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Wang Y, Xia Y, Qian J, Xie Y, Shu R, Lin Z. Native vs. ribosome-crosslinked collagen membranes for periodontal regeneration: A randomized clinical trial. J Periodontal Res 2024. [PMID: 38962931 DOI: 10.1111/jre.13321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/05/2024]
Abstract
AIM To evaluate whether the ribosome-crosslinked collagen membrane (RCCM) is non-inferior to the natural collagen membrane (NCM) used in regeneration surgery in terms of clinical attachment level (CAL) gain at 6 months. METHODS Eighty patients diagnosed as generalized periodontitis presenting with isolated infrabony defect (≥4 mm deep) were enrolled and randomized to receive regenerative surgery, either with NCM or RCCM, both combined with deproteinized bovine bone mineral (DBBM). CAL, pocket probing depth (PPD), and gingival recession (GR) were recorded at baseline, 3, and 6 months postoperatively. Periapical radiographs were taken at baseline, immediately, and 6 months after surgery. Early wound healing index (EHI) and patients' responses were recorded at 2 weeks postoperatively. RESULTS At 6 months post-surgery, the mean CAL gain was 3.1 ± 1.5 mm in the NCM group and 2.9 ± 1.5 mm in the RCCM group, while the mean PPD was 4.3 ± 1.1 mm in the NCM group and 4.2 ± 1.0 mm in the RCCM group. Both groups demonstrated a statistically significant improvement from the baseline (p < .01). RCCM was non-inferior to NCM concerning the primary outcome (CAL gain at 6 months). The GR at 6 months postoperatively was 1.3 ± 1.2 and 1.2 ± 1.1 mm, which showed no difference compared with baseline. At 6 months follow-up, the radiographic linear bone fill (RLBF) was 6.5 ± 2.8 and 5.5 ± 2.6 mm (p > .05), while the bone fill percentage (BF%) was 102.3 ± 53.5% and 92.3 ± 40.1% (p > .05), in the NCM and RCCM groups, respectively. There was no significant difference in EHI and postoperative responses between two groups. CONCLUSION RCCM + DBBM resulted in no-inferior clinical and radiographic outcomes to NCM + DBBM for the treatment of isolated infrabony defect in 6 months.
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Affiliation(s)
- Yiwei Wang
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yiru Xia
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Department of Periodontology, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Jielei Qian
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yufeng Xie
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Department of Periodontology, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Rong Shu
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhikai Lin
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
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van Orten A, Goetz W, Bilhan H. A Novel Prehydrated Porcine-Derived Acellular Dermal Matrix: A Histological and Clinical Evaluation. Int J Biomater 2024; 2024:7322223. [PMID: 38966862 PMCID: PMC11223909 DOI: 10.1155/2024/7322223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/22/2024] [Accepted: 06/06/2024] [Indexed: 07/06/2024] Open
Abstract
It is well known that soft tissue quality and quantity around dental implants is of paramount importance for later peri-implant health. For this purpose, the clinical and histological outcomes of the peri-implant mucosa, following soft tissue augmentation for soft tissue improvement with a novel prehydrated porcine acellular dermal matrix graft (PPADMG) in conjunction with simultaneous implant placement, were evaluated in this case series. Twenty-two patients were included in the study. They underwent a late implant placement protocol combined with PPADMG for soft tissue augmentation. A punch biopsy was taken at the time of uncovery of the submerged healed implant after a mean of 157 days healing time. Supracrestal soft tissue height (STH) was measured at the time of implant placement and uncovery. All sites showed a clinical increase in STH. The histological structure of the biopsies resembled a similar structure as found in the healthy oral mucosa. No unexpected tissue reactions could be found. Within the limits of this clinical and histological study, it may be concluded that STH improvement with this novel porcine-derived acellular dermal matrix, in combination with simultaneous implant placement, is a viable option to create a peri-implant tissue thickness and stability.
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Affiliation(s)
- Andreas van Orten
- Private Dental Practice Do24, Dortmunder Str. 24–28, 45731 Waltrop, Germany
| | - Werner Goetz
- Policlinic of OrthodonticsCentre for Dental CareBasic Science Research in Oral BiologyFriedrich-Wilhelms University, Welschnonnenstr. 17, 53111 Bonn, Germany
| | - Hakan Bilhan
- Department of PeriodontologySchool for Health SciencesWitten/Herdecke University, Alfred-Herrhausen-Str. 45, 58448 Witten, Germany
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Zhao R, Zhang Z, Yang P, Xu X, Yuan Z, Gong J. Efficacy of bone ring grafts for the reconstruction of alveolar ridge deficiencies: a systematic review. Part II: animal trials. Ann Med Surg (Lond) 2024; 86:2963-2975. [PMID: 38694314 PMCID: PMC11060297 DOI: 10.1097/ms9.0000000000001952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/04/2024] [Indexed: 05/04/2024] Open
Abstract
Background Bone ring (BR) grafts have been introduced to reconstruct alveolar ridge defects with simultaneous implant placement, but their clinical effectiveness remains undetermined. The aim of the current systematic review was to critically appraise evidence from animal studies regarding the effectiveness of BR grafts in alveolar ridge reconstruction and their variations under different surgical protocols. Methods Electronic retrieval of six databases (MEDLINE, Embase, Cochrane Library, ScienceDirect, Web of Science, and Scopus) and citation search until 11 October 2023, for animal studies on bone augmentation employing BR grafts. The outcome variables were total bone area (BA), bone volume (BV), bone-implant contact (BIC), and histology. The protocol was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and prospectively registered with PROSPERO (CRD42023453949). Results Ten studies were included in the qualitative analysis according to the screening criteria. Two studies demonstrated favorable bone remodeling and osseointegration of the BR with both the implant and pristine bone. A comparative study between autogenous BRs and allogenic BRs reported a higher percentage of BA and BIC at 4 months of healing, but conflicting data were observed at 8 months. Another study indicated a significant advantage of autogenous BRs over bovine and biphasic ceramic BRs in terms of BA and BIC after 5 weeks. Three studies found that using collagen membranes did not significantly affect BA, BV, or BIC when used simultaneously with autogenous BRs during implant placement. Two studies evaluated one-stage and two-stage implant placement in conjunction with BR grafts, revealing similar levels of BA, BV, and BIC except for differences in total treatment time. Furthermore, one study found that the use of mucogingival junction incision and split-thickness flap significantly reduced the incidence of wound dehiscence compared with conventional incision and flap. Conclusions Vertical bone augmentation surgery utilizing BR grafts with one-stage implant placement yielded histological and histomorphometric outcomes comparable to those achieved with two-stage implant placement or the additional application of collagen membrane.
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Affiliation(s)
- Ruimin Zhao
- Department of Stomatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City
| | - Zhelun Zhang
- Department of Stomatology, Longyou Traditional Chinese Medicine Hospital, Zhejiang
| | - Peixuan Yang
- Department of Stomatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City
| | - Xu Xu
- Department of Stomatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City
- School of Stomatology, Zhejiang Chinese Medicine University, Zhejiang, People’s Republic of China
| | - Zhenfei Yuan
- Department of Stomatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City
| | - Jiaming Gong
- Department of Stomatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City
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Stricher M, Vigneron P, Delbecq F, Sarde CO, Egles C. The microalga Volvox carteri as a cell supportive building block for tissue engineering. Mater Today Bio 2024; 25:101013. [PMID: 38464496 PMCID: PMC10923841 DOI: 10.1016/j.mtbio.2024.101013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/18/2024] [Accepted: 02/26/2024] [Indexed: 03/12/2024] Open
Abstract
Background V. carteri f. nagariensis constitutes, in its most simplified form, a cellularized spheroid built around and stabilised by a form of primitive extracellular matrix (ECM). Methods We developed a modular approach to soft tissue engineering, by compact stacking V. carteri-based building blocks. This approach is made possible by the structure and cell adhesive properties of these building blocks, which results from the composition of their algal ECM. Results A primary biocompatibility assessment demonstrated the cytocompatibility of the algal suspension, its histogenesis-promoting properties, and that it did not induce an inflammatory response in vitro. These results allowed us to consider the use of this algal suspension for soft tissue augmentation, and to initiate an in vivo biocompatibility study. V. carteri exhibited cellular fate-directing properties, causing (i) fibroblasts to take on an alkaline phosphatase+ stem-cell-like phenotype and (ii) both human adipose-derived stem cells and mouse embryonic stem cells to differentiate into preadipocytes to adipocytes. The ability of V. carteri to support histogenesis and adipogenesis was also observed in vivo by subcutaneous tissue augmentation of athymic mice, highlighting the potential of V. carteri to support or influence tissue regeneration. Conclusions We present for the first time V. carteri as an innovative and inspiring biomaterial for tissue engineering and soft tissue regeneration. Its strategies in terms of shape, structure and composition can be central in the design of a new generation of bio-inspired heterogeneous biomaterials recapitulating more appropriately the complexity of body tissues when guiding their regeneration.
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Affiliation(s)
- Mathilde Stricher
- Université de Technologie de Compiègne, CNRS, Biomechanics and Bioengineering, Centre de Recherche Royallieu, CEDEX CS 60 319, 60 203, Compiègne, France
| | - Pascale Vigneron
- Université de Technologie de Compiègne, CNRS, Biomechanics and Bioengineering, Centre de Recherche Royallieu, CEDEX CS 60 319, 60 203, Compiègne, France
| | - Frederic Delbecq
- Université de Technologie de Compiègne, ESCOM, TIMR (Integrated Transformations of Renewable Matter), Centre de Recherche Royallieu, CEDEX CS 60 319, 60 203, Compiègne, France
| | - Claude-Olivier Sarde
- Université de Technologie de Compiègne, ESCOM, TIMR (Integrated Transformations of Renewable Matter), Centre de Recherche Royallieu, CEDEX CS 60 319, 60 203, Compiègne, France
| | - Christophe Egles
- Université de Technologie de Compiègne, CNRS, Biomechanics and Bioengineering, Centre de Recherche Royallieu, CEDEX CS 60 319, 60 203, Compiègne, France
- Univ Rouen Normandie, INSA Rouen Normandie, CNRS, Normandie Univ, PBS UMR 6270, 55 Rue Saint-Germain, 27 000, Évreux, France
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5
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Bienz SP, Gadzo N, Zuercher AN, Wiedemeier D, Jung RE, Thoma DS. Clinical and histological wound healing patterns of collagen-based substitutes: An experimental randomized controlled trial in standardized palatal defects in humans. J Clin Periodontol 2024; 51:319-329. [PMID: 38017650 DOI: 10.1111/jcpe.13903] [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: 06/23/2023] [Revised: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 11/30/2023]
Abstract
AIM To evaluate the progression of wound healing of standardized palatal defects in groups using three different collagen-based wound dressings and a control group, in terms of wound closure, pain perception and descriptive histology. MATERIALS AND METHODS Twenty participants were enrolled in this experimental study, in whom four palatal defects were created. The defects (6 mm diameter, 3 mm depth) were randomly assigned to one of four treatment modalities: C (control), MG (Mucograft®), MD (mucoderm®) and FG (Fibro-Gide®). Photographs were taken, and pain assessment was performed before and after treatment and at 5, 7, 9, 12, 14 and 16 days after surgery. All participants wore a palatal splint for a duration of 16 days. RESULTS All groups achieved complete wound closure at 14 days. The percentage of the remaining open wound on day 7 amounted to 49.3% (C; interquartile range [IQR]: 22.6), 70.1% (FG; IQR: 20.7), 56.8% (MD; IQR: 26.3) and 62.2% (MG; IQR: 34.4). Statistically significant differences were found between FG and C (p =.01) and between MD and FG (p =.04). None of the participants rated pain higher than 4 out of 10 during the entire study period. CONCLUSIONS Collagen-based wound dressings provide coverage of open defects, albeit without acceleration of wound closure or reduction of pain. FG (which is not intended for open oral wounds) showed slower wound closure compared to C and MD.
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Affiliation(s)
- Stefan P Bienz
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Naida Gadzo
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Anina N Zuercher
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Daniel Wiedemeier
- Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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6
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Ozkendir O, Karaca I, Cullu S, Erdoğan OC, Yaşar HN, Dikici S, Owen R, Aldemir Dikici B. Engineering periodontal tissue interfaces using multiphasic scaffolds and membranes for guided bone and tissue regeneration. BIOMATERIALS ADVANCES 2024; 157:213732. [PMID: 38134730 DOI: 10.1016/j.bioadv.2023.213732] [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: 10/22/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Periodontal diseases are one of the greatest healthcare burdens worldwide. The periodontal tissue compartment is an anatomical tissue interface formed from the periodontal ligament, gingiva, cementum, and bone. This multifaceted composition makes tissue engineering strategies challenging to develop due to the interface of hard and soft tissues requiring multiphase scaffolds to recreate the native tissue architecture. Multilayer constructs can better mimic tissue interfaces due to the individually tuneable layers. They have different characteristics in each layer, with modulation of mechanical properties, material type, porosity, pore size, morphology, degradation properties, and drug-releasing profile all possible. The greatest challenge of multilayer constructs is to mechanically integrate consecutive layers to avoid delamination, especially when using multiple manufacturing processes. Here, we review the development of multilayer scaffolds that aim to recapitulate native periodontal tissue interfaces in terms of physical, chemical, and biological characteristics. Important properties of multiphasic biodegradable scaffolds are highlighted and summarised, with design requirements, biomaterials, and fabrication methods, as well as post-treatment and drug/growth factor incorporation discussed.
