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Gil ACK, Merino EAD, Costa DP, Giracca CN, Mazzon R, Magrin GL, de Almeida J, Benfatti CAM. A Novel Device for the Evaluation of In Vitro Bacterial Colonization in Membranes for Guided Tissue and Bone Regeneration. Dent J (Basel) 2024; 12:202. [PMID: 39056989 PMCID: PMC11275268 DOI: 10.3390/dj12070202] [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: 05/15/2024] [Revised: 06/19/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
Purpose: To evaluate, in vitro, the efficiency of a novel apparatus to test the adherence and penetration of bacteria on different membranes for guided regeneration. Methodology: To create the 3D device, Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) systems were used. Three types of biomaterials were tested (n = 6): (DT) a collagen membrane; (DS) a polymer membrane; and (LP) a dense polytetrafluoroethylene barrier. The biomaterials were adapted to the apparatuses and challenged with two different monospecies bacterial culture of A. actinomycetemcomitans b and S. mutans. After 2 h, bacterial adherence and penetration were quantified by counting the number of colony-forming units (CFUs). Two specimens from each group were used for image analysis using Confocal Laser Scanning Microscopy. Statistical analysis was performed. Findings: The DS group had a higher adherence of S. mutans compared to A. actinomycetemcomitans b (p = 0.05). There was less adherence of A. actinomycetemcomitans b in the DS group, compared to the LP (p = 0.011) and DT (p < 0.001) groups. Only the membranes allowed penetration, which was blocked by barriers. The DT group allowed a greater penetration of S. mutans to occur compared to A. actinomycetemcomitans b (p = 0.009), which showed a higher penetration into the DS membranes compared to S. mutans (p = 0.016). The penetration of A. actinomycetemcomitans b through DS was higher compared to its penetration through DT and LP (p < 0.01 for both). DT and DS allowed a greater penetration of S. mutans to occur compared to LP, which prevented both bacterial species from penetrating. Conclusion: The apparatus allowed for the settlement and complete sealing of the biomaterials, enabling standardization.
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Affiliation(s)
- Ana Clara Kuerten Gil
- Department of Implant Dentistry, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (A.C.K.G.); (C.A.M.B.)
| | - Eugenio A. D. Merino
- Department of Production Engineering, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (E.A.D.M.); (D.P.C.); (C.N.G.)
| | - Diogo Pontes Costa
- Department of Production Engineering, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (E.A.D.M.); (D.P.C.); (C.N.G.)
| | - César Nunes Giracca
- Department of Production Engineering, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (E.A.D.M.); (D.P.C.); (C.N.G.)
| | - Ricardo Mazzon
- Department of Microbiology, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil;
| | - Gabriel Leonardo Magrin
- Department of Implant Dentistry, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil; (A.C.K.G.); (C.A.M.B.)
| | - Josiane de Almeida
- Department of Endodontics, University of South Santa Catarina, Florianópolis 88010-010, Brazil;
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Braz SHG, Monteiro MF, Matumoto EK, Corrêa MG, Casarin RCV, Ribeiro FV, Cirano FR, Casati MZ, Pimentel SP. Microbial colonization in the partially exposed nonabsorbable membrane during alveolar ridge preservation. Clin Oral Investig 2024; 28:373. [PMID: 38874776 DOI: 10.1007/s00784-024-05763-7] [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: 03/21/2024] [Accepted: 06/01/2024] [Indexed: 06/15/2024]
Abstract
AIM This study evaluated the impact of the partial exposition of the nonabsorbable membrane (dPTFE) on microbial colonization during bone healing. MATERIALS AND METHODS Patients indicated for tooth extraction were randomized to dPTFE group (n = 22) - tooth extraction and alveolar ridge preservation (ARP) using an intentionally exposed dPTFE membrane and USH group (n = 22) - tooth extraction and unassisted socket healing. Biofilm samples were collected at the barrier in the dPTFE and on the natural healing site in the USH after 3 and 28 days. Samples from the inner surface of the dPTFE barrier were also collected (n = 13). The microbiome was evaluated using the Illumina MiSeq system. RESULTS Beta diversity was different from 3 to 28 days in both groups, and at 28 days, different microbial communities were identified between therapies. The dPTFE was characterized by a higher prevalence and abundance of gram-negative and anaerobic species than USH. Furthermore, the inner surface of the dPTFE membrane was colonized by a different community than the one observed on the outer surface. CONCLUSION Intentionally exposed dPTFE membrane modulates microbial colonization in the ARP site, creating a more homogeneous and anaerobic community on the inner and outer surfaces of the membrane. CLINICAL RELEVANCE DPTFE promoted faster biofilm colonization and enrichment of gram-negative and anaerobes close to the regenerated site in the membrane's inner and outer surfaces. dPTFE membrane can be used exposed to the oral site, but approaches for biofilm control should still be considered. The study was retrospectively registered at Clinicaltrials.gov (NCT04329351).
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Affiliation(s)
- Silvia Helena Garcia Braz
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Mabelle Freitas Monteiro
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Areião, Piracicaba, 13414-903, SP, Brazil.
| | - Edson Ken Matumoto
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Mônica Grazieli Corrêa
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Renato Corrêa Viana Casarin
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Areião, Piracicaba, 13414-903, SP, Brazil
| | - Fernanda Vieira Ribeiro
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Fabiano Ribeiro Cirano
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Marcio Zaffalon Casati
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Suzana Peres Pimentel
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
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Ali M, Mohd Noor SNF, Mohamad H, Ullah F, Javed F, Abdul Hamid ZA. Advances in guided bone regeneration membranes: a comprehensive review of materials and techniques. Biomed Phys Eng Express 2024; 10:032003. [PMID: 38224615 DOI: 10.1088/2057-1976/ad1e75] [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: 06/06/2023] [Accepted: 01/15/2024] [Indexed: 01/17/2024]
Abstract
Guided tissue/bone regeneration (GTR/GBR) is a widely used technique in dentistry to facilitate the regeneration of damaged bone and tissue, which involves guiding materials that eventually degrade, allowing newly created tissue to take its place. This comprehensive review the evolution of biomaterials for guided bone regeneration that showcases a progressive shift from non-resorbable to highly biocompatible and bioactive materials, allowing for more effective and predictable bone regeneration. The evolution of biomaterials for guided bone regeneration GTR/GBR has marked a significant progression in regenerative dentistry and maxillofacial surgery. Biomaterials used in GBR have evolved over time to enhance biocompatibility, bioactivity, and efficacy in promoting bone growth and integration. This review also probes into several promising fabrication techniques like electrospinning and latest 3D printing fabrication techniques, which have shown potential in enhancing tissue and bone regeneration processes. Further, the challenges and future direction of GTR/GBR are explored and discussed.
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Affiliation(s)
- Mohammed Ali
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300, Nibong Tebal, Pulau Pinang, Malaysia
| | - Siti Noor Fazliah Mohd Noor
- Dental Stimulation and Virtual Learning, Research Excellence Consortium, Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Bertam 13200 Kepala Batas, Pulau Pinang, Malaysia
| | - Hasmaliza Mohamad
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300, Nibong Tebal, Pulau Pinang, Malaysia
| | - Faheem Ullah
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300, Nibong Tebal, Pulau Pinang, Malaysia
- Department of Biological Sciences, Biopolymer Research Centre (BRC), National University of Medical Sciences, 46000, Rawalpindi, Pakistan
| | - Fatima Javed
- Department of Chemistry, Shaheed Benazir Butto Women University Peshawar, Charsadda Road Laramma, 25000, Peshawar, Pakistan
| | - Zuratul Ain Abdul Hamid
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300, Nibong Tebal, Pulau Pinang, Malaysia
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Turri A, Omar O, Trobos M, Thomsen P, Dahlin C. Modulation of gene expression and bone formation by expanded and dense polytetrafluoroethylene membranes during guided bone regeneration: An experimental study. Clin Implant Dent Relat Res 2024; 26:266-280. [PMID: 37357340 DOI: 10.1111/cid.13241] [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: 03/09/2023] [Revised: 05/28/2023] [Accepted: 06/07/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Nonresorbable membranes promote bone formation during guided bone regeneration (GBR), yet the relationships between membrane properties and molecular changes in the surrounding tissue are largely unknown. AIM To compare the molecular events in the overlying soft tissue, the membrane, and the underlying bone defect during GBR using dual-layered expanded membranes versus dense polytetrafluoroethylene (PTFE) membranes. MATERIALS AND METHODS Rat femur defects were treated with either dense PTFE (d-PTFE) or dual-layered expanded PTFE (dual e-PTFE) or left untreated as a sham. Samples were collected after 6 and 28 days for gene expression, histology, and histomorphometry analyses. RESULTS The two membranes promoted the overall bone formation compared to sham. Defects treated with dual e-PTFE exhibited a significantly higher proportion of new bone in the top central region after 28 days. Compared to that in the sham, the soft tissue in the dual e-PTFE group showed 2-fold higher expression of genes related to regeneration (FGF-2 and FOXO1) and vascularization (VEGF). Furthermore, compared to cells in the d-PTFE group, cells in the dual e-PTFE showed 2.5-fold higher expression of genes related to osteogenic differentiation (BMP-2), regeneration (FGF-2 and COL1A1), and vascularization (VEGF), in parallel with lower expression of proinflammatory cytokines (IL-6 and TNF-α). Multiple correlations were found between the molecular activities in membrane-adherent cells and those in the soft tissue. CONCLUSION Selective surface modification of the two sides of the e-PTFE membrane constitutes a novel means of modulating the tissue response and promoting bone regeneration.
