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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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Pan Y, Xiao Y, Hao Y, Shi K, Pan M, Qian Z. An injectable mPEG-PDLLA microsphere/PDLLA-PEG-PDLLA hydrogel composite for soft tissue augmentation. CHINESE CHEM LETT 2022. [DOI: 10.1016/j.cclet.2021.12.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Poly (l-lactic acid) membrane crosslinked with Genipin for guided bone regeneration. Int J Biol Macromol 2021; 191:1228-1239. [PMID: 34619279 DOI: 10.1016/j.ijbiomac.2021.09.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/08/2021] [Accepted: 09/17/2021] [Indexed: 12/20/2022]
Abstract
In this study, we chemically modified poly(L-lactic acid) (PLLA) with functional amine groups and fabricated a PLLA membrane crosslinked with genipin as a biomembrane for inducing guided bone regeneration (GBR). The mechanical strength of the PLLA-amine membrane was improved by crosslinking with genipin compared to pure PLLA membrane. The surface of the PLLA-amine membrane crosslinked with genipin had many more uniform pores. Attachment and proliferation of MC3T3-E1 cells were increased and improved on the PLLA-amine membrane crosslinked with genipin. In an in vitro osteogenesis study, MC3T3-E1 cells on the PLLA membrane showed higher alkaline phosphatase (ALP) activity and calcification ability evaluated by alizarin red S staining than those on the pure PLLA membrane. When a skull defect hole of a rat was covered with the PLLA-amine membrane crosslinked with genipin, vigorous new bone regeneration determined by computed tomography at 8 weeks post operation was superior to that when the skull defect was covered with the pure PLLA membrane. Taken together, these results demonstrate that the PLLA-amine membrane crosslinked with genipin has a promising therapeutic application to GBR as a barrier membrane for covering the defect site.
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Lin CC, Chiu JY. A novel γ-PGA composite gellan membrane containing glycerol for guided bone regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 118:111404. [PMID: 33255007 DOI: 10.1016/j.msec.2020.111404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 08/03/2020] [Accepted: 08/11/2020] [Indexed: 11/19/2022]
Abstract
An ideal barrier membrane design should incorporate the function of a delivery vehicle for transporting drugs and osteoinductive factors to where the body is under inflammation. In the present study, a functional hydrogel-based barrier membrane is fabricated using calcium-form poly-γ-glutamic acid (γ-PGA) and glycerol blending into gellan gum. The concentration of the calcium-form poly-γ-glutamic acid (γ-PGA) and the glycerol ratio are studied for improving practicability in easy-handling and expanding the coverage area. Gellan gum-based membranes with uniformly distributed calcium aggregates are not only successfully manufactured but also providing excellent characteristics for protein adsorption, bioactivity, and bone cell maturation. Our composite gellan gum-based membranes were tested including to their morphology, mechanical properties, swelling behavior, protein adsorption, drug diffusion, and lysozyme degradation. The biocompatibility, proliferation, and osteoblastic response of membranes were examined by osteoblast-like (MG63) cells. Our results indicate that adequate physical cross-linking with γ-PGA improves the original mechanical properties and delays degradation. Growing glycerol ratio not only enhances the elongation at break and diffusion rate, but it also changes the tensile strength and the remaining weight. In vitro biocompatibility tests, an adequate ratio of γ-PGA modification significantly enhances the proliferation, the secretion of alkaline phosphatase (ALP) and mineralization. However, worth noting is the glycerol-modified membrane cannot bear a close resemblance with the non-glycerol group in the high level of osteoblastic response. In general, these tunable materials with biocompatibility, biodegradability, and positive osteoblastic responses were poised to be possible candidates for bone defect repair.
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Affiliation(s)
- Chi-Chang Lin
- Department of Chemical and Material Engineering, Tunghai University, Taichung 40704, Taiwan.
| | - Jiun-Yan Chiu
- Department of Chemical and Material Engineering, Tunghai University, Taichung 40704, Taiwan
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Shahdad S, Gamble E, Matani J, Zhang L, Gambôa A. Randomized clinical trial comparing PEG‐based synthetic to porcine‐derived collagen membrane in the preservation of alveolar bone following tooth extraction in anterior maxilla. Clin Oral Implants Res 2020; 31:1010-1024. [PMID: 32799365 DOI: 10.1111/clr.13648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/23/2020] [Accepted: 05/23/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Shakeel Shahdad
- Barts Health NHS Trust The Royal London Dental Hospital London UK
- Barts and The London School of Medicine and Dentistry Queen Mary University of London London UK
| | - Eugene Gamble
- Barts Health NHS Trust The Royal London Dental Hospital London UK
| | - Jay Matani
- Barts and The London School of Medicine and Dentistry Queen Mary University of London London UK
| | - Liang Zhang
- Barts and The London School of Medicine and Dentistry Queen Mary University of London London UK
- State Key Laboratory of Oral Diseases Department of Oral Implantology National Clinical Research Center for Oral Diseases West China Hospital of Stomatology Sichuan University Chengdu China
| | - Ana Gambôa
- University of Bristol School of Oral and Dental Sciences Bristol UK
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Jung RE, Mihatovic I, Cordaro L, Windisch P, Friedmann A, Blanco Carrion J, Sanz Sanchez I, Hallman M, Quirynen M, Hammerle CHF. Comparison of a polyethylene glycol membrane and a collagen membrane for the treatment of bone dehiscence defects at bone level implants-A prospective, randomized, controlled, multicenter clinical trial. Clin Oral Implants Res 2020; 31:1105-1115. [PMID: 32875638 DOI: 10.1111/clr.13657] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 07/30/2020] [Accepted: 08/02/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of the present randomized, controlled clinical multicenter trial was to compare a polyethylene glycol (PEG) and a native collagen membrane (BG) for simultaneous guided bone regeneration at bony dehiscence-type defects around bone level titanium implants. MATERIAL AND METHODS The study enrolled 117 patients requiring implant treatment in the posterior maxilla or mandible with expected buccal bony dehiscence-type defects at the placed titanium implants. According to a parallel groups design, defects were filled with a synthetic bone filler and randomly assigned to either PEG or BG membrane. As primary parameter, the relative vertical bone fill was assessed at baseline and at re-entry after 6 months of healing. As secondary parameters, the marginal bone level (MBL) was assessed radiographically and soft tissue conditions were recorded up to 18 months postloading. RESULTS Both groups showed comparable vertical bone fill revealing a relative change in defect height of 59.7% (PEG) and 64.4% (BG). The absolute mean reduction in defect size was 2.5 mm in the PEG group and 3.2 mm in the BG group. Although both groups revealed a statistically significant mean defect reduction (p < .001), a comparison between the two groups did not show statistical significances. The non-inferiority test with inferiority limit of -5% could not be rejected, based on the 90% confidence interval of the differences of the two means with lower limit -15.4%. After 18 months, an MBL increase of 0.45 ± 0.43 mm in the PEG group and 0.41 ± 0.81 mm in the BG group was detected (p < .001). Soft tissue complications were observed in both groups without showing statistical significance. CONCLUSIONS Both membranes supported bone regeneration at dehiscence-type defects and obtained vertical bone fill with a relative change in defect height of 59.7% (PEG) and 64.4% (BG); however, the non-inferiority of PEG could not be shown.