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Affiliation(s)
- Ozgu Ozkendir
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir 35433, Turkey
| | - Ilayda Karaca
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir 35433, Turkey
| | - Selin Cullu
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir 35433, Turkey
| | - Oğul Can Erdoğan
- Department of Molecular Biology and Genetics, Izmir Institute of Technology, Urla, Izmir 35433, Turkey
| | - Hüsniye Nur Yaşar
- Department of Molecular Biology and Genetics, Izmir Institute of Technology, Urla, Izmir 35433, Turkey
| | - Serkan Dikici
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir 35433, Turkey
| | - Robert Owen
- School of Pharmacy, University of Nottingham Biodiscovery Institute, University of Nottingham, Nottingham NG7 2RD, United Kingdom
| | - Betül Aldemir Dikici
- Department of Bioengineering, Izmir Institute of Technology, Urla, Izmir 35433, Turkey.
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Mitropoulou A, Markatos DN, Dimopoulos A, Marazioti A, Mikelis CM, Mavrilas D. Development and Evaluation of Biodegradable Core-Shell Microfibrous and Nanofibrous Scaffolds for Tissue Engineering Applications. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2024; 35:10. [PMID: 38285092 PMCID: PMC10824864 DOI: 10.1007/s10856-024-06777-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
Tissue engineering scaffolds as three-dimensional substrates may serve as ideal templates for tissue regeneration by simulating the structure of the extracellular matrix (ECM). Many biodegradable synthetic polymers, either hydrophobic, like Poly-ε-caprolactone (PCL), or hydrophilic, like Poly(Vinyl Alcohol) (PVA), are widely used as candidate bioactive materials for fabricating tissue engineering scaffolds. However, a combination of good cytocompatibility of hydrophilic polymers with good biomechanical performance of hydrophobic polymers could be beneficial for the in vivo performance of the scaffolds. In this study, we aimed to fabricate biodegradable fibrous scaffolds by combining the properties of hydrophobic PCL with those of hydrophilic PVA and evaluate their properties in comparison with pristine PCL scaffolds. Therefore, single-layered PCL scaffolds, sequential tri-layered (PVA/PCL/PVA), and core-shell (PVA as shell and PCL as core) composite scaffolds were developed utilizing the electrospinning technique. The material structural and biomechanical properties of the electrospun scaffolds, before and after their hydrolytic degradation over a seven-month period following storage in phosphate-buffered saline (PBS) at 37 °C, were comprehensively compared. In addition, human embryonic kidney cells (HEK-293) were cultured on the scaffolds to investigate potential cell attachment, infiltration, and proliferation. The results demonstrated the long-term efficacy of core-shell biodegradable fibrous scaffolds in comparison to single-layers PCL and tri-layers PVA/PCL/PVA, not only due to its superior morphological characteristics and mechanical properties, but also due to its ability to promote homogeneous cell distribution and proliferation, without any external chemical or physical stimuli.
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Affiliation(s)
- Athina Mitropoulou
- Department of Mechanical Engineering and Aeronautics, Laboratory of Biomechanics and Biomedical Engineering, University of Patras, Patras, GR, Greece.
| | - Dionysios N Markatos
- Department of Mechanical Engineering and Aeronautics, Laboratory of Technology and Strength of Materials, University of Patras, Patras, GR, Greece
| | - Andreas Dimopoulos
- Prometheus Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium
- Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Antonia Marazioti
- Department of Physiotherapy, Laboratory of Basic Sciences, University of Peloponnese, Sparta, GR, Greece
| | | | - Dimosthenis Mavrilas
- Department of Mechanical Engineering and Aeronautics, Laboratory of Biomechanics and Biomedical Engineering, University of Patras, Patras, GR, Greece
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8
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Han HS, Lee JT, Oh S, Cho YD, Kim S. Effectiveness of a collagen matrix seal and xenograft in alveolar ridge preservation: an experimental study in dogs. Sci Rep 2024; 14:163. [PMID: 38168516 PMCID: PMC10762190 DOI: 10.1038/s41598-023-50370-3] [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: 09/22/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
Majority of previous studies on alveolar ridge preservation (ARP) used collagen membranes as barrier membranes, and further evidence for ARP in dehiscent extraction sockets with a deproteinized bovine bone mineral (DBBM) and matrix is needed. The aim of this study is to assess the impact of non-cross linked collagen membranes (membrane) and crosslinked collagen matrices (matrix) on ARP using DBBM in extraction sockets with buccal dehiscence. In six mongrel dogs, the mesial roots of three mandibular premolars (P2, P3, and P4) were extracted 1 month after dehiscence defect induction. Two experimental groups were randomly assigned: (1) DBBM with a membrane (DBBM/membrane group) and (2) DBBM with a matrix (DBBM/matrix group). Three-dimensional (3D) volumetric, microcomputed tomography (μCT), and histologic analyses were performed to assess the ridge preservation. Both groups were effective to maintain the ridge width (p > 0.05), and the DBBM/matrix group showed more favorable soft tissue regeneration and bone quality in the histological analysis (p = 0.05). Based on these results, DBBM/matrix could be better choice for ARP in cases of buccal dehiscence defects.
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Affiliation(s)
- Hee-Seung Han
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jung-Tae Lee
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Seunghan Oh
- Department of Dental Biomaterials, The Institute of Biomaterial and Implant, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea.
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9
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Abedi M, Shafiee M, Afshari F, Mohammadi H, Ghasemi Y. Collagen-Based Medical Devices for Regenerative Medicine and Tissue Engineering. Appl Biochem Biotechnol 2023:10.1007/s12010-023-04793-3. [PMID: 38133881 DOI: 10.1007/s12010-023-04793-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
Assisted reproductive technologies are key to solving the problems of aging and organ defects. Collagen is compatible with living tissues and has many different chemical properties; it has great potential for use in reproductive medicine and the engineering of reproductive tissues. It is a natural substance that has been used a lot in science and medicine. Collagen is a substance that can be obtained from many different animals. It can be made naturally or created using scientific methods. Using pure collagen has some drawbacks regarding its physical and chemical characteristics. Because of this, when collagen is processed in various ways, it can better meet the specific needs as a material for repairing tissues. In simpler terms, collagen can be used to help regenerate bones, cartilage, and skin. It can also be used in cardiovascular repair and other areas. There are different ways to process collagen, such as cross-linking it, making it more structured, adding minerals to it, or using it as a carrier for other substances. All of these methods help advance the field of tissue engineering. This review summarizes and discusses the current progress of collagen-based materials for reproductive medicine.
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Affiliation(s)
- Mehdi Abedi
- Pharmaceutical Science Research Center, Shiraz University of Medical Science, Shiraz, Iran.
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran.
| | - Mina Shafiee
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran
| | - Farideh Afshari
- Department of Tissue Engineering and Applied Cell Science, School of Advanced Medical Sciences and Technology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamidreza Mohammadi
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran
| | - Younes Ghasemi
- Pharmaceutical Science Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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10
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Marques D, Teixeira LN, Elias CN, Lemos AB, Martinez EF. Surface topography of resorbable porcine collagen membranes, and their effect on early osteogenesis: An in vitro study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101607. [PMID: 37582461 DOI: 10.1016/j.jormas.2023.101607] [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: 07/20/2023] [Revised: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE Guided tissue regeneration (GTR) is based on the use of different membranes that function as sealants and barriers in specific clinical situations. Among the several tissue production methods and origins, resorbable porcine-derived membranes are the most commonly used. Because these membranes are so diverse, and have several different clinical applications, doubts linger as to their effect in stimulating osteogenesis. The objective of this study was to make an in vitro evaluation of the viability and differentiation of osteoblastic cells cultured on the surface of the following collagen membranes: Jason® (Botiss Biomaterials), Collprotect® (Botiss Biomaterials), and Bio-Gide® (Geistlich). MATERIAL AND METHODS Fragments of the 3 resorbable collagen membranes (5 × 5 mm) were used, and pre-osteoblastic SAOS-2 cells (ATCC, USA) were plated on their porous surfaces. Evaluation of the membranes was performed at 3, 5 and 7 days, considering the following parameters: (1) topographic analysis of the different surfaces by scanning electron microscope; (2) cellular viability by MTT, (3) quantification of type I collagen and osteopontin by Elisa. The quantitative analyses were carried out using a significance level of 5%. RESULTS Collprotect® and Jason® membranes presented a rough surface with an irregular aspect on both sides, while double-layered Bio-Gide® had one layer with a smooth surface and the other with a rough surface along each respective length. The viability assays revealed that the cells cultured the cells grown on Collprotect® showed higher viability than those grown in Bio-Gide® or Jason®, especially after 5 and 7 days. After 3 and 5 days, evaluation of type I collagen showed that the cells plated on the Jason® and Collprotect® surfaces had greater collagen secretion than those plated on BioGide®. After 7 days, an increase in osteopontin levels was observed when the cells were plated on all the experimental membranes, compared with the control group. CONCLUSION All the tested membranes were suitable for use in GTR clinical procedures. Their indication in specific regenerative cases depends on the mechanical and biological properties of their originating tissues, thus enabling better results and assertive choices by dental professionals.
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Affiliation(s)
- Dalton Marques
- Division of Oral Implantology, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | | | - Carlos Nelson Elias
- Instituto Militar de Engenharia, Departamento de Ciência dos Materiais, Rio de Janeiro, RJ, Brasil
| | - Alexandre Barboza Lemos
- Division of Oral Implantology, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil; Instituto Militar de Engenharia, Departamento de Ciência dos Materiais, Rio de Janeiro, RJ, Brasil
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11
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Lim HC, Paeng KW, Jung UW, Benic GI. Vertical bone augmentation using collagenated or non-collagenated bone substitute materials with or without recombinant human bone morphogenetic protein-2 in a rabbit calvarial model. J Periodontal Implant Sci 2023; 53:429-443. [PMID: 37038830 PMCID: PMC10761281 DOI: 10.5051/jpis.2204240212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/01/2023] [Accepted: 01/17/2023] [Indexed: 03/18/2023] Open
Abstract
PURPOSE The aim of this study was to determine 1) the bone-regenerative effect of porcine bone block materials with or without collagen matrix incorporation, 2) the effect of a collagen barrier, and 3) the effect of adding recombinant human bone morphogenetic protein-2 (rhBMP-2) to the experimental groups. METHODS Four treatment modalities were applied to rabbit calvaria: 1) deproteinized bovine bone mineral blocks (DBBM), 2) porcine bone blocks with collagen matrix incorporation (PBC), 3) porcine bone blocks alone without collagen matrix incorporation (PB), and 4) PBC blocks covered by a collagen membrane (PBC+M). The experiments were repeated with the addition of rhBMP-2. The animals were sacrificed after either 2 or 12 weeks of healing. Micro-computed tomography (micro-CT), histologic, and histomorphometric analyses were performed. RESULTS Micro-CT indicated adequate volume stability in all block materials. Histologically, the addition of rhBMP-2 increased the amount of newly formed bone (NB) in all the blocks. At 2 weeks, minimal differences were noted among the NB of groups with or without rhBMP-2. At 12 weeks, the PBC+M group with rhBMP-2 presented the greatest NB (P<0.05 vs. the DBBM group with rhBMP-2), and the PBC and PB groups had greater NB than the DBBM group (P>0.05 without rhBMP-2, P<0.05 with rhBMP-2). CONCLUSIONS The addition of rhBMP-2 enhanced NB formation in vertical augmentation using bone blocks, and a collagen barrier may augment the effect of rhBMP-2.