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Affiliation(s)
- Alberto Turri
- The Brånemark Clinic, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Omar Omar
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Margarita Trobos
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral, Maxillofacial Surgery and Research and Development, NU-Hospital Organisation, Trollhättan, Sweden
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Wang X, Shen P, Gu N, Shao Y, Lu M, Tang C, Wang C, Chu C, Xue F, Bai J. Dual Mg-Reinforced PCL Membrane with a Janus Structure for Vascularized Bone Regeneration and Bacterial Elimination. ACS Biomater Sci Eng 2024; 10:537-549. [PMID: 38065085 DOI: 10.1021/acsbiomaterials.3c01360] [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] [Indexed: 01/09/2024]
Abstract
Commercially available guided bone regeneration (GBR) membranes often exhibit limited mechanical properties or bioactivity, leading to poor performance in repairing bone defects. To surmount this limitation, we developed a Janus structural composite membrane (Mg-MgO/PCL) reinforced by dual Mg (Mg sheets and MgO NPs) by using a combined processing technique involving casting and electrospinning. Results showed that the addition of Mg sheets and MgO NPs enhanced the mechanical properties of the composite membrane for osteogenic space maintenance, specifically tensile strength (from 10.2 ± 1.2 to 50.3 ± 4.5 MPa) and compression force (from 0 to 0.94 ± 0.09 N mm-1), through Mg sheet reinforcement and improved crystallization. The dense cast side of the Janus structure membrane displayed better fibroblast barrier capacity than a single fiber structure; meanwhile, the PCL matrix protected the Mg sheet from severe corrosion due to predeformation. The porous microfibers side supported preosteoblast cell adhesion, enhanced osteogenesis, and angiogenesis in vitro, through the biomimetic extracellular matrix and sustainable Mg2+ release. Furthermore, the Mg-MgO/PCL membrane incorporating 2 wt % MgO NPs exhibited remarkable antimicrobial properties, inducing over 88.75% apoptosis in Staphylococcus aureus. An in vivo experiment using the rat skull defect model (Φ = 5 mm) confirmed that the Mg-MgO/PCL membrane significantly improved new bone formation postsurgery. Collectively, our investigation provides valuable insights into the design of multifunctional membranes for clinical oral GBR application.
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Affiliation(s)
- Xianli Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Peiqi Shen
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Nannan Gu
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Yi Shao
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Mengmeng Lu
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
| | - Chunbo Tang
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
| | - Cheng Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Chenglin Chu
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Feng Xue
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
- Jiangsu Key Laboratory for Light Metal Alloys, Nanjing 211224, Jiangsu, China
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Cintra Moreira MV, Figueiredo LC, da Cunha Melo MAR, Uyeda FH, da Silva LDA, Macedo TT, Sacco R, Mourão CF, Shibli JA, Bueno-Silva B. Evaluation of the Microbial Profile on the Polydioxanone Membrane and the Collagen Membrane Exposed to Multi-Species Subgingival Biofilm: An In Vitro Study. MEMBRANES 2023; 13:907. [PMID: 38132911 PMCID: PMC10744605 DOI: 10.3390/membranes13120907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/02/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
Dehiscence in surgeries involving membranes often leads to bacterial contamination, hindering the healing process. This study assessed bacterial colonization on various membrane materials. Polydioxanone (PDO) membranes, with thicknesses of 0.5 mm and 1 mm, and a collagen membrane were examined. Packages containing polystyrene pins were crafted using these membranes, attached to 24-well plates, and exposed to oral bacteria from supra and subgingival biofilm. After a week's anaerobic incubation, biofilm formation was evaluated using the DNA-DNA hybridization test. Statistical analysis employed the Kruskal-Wallis test with Dunn's post hoc test. The biofilm on the polystyrene pins covered by the 0.5 mm PDO membrane showed a higher count of certain pathogens. The collagen membrane had a greater total biofilm count on its inner surface compared to both PDO membranes. The external collagen membrane face had a higher total biofilm count than the 0.5 mm PDO membrane. Furthermore, the 1 mm PDO membrane exhibited a greater count of specific pathogens than its 0.5 mm counterpart. In conclusion, the collagen membrane presented more biofilm and pathogens both internally and on its inner surface.
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Affiliation(s)
- Marcus Vinícius Cintra Moreira
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (M.V.C.M.); (L.C.F.); (F.H.U.)
| | - Luciene C. Figueiredo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (M.V.C.M.); (L.C.F.); (F.H.U.)
| | - Marcelo Augusto Ruiz da Cunha Melo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (M.V.C.M.); (L.C.F.); (F.H.U.)
| | - Fabio Hideaki Uyeda
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (M.V.C.M.); (L.C.F.); (F.H.U.)
| | - Lucas Daylor Aguiar da Silva
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (M.V.C.M.); (L.C.F.); (F.H.U.)
| | - Tatiane Tiemi Macedo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (M.V.C.M.); (L.C.F.); (F.H.U.)
| | - Roberto Sacco
- Department of Oral Surgery, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE1 9SP, UK
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Jamil A. Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (M.V.C.M.); (L.C.F.); (F.H.U.)
| | - Bruno Bueno-Silva
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (M.V.C.M.); (L.C.F.); (F.H.U.)
- Departament of Bioscienses, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, SP, Brazil
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Bokobza A, Nicot R, Raoul G, Afota F, Choukroun J, Savoldelli C. Management of postoperative outcomes of polytetrafluoroethylene membranes in alveolar ridge reconstruction: a systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101641. [PMID: 37739223 DOI: 10.1016/j.jormas.2023.101641] [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: 09/03/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
Guided bone regeneration (GBR) is a validated technique with satisfactory outcomes during 30 years of follow-up. The use of polytetrafluoroethylene (PTFE) membrane for vertical augmentation has been studied extensively. However, studies have reported exposure rates of up to 31%, there is no consensus on the management of postoperative exposure. The objective of this study was to propose a management approach for postoperative exposure of polytetrafluoroethylene (PTFE) membranes in alveolar ridge reconstruction. MATERIAL AND METHOD An electronic search in PubMed Central's and additional electronic databases was performed. The search strategy was limited to human studies, full-text English or French articles published from 1990 until april 2023. The extracted data included defect location, membrane type, biomaterials, time to postoperative exposure, and Fontana classification stage. Protocol bias assessment was performed using an adaptation of the QUADAS-2 tool. This review has been registered on PROSPERO (ID: CRD42023445497). RESULTS A total of 43 articles were found to be eligible, and 11 of these met the predefined inclusion and exclusion criteria. Based on the results of this systematic review, an algorithm for the management of PTFE membrane exposure is proposed. CONCLUSION Postoperative membrane exposure is not a determining factor for the success of bone grafting. In cases with postoperative complications, the majority of cases still achieved adequate implant-prosthetic rehabilitation. Lastly, this series of 11 articles was insufficient to draw conclusions regarding good practice recommendations. A larger series is required to validate the specific management approaches.
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Affiliation(s)
- Allan Bokobza
- Univ. Lille, CHU Lille, Department of Oral and Maxillofacial Surgery, F-59000 Lille, France.
| | - Romain Nicot
- Univ. Lille, CHU Lille, Inserm, Department of Oral and Maxillofacial Surgery, U1008 - Advanced Drug Delivery Systems, F-59000 Lille, France
| | - Gwénaël Raoul
- Univ. Lille, CHU Lille, Inserm, Department of Oral and Maxillofacial Surgery, U1008 - Advanced Drug Delivery Systems, F-59000 Lille, France
| | - Franck Afota
- Head and Neck Institute, University Hospital of Nice, 31 avenue de Valombrose, 06100 Nice, France
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Mizraji G, Davidzohn A, Gursoy M, Gursoy U, Shapira L, Wilensky A. Membrane barriers for guided bone regeneration: An overview of available biomaterials. Periodontol 2000 2023; 93:56-76. [PMID: 37855164 DOI: 10.1111/prd.12502] [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: 03/13/2023] [Revised: 05/21/2023] [Accepted: 05/29/2023] [Indexed: 10/20/2023]
Abstract
Dental implants revolutionized the treatment options for restoring form, function, and esthetics when one or more teeth are missing. At sites of insufficient bone, guided bone regeneration (GBR) is performed either prior to or in conjunction with implant placement to achieve a three-dimensional prosthetic-driven implant position. To date, GBR is well documented, widely used, and constitutes a predictable and successful approach for lateral and vertical bone augmentation of atrophic ridges. Evidence suggests that the use of barrier membranes maintains the major biological principles of GBR. Since the material used to construct barrier membranes ultimately dictates its characteristics and its ability to maintain the biological principles of GBR, several materials have been used over time. This review, summarizes the evolution of barrier membranes, focusing on the characteristics, advantages, and disadvantages of available occlusive barrier membranes and presents results of updated meta-analyses focusing on the effects of these membranes on the overall outcome.
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Affiliation(s)
- Gabriel Mizraji
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Mervi Gursoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
- Oral Health Care, Welfare Division, City of Turku, Turku, Finland
| | - Ulvi Gursoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Asaf Wilensky
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
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Wang X, Qian Y, Wang S, Wang M, Sun K, Cheng Z, Shao Y, Zhang S, Tang C, Chu C, Xue F, Tao L, Lu M, Bai J. Accumulative Rolling Mg/PLLA Composite Membrane with Lamellar Heterostructure for Enhanced Bacteria Inhibition and Rapid Bone Regeneration. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023; 19:e2301638. [PMID: 37345962 DOI: 10.1002/smll.202301638] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/19/2023] [Indexed: 06/23/2023]
Abstract
Developing composite materials with optimized mechanics, degradation, and bioactivity for bone regeneration has long been a crucial mission. Herein, a multifunctional Mg/Poly-l-lactic acid (Mg/PLLA) composite membrane based on the "materials plain" concept through the accumulative rolling (AR) method is proposed. Results show that at a rolling ratio of 75%, the comprehensive mechanical properties of the membrane in the rolling direction are self-reinforced significantly (elongation at break ≈53.2%, tensile strength ≈104.0 MPa, Young's modulus ≈2.13 GPa). This enhancement is attributed to the directional arrangement and increased crystallization of PLLA molecular chains, as demonstrated by SAXS and DSC results. Furthermore, the AR composite membrane presents a lamellar heterostructure, which not only avoids the accumulation of Mg microparticles (MgMPs) but also regulates the degradation rate. Through the contribution of bioactive MgMPs and their photothermal effect synergistically, the membrane effectively eliminates bacterial infection and accelerates vascularized bone regeneration both in vitro and in vivo. Notably, the membrane exhibits outstanding rat skull bone regeneration performance in only 4 weeks, surpassing most literature reports. In short, this work develops a composite membrane with a "one stone, four birds" effect, opening an efficient avenue toward high-performance orthopedic materials.
