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Lima JR, Soares PBF, Pinotti FE, Marcantonio RAC, Marcantonio-Junior E, de Oliveira GJPL. Comparison of the osseointegration of implants placed in areas grafted with HA/TCP and native bone. Microsc Res Tech 2022; 85:2776-2783. [PMID: 35397154 DOI: 10.1002/jemt.24126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 03/04/2022] [Accepted: 03/31/2022] [Indexed: 11/10/2022]
Abstract
This study evaluated the osseointegration of implants in areas grafted with biphasic ceramic based on hydroxyapatite/β-tricalcium phosphate (HA/TCP) and in native bone (NB). Twenty-eight rats were randomly assigned into two groups of 14 animals each: HA/TCP group: implants installed in areas grafted with HA/TCP and NB group: implants installed in areas of native bone. Bone defects were made in both tibiae of the rats belonging to the HA/TCP group and then filled with this bone substitute. After 60 days, the rats were submitted to surgical procedures for implant placement in grafted areas in both tibiae in the HA/TCP group while the implants were installed directly in native bone in the NB group. The animals were euthanized 15 and 45 days, respectively, after the implant placement. Biomechanical (removal torque), microtomographic (volume of mineralized tissues around the implants), and histomorphometric (Bone-Implant contact-%BIC and bone area between the implant threads-%BBT) analyzes were conducted to assess the osseointegration process. The HA/TCP group showed lower values of removal torque, volume of mineralized tissue around the implants, lower %BIC, and %BBT compared to the NB group in both experimental periods. Osseointegration of implants placed in grafted areas with HA/TCP was lower compared to the osseointegration observed in native bone areas.
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Affiliation(s)
- Julia Raulino Lima
- Department of Periodontology/Implantology, Universidade Federal de Uberlândia - UFU, School of Dentistry, Uberlândia, MG, Brazil
| | | | - Felipe Eduardo Pinotti
- Department of Diagnosis and Surgery, Universidade Estadual Paulista - UNESP, School of Dentistry, Araraquara, SP, Brazil
| | | | - Elcio Marcantonio-Junior
- Department of Diagnosis and Surgery, Universidade Estadual Paulista - UNESP, School of Dentistry, Araraquara, SP, Brazil
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Kim YK, Ku JK. Sinus membrane elevation and implant placement. J Korean Assoc Oral Maxillofac Surg 2020; 46:292-298. [PMID: 32855378 PMCID: PMC7469962 DOI: 10.5125/jkaoms.2020.46.4.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022] Open
Abstract
Sinus Schneiderian membrane elevation surgery is widely performed for dental implant placement in the maxillary posterior region. With regard to sinus elevation surgery, various complications can occur and lead to implant failure. For successful implants in the maxillary posterior region, the clinician must be well acquainted with sinus anatomy and pathology, a variety of bone graft materials, the principles of sinus elevation surgery, and prevention and management of complications.
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Affiliation(s)
- Young-Kyun Kim
- Editor-in-Chief of J Korean Assoc Oral Maxillofac Surg, Seongnam, Korea.,Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Seongnam, Korea.,Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Seongnam, Korea
| | - Jeong-Kui Ku
- Section Editor of J Korean Assoc Oral Maxillofac Surg, Seongnam, Korea.,Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Hospital, Armed Forces Medical Command, Seongnam, Korea
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Dewi AH, Ana ID. The use of hydroxyapatite bone substitute grafting for alveolar ridge preservation, sinus augmentation, and periodontal bone defect: A systematic review. Heliyon 2018; 4:e00884. [PMID: 30417149 PMCID: PMC6218667 DOI: 10.1016/j.heliyon.2018.e00884] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/16/2018] [Accepted: 10/23/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES We determined and structurally analyzed the reported effect of hydroxyapatite (HA) bone substitute on alveolar bone regeneration. To the best of our knowledge, no systematic reviews have previously reported the bone regenerative effect of the HA bone substitute. MATERIALS AND METHODS A literature search was performed for articles published up to August 2015 using MEDLINE with the search terms "hydroxyapatite," "bone regeneration," and "alveolar bone" as well as their known synonyms. The inclusion criteria were set up for human trials with at least five patients. The literature search, eligible article selection, and data extraction were independently performed by two readers, and their agreement was reported by κ value. RESULTS Of the 504 studies found using the MEDLINE literature search, 241 were included for further steps (inter-reader agreement, κ = 0.968). Abstract screening yielded 74 studies (κ = 0.910), with 42 completely fulfilling the inclusion criteria (κ = 0.864). In a final step, 42 studies were further analyzed, with 17 and 25 studies with and without statistical analysis, respectively. The 17 studies reporting similar outcome measures were compared using the calculated 95% confidence intervals. The effect of HA on ridge preservation could not be evaluated. CONCLUSIONS The use of the HA bone substitute interfered with the normal healing process, with significant differences found for sinus augmentation but not for periodontal bone defects. Thus, a bone substitute with optimal bone regenerative properties for alveolar ridge or socket preservation, sinus augmentation, and periodontal bony defect should be developed.