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Affiliation(s)
- Ronald Ernst Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Ilja Mihatovic
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany
| | - Luca Cordaro
- Department of Periodontics and Prosthodontics, Policlinico Umberto I, Eastman Dental Hospital, Rome, Italy
| | - Péter Windisch
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Anton Friedmann
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Juan Blanco Carrion
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ignacio Sanz Sanchez
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Mats Hallman
- Department of Oral and Maxillofacial Surgery, Public Health Service, Gävle, Sweden
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
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Hozumi T, Sreedevi AM, Ohta S, Ito T. Nonlinear Pressure Drop Oscillations during Gelation in a Kenics Static Mixer. Ind Eng Chem Res 2020. [DOI: 10.1021/acs.iecr.9b06571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Takuro Hozumi
- Department of Chemical System Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Athira M Sreedevi
- Department of Chemical System Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Seiichi Ohta
- Center for Disease Biology and Integrative Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Taichi Ito
- Department of Chemical System Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Center for Disease Biology and Integrative Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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The Release of the Bromodomain Ligand N,N-Dimethylacetamide Adds Bioactivity to a Resorbable Guided Bone Regeneration Membrane in a Rabbit Calvarial Defect Model. MATERIALS 2020; 13:ma13030501. [PMID: 31973011 PMCID: PMC7040842 DOI: 10.3390/ma13030501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/08/2020] [Accepted: 01/14/2020] [Indexed: 12/23/2022]
Abstract
N,N-Dimethylacetamide (DMA) is FDA approved as an excipient and is used as drug-delivery vehicle. Due to its amphipathic nature and diverse bioactivities, it appears to be a good combination of biodegradable poly-lactide-co-glycolide (PLGA)-based guided bone regeneration membranes. Here we show that the solvent DMA can be loaded to PLGA membranes by different regimes, leading to distinct release profiles, and enhancing the bone regeneration in vivo. Our results highlight the potential therapeutic benefits of DMA in guided bone regeneration procedures, in combination with biodegradable PLGA membranes.
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Histological Evaluation of a New Beta-Tricalcium Phosphate/Hydroxyapatite/Poly (1-Lactide-Co-Caprolactone) Composite Biomaterial in the Inflammatory Process and Repair of Critical Bone Defects. Symmetry (Basel) 2019. [DOI: 10.3390/sym11111356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: The use of biomaterials is commonplace in dentistry for bone regeneration. The aim of this study was to evaluate the performance of a new alloplastic material for bone repair in critical defects and to evaluate the extent of the inflammatory process. Methods: Forty-five New Zealand rabbits were divided into five groups according to evaluation time (7, 14, 30, 60, 120 days), totaling 180 sites with six-millimeter diameter defects in their tibiae. The defects were filled with alloplastic material consisting of poly (lactide-co-caprolactone), beta-tricalcium phosphate, hydroxyapatite and nano-hydroxyapatite (BTPHP) in three different presentations: paste, block, and membrane. Comparisons were established with reference materials, such as Bio-ossTM, Bio-oss CollagenTM, and Bio-gideTM, respectively. The samples were HE-stained and evaluated for inflammatory infiltrate (scored for intensity from 0 to 3) and the presence of newly formed bone at the periphery of the defects. Results: Greater bone formation was observed for the alloplastic material and equivalent inflammatory intensity for both materials, regardless of evaluation time. At 30 days, part of the synthetic biomaterial, regardless of the presentation, was resorbed. Conclusions: We concluded that this novel alloplastic material showed osteoconductive potential, biocompatibility, low inflammatory response, and gradual resorption, thus an alternative strategy for guided bone regeneration.
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Kobayashi E, Fujioka‐Kobayashi M, Saulacic N, Schaller B, Sculean A, Miron RJ. Effect of enamel matrix derivative liquid in combination with a natural bone mineral on new bone formation in a rabbit GBR model. Clin Oral Implants Res 2019; 30:542-549. [DOI: 10.1111/clr.13440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/09/2018] [Accepted: 09/22/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Eizaburo Kobayashi
- Department of Cranio‐Maxillofacial Surgery, Inselspital, Bern University Hospital University of Bern Bern Switzerland
- Department of Oral and Maxillofacial Surgery, School of Life, Dentistry at Niigata The Nippon Dental University Niigata Japan
| | - Masako Fujioka‐Kobayashi
- Department of Cranio‐Maxillofacial Surgery, Inselspital, Bern University Hospital University of Bern Bern Switzerland
| | - Nikola Saulacic
- Department of Cranio‐Maxillofacial Surgery, Inselspital, Bern University Hospital University of Bern Bern Switzerland
| | - Benoit Schaller
- Department of Cranio‐Maxillofacial Surgery, Inselspital, Bern University Hospital University of Bern Bern Switzerland
| | - Anton Sculean
- Department of Periodontology University of Bern Bern Switzerland
| | - Richard J. Miron
- Department of Periodontology University of Bern Bern Switzerland
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Santana R, Gyurko R, Kanasi E, Xu WP, Dibart S. Synthetic polymeric barrier membrane associated with blood coagulum, human allograft, or bovine bone substitute for ridge preservation: a randomized, controlled, clinical and histological trial. Int J Oral Maxillofac Surg 2018; 48:675-683. [PMID: 31014520 DOI: 10.1016/j.ijom.2018.02.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 02/11/2018] [Accepted: 02/26/2018] [Indexed: 10/27/2022]
Abstract
During the normal healing process, an extraction site may lose significant bone volume, making implant placement problematic. Quantitative evaluations of the amount of bone maintained by socket preservation with various materials are limited. The objective of this study was to evaluate, both clinically and histologically, the extent of alveolar bone preservation by blood coagulum (BC) and the potential additional benefits of bone allograft material (AL) versus the state-of-the-art bovine bone mineral (BB), covered by a polyethylene glycol (PEG) barrier, in extraction socket grafting procedures. Adult patients (n=32) with single-rooted teeth indicated for extraction were treated (45 sites). After atraumatic extraction, the sockets were filled with BC, AL, or BB and covered with a synthetic PEG barrier membrane. Changes in bone height and width were measured clinically and the amount of bone formed and residual graft particles were measured histologically after 6 months. Changes in ridge width at 6 months were -1.5mm for AL versus -2.5mm for BB and -2.3mm for BC. New bone formation amounted to 47.8%, 33.3%, and 28.2% at BC-, AL-, and BB-treated sites, respectively. Using AL with the PEG barrier preserved the ridge width at 6 months better than BB or BC and resulted in similar amounts of bone histologically to BB.
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Affiliation(s)
- R Santana
- Department of Periodontology, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA; Department of Periodontology, Federal Fluminense University, Dental School, Niteroi, Rio de Janeiro, Brazil
| | - R Gyurko
- Periodontology Department, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - E Kanasi
- Department of Periodontology, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA
| | - W P Xu
- Department of Periodontology, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA
| | - S Dibart
- Department of Periodontology, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA.
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De Lucca L, da Costa Marques M, Weinfeld I. Guided bone regeneration with polypropylene barrier in rabbit's calvaria: A preliminary experimental study. Heliyon 2018; 4:e00651. [PMID: 30003155 PMCID: PMC6041361 DOI: 10.1016/j.heliyon.2018.e00651] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/14/2018] [Accepted: 06/05/2018] [Indexed: 11/28/2022] Open
Abstract
Objectives This study aimed to evaluate the bone formation process in experimental defects created on rabbit calvarial, in which one of the bone defects was covered by the impermeable membrane before suturing the skin flap, while the other was closed only by the cutaneous flap. The experimental holes were filled only by the blood clot. Material and methods Sixteen New Zealand female rabbits weighing between 3.5 and 4 kg were used. Two experimental bone defects were made in the rabbit calvarial. The holes were filled only with the blood clot and one of them was covered with an impermeable polypropylene membrane. A histological analysis was made at 21 and 42 days following the surgery. Histological evaluation consisted of the following: 1. inflammatory process; 2. Bone repair; 3. Bone remodeling; 4. Presence of osteoid matrix and mineralization, and 5. Formation of hematopoietic tissue. Each characteristic was analyzed semi quantitatively. Results There was a statistical difference between the test and the control group at 21 days of healing in the following items: presence of cementation line (p = 0.012), presence of osteoid tissue (p = 0.012), and trabecular bone tissue development and mineralization (p = 0.012). A greater amount of lamellar bone tissue (mature) was also observed in the test group compared to the control group. Conclusion The semiquantitative analysis showed that at 21 days there was a superiority of the repair process in the test group; at 42 days there was no significant difference in bone formation between the two groups; and that the polypropylene membrane is feasible to be used in GBR. Clinical significance The impermeable polypropylene barrier is feasible for use in the guided bone regeneration technique. It can be used only on the blood clot, without the need for grafting, and can be easily removed a few days after surgery. These results are unprecedented.
