms of overall neurological function. While autologous bone flap (ABF) harvested at the time of DC is the ideal material for skull defect reconstruction, it carries several risks. Aseptic bone flap resorption (BFR) is one of the most common complications, often leading to surgical failure. The aim of our study was to systematically review the literature and carry out a meta-analysis of possible factors involved in BFR in patients undergoing ABF cranioplasty after DC. A systematic review and meta-analysis was performed in accordance with the PRISMA guidelines. Different medical databases (PubMed, Embase, and Scopus) were screened for eligible scientific reports until April 30th 2021. The following data were collected for meta-analysis to assess their role in BFR: sex, age, the interval time between DC and CP, the presence of systemic factors, the etiology determining the DC, CP surgical time, CP features, VP shunt placement, CP infection. Studies including pediatric patients or with less than 50 patients were excluded. Fifteen studies were included. There was a statistically significant increased incidence of BFR in patients with CPF > 2 compared to patients with CPF ≤ 2 (54.50% and 22.76% respectively, p = 0.010). TBI was a significantly more frequent etiology in the BFR group compared to patients without BFR (61.95% and 47.58% respectively, p < 0.001). Finally, patients with BFR were significantly younger than patients without BFR (39.12 ± 15.36 years and 47.31 ± 14.78 years, respectively, p < 0.001). The funnel plots were largely symmetrical for all the studied factors. Bone flap fragmentation, TBI etiology, and young age significantly increase the risk of bone resorption. Further studies are needed to strengthen our results and to clarify if, in those cases, a synthetic implant for primary CP should be recommended.
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Affiliation(s)
- Francesco Signorelli
- Depatment of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy
| | - Martina Giordano
- Department of Neuroscience, Neurosurgery Section, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valerio Maria Caccavella
- Depatment of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy. .,Department of Neuroscience, Neurosurgery Section, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Eleonora Ioannoni
- Neurosurgical Intensive Care Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Camilla Gelormini
- Neurosurgical Intensive Care Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Anselmo Caricato
- Neurosurgical Intensive Care Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessandro Olivi
- Depatment of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy.,Department of Neuroscience, Neurosurgery Section, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola Montano
- Depatment of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy.,Department of Neuroscience, Neurosurgery Section, Università Cattolica del Sacro Cuore, Rome, Italy
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Stukel Shah JM, Lundquist B, Macaitis J, Pfau-Cloud MR, Beltran FO, Grunlan MA, Lien W, Wang HC, Burdette AJ. Comparative evaluation of mesenchymal stromal cell growth and osteogenic differentiation on a shape memory polymer scaffold. J Biomed Mater Res B Appl Biomater 2022; 110:2063-2074. [PMID: 35344262 DOI: 10.1002/jbm.b.35061] [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: 11/18/2021] [Revised: 03/08/2022] [Accepted: 03/12/2022] [Indexed: 11/06/2022]
Abstract
Trauma-induced, critical-size bone defects pose a clinical challenge to heal. Albeit autografts are the standard-of-care, they are limited by their inability to be shaped to various defect geometries and often incur donor site complications. Herein, the combination of a "self-fitting" shape memory polymer (SMP) scaffold and seeded mesenchymal stromal cells (MSCs) was investigated as an alternative. The porous SMP scaffold, prepared from poly(ε-caprolactone) diacrylate (PCL-DA) and coated with polydopamine, provided conformal shaping and cell adhesion. MSCs from five tissues, amniotic (AMSCs), chorionic tissue (CHSCs), umbilical cord (UCSCs), adipose (ADSCs), and bone marrow (BMSCs) were evaluated for viability, density, and osteogenic differentiation on the SMP scaffold. BMSCs exhibited the fastest increase in cell density by day 3, but after day 10, CHSCs, UCSCs, and ADSCs approached similar cell density. BMSCs also showed the greatest calcification among the cell types, followed closely by ADSCs, CHSCs and AMSCs. Alkaline phosphatase (ALP) activity peaked at day 7 for AMSCs, UCSCs, ADSCs and BMSCs, and at day 14 for CHSCs, which had the greatest overall ALP activity. Of all the cell types, only scaffolds cultured with ADSCs in osteogenic media had increased hardness and local modulus as compared to blank scaffolds after 21 days of cell culture and osteogenic differentiation. Overall, ADSCs performed most favorably on the SMP scaffold. The SMP scaffold was able to support key cellular behaviors of MSCs and could potentially be a viable, regenerative alternative to autograft.