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Affiliation(s)
- Hyun-Chang Lim
- Department of Periodontology, Kyung Hee University, College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
| | - Goran I Benic
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Institute for Research and Education in Dental Medicine, Lugano, Switzerland
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Saha S, Costa RC, Silva MC, Fonseca-Santos JM, Chen L, Phakatkar AH, Bhatia H, Faverani LP, Barão VA, Shokuhfar T, Sukotjo C, Takoudis C. Collagen membrane functionalized with magnesium oxide via room-temperature atomic layer deposition promotes osteopromotive and antimicrobial properties. Bioact Mater 2023; 30:46-61. [PMID: 37521273 PMCID: PMC10382637 DOI: 10.1016/j.bioactmat.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/02/2023] [Accepted: 07/17/2023] [Indexed: 08/01/2023] Open
Abstract
Artificial bone grafting materials such as collagen are gaining interest due to the ease of production and implantation. However, collagen must be supplemented with additional coating materials for improved osteointegration. Here, we report room-temperature atomic layer deposition (ALD) of MgO, a novel method to coat collagen membranes with MgO. Characterization techniques such as X-ray photoelectron spectroscopy, Raman spectroscopy, and electron beam dispersion mapping confirm the chemical nature of the film. Scanning electron and atomic force microscopies show the surface topography and morphology of the collagen fibers were not altered during the ALD of MgO. Slow release of magnesium ions promotes bone growth, and we show the deposited MgO film leaches trace amounts of Mg when incubated in phosphate-buffered saline at 37 °C. The coated collagen membrane had a superhydrophilic surface immediately after the deposition of MgO. The film was not toxic to human cells and demonstrated antibacterial properties against bacterial biofilms. Furthermore, in vivo studies performed on calvaria rats showed MgO-coated membranes (200 and 500 ALD) elicit a higher inflammatory response, leading to an increase in angiogenesis and a greater bone formation, mainly for Col-MgO500, compared to uncoated collagen. Based on the characterization of the MgO film and in vitro and in vivo data, the MgO-coated collagen membranes are excellent candidates for guided bone regeneration.
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Affiliation(s)
- Soumya Saha
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, USA
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Mirela Caroline Silva
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - João Matheus Fonseca-Santos
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Lin Chen
- Department of Periodontics, Center for Wound Healing and Tissue Regeneration, College of Dentistry, University of Illinois Chicago, Chicago, USA
| | - Abhijit H. Phakatkar
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, USA
| | - Harshdeep Bhatia
- Department of Chemical Engineering, University of Illinois Chicago, Chicago, USA
| | - Leonardo P. Faverani
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Valentim A.R. Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Tolou Shokuhfar
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, USA
| | - Cortino Sukotjo
- Department of Restorative Dentistry, University of Illinois Chicago College of Dentistry, Chicago, USA
| | - Christos Takoudis
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, USA
- Department of Chemical Engineering, University of Illinois Chicago, Chicago, USA
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13
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Abalymov A, Pinchasik BE, Akasov RA, Lomova M, Parakhonskiy BV. Strategies for Anisotropic Fibrillar Hydrogels: Design, Cell Alignment, and Applications in Tissue Engineering. Biomacromolecules 2023; 24:4532-4552. [PMID: 37812143 DOI: 10.1021/acs.biomac.3c00503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Efficient cellular alignment in biomaterials presents a considerable challenge, demanding the refinement of appropriate material morphologies, while ensuring effective cell-surface interactions. To address this, biomaterials are continuously researched with diverse coatings, hydrogels, and polymeric surfaces. In this context, we investigate the influence of physicochemical parameters on the architecture of fibrillar hydrogels that significantly orient the topography of flexible hydrogel substrates, thereby fostering cellular adhesion and spatial organization. Our Review comprehensively assesses various techniques for aligning polymer fibrils within hydrogels, specifically interventions applied during and after the cross-linking process. These methodologies include mechanical strains, precise temperature modulation, controlled fluidic dynamics, and chemical modulators, as well as the use of magnetic and electric fields. We highlight the intrinsic appeal of these methodologies in fabricating cell-aligning interfaces and discuss their potential implications within the fields of biomaterials and tissue engineering, particularly concerning the pursuit of optimal cellular alignment.
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Affiliation(s)
- Anatolii Abalymov
- Science Medical Center, Saratov State University, 410012 Saratov, Russia
| | - Bat-El Pinchasik
- School of Mechanical Engineering, Faculty of Engineering, Tel-Aviv University, 69978 Tel-Aviv, Israel
| | - Roman A Akasov
- Sechenov University and Federal Scientific Research Centre "Crystallography and Photonics" of Russian Academy of Sciences, 101000 Moscow, Russia
| | - Maria Lomova
- Science Medical Center, Saratov State University, 410012 Saratov, Russia
| | - Bogdan V Parakhonskiy
- Department of Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium
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14
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Dogan Kaplan A, Cinar IC, Gultekin BA, Avci Kupeli Z, Ozfirat EC, Yalcin S. The Effect of Different Types of Collagen Membranes on Peri-Implant Dehiscence Defects. J Craniofac Surg 2023; 34:2479-2484. [PMID: 37431934 DOI: 10.1097/scs.0000000000009536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 05/20/2023] [Indexed: 07/12/2023] Open
Abstract
AIM This experimental study aimed to compare the bone-implant contact (BIC) following guided bone regeneration with 3 bioabsorbable collagen membranes on peri-implant dehiscence defects. METHODS Forty-eight standard dehiscence defects were created in the sheep iliac bone crest, and dental implants were placed into the defects. With the guided bone regeneration technique, the autogenous graft was placed into the defect and covered with different types of membranes: Geistlich Bio-Gide, Ossix Plus, and Symbios Prehydrated were covered. One group was left without a membrane as the control group (C) by applying only an autogenous graft. After recovery periods of 3 and 6 weeks, the experimental animals were sacrificed. Histologic sections were prepared by a nondecalcified method, and BIC was examined. RESULTS There was no statistically important difference between groups in the third week ( P >0.05). A statistically significant difference between groups was found in the sixth week ( P <0.01). Bone-implant contact values of the C group were significantly lower than those of the Geistlich Bio-Gide and Ossix Plus groups ( P <0.05). There was no statistically significant difference between control and Symbios Prehydrated groups ( P >0.05). In all sections, osseointegration was observed, with no signs of inflammation, necrosis, or foreign body reaction. CONCLUSION In our study, it has been concluded that the resorbable collagen membranes used in treating peri-implant dehiscence defects might affect the BIC, and the success varies according to the type of membrane used.
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Affiliation(s)
- Aylin Dogan Kaplan
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul
| | - Ihsan Caglar Cinar
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul
| | | | - Zehra Avci Kupeli
- Department of Pathology, Faculty of Veterinary Medicine, Bursa Uludag University
| | - Eren Can Ozfirat
- Department of Surgery, Faculty of Veterinary Medicine, Bursa Uludag University, Bursa, Turkey
| | - Serdar Yalcin
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul
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15
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Kim K, Su Y, Kucine AJ, Cheng K, Zhu D. Guided Bone Regeneration Using Barrier Membrane in Dental Applications. ACS Biomater Sci Eng 2023; 9:5457-5478. [PMID: 37650638 DOI: 10.1021/acsbiomaterials.3c00690] [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] [Indexed: 09/01/2023]
Abstract
Guided bone regeneration (GBR) is a widely used technique in preclinical and clinical studies due to its predictability. Its main purpose is to prevent the migration of soft tissue into the osseous wound space, while allowing osseous cells to migrate to the site. GBR is classified into two main categories: resorbable and non-resorbable membranes. Resorbable membranes do not require a second surgery but tend to have a short resorption period. Conversely, non-resorbable membranes maintain their mechanical strength and prevent collapse. However, they require removal and are susceptible to membrane exposure. GBR is often used with bone substitute graft materials to fill the defect space and protect the bone graft. The membrane can also undergo various modifications, such as surface modification and biological factor loading, to improve barrier functions and bone regeneration. In addition, bone regeneration is largely related to osteoimmunology, a new field that focuses on the interactions between bone and the immune system. Understanding these interactions can help in developing new treatments for bone diseases and injuries. Overall, GBR has the potential to be a powerful tool in promoting bone regeneration. Further research in this area could lead to advancements in the field of bone healing. This review will highlight resorbable and non-resorbable membranes with cellular responses during bone regeneration, provide insights into immunological response during bone remodeling, and discuss antibacterial features.
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Affiliation(s)
- Kakyung Kim
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
| | - Yingchao Su
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
| | - Allan J Kucine
- Department of Oral and Maxillofacial Surgery, Stony Brook University, Stony Brook, New York 11794, United States
| | - Ke Cheng
- Department of Biomedical Engineering, Columbia University, New York City, New York 10027, United States
| | - Donghui Zhu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
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16
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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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17
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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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18
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Donos N, Akcali A, Padhye N, Sculean A, Calciolari E. Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? Periodontol 2000 2023; 93:26-55. [PMID: 37615306 DOI: 10.1111/prd.12518] [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: 02/10/2023] [Revised: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune-inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non-invasive imaging and with patient-reported outcome measures. We also envisage that the integration of multi-omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Ninad Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Dentistry, Dental School, University of Parma, Parma, Italy
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Vargas SM, Johnson TM, Pfaff AS, Bumpers AP, Wagner JC, Retrum JK, Colamarino AN, Bunting ME, Wilson JP, McDaniel CR, Herold RW, Stancoven BW, Lincicum AR. Clinical protocol selection for alveolar ridge augmentation at sites exhibiting slight, moderate, and severe horizontal ridge deficiencies. Clin Adv Periodontics 2023; 13:174-196. [PMID: 36760073 DOI: 10.1002/cap.10239] [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: 10/07/2022] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
FOCUSED CLINICAL QUESTION What factors identify the optimal bone augmentation techniques for managing slight, moderate, and severe horizontal alveolar ridge deficiency (ARD) at dental implant sites? SUMMARY Horizontal ARD is a concern at a high proportion of sites receiving dental implants, and clinicians have developed a variety of surgical procedures to address such defects. In a particular case, selection of the optimal treatment may depend predominantly on defect severity, location (anterior versus posterior), and configuration (contained versus noncontained). This report provides a framework for selecting an augmentation method when presented with a slight, moderate, or severe horizontal ARD at a site requiring dental implant placement. CONCLUSION Multiple treatment options are available for planned implant sites exhibiting horizontal ARD; severe posterior and slight anterior defects intuitively call for different approaches. Although rigid guidelines for selecting the optimal augmentation method do not exist, some techniques are poorly suited for esthetically demanding sites. A framework considering defect severity, location, and configuration may help guide clinical decisions on this topic.
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Affiliation(s)
- Sarah M Vargas
- Department of Periodontics, United States Army Dental Health Activity, Fort Bragg, North Carolina, USA
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Aaron S Pfaff
- Department of Periodontics, United States Army Dental Health Activity, Fort Wainwright, Alaska, USA
| | - April P Bumpers
- Department of Periodontics, United States Army Dental Health Activity, Fort Jackson, South Carolina, USA
| | - Jennah C Wagner
- Department of Periodontics, United States Army Dental Health Activity, Fort Meade, Maryland, USA
| | - Joseph K Retrum
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Aaron N Colamarino
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Megan E Bunting
- Department of Periodontics, United States Army Dental Health Activity, Fort Drum, New York, USA
| | - James P Wilson
- Department of Periodontics, United States Army Dental Health Activity, Fort Campbell, Kentucky, USA
| | - Carsen R McDaniel
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Robert W Herold
- Department of Periodontics, Veterans Administration Medical Center, Augusta, Georgia, USA
| | - Brian W Stancoven
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Adam R Lincicum
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
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20
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Blašković M, Blašković D, Hangyasi DB, Peloza OC, Tomas M, Čandrlić M, Rider P, Mang B, Kačarević ŽP, Trajkovski B. Evaluation between Biodegradable Magnesium Metal GBR Membrane and Bovine Graft with or without Hyaluronate. MEMBRANES 2023; 13:691. [PMID: 37623752 PMCID: PMC10456676 DOI: 10.3390/membranes13080691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/12/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023]
Abstract
Bone substitutes and barrier membranes are widely used in dental regeneration procedures. New materials are constantly being developed to provide the most optimal surgical outcomes. One of these developments is the addition of hyaluronate (HA) to the bovine bone graft, which has beneficial wound healing and handling properties. However, an acidic environment that is potentially produced by the HA is known to increase the degradation of magnesium metal. The aim of this study was to evaluate the potential risk for the addition of HA to the bovine bone graft on the degradation rate and hence the efficacy of a new biodegradable magnesium metal GBR membrane. pH and conductivity measurements were made in vitro for samples placed in phosphate-buffered solutions. These in vitro tests showed that the combination of the bovine graft with HA resulted in an alkaline environment for the concentrations that were used. The combination was also tested in a clinical setting. The use of the magnesium metal membrane in combination with the tested grafting materials achieved successful treatment in these patients and no adverse effects were observed in vivo for regenerative treatments with or without HA. Magnesium based biodegradable GBR membranes can be safely used in combination with bovine graft with or without hyaluronate.