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Affiliation(s)
| | | | - Ilan Weinfeld
- Universidade de Santo Amaro - UNISA, São Paulo, SP, Brazil
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Cha JK, Jung UW, Thoma DS, Hämmerle CHF, Jung RE. Osteogenic efficacy of BMP-2 mixed with hydrogel and bone substitute in peri-implant dehiscence defects in dogs: 16 weeks of healing. Clin Oral Implants Res 2018; 29:300-308. [PMID: 29341335 DOI: 10.1111/clr.13117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective of this study was to determine the effect of bone morphogenetic protein-2 (BMP-2) mixed with either polyethylene glycol hydrogel or synthetic bone substitute (SBS) on new bone formation in peri-implant dehiscence defects after 16 weeks of healing. MATERIALS AND METHODS A guided bone regeneration procedure was performed in box-type peri-implant defects that were surgically prepared in six beagle dogs. The following four experimental groups were used (i) control (no graft), (ii) SBS+hydrogel, (iii) SBS+BMP-2/hydrogel and (iv) BMP-2/SBS+hydrogel. Volumetric analysis using micro-computed tomography and histomorphometric analysis was performed at 16 weeks post-operatively. RESULTS The amount of new bone and the total augmented volume did not differ significantly between both BMP-treated groups and the SBS+hydrogel group (p > .05). Likewise, no histometric differences were observed in the values of new bone area and bone-to-implant contact ratio among the three augmentation groups (new bone area: 0.06 ± 0.08, 0.19 ± 0.20, 0.48 ± 0.37 and 0.56 ± 0.60 mm2 [mean ± standard deviation] in groups 1-4, respectively; bone-to-implant contact: 9.44 ± 11.51%, 19.91 ± 15.19%, 46.31 ± 29.82% and 42.58 ± 26.27% in groups 1-4, respectively). CONCLUSION The osteogenic efficacy of BMP-2 on the regeneration of peri-implant bone defects was not detectable after 16 weeks regardless of the carrier materials.
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Affiliation(s)
- Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Daniel S Thoma
- Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland
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Maxillary Sinus Floor Augmentation Using Biphasic Calcium Phosphate and a Hydrogel Polyethylene Glycol Covering Membrane: An Histological and Histomorphometric Evaluation. IMPLANT DENT 2017; 25:599-605. [PMID: 27548109 DOI: 10.1097/id.0000000000000435] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Maxillary sinus floor augmentation with a lateral approach is usually performed using a bone substitute covered with standard collagen or a synthetic barrier membrane to prevent soft tissue ingrowth within the bone graft. The purpose of this case series was to evaluate a polyethylene glycol (PEG) membrane with a hydrogel consistency, used to protect the lateral sinus anstrotomy, by analyzing the histological quality and histomorphometric quantity of newly formed bone (NB) in a maxillary sinus graft using biphasic calcium phosphate (BCP). MATERIALS AND METHODS Fifteen sinuses were grafted from 12 patients. Six months after the maxillary sinus floor augmentation, bone biopsies were harvested from 7 patients during the implant placement second-step surgery. RESULTS The histomorphometric evaluation of the 7 grafted sinuses showed mean values of 27.4 ± 4.6% for NB, 26.9 ± 5.4% for remaining BCP particles, and 45.7 ± 6.0% for connective tissue/bone marrow. No implant failure was observed in the 14- to 45-month follow-up period after maxillary sinus floor augmentation procedure and in the 8- to 39-month follow-up period after implant loading. CONCLUSION The use of a hydrogel PEG membrane to protect BCP proved to be a valuable grafting procedure to enhance the vital bone formation in the maxillary sinus floor augmentation procedure.
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Chu C, Deng J, Hou Y, Xiang L, Wu Y, Qu Y, Man Y. Application of PEG and EGCG modified collagen-base membrane to promote osteoblasts proliferation. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 76:31-36. [PMID: 28482532 DOI: 10.1016/j.msec.2017.02.157] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 12/11/2016] [Accepted: 02/24/2017] [Indexed: 02/05/2023]
Abstract
Collagen membranes possess ideal biological properties and can be served as a barrier for supporting infiltration and proliferation of osteoblasts in guided bone regeneration (GBR). However, pure collagen lacks desirable mechanical properties and also leads to inflammation, resulting in progressive bone resorption. In our previous study, EGCG cross-linked collagen membranes exhibit better mechanical properties and anti-inflammatory effect. However, higher concentration of EGCG may not improve cell viability. Herein, we present an enhanced EGCG cross-linked collagen membranes with surface modification of PEG to improve cell viability and cell adhesion, considering the better biocompatibility of PEG. Scanning electron microscope images showed that PEG-EGCG-collagen membrane exhibited smoother surface fiber aggregates. Fourier transform infrared spectroscopy demonstrated that the structure characteristics were maintained after addition of EGCG and PEG. Cell viability was significantly increased after modification of PEG, as determined by the Cell Counting Kit-8 (CCK-8) and live/dead assay. Better shapes of cytoskeleton were observed in immunostaining images. Additionally, enzyme-linked immunosorbent assay showed PEG-EGCG-collagen membrane significantly decreased the level of inflammatory factors secreted by MG63 cells. Collectively, with respect to all the aspects including intact structure, cell viability promotion and mediation of pro-inflammatory cytokine secretion, our results indicate that PEG-EGCG-collagen membrane might be used in GBR applications.
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Affiliation(s)
- Chenyu Chu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jia Deng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yi Hou
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, Chengdu 610041, China
| | - Lin Xiang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yingying Wu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yili Qu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Yi Man
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
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Thoma DS, Weber FE, Bienz SP, Ge Y, Hämmerle CHF, Jung RE. Biodegradation and tissue integration of various polyethylene glycol matrices: a comparative study in rabbits. Clin Oral Implants Res 2017; 28:e244-e251. [PMID: 28111809 DOI: 10.1111/clr.13004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To test whether or not chemical and/or physical modifications of polyethylene glycol (PEG) hydrogels influence degradation time, matrix/membrane stability, and integration into surrounding hard and soft tissues. MATERIAL AND METHODS In 28 rabbits, six treatment modalities were randomly applied to six sites on the rabbit skull: a dense network PEG hydrogel (PEG HD), a medium-dense network PEG hydrogel (PEG MD), a medium-dense network PEG hydrogel modified with an RGD sequence (PEG MD/RGD), a medium-dense network PEG hydrogel modified with RGD with reduced carboxymethyl cellulose (PEG MD/RGD_LV), a loose network PEG hydrogel modified with RGD (PEG LD/RGD), and a collagen membrane (BG). Descriptive histology and histomorphometry were performed at 1, 2, 4, and 6 weeks. RESULTS PEG HD revealed the highest percentage of residual matrix at all time points starting with 47.2% (95% CI: 32.8-63.8%) at 1 week and ending with 23.4% (95% CI: 10.3-49.8%) at 6 weeks. The hydrogel with the loosest network (PEG LD/RGD) was stable the first 2 weeks and then degraded continuously with a final area of 8.3% (95% CI: 3.2-21.2%). PEG HD was the most stable and densely stained membrane, whereas PEG MD and PEG LD matrices integrated faster, but started to degrade to a higher degree between 2 and 4 weeks. PEG MD degradation was dependent on the addition of RGD and the amount of CMC. CONCLUSIONS Chemical and/or physical modifications of PEG hydrogels influenced matrix stability. PEG MD/RGD demonstrated an optimal balance between degradation time and integration into the surrounding soft and hard tissues.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Franz E Weber
- Center of Dental Medicine, Oral Biotechnology & Bioengineering, University of Zurich, Zurich, Switzerland
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Yanjun Ge
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
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Jazayeri HE, Tahriri M, Razavi M, Khoshroo K, Fahimipour F, Dashtimoghadam E, Almeida L, Tayebi L. A current overview of materials and strategies for potential use in maxillofacial tissue regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 70:913-929. [DOI: 10.1016/j.msec.2016.08.055] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/01/2016] [Accepted: 08/22/2016] [Indexed: 02/06/2023]