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Affiliation(s)
- Jessica M Stukel Shah
- Directorate of Combat Casualty Care & Operational Medicine, Naval Medical Research Unit San Antonio, San Antonio, Texas, USA
| | - Bridney Lundquist
- Directorate of Combat Casualty Care & Operational Medicine, Naval Medical Research Unit San Antonio, San Antonio, Texas, USA
| | - Joseph Macaitis
- Directorate of Combat Casualty Care & Operational Medicine, Naval Medical Research Unit San Antonio, San Antonio, Texas, USA
| | - Michaela R Pfau-Cloud
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Felipe O Beltran
- Department of Materials Science and Engineering, Texas A&M University, College Station, Texas, USA
| | - Melissa A Grunlan
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA.,Department of Materials Science and Engineering, Texas A&M University, College Station, Texas, USA.,Department of Chemistry, Texas A&M University, College Station, Texas, USA
| | - Wen Lien
- USAF Dental Research & Consultation Service, JBSA Fort Sam Houston, San Antonio, Texas, USA
| | - Heuy-Ching Wang
- Directorate of Combat Casualty Care & Operational Medicine, Naval Medical Research Unit San Antonio, San Antonio, Texas, USA
| | - Alexander J Burdette
- Directorate of Combat Casualty Care & Operational Medicine, Naval Medical Research Unit San Antonio, San Antonio, Texas, USA
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Autogenous Tooth Bone Grafts for Repair and Regeneration of Maxillofacial Defects: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063690. [PMID: 35329377 PMCID: PMC8955500 DOI: 10.3390/ijerph19063690] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/16/2022]
Abstract
Autogenous tooth graft is an innovative and ingenious technique that employs a stepwise approach and utilizes human teeth as an autogenous source of bone graft. The structure of teeth closely resembles bone, both physically and biochemically, and can be efficiently used for the process as it depicts properties of osteoinduction and osteoconduction. Autogenous tooth bone has characteristics similar to bone grafts in terms of healing potential, physical properties, and clinical outcome. Autogenous tooth graft has shown reasonable promise as a graft material for the regeneration of maxillary and mandibular defects. Autogenous tooth bone graft finds its principal application in sinus and ridge augmentations and for socket preservation before implant placement. Additionally, it can be used successfully for alveolar cleft patients and patients with limited periodontal defects. The overall complication rates reported for autogenous tooth grafts are comparable to other graft sources. However, although long-term results are still underway, it is still recommended as a grafting option for limited defects in the cranio-facial region.
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Sghaireen MG, Shrivastava D, Alnusayri MO, Alahmari AD, Aldajani AM, Srivastava KC, Alam MK. Bone Grafts in Dental Implant Management: A Narrative Review. Curr Pediatr Rev 2022; 19:15-20. [PMID: 35410611 DOI: 10.2174/1573396318666220411105715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/10/2022] [Accepted: 02/01/2022] [Indexed: 01/28/2023]
Abstract
Successful implant dentistry can be directly related to the quality and quantity of bone at the recipient site of the implant. Over the years, bone grafts have been used for the treatment of various osseous defects. Due to the widespread acceptance of dental implants, interest in bone reconstruction for the oral cavity has increased dramatically over the past decade. Many patients who request implant rehabilitation require ancillary procedures to increase the quantity and quality of the recipient's bone. The internal architecture of the bone is generally described in terms of quality of the bone, which in turn reflects the strength (degree of compactness) of the bone. This is considered a crucial factor about the available bone at the edentulous site while planing about the design of the planned implant, surgical approach, healing time, and the initial progressive bone loading during the prosthetic reconstruction. Atrophy of the alveolar processes is expressed as a reduction of height and width. Databases were electronically searched up to April 2019 to identify human bone graft studies to provide contemporary and comprehensive information about the various bone grafts used in dental implant management.
