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Does Periosteal Graft Combined With Platelet-Rich Plasma Enhance the Healing of Bone Defect? J Craniofac Surg 2018; 29:1072-1080. [DOI: 10.1097/scs.0000000000004229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Shanbhag S, Pandis N, Mustafa K, Nyengaard JR, Stavropoulos A. Bone tissue engineering in oral peri-implant defects in preclinical in vivo research: A systematic review and meta-analysis. J Tissue Eng Regen Med 2017; 12:e336-e349. [PMID: 28095650 DOI: 10.1002/term.2412] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/23/2016] [Accepted: 01/13/2017] [Indexed: 12/12/2022]
Abstract
The regeneration and establishment of osseointegration within oral peri-implant bone defects remains a clinical challenge. Bone tissue engineering (BTE) is emerging as a promising alternative to autogenous and/or biomaterial-based bone grafting. The objective of this systematic review was to answer the focused question: in animal models, do cell-based BTE strategies enhance bone regeneration and/or implant osseointegration in experimental peri-implant defects, compared with grafting with autogenous bone or only biomaterial scaffolds? Electronic databases were searched for controlled animal studies reporting on peri-implant defects and implantation of mesenchymal stem cells (MSC) or other cells seeded on biomaterial scaffolds, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Random effects meta-analyses were performed for the outcomes histomorphometric bone area fraction (BA) and bone-to-implant contact (BIC). Nineteen studies reporting on large animal models (dogs and sheep) were included. Experimental defects were created surgically (16 studies) or via ligature-induced peri-implantitis (LIPI, three studies). In general, studies presented with an unclear to high risk of bias. In most studies, MSC were used in combination with alloplastic mineral phase or polymer scaffolds; no study directly compared cell-loaded scaffolds vs. autogenous bone. In three studies, cells were also modified by ex vivo gene transfer of osteoinductive factors. The meta-analyses indicated statistically significant benefits in favour of: (a) cell-loaded vs. cell-free scaffolds [weighted mean differences (WMD) of 10.73-12.30% BA and 11.77-15.15% BIC] in canine surgical defect and LIPI models; and (b) gene-modified vs. unmodified cells (WMD of 29.44% BA and 16.50% BIC) in canine LIPI models. Overall, heterogeneity in the meta-analyses was high (I2 70-88%); considerable variation was observed among studies regarding the nature of cells and scaffolds used. In summary, bone regeneration and osseointegration in peri-implant defects are enhanced by the addition of osteogenic cells to biomaterial scaffolds. Although the direction of treatment outcome is clearly in favour of BTE strategies, due to the limited magnitude of treatment effect observed, no conclusive statements regarding the clinical benefit of such procedures for oral indications can yet be made. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Siddharth Shanbhag
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, Norway.,Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Kamal Mustafa
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Jens R Nyengaard
- Stereology and Electron Microscopy Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Andreas Stavropoulos
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, Norway
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Matsuoka F, Takeuchi I, Agata H, Kagami H, Shiono H, Kiyota Y, Honda H, Kato R. Morphology-based prediction of osteogenic differentiation potential of human mesenchymal stem cells. PLoS One 2013; 8:e55082. [PMID: 23437049 PMCID: PMC3578868 DOI: 10.1371/journal.pone.0055082] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 12/18/2012] [Indexed: 12/24/2022] Open
Abstract
Human bone marrow mesenchymal stem cells (hBMSCs) are widely used cell source for clinical bone regeneration. Achieving the greatest therapeutic effect is dependent on the osteogenic differentiation potential of the stem cells to be implanted. However, there are still no practical methods to characterize such potential non-invasively or previously. Monitoring cellular morphology is a practical and non-invasive approach for evaluating osteogenic potential. Unfortunately, such image-based approaches had been historically qualitative and requiring experienced interpretation. By combining the non-invasive attributes of microscopy with the latest technology allowing higher throughput and quantitative imaging metrics, we studied the applicability of morphometric features to quantitatively predict cellular osteogenic potential. We applied computational machine learning, combining cell morphology features with their corresponding biochemical osteogenic assay results, to develop prediction model of osteogenic differentiation. Using a dataset of 9,990 images automatically acquired by BioStation CT during osteogenic differentiation culture of hBMSCs, 666 morphometric features were extracted as parameters. Two commonly used osteogenic markers, alkaline phosphatase (ALP) activity and calcium deposition were measured experimentally, and used as the true biological differentiation status to validate the prediction accuracy. Using time-course morphological features throughout differentiation culture, the prediction results highly correlated with the experimentally defined differentiation marker values (R>0.89 for both marker predictions). The clinical applicability of our morphology-based prediction was further examined with two scenarios: one using only historical cell images and the other using both historical images together with the patient's own cell images to predict a new patient's cellular potential. The prediction accuracy was found to be greatly enhanced by incorporation of patients' own cell features in the modeling, indicating the practical strategy for clinical usage. Consequently, our results provide strong evidence for the feasibility of using a quantitative time series of phase-contrast cellular morphology for non-invasive cell quality prediction in regenerative medicine.
