1
|
Shanbhag S, Kampleitner C, Sanz-Esporrin J, Lie SA, Gruber R, Mustafa K, Sanz M. Regeneration of alveolar bone defects in the experimental pig model: A systematic review and meta-analysis. Clin Oral Implants Res 2024; 35:467-486. [PMID: 38450852 DOI: 10.1111/clr.14253] [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: 12/05/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Pigs are emerging as a preferred experimental in vivo model for bone regeneration. The study objective was to answer the focused PEO question: in the pig model (P), what is the capacity of experimental alveolar bone defects (E) for spontaneous regeneration in terms of new bone formation (O)? METHODS Following PRISMA guidelines, electronic databases were searched for studies reporting experimental bone defects or extraction socket healing in the maxillae or mandibles of pigs. The main inclusion criteria were the presence of a control group of untreated defects/sockets and the assessment of regeneration via 3D tomography [radiographic defect fill (RDF)] or 2D histomorphometry [new bone formation (NBF)]. Random effects meta-analyses were performed for the outcomes RDF and NBF. RESULTS Overall, 45 studies were included reporting on alveolar bone defects or extraction sockets, most frequently in the mandibles of minipigs. Based on morphology, defects were broadly classified as 'box-defects' (BD) or 'cylinder-defects' (CD) with a wide range of healing times (10 days to 52 weeks). Meta-analyses revealed pooled estimates (with 95% confidence intervals) of 50% RDF (36.87%-63.15%) and 43.74% NBF (30.47%-57%) in BD, and 44% RDF (16.48%-71.61%) and 39.67% NBF (31.53%-47.81%) in CD, which were similar to estimates of socket-healing [48.74% RDF (40.35%-57.13%) and 38.73% NBF (28.57%-48.89%)]. Heterogeneity in the meta-analysis was high (I2 > 90%). CONCLUSION A substantial body of literature revealed a high capacity for spontaneous regeneration in experimental alveolar bone defects of (mini)pigs, which should be considered in future studies of bone regeneration in this animal model.
Collapse
Affiliation(s)
- Siddharth Shanbhag
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Carina Kampleitner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, The Research Center in Cooperation with AUVA, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Javier Sanz-Esporrin
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Stein-Atle Lie
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Reinhard Gruber
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Kamal Mustafa
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Mariano Sanz
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| |
Collapse
|
2
|
Wang D, Zhou X, Cao H, Zhang H, Wang D, Guo J, Wang J. Barrier membranes for periodontal guided bone regeneration: a potential therapeutic strategy. FRONTIERS IN MATERIALS 2023; 10. [DOI: 10.3389/fmats.2023.1220420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Abstract
Periodontal disease is one of the most common oral diseases with the highest incidence world-wide. In particular, the treatment of periodontal bone defects caused by periodontitis has attracted extensive attention. Guided bone regeneration (GBR) has been recognized as advanced treatment techniques for periodontal bone defects. GBR technique relies on the application of barrier membranes to protect the bone defects. The commonly used GBR membranes are resorbable and non-resorbable. Resorbable GBR membranes are divided into natural polymer resorbable membranes and synthetic polymer resorbable membranes. Each has its advantages and disadvantages. The current research focuses on exploring and improving its preparation and application. This review summarizes the recent literature on the application of GBR membranes to promote the regeneration of periodontal bone defects, elaborates on GBR development strategies, specific applications, and the progress of inducing periodontal bone regeneration to provide a theoretical basis and ideas for the future application of GBR membranes to promote the repair of periodontal bone defects.
Collapse
|
3
|
Liu Y, Zhao Y, Zhu W, Han M, Mi F, Wang B. Comprehensive reparative effects of bacteriostatic poly(L-lactide-co-glycolide)/poly(L-lactide-co-ε-caprolactone) electrospinning membrane on alveolar bone defects in progressive periodontitis. J Biomed Mater Res B Appl Biomater 2023; 111:513-525. [PMID: 36196879 DOI: 10.1002/jbm.b.35168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/06/2022] [Accepted: 09/14/2022] [Indexed: 01/21/2023]
Abstract
Periodontitis is a chronic inflammatory disease that leads to the loss of alveolar bone, among several studies focusing on reconstructing periodontal bone caused by periodontitis, guided bone regeneration (GBR) is a promising approach. In this study a serial clinically applied antibiotics loaded poly(L-lactide-co-glycolide)/poly(L-lactide-co-ε-caprolactone) (PLGA/PLCA) fibrous mesh to prevent and reconstruct defective bone in periodontitis were prepared by electrospinning. Incorporation of antibiotics promoted the hydrophilicity but decreased the crystallinity of PLGA/PLCA membranes. Antibiotics could be sustained released from membranes. Metronidazole, minocycline, and doxycycline incorporated membranes could suppress Porphyromonas gingivalis (P. gingivalis) within 21 days in vitro. Metronidazole and minocycline incorporated membranes decreased 41% and 55.5% colony counts in rat gingival crevicular fluid in vivo. Minocycline-loaded membrane could support the proliferation of MC3T3-E1 cells and maintained 79% viability of human ligament fibroblasts cultured on it. And MC3T3-E1 cells could undergo osteoblastic differentiation when cultured with pure PLGA/PLCA membrane and minocycline incorporated membrane. Then in vivo repairable effects of those antibiotics loaded membranes were evaluated in alveolar bone defected P. gingivalis infected model. The application of minocycline loaded membranes, effectively prevented the bone resorption of periodontitis caused by P. gingivalis. After been treated with minocycline incorporated membrane, volume of defected bone of maintained at about 50% level of control rats. 8 weeks post-operation, newly regenerated bone was observed in the operative alveolar bone of the pure PLGA/PLCA membrane, metronidazole and minocycline incorporated PLGA/PLCA membrane treated groups. Minocycline/PLGA/PLCA electrospinning membrane is a promising GBR material that can be applied to guide regeneration of periodontitis-induced alveolar bone damage.