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Thoma DS, Jung UW, Park JY, Bienz SP, Hüsler J, Jung RE. Bone augmentation at peri-implant dehiscence defects comparing a synthetic polyethylene glycol hydrogel matrix vs. standard guided bone regeneration techniques. Clin Oral Implants Res 2016; 28:e76-e83. [PMID: 27206342 DOI: 10.1111/clr.12877] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The aim of the study was to test whether or not the use of a polyethylene glycol (PEG) hydrogel with or without the addition of an arginylglycylaspartic acid (RGD) sequence applied as a matrix in combination with hydroxyapatite/tricalciumphosphate (HA/TCP) results in similar peri-implant bone regeneration as traditional guided bone regeneration procedures. MATERIAL AND METHODS In 12 beagle dogs, implant placement and peri-implant bone regeneration were performed 2 months after tooth extraction in the maxilla. Two standardized box-shaped defects were bilaterally created, and dental implants were placed in the center of the defects with a dehiscence of 4 mm. Four treatment modalities were randomly applied: i)HA/TCP mixed with a synthetic PEG hydrogel, ii)HA/TCP mixed with a synthetic PEG hydrogel supplemented with an RGD sequence, iii)HA/TCP covered with a native collagen membrane (CM), iv)and no bone augmentation (empty). After a healing period of 8 or 16 weeks, micro-CT and histological analyses were performed. RESULTS Histomorphometric analysis revealed a greater relative augmented area for groups with bone augmentation (43.3%-53.9% at 8 weeks, 31.2%-42.8% at 16 weeks) compared to empty controls (22.9% at 8 weeks, 1.1% at 16 weeks). The median amount of newly formed bone was greatest in group CM at both time-points. Regarding the first bone-to-implant contact, CM was statistically significantly superior to all other groups at 8 weeks. CONCLUSIONS Bone can partially be regenerated at peri-implant buccal dehiscence defects using traditional guided bone regeneration techniques. The use of a PEG hydrogel applied as a matrix mixed with a synthetic bone substitute material might lack a sufficient stability over time for this kind of defect.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
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Jang JW, Lee JS, Jung UW, Kim CS, Cho KS. In Vivo Evaluation of Commercially Available Gel-Type Polyethylene Glycol Membrane for Carrier of Recombinant Human Bone Morphogenetic Protein-2. J Oral Maxillofac Surg 2016; 75:297.e1-297.e13. [PMID: 27288839 DOI: 10.1016/j.joms.2016.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 05/10/2016] [Accepted: 05/11/2016] [Indexed: 11/15/2022]
Abstract
PURPOSE This study evaluated a commercially available, 3-dimensional gel-type polyethylene glycol (PEG) membrane as a carrier for recombinant human bone morphogenetic protein-2 (rhBMP-2) using a rat calvarial defect model. Another gel-type carrier, fibrin-fibronectin system (FFS), was used as a positive control. MATERIALS AND METHODS Critical-size defects were made in the rat calvarium, which were allocated to 1 of 10 groups comprising 2 healing periods and biomaterial conditions: 1) sham control, 2) FFS only, 3) FFS plus BMP-2, 4) PEG only, and 5) PEG plus BMP-2. Radiographic and histologic analyses were performed at 2 and 8 weeks after surgery. RESULTS After 2 weeks, some parts of the FFS were biodegraded and extensive cellular infiltration was observed at sites that received FFS or FFS plus BMP-2. The PEG membrane retained its augmented volume without cellular infiltration at sites that received PEG or PEG plus BMP-2. After 8 weeks, the FFS was completely degraded and replaced by new bone and connective tissues. In contrast, the volume of residual PEG was similar to that at 2 weeks, with slight cellular infiltration. In particular, there was progressive bone regeneration around micro-cracks and resorbed outer surface in the PEG + BMP-2 group. Although the PEG + BMP-2 group showed increased area and percentage of new bone, there was no statistical relevance after 2 and 8 weeks in histomorphometric analyses. However, the appearance of the healing differed (with new bone formation along micro-cracks in the PEG + BMP-2 group), and further studies with longer healing periods are needed to draw conclusions about clinical applications. CONCLUSION Evidence of mechanical stability and new bone formation along micro-cracks when using PEG plus BMP-2 might support the PEG membrane as a candidate carrier material for rhBMP-2.
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Affiliation(s)
- Ji-Woong Jang
- PhD Student, Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jung-Seok Lee
- Clinical Assistant Professor, Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ui-Won Jung
- Associate Professor, Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Chang-Sung Kim
- Professor and Department Head, Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyoo-Sung Cho
- Professor, Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea.
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Sumanth KS, Savitha B, Lotwani V, Revathi K, Reddy S. Treating Dehiscence During Implant Placement and Loading on Angled Abutment in Maxillary Lateral Incisor Region: A Case Report. J Indian Prosthodont Soc 2015. [PMID: 26199539 DOI: 10.1007/s13191-014-0376-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The primary factor causing recession is the morphology and anatomy of the dentition. The facial bony plate overlying the root is usually very thin. The complete absence of bone over the facial root surface is referred to as dehiscence. Such buccal bone defects in case of implant dentistry threaten the survival of dental implant. Many surgical techniques are introduced to enhance alveolar bone volume for placing the dental implants. Guided bone regeneration (GBR) is one such established surgical technique for correcting buccal dehiscence defects, along with the use of various barrier membranes for the same. This case report describes an implant placement in the maxillary left lateral incisor region showing dehiscence on the labial cortical plate, along with bone graft and GTR membrane.
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Affiliation(s)
- K S Sumanth
- Department of Periodontics, A.C.P.M Dental College, Dhule, Maharashtra India
| | - B Savitha
- Department of Periodontics, A.C.P.M Dental College, Dhule, Maharashtra India
| | - Vijayanti Lotwani
- Department of Periodontics, A.C.P.M Dental College, Dhule, Maharashtra India
| | - K Revathi
- Department of Periodontics, A.C.P.M Dental College, Dhule, Maharashtra India
| | - Srikanth Reddy
- Department of Periodontics, A.C.P.M Dental College, Dhule, Maharashtra India
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Kitayama S, Wong LO, Ma L, Hao J, Kasugai S, Lang NP, Mattheos N. Regeneration of rabbit calvarial defects using biphasic calcium phosphate and a strontium hydroxyapatite-containing collagen membrane. Clin Oral Implants Res 2015; 27:e206-e214. [PMID: 25916272 DOI: 10.1111/clr.12605] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Biphasic calcium phosphate (BCP) composed of 10% hydroxyapatite (HA) and 90% beta-tricalcium phosphate has been developed. Recently, a strontium hydroxyapatite-containing collagen membrane (Sr) was shown to stimulate early bone formation in rat calvarial defects at 4 weeks postoperatively, as compared with a cross-linked collagen membrane, for guided bone regeneration (GBR). The objective of this study was to evaluate these novel biomaterials for GBR in relation to a non-cross-linked collagen membrane (BG) and deproteinized bovine bone mineral (BO). MATERIALS AND METHODS Twenty New Zealand rabbits were used in this study. Four defects of 7 mm in diameter were created in each rabbit, and three of the defects were treated with BG/BO, Sr/BO, and Sr/BCP. Ten rabbits were sacrificed at 12 and 24 weeks, respectively. Histological and histomorphometric analyses were conducted. Volumetric densities of mineralized new bone (MNB), bone marrow (BM), residual grafting material (RG), and non-mineralized connective tissue (NCT) were determined for each group. RESULTS After 12 weeks, Sr/BCP yielded more MNB than BG/BO and Sr/BO with no significant difference among the three groups. After 24 weeks, however, Sr/BCP demonstrated significantly more MNB than BG/BO and Sr/BO. Both after 12 and 24 weeks, Sr/BCP showed significantly less RG than BG/BO and Sr/BO. There was a significant increase in MNB in Sr/BCP from 12 to 24 weeks. CONCLUSIONS In defects grafted with BCP, more MNB was formed while less RG remained, than in defects grafted with BO. The Sr membrane was as effective as BG when comparing Sr/BO with BG/BO.