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Affiliation(s)
- Xianli Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Yuxin Qian
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Shuang Wang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Mingxi Wang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Ke Sun
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Zhaojun Cheng
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Yi Shao
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Shixuan Zhang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Chunbo Tang
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Chenglin Chu
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Feng Xue
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Li Tao
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
| | - Mengmeng Lu
- Department of Oral Implantology, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing, Jiangsu, 211189, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing, Jiangsu, 211189, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou, 215000, China
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10
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Buser D, Urban I, Monje A, Kunrath MF, Dahlin C. Guided bone regeneration in implant dentistry: Basic principle, progress over 35 years, and recent research activities. Periodontol 2000 2023; 93:9-25. [PMID: 38194351 DOI: 10.1111/prd.12539] [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: 09/12/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 01/10/2024]
Abstract
Bone augmentation procedures are frequent today in implant patients, since an implant should be circumferentially anchored in bone at completion of bone healing to have a good long-term stability. The best documented surgical technique to achieve this goal is guided bone regeneration (GBR) utilizing barrier membranes in combination with bone fillers. This clinical review paper reflects 35 years of development and progress with GBR. In the 1990s, GBR was developed by defining the indications for GBR, examining various barrier membranes, bone grafts, and bone substitutes. Complications were identified and reduced by modifications of the surgical technique. Today, the selection criteria for various surgical approaches are much better understood, in particular, in post-extraction implant placement. In the majority of patients, biodegradable collagen membranes are used, mainly for horizontal bone augmentation, whereas bioinert PTFE membranes are preferred for vertical ridge augmentation. The leading surgeons are using a composite graft with autogenous bone chips to accelerate bone formation, in combination with a low-substitution bone filer to better maintain the augmented bone volume over time. In addition, major efforts have been made since the millenium change to reduce surgical trauma and patient morbidity as much as possible. At the end, some open questions related to GBR are discussed.
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Affiliation(s)
- Daniel Buser
- School of Dental Medicine, University of Bern, Bern, Switzerland
- Centre for Implantology Buser and Frei, Bern, Switzerland
| | - Istvan Urban
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, UIC Barcelona, Barcelona, Spain
- Division of Periodontology, CICOM-Monje, Badajoz, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Marcel F Kunrath
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dentistry, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral, Maxillofacial Surgery and Research and Development, NU-Hospital Organisation, Trollhättan, Sweden
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11
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Gil ACK, Prado MM, Rocha LRD, Benfatti C, Schuldt Filho G, Almeida JD. In vitro evaluation of membranes for regenerative procedures against oral bacteria. Braz Dent J 2023; 34:57-65. [PMID: 37466526 PMCID: PMC10355258 DOI: 10.1590/0103-6440202305060] [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: 05/22/2022] [Accepted: 03/20/2023] [Indexed: 07/20/2023] Open
Abstract
The current literature on guided bone regeneration (GBR) and guided tissue regeneration (GTR) membrane contamination reports that the physicochemical characteristics of these biomaterials might influence affinity to bacteria, which appears to be a major drawback for the clinical outcome of the regenerative procedures. Thus, this study aimed to evaluate, in vitro, a multispecies biofilm adherence and passage of bacteria through different types of commercially available membranes for GTR/GBR. Four types of membranes were tested (n=12): LC) Lumina Coat®; JS) Jason®; BG) Biogide®; and LP) Lumina PTFE®. Aluminum foil (AL) simulated an impermeable barrier and was used as the control. The membranes were adapted to specific apparatus and challenged with a mixed bacterial culture composed of A. actinomycetemcomitans b, S. mutans, S. mitis, and A. israelii. After 2 h or 7 days, bacterial adhesion and passage of bacteria were evaluated through CFU counting, which was analyzed by two-way ANOVA e post hoc Tukey, at a 5% significance level. Representative areas of two membranes of each group were analyzed through scanning electron microscopy (SEM) to assess the morphology and organization of the biofilm over the membrane fibers. LC and LP presented similar values of adhered bacterial cells (p > 0.05), significantly inferior when compared to the other groups, in both time points (p < 0.05). All the tested groups were permeable to bacterial cells, with no significant difference between the trial period of 2 h and 7 days (p > 0.05). SEM analyses demonstrated that adhered bacteria number increased throughout the time points (2 h < 7 days). Commercially available biological membranes demonstrated intense bacterial adherence and passage of bacteria, which increased throughout the trial period.
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Affiliation(s)
- Ana Clara Kuerten Gil
- Department of Implant Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Maick Meneguzzo Prado
- Department of Chemical Engineering, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Laura Rhoden da Rocha
- Department of Endodontics, University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - César Benfatti
- Department of Implant Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Guenther Schuldt Filho
- Department of Implant Dentistry, University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Josiane de Almeida
- Department of Endodontics, University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
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12
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Li Y, Meng Y, Bai Y, Wang Y, Wang J, Heng B, Wei J, Jiang X, Gao M, Zheng X, Zhang X, Deng X. Restoring the electrical microenvironment using ferroelectric nanocomposite membranes to enhance alveolar ridge regeneration in a mini-pig preclinical model. J Mater Chem B 2023; 11:985-997. [PMID: 36520085 DOI: 10.1039/d2tb02054h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The maintenance and incremental growth of the alveolar bone at the tooth extraction site, to achieve the required height and width for implant restoration, remains a major clinical challenge. Here, the concept of restoring the electrical microenvironment to improve the effects of alveolar ridge preservation (ARP) was investigated in a mini-pig preclinical model. The endogeneous electrical microenvironment of the dental alveolar socket was recapitulated by fabricating a biomimetic ferroelectric BaTiO3/poly(vinylidene fluoridetrifluoroethylene) (BTO/P(VDF-TrFE)) non-resorbable nanocomposite membrane polarized by corona poling. The polarized nanocomposite membrane exhibited excellent electrical stability. After implantation with bone grafts and covering with the charged membrane in tooth extraction sites for three months, both the vertical and horizontal dimension resorption of the alveolar ridge were significantly prevented, as assessed by cone beam computed tomography (CBCT) analyses. Micro-CT analysis showed that the charged membrane induced significant enhancement of newly regenerated bone at the tooth extraction sites. Histological analysis further confirmed that the restoration of the electrical microenvironment significantly promoted buccal alveolar bone regeneration and maturation. In addition, the charged membranes can maintain their structural integrity during the entire implantation period and exhibit positive long-term systemic safety, as assessed by preclinical sub-chronic systemic toxicity. These findings thus provide an innovative strategy for restoring the electrical microenvironment to enhance ARP following dentition defect and edentulism, which could further advance prosthodontics implant technology.
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Affiliation(s)
- Yiping Li
- Department of Dental Materials & Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China. .,Department of Prosthodontics, Xiangya Stomatological Hospital & School of Stomatology, Central South University, Changsha, 410078, P. R. China.,Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China.
| | - Yanze Meng
- Department of Dental Materials & Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China.
| | - Yunyang Bai
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China.
| | - Yijun Wang
- Department of Dental Materials & Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China.
| | - Jiaqi Wang
- Department of Prosthodontics, Xiangya Stomatological Hospital & School of Stomatology, Central South University, Changsha, 410078, P. R. China
| | - Boonchin Heng
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Jinqi Wei
- First Clinical Division, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Xi Jiang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Min Gao
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China. .,National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NMPA Key Laboratory for Dental Materials, Beijing Laboratory of Biomedical Materials & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
| | - Xiaona Zheng
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China. .,National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NMPA Key Laboratory for Dental Materials, Beijing Laboratory of Biomedical Materials & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
| | - Xuehui Zhang
- Department of Dental Materials & Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China. .,National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NMPA Key Laboratory for Dental Materials, Beijing Laboratory of Biomedical Materials & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
| | - Xuliang Deng
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China. .,National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NMPA Key Laboratory for Dental Materials, Beijing Laboratory of Biomedical Materials & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
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13
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Qasim SSB, Al-Asfour AA, Abuzayeda M, Mohamed AM, Trajkovski B, Murray CA, Zafiropoulos GG. Differences in Mechanical and Physicochemical Properties of Several PTFE Membranes Used in Guided Bone Regeneration. MATERIALS (BASEL, SWITZERLAND) 2023; 16:904. [PMID: 36769909 PMCID: PMC9917410 DOI: 10.3390/ma16030904] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Non-resorbable PTFE membranes are frequently used in dental-guided bone regeneration (GBR). However, there is a lack of detailed comparative studies that define variations among commonly used PTFE membranes in daily dental clinical practice. The aim of this study was to examine differences in physicochemical and mechanical properties of several recent commercial PTFE membranes for dental GBR (CytoplastTM TXT-200, permamem®, NeoGen®, Surgitime, OsseoGuard®-TXT, OsseoGuard®-NTXT). Such differences have been rarely recorded so far, which might be a reason for the varied clinical results. For that reason, we analyzed their surface architecture, chemical composition, tensile strength, Young's modulus, wettability, roughness, density, thickness and porosity. SEM revealed different microarchitectures among the non-textured membranes; the textured ones had hexagonal indentations and XPS indicated an identical spectral portfolio in all membranes. NeoGen® was determined to be the strongest and OsseoGuard®-TXT was the most elastic. Wettability and roughness were highest for Surgitime but lowest for OsseoGuard®-NTXT. Furthermore, permamem® was the thinnest and NeoGen® was identified as the thickest investigated GBR membrane. The defect volumes and defect volume ratio (%) varied significantly, indicating that permamem® had the least imperfect structure, followed by NeoGen® and then Cytoplast TM TXT-200. These differences may potentially affect the clinical outcomes of dental GBR procedures.