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Affiliation(s)
- Fumiko Matsuoka
- Department of Biotechnology, Graduate School of Engineering, Nagoya University, Nagoya, Aichi, Japan
| | - Ichiro Takeuchi
- Department of Engineering, Nagoya Institute of Technology, Nagoya, Aichi, Japan
| | - Hideki Agata
- Tissue Engineering Research Group, Division of Molecular Therapy, The Institute of Medical Science The University of Tokyo, Tokyo, Japan
| | - Hideaki Kagami
- Tissue Engineering Research Group, Division of Molecular Therapy, The Institute of Medical Science The University of Tokyo, Tokyo, Japan
- Department of Oral and Maxillofacial Surgery, Matsumoto Dental University School of Dentistry, Shiojiri, Nagano, Japan
| | | | | | - Hiroyuki Honda
- Department of Biotechnology, Graduate School of Engineering, Nagoya University, Nagoya, Aichi, Japan
| | - Ryuji Kato
- Department of Biotechnology, Graduate School of Engineering, Nagoya University, Nagoya, Aichi, Japan
- Department of Basic Medicinal Sciences, Graduate School of Pharmaceutical Sciences, Nagoya University, Nagoya, Aichi, Japan
- * E-mail:
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Metzler P, von Wilmowsky C, Zimmermann R, Wiltfang J, Schlegel KA. The effect of current used bone substitution materials and platelet-rich plasma on periosteal cells by ectopic site implantation: An in-vivo pilot study. J Craniomaxillofac Surg 2012; 40:409-15. [DOI: 10.1016/j.jcms.2011.07.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 07/19/2011] [Accepted: 07/23/2011] [Indexed: 11/26/2022] Open
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Nagata M, Hoshina H, Li M, Arasawa M, Uematsu K, Ogawa S, Yamada K, Kawase T, Suzuki K, Ogose A, Fuse I, Okuda K, Uoshima K, Nakata K, Yoshie H, Takagi R. A clinical study of alveolar bone tissue engineering with cultured autogenous periosteal cells: coordinated activation of bone formation and resorption. Bone 2012; 50:1123-9. [PMID: 22406494 DOI: 10.1016/j.bone.2012.02.631] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 02/16/2012] [Accepted: 02/23/2012] [Indexed: 11/18/2022]
Abstract
In ongoing clinical research into the use of cultured autogenous periosteal cells (CAPCs) in alveolar bone regeneration, CAPCs were grafted into 33 sites (15 for alveolar ridge augmentation and 18 for maxillary sinus lift) in 25 cases. CAPCs were cultured for 6weeks, mixed with particulate autogenous bone and platelet-rich plasma, and then grafted into the sites. Clinical outcomes were determined from high-resolution three-dimensional computed tomography (3D-CT) images and histological findings. No serious adverse events were attributable to the use of grafted CAPCs. Bone regeneration was satisfactory even in cases of advanced atrophy of the alveolar process. Bone biopsy after bone grafting with CAPCs revealed prominent recruitment of osteoblasts and osteoclasts accompanied by angiogenesis around the regenerated bone. 3D-CT imaging suggested that remodeling of the grafted autogenous cortical bone particles was faster in bone grafting with CAPCs than in conventional bone grafting. The use of CAPCs offers cell-based bone regeneration therapy, affording complex bone regeneration across a wide area, and thus expanding the indications for dental implants. Also, it enables the content of particulate autogenous bone in the graft material to be reduced to as low as 40%, making the procedure less invasive, or enabling larger amounts of graft materials to be prepared. It may also be possible to dispense with the use of autogenous bone altogether in the future. The results suggest that CAPC grafting induces bone remodeling, thereby enhancing osseointegration and consequently reducing postoperative waiting time after dental implant placement.