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Affiliation(s)
| | - Ika Dewi Ana
- Department of Dental Biomedical Sciences, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
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Niu CC, Lin SS, Chen WJ, Liu SJ, Chen LH, Yang CY, Wang CJ, Yuan LJ, Chen PH, Cheng HY. Benefits of biphasic calcium phosphate hybrid scaffold-driven osteogenic differentiation of mesenchymal stem cells through upregulated leptin receptor expression. J Orthop Surg Res 2015; 10:111. [PMID: 26179165 PMCID: PMC4506435 DOI: 10.1186/s13018-015-0236-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 06/12/2015] [Indexed: 11/20/2022] Open
Abstract
Background The use of mesenchymal stem cells (MSCs) and coralline hydroxyapatite (HA) or biphasic calcium phosphate (BCP) as a bone substitute for posterolateral spinal fusion has been reported. However, the genes and molecular signals by which MSCs interact with their surrounding environment require further elucidation. Methods MSCs were harvested from bone grafting patients and identified by flow cytometry. A composite scaffold was developed using poly(lactide-co-glycolide) (PLGA) copolymer, coralline HA, BCP, and collagen as a carrier matrix for MSCs. The gene expression profiles of MSCs cultured in the scaffolds were measured by microarrays. The alkaline phosphatase (ALP) activity of the MSCs was assessed, and the expression of osteogenic genes and proteins was determined by quantitative polymerase chain reaction (Q-PCR) and Western blotting. Furthermore, we cultured rabbit MSCs in BCP or coralline HA hybrid scaffolds and transplanted these mixtures into rabbits for spinal fusion. We investigated the differences between BCP and coralline HA hybrid scaffolds by dual-energy X-ray absorptiometry (DEXA) and computed tomography (CT). Results Tested in vitro, the cells were negative for hematopoietic cell markers and positive for MSC markers. There was higher expression of 80 genes and lower of 101 genes of MSCs cultured in BCP hybrid scaffolds. Some of these genes have been shown to play a role in osteogenesis of MSCs. In addition, MSCs cultured in BCP hybrid scaffolds produced more messenger RNA (mRNA) for osteopontin, osteocalcin, Runx2, and leptin receptor (leptin-R) than those cultured in coralline HA hybrid scaffolds. Western blotting showed more Runx2 and leptin-R protein expression in BCP hybrid scaffolds. For in vivo results, 3D reconstructed CT images showed continuous bone bridges and fusion mass incorporated with the transverse processes. Bone mineral content (BMC) values were higher in the BCP hybrid scaffold group than in the coralline HA hybrid scaffold group. Conclusions The BCP hybrid scaffold for osteogenesis of MSCs is better than the coralline HA hybrid scaffold by upregulating expression of leptin-R. This was consistent with in vivo data, which indicated that BCP hybrid scaffolds induced more bone formation in a spinal fusion model.