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Affiliation(s)
- Marko Blašković
- Department of Oral Surgery, Faculty of Dental Medicine Rijeka, University of Rijeka, Krešimirova 40/42, 51000 Rijeka, Croatia;
- Dental Clinic Dr. Blašković, Linićeva ulica 16, 51000 Rijeka, Croatia;
| | - Dorotea Blašković
- Dental Clinic Dr. Blašković, Linićeva ulica 16, 51000 Rijeka, Croatia;
| | | | - Olga Cvijanović Peloza
- Department of Anatomy, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia;
| | - Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia; (M.T.); (M.Č.)
| | - Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia; (M.T.); (M.Č.)
| | - Patrick Rider
- Botiss Biomaterials, Ullsteinstrasse 108, 12109 Berlin, Germany; (P.R.); (B.M.)
| | - Berit Mang
- Botiss Biomaterials, Ullsteinstrasse 108, 12109 Berlin, Germany; (P.R.); (B.M.)
| | - Željka Perić Kačarević
- Department of Anatomy, Embriology, Pathology and Pathohistology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
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21
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Pla R, Sanz-Esporrin J, Noguerol F, Vignoletti F, Gamarra P, Sanz M. A Synthetic Bio-Absorbable Membrane in Guided Bone Regeneration in Dehiscence-Type Defects: An Experimental In Vivo Investigation in Dogs. Bioengineering (Basel) 2023; 10:841. [PMID: 37508867 PMCID: PMC10376221 DOI: 10.3390/bioengineering10070841] [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: 05/04/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
This study aimed to determine the performance and characteristics of a synthetic barrier membrane of polylactic acid and acetyl butyl citrate (PLAB) for the lateral bone augmentation of peri-implant dehiscence defects (mean height × depth = 3 mm × 1 mm). In eight dogs, three treatment groups were randomly allocated at each chronic peri-implant dehiscence-type defect: (i) a deproteinized bovine bone mineral covered by a synthetic barrier membrane (test group), (ii) a deproteinized bovine bone mineral covered by a natural collagen membrane (positive control), and (iii) a synthetic barrier membrane (negative control). After 4 and 12 weeks of submerged healing, dissected tissue blocks were processed for calcified and decalcified histological analysis. Histometric measurements for tissue and bone width were performed, and bone-to-implant contact and alkaline phosphatase expression where measured. After 4 and 12 weeks of healing, no statistical differences between the groups were observed for the histometric measurements. The expression of alkaline phosphatase was higher in the positive control group after 4 weeks followed by the positive and negative controls (5.25 ± 4.09, 4.46 ± 3.03, and 4.35 ± 2.28%, p > 0.05) and 12 weeks followed by the negative and positive controls (4.3 ± 2.14, 3.21 ± 1.53, and 2.39 ± 1.03%, p > 0.05). Concerning the bone-to-implant contact, after 4 weeks, the test group obtained the highest results (39.54 ± 48.7) vs. (31.24 ± 42.6) and (20.23 ± 36.1), respectively, while after 12 weeks, the positive control group obtained the highest Bone to imaplant contact (BIC) results, followed by the test and negative controls, (35.91 ± 24.9) vs. (18.41 ± 20.5) and (24.3 ± 32.1), respectively; no statistically significant differences were obtained. Within the limitations of the study, new bone formation can be achieved in guided bone regeneration procedures simultaneously with implant placement either with the use of a PLAB membrane or a native collagen membrane, although these differences were not statistically significant.
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Affiliation(s)
- Rafael Pla
- Faculty of Dentistry, University Complutense of Madrid (UCM), 28040 Madrid, Spain
| | - Javier Sanz-Esporrin
- Faculty of Dentistry, University Complutense of Madrid (UCM), 28040 Madrid, Spain
| | - Fernando Noguerol
- Faculty of Dentistry, University Complutense of Madrid (UCM), 28040 Madrid, Spain
| | - Fabio Vignoletti
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid (UCM), 28040 Madrid, Spain
| | - Pablo Gamarra
- Faculty of Dentistry, University Complutense of Madrid (UCM), 28040 Madrid, Spain
| | - Mariano Sanz
- Faculty of Dentistry, University Complutense of Madrid (UCM), 28040 Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid (UCM), 28040 Madrid, Spain
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22
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Jin X, Park JY, Lee JS, Jung UW, Choi SH, Cha JK. Tissue integration patterns of non-crosslinked and crosslinked collagen membranes: an experimental in vivo study. J Periodontal Implant Sci 2023; 53:207-217. [PMID: 36468485 PMCID: PMC10315255 DOI: 10.5051/jpis.2203260163] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/25/2022] [Accepted: 10/12/2022] [Indexed: 11/26/2023] Open
Abstract
PURPOSE Non-crosslinked and crosslinked collagen membranes are known to exhibit distinct degradation characteristics, resulting in contrasting orientations of the adjacent tissues and different biological processes. The aim of this study was to conduct a histomorphometric assessment of non-crosslinked and crosslinked collagen membranes regarding neovascularization, tissue integration, tissue encapsulation, and biodegradation. METHODS Guided bone regeneration was performed using either a non-crosslinked (BG) or a crosslinked collagen membrane (CM) in 15 beagle dogs, which were euthanized at 4, 8, and 16 weeks (n=5 each) for histomorphometric analysis. The samples were assessed regarding neovascularization, tissue integration, encapsulation, the remaining membrane area, and pseudoperiosteum formation. The BG and CM groups were compared at different time periods using nonparametric statistical methods. RESULTS The remaining membrane area of CM was significantly greater than that of BG at 16 weeks; however, there were no significant differences at 4 and 8 weeks. Conversely, the neovascularization score for CM was significantly less than that for BG at 16 weeks. BG exhibited significantly greater tissue integration and encapsulation scores than CM at all time periods, apart from encapsulation at 16 weeks. Pseudoperiosteum formation was observed in the BG group at 16 weeks. CONCLUSIONS Although BG membranes were more rapidly biodegraded than CM membranes, they were gradually replaced by connective tissue with complete integration and maturation of the surrounding tissues to form dense periosteum-like connective tissue. Further studies need to be performed to validate the barrier effect of the pseudoperiosteum.
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Affiliation(s)
- Xiang Jin
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jin-Young Park
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea.
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23
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Kim KM, Choi SY, Park JH, Kim HY, Kim SJ, Kim JW. Six-month stability following extensive alveolar bone augmentation by sausage technique. Maxillofac Plast Reconstr Surg 2023; 45:16. [PMID: 37087707 PMCID: PMC10123023 DOI: 10.1186/s40902-023-00384-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/19/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Resorption of alveolar bone is a common sequela of tooth loss and presents a clinical problem, especially in the esthetic zone. When ridge resorption occurs, adequate bone augmentation is essential to obtain satisfactory esthetic results. The purpose of this study was to determine the increase and retention rate of bone height or width in patients who received extensive bone augmentation and to analyze factors affecting its prognosis and stability. METHODS This study was performed on patients who received extensive bone augmentation by sausage technique at the Department of Oral and Maxillofacial Surgery at Ewha Womans University Mok-dong Hospital from January 1, 2018, to February 28, 2022. CBCT images were taken before and 6 months after surgery to compare the amount of increase in bone height or width at the graft site. They were measured using reliable points such as adjacent implants or cephalometric landmarks, inferior alveolar nerve canals as reference points. RESULTS A total of 8 patients underwent extensive bone grafting during the given period (mean age was 53.75 years, 2 males and 6 females). Four patients received horizontal augmentation, and 4 received vertical augmentation. When divided by surgical site, 4 patients are in maxilla and 4 in mandible. The average amount of increase in bone width or bone height was 5.38 mm, and the retention rate was about 79.9% after 6 months. The retention rate of horizontal augmentation was 88.8%, which was higher than that of vertical augmentation, which was 74.5%. The maxillary area accounted for 92.2%, and the amount of bone resorption was lower than that of the mandibular area, which was 72.6%. The average stitch out period was about 2.4 weeks, and postoperative dehiscence was observed about 37.5% of the total, more frequently in the mandible (50.0%) than in the maxilla (25.0%). CONCLUSION In conclusion, extensive bone augmentation achieved significant horizontal or vertical bone height or width increase, and the retention rate after 6 months was also high. In addition, surgery in the maxillary region showed a more successful bone augmentation than in the mandible, with a higher maintenance rate and fewer cases of dehiscence.
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Affiliation(s)
- Kang-Min Kim
- Department of Oral and Maxillofacial Surgery, Mok-dong Hospital, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Soo-Young Choi
- Department of Oral and Maxillofacial Surgery, Mok-dong Hospital, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Mok-dong Hospital, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Heon-Young Kim
- Department of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Seoul Hospital, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Sun-Jong Kim
- Department of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Seoul Hospital, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Mok-dong Hospital, School of Medicine, Ewha Womans University, Seoul, Korea.
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24
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Abdo VL, Suarez LJ, de Paula LG, Costa RC, Shibli J, Feres M, Barāo VAR, Bertolini M, Souza JGS. Underestimated microbial infection of resorbable membranes on guided regeneration. Colloids Surf B Biointerfaces 2023; 226:113318. [PMID: 37075523 DOI: 10.1016/j.colsurfb.2023.113318] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/29/2023] [Accepted: 04/12/2023] [Indexed: 04/21/2023]
Abstract
Barrier membranes are critical in creating tissuecompartmentalization for guided tissue (GTR) and bone regeneration (GBR) therapies. More recently, resorbable membranes have been widely used for tissue and bone regeneration due to their improved properties and the dispensable re-entry surgery for membrane removal. However, in cases with membrane exposure, this may lead to microbial contamination that will compromise the integrity of the membrane, surrounding tissue, and bone regeneration, resulting in treatment failure. Although the microbial infection can negatively influence the clinical outcomes of regenerative therapy, such as GBR and GTR, there is a lack of clinical investigations in this field, especially concerning the microbial colonization of different types of membranes. Importantly, a deeper understanding of the mechanisms of biofilm growth and composition and pathogenesis on exposed membranes is still missing, explaining the mechanisms by which bone regeneration is reduced during membrane exposure. This scoping review comprehensively screened and discussed the current in vivo evidence and possible new perspectives on the microbial contamination of resorbable membranes. Results from eligible in vivo studies suggested that different bacterial species colonized exposed membranes according to their composition (collagen, expanded polytetrafluoroethylene (non-resorbable), and polylactic acid), but in all cases, it negatively affected the attachment level and amount of bone gain. However, limited models and techniques have evaluated the newly developed materials, and evidence is scarce. Finally, new approaches to enhance the antimicrobial effect should consider changing the membrane surface or incorporating long-term released antimicrobials in an effort to achieve better clinical success.
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Affiliation(s)
- Victoria L Abdo
- Department of Periodontology, Dental Research Division, Guarulhos University, Praça Tereza Cristina, 88 - Centro, Guarulhos, São Paulo 07023-070, Brazil
| | - Lina J Suarez
- Department of Periodontology, Dental Research Division, Guarulhos University, Praça Tereza Cristina, 88 - Centro, Guarulhos, São Paulo 07023-070, Brazil; Departamento de Ciencias Básicas y Medicina Oral, Universidad Nacional de Colombia, Cra 45 # 26-85, Bogotá 11001, Colombia
| | - Lucca Gomes de Paula
- Dental Science School (Faculdade de Ciências Odontológicas - FCO), Av. Waldomiro Marcondes Oliveira, 20 - Ibituruna, Montes Claros, Minas Gerais 39401-303, Brazil
| | - Raphael C Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Jamil Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Praça Tereza Cristina, 88 - Centro, Guarulhos, São Paulo 07023-070, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Praça Tereza Cristina, 88 - Centro, Guarulhos, São Paulo 07023-070, Brazil; Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Valentim A R Barāo
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Martinna Bertolini
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, 3501 Terrace St, Pittsburgh, PA 15213, USA
| | - Joāo Gabriel Silva Souza
- Department of Periodontology, Dental Research Division, Guarulhos University, Praça Tereza Cristina, 88 - Centro, Guarulhos, São Paulo 07023-070, Brazil; Dental Science School (Faculdade de Ciências Odontológicas - FCO), Av. Waldomiro Marcondes Oliveira, 20 - Ibituruna, Montes Claros, Minas Gerais 39401-303, Brazil.
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25
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Lee Y, Lee JT, Han HS, Oh S, Cho YD, Kim S. Gingival biotype modification with collagen matrix or autogenous subepithelial connective tissue graft: Histologic and volumetric analyses in a beagle model. Heliyon 2023; 9:e15026. [PMID: 37151660 PMCID: PMC10161361 DOI: 10.1016/j.heliyon.2023.e15026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/07/2023] [Accepted: 03/24/2023] [Indexed: 05/09/2023] Open
Abstract
Objectives To evaluate the volumetric effect and biocompatibility of porcine tendon-derived type I collagen matrix graft (CG) in gingival biotype modification (GBM) compared with subepithelial connective tissue graft (SCTG) in a beagle model. Methods Surface analysis using scanning electron microscopy and a collagen degradation assay of CG was performed in vitro. Six adult dogs were used in in vivo experiment, and each received autologous SCTG or CG at the anterior side. Histometric and three-dimensional digital volume analyses were conducted to compare quantitative changes in CG and SCTG in GBM. Immunohistochemical analysis was performed for the qualitative evaluation of CG compared to SCTG. Results CG had a double-layered structure, and its degradation was slower than that of other well-reported materials. No critical problems were associated with the healing procedure. Changes in gingival thickness and volume in the CG and SCTG groups were equivalent, with no significant differences between the groups. Type I collagen and vascular endothelial growth factor expression levels were similar in both groups. Significance CG and SCTG had equivalent potential for GBM in terms of quantity and quality. Additionally, CG could be used as a reasonable substitute for SCTG, making surgery convenient and predicting successful clinical outcomes.