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Affiliation(s)
- Mohammed G Sghaireen
- Department of Prosthetic Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Deepti Shrivastava
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Mohammed O Alnusayri
- Department of Prosthetic Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Abdulmajeed D Alahmari
- Department of Prosthetic Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Ali M Aldajani
- Department of Prosthetic Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Kumar C Srivastava
- Department of Oral Maxil-lofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Mohammad K Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil international University, Dhaka, Bangladesh
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The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series. Arch Orthop Trauma Surg 2022; 142:2567-2575. [PMID: 33834287 PMCID: PMC9474387 DOI: 10.1007/s00402-021-03880-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/24/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The allogeneic bone screw transplant is a new osteosynthesis device making the use of foreign fixation material obsolete for various kinds of indications. Moreover, it is integrated into the recipient bone by natural bone remodeling without harming the surrounding tissue. The aim of this study was to determine the efficacy and safety of the transplant for osteotomy and arthrodesis in hand and foot surgery and to evaluate the clinical importance of the device. MATERIALS AND METHODS A single-surgeon case series of 32 patients who had undergone hand or foot surgery with the application of an allogeneic bone screw with an average follow-up time of 1 year is reported. Clinical data were reviewed to evaluate the pain levels and satisfaction of the patients and the frequency and type of complications occurring during the healing process. Routine radiography and computed tomography were reviewed to determine the fusion rate, the ingrowth behavior of the transplant and the possible occurrence of transplant failure. RESULTS High patient satisfaction was paired with low postoperative pain levels and a low complication rate. 97% of the patients were free of pain at the timepoint of the second follow-up examination, the mean time of recovery of full mobility was 50.1 ± 26.1 days after surgery. Wound healing disturbance occurred only in two cases. Bony consolidation of the osteotomy or arthrodesis gap as well as osseointegration of the transplant was seen in all cases. No transplant failure or transplant loosening occurred. CONCLUSIONS The application of the allogeneic bone screw resulted in a 100% fusion rate while the patient burden was low. The transplant is safe and suited for various kinds of osteosynthesis in hand and foot surgery.
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Pfau MR, Beltran FO, Woodard LN, Dobson LK, Gasson SB, Robbins AB, Lawson ZT, Brian Saunders W, Moreno MR, Grunlan MA. Evaluation of a self-fitting, shape memory polymer scaffold in a rabbit calvarial defect model. Acta Biomater 2021; 136:233-242. [PMID: 34571270 PMCID: PMC8742656 DOI: 10.1016/j.actbio.2021.09.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/08/2021] [Accepted: 09/21/2021] [Indexed: 12/20/2022]
Abstract
Self-fitting scaffolds prepared from biodegradable poly(ε-caprolactone)-diacrylate (PCL-DA) have been developed for the treatment of craniomaxillofacial (CMF) bone defects. As a thermoresponsive shape memory polymer (SMP), with the mere exposure to warm saline, these porous scaffolds achieve a conformal fit in defects. This behavior was expected to be advantageous to osseointegration and thus bone healing. Herein, for an initial assessment of their regenerative potential, a pilot in vivo study was performed using a rabbit calvarial defect model. Exogenous growth factors and cells were excluded from the scaffolds. Key scaffold material properties were confirmed to be maintained following gamma sterilization. To assess scaffold integration and neotissue infiltration along the defect perimeter, non-critically sized (d = 8 mm) bilateral calvarial defects were created in 12 New Zealand white rabbits. Bone formation was assessed at 4 and 16 weeks using histological analysis and micro-CT, comparing defects treated with an SMP scaffold (d = 9 mm x t = 1 or 2 mm) to untreated defects (i.e. defects able to heal without intervention). To further assess osseointegration, push-out tests were performed at 16 weeks and compared to defects treated with poly(ether ether ketone) (PEEK) discs (d = 8.5 mm x t = 2 mm). The results of this study confirmed that the SMP scaffolds were biocompatible and highly conducive to bone formation and ingrowth at the perimeter. Ultimately, this resulted in similar bone volume and surface area versus untreated defects and superior performance in push-out testing versus defects treated with PEEK discs. STATEMENT OF SIGNIFICANCE: Current treatments of craniomaxillofacial (CMF) bone defects include biologic and synthetic grafts but they are limited in their ability to form good contact with adjacent tissue. A regenerative engineering approach using a biologic-free scaffold able to achieve conformal fitting represents a potential "off-the-shelf" surgical product to heal CMF bone defects. Having not yet been evaluated in vivo, this study provided the preliminary assessment of the bone healing potential of self-fitting PCL scaffolds using a rabbit calvarial defect model. The study was designed to assess scaffold biocompatibility as well as bone formation and ingrowth using histology, micro-CT, and biomechanical push-out tests. The favorable results provide a basis to pursue establishing self-fitting scaffolds as a treatment option for CMF defects.