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Affiliation(s)
- Syed Saad Bin Qasim
- Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, Safat 13110, Kuwait
| | - Adel A. Al-Asfour
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat 13110, Kuwait
| | - Moosa Abuzayeda
- Department of Prosthodontics, College of Dentistry, MBR University, Dubai P.O. Box 505055, United Arab Emirates
| | - Ahmed M. Mohamed
- Department of Chemistry, Faculty of Science, Kuwait University, Safat 13060, Kuwait
| | | | - Colin Alexander Murray
- Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
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14
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Ren Y, Fan L, Alkildani S, Liu L, Emmert S, Najman S, Rimashevskiy D, Schnettler R, Jung O, Xiong X, Barbeck M. Barrier Membranes for Guided Bone Regeneration (GBR): A Focus on Recent Advances in Collagen Membranes. Int J Mol Sci 2022; 23:ijms232314987. [PMID: 36499315 PMCID: PMC9735671 DOI: 10.3390/ijms232314987] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/25/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
Guided bone regeneration (GBR) has become a clinically standard modality for the treatment of localized jawbone defects. Barrier membranes play an important role in this process by preventing soft tissue invasion outgoing from the mucosa and creating an underlying space to support bone growth. Different membrane types provide different biological mechanisms due to their different origins, preparation methods and structures. Among them, collagen membranes have attracted great interest due to their excellent biological properties and desired bone regeneration results to non-absorbable membranes even without a second surgery for removal. This work provides a comparative summary of common barrier membranes used in GBR, focusing on recent advances in collagen membranes and their biological mechanisms. In conclusion, the review article highlights the biological and regenerative properties of currently available barrier membranes with a particular focus on bioresorbable collagen-based materials. In addition, the advantages and disadvantages of these biomaterials are highlighted, and possible improvements for future material developments are summarized.
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Affiliation(s)
- Yanru Ren
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
- BerlinAnalytix GmbH, 12109 Berlin, Germany
| | - Lu Fan
- NMI Natural and Medical Sciences Institute, University of Tübingen, 72770 Reutlingen, Germany
| | | | - Luo Liu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing 100013, China
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
| | - Stevo Najman
- Scientific Research Center for Biomedicine, Department for Cell and Tissue Engineering, Faculty of Medicine, University of Niš, 18000 Niš, Serbia
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18000 Niš, Serbia
| | - Denis Rimashevskiy
- Department of Traumatology and Orthopedics, Peoples’ Friendship University of Russia, 117198 Moscow, Russia
| | - Reinhard Schnettler
- University Medical Centre, Justus Liebig University of Giessen, 35390 Giessen, Germany
| | - Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
| | - Xin Xiong
- NMI Natural and Medical Sciences Institute, University of Tübingen, 72770 Reutlingen, Germany
| | - Mike Barbeck
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
- BerlinAnalytix GmbH, 12109 Berlin, Germany
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing 100013, China
- Correspondence: ; Tel.: +49-(0)-176-81022467
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15
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Palkovics D, Bolya-Orosz F, Pinter C, Molnar B, Windisch P. Reconstruction of vertical alveolar ridge deficiencies utilizing a high-density polytetrafluoroethylene membrane /clinical impact of flap dehiscence on treatment outcomes: case series/. BMC Oral Health 2022; 22:490. [PMCID: PMC9664701 DOI: 10.1186/s12903-022-02513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Objectives
The aim of this study was to evaluate the effects of membrane exposure during vertical ridge augmentation (VRA) utilizing guided bone regeneration with a dense polytetrafluoroethylene (d-PTFE) membrane and a tent-pole space maintaining approach by registering radiographic volumetric, linear and morphological changes.
Methods
In 8 cases alveolar ridge defects were accessed utilizing a split-thickness flap design. Following flap elevation VRA was performed with tent-pole space maintaining approach utilizing the combination of a non-reinforced d-PTFE membrane and a composite graft (1:1 ratio of autogenous bone chips and bovine derived xenografts). Three-dimensional radiographic evaluation of hard tissue changes was carried out with the sequence of cone-beam computed tomography (CBCT) image segmentation, spatial registration and 3D subtraction analysis.
Results
Class I or class II membrane exposure was observed in four cases. Average hard tissue gain was found to be 0.70 cm3 ± 0.31 cm3 and 0.82 cm3 ± 0.40 cm3 with and without membrane exposure resulting in a 17% difference. Vertical hard tissue gain averaged 4.06 mm ± 0.56 mm and 3.55 mm ± 0.43 mm in case of submerged and open healing, respectively. Difference in this regard was 14% between the two groups. Horizontal ridge width at 9-month follow-up was 5.89 mm ± 0.51 mm and 5.61 mm ± 1.21 mm with and without a membrane exposure respectively, resulting in a 5% difference.
Conclusions
With the help of the currently reported 3D radiographic evaluation method, it can be concluded that exposure of the new-generation d-PTFE membrane had less negative impact on clinical results compared to literature data reporting on expanded polytetrafluoroethylene membranes.
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16
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Zelikman H, Slutzkey G, Rosner O, Levartovsky S, Matalon S, Beitlitum I. Bacterial Growth on Three Non-Resorbable Polytetrafluoroethylene (PTFE) Membranes-An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5705. [PMID: 36013840 PMCID: PMC9414989 DOI: 10.3390/ma15165705] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/11/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
GBR (Guided Bone Regeneration) procedure is challenged by the risk of membrane exposure to the oral cavity and contamination. The barrier quality of these membranes serve as a mechanical block from bacterial penetration into the GBR site. The purpose of this in vitro study was to evaluate the antibacterial effect of three commercial non-resorbable polytetrafluoroethylene membranes. (Two d-PTFE membranes and one double layer e-PTFE +d-PTFE membrane). A validated in vitro model with two bacterial species (Streptococcus sanguinis and Fusobacterium nucleatum) was used. Eight samples from membrane each were placed in a 96-well microtiter plate. The experimental and positive control groups were exposed to a bacterial suspension which involved one bacterial species in each plate. Bacterial growth was monitored spectrophotometrically at 650 nm for 24 h in temperature controlled microplate spectrophotometer under anaerobic conditions. One- Sample Kolmogorov−Smirnov Normal test and the Kruskal−Wallis test was used for the statistical analysis. As shown by the bacterial growth curves obtained from the spectrophotometer readings, all three membranes resulted in bacterial growth. We have not found a statistical difference in F. nucleatum growth between different membrane samples and the positive control group. However, S. sanguinis growth was reduced significantly in the presence of two membranes (CYTOPLAST TXT-200 and NeoGenTM) when compared to the control (p < 0.01). The presence of Permamem® had no significant influence on S. sanguinis growth. Some types of commercial non-resorbable PTFE membranes may have an impact on the growth dynamics of specific bacterial species.
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Affiliation(s)
- Helena Zelikman
- Department of Oral Rehabilitation, Goldschleger School of Dental Medicine, Sackler Medical Faculty, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Gil Slutzkey
- Department of Periodontology and Dental Implantology, Goldschleger School of Dental Medicine, Sackler Medical Faculty, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Ofir Rosner
- Department of Oral Rehabilitation, Goldschleger School of Dental Medicine, Sackler Medical Faculty, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Shifra Levartovsky
- Department of Oral Rehabilitation, Goldschleger School of Dental Medicine, Sackler Medical Faculty, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Shlomo Matalon
- Department of Oral Rehabilitation, Goldschleger School of Dental Medicine, Sackler Medical Faculty, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Ilan Beitlitum
- Department of Periodontology and Dental Implantology, Goldschleger School of Dental Medicine, Sackler Medical Faculty, Tel Aviv University, Tel Aviv 6997801, Israel
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17
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Various Coated Barrier Membranes for Better Guided Bone Regeneration: A Review. COATINGS 2022. [DOI: 10.3390/coatings12081059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A good barrier membrane is one of the important factors for effective guided bone/tissue regeneration (GBR/GTR) in the case of periodontal bone defects. Several methods are being discussed to overcome and improve the shortcomings of commercially available membranes. One of the methods is to coat the membrane with bioactive materials. In this study, 41 studies related to coated membranes for GBR/GTR published in the last 5 years were reviewed. These studies reported coating the membrane with various bioactive materials through different techniques to improve osteogenesis, antimicrobial properties, and physical/mechanical properties. The reported studies have been classified and discussed based on the purpose of coating. The goal of the most actively studied research on coating or surface modification of membranes is to improve new bone formation. For this purpose, calcium phosphate, bioactive glass, polydopamine, osteoinduced drugs, chitosan, platelet-rich fibrin, enamel matrix derivatives, amelotin, hyaluronic acid, tantalum, and copper were used as membrane coating materials. The paradigm of barrier membranes is changing from only inert (or biocompatible) physical barriers to bioactive osteo-immunomodulatory for effective guided bone and tissue regeneration. However, there is a limitation that there exists only a few clinical studies on humans to date. Efforts are needed to implement the use of coated membranes from the laboratory bench to the dental chair unit. Further clinical studies are needed in the patients’ group for long-term follow-up to confirm the effect of various coating materials.
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18
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Liu Y, Guo L, Li X, Liu S, Du J, Xu J, Hu J, Liu Y. Challenges and tissue engineering strategies of periodontal guided tissue regeneration. Tissue Eng Part C Methods 2022; 28:405-419. [PMID: 35838120 DOI: 10.1089/ten.tec.2022.0106] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Periodontitis is a chronic infectious oral disease with a high prevalence rate in the world, and is a major cause of tooth loss. Nowadays, people have realized that the local microenvironment that includes proteins, cytokines, and extracellular matrix has a key influence on the functions of host immune cells and periodontal ligament stem cells during a chronic infectious disease such as periodontitis. The above pathological process of periodontitis will lead to a defect of periodontal tissues. Through the application of biomaterials, biological agents, and stem cells therapy, guided tissue regeneration (GTR) makes it possible to reconstruct healthy periodontal ligament tissue after local inflammation control. To date, substantial advances have been made in periodontal guided tissue regeneration. However, the process of periodontal remodeling experiences complex microenvironment changes, and currently periodontium regeneration still remains to be a challenging feat. In this review, we summarized the main challenges in each stage of periodontal regeneration, and try to put forward appropriate biomaterial treatment mechanisms or potential tissue engineering strategies that provide a theoretical basis for periodontal tissue engineering regeneration research.