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Affiliation(s)
- Shuzo Kitayama
- Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Lok O Wong
- Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Li Ma
- Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Jia Hao
- Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Kasugai
- Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Niklaus P Lang
- Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Nikos Mattheos
- Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong
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Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater 2015; 31:640-7. [PMID: 25882277 DOI: 10.1016/j.dental.2015.03.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 03/14/2015] [Accepted: 03/16/2015] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To review the histological and clinical outcomes of the use of bone substitues in different oral bone regenerative procedures: socket preservation, immediate implant placement, lateral and vertical bone augmentation. METHODS Histological animal studies and clinical trials regarding the performances of bone substitutes, either allogenic, xenogeneic or alloplastic, have been evaluated. Different procedures examined separately and evidence-based results were provided. RESULTS The use of deproteinized bovine bone mineral (DBBM) seems to be effective most clinical indications, due to their osteoconductivity, space maintenance characteristics and slow resorption. The combination of Hydroxyapatite and Beta Tricalcium Phospate (HA/TCP) has also reported similar histological evidence and clinical outcomes. The use of autogenous block grafts is still the method of choice in clinical situations in need of vertical bone augmentation. CONCLUSIONS The use of bone substitutes is the standard of therapy in current modalities of lateral bone augmentation, mainly when used in conjunction with implant placement.
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Affiliation(s)
- Mariano Sanz
- Faculty of Odontology, University Complutense of Madrid, Plaza Ramon y Cajal, 28040 Madrid, Spain.
| | - Fabio Vignoletti
- Faculty of Odontology, University Complutense of Madrid, Plaza Ramon y Cajal, 28040 Madrid, Spain.
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23
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Donos N, Dereka X, Mardas N. Experimental models for guided bone regeneration in healthy and medically compromised conditions. Periodontol 2000 2015; 68:99-121. [DOI: 10.1111/prd.12077] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2014] [Indexed: 02/06/2023]
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Oteri G, Pizzino G, Pisano M, Peditto M, Squadrito F, Bitto A. Polyethylene glycol formulations show different soft tissue remodeling and angiogenesis features. Tissue Eng Part A 2014; 21:580-5. [PMID: 25275669 DOI: 10.1089/ten.tea.2014.0260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Soft tissue regeneration and remodeling is fundamental in periodontal surgery, thus we investigated the angiogenic response elicited in the subcutaneous tissue of rats by a proprietary, polyethylene glycol hydrogel formulation (PEG) alone or conjugated with specific amelogenins (EMD) or nanobioglass particles (NBG). METHODS Discs with three different formulations (PEG, PEG-EMD, and PEG-NBG) were inserted into four unconnected subcutaneous pouches, produced on the back of Sprague-Dawley rats (n=56, divided into three groups), and used for blood flow evaluation by Laser Doppler analysis at 1, 2, 4, 8, and 16 weeks or for histological and immunohistochemical analysis at 1, 2, 4, 8, and 16 weeks. RESULTS All formulations showed tissue integration, absence of inflammatory reaction (as revealed by myeloperoxidase staining), and increased vascularization (by counting microvascular density following CD31 staining). Laser Doppler analysis revealed a statistically significant increase in blood flow after 1 week for PEG-EMD and after 2 weeks for PEG-NBG. The angiogenic response was significantly increased at 1, 2, and 8 weeks for PEG-EMD, but only at 4 weeks for PEG-NBG. CONCLUSIONS The studied biomaterials revealed equal biocompatibility and tissue integration properties. PEG-EMD showed the most pronounced and consistent angiogenic response in the early phases of wound healing, while the PEG-NBG formulation provided a slower and delayed, but relevant, response.
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Affiliation(s)
- Giacomo Oteri
- 1 Department of Dentistry and Medical and Surgical Experimental Sciences, University of Messina , Messina, Italy
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25
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Vierra M, Mau LP, Huynh-Ba G, Schoolfield J, Cochran DL. A lateral ridge augmentation study to evaluate a synthetic membrane for guided bone regeneration: an experiment in the canine mandible. Clin Oral Implants Res 2014; 27:73-82. [DOI: 10.1111/clr.12517] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Matthew Vierra
- Department of Periodontics; University of Texas Health Science Center at San Antonio (UTHSCSA); San Antonio TX USA
| | - Lian Ping Mau
- Department of Dentistry; Chi Mei Medical Center; Tainan City Taiwan
| | - Guy Huynh-Ba
- Department of Periodontics; University of Texas Health Science Center at San Antonio (UTHSCSA); San Antonio TX USA
| | - John Schoolfield
- Department of Periodontics; University of Texas Health Science Center at San Antonio (UTHSCSA); San Antonio TX USA
| | - David L. Cochran
- Department of Periodontics; University of Texas Health Science Center at San Antonio (UTHSCSA); San Antonio TX USA
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Jung UW, Lee IK, Park JY, Thoma DS, Hämmerle CHF, Jung RE. The efficacy of BMP-2 preloaded on bone substitute or hydrogel for bone regeneration at peri-implant defects in dogs. Clin Oral Implants Res 2014; 26:1456-65. [PMID: 25263966 DOI: 10.1111/clr.12491] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The objective of this experiment was to test whether or not a synthetic bone substitute (SBS) was more effective than a polyethylene glycol hydrogel as a carrier material for bone morphogenetic protein-2 (BMP-2) when attempting to regenerate bone. MATERIAL AND METHODS Two identical, box-type dehiscence defects (4 × 4 mm buccolingually and apicocoronally, and 8 mm mesiodistally) were surgically prepared on buccal sides of the left and right edentulous ridge in five beagle dogs. Following implant placement, the defects either received (i) no graft, (ii) SBS+hydrogel, (iii) SBS+BMP-2 loaded hydrogel, and (iv) BMP-2-loaded SBS+hydrogel. The animals were euthanized at 8 weeks postsurgery. Radiographic and histomorphometric analyses were performed. RESULTS The hydrogel alone was not able to stabilize the grafted bone particles at 8 weeks, and SBS+hydrogel group did not significantly differ from the control group in all volumetric measurements. On the other hand, extensively regenerated new bone was connected with most of the remaining SBS particles in the BMP-2 groups. The BMP-2 groups exhibited significantly greater new bone formation (10.65 mm(3) and 1.47 mm(2) in the SBS+BMP-2-loaded hydrogel group; 14.17 mm(3) and 0.93 mm(2) in the BMP-2-loaded SBS+hydrogel) than non-BMP-2 groups (1.27 mm(3) and 0.00 mm(2) in the control group; 2.01 mm(3) and 0.19 mm(2) in the SBS+hydrogel group) in volumetric and histomorphometric analyses (P < 0.001). However, there were no significant differences between both BMP-2 groups. CONCLUSION BMP-2 could yield enhanced bone regeneration in the critical-size peri-implant defects regardless of whether SBS or hydrogel is used for preloading, although the outcomes seem to be more reproducible with BMP-2 preloaded on SBS.