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Affiliation(s)
- Michaela R Pfau
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas 77843, US
| | - Felipe O Beltran
- Department of Materials Science and Engineering, Texas A&M University, College Station, Texas 77843, US
| | - Lindsay N Woodard
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas 77843, US
| | - Lauren K Dobson
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas 77843, US
| | - Shelby B Gasson
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas 77843, US
| | - Andrew B Robbins
- Department of Mechanical Engineering, Texas A&M University, College Station, Texas 77843, US
| | - Zachary T Lawson
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas 77843, US
| | - W Brian Saunders
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas 77843, US
| | - Michael R Moreno
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas 77843, US; Department of Mechanical Engineering, Texas A&M University, College Station, Texas 77843, US
| | - Melissa A Grunlan
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas 77843, US; Department of Materials Science and Engineering, Texas A&M University, College Station, Texas 77843, US; Department of Chemistry, Texas A&M University, College Station, Texas 77843, US.
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Norbertczak HT, Fermor HL, Edwards JH, Rooney P, Ingham E, Herbert A. Decellularised human bone allograft from different anatomical sites as a basis for functionally stratified repair material for bone defects. J Mech Behav Biomed Mater 2021; 125:104965. [PMID: 34808451 DOI: 10.1016/j.jmbbm.2021.104965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/06/2021] [Accepted: 11/06/2021] [Indexed: 12/12/2022]
Abstract
Tissue engineered bone solutions aim to overcome the limitations of autologous and allogeneic grafts. Decellularised tissues are produced by washing cellular components from human or animal tissue to produce an immunologically safe and biocompatible scaffold, capable of integration following implantation. A decellularisation procedure utilising low concentration sodium dodecyl sulphate (0.1% w/v) was applied to trabecular bone from human femoral heads (FH) and tibial plateaus (TP). Biological (histology, DNA quantification), biomechanical (compression testing) and structural (μCT) comparisons were made between decellularised and unprocessed cellular tissue. Total DNA levels of decellularised FH and TP bone were below 50 ng mg-1 dry tissue weight and nuclear material was removed. No differences were found between cellular and decellularised bone, from each anatomical region, for all the biomechanical and structural parameters investigated. Differences were found between cellular FH and TP and between decellularised FH and TP. Decellularised FH had a higher ultimate compressive stress, Young's modulus and 0.2% proof stress than decellularised TP (p = 0.001, 0.002, 0.001, Mann Whitney U test, MWU). The mineral density of cellular and decellularised TP bone was significantly greater than cellular and decellularised FH bone respectively (cellular: p = 0.001, decellularised: p < 0.001, MWU). The bone volume fraction and trabecular thickness of cellular and decellularised FH bone were significantly greater than cellular and decellularised TP bone respectively (cellular: p = 0.001, 0.005; decellularised: p < 0.001, <0.001, MWU). Characterisation of decellularised trabecular bone from different anatomical regions offers the possibility of product stratification, allowing selection of biomechanical properties to match particular anatomical regions undergoing bone graft procedures.