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Affiliation(s)
- Yoonsub Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, South Korea
| | - Jung-Tae Lee
- Department of Periodontics, One-Stop Specialty Center, Seoul National University, Dental Hospital, Seoul 05698, South Korea
| | - Hee-seung Han
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, South Korea
| | - Seunghan Oh
- Department of Dental Biomaterials, The Institute of Biomaterial and Implant, School of Dentistry, Wonkwang University, Iksan, South Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, South Korea
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, South Korea
- Corresponding author. Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University ,101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea.
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26
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Park JY, Hong KJ, Ko KA, Cha JK, Gruber R, Lee JS. Platelet-rich fibrin combined with a particulate bone substitute versus guided bone regeneration in the damaged extraction socket: An in vivo study. J Clin Periodontol 2023; 50:358-367. [PMID: 36330669 DOI: 10.1111/jcpe.13742] [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: 04/21/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
AIM It has been proposed that platelet-rich fibrin (PRF) can be used to support bone regeneration during alveolar ridge augmentation. The aim of this study was to determine whether an approach utilizing PRF provides similar performance to the established guided bone regeneration (GBR) procedure. MATERIALS AND METHODS Two-wall defects were surgically created in beagle dogs and treated in three experimental groups: (i) a sticky bone (SB) substitute prepared using liquid PRF and deproteinized porcine bone mineral (DPBM); (ii) SB covered with solid PRF compressed into a membrane; and (iii) GBR performed using DPBM covered by a collagen membrane. Quantitative reverse-transcription polymerase chain reaction was applied to the specimen after 1 week of healing, and microcomputed tomography (micro-CT) and histological outcomes were analysed after 8 weeks of healing. RESULTS Compared with GBR, PRF resulted in a moderate increase in the expression levels of osteoblast and osteoclast markers, osteocalcin, and calcitonin receptor. Moreover, PRF modestly increased angiogenesis and the inflammation markers vascular endothelial growth factor (VEGF) and IL-6. Micro-CT and histological analyses confirmed the expected increased alveolar ridge area, with no significant differences between the three groups. Consistently, graft consolidation, as indicated by new bone formation at the defect site, did not differ significantly between groups. CONCLUSIONS The present results demonstrate that PRF-based approaches perform comparably to the established GBR procedure in terms of the consolidation of DPBM in two-wall alveolar defects.
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Affiliation(s)
- Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Kyu-Jin Hong
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Kyung-A Ko
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Reinhard Gruber
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
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27
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Sehgal V, Ruangsawasdi N, Kiattavorncharoen S, Bencharit S, Thanasrisuebwong P. Occlusive and Proliferative Properties of Different Collagen Membranes-An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1657. [PMID: 36837285 PMCID: PMC9964610 DOI: 10.3390/ma16041657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/03/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Different collagen barrier membranes come in various sources and crosslinking that may affect barrier function and tissue integration. This study investigated barrier function and tissue integration of the three different collagen membranes (Jason®: porcine pericardium, GENOSS: bovine tendon, and BioMend® Extend: cross-linked bovine tendon) with human gingival fibroblasts. The barrier function and tissue integration properties were determined under confocal microscopy. Morphological characteristics were observed using scanning electron microscopy. Our results showed that all collagen membranes allowed a small number of cells to migrate, and the difference in barrier function ability was not significant. The cross-linked characteristics did not improve barrier ability. The native collagen membrane surfaces allowed evenly scattered proliferation of HGF, while the cross-linked collagen membrane induced patchy proliferation. Statistically significant differences in cell proliferation were found between Jason and BioMend Extend membranes (p = 0.04). Scanning electron microscope showed a compact membrane surface at the top, while the bottom surfaces displayed interwoven collagen fibers, which were denser in the crosslinked collagen membranes. Within the limitations of this study, collagen membranes of different origins and physical properties can adequately prevent the invasion of unwanted cells. Native collagen membranes may provide a better surface for gingival cell attachment and proliferation.
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Affiliation(s)
- Vishal Sehgal
- Master of Science Program in Implant Dentistry, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Nisarat Ruangsawasdi
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Sirichai Kiattavorncharoen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Sompop Bencharit
- Office of Oral Health Innovation, Department of Oral Rehabilitation, The James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
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Zhang Z, He Q, Zhu J, Lin X, Yang Y, Chen H, Huang X, Xu R, Deng F. Optimizing the combined soft tissue repair and osteogenesis using double surfaces of crosslinked collagen scaffolds. J Biomed Mater Res B Appl Biomater 2023; 111:1271-1285. [PMID: 36779616 DOI: 10.1002/jbm.b.35231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/14/2023]
Abstract
Excessive tissue damage or loss has been solved by guided tissue regeneration and guided bone regeneration theories. However, the unfavorable degradation property of the resorbable collagen scaffold brings a big challenge to support soft tissue stabilization and time-consuming osteogenesis. The combined effect for soft tissue and bone of the collagen scaffold with better degradation pattern has not been clearly proven. This study determined whether the double surfaces of crosslinked collagen scaffolds could optimize the combined soft tissue repair and osteogenesis. In this study, we applied the chemically crosslinking treatment to the commercially available collagen scaffolds. Surface characterization, mechanical property and cell proliferation in vitro were evaluated. Combined bilateral skin and bone defects were established with the smooth surface of scaffold facing the skin defect and the rough surface facing the bone defect on the calvaria of rat. Micro-CT and histological evaluation were applied to determine the scaffold degradation pattern, soft tissue repair and osteogenesis. The crosslinked collagen scaffolds showed comparably favorable surface porosity, structure intactness, superhydrophilicity and mechanical properties. Compared to the native scaffolds, the crosslinked scaffolds could optimize the combined soft tissue repair and osteogenesis by preferably prolonged degradation time. Early pro-angiogenesis facilitated soft tissue repair and osteogenesis by upregulated soft tissue matrix degradation and balanced pro-osteogenesis with limited osteoclast-mediated bone resorption. Taken together, this study offers a promising repair strategy for the combined soft tissue and bone defects. Further, the possible mechanism of controllable scaffold degradation should be conducted.
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Affiliation(s)
- Zhengchuan Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Qifen He
- Department of Stomatology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jinhao Zhu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaoxuan Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yang Yang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Hongcheng Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaoqiong Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Ruogu Xu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Sukchan K, Pripatnanont P, Tunthasen R, Meesane J. The efficacy of a semi-resorbable membrane based on silk fibroin-Glycerol on bone regeneration in rabbit calvarial defects compared to a commercial collagen membrane. J Biomater Appl 2023; 37:1205-1217. [PMID: 36044990 DOI: 10.1177/08853282221124287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Silk fibroin-glycerol-based membranes were fabricated and characterized for use as a self-maintaining and non-collapsible semi-resorbable membrane in guided bone regeneration. The study assessed the bone regeneration capacity of silk fibroin-glycerol-based membranes compared to a collagen membrane in 10-mm circular bilateral calvarial defects of 20 male New Zealand white rabbits. The animals were divided into two sets of time frames of 4 and 12 weeks and allocated into four groups (n = 5/group); an empty defect (E), a collagen membrane (Bio-Gide®; BG), a silk fibroin-glycerol-collagen membrane (SGC), and a silk fibroin-glycerol membrane (SG). The bone density (optical density, OD) from the 2D radiographs, tissue reaction from histological sections, new bone volume, and area from micro-CT and the histomorphometry were evaluated. The Mean OD of the E (34.49 ± 14.21%) and BG groups (35.71 ± 9.65%) at 12 weeks were higher than at 4 weeks, but the SGC (39.04 ± 7.94%) and SG (40.96 ± 9.25%) groups were lower at 4 weeks. The new bone volumes at 4 weeks of the SG (24.19 ± 1.35%) and SGC groups (24.19 ± 3.47%) were significantly higher than the BG group (16.93 ± 2.95%) but were not different from the E group (18.39±4.78%). At 12 weeks, the new bone volumes in the SGC (29.09 ± 3.81%), SG (29.11 ± 5.94%), and BG groups (26.26 ± 4.42%) were higher than in the E group (21.63 ± 5.81%) without statistical significance. Histological images in the SGC and SG groups showed slow biodegradation without a foreign body reaction. The new bone area at 4 weeks was lowest in BG (12.95 ± 5.44%), and the others were comparable. At 12 weeks, the new bone area in the E group (23.55±8.69%) was lower than the BG (31.42 ± 6.18%), SG (35.25 ± 13.92%), and SGC groups (36.35 ± 10.23%). Silk fibroin-glycerol-based membranes are semi-resorbable membranes that possess a self-maintaining property, have a barrier function without collapsing, and are successful in facilitating bone regeneration.
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Affiliation(s)
- Kongkiat Sukchan
- Oral and Maxillofacial Surgery Section, 26686Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Prisana Pripatnanont
- Oral and Maxillofacial Surgery Section, 26686Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Rudjit Tunthasen
- Oral and Maxillofacial Surgery Section, 26686Prince of Songkla University, Hat Yai, Songkhla, Thailand.,Department of Oral Surgery, 26686Naresuan University, Phitsanulok, Thailand
| | - Jirut Meesane
- Institute of Biomedical Engineering, 37689Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Di Pillo MK, Montagner PG, Teixeira LN, Martinez EF. In vivo evaluation of a collagen membrane in bone neoformation: A morphological and histomorphometric study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101372. [PMID: 36574881 DOI: 10.1016/j.jormas.2022.101372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/23/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Guided bone regeneration (GBR) is a technique that involves the placement of mechanical barriers to protect the blood clot, and create an isolated space to prevent competition from epithelial and connective tissues in bone augmentation treatments. Collagen membranes stand out from other materials available for performing regenerative surgeries, and are widely used because of their ability to promote cell adhesion and homeostasis, and their biocompatibility, ease of handling, and low immunogenicity. In this context, researchers have investigated xenogenic membranes/barriers that cost less and have slower resorption rates. The current study aimed to assess the osteogenic potential induced by a crosslinked, synthesized xenogenic membrane 100 µm thick when applied in vivo to critical defects in rat calvaria. MATERIAL AND METHODS Critical size defects were created in the calvaria of thirty male Wistar rats, and randomly divided into the following two groups: G1 - clot covered with a commercial xenogenic membrane (Lumina-Coat®, Criteria, Brazil), and G2 - clot covered with a synthesized xenogenic membrane. The animals were euthanized after 7, 15 and 30 days, and samples of calvaria were processed to perform morphometric evaluations to measure bone neoformation in the defect region. In addition, ultrastructural characterization of the collagen membranes was performed by scanning electron microscope. The quantitative analyses were carried out by adopting a significance level of 5%. RESULTS The ultrastructural characterization revealed that the synthesized membrane had thicker collagen fibers and a more cohesive surface, compared with the Lumina-Coat® collagen membrane (G1). There was no significant difference in bone neoformation between the membranes (p>0.05), at any of the time periods analyzed. The bone quantification area increased significantly over time for both membranes (p<0.05). CONCLUSION The synthesized membrane exhibited morphological characteristics similar to those of the commercial membrane evaluated, allowed potentially active participation in the bone neoformation process, and served as a low-cost alternative for GBR procedures.
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Park WB, Crasto GJ, Han JY, Kang P, Lim HC. Bone Regenerative Potential of Cross-Linked Collagen Membrane in Peri-Implant Osseous Defect: Case Series with Histologic/Micro-Computed Tomographic Findings. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010176. [PMID: 36676800 PMCID: PMC9861024 DOI: 10.3390/medicina59010176] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023]
Abstract
The role of a barrier membrane is crucial in guided bone regeneration (GBR) for space creation and cell occlusiveness. Those properties of the membrane should be sustained for a sufficient period. For such purpose, several cross-linked collagen membranes were introduced and demonstrated favorable clinical outcomes. However, histologic data were not sufficient to support the effect of cross-linked collagen membranes. In the present case series, healing after GBR using a cross-linked collagen membrane was investigated in-depth via histologic and micro-computed tomographic (micro-CT) analyses. 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide cross-linked collagen membrane was used in GBR for treating various peri-implant bone defects in seven patients. After 4-7 months of healing, newly formed tissue of hard consistency was observed over the implant platform. This tissue was carefully harvested and assessed. In micro-CT and histological analyses, evident new bone formation was revealed, especially in the vicinity of the collagen membrane. Moreover, it was histologically found that some newly formed bone was in intimate contact with the membrane. Although the exact mechanism of bone regeneration in the present cases was not clearly elucidated, the cross-linked collagen membrane appeared to contribute to ossification in GBR. Further studies are needed to confirm the findings of the present case series.
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Affiliation(s)
- Won-Bae Park
- Private Practice in Periodontics and Implant Dentistry, Seoul 02771, Republic of Korea
| | - Gazelle Jean Crasto
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, #PH7E-110, 630 W. 168 St., New York, NY 10032, USA
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Philip Kang
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, #PH7E-110, 630 W. 168 St., New York, NY 10032, USA
- Correspondence: (P.K.); (H.-C.L.); Tel.: +82-2-958-9382 (H.-C.L.)
| | - Hyun-Chang Lim
- Department of Periodontology, Kyung Hee University College of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea
- Correspondence: (P.K.); (H.-C.L.); Tel.: +82-2-958-9382 (H.-C.L.)