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Affiliation(s)
- Masaki Nagata
- Department of Oral and Maxillofacial Surgery, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
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Vignoletti F, Abrahamsson I. Quality of reporting of experimental research in implant dentistry. Critical aspects in design, outcome assessment and model validation. J Clin Periodontol 2012; 39 Suppl 12:6-27. [DOI: 10.1111/j.1600-051x.2011.01830.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Fabio Vignoletti
- Department of Periodontology; Faculty of Odontology; Complutense University of Madrid; Madrid; Spain
| | - Ingemar Abrahamsson
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg; Sweden
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Ribeiro FV, Suaid FF, Ruiz KGS, Rodrigues TL, Carvalho MD, Nociti FH, Sallum EA, Casati MZ. Peri-implant reconstruction using autologous periosteum-derived cells and guided bone regeneration. J Clin Periodontol 2010; 37:1128-36. [DOI: 10.1111/j.1600-051x.2010.01635.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Agata H, Asahina I, Watanabe N, Ishii Y, Kubo N, Ohshima S, Yamazaki M, Tojo A, Kagami H. Characteristic change and loss of in vivo osteogenic abilities of human bone marrow stromal cells during passage. Tissue Eng Part A 2010; 16:663-73. [PMID: 19754223 DOI: 10.1089/ten.tea.2009.0500] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although human bone marrow stromal cells (BMSCs) have the ability to form bone when transplanted, the responsible factors for in vivo osteogenic abilities are poorly understood. Here we report conditions that are required for human BMSCs to demonstrate their in vivo osteogenic abilities. BMSCs were obtained from healthy donors and their in vivo osteogenic abilities were analyzed. Transplantation analyses revealed that the passage number and length of osteogenic induction significantly affected ectopic bone formation. Although 2-week induction increased the percentage of success in bone formation compared with the 1-week induction, BMSCs completely lost their in vivo osteogenic ability after passage 4 regardless of the length of osteogenic induction. Despite their in vivo osteogenic ability, no significant difference was observed in alkaline phosphatase activity or gene expression of osteogenic markers between BMSCs at passages 1 and 3. Differences were only observed in in vitro mineralizing abilities. Application of basic fibroblast growth factor helped to maintain the BMSCs in vivo osteogenic ability; basic fibroblast growth factor altered cell growth and expression of HLA-DR. The results strongly suggest that there are several required conditions for human BMSCs to demonstrate their bone-forming capabilities, which should be further investigated and considered when designing a protocol for clinical bone tissue engineering.
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Affiliation(s)
- Hideki Agata
- Division of Molecular Therapy, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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Ribeiro FV, Suaid FF, Ruiz KGS, Salmon CR, Paparotto T, Nociti FH, Sallum EA, Casati MZ. Periosteum-derived cells as an alternative to bone marrow cells for bone tissue engineering around dental implants. A histomorphometric study in beagle dogs. J Periodontol 2010; 81:907-16. [PMID: 20450354 DOI: 10.1902/jop.2010.090604] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The aim of this study is to investigate the potential use of periosteum-derived cells (PCs) for tissue engineering in peri-implant defects. METHODS Bone marrow cells (BMCs) and PCs were harvested from seven adult beagle dogs, cultured in vitro, and phenotypically characterized with regard to their osteogenic properties. The animals were then subjected to teeth extraction, and 3 months later, two implant sites were drilled, bone dehiscences created, and dental implants placed. Dehiscences were randomly assigned to one of two groups: PCs (PCs + carrier) and BMCs (BMCs + carrier). After 3 months, the animals were sacrificed and the implants with adjacent hard tissues were processed for undecalcified sections. Bone-to-implant contact, bone fill within the limits of implant threads, and new bone area in a zone lateral to the implant were histometrically obtained. RESULTS In vitro, phenotypic characterization demonstrated that both cell populations presented osteogenic potential, as identified by the mineral nodule formation and the expression of bone markers. Histometrically, an intergroup analysis showed that both cell-treated defects had similar bone fill within the limits of implant threads and bone-to-implant contact (P >0.05), and although a trend toward higher new bone area values was found for the PC group, there was no significant difference between the experimental groups (P >0.05). CONCLUSIONS Periosteal and bone marrow cells presented a similar potential for bone reconstruction. As such, periosteum may be considered as an alternative source of osteogenic cells in implant dentistry.
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Affiliation(s)
- Fernanda V Ribeiro
- Department of Prosthodontics and Periodontics, School of Dentistry at Piracicaba, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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