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Affiliation(s)
- Halina T Norbertczak
- Institute of Medical and Biological Engineering, School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom.
| | - Hazel L Fermor
- Institute of Medical and Biological Engineering, School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Jennifer H Edwards
- Institute of Medical and Biological Engineering, School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Paul Rooney
- NHS Blood and Transplant Tissue and Eye Services, Liverpool, United Kingdom
| | - Eileen Ingham
- Institute of Medical and Biological Engineering, School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Anthony Herbert
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, United Kingdom
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Alkhasawnah Q, Elmas S, Sohrabi K, Attia S, Heinemann S, El Khassawna T, Heiss C. Confirmation of Calcium Phosphate Cement Biodegradation after Jawbone Augmentation around Dental Implants Using Three-Dimensional Visualization and Segmentation Software. MATERIALS 2021; 14:ma14227084. [PMID: 34832488 PMCID: PMC8618138 DOI: 10.3390/ma14227084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/10/2021] [Accepted: 11/16/2021] [Indexed: 01/01/2023]
Abstract
The use of autologous bone graft for oral rehabilitation of bone atrophy is considered the gold standard. However, the available grafts do not allow a fast loading of dental implants, as they require a long healing time before full functionality. Innovative bioactive materials provide an easy-to-use solution to this problem. The current study shows the feasibility of calcium phosphate cement paste (Paste-CPC) in the sinus. Long implants were placed simultaneously with the cement paste, and provisional prosthetics were also mounted in the same sessions. Final prosthetics and the full loading took place within the same week. Furthermore, the study shows for the first time the possibility to monitor not only healing progression using Cone Beam Computer tomography (CBCT) but also material retention, over two years, on a case study example. The segmented images showed a 30% reduction of the cement size and an increased mineralized tissue in the sinus. Mechanical testing was performed qualitatively using reverse torque after insertion and cement solidification to indicate clinical feasibility. Both functional and esthetic satisfaction remain unchanged after one year. This flowable paste encourages the augmentation procedure with less invasive measure through socket of removed implants. However, this limitation can be addressed in future studies.
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Affiliation(s)
- Qusai Alkhasawnah
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (Q.A.); (S.E.); (C.H.)
- Center of Dental Implants, Jordan German Dental Institute, Mamdouh Al Saraireh Street 5, Amman 11821, Jordan
| | - Sera Elmas
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (Q.A.); (S.E.); (C.H.)
| | - Keywan Sohrabi
- Faculty of Health Sciences, University of Applied Sciences, Wiesenstrasse 14, 35390 Giessen, Germany;
| | - Sameh Attia
- Department of Oral and Maxillofacial Surgery, Justus-Liebig University of Giessen, Klinikstr. 33, 35392 Giessen, Germany;
| | | | - Thaqif El Khassawna
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (Q.A.); (S.E.); (C.H.)
- Faculty of Health Sciences, University of Applied Sciences, Wiesenstrasse 14, 35390 Giessen, Germany;
- Correspondence: ; Tel.: +49-641-993-0581
| | - Christian Heiss
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (Q.A.); (S.E.); (C.H.)
- Department of Trauma, Hand and Reconstructive Surgery, Justus-Liebig University Giessen, Rudolf-Buchheim-Street 7, 35392 Giessen, Germany
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Gillman CE, Jayasuriya AC. FDA-approved bone grafts and bone graft substitute devices in bone regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 130:112466. [PMID: 34702541 PMCID: PMC8555702 DOI: 10.1016/j.msec.2021.112466] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/26/2021] [Accepted: 09/24/2021] [Indexed: 12/28/2022]
Abstract
To induce bone regeneration there is a complex cascade of growth factors. Growth factors such as recombinant BMP-2, BMP-7, and PDGF are FDA-approved therapies in bone regeneration. Although, BMP shows promising results as being an alternative to autograft, it also has its own downfalls. BMP-2 has many adverse effects such as inflammatory complications such as massive soft-tissue swelling that can compromise a patient's airway, ectopic bone formation, and tumor formation. BMP-2 may also be advantageous for patients not willing to give up smoking as it shows bone regeneration success with smokers. BMP-7 is no longer an option for bone regeneration as it has withdrawn off the market. PDGF-BB grafts in studies have shown PDGF had similar fusion rates to autologous grafts and fewer adverse effects. There is also an FDA-approved bioactive molecule for bone regeneration, a peptide P-15. P-15 was found to be effective, safe, and have similar outcomes to autograft at 2 years post-op for cervical radiculopathy due to cervical degenerative disc disease. Growth factors and bioactive molecules show some promising results in bone regeneration, although more research is needed to avoid their adverse effects and learn about the long-term effects of these therapies. There is a need of a bone regeneration method of similar quality of an autograft that is osteoconductive, osteoinductive, and osteogenic. This review covers all FDA-approved bone regeneration therapies such as the "gold standard" autografts, allografts, synthetic bone grafts, and the newer growth factors/bioactive molecules. It also covers international bone grafts not yet approved in the United States and upcoming technologies in bone grafts.