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Affiliation(s)
- Yitong Liu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Lijia Guo
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China;
| | - Xiaoyan Li
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Siyan Liu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Juan Du
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Junji Xu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Jingchao Hu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Yi Liu
- Capital Medical University School of Stomatology, Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction,, Tian Tan Xi Li No.4, Beijing, Beijing , China, 100050;
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Joo G, Park M, Park S, Tripathi G, Lee BT. Tailored alginate/PCL-gelatin-β-TCP membrane for guided bone regeneration. Biomed Mater 2022; 17. [PMID: 35487207 DOI: 10.1088/1748-605x/ac6bd8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/29/2022] [Indexed: 11/12/2022]
Abstract
Membranes prepared for guided bone regeneration (GBR) signify valued resources, inhibiting fibrosis and assisting bone regenration. However, existing membranes lack bone regenerative capacity or adequate degradation profile. An alginate-casted polycaprolactone (PCL)-gelatin-β-tricalcium phosphate (β-TCP) dual membrane was fabricated by electrospinning and casting processes to enhance new bone formation under a guided bone regeneration (GBR) process. Porous membranes were synthesized with suitable hydrophilicity, swelling, and degradation behavior to confirm the compatibility of the product in the body. Furthermore, osteoblast-type cell toxicity and cell adhesion results showed that the electrospun membrane offered compatible environment to cells while the alginate sheet was found capable enough to supress the cellular attachment, but was a non-toxic material. Post-implantation, the in-vivo outcomes of the dual-layered membrane, showed appreciable bone formation. Significantly, osteoid islands had fused in the membrane group by 8 weeks. The infiltration of fibrous tissues was blocked by the alginate membrane, and the ingrowth of new bone was enhanced. Immunocytochemical analysis indicated that the dual membrane could direct more proteins which control mineralization and convene osteoconductive properties of tissue-engineered bone grafts.
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Affiliation(s)
- Gyeongjin Joo
- Soonchunhyang University College of Medicine, 366-1, Ssangyougndong, Cheonan, Chungcheongnam-do, 31204, Korea (the Republic of)
| | - Myeongki Park
- Soonchunhyang University College of Medicine, 366-1, Ssangyougndong, Cheonan, Chungcheongnam-do, 31204, Korea (the Republic of)
| | - Seongsu Park
- Soonchunhyang University College of Medicine, 366-1, Ssangyougndong, Cheonan, Chungcheongnam-do, 31204, Korea (the Republic of)
| | - Garima Tripathi
- Soonchunhyang University College of Medicine, 2Institute of Tissue Regeneration, College of Medicine, Soonchunhyang University, Cheonan, South Korea, Cheonan, Chungcheongnam-do, 31204, Korea (the Republic of)
| | - Byong-Taek Lee
- Soonchunhyang University College of Medicine, 366-1, Ssangyougndong, Cheonan, Chungcheongnam-do, 31204, Korea (the Republic of)
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20
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Permeability of P. gingivalis or its metabolic products through collagen and dPTFE membranes and their effects on the viability of osteoblast-like cells: an in vitro study. Odontology 2022; 110:710-718. [PMID: 35355145 DOI: 10.1007/s10266-022-00705-9] [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: 08/23/2021] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
Membrane exposure is a widely reported and relatively common complication in Guided Bone Regeneration (GBR) procedures. The introduction of micro-porous dPTFE barriers, which are impervious to bacterial cells, could reduce the technique sensitivity to membrane exposure, even if there are no studies investigating the potential passage of bacterial metabolites through the barrier. Aim of this study was the in vitro evaluation of the permeability of three different GBR membranes (dPTFE, native and cross-linked collagen membranes) to Porphyromonas gingivalis; in those cases, where bacterial penetration could not be observed, another purpose was the analysis of the viability and differentiation capability of an osteosarcoma (U2OS) cell line in presence of bacteria eluate obtained through membrane percolation. A system leading to the percolation of P. gingivalis broth culture through the experimental membranes was arranged to assess the permeability to bacteria after 24 and 72 h of incubation. The obtained solution was then added to U2OS cell cultures which underwent, after 10 days of incubation, MTT and red alizarin essays. The dPTFE membrane showed resistance to bacterial penetration, while both types of collagen membranes were crossed by P. gingivalis after 24 h. The bacteria eluate filtered through dPTFE membrane didn't show any toxicity on U2OS cells. Results of this study demonstrate that dPTFE membranes can contrast the penetration of both P. gingivalis and its metabolites toxic for osteoblast-like cells. The toxicity analysis was not possible for the collagen membranes, since permeability to bacterial cells was observed within the first period of incubation.
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21
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Adhesion of Oral Bacteria to Commercial d-PTFE Membranes: Polymer Microstructure Makes a Difference. Int J Mol Sci 2022; 23:ijms23062983. [PMID: 35328404 PMCID: PMC8949314 DOI: 10.3390/ijms23062983] [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] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/06/2022] [Accepted: 03/08/2022] [Indexed: 12/04/2022] Open
Abstract
Bacterial contamination of the membranes used during guided bone regeneration directly influences the outcome of this procedure. In this study, we analyzed the early stages of bacterial adhesion on two commercial dense polytetrafluoroethylene (d-PTFE) membranes in order to identify microstructural features that led to different adhesion strengths. The microstructure was investigated by X-ray diffraction (XRD), differential scanning calorimetry (DSC), and Fourier transform infrared (FTIR). The surface properties were analyzed by atomic force microscopy (AFM), scanning electron microscopy (SEM), and surface free energy (SFE) measurements. Bacterial properties were determined using the microbial adhesion to solvents (MATS) assay, and bacterial surface free energy (SFE) was measured spectrophotometrically. The adhesion of four species of oral bacteria (Streptococcus mutans, Streptococcus oralis, Aggregatibacter actinomycetemcomitas, and Veilonella parvula) was studied on surfaces with or without the artificial saliva coating. The results indicated that the degree of crystallinity (78.6% vs. 34.2%, with average crystallite size 50.54 nm vs. 32.86 nm) is the principal feature promoting the adhesion strength, through lower nanoscale roughness and possibly higher surface stiffness. The spherical crystallites (“warts”), observed on the surface of the highly crystalline sample, were also identified as a contributor. All bacterial species adhered better to a highly crystalline membrane (around 1 log10CFU/mL difference), both with and without artificial saliva coating. Our results show that the changes in polymer microstructure result in different antimicrobial properties even for chemically identical PTFE membranes.
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22
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Advances in Modification Methods Based on Biodegradable Membranes in Guided Bone/Tissue Regeneration: A Review. Polymers (Basel) 2022; 14:polym14050871. [PMID: 35267700 PMCID: PMC8912280 DOI: 10.3390/polym14050871] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 02/04/2023] Open
Abstract
Guided tissue/bone regeneration (GTR/GBR) is commonly applied in dentistry to aid in the regeneration of bone/tissue at a defective location, where the assistive material eventually degrades to be substituted with newly produced tissue. Membranes separate the rapidly propagating soft tissue from the slow-growing bone tissue for optimal tissue regeneration results. A broad membrane exposure area, biocompatibility, hardness, ductility, cell occlusion, membrane void ratio, tissue integration, and clinical manageability are essential functional properties of a GTR/GBR membrane, although no single modern membrane conforms to all of the necessary characteristics. This review considers ongoing bone/tissue regeneration engineering research and the GTR/GBR materials described in this review fulfill all of the basic ISO requirements for human use, as determined through risk analysis and rigorous testing. Novel modified materials are in the early stages of development and could be classified as synthetic polymer membranes, biological extraction synthetic polymer membranes, or metal membranes. Cell attachment, proliferation, and subsequent tissue development are influenced by the physical features of GTR/GBR membrane materials, including pore size, porosity, and mechanical strength. According to the latest advances, key attributes of nanofillers introduced into a polymer matrix include suitable surface area, better mechanical capacity, and stability, which enhances cell adhesion, proliferation, and differentiation. Therefore, it is essential to construct a bionic membrane that satisfies the requirements for the mechanical barrier, the degradation rate, osteogenesis, and clinical operability.
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Classification Based on Extraction Socket Buccal Bone Morphology and Related Treatment Decision Tree. MATERIALS 2022; 15:ma15030733. [PMID: 35160679 PMCID: PMC8836467 DOI: 10.3390/ma15030733] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 01/24/2023]
Abstract
Background: Alveolar ridge preservation (ARP) can successfully reduce volumetric ridge changes. However, there is still no consensus on what technique is the most advantageous for each specific clinical scenario. Hence, the aim of the present paper was to provide a treatment decision tree to guide the choice of predictable ARP procedures based on extraction socket buccal bone morphology and integrity. Material and Methods: Three socket types (ST) are proposed and discussed based on buccal bone morphology (intact, dehiscence or fenestration). Results: A decision tree for ARP was developed in order to merge ST classification with suitable treatment modalities. In the decision tree, the issue of when to allow unassisted healing or ARP was discussed. Described methods included bone grafting and collagen plug, and absorbable membrane or non-resorbable membrane, with or without flap elevation. Conclusion: A decision tree for ARP procedures was provided to guide clinicians towards the most conservative and predictable treatment approach based on remaining socket anatomical structures after extraction.