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Affiliation(s)
- Chi-Chien Niu
- Department of Orthopaedics, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street 333, Kweishan, Taoyuan, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Song-Shu Lin
- Department of Orthopaedics, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street 333, Kweishan, Taoyuan, Taiwan.
| | - Wen-Jer Chen
- Department of Orthopaedics, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street 333, Kweishan, Taoyuan, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Shih-Jung Liu
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan.
| | - Lih-Huei Chen
- Department of Orthopaedics, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street 333, Kweishan, Taoyuan, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Chuen-Yung Yang
- Department of Orthopaedics, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street 333, Kweishan, Taoyuan, Taiwan.
| | - Chao-Jan Wang
- Department of Radiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Li-Jen Yuan
- Department of Orthopaedics, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street 333, Kweishan, Taoyuan, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Po-Han Chen
- Department of Orthopaedics, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street 333, Kweishan, Taoyuan, Taiwan.
| | - Hsiao-Yang Cheng
- Department of Radiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Barboni B, Mangano C, Valbonetti L, Marruchella G, Berardinelli P, Martelli A, Muttini A, Mauro A, Bedini R, Turriani M, Pecci R, Nardinocchi D, Zizzari VL, Tetè S, Piattelli A, Mattioli M. Synthetic bone substitute engineered with amniotic epithelial cells enhances bone regeneration after maxillary sinus augmentation. PLoS One 2013; 8:e63256. [PMID: 23696804 PMCID: PMC3656960 DOI: 10.1371/journal.pone.0063256] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 04/01/2013] [Indexed: 12/13/2022] Open
Abstract
Background Evidence has been provided that a cell-based therapy combined with the use of bioactive materials may significantly improve bone regeneration prior to dental implant, although the identification of an ideal source of progenitor/stem cells remains to be determined. Aim In the present research, the bone regenerative property of an emerging source of progenitor cells, the amniotic epithelial cells (AEC), loaded on a calcium-phosphate synthetic bone substitute, made by direct rapid prototyping (rPT) technique, was evaluated in an animal study. Material And Methods Two blocks of synthetic bone substitute (∼0.14 cm3), alone or engineered with 1×106 ovine AEC (oAEC), were grafted bilaterally into maxillary sinuses of six adult sheep, an animal model chosen for its high translational value in dentistry. The sheep were then randomly divided into two groups and sacrificed at 45 and 90 days post implantation (p.i.). Tissue regeneration was evaluated in the sinus explants by micro-computer tomography (micro-CT), morphological, morphometric and biochemical analyses. Results And Conclusions The obtained data suggest that scaffold integration and bone deposition are positively influenced by allotransplantated oAEC. Sinus explants derived from sheep grafted with oAEC engineered scaffolds displayed a reduced fibrotic reaction, a limited inflammatory response and an accelerated process of angiogenesis. In addition, the presence of oAEC significantly stimulated osteogenesis either by enhancing bone deposition or making more extent the foci of bone nucleation. Besides the modulatory role played by oAEC in the crucial events successfully guiding tissue regeneration (angiogenesis, vascular endothelial growth factor expression and inflammation), data provided herein show that oAEC were also able to directly participate in the process of bone deposition, as suggested by the presence of oAEC entrapped within the newly deposited osteoid matrix and by their ability to switch-on the expression of a specific bone-related protein (osteocalcin, OCN) when transplanted into host tissues.