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Araújo LK, Lopes MDS, Souza FFPD, Melo MMD, Paulo ADO, Castro-Silva II. Efficiency analysis of commercial polymeric membranes for bone regeneration in rat cranial defects. Acta Cir Bras 2023; 38:e380623. [PMID: 36888756 PMCID: PMC10037556 DOI: 10.1590/acb380623] [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: 11/30/2022] [Accepted: 01/06/2023] [Indexed: 03/08/2023] Open
Abstract
PURPOSE To evaluate the in vivo efficiency of commercial polymeric membranes for guided bone regeneration. METHODS Rat calvarial critical size defects was treated with LuminaCoat (LC), Surgitime PTFE (SP), GenDerm (GD), Pratix (PR), Techgraft (TG) or control (C-) and histomorphometric analysis determined the percentage of new bone, connective tissue and biomaterial at 1 or 3 months. Statistical analysis used ANOVA with Tukey's post-test for means at same experimental time and the paired Student's t test between the two periods, considering p < 0.05. RESULTS New bone at 1 month was higher for SP, TG and C-, at 3 months there were no differences, and between 1 and 3 months PR had greater increase growthing. Connective tissue at 1 month was higher for C-, at 3 months for PR, TG and C-, and between 1 and 3 months C- had sharp decline. Biomaterial at 1 month was higher for LC, in 3 months for SP and TG, and between 1 and 3 months, LC, GD and TG had more decreasing mean. CONCLUSIONS SP had greater osteopromotive capacity and limitation of connective ingrowth, but did not exhibit degradation. PR and TG had favorable osteopromotion, LC less connective tissue and GD more accelerated biodegradation.
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Affiliation(s)
- Lana Karine Araújo
- Universidade Federal do Ceará - Postgraduate Program in Biotechnology - Sobral (CE), Brazil
| | | | | | | | | | - Igor Iuco Castro-Silva
- Universidade Federal do Ceará - Postgraduate Program in Biotechnology - Sobral (CE), Brazil
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Bienz SP, Vaquette C, Ioannidis A, Hämmerle CHF, Jung RE, Ivanovski S, Thoma DS. Tissue integration and biodegradation of soft tissue substitutes with and without compression: an experimental study in the rat. Clin Oral Investig 2023; 27:313-328. [PMID: 36255492 PMCID: PMC9877052 DOI: 10.1007/s00784-022-04726-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/27/2022] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To analyze the influence of compression on tissue integration and degradation of soft tissue substitutes. MATERIAL AND METHODS Six subcutaneous pouches in twenty-eight rats were prepared and boxes made of Al2O3 were implanted and used as carriers for soft tissue substitutes: a collagen matrix (MG), two volume-stable collagen matrices (FG/MGA), and a polycaprolactone scaffold(E). The volume-stable materials (FG/MGA/E) were further implanted with a twofold (2) and a fourfold (4) compression, created by the stacking of additional layers of the substitute materials. The samples were retrieved at 1, 2, and 12 weeks (10 groups, 3 time points, n = 5 per time point and group, overall, 150 samples). The area fraction of infiltrated fibroblasts and inflammatory cells was evaluated histologically. Due to within-subject comparisons, mixed models were conducted for the primary outcome. The level of significance was set at 5%. RESULTS The area fraction of fibroblasts increased in all groups over time. At 12 weeks, the densely compressed materials FG4 (1.1%), MGA4 (1.7%), and MGA2 (2.5%) obtained lower values as compared to the other groups, ranging between 4.7 (E2) and 6.5% (MG). Statistically significant differences (p ≤ 0.05) were observed between groups FG4 vs MG/FG2/E/E4 as well as between MGA4 vs MG/FG2/E/E4 and E vs MGA2. CONCLUSIONS Higher levels of compression led to delayed tissue integration. The effect of different compression levels was more distinct when compared to the differences between the materials. CLINICAL RELEVANCE All biomaterials demonstrated tissue integration and a minimal concomitant inflammatory reaction. Clinically, it might be more favorable to obtain a sufficient flap release or to reduce the material size to improve the tissue integration processes.
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Affiliation(s)
- Stefan P Bienz
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.
| | - Cedryck Vaquette
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - Alexis Ioannidis
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | | | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Sašo Ivanovski
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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Barik A, Kirtania MD. In-Vitro and In-Vivo Tracking of Cell-Biomaterial Interaction to Monitor the Process of Bone Regeneration. Regen Med 2023. [DOI: 10.1007/978-981-19-6008-6_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Hoshi M, Taira M, Sawada T, Hachinohe Y, Hatakeyama W, Takafuji K, Tekemoto S, Kondo H. Preparation of Collagen/Hydroxyapatite Composites Using the Alternate Immersion Method and Evaluation of the Cranial Bone-Forming Capability of Composites Complexed with Acidic Gelatin and b-FGF. MATERIALS (BASEL, SWITZERLAND) 2022; 15:8802. [PMID: 36556608 PMCID: PMC9787395 DOI: 10.3390/ma15248802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Bone-substitute materials are essential in dental implantology. We prepared collagen (Col)/hydroxyapatite (Hap)/acidic gelatin (AG)/basic fibroblast growth factor (b-FGF) constructs with enhanced bone-forming capability. The Col/Hap apatite composites were prepared by immersing Col sponges alternately in calcium and phosphate ion solutions five times, for 20 and 60 min, respectively. Then, the sponges were heated to 56 °C for 48 h. Scanning electron microscopy/energy-dispersive X-ray spectroscopy, Fourier-transform infrared spectroscopy, and X-ray diffraction analyses showed that the Col/Hap composites contained poorly crystalline Hap precipitates on the Col matrix. Col/Hap composite granules were infiltrated by AG, freeze-dried, and immersed in b-FGF solution. The wet quaternary constructs were implanted in rat cranial bone defects for 8 weeks, followed by soft X-ray measurements and histological analysis. Animal studies have shown that the constructs moderately increase bone formation in cranial bone defects. We found that an alternate immersion time of 20 min led to the greatest bone formation (p < 0.05). Constructs placed inside defects slightly extend the preexisting bone from the defect edges and lead to the formation of small island-like bones inside the defect, followed by disappearance of the constructs. The combined use of Col, Hap, AG, and b-FGF might bring about novel bone-forming biomaterials.
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Affiliation(s)
- Miki Hoshi
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan
| | - Masayuki Taira
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho 028-3694, Japan
| | - Tomofumi Sawada
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho 028-3694, Japan
| | - Yuki Hachinohe
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan
| | - Wataru Hatakeyama
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan
| | - Kyoko Takafuji
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan
| | - Shinji Tekemoto
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho 028-3694, Japan
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan
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Layered scaffolds in periodontal regeneration. J Oral Biol Craniofac Res 2022; 12:782-797. [PMID: 36159068 PMCID: PMC9489757 DOI: 10.1016/j.jobcr.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/02/2022] [Indexed: 11/21/2022] Open
Abstract
Periodontitis is a common inflammatory disease in dentistry that may lead to tooth loss and aesthetic problems. Periodontal tissue has a sophisticated architecture including four sections of alveolar bone, cementum, gingiva, and periodontal ligament fiber; all these four can be damaged during periodontitis. Thus, for whole periodontal regeneration, it is important to form both hard and soft tissue structures simultaneously on the tooth root surface without forming junctional epithelium and ankylosis. This condition makes the treatment of the periodontium a challenging process. Various regenerative methods including Guided Bone/Tissue Regeneration (GBR/GTR) using various membranes have been developed. Although using such GBR/GTR membranes was successful for partial periodontal treatment, they cannot be used for the regeneration of complete periodontium. For this purpose, multilayered scaffolds are now being developed. Such scaffolds may include various biomaterials, stem cells, and growth factors in a multiphasic configuration in which each layer is designed to regenerate specific section of the periodontium. This article provides a comprehensive review of the multilayered scaffolds for periodontal regeneration based on natural or synthetic polymers, and their combinations with other biomaterials and bioactive molecules. After highlighting the challenges related to multilayered scaffolds preparation, features of suitable scaffolds for periodontal regeneration are discussed.
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Kölliker R, Hicklin SP, Hirsiger C, Liu CC, Janett F, Schmidlin PR. In Vitro Evaluation of the Permeability of Different Resorbable Xenogeneic Membranes after Collagenolytic Degradation. MEMBRANES 2022; 12:787. [PMID: 36005702 PMCID: PMC9415831 DOI: 10.3390/membranes12080787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
In this in vitro study, we compare the penetration of cells through different resorbable collagen membranes, which were collagenolytically degraded over different time periods. Three different resorbable collagen membranes were evaluated, including two non-cross-linked (NCL) membranes-namely, a porcine (NCL-P) and an equine (NCL-E) membrane-and an enzymatically cross-linked porcine (ECL-B) membrane. A special two-chamber model was fabricated, allowing for the placement of separating membranes, and a non-porous polyester membrane was used as a negative control (C), in order to verify the impermeability of the experimental chamber device. Round membrane samples with a diameter of 16 mm were fabricated. Eighteen membranes of each type were punched and placed on polyethylene nets as carriers. The membranes were then biodegraded-each on its carrier-in 12-well polystyrene plates: three samples of each membrane type were degraded for 1.5, 3, 6, or 12 h in 2 mL of a buffered collagenase solution, at 37 °C. For control purposes, three samples of each membrane type were not degraded, but only immersed in buffer solution for 1.5, 3, 6, or 12 h, at 37 °C. Another three samples of each type of membrane were degraded until complete dissolution, in order to determine the full hydroxyproline content for comparison. Liquid-preserved boar semen (containing at least 120 million sperm cells per milliliter) was used to test the cell occlusivity of the degraded membranes. At baseline and initial degradation, all tested membranes were tight, and no penetration was observed with up to 30 min of incubation time (results not shown). After 1.5 h, cells were partially capable of penetrating the NCL-E membrane only. One sample showed leakage, with a sperm volume of 1.7 million cells/mL over all samples. No penetration occurred in the test, NCL-P, and ECL-B groups. After a degradation time of 3 h, the NCL-P and ECL-B membranes remained occlusive to cells. All the membranes and measurements indicated leakage in the NCL-E group. After 6 h, four NCL-P measurements showed the first signs of cell penetration, as boar spermatozoa were detectable in the lower chamber (64 million cells/mL). The ECL-B membranes remained completely cell occlusive. After 12 h, four NCL-P measurements were cell penetration positive (14.6 million cells/mL), while the ECL-B group remained tight and showed no cell penetration. As the findings of our study are well in accordance with the results of several previous animal studies, it can be concluded that the surrogate model is capable of performing rapid and cheap screening of cell occlusivity for different collagen membranes in a very standardized manner. In particular, claims of long degradation resistance can be easily proven and compared. As the boar spermatozoa used in the present report had a size of 9 × 5 μm, smaller bacteria are probably also able to penetrate the leaking membranes; in this regard, our proposed study set-up may provide valuable information, although it must be acknowledged that sperm cells show active mobility and do not only translocate by growth.
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Affiliation(s)
- Ramona Kölliker
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Stefan P. Hicklin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Constanze Hirsiger
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Chun Ching Liu
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Fredi Janett
- Clinic of Reproductive Medicine, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 204, 8057 Zurich, Switzerland
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
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Wang LH, Ruan Y, Zhao WY, Chen JP, Yang F. Modified membrane fixation technique in a severe continuous horizontal bone defect: A case report. World J Clin Cases 2022; 10:5789-5797. [PMID: 35979105 PMCID: PMC9258389 DOI: 10.12998/wjcc.v10.i17.5789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/26/2022] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Continuous severe horizontal bone defect is common in the aesthetic maxillary anterior area, and presents a major challenge in implant dentistry and requires predictable bone augmentation to increase the width of the alveolar bone.
CASE SUMMARY A 24-year-old man, with a history of well-controlled IgA nephropathy, presented to the Dentistry Department of our hospital complaining of missing his right maxillary anterior teeth 1 mo ago. Severe horizontal alveolar bone defects at sites of teeth 12, 13 and 14 were diagnosed. A modified guided bone regeneration surgical approach stabilizing the absorbable collagen membrane and particulate graft materials by periosteal diagonal mattress suture (PDMS) combined with four corner pins was used for this severe continuous horizontal bone defect. The outcome revealed that the newly formed alveolar ridge dimension increased from 0.72 mm to 11.55 mm horizontally 10 mo postoperatively, with no adverse events. The implant surgery was successfully performed.
CONCLUSION This case highlights that PDMS combined with four corner pins is feasible to maintain the space and stabilize the graft and membranes in severe continuous horizontal bone defect.