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Vimalraj S, Sekaran S. Commentary: "Silver Nanoparticles Coated Poly(L-Lactide) Electrospun Membrane for Implant Associated Infections Prevention". Front Pharmacol 2021; 12:759304. [PMID: 34776977 PMCID: PMC8580876 DOI: 10.3389/fphar.2021.759304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/24/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Selvaraj Vimalraj
- Centre for Biotechnology, Anna University, Chennai, India
- Department of Pharmacology, Saveetha Dental College and Hospitals, Saveetha Institute for Medical and Technical Sciences, Chennai, India
| | - Saravanan Sekaran
- Department of Pharmacology, Saveetha Dental College and Hospitals, Saveetha Institute for Medical and Technical Sciences, Chennai, India
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Dhaliwal JS, Abd Rahman NA, Ming LC, Dhaliwal SKS, Knights J, Albuquerque Junior RF. Microbial Biofilm Decontamination on Dental Implant Surfaces: A Mini Review. Front Cell Infect Microbiol 2021; 11:736186. [PMID: 34692562 PMCID: PMC8531646 DOI: 10.3389/fcimb.2021.736186] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 09/09/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction After insertion into the bone, implants osseointegrate, which is required for their long-term success. However, inflammation and infection around the implants may lead to implant failure leading to peri-implantitis and loss of supporting bone, which may eventually lead to failure of implant. Surface chemistry of the implant and lack of cleanliness on the part of the patient are related to peri-implantitis. The only way to get rid of this infection is decontamination of dental implants. Objective This systematic review intended to study decontamination of microbial biofilm methods on titanium implant surfaces used in dentistry. Methods The electronic databases Springer Link, Science Direct, and PubMed were explored from their inception until December 2020 to identify relevant studies. Studies included had to evaluate the efficiency of new strategies either to prevent formation of biofilm or to treat matured biofilm on dental implant surfaces. Results and Discussion In this systematic review, 17 different groups of decontamination methods were summarized from 116 studies. The decontamination methods included coating materials, mechanical cleaning, laser treatment, photodynamic therapy, air polishing, anodizing treatment, radiation, sonication, thermal treatment, ultrasound treatment, chemical treatment, electrochemical treatment, antimicrobial drugs, argon treatment, and probiotics. Conclusion The findings suggest that most of the decontamination methods were effective in preventing the formation of biofilm and in decontaminating established biofilm on dental implants. This narrative review provides a summary of methods for future research in the development of new dental implants and decontamination techniques.
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Affiliation(s)
- Jagjit Singh Dhaliwal
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Nurul Adhwa Abd Rahman
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Long Chiau Ming
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Sachinjeet Kaur Sodhi Dhaliwal
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Joe Knights
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
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Roina Y, Auber F, Hocquet D, Herlem G. ePTFE-based biomedical devices: An overview of surgical efficiency. J Biomed Mater Res B Appl Biomater 2021; 110:302-320. [PMID: 34520627 DOI: 10.1002/jbm.b.34928] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/26/2021] [Accepted: 08/01/2021] [Indexed: 12/19/2022]
Abstract
Polytetrafluoroethylene (PTFE) is a ubiquitous material used for implants and medical devices in general because of its high biocompatibility and inertness: blood vessel, heart, table jawbone, nose, eyes, or abdominal wall can benefit from its properties in case of disease or injury. Its expanded version, ePTFE is an improved version of PTFE with better mechanical properties, which extends its medical applications. A material as frequently used as ePTFE with these exceptional properties deserves a review of its main uses, developments, and possibility of improvements. In this systematic review, we examined clinical trials related to ePTFE-based medical devices from the literature. Then, we excluded all trials using ePTFE as a control to test other devices. ePTFE-coated stents, hemodialysis and bypass grafts, guided bone and tissue regeneration membranes, hernia and heart repair and other devices are reviewed. The rates of success using these devices and their efficiency compared to other materials used for the same purposes are reported. ePTFE appears to be more or just as efficient compared to them. Some success rates remain low, suggesting the need of improvement ePTFE for medical applications.
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Affiliation(s)
- Yaëlle Roina
- Nanomedicine Lab EA4662, Bat. E, Université de Franche-Comté, UFR Sciences & Techniques, Besançon Cedex, France
| | - Frédéric Auber
- Nanomedicine Lab EA4662, Bat. E, Université de Franche-Comté, UFR Sciences & Techniques, Besançon Cedex, France
| | - Didier Hocquet
- Hygiène Hospitalière, UMR CNRS 6249, Université de Bourgogne Franche-Comté, Besançon, France
| | - Guillaume Herlem
- Nanomedicine Lab EA4662, Bat. E, Université de Franche-Comté, UFR Sciences & Techniques, Besançon Cedex, France
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Liao X, Yu X, Yu H, Huang J, Zhang B, Xiao J. Development of an anti-infective coating on the surface of intraosseous implants responsive to enzymes and bacteria. J Nanobiotechnology 2021; 19:241. [PMID: 34384446 PMCID: PMC8359346 DOI: 10.1186/s12951-021-00985-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 08/05/2021] [Indexed: 12/18/2022] Open
Abstract
Background Bacterial proliferation on the endosseous implants surface presents a new threat to the using of the bone implants. Unfortunately, there is no effective constructed antibacterial coating which is bacterial anti-adhesion substrate-independent or have long-term biofilm inhibition functions. Methods Drug release effect was tested in Chymotrypsin (CMS) solution and S. aureus. We used bacterial inhibition rate assays and protein leakage experiment to analyze the in vitro antibacterial effect of (Montmorillonite/Poly-l-lysine-Chlorhexidine)10 [(MMT/PLL-CHX)10] multilayer film. We used the CCK-8 assay to analyze the effect of (MMT/PLL-CHX)10 multilayer films on the growth and proliferation of rat osteoblasts. Rat orthopaedic implant-related infections model was constructed to test the antimicrobial activity effect of (MMT/PLL-CHX)10 multilayer films in vivo. Results In this study, the (MMT/PLL-CHX)10 multilayer films structure were progressively degraded and showed well concentration-dependent degradation characteristics following incubation with Staphylococcus aureus and CMS solution. Bacterial inhibition rate assays and protein leakage experiment showed high levels of bactericidal activity. While the CCK-8 analysis proved that the (MMT/PLL-CHX)10 multilayer films possess perfect biocompatibility. It is somewhat encouraging that in the in vivo antibacterial tests, the K-wires coated with (MMT/PLL-CHX)10 multilayer films showed lower infections incidence and inflammation than the unmodified group, and all parameters are close to SHAM group. Conclusion (MMT/PLL-CHX)10 multilayer films provides a potential therapeutic method for orthopaedic implant-related infections.
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Affiliation(s)
- Xin Liao
- The Second Affiliated Hospital (Jiande Branch), Zhejiang University School of Medicine, Jiande, Hangzhou, Zhejiang, China
| | - Xingfang Yu
- Department of Orthopedics, The Affiliated Yiwu Hospital of Wenzhou Medical University, 699 Jiangdong Road, Yiwu, 322000, Zhejiang, China
| | - Haiping Yu
- The Second Affiliated Hospital (Jiande Branch), Zhejiang University School of Medicine, Jiande, Hangzhou, Zhejiang, China
| | - Jiaqi Huang
- The Second Affiliated Hospital (Jiande Branch), Zhejiang University School of Medicine, Jiande, Hangzhou, Zhejiang, China
| | - Bi Zhang
- The Second Affiliated Hospital (Jiande Branch), Zhejiang University School of Medicine, Jiande, Hangzhou, Zhejiang, China
| | - Jie Xiao
- The Second Affiliated Hospital (Jiande Branch), Zhejiang University School of Medicine, Jiande, Hangzhou, Zhejiang, China.
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Sasaki JI, Abe GL, Li A, Thongthai P, Tsuboi R, Kohno T, Imazato S. Barrier membranes for tissue regeneration in dentistry. Biomater Investig Dent 2021; 8:54-63. [PMID: 34104896 PMCID: PMC8158285 DOI: 10.1080/26415275.2021.1925556] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/29/2021] [Indexed: 12/14/2022] Open
Abstract
Background: In dentistry, barrier membranes are used for guided tissue regeneration (GTR) and guided bone regeneration (GBR). Various membranes are commercially available and extensive research and development of novel membranes have been conducted. In general, membranes are required to provide barrier function, biosafety, biocompatibility and appropriate mechanical properties. In addition, membranes are expected to be bioactive to promote tissue regeneration. Objectives: This review aims to organize the fundamental characteristics of the barrier membranes that are available and studied for dentistry, based on their components. Results: The principal components of barrier membranes are divided into nonbiodegradable and biodegradable materials. Nonbiodegradable membranes are manufactured from synthetic polymers, metals or composites of these materials. The first reported barrier membrane was made from expanded polytetrafluoroethylene (e-PTFE). Titanium has also been applied for dental regenerative therapy and shows favorable barrier function. Biodegradable membranes are mainly made from natural and synthetic polymers. Collagens are popular materials that are processed for clinical use by cross-linking. Aliphatic polyesters and their copolymers have been relatively recently introduced into GTR and GBR treatments. In addition, to improve the tissue regenerative function and mechanical strength of biodegradable membranes, inorganic materials such as calcium phosphate and bioactive glass have been incorporated at the research stage. Conclusions: Currently, there are still insufficient guidelines for barrier membrane choice in GTR and GBR, therefore dentists are required to understand the characteristics of barrier membranes.
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Affiliation(s)
- Jun-Ichi Sasaki
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Gabriela L. Abe
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Aonan Li
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Pasiree Thongthai
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Ririko Tsuboi
- Department of Advanced Functional Materials Science, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Tomoki Kohno
- Department of Advanced Functional Materials Science, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Satoshi Imazato
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Japan
- Department of Advanced Functional Materials Science, Osaka University Graduate School of Dentistry, Suita, Japan
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Yu X, Liao X, Chen H. Antibiotic-Loaded MMT/PLL-Based Coating on the Surface of Endosseous Implants to Suppress Bacterial Infections. Int J Nanomedicine 2021; 16:2983-2994. [PMID: 33907402 PMCID: PMC8071093 DOI: 10.2147/ijn.s299154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/01/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Bone infections remain one of the most common and serious complications of orthopedic surgery, posing a tremendous economic burden to society and patients. This is because bacteria colonize and multiply on the surface of the implant. The (MMT/PLL)8 multilayer films have been shown to effectively release antibiotics depending on the changes in the microenvironment. Here, vancomycin was loaded into the (MMT/PLL)8 multilayer films, which were prepared to be used as a local delivery system for the treatment of bone infections. METHODS We used the layer-by-layer self-assembly method to prepare VA-loaded coatings (MMT/PLL-VA)8 consisting of montmorillonite (MMT), poly-L-lysine (PLL), and VA. The thickness and surface morphology of coatings were characterized using spectroscopic ellipsometry and scanning electron microscopy (SEM). In order to evaluate the drug release behavior from coatings in different media, we measured the size of the zone of inhibition. Additionally, in vitro antibacterial activity was assessed using the shake-flask culture method and SEM images, while that of in vivo was evaluated by establishing an animal model of bone infection. RESULTS Our findings revealed that small-molecule antibiotics were successfully loaded into the (MMT/PLL-VA)8 multilayer film structure during the hierarchical self-assembly process and subsequently the multilayer film structure depicted linear growth behavior. The PLL in the multilayer films was progressively degraded which triggered the VA release when contacted with CMS or bacterial infections. The release of VA from multilayer film structure depends on the concentration changes of CMS. Notably, the multilayer films presented great in vitro cell compatibility. Moreover, the prepared antibacterial multilayer films showed excellent antibacterial property by killing more than 99.99% of S. aureus in 24 h. More importantly, we found that multilayer film exhibits good sterilization effect and biocompatibility under the stimulation of bacterial liquid both in vitro and in vivo antibacterial ability tests. CONCLUSION Altogether, this study shows that (MMT/PLL-VA)8 multilayer films containing CMS and bacteria-responsive drug release properties posess high bactericidal activity and good biocompatibility. This finding provides a novel strategy for the treatment of bone infections.