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Affiliation(s)
- Cassidy E Gillman
- The Doctor of Medicine (M.D.) Program, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH 43614, USA
| | - Ambalangodage C Jayasuriya
- Department of Orthopaedic Surgery, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH 43614, USA.
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Arabiyat AS, Pfau MR, Grunlan MA, Hahn MS. Intrinsic osteoinductivity of PCL-DA/PLLA semi-IPN shape memory polymer scaffolds. J Biomed Mater Res A 2021; 109:2334-2345. [PMID: 33988292 PMCID: PMC8736335 DOI: 10.1002/jbm.a.37216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/22/2021] [Accepted: 05/01/2021] [Indexed: 02/06/2023]
Abstract
Engineering osteoinductive, self-fitting scaffolds offers a potential treatment modality to repair irregularly shaped craniomaxillofacial bone defects. Recently, we innovated on osteoinductive poly(ε-caprolactone)-diacrylate (PCL-DA) shape memory polymers (SMPs) to incorporate poly-L-lactic acid (PLLA) into the PCL-DA network, forming a semi-interpenetrating network (semi-IPN). Scaffolds formed from these PCL-DA/PLLA semi-IPNs display stiffnesses within the range of trabecular bone and accelerated degradation relative to scaffolds formed from slowly degrading PCL-DA SMPs. Herein, we demonstrate for the first time that PCL-DA/PLLA semi-IPN SMP scaffolds show increased intrinsic osteoinductivity relative to PCL-DA. We also confirm that application of a bioinspired polydopamine (PD) coating further improves the osteoinductive capacity of these PCL-DA/PLLA semi-IPN SMPs. In the absence of osteogenic supplements, protein level assessment of human mesenchymal stem cells (h-MSCs) cultured in PCL-DA/PLLA scaffolds revealed an increase in expression of osteogenic markers osterix, bone morphogenetic protein-4 (BMP-4), and collagen 1 alpha 1 (COL1A1), relative to PCL-DA scaffolds and osteogenic medium controls. Likewise, the expression of runt-related transcription factor 2 (RUNX2) and BMP-4 was elevated in the presence of PD-coating. In contrast, the chondrogenic and adipogenic responses associated with the scaffolds matched or were reduced relative to osteogenic medium controls, indicating that the scaffolds display intrinsic osteoinductivity.