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Affiliation(s)
- Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - In-Kyeong Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Daniel S Thoma
- Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland
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27
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Benic GI, Hämmerle CHF. Horizontal bone augmentation by means of guided bone regeneration. Periodontol 2000 2014; 66:13-40. [DOI: 10.1111/prd.12039] [Citation(s) in RCA: 214] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 12/18/2022]
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Ohayon L. Guided Bone Regeneration Using a Synthetic Polyethylene Glycol Hydrogel Membrane Over a Bone Substitute Material After Immediate Placement of a Non-Submerged Implant. Clin Adv Periodontics 2014. [DOI: 10.1902/cap.2012.120009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yip I, Ma L, Mattheos N, Dard M, Lang NP. Defect healing with various bone substitutes. Clin Oral Implants Res 2014; 26:606-14. [DOI: 10.1111/clr.12395] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Ian Yip
- Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - Li Ma
- Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - Nikos Mattheos
- Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - Michel Dard
- Department of Periodontology and Implant Dentistry; College of Dentistry; New York University; New York NY USA
| | - Niklaus P. Lang
- Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Hong Kong
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Ni P, Ding Q, Fan M, Liao J, Qian Z, Luo J, Li X, Luo F, Yang Z, Wei Y. Injectable thermosensitive PEG–PCL–PEG hydrogel/acellular bone matrix composite for bone regeneration in cranial defects. Biomaterials 2014; 35:236-48. [DOI: 10.1016/j.biomaterials.2013.10.016] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 10/02/2013] [Indexed: 10/26/2022]
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Jung RE, Benic GI, Scherrer D, Hämmerle CHF. Cone beam computed tomography evaluation of regenerated buccal bone 5 years after simultaneous implant placement and guided bone regeneration procedures - a randomized, controlled clinical trial. Clin Oral Implants Res 2013; 26:28-34. [DOI: 10.1111/clr.12296] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Goran I. Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | | | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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Thoma DS, Schneider D, Mir-Mari J, Hämmerle CHF, Gemperli AC, Molenberg A, Dard M, Jung RE. Biodegradation and bone formation of various polyethylene glycol hydrogels in acute and chronic sites in mini-pigs. Clin Oral Implants Res 2013; 25:511-21. [DOI: 10.1111/clr.12203] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - David Schneider
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Javier Mir-Mari
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | | | | | - Michel Dard
- Institut Straumann AG; Basel Switzerland
- Department of Periodontology and Implant Dentistry; College of Dentistry; New York University; New York NY USA
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
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33
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Tığlı Aydın RS, Hazer B, Acar M, Gümüşderelioğlu M. Osteogenic activities of polymeric soybean oil-g-polystyrene membranes. Polym Bull (Berl) 2013. [DOI: 10.1007/s00289-013-0976-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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34
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Dahlin C, Johansson A, Hoffman M, Molenberg A. Early biocompatibility of poly (ethylene glycol) hydrogel barrier materials for guided bone regeneration. An in vitro study using human gingival fibroblasts (HGF-1). Clin Oral Implants Res 2012; 25:16-20. [PMID: 23173910 DOI: 10.1111/clr.12076] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the early cellular attachment and viability to modified polyethylene glycol (PEG) hydrogels with the influence of arginine-glycine-aspartic acid (RGD) in an in vitro model system. MATERIAL AND METHODS Human gingival fibroblasts (HGF-1) were cultured on 6 different modalities of PEG hydrogel in hydrophobic polystyrene wells. A total of 7500 cells/well (10,000 cells/cm(2)) were dispersed over the PEG filled wells and incubated in triplicates for 24 h, 7 and 13 days. Cell numbers were calculated by means of a NucleoCounter. Cell viability was determined by measuring lactate dehydrogenase (LDH). For statistical analysis, nonparametric Kruska-Wallis test followed by Dunetts T3 test were used. RESULTS All PEG modifications showed good biocompatibility, as demonstrated by low LDH values per cell at the earlier two time points. After 13 days, all PEG modifications showed significantly lower number of cells compared with the controls, and the MX60 configurations demonstrated significantly higher LDH/cell values compared with the other hydrogels. CONCLUSIONS Modifications of the physio-chemical properties of PEG hydrogels and the addition of RGD and spacers influenced the initial cellular response of cultured HGF-1 cells. With the exception of MX60 after 13 days, all PEG formulations performed similarly well. Early cellular response should be considered when developing PEG-based material for clinical purposes.
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Affiliation(s)
- Christer Dahlin
- Department of Biomaterials, Institutie for Surgical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Oral & Maxillofacial Surgery, NÄL Medical Centre Hospital, Trollhättan, Sweden
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Wehrhan F, Amann K, Molenberg A, Lutz R, Neukam FW, Schlegel KA. Critical size defect regeneration using PEG-mediated BMP-2 gene delivery and the use of cell occlusive barrier membranes - the osteopromotive principle revisited. Clin Oral Implants Res 2012; 24:910-20. [PMID: 23865504 DOI: 10.1111/j.1600-0501.2012.02489.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to investigate if osseous regeneration can be accelerated by involvement of periosteal tissue. Bone defect regeneration could be accelerated by the involvement of periosteal tissue if osteogenic cell signalling is maintained within the defect. It was questioned if local cell-mediated BMP-2 gene delivery makes a cell occlusive membrane dispensable during bone critical size defect regeneration. METHODS PEG matrix (degradation time 10 days) and PEG membrane (degradation time 120 days) were used in the pig calvarial model. Cylindrical (1 × 1 cm) critical size defects (CSD) (9 per animal; 20 animals) were filled with: (i) particulated autologous bone, covered with PEG membrane (group 1); (ii) HA/TCP, covered with PEG membrane (group 2); (iii) HA/TCP, mixed with PEG matrix (group 3); and (iv) HA/TCP mixed with BMP-2-transfected osteoblasts and PEG matrix (group 4). BMP-2/4 gene transfer: liposomal in vitro transfection of BMP-2/V5-tag fusion-protein. Quantitative histomorphometry (toluidine blue staining) after 2, 4 and 12 weeks assessed bone formation. Semiquantitative immunohistochemistry estimated the expression of BMP-2, V5-tag, Runx-2 and Sox9. RESULTS PEG matrix embedded BMP-2 expressing cells presented higher bone formation (P < 0.05) than HA/TCP + PEG matrix defect filling or PEG membrane covering (HA/TCP filling) after 12 weeks. Highest expression of BMP-2, Runx-2 and lowest expression of fibrous tissue marker Sox9 was seen in the BMP-2 group. CONCLUSION PEG matrix embedded BMP-2 expressing cells are capable to maintain osteogenic signalling and to accelerate osseous defect regeneration in absence of a cell occlusive membrane.
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Affiliation(s)
- Falk Wehrhan
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany.
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Ramseier CA, Rasperini G, Batia S, Giannobile WV. Advanced reconstructive technologies for periodontal tissue repair. Periodontol 2000 2012; 59:185-202. [PMID: 22507066 PMCID: PMC3335769 DOI: 10.1111/j.1600-0757.2011.00432.x] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Reconstructive therapies to promote the regeneration of lost periodontal support have been investigated through both preclinical and clinical studies. Advanced regenerative technologies using new barrier-membrane techniques, cell-growth-stimulating proteins or gene-delivery applications have entered the clinical arena. Wound-healing approaches using growth factors to target the restoration of tooth-supporting bone, periodontal ligament and cementum are shown to significantly advance the field of periodontal-regenerative medicine. Topical delivery of growth factors, such as platelet-derived growth factor, fibroblast growth factor or bone morphogenetic proteins, to periodontal wounds has demonstrated promising results. Future directions in the delivery of growth factors or other signaling models involve the development of innovative scaffolding matrices, cell therapy and gene transfer, and these issues are discussed in this paper.
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Affiliation(s)
- Christoph A. Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giulio Rasperini
- Unit of Periodontology, department of Surgical, Regenerative and Diagnostic Science, Foundation IRCCS Cà Granda Policlinico, University of Milan, Milan Italy
| | - Salvatore Batia
- Unit of Periodontology, department of Surgical, Regenerative and Diagnostic Science, Foundation IRCCS Cà Granda Policlinico, University of Milan, Milan Italy
| | - William V. Giannobile
- Deptartment of Periodontics and Oral Medicine and Michigan Center for Oral Health Research, University of Michigan, 1011 N. University Ave., Ann Arbor, MI 48109-1078, USA
- Department of Biomedical Engineering, College of Engineering, University of Michigan, 1011 N. University Ave., Ann Arbor, MI 48109-1078, USA
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van Leeuwen AC, Huddleston Slater JJR, Gielkens PFM, de Jong JR, Grijpma DW, Bos RRM. Guided bone regeneration in rat mandibular defects using resorbable poly(trimethylene carbonate) barrier membranes. Acta Biomater 2012; 8:1422-9. [PMID: 22186161 DOI: 10.1016/j.actbio.2011.12.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 11/16/2011] [Accepted: 12/05/2011] [Indexed: 11/15/2022]
Abstract
The present study evaluates a new synthetic degradable barrier membrane based on poly(trimethylene carbonate) (PTMC) for use in guided bone regeneration. A collagen membrane and an expanded polytetrafluoroethylene (e-PTFE) membrane served as reference materials. In 192 male Sprague-Dawley rats, a standardized 5.0mm circular defect was created in the left mandibular angle. New bone formation was demonstrated by post mortem micro-radiography, micro-computed tomography imaging and histological analysis. Four groups (control, PTMC, collagen, e-PTFE) were evaluated at three time intervals (2, 4 and 12 weeks). In the membrane groups the defects were covered; in the control group the defects were left uncovered. Data were analysed using a multiple regression model. In contrast to uncovered mandibular defects, substantial bone healing was observed in defects covered with a barrier membrane. In the latter case, the formation of bone was progressive over 12 weeks. No statistically significant differences between the amount of new bone formed under the PTMC membranes and the amount of bone formed under the collagen and e-PTFE membranes were observed. Therefore, it can be concluded that PTMC membranes are well suited for use in guided bone regeneration.