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Affiliation(s)
- Xingfang Yu
- Department of Orthopedics, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu, Zhejiang, 322000, People’s Republic of China
| | - Xin Liao
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China
| | - Hongwei Chen
- Department of Orthopedics, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu, Zhejiang, 322000, People’s Republic of China
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30
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Chen K, Zhou G, Li Q, Tang H, Wang S, Li P, Gu X, Fan Y. In vitro degradation, biocompatibility and antibacterial properties of pure zinc: assessing the potential of Zn as a guided bone regeneration membrane. J Mater Chem B 2021; 9:5114-5127. [PMID: 34128016 DOI: 10.1039/d1tb00596k] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Membrane exposure is a common complication after the guided bone regeneration (GBR) procedure and has a detrimental influence on the bone regeneration outcomes, while the commercially available GBR membranes show limited exposure tolerance. Recently, zinc (Zn) has been suggested as a promising material to be used as a barrier membrane in GBR therapy for bone augmentation. In this study, the degradation behavior in artificial saliva solution, cytotoxicity and antibacterial activity of pure Zn were investigated to explore its degradation and associated biocompatibility in the case of premature membrane exposure. The results indicated that the degradation rate of Zn in artificial saliva solution was about 31.42 μm year-1 after 28 days of immersion. The corrosion products on the Zn surface were mainly composed of Zn3(PO4)2, Ca3(PO4)2, CaHPO4, Zn5(CO3)2(OH)6 and ZnO. Besides, Zn presented an acceptable in vitro HGF cytocompatibility and a high antibacterial activity against Porphyromonas gingivalis. The preliminary results demonstrate that pure Zn exhibits appropriate degradation behavior, adequate cell compatibility and favorable antibacterial properties in the oral environment and is thus believed to sustain profitable function when membrane exposure occurs. The results provided new insights for understanding the exposure tolerance of Zn based membranes and are beneficial to their clinical applications.
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Affiliation(s)
- Kai Chen
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China.
| | - Gang Zhou
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China.
| | - Qing Li
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Hongyan Tang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China.
| | - Shanyu Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China.
| | - Ping Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China.
| | - Xuenan Gu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China.
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China.
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Biocompatibility and Immune Response of a Newly Developed Volume-Stable Magnesium-Based Barrier Membrane in Combination with a PVD Coating for Guided Bone Regeneration (GBR). Biomedicines 2020; 8:biomedicines8120636. [PMID: 33419327 PMCID: PMC7767206 DOI: 10.3390/biomedicines8120636] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/13/2020] [Accepted: 12/18/2020] [Indexed: 02/08/2023] Open
Abstract
To date, there are no bioresorbable alternatives to non-resorbable and volume-stable membranes in the field of dentistry for guided bone or tissue regeneration (GBR/GTR). Even magnesium (Mg) has been shown to constitute a favorable biomaterial for the development of stabilizing structures. However, it has been described that it is necessary to prevent premature degradation to ensure both the functionality and the biocompatibility of such Mg implants. Different coating strategies have already been developed, but most of them did not provide the desired functionality. The present study analyses a new approach based on ion implantation (II) with PVD coating for the passivation of a newly developed Mg membrane for GBR/GTR procedures. To demonstrate comprehensive biocompatibility and successful passivation of the Mg membranes, untreated Mg (MG) and coated Mg (MG-Co) were investigated in vitro and in vivo. Thereby a collagen membrane with an already shown biocompatibility was used as control material. All investigations were performed according to EN ISO 10993 regulations. The in vitro results showed that both the untreated and PVD-coated membranes were not cytocompatible. However, both membrane types fulfilled the requirements for in vivo biocompatibility. Interestingly, the PVD coating did not have an influence on the gas cavity formation compared to the uncoated membrane, but it induced lower numbers of anti-inflammatory macrophages in comparison to the pure Mg membrane and the collagen membrane. In contrast, the pure Mg membrane provoked an immune response that was fully comparable to the collagen membrane. Altogether, this study shows that pure magnesium membranes represent a promising alternative compared to the nonresorbable volume-stable materials for GBR/GTR therapy.
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Xu Y, Zhao S, Weng Z, Zhang W, Wan X, Cui T, Ye J, Liao L, Wang X. Jelly-Inspired Injectable Guided Tissue Regeneration Strategy with Shape Auto-Matched and Dual-Light-Defined Antibacterial/Osteogenic Pattern Switch Properties. ACS APPLIED MATERIALS & INTERFACES 2020; 12:54497-54506. [PMID: 33226209 DOI: 10.1021/acsami.0c18070] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Periodontitis is a bacterial infectious disease leading to the loss of periodontal supporting tissues and teeth. The current guided tissue regeneration (GTR) membranes for periodontitis treatments cannot effectively promote tissue regeneration for the limited antibacterial properties and the excessively fast degradation rate. Besides, they need extra tailoring according to variform defects before implantation, leading to imprecise match. This study proposed an injectable sodium alginate hydrogel composite (CTP-SA) doped with cubic cuprous oxide (Cu2O) and polydopamine-coated titanium dioxide (TiO2@PDA) nanoparticles for GTR. Inspired by the gelation process of the jelly, the phase change (liquid to solid) of CTP-SA after injection could automatch variform bone defects. Meanwhile, CTP-SA exhibited broad-spectrum antibacterial capabilities under blue light (BL) irradiation, including Streptococcus mutans (one of the most abundant bacteria in oral biofilms). Moreover, the reactive oxygen species released under BL excitation could accelerate the oxidation of Cu+ to Cu2+. Afterward, osteogenesis could be enhanced through two factors simultaneously: the stimulation of newly formed Cu2+ and the photothermal effect of CTP-SA under near-infrared (NIR) irradiation. Collectively, through this dual-light (blue and NIR) noninvasive regulation, CTP-SA could switch antibacterial and osteogenic modes to address requirements of patients at different healing stages, thereby realizing the customized GTR procedures.
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Affiliation(s)
- Yingying Xu
- Affiliated Stomatological Hospital, Nanchang University, Nanchang, Jiangxi 330006, P. R. China
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, Jiangxi 330088, P. R. China
- Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi 330006, P. R. China
| | - Siyu Zhao
- Affiliated Stomatological Hospital, Nanchang University, Nanchang, Jiangxi 330006, P. R. China
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, Jiangxi 330088, P. R. China
- Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi 330006, P. R. China
| | - Zhenzhen Weng
- College of Chemistry, Nanchang University, Nanchang, Jiangxi 330088, P. R. China
| | - Wei Zhang
- College of Chemistry, Nanchang University, Nanchang, Jiangxi 330088, P. R. China
| | - Xinyi Wan
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, Jiangxi 330088, P. R. China
| | - Tongcan Cui
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, Jiangxi 330088, P. R. China
| | - Jing Ye
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, Jiangxi 330088, P. R. China
| | - Lan Liao
- Affiliated Stomatological Hospital, Nanchang University, Nanchang, Jiangxi 330006, P. R. China
- Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi 330006, P. R. China
| | - Xiaolei Wang
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, Jiangxi 330088, P. R. China
- College of Chemistry, Nanchang University, Nanchang, Jiangxi 330088, P. R. China
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Turri A, Čirgić E, Shah FA, Hoffman M, Omar O, Dahlin C, Trobos M. Early plaque formation on PTFE membranes with expanded or dense surface structures applied in the oral cavity of human volunteers. Clin Exp Dent Res 2020; 7:137-146. [PMID: 33169543 PMCID: PMC8019762 DOI: 10.1002/cre2.344] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/20/2020] [Accepted: 08/23/2020] [Indexed: 12/14/2022] Open
Abstract
Objectives This clinical randomized study aimed to evaluate the early plaque formation on nonresorbable polytetrafluoroethylene (PTFE) membranes having either a dense (d‐PTFE) or an expanded (e‐PTFE) microstructure and exposed to the oral cavity. Material and Methods Twelve individuals were enrolled in this study. In a split‐mouth design, five test membranes (e‐PTFE) with a dual‐layer configuration and five control membranes (d‐PTFE) were bonded on the buccal surfaces of posterior teeth of each subject. All study subjects refrained from toothbrushing during the study period. Specimens were detached from the teeth at 4 and 24 hr and subjected to viability counting, confocal microscopy, and scanning electron microscopy. Plaque samples were harvested from neighboring teeth at baseline, 4, and 24 hr, as control. Wilcoxon signed rank test was applied. Results No bond failure of the membranes was reported. Between the early and late time points, viable bacterial counts increased on all membranes, with no difference between the test and control. The number of Staphylococcus spp. decreased on the tooth surfaces and increased on both membranes overtime, with a significant difference compared to teeth. The total biomass and average biofilm thickness of live and dead cells were significantly greater at the d‐PTFE barriers after 4 hr. Conclusion This study demonstrated that the e‐PTFE membrane was associated with a lesser degree of biofilm accumulation during the initial exposure compared to the d‐PTFE membrane. The present experimental setup provides a valuable toolbox to study the in vivo behavior of different membranes used in guided bone regeneration (GBR).