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Affiliation(s)
- Lin-Hong Wang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
| | - Yan Ruan
- Graduate Department, Bengbu Medical College, Bengbu 233030, Anhui Province, China
| | - Wen-Yan Zhao
- Department of Stomatology, The First People's Hospital of Hangzhou Lin'an District, Hangzhou 311399, Zhejiang Province, China
| | - Jian-Ping Chen
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
| | - Fan Yang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China
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Bizelli VF, Ramos EU, Veras ASC, Teixeira GR, Faverani LP, Bassi APF. Calvaria Critical Size Defects Regeneration Using Collagen Membranes to Assess the Osteopromotive Principle: An Animal Study. MEMBRANES 2022; 12:membranes12050461. [PMID: 35629786 PMCID: PMC9143843 DOI: 10.3390/membranes12050461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/10/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022]
Abstract
Guided bone regeneration (GBR) is a common practice in implantology, and it is necessary to use membranes in this process. The present study aimed to evaluate the osteopromotive principle of two porcine collagen membranes in critical-size defects at rats calvaria. Ninety-six Albinus Wistar rats were divided into BG (positive control), JS, CS, and CG (negative control) groups and were sacrificed at 7, 15, 30, and 60 days postoperatively. The samples were assessed by histological, histometric, immunohistochemical, and microtomographic analyses. More intense inflammatory profile was seen in the JS and CS groups (p < 0.05). At 60 days, the JS group showed a satisfactory osteopromotive behavior compared to BG (p = 0.193), while CS did not demonstrate the capacity to promote bone formation. At the immunohistochemical analysis, the CS showed mild labeling for osteocalcin (OC) and osteopontin (OP), the JS demonstrated mild to moderate for OC and OP and the BG demonstrated moderate to intense for OC and OP. The tridimensional analysis found the lowest average for the total volume of newly formed bone in the CS (84,901 mm2), compared to the BG (319,834 mm2) (p < 0.05). We conclude that the different thicknesses and treatment techniques of each membrane may interfere with its biological behavior.
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Affiliation(s)
- Vinícius Ferreira Bizelli
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (E.U.R.); (L.P.F.); (A.P.F.B.)
- Correspondence: ; Tel.: +55-(014)-981713458
| | - Edith Umasi Ramos
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (E.U.R.); (L.P.F.); (A.P.F.B.)
| | - Allice Santos Cruz Veras
- Multicenter Graduate Program in Physiological Sciences, SBFIS, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente 19060-900, SP, Brazil; (A.S.C.V.); (G.R.T.)
| | - Giovana Rampazzo Teixeira
- Multicenter Graduate Program in Physiological Sciences, SBFIS, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente 19060-900, SP, Brazil; (A.S.C.V.); (G.R.T.)
| | - Leonardo P. Faverani
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (E.U.R.); (L.P.F.); (A.P.F.B.)
| | - Ana Paula Farnezi Bassi
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (E.U.R.); (L.P.F.); (A.P.F.B.)
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Wu Y, Chen S, Luo P, Deng S, Shan Z, Fang J, Liu X, Xie J, Liu R, Wu S, Wu X, Chen Z, Yeung KWK, Liu Q, Chen Z. Optimizing the bio-degradability and biocompatibility of a biogenic collagen membrane through cross-linking and zinc-doped hydroxyapatite. Acta Biomater 2022; 143:159-172. [PMID: 35149241 DOI: 10.1016/j.actbio.2022.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 01/07/2023]
Abstract
Biogenic collagen membranes have been widely used as soft tissue barriers in guided bone regeneration (GBR) and guided tissue regeneration (GTR). Nevertheless, their clinical performance remains unsatisfactory because of their low mechanical strength and fast degradation rate in vivo. Although cross-linking with chemical agents is effective and reliable for prolonging the degradation time of collagen membranes, some adverse effects including potential cytotoxicity and undesirable tissue integration have been observed during this process. As a fundamental nutritional trace element, zinc plays an active role in promoting the growth of cells and regulating the degradation of the collagen matrix. Herein, a biogenic collagen membrane was cross-linked with glutaraldehyde-alendronate to prolong its degradation time. The physiochemical and biological properties were enhanced by the incorporation of zinc-doped nanohydroxyapatite (nZnHA), with the native structure of collagen preserved. Specifically, the cross-linking combined with the incorporation of 1% and 2% nZnHA seemed to endow the membrane with the most appropriate biocompatibility and tissue integration capability among the cross-linked membranes, as well as offering a degradation period of six weeks in a rat subcutaneous model. Thus, improving the clinical performance of biogenic collagen membranes by cross-linking together with the incorporation of nZnHA is a promising strategy for the improvement of biogenic collagen membranes. STATEMENT OF SIGNIFICANCE: The significance of this research includes.
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Affiliation(s)
- You Wu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Shoucheng Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Pu Luo
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Shudan Deng
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Zhengjie Shan
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Jinghan Fang
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Xingchen Liu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Jiaxin Xie
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Runheng Liu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Shiyu Wu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Xiayi Wu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Zetao Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Kelvin W K Yeung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Quan Liu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China.
| | - Zhuofan Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China.
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Iglesias-Velázquez Ó, Zamora RS, López-Pintor RM, Tresguerres FGF, Berrocal IL, García CM, Tresguerres IF, García-Denche JT. Periosteal Pocket Flap technique for lateral ridge augmentation. A comparative pilot study versus guide bone regeneration. Ann Anat 2022; 243:151950. [DOI: 10.1016/j.aanat.2022.151950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/08/2022] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
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Lindner C, Alkildani S, Stojanovic S, Najman S, Jung O, Barbeck M. In Vivo Biocompatibility Analysis of a Novel Barrier Membrane Based on Bovine Dermis-Derived Collagen for Guided Bone Regeneration (GBR). MEMBRANES 2022; 12:membranes12040378. [PMID: 35448348 PMCID: PMC9027842 DOI: 10.3390/membranes12040378] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 12/19/2022]
Abstract
Collagen-based barrier membranes are nowadays the prevalent option for Guided Bone Regeneration (GBR) procedures. Xenogeneic collagen is highly biocompatible as it shares a similar structure to native human collagen, which prevents it from eliciting an exaggerated host immune response. Most commercially available collagen barrier membranes are porcine-derived, while bovine-derived alternatives are still rarely available. The aim of the present study was to investigate the tissue responses and the barrier functionality of a novel GBR membrane composed of bovine collagen type I (BM). Therefore, the subcutaneous implantation model in Wistar rats was performed to compare the novel medical device with two already clinically used native porcine-based barrier membranes, i.e., Jason® membrane (JM) and Bio-Gide® (BG), at 10-, 30-, 60-, and 90-days post implantationem. Histochemical and immunohistochemical stains were used for histopathological evaluation including a biocompatibility scoring according to the DIN EN ISO 10993-6 norm as well as histomorphometrical analyses of the occurrence of M1 and M2 macrophages and the transmembraneous vascularization. The bovine membrane exhibited a host tissue reaction that was comparable to both control materials, which was verified by the scoring results and the histomorphometrical macrophage measurements. Moreover, the novel membrane exhibited an integration pattern without material fragmentation up to day 60. At day 90, material fragmentation was observable that allowed for “secondary porosity” including transmembrane vascularization. The results of this study suggest that the novel bovine barrier membrane is fully biocompatible and suitable for indications that require GBR as a suitable alternative to porcine-sourced barrier membranes.
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Affiliation(s)
| | - Said Alkildani
- BerlinAnalytix GmbH, 12109 Berlin, Germany; (C.L.); (S.A.)
| | - Sanja Stojanovic
- Department for Cell and Tissue Engineering, Faculty of Medicine, University of Niš, 18000 Nis, Serbia; (S.S.); (S.N.)
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18000 Nis, Serbia
| | - Stevo Najman
- Department for Cell and Tissue Engineering, Faculty of Medicine, University of Niš, 18000 Nis, Serbia; (S.S.); (S.N.)
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18000 Nis, Serbia
| | - Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany;
| | - Mike Barbeck
- BerlinAnalytix GmbH, 12109 Berlin, Germany; (C.L.); (S.A.)
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany;
- Correspondence: ; Tel.: +49-176-81022467
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Li D, Wang T, Zhao J, Wu J, Zhang S, He C, Zhu M, El-Newehy M, El-Hamshary H, Morsi Y, Gao Y, Mo X. Prodrug inspired bi-layered electrospun membrane with properties of enhanced tissue integration for guided tissue regeneration. J Biomed Mater Res B Appl Biomater 2022; 110:2050-2062. [PMID: 35322549 DOI: 10.1002/jbm.b.35059] [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: 03/31/2021] [Revised: 03/01/2022] [Accepted: 03/12/2022] [Indexed: 11/09/2022]
Abstract
Guided tissue regeneration (GTR) membranes play a vital role in periodontal surgery. Recently a series of composite electrospun membranes have been fabricated to improve the unexpected biodegradation of collagen-based GTR membranes. However, their tissue integrity needs to be studied in depth. In this study, a bi-layered electrospun membrane (BEM) inspired by "prodrug" was fabricated, which contained a dense-layer (BEM-DL) and a potential loose-layer (BEM-LL). The nanofibers of BEM-DL were composed of poly(l-lactic-co-glycolic acid) and tilapia skin collagen (TSC). Whereas the BEM-LL consisted of two types of nanofibers, one was the same as BEM-DL and the other was made from TSC. The morphology, degradation in vitro, cytocompatibility and biocompatibility in rats were investigated with a poly(lactic-co-glycolic acid) electrospun membrane (PLGA) as the negative control. The pore size of BEM-LL soaked for 7 days became larger than the original sample (164.8 ± 90.9 and 52.5 ± 21.0 μm2 , respectively), which was significantly higher (p < .05) than that of BEM-DL and PLGA. The BEM-LL displayed a larger weight loss rate of 82.3 ± 3.6% than the BEM-DL of 46.0 ± 2.8% at day 7 because of the rapid degradation of TSC fibers. The cytocompatibility test demonstrated that L929 cells were only spread on the surface of the BEM-DL while MC3T3-E1 cells grew into the BEM-LL layer. The subcutaneous implantation test further proved that BEM-DL performed as a cellular barrier, whereas BEM-LL was conducive to cell infiltration as deep as 200 μm with reduced fibrous encapsulation. Herein, the BEM inspired by "prodrug" is a promising GTR membrane with a property of enhanced tissue integration.
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Affiliation(s)
- Dongsheng Li
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Tong Wang
- College of Life Sciences, Yantai University, Yantai, China
| | - Juanjuan Zhao
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, China
| | - Jinglei Wu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Shumin Zhang
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, China
| | - Chuanglong He
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Meifang Zhu
- State Key Lab of Chemical Fibers & Polymer Materials, College of Materials Science & Engineering, Donghua University, Shanghai, China
| | - Mohamed El-Newehy
- Department of Chemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Hany El-Hamshary
- Department of Chemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Yosry Morsi
- Faculty of Engineering and Industrial Sciences, Swinburne University of Technology, Boroondara, Australia
| | - Yonglin Gao
- College of Life Sciences, Yantai University, Yantai, China
| | - Xiumei Mo
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
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Fraser D, Caton J, Benoit DSW. Periodontal Wound Healing and Regeneration: Insights for Engineering New Therapeutic Approaches. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.815810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Periodontitis is a widespread inflammatory disease that leads to loss of the tooth supporting periodontal tissues. The few therapies available to regenerate periodontal tissues have high costs and inherent limitations, inspiring the development of new approaches. Studies have shown that periodontal tissues have an inherent capacity for regeneration, driven by multipotent cells residing in the periodontal ligament (PDL). The purpose of this review is to describe the current understanding of the mechanisms driving periodontal wound healing and regeneration that can inform the development of new treatment approaches. The biologic basis underlying established therapies such as guided tissue regeneration (GTR) and growth factor delivery are reviewed, along with examples of biomaterials that have been engineered to improve the effectiveness of these approaches. Emerging therapies such as those targeting Wnt signaling, periodontal cell delivery or recruitment, and tissue engineered scaffolds are described in the context of periodontal wound healing, using key in vivo studies to illustrate the impact these approaches can have on the formation of new cementum, alveolar bone, and PDL. Finally, design principles for engineering new therapies are suggested which build on current knowledge of periodontal wound healing and regeneration.