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Affiliation(s)
- A C van Leeuwen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, P.O. Box 30.001, 9700 RB, The Netherlands.
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Karfeld-Sulzer LS, Weber FE. Biomaterial development for oral and maxillofacial bone regeneration. J Korean Assoc Oral Maxillofac Surg 2012. [DOI: 10.5125/jkaoms.2012.38.5.264] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Lindsay S. Karfeld-Sulzer
- Oral Biotechnology and Bioengineering, Department of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Franz E. Weber
- Oral Biotechnology and Bioengineering, Department of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
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Wehrhan F, Amann K, Molenberg A, Lutz R, Neukam FW, Schlegel KA. PEG matrix enables cell-mediated local BMP-2 gene delivery and increased bone formation in a porcine critical size defect model of craniofacial bone regeneration. Clin Oral Implants Res 2011; 23:805-13. [PMID: 22151397 DOI: 10.1111/j.1600-0501.2011.02223.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2011] [Indexed: 01/19/2023]
Abstract
PURPOSE This study addressed the suitability of a polyethylene glycol (PEG) matrix as scaffold for cell-mediated local BMP-2 gene transfer in a calvarial critical size defect (CSD) model. MATERIALS AND METHODS PEG matrix (degradation time 10 days) and PEG membrane (degradation time 120 days) were used in the pig calvarial model. Cylindrical (1 × 1 cm) CSD (9 per animal; 20 animals) were filled with: (i) HA/TCP, covered by PEG membrane (group 1); (ii) HA/TCP, mixed with PEG matrix (group 2); and (iii) HA/TCP mixed with BMP-2 transfected osteoblasts and PEG matrix (group 3). BMP-2/4 gene transfer: liposomal in vitro transfection of BMP-2/V5-tag fusion-protein. Quantitative histomorphometry (toluidine blue staining) after 2, 4 and 12 weeks assessed bone formation. Semiquantitative immunohistochemistry estimated the expression of BMP-2 and V5-tag. RESULTS Group 3 showed significantly higher new bone formation than groups 1, 2 at 4 (P < 0.05) and 12 (P < 0.02) weeks. BMP-2-V5-tag was detected for 4 weeks. BMP-2 expression in group 3 was higher compared to all other groups after 2 and 4 (P < 0.02) weeks. CONCLUSIONS The PEG matrix serves as scaffold for cell-mediated BMP-2 gene delivery in guided bone regeneration facilitating cell survival and protein synthesis for at least 4 weeks. Local BMP-2 gene delivery by PEG matrix-embedded cells leads to increased bone formation during critical size defect regeneration.
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Affiliation(s)
- Falk Wehrhan
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
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Schmidlin PR, Nicholls F, Kruse A, Zwahlen RA, Weber FE. Evaluation of moldable,in situhardening calcium phosphate bone graft substitutes. Clin Oral Implants Res 2011; 24:149-57. [DOI: 10.1111/j.1600-0501.2011.02315.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2011] [Indexed: 12/20/2022]
Affiliation(s)
- P. R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology; Center of Dental Medicine; University of Zürich; Zürich; Switzerland
| | - F. Nicholls
- Institute of Laboratory Animal Science; University of Zurich; Zürich; Switzerland
| | - A. Kruse
- Department of Cranio-Maxillofacial Surgery; Oral Biotechnology & Bioengineering; University Hospital Zurich; Zürich; Switzerland
| | - R. A. Zwahlen
- Department of Cranio-Maxillofacial Surgery; Oral Biotechnology & Bioengineering; University Hospital Zurich; Zürich; Switzerland
| | - F. E. Weber
- Department of Cranio-Maxillofacial Surgery; Oral Biotechnology & Bioengineering; University Hospital Zurich; Zürich; Switzerland
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Zambon R, Mardas N, Horvath A, Petrie A, Dard M, Donos N. The effect of loading in regenerated bone in dehiscence defects following a combined approach of bone grafting and GBR. Clin Oral Implants Res 2011; 23:591-601. [PMID: 22092957 DOI: 10.1111/j.1600-0501.2011.02279.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2011] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate by histology the effect of loading on the regenerated bone at dehiscence type defects around implants when treated with a combined approach of bone grafting and guided bone regeneration (GBR). MATERIALS AND METHODS In twelve Göttingen mini-pigs, the lower premolars and first molars were extracted and the alveolar process was reduced in width. After 3 months, two Straumann SLActive (Straumann AG, Basel, Switzerland) implants were placed in each hemi-mandible. Twelve implants were placed into the reduced alveolar ridge (group P) with no further defect or treatment on the site, while on 36 implants, buccal dehiscence defects were created and treated as follows: Group T1: synthetic bone substitute (Straumann Bone Ceramic, SBC, Straumann AG). Group T2: SBC with a polyethylene glycol membrane (Straumann MembraGel, Straumann AG); Group N: the dehiscence remained untreated. Three months following implantation, long, custom-made, healing abutments were placed in one hemi-mandible only to ensure functional loading. After 2 months, histological analysis was performed. RESULTS A trend for lower residual defect height and higher bone-to-implant contact was observed in the loaded sites compared with non-loaded sites in groups P, T1 and N. In group T2, the opposite effect was observed. In terms of bone formation, sites treated with SBC grafting and GBR (group T2) exhibited the largest surface area of regenerated bone followed by T1 and N. Significant resorption of the graft particles was noted in group T2 and the graft surface area occupied by SBC was significantly higher in group T1 compared with group T2 (P < 0.05). CONCLUSIONS Loading may have a positive effect on bone-to-implant contact in implants inserted in pristine bone or inserted in dehiscence sites and treated by grafting/no grafting.