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Affiliation(s)
- Alberto Turri
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,The Brånemark Clinic, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Emina Čirgić
- Department of Orthodontics, University Clinics of Odontology, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.,Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Furqan A Shah
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Hoffman
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Omar Omar
- Vice Deanship for Postgraduate Studies and Scientific Research, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Oral, Maxillofacial Surgery and Research and Development, NU-Hospital Organisation, Trollhättan, Sweden
| | - Margarita Trobos
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Wang HC, Wang Y, Long X, Wang X. Mandibular osteomyelitis after hyaluronic acid injection. J Cosmet Dermatol 2020; 20:457-459. [PMID: 32592232 DOI: 10.1111/jocd.13575] [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: 04/02/2020] [Revised: 05/26/2020] [Accepted: 06/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mandibular osteomyelitis after filler injection is extremely rare. AIMS We reported a case of mandibular osteomyelitis after hyaluronic acid injection. PATIENTS A 33-year-old woman received 1 mL hyaluronic acid injection on her chin 1 year ago, after which her chin kept swelling and painful, and gradually ulcerated with pus flowing out. She received antibiotics, debridement procedures, negative pressure wound therapy, and hyperbaric oxygen therapy without symptoms improved. Cone-beam computed tomography scan showed local bone destruction, sequestrum formation, and tissue calcification on the right mandible body. The patient was diagnosed with mandibular osteomyelitis and received local curettage for the removal of necrotized bone. RESULTS Literature search found no case reports on mandibular osteomyelitis after filler injection so far. CONCLUSION Minimizing the risk of contamination and infection is strictly required during the filler injection process. Once the patient shows signs of incurable mandibular infection postoperation, clinicians should consider the possibility of osteomyelitis.
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Affiliation(s)
- Hayson Chenyu Wang
- Department of Plastic surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.,Nuffield Department of Surgical Science, University of Oxford, Oxford, UK
| | - Yunting Wang
- Department of Stomatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao Long
- Department of Plastic surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaojun Wang
- Department of Plastic surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Guo H, Xia D, Zheng Y, Zhu Y, Liu Y, Zhou Y. A pure zinc membrane with degradability and osteogenesis promotion for guided bone regeneration: In vitro and in vivo studies. Acta Biomater 2020; 106:396-409. [PMID: 32092431 DOI: 10.1016/j.actbio.2020.02.024] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 01/30/2020] [Accepted: 02/18/2020] [Indexed: 12/11/2022]
Abstract
Selection of an appropriate membrane material for guided bone regeneration (GBR) is still ongoing among resorbable and nonresorbable membranes with different characteristics. The major problem with nonresorbable membranes is the inevitable secondary surgery, while resorbable polymer membranes have limitations in providing sufficient mechanical support during the bone repair period due to premature loss of mechanical strength. Pure magnesium foil has been evaluated to explore its feasibility as a resorbable GBR membrane. It exhibited better mechanical properties, whereas poor formability and fast degradation rate were noted. In light of this, pure zinc membrane was developed as a pilot research in this paper. We designed three types of pure zinc membranes: pure Zn without pores, pure Zn with 300 µm diameter and 1000 µm diameter pores, and pure titanium without pores as a control. The mechanical property, in vitro immersion tests, and MC3T3-E1 cell viability assays were tested. Moreover, in vivo behaviors of three type zinc membranes were evaluated by using a rat calvarial critical-sized bone defect model. The experimental results indicated that pure Zn membrane with 300 µm pores showed the most favorable osteogenic capability, comparable to that of titanium membrane without pores. Therefore, considering appropriate degradation rate, adequate mechanical maintenance, and profitable osteogenic capacity, metallic pure zinc is believed to be a promising candidate for barrier membranes in GBR therapy for bone regeneration, and its mechanical property can be enhanced with further alloying. STATEMENT OF SIGNIFICANCE: Metallic element zinc plays a pivotal role in the growth and mineralization of bone tissues. As a pilot research, three type of guided bone regeneration (GBR) membranes were developed in the present work: pure Zn without pores, pure Zn with 300 µm-diameter and 1000 µm-diameter pores respectively. The mechanical property, in vitro immersion tests and MC3T3-E1 cell viability assays were tested, with pure titanium without pores as a control, thereafter the in vivo performance were evaluated by using a rat calvarial critical-sized bone defect model. It indicated that pure Zn membrane with 300 µm pores showed the most favorable osteogenic capability, comparable to that of titanium membrane control, and is believed to be a promising material candidate as barrier membrane in GBR therapy for bone regeneration.
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Implant-Supported Rehabilitation Using GBR Combined with Bone Graft on a Reconstructed Maxilla with the Fibula Free Flap. Case Rep Dent 2019; 2019:2713542. [PMID: 31781408 PMCID: PMC6875248 DOI: 10.1155/2019/2713542] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/27/2019] [Indexed: 12/26/2022] Open
Abstract
Alveolar ridge augmentation procedures allow restoring jaw defects due to teeth extractions, periodontal diseases, trauma, or outcomes from a previous surgery. This case report describes a patient suffering from Fibrous Dysplasia of the right upper maxilla surgically reconstructed by fibula free flap. In 2003, four dental implants were placed in the 1.2, 1.3, 1.5, and 1.6 areas. Twelve years later, the onset of peri-implantitis led to the failure of osseointegration with consequent thinning of the fibula flap. To avoid the risk of fracture and to restore the bone volumes necessary for a new implant-prosthetic rehabilitation, we used heterologous biomaterials in combination with a non-reabsorbable membrane, according to the Guided Bone Regeneration (GBR) technique. GBR was performed using the Equimatrix® natural bone mineral matrix, Cytoplast™ Ti-150, a non-reabsorbable titanium-reinforced membrane, and four fastening screws to pin the membrane. After six months, the membrane was removed and two Zimmer® implants 3.7 × 13 mm were placed in the 1.1 and 1.2 areas. A fixed implant-supported prosthesis with a custom-milled titanium bar screwed to the implants was made. Computed tomography (CT) six months after GBR showed a good bone regeneration of 1.5 cm mesiodistal (MD), 1.8 cm buccopalatal (BP), and 2.8 cm in height. The main difficulty of this clinical case concerns the low predictability of success of GBR on a maxillary reconstructed area with a free fibula flap: there is no previous evidence in the literature. Clinical and radiographic exams nowadays show that there is no macroscopic bone reabsorption; however, further research is needed to obtain more information.
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Magnetodielectric Effects in Magnetorheological Elastomers Based on Polymer Fabric, Silicone Rubber, and Magnetorheological Suspension. ADVANCES IN POLYMER TECHNOLOGY 2019. [DOI: 10.1155/2019/1983547] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We fabricate a hybrid magnetorheological elastomer (hMRE) based on a microfiber cloth soaked with a mixture containing magnetorheological suspension (MRS) and silicone rubber (SR). Two parallel copper electrodes are attached to the hMRE and the capacitance C is measured as a function of time t, for fixed values of magnetic flux density B. We show that C is stable in time and is sensibly influenced by B, while the relative dielectric permittivity increases up to two orders of magnitude when B reaches 340 mT. We explain the physical mechanism which leads to the observed magnetodielectric effects. The obtained results can be used for various biomedical applications such as in fabrication of active biomagnetic membranes used in dental implantology.
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Korzinskas T, Jung O, Smeets R, Stojanovic S, Najman S, Glenske K, Hahn M, Wenisch S, Schnettler R, Barbeck M. In Vivo Analysis of the Biocompatibility and Macrophage Response of a Non-Resorbable PTFE Membrane for Guided Bone Regeneration. Int J Mol Sci 2018; 19:E2952. [PMID: 30262765 PMCID: PMC6213856 DOI: 10.3390/ijms19102952] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 09/19/2018] [Accepted: 09/25/2018] [Indexed: 01/12/2023] Open
Abstract
The use of non-resorbable polytetrafluoroethylene (PTFE) membranes is indicated for the treatment of large, non-self-containing bone defects, or multi-walled defects in the case of vertical augmentations. However, less is known about the molecular basis of the foreign body response to PTFE membranes. In the present study, the inflammatory tissue responses to a novel high-density PTFE (dPTFE) barrier membrane have preclinically been evaluated using the subcutaneous implantation model in BALB/c mice by means of histopathological and histomorphometrical analysis methods and immunohistochemical detection of M1- and M2-macrophages. A collagen membrane was used as the control material. The results of the present study demonstrate that the tissue response to the dPTFE membrane involves inflammatory macrophages, but comparable cell numbers were also detected in the implant beds of the control collagen membrane, which is known to be biocompatible. Although these data indicate that the analyzed dPTFE membrane is not fully bioinert, but its biocompatibility is comparable to collagen-based membranes. Based on its optimal biocompatibility, the novel dPTFE barrier membrane may optimally support bone healing within the context of guided bone regeneration (GBR).
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Affiliation(s)
- Tadas Korzinskas
- Section for Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Ole Jung
- Section for Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Ralf Smeets
- Section for Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Sanja Stojanovic
- Institute of Biology and Human Genetics, Department for Cell and Tissue Engineering, University of Niš, Faculty of Medicine, 18106 Niš, Serbia.
| | - Stevo Najman
- Institute of Biology and Human Genetics, Department for Cell and Tissue Engineering, University of Niš, Faculty of Medicine, 18106 Niš, Serbia.
| | - Kristina Glenske
- Clinic of Small Animals, c/o Institute of Veterinary Anatomy, Histology and Embryology, Justus Liebig University of Giessen, 35390 Giessen, Germany.
| | - Michael Hahn
- Department of Osteology and Biomechanics, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Sabine Wenisch
- Clinic of Small Animals, c/o Institute of Veterinary Anatomy, Histology and Embryology, Justus Liebig University of Giessen, 35390 Giessen, Germany.
| | - Reinhard Schnettler
- University Medical Center, Justus Liebig University of Giessen, 35390 Giessen, Germany.
| | - Mike Barbeck
- Section for Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany.
- BerlinAnalytix GmbH, 12109 Berlin, Germany.
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