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Affiliation(s)
- Barbara Barboni
- Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy
- Stem TeCh Group, Chieti, Italy
| | - Carlo Mangano
- Department of Surgical and Morphological Science, University of Insubria, Varese, Italy
| | - Luca Valbonetti
- Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy
- Stem TeCh Group, Chieti, Italy
| | - Giuseppe Marruchella
- Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy
| | - Paolo Berardinelli
- Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy
| | - Alessandra Martelli
- Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy
| | - Aurelio Muttini
- Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy
- Stem TeCh Group, Chieti, Italy
| | - Annunziata Mauro
- Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy
| | - Rossella Bedini
- Department of Technologies and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Maura Turriani
- Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy
| | - Raffaella Pecci
- Department of Technologies and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Delia Nardinocchi
- Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy
| | - Vincenzo Luca Zizzari
- Department of Medical, Oral and Biotechnological Science, University “G. d'Annunzio”, Chieti, Italy
| | - Stefano Tetè
- Department of Medical, Oral and Biotechnological Science, University “G. d'Annunzio”, Chieti, Italy
- Stem TeCh Group, Chieti, Italy
- * E-mail:
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Science, University “G. d'Annunzio”, Chieti, Italy
| | - Mauro Mattioli
- Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy
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The influence of bone substitute materials on the bone volume after maxillary sinus augmentation: a microcomputerized tomography study. Clin Oral Investig 2012; 17:543-51. [PMID: 22538473 DOI: 10.1007/s00784-012-0732-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 04/09/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study aims to evaluate the effect of adding bone substitute materials (BSM) to particulated autogenous bone (PAB) on the volume fraction (Vf) of newly formed bone after maxillary sinus augmentation. MATERIALS AND METHODS Thirty healthy patients undergoing maxillary sinus augmentation were included. PAB (N = 10), mixtures of PAB and beta-tricalciumphosphate (PAB/β-TCP) (N = 10), as well as PAB and β-TCP and hydroxyapatite (PAB/HA/β-TCP) (N = 10) were randomly used for sinus augmentation. A sample of the graft material was maintained from each patient at time of maxillary sinus augmentation, and Vfs of the PAB and/or BSM in the samples were determined by means of microcomputerized tomography (μ-CT). Five months later, samples of the grafted areas were harvested during implantation using a trephine bur. μ-CT analysis of these samples was performed, and the Vf of bone and BSM were compared with the data obtained 5 months earlier from the original material. RESULTS The mean Vf of the bone showed a statistically significant increase (p < 0.05) in all groups after a healing period of 5 months without statistically significant difference between the groups. CONCLUSIONS With regard to the increase of bone volume, it is not relevant if PAB is used alone or combined with β-TCP or HA/β-TCP. CLINICAL RELEVANCE The amount of PAB and associated donor site morbidity may be reduced by adding BSM for maxillary sinus augmentation.
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Martinez A, Franco J, Saiz E, Guitian F. Maxillary sinus floor augmentation on humans: Packing simulations and 8 months histomorphometric comparative study of anorganic bone matrix and β-tricalcium phosphate particles as grafting materials. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2010; 30:763-769. [PMID: 21625341 PMCID: PMC3103085 DOI: 10.1016/j.msec.2010.03.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The present study compares the behaviour of an anorganic bone matrix material and a synthetic β-Tricalcium phosphate employed as grafting materials in a sinus floor augmentation two step protocol in humans. In order to estimate the initial occupation level for the two materials, an 'in vitro' simulation has been performed to analyse macroporosity created due to particle packing in terms of porosity and interparticle distances. Grafting in the sinus floor augmentation was performed by filling the defects only with pure grafting materials without autogenous bone addition. The new-bone generated is 100% based on the osteoconductive properties of the grafted materials in contact with physiological fluids. The implants were placed 8 months after the grafting procedure. All the implanted positions were biopsied and embedded in methacrylate resin. Histomorphometric analyses were done over thin film undecalcified sections. Packing simulations allow establishing a comparison of the resorbed volumes related to the initial occupancy of the grafting materials inside the defect. The nature of this interconnected pore network is very alike for either material so new-bone generated was similar (~35 vol.%).
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Affiliation(s)
- A. Martinez
- Facultad de Medicina y Odontología, University of Santiago de Compostela, Rua San Francisco s/n; 15782 Santiago de Compostela, Spain
| | - J. Franco
- Lawrence Berkeley National Laboratory, 1 Cyclotron Rd Mail stop 62R0203 Berkeley, CA 94720, USA
| | - E. Saiz
- Lawrence Berkeley National Laboratory, 1 Cyclotron Rd Mail stop 62R0203 Berkeley, CA 94720, USA
| | - F. Guitian
- Instituto de Ceramica de Galicia, Av Mestre Mateo s/n, 15782 Santiago de Compostela, Spain
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