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Affiliation(s)
- Riccardo Zambon
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK
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Thoma DS, Dard MM, Hälg GA, Ramel CF, Hämmerle CHF, Jung RE. Evaluation of a biodegradable synthetic hydrogel used as a guided bone regeneration membrane: an experimental study in dogs. Clin Oral Implants Res 2011; 23:160-168. [PMID: 21692857 DOI: 10.1111/j.1600-0501.2011.02217.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To test whether or not an experimental polyethylene glycol (PEG) membrane maintains the bone graft volume and contributes to the preservation of the ridge contour in comparison with a commercially available synthetic membrane. MATERIALS AND METHODS In 18 dogs, all mandibular premolars and the first molars were extracted. Ten weeks later, acute standardized defects were prepared. The defects of four dogs were randomly assigned to three modalities: (1) PEG plus deproteinized bovine bone mineral (DBBM) (PEG), (2) a resorbable glycolide trimethylene carbonate membrane plus DBBM (PGA-TMC), and (3) DBBM alone (DBBM). These dogs were then sacrificed for the baseline measurements. The remaining defects of 14 dogs were randomly assigned to (1) PEG plus DBBM, (2) PGA-TMC plus DBBM, (3) DBBM, and (4) empty defect. The dogs were sacrificed at baseline (n=4), 4 weeks (n=7), or at 16 weeks (n=7). Mixed model regressions and the non-parametric Brunner-Langer method were applied for statistical analysis. RESULTS At baseline, equal tissue augmentation was observed in all groups. At 4 and 16 weeks, the greatest augmented area fractions were calculated for PEG (103%; 107%, respectively), followed by PGA-TMC (98%; 91%), DBBM (85%; 78%), and empty (46%; 54%), being statistically significant different (P<0.001) between PEG and empty at 4 and 16 weeks, and PEG and DBBM at 16 weeks. The overall decrease (P≤0.01) in the amount of bone graft between baseline and 16 weeks was -14% (PEG), -22% (PGA-TMC), and -23% (DBBM). CONCLUSIONS The study demonstrates that the combination of the PEG membrane with DBBM maintains the bone graft volume over time better than controls. The PEG membrane with DBBM was also the most effective method to preserve the ridge contour.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental Medicine, Zurich, SwitzerlandInstitut Straumann AG, Basel, Switzerland
| | - Michel M Dard
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental Medicine, Zurich, SwitzerlandInstitut Straumann AG, Basel, Switzerland
| | - Gian-Andrea Hälg
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental Medicine, Zurich, SwitzerlandInstitut Straumann AG, Basel, Switzerland
| | - Christian F Ramel
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental Medicine, Zurich, SwitzerlandInstitut Straumann AG, Basel, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental Medicine, Zurich, SwitzerlandInstitut Straumann AG, Basel, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental Medicine, Zurich, SwitzerlandInstitut Straumann AG, Basel, Switzerland
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Friedmann A, Gissel K, Soudan M, Kleber BM, Pitaru S, Dietrich T. Randomized controlled trial on lateral augmentation using two collagen membranes: morphometric results on mineralized tissue compound. J Clin Periodontol 2011; 38:677-85. [PMID: 21557757 DOI: 10.1111/j.1600-051x.2011.01738.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Guided bone regeneration is considered an effective tool for gaining mineralized tissue either at exposed implant surface or in deficient alveolar ridge areas before implant placement. MATERIAL AND METHODS Customized casts obtained following impression taking at surgery and re-entry allowed for morphometric assessment of alveolar ridge alterations 6 months after one-stage augmentation of bone dehiscences. In a randomized pilot study using biphasic calcium phosphate tests (n=17) received treatment with ribose cross-linked collagen membranes (RCLM), whereas controls (n=20) received non-cross-linked membranes. The primary endpoint was to quantify the effect of membrane type on dimensional changes in bone margins at crestal level of endosseous implants. RESULTS Soft tissue dehiscencies occurred at 70.5% and 55% frequency for tests and controls, respectively. Gain in clinically hard newly mineralized tissue at the crestal level was significantly higher in test group in lateral (1.8 versus 0.7 mm; p=.046) and in vertical dimensions (1.1 versus 0.2 mm; p=.035) compared with controls. Second measurement obtained at the border of reflected flap revealed no significant difference between groups (3.0 versus 2.1 mm; p=0.57) for lateral dimension. CONCLUSIONS Both collagen devices were effective in bone augmentation. RCLMs supported mineralization process and remodelling even in sites showing compromised healing as indicated by morphometric outcome.
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Affiliation(s)
- Anton Friedmann
- Department of Periodontology, School of Dentistry, Faculty of Health, University of Witten, Witten, Germany.
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Schwarz F, Mihatovic I, Golubovic V, Hegewald A, Becker J. Influence of two barrier membranes on staged guided bone regeneration and osseointegration of titanium implants in dogs: part 1. Augmentation using bone graft substitutes and autogenous bone. Clin Oral Implants Res 2011; 23:83-9. [DOI: 10.1111/j.1600-0501.2011.02187.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Thoma DS, Subramani K, Weber FE, Luder HU, Hämmerle CHF, Jung RE. Biodegradation, soft and hard tissue integration of various polyethylene glycol hydrogels: a histomorphometric study in rabbits. Clin Oral Implants Res 2011; 22:1247-54. [DOI: 10.1111/j.1600-0501.2010.02075.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Siar CH, Toh CG, Romanos G, Ng KH. Subcutaneous reactions and degradation characteristics of collagenous and noncollagenous membranes in a macaque model. Clin Oral Implants Res 2010; 22:113-20. [DOI: 10.1111/j.1600-0501.2010.01970.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Szpalski C, Barr J, Wetterau M, Saadeh PB, Warren SM. Cranial bone defects: current and future strategies. Neurosurg Focus 2010; 29:E8. [DOI: 10.3171/2010.9.focus10201] [Citation(s) in RCA: 147] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Bony defects in the craniomaxillofacial skeleton remain a major and challenging health concern. Surgeons have been trying for centuries to restore functionality and aesthetic appearance using autografts, allografts, and even xenografts without entirely satisfactory results. As a result, physicians, scientists, and engineers have been trying for the past few decades to develop new techniques to improve bone growth and bone healing. In this review, the authors summarize the advantages and limitations of current animal models; describe current materials used as scaffolds, cell-based, and protein-based therapies; and lastly highlight areas for future investigation. The purpose of this review is to highlight the major scaffold-, cell-, and protein-based preclinical tools that are currently being developed to repair cranial defects.
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Schwarz F, Jung RE, Fienitz T, Wieland M, Becker J, Sager M. Impact of guided bone regeneration and defect dimension on wound healing at chemically modified hydrophilic titanium implant surfaces: an experimental study in dogs. J Clin Periodontol 2010; 37:474-85. [DOI: 10.1111/j.1600-051x.2010.01551.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Valderrama P, Jung RE, Thoma DS, Jones AA, Cochran DL. Evaluation of Parathyroid Hormone Bound to a Synthetic Matrix for Guided Bone Regeneration Around Dental Implants: A Histomorphometric Study in Dogs. J Periodontol 2010; 81:737-47. [DOI: 10.1902/jop.2010.090562] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Humber CC, Sándor GKB, Davis JM, Peel SAF, Brkovic BMB, Kim YD, Holmes HI, Clokie CML. Bone healing with an in situ-formed bioresorbable polyethylene glycol hydrogel membrane in rabbit calvarial defects. ACTA ACUST UNITED AC 2010; 109:372-84. [PMID: 20060340 DOI: 10.1016/j.tripleo.2009.10.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Revised: 09/05/2009] [Accepted: 10/05/2009] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The aims of this study were to test whether or not the application of an in situ-formed synthetic polyethylene glycol hydrogel (PEG) used as a biodegradable membrane for guided bone regeneration with a variety of graft materials and ambient oxygen or hyperbaric oxygen (HBO) environments would result in enhanced bone regeneration, and to observe the histologic and histomorphometric aspects of bone healing of the calvarial defects with and without a PEG membrane. STUDY DESIGN Thirty adult, skeletally mature, male New Zealand white rabbits were randomly divided into 3 groups of 10 animals each. Bilateral 15-mm-diameter critical-size defects were created in the parietal bones of each animal. Group 1 served as a control with unfilled bilateral calvarial defects, group 2 had bilateral calvarial defects filled with morcelized autogenous calvarial bone, and group 3 had bilateral calvarial defects filled with a biphasic calcium phosphate ceramic. One of the calvarial defects was randomly protected with a PEG resorbable liquid membrane in each animal. Five animals from each group underwent a course of HBO treatment (2.4 ATA 100% oxygen for 90 minutes 5 days a week for 4 weeks) and the other 5 served as control and did not receive any supplemental oxygen (normobaric). The animals were killed 6 weeks after their surgery, and their parietal bones were harvested. The specimens were analyzed with microscopic computerized tomography (microCT) scans and histomorphometrics. RESULTS The unfilled normobaric control bony defects did not heal, proving the critical-size nature of these defects. The presence of autogenous bone or bone ceramic in the defects increased the bone volume fraction and bone mineral density of the defects (P < .001). The presence of a membrane in the ungrafted and autogenous bone grafted defects resulted in a decrease in the corrected bone volume fraction (P = .002) but not in the bone ceramic grafted defects (P = .580). Bony healing of defects where the membrane was unsupported was compromised; the membrane did not maintain the desired bone regeneration volume with the unfilled and autogenous bone grafted groups. The PEG resorbable liquid membrane worked best with the bone ceramic material. HBO did not ameliorate the healing of the autogenous bone graft or ceramic filled defects in the 6-week time period of this study. CONCLUSIONS Although the PEG resorbable liquid membrane is easy to use and forms an occlusive layer, caution is recommended when using the membrane over an unsupported defect. HBO did not ameliorate bony healing with the membrane at the early 6-week time point. The authors recommend future assessment with HBO at the 12-week time point.
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Affiliation(s)
- Craig C Humber
- Oral and Maxillofacial Surgery and Anesthesia, University of Toronto, Toronto, Canada
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