Collapse
Affiliation(s)
- Yiming Liu
- Department of Stomatology, North Sichuan Medical College & Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yun Zhao
- Department of Stomatology, North Sichuan Medical College & Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Wanchun Zhu
- Department of Stomatology, North Sichuan Medical College & Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Mei Han
- Department of Stomatology, North Sichuan Medical College & Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Fanglin Mi
- Department of Stomatology, North Sichuan Medical College & Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Bing Wang
- Department of Chemistry, School of Pharmacy, North Sichuan Medical College, Nanchong, China
| |
Collapse
|
4
|
Thieu MKL, Stoetzel S, Rahmati M, El Khassawna T, Verket A, Sanz-Esporrin J, Sanz M, Ellingsen JE, Haugen HJ. Immunohistochemical comparison of lateral bone augmentation using a synthetic TiO 2 block or a xenogeneic graft in chronic alveolar defects. Clin Implant Dent Relat Res 2023; 25:57-67. [PMID: 36222116 PMCID: PMC10092822 DOI: 10.1111/cid.13143] [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: 07/14/2022] [Revised: 08/28/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate osteogenic markers and alveolar ridge profile changes in guided bone regeneration (GBR) of chronic noncontained bone defects using a nonresorbable TiO2 block. MATERIALS AND METHODS Three buccal bone defects were created in each hemimandible of eight beagle dogs and allowed to heal for 8 weeks before GBR. Treatment was assigned by block randomization: TiO2 block: TiO2 -scaffold and a collagen membrane, DBBM particulates: Deproteinized bovine bone mineral (DBBM) and a collagen membrane, Empty control: Only collagen membrane. Bone regeneration was assessed on two different healing timepoints: early (4 weeks) and late healing (12 weeks) using several immunohistochemistry markers including alpha-smooth muscle actin (α-SMA), osteopontin, osteocalcin, tartrate-resistant acid phosphatase, and collagen type I. Histomorphometry was performed on Movat Pentachrome-stained and Von Kossa/Van Gieson-stained sections. Stereolithographic (STL) models were used to compare alveolar profile changes. RESULTS The percentage of α-SMA and osteopontin increased in TiO2 group after 12 weeks of healing at the bone-scaffold interface, while collagen type I increased in the empty control group. In the defect area, α-SMA decreased in the empty control group, while collagen type I increased in the DBBM group. All groups maintained alveolar profile from 4 to 12 weeks, but TiO2 group demonstrated the widest soft tissue contour profile. CONCLUSIONS The present findings suggested contact osteogenesis when GBR is performed with a TiO2 block or DBBM particulates. The increase in osteopontin indicated a potential for bone formation beyond 12 weeks. The alveolar profile data indicated a sustained lateral increase in lateral bone augmentation using a TiO2 block and a collagen membrane, as compared with DBBM and a collagen membrane or a collagen membrane alone.