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Affiliation(s)
- Ahmad S. Arabiyat
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute (RPI), Troy, New York
- Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute (RPI), Troy, New York
| | - Michaela R. Pfau
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas
| | - Melissa A. Grunlan
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas
- Department of Materials Science and Engineering, Texas A&M University, College Station, Texas
- Department of Chemistry, Texas A&M University, College Station, Texas
| | - Mariah S. Hahn
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute (RPI), Troy, New York
- Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute (RPI), Troy, New York
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Dewey MJ, Milner DJ, Weisgerber D, Flanagan CL, Rubessa M, Lotti S, Polkoff KM, Crotts S, Hollister SJ, Wheeler MB, Harley BAC. Repair of critical-size porcine craniofacial bone defects using a collagen-polycaprolactone composite biomaterial. Biofabrication 2021; 14. [PMID: 34663761 DOI: 10.1088/1758-5090/ac30d5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 10/18/2021] [Indexed: 12/16/2022]
Abstract
Regenerative medicine approaches for massive craniomaxillofacial (CMF) bone defects face challenges associated with the scale of missing bone, the need for rapid graft-defect integration, and challenges related to inflammation and infection. Mineralized collagen scaffolds have been shown to promote mesenchymal stem cell osteogenesis due to their porous nature and material properties, but are mechanically weak, limiting surgical practicality. Previously, these scaffolds were combined with 3D-printed polycaprolactone (PCL) mesh to form a scaffold-mesh composite to increase strength and promote bone formation in sub-critical sized porcine ramus defects. Here, we compare the performance of mineralized collagen-PCL composites to the PCL mesh in a critical-sized porcine ramus defect model. While there were no differences in overall healing response between groups, our data demonstrated broadly variable metrics of healing regarding new bone infiltration and fibrous tissue formation. Abscesses were present surrounding some implants and PCL polymer was still present after 9-10 months of implantation. Overall, while there was limited successful healing, with 2 of 22 implants showed substantial levels of bone regeneration, and others demonstrating some form of new bone formation, the results suggest targeted improvements to improve repair of large animal models to more accurately represent CMF bone healing. Notably, strategies to increase osteogenesis throughout the implant, modulate the immune system to support repair, and employ shape-fitting tactics to avoid implant micromotion and resultant fibrosis. Improvements to the mineralized collagen scaffolds involve changes in pore size and shape to increase cell migration and osteogenesis and inclusion or delivery of factors to aid vascular ingrowth and bone regeneration.
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Affiliation(s)
- Marley J Dewey
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America
| | - Derek J Milner
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America.,Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America
| | - Daniel Weisgerber
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America
| | - Colleen L Flanagan
- Department of Bioengineering, University of Michigan, Ann Arbor, MI, 30332, United States of America
| | - Marcello Rubessa
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America
| | - Sammi Lotti
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America
| | - Kathryn M Polkoff
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America
| | - Sarah Crotts
- Center for 3D Medical Fabrication, Wallace A. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, United States of America
| | - Scott J Hollister
- Center for 3D Medical Fabrication, Wallace A. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, United States of America
| | - Matthew B Wheeler
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America.,Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America
| | - Brendan A C Harley
- Department of Materials Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America.,Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America.,Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States of America
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Dhuvad JM, Mehta D. Does an autogenous demineralized dentin (ADDM) graft has the ability to form a new bone? Natl J Maxillofac Surg 2021; 12:181-187. [PMID: 34483574 PMCID: PMC8386253 DOI: 10.4103/njms.njms_12_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 12/12/2019] [Accepted: 03/25/2021] [Indexed: 11/04/2022] Open
Abstract
Aim: This aimed to evaluate a new bone formation and to provide a single-stage treatment, i.e., extraction of tooth followed by autogenous dentin demineralized (ADDM) graft in the same extraction socket (ES) – for adult patients who require tooth extraction. Materials and Methods: Two hundred teeth extractions were performed to investigate the efficacy of ADDM graft in the formation of new bone. After demineralization of dentin graft parameters such as exposure of graft, any signs of infections/pus/exudates, pain, and bone density were evaluated. Results: On follow-up, exposure of graft was recorded in five sockets at 1 month and infection was recorded in four sockets. Pain was significantly high at postoperative day 1 and least with 3rd and 6th months. There was a highly significant bone formation (P < 0.01, 0.05) in the ES group at various time intervals, while there were no significant differences in the adjacent bone group. Conclusion: Using ADDM graft in providing a single-stage treatment plan, i.e., extraction of tooth followed by autogenous demineralized dentin graft in the same ES in adult patients – is an alternative for the immediate reconstruction of alveolar bone defects to facilitate the future prosthesis. It also saves the cost of other graft materials which are commercially available in market for the patient and also reduces the infective dental waste globally.
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Affiliation(s)
- Jigar M Dhuvad
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Ahmedabad, Gujarat, India
| | - Deval Mehta
- Department of Oral and Maxillofacial Surgery, College of Dental Science and Research Centre, Ahmedabad, Gujarat, India
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