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A Comparative Study of an Anti-Thrombotic Small-Diameter Vascular Graft with Commercially Available e-PTFE Graft in a Porcine Carotid Model. Tissue Eng Regen Med 2022; 19:537-551. [PMID: 35167044 PMCID: PMC9130378 DOI: 10.1007/s13770-021-00422-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 12/11/2022] Open
Abstract
Background: We have designed a reinforced drug-loaded vascular graft composed of polycaprolactone (PCL) and polydioxanone (PDO) via a combination of electrospinning/3D printing approaches. To evaluate its potential for clinical application, we compared the in vivo blood compatibility and performance of PCL/PDO + 10%DY grafts doped with an antithrombotic drug (dipyridamole) with a commercial expanded polytetrafluoroethylene (e-PTFE) graft in a porcine model. Methods: A total of 10 pigs (weight: 25–35 kg) were used in this study. We made a new 5-mm graft with PCL/PDO composite nanofiber via the electrospinning technique. We simultaneously implanted a commercially available e-PTFE graft (n = 5) and our PCL/PDO + 10%DY graft (n = 5) into the carotid arteries of the pigs. No anticoagulant/antiplatelet agent was administered during the follow-up period, and ultrasonography was performed weekly to confirm the patency of the two grafts in vivo. Four weeks later, we explanted and compared the performance of the two grafts by histological analysis and scanning electron microscopy (SEM). Results: No complications, such as sweating on the graft or significant bleeding from the needle hole site, were seen in the PCL/PDO + 10%DY graft immediately after implantation. Serial ultrasonographic examination and immunohistochemical analysis demonstrated that PCL/PDO + 10%DY grafts showed normal physiological blood flow and minimal lumen reduction, and pulsed synchronously with the native artery at 4 weeks after implantation. However, all e-PTFE grafts occluded within the study period. The luminal surface of the PCL/PDO + 10%DY graft in the transitional zone was fully covered with endothelial cells as observed by SEM. Conclusion: The PCL/PDO + 10%DY graft was well tolerated, and no adverse tissue reaction was observed in porcine carotid models during the short-term follow-up. Colonization of the graft by host endothelial and smooth muscle cells coupled with substantial extracellular matrix production marked the regenerative capability. Thus, this material may be an ideal substitute for vascular reconstruction and bypass surgeries. Long-term observations will be necessary to determine the anti-thrombotic and remodeling potential of this device. Supplementary Information The online version contains supplementary material available at 10.1007/s13770-021-00422-4.
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Sanz-Sánchez I, Sanz-Martín I, Ortiz-Vigón A, Molina A, Sanz M. Complications in bone-grafting procedures: Classification and management. Periodontol 2000 2022; 88:86-102. [PMID: 35103322 DOI: 10.1111/prd.12413] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bone-regenerative interventions aiming to restore deficient alveolar ridges, such as the use of block grafts or through the application of guided bone-regeneration principles, have reported positive outcomes in the published scientific literature. These interventions, however, are invasive, and hence, intraoperative and/or postoperative complications may occur. The types of complications and their severity may vary from the exposure of the biomaterial (membrane or graft) to postsurgical infections, neurosensorial disturbances, occurrence of hemorrhage, and pain, etc. The aim of the present narrative review was to search the available scientific evidence concerning the incidence of these complications, their effect on treatment outcomes, their clinical management and, finally, strategies aimed at prevention. Exposure of the barrier membrane or the block graft is the most common complication associated with oral regenerative interventions. To manage these complications, depending on the extent of the exposure and the presence or absence of concomitant infections, therapeutic measures may vary, from the topical application of antiseptics to the removal of the barrier membrane or the block graft. Regardless of their treatment, the occurrence of these complications has been associated with patient selection, with compliant patients (eg, nonsmokers) having a lower reported incidence of complications. Similarly, surgical factors such as correct flap elevation and a tensionless closure are of obvious importance. Finally, to prevent the incidence of complications, it appears prudent to utilize whenever possible less invasive surgical interventions.
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Affiliation(s)
- Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | | | | | - Ana Molina
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
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Hoshi M, Sawada T, Hatakeyama W, Taira M, Hachinohe Y, Takafuji K, Kihara H, Takemoto S, Kondo H. Characterization of Five Collagenous Biomaterials by SEM Observations, TG-DTA, Collagenase Dissolution Tests and Subcutaneous Implantation Tests. MATERIALS 2022; 15:ma15031155. [PMID: 35161098 PMCID: PMC8839282 DOI: 10.3390/ma15031155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/24/2022] [Accepted: 01/30/2022] [Indexed: 11/25/2022]
Abstract
Collagenous biomaterials that are clinically applied in dentistry have dermis-type and membrane-type, both of which are materials for promoting bone and soft tissue formation. The properties of materials supplied with different types could affect their biodegradation periods. The purpose of this study was to characterize five of these products by four different methods: scanning electron microscopy (SEM) observation, thermogravimetry-differential thermal analysis (TG-DTA), 0.01 wt% collagenase dissolution test, and subcutaneous implantation test in vivo. SEM micrographs revealed that both dermis and membranous materials were fibrous and porous. The membranous materials had higher specific derivative thermal gravimetry (DTG) peak temperatures in TG-DTA at around 320 °C, longer collagenase dissolution time ranging from about 300 to 500 min, and more longevity in mice exceeding 9 weeks than the dermis materials. There existed a correlation between the peak temperature in TG-DTA and the collagenase dissolution time. It was considered that higher cross-link degree among collagen fibrils of the membrane-type collagenous materials might account for these phenomena. The experimental protocol and numerical results obtained could be helpful for selection and future development of fibrous collagenous biomaterials in clinical use.
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Affiliation(s)
- Miki Hoshi
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Iwate, Japan; (M.H.); (W.H.); (Y.H.); (K.T.); (H.K.); (H.K.)
| | - Tomofumi Sawada
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho 028-3694, Iwate, Japan; (T.S.); (S.T.)
| | - Wataru Hatakeyama
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Iwate, Japan; (M.H.); (W.H.); (Y.H.); (K.T.); (H.K.); (H.K.)
| | - Masayuki Taira
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho 028-3694, Iwate, Japan; (T.S.); (S.T.)
- Correspondence: ; Tel.: +81-19-651-5110
| | - Yuki Hachinohe
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Iwate, Japan; (M.H.); (W.H.); (Y.H.); (K.T.); (H.K.); (H.K.)
| | - Kyoko Takafuji
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Iwate, Japan; (M.H.); (W.H.); (Y.H.); (K.T.); (H.K.); (H.K.)
| | - Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Iwate, Japan; (M.H.); (W.H.); (Y.H.); (K.T.); (H.K.); (H.K.)
| | - Shinji Takemoto
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho 028-3694, Iwate, Japan; (T.S.); (S.T.)
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Iwate, Japan; (M.H.); (W.H.); (Y.H.); (K.T.); (H.K.); (H.K.)
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An YZ, Strauss FJ, Park JY, Shen YQ, Thoma DS, Lee JS. Membrane fixation enhances guided bone regeneration in standardized calvarial defects: A pre-clinical study. J Clin Periodontol 2022; 49:177-187. [PMID: 34866208 DOI: 10.1111/jcpe.13583] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/09/2021] [Accepted: 11/23/2021] [Indexed: 12/21/2022]
Abstract
AIM To determine whether collagen membrane (CM) fixation enhances guided bone regeneration in standardized defects. MATERIALS AND METHODS Four 8-mm-diameter defects were surgically made in eight rabbit calvaria, and randomly allocated into four groups: control (empty), unfixed-CM, fixed-CM, and unfixed-CM with bone graft (BG + CM) (positive control). After 1- and 4-week healing periods, the animals were sacrificed and quantitative reverse transcription polymerase chain reaction, micro-computed tomography, and histological outcomes were assessed. RESULTS At week 1, the expression levels of BMP-2, FGF-2, VEGF, and osteocalcin were significantly higher in the fixed-CM group than in the unfixed-CM and control groups (p < .05). Conversely, cathepsin-K was significantly expressed in the unfixed-CM group. No significant differences in expression markers were observed between the fixed-CM and BG + CM groups (p > .05). At week 4, new bone formation was significantly higher in the fixed-CM group than the unfixed-CM and control groups (p < .05), but similar to the BG + CM group (p > .05). CONCLUSIONS CM fixation enhances the expression of osteogenic factors similar to BG + CM, leading to significantly more new bone formation. This suggests that the osteogenic potential is greater when membranes are fixed, thereby limiting the necessity of membrane-supporting materials to enhance bone formation.
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Affiliation(s)
- Yin-Zhe An
- Department of Periodontology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Yu Qin Shen
- Department of Periodontology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Daniel Stefan Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Jung-Seok Lee
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Republic of Korea
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Li C, Lv H, Du Y, Zhu W, Yang W, Wang X, Wang J, Chen W. Biologically modified implantation as therapeutic bioabsorbable materials for bone defect repair. Regen Ther 2021; 19:9-23. [PMID: 35024389 PMCID: PMC8732753 DOI: 10.1016/j.reth.2021.12.004] [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: 11/04/2021] [Revised: 12/08/2021] [Accepted: 12/20/2021] [Indexed: 12/26/2022] Open
Abstract
For decades, researches have concentrated on the mechanical properties, biodegradation, and biocompatibility of implants used in the therapy of large size bone defect. In vivo studies demonstrate that bioabsorbable bone substitute materials can reduce the risk of common symptoms such as inflammation and osteonecrosis caused by bio-inert materials after long-term implantation. Several organic, inorganic, and composite materials have been approved for clinical application, based on their unique characteristics and advantages. Although some artificial bioabsorbable bone substitute materials have been used for years, there are still some disadvantages existing, such as low mechanical strength, high brittleness, and low degradation rate. Therefore, novel bioabsorbable composite materials biomaterials have been developed for bone defect repair. In this review, we provide an overview of the development of artificial bioabsorbable bone substitute materials and highlight the advantages and disadvantages. Furthermore, recent advances in bioabsorbable bone substitute materials used in bone defect repair are outlined. Finally, we discuss current challenges and further developments in the clinical application of bioabsorbable bone substitute materials.
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Affiliation(s)
- Chao Li
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China
| | - Hongzhi Lv
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China
| | - Yawei Du
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, PR China
| | - Wenbo Zhu
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China
| | - Weijie Yang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China
| | - Xiumei Wang
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, No.30 Shuangqing Road, Beijing 100084, PR China
| | - Juan Wang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Corresponding author. No.139 Ziqiang Road, Shjiazhuang 050051, PR China. Fax: +86-311-87023626.
| | - Wei Chen
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051, PR China,Corresponding author. No.139 Ziqiang Road, Shjiazhuang 050051, PR China. Fax: +86-311-87023626.
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Friedmann A, Fickl S, Fischer KR, Dalloul M, Goetz W, Kauffmann F. Horizontal Augmentation of Chronic Mandibular Defects by the Guided Bone Regeneration Approach: A Randomized Study in Dogs. MATERIALS (BASEL, SWITZERLAND) 2021; 15:238. [PMID: 35009383 PMCID: PMC8746186 DOI: 10.3390/ma15010238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Various biomaterial combinations have been studied focusing on their ability to stabilize blood clots and maintain space under soft tissue to support new bone formation. A popular combination is Deproteinized Bovine Bone Mineral (DBBM) placed with a native collagen membrane (NCM) tacked to native bone. In this study, we compared the outcome of this treatment option to those achieved with three different graft/membrane combinations with respect to total newly occupied area and the mineralized compound inside. After bi-lateral extraction of two mandibular premolars in five adult beagles L-shaped alveolar defects were created. A total of 20 defects healed for 6 weeks resulting in chronic type bone defects. At baseline, four options were randomly allocated to five defects each: a. DBBM + NCM with a four-pin fixation across the ridge; b. DBBM + RCLC (ribose cross-linked collagen membrane); c. DBBM + NPPM (native porcine pericardium membrane); and d. Ca-sulfate (CS) + RCLC membrane. Membranes in b/c/d were not fixed; complete tensionless wound closure was achieved by CAF. Termination after 3 months and sampling followed, and non-decalcified processing and toluidine blue staining were applied. Microscopic images obtained at standardized magnification were histomorphometrically assessed by ImageJ software (NIH). An ANOVA post hoc test was applied; histomorphometric data are presented in this paper as medians and interquartile ranges (IRs). All sites healed uneventfully, all sites were sampled and block separation followed before Technovit embedding. Two central sections per block for each group were included. Two of five specimen were lost due to processing error and were excluded from group b. New bone area was significantly greater for option b. compared to a. (p = 0.001), c. (p = 0.002), and d. (p = 0.046). Residual non-bone graft area was significantly less for option d. compared to a. (p = 0.026) or c. (p = 0.021). We conclude that collagen membranes with a prolonged resorption/barrier profile combined with bone substitutes featuring different degradation profiles sufficiently support new bone formation. Tacking strategy/membrane fixation appears redundant when using these biomaterials.
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Affiliation(s)
- Anton Friedmann
- Department of Periodontology, Faculty of Health, School of Dentistry, Witten/Herdecke University, 58455 Witten, Germany;
| | - Stefan Fickl
- Department of Periodontology, University of Würzburg, 97070 Würzburg, Germany;
- Private Office, 90762 Fürth, Germany
| | - Kai R. Fischer
- Center of Dental Medicine, Clinic for Conservative Preventive Dentistry, Division for Periodontology & Peri-Implant Diseases, University of Zurich, 8032 Zurich, Switzerland;
| | - Milad Dalloul
- Department of Periodontology, Faculty of Health, School of Dentistry, Witten/Herdecke University, 58455 Witten, Germany;
- Private Office, 56727 Koblenz, Germany
| | - Werner Goetz
- Department for Orthodontics, Friedrich-Wilhelm-University Bonn, 53111 Bonn, Germany;
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