Collapse
Affiliation(s)
- Minh Khai Le Thieu
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.,Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Sabine Stoetzel
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Maryam Rahmati
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Thaqif El Khassawna
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Anders Verket
- Department of Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig University Giessen, Giessen, Germany
| | | | - Mariano Sanz
- Periodontology, University Complutense of Madrid, Madrid, Spain
| | - Jan Eirik Ellingsen
- Department of Prosthetics and Oral Function, University of Oslo, Oslo, Norway
| | - Håvard Jostein Haugen
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| |
Collapse
|
5
|
Schröder M, Reseland JE, Haugen HJ. Osteoblasts in a Perfusion Flow Bioreactor—Tissue Engineered Constructs of TiO2 Scaffolds and Cells for Improved Clinical Performance. Cells 2022; 11:cells11131995. [PMID: 35805079 PMCID: PMC9265932 DOI: 10.3390/cells11131995] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 01/25/2023] Open
Abstract
Combining biomaterial scaffolds with cells serves as a promising strategy for engineering critical size defects; however, homogenous cellular growth within large scaffolds is challenging. Mechanical stimuli can enhance bone regeneration by modulating cellular growth and differentiation. Here, we compare dynamic seeding in a perfusion flow bioreactor with static seeding for a synthetic bone scaffold for up to 21 days using the cell line MC3T3-E1 and primary human osteoblast, confocal laser scanning microscopy, and real-time reverse transcriptase-polymerase chain reaction. The secretion of bone-related proteins was quantified using multiplex immunoassays. Dynamic culture improved cellular distribution through the TiO2 scaffold and induced a five-fold increase in cell number after 21 days. The relative mRNA expression of osteopontin of MC3T3-E1 was 40-fold enhanced after 7 and 21 days at a flow rate of 0.08 mL/min, and that of collagen type I alpha I expression was 18-fold after 21 days. A flow rate of 0.16 mL/min was 10-fold less effective. Dynamic culture increased the levels of dickkopf-related protein 1 (60-fold), osteoprotegrin (29-fold), interleukin-6 (23-fold), interleukin-8 (36-fold), monocyte chemoattractant protein 1 (28-fold) and vascular endothelial growth factor (6-fold) in the medium of primary human osteoblasts after 21 days compared to static seeding. The proposed method may have clinical potential for bone tissue engineering.
Collapse
|
6
|
Le Thieu MK, Homayouni A, Hæren LR, Tiainen H, Verket A, Ellingsen JE, Rønold HJ, Wohlfahrt JC, Cantalapiedra AG, Muñoz FMG, Mendaña MP, Lyngstadaas SP, Haugen HJ. Impact of simultaneous placement of implant and block bone graft substitute: an in vivo peri-implant defect model. Biomater Res 2021; 25:43. [PMID: 34823602 PMCID: PMC8620131 DOI: 10.1186/s40824-021-00245-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/15/2021] [Indexed: 12/31/2022] Open
Abstract
Background Insufficient bone volume around an implant is a common obstacle when dental implant treatment is considered. Limited vertical or horizontal bone dimensions may lead to exposed implant threads following placement or a gap between the bone and implant. This is often addressed by bone augmentation procedures prior to or at the time of implant placement. This study evaluated bone healing when a synthetic TiO2 block scaffold was placed in circumferential peri-implant defects with buccal fenestrations. Methods The mandibular premolars were extracted and the alveolar bone left to heal for 4 weeks prior to implant placement in six minipigs. Two cylindrical defects were created in each hemi-mandible and were subsequent to implant placement allocated to treatment with either TiO2 scaffold or sham in a split mouth design. After 12 weeks of healing time, the samples were harvested. Microcomputed tomography (MicroCT) was used to investigate defect fill and integrity of the block scaffold. Distances from implant to bone in vertical and horizontal directions, percentage of bone to implant contact and defect fill were analysed by histology. Results MicroCT analysis demonstrated no differences between the groups for defect fill. Three of twelve scaffolds were partly fractured. At the buccal sites, histomorphometric analysis demonstrated higher bone fraction, higher percentage bone to implant contact and shorter distance from implant top to bone 0.5 mm lateral to implant surface in sham group as compared to the TiO2 group. Conclusions This study demonstrated less bone formation with the use of TiO2 scaffold block in combination with implant placement in cylindrical defects with buccal bone fenestrations, as compared to sham sites.
Collapse
Affiliation(s)
- Minh Khai Le Thieu
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Amin Homayouni
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Lena Ringsby Hæren
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Hanna Tiainen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Anders Verket
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Jan Eirik Ellingsen
- Department of Prosthetic Dentistry and Oral Function, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hans Jacob Rønold
- Department of Prosthetic Dentistry and Oral Function, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Johan Caspar Wohlfahrt
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Antonio Gonzalez Cantalapiedra
- Universidade de Santiago de Compostela, Facultad de Veterinaria, Campus Universitario, s/n, 27002, Lugo, Spain.,Ibonelab S.L., Laboratory of Biomaterials, Avda. da Coruña, 500 (CEI-NODUS), 27003, Lugo, Spain
| | - Fernando Maria Guzon Muñoz
- Universidade de Santiago de Compostela, Facultad de Veterinaria, Campus Universitario, s/n, 27002, Lugo, Spain.,Ibonelab S.L., Laboratory of Biomaterials, Avda. da Coruña, 500 (CEI-NODUS), 27003, Lugo, Spain
| | - Maria Permuy Mendaña
- Universidade de Santiago de Compostela, Facultad de Veterinaria, Campus Universitario, s/n, 27002, Lugo, Spain.,Ibonelab S.L., Laboratory of Biomaterials, Avda. da Coruña, 500 (CEI-NODUS), 27003, Lugo, Spain
| | - Ståle Petter Lyngstadaas
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway.
| |
Collapse
|