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Ferraz MP. Bone Grafts in Dental Medicine: An Overview of Autografts, Allografts and Synthetic Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16114117. [PMID: 37297251 DOI: 10.3390/ma16114117] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
This review provides an overview of various materials used in dentistry and oral and maxillofacial surgeries to replace or repair bone defects. The choice of material depends on factors such as tissue viability, size, shape, and defect volume. While small bone defects can regenerate naturally, extensive defects or loss or pathological fractures require surgical intervention and the use of substitute bones. Autologous bone, taken from the patient's own body, is the gold standard for bone grafting but has drawbacks such as uncertain prognosis, surgery at the donor site, and limited availability. Other alternatives for medium and small-sized defects include allografts (from human donors), xenografts (from animals), and synthetic materials with osteoconductive properties. Allografts are carefully selected and processed human bone materials, while xenografts are derived from animals and possess similar chemical composition to human bone. Synthetic materials such as ceramics and bioactive glasses are used for small defects but may lack osteoinductivity and moldability. Calcium-phosphate-based ceramics, particularly hydroxyapatite, are extensively studied and commonly used due to their compositional similarity to natural bone. Additional components, such as growth factors, autogenous bone, and therapeutic elements, can be incorporated into synthetic or xenogeneic scaffolds to enhance their osteogenic properties. This review aims to provide a comprehensive analysis of grafting materials in dentistry, discussing their properties, advantages, and disadvantages. It also highlights the challenges of analyzing in vivo and clinical studies to select the most suitable option for specific situations.
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Affiliation(s)
- Maria Pia Ferraz
- Departamento de Engenharia Metalúrgica e de Materiais, Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4099-002 Porto, Portugal
- INEB-Instituto de Engenharia Biomédica, Universidade do Porto, 4099-002 Porto, Portugal
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Bone Regeneration Effect of Nanochitosan with or without Temporally-controlled Release of Dexamethasone. J Endod 2023; 49:496-503. [PMID: 36898664 DOI: 10.1016/j.joen.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/18/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023]
Abstract
INTRODUCTION Chitosan is a cationic biopolymer and its modification as a nanoparticle, as well as loading a corticosteroid on it, may enhance its bone regenerative effect. The aim of this study was to investigate the bone regenerative effect of nanochitosan with or without dexamethasone. METHODS Under general anesthesia, four cavities were created in the calvarium of 18 rabbits and filled with either nanochitosan, nanochitosan with a temporally-controlled release of dexamethasone (nanochitosan+dexamethasone), an autograft, or left unfilled (control). The defects were then covered with a collagen membrane. The rabbits were randomly divided into 2 groups and were sacrificed at 6 or 12 weeks post-surgery. The new bone type, osteogenesis pattern, foreign body reaction, as well as the type and severity of the inflammatory response were evaluated histologically. The amount of new bone was determined using histomorphometry and cone-beam computed tomography (CBCT). A one-way ANOVA with repeated-measures was performed to compare results between the groups at each interval. A T-test and Chi-square were also conducted to analyze changes in variables between the two intervals. RESULTS Nanochitosan and the combination of nanochitosan and dexamethasone significantly increased the combination of woven and lamellar bone (P=0.007). No sample showed a foreign body reaction or any acute or severe inflammation. Chronic inflammation was significantly decreased in number (P=0.002) and severity (P=0.003) over time. There was no significant difference between the extent and pattern of osteogenesis amongst the four groups, as evaluated by histomorphometry and CBCT at each interval. CONCLUSION Nanochitosan and nanochitosan+dexamethasone were comparable to the gold standard of autograft regarding the type and severity of inflammation, as well as the level and pattern of osteogenesis, yet they induced more woven and lamellar bone.
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Ghayor C, Bhattacharya I, Guerrero J, Özcan M, Weber FE. 3D-Printed HA-Based Scaffolds for Bone Regeneration: Microporosity, Osteoconduction and Osteoclastic Resorption. MATERIALS 2022; 15:ma15041433. [PMID: 35207973 PMCID: PMC8875550 DOI: 10.3390/ma15041433] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/04/2022] [Accepted: 02/09/2022] [Indexed: 02/04/2023]
Abstract
Additive manufacturing enables the realization of the macro- and microarchitecture of bone substitutes. The macroarchitecture is determined by the bone defect and its shape makes the implant patient specific. The preset distribution of the 3D-printed material in the macroarchitecture defines the microarchitecture. At the lower scale, the nanoarchitecture of 3D-printed scaffolds is dependent on the post-processing methodology such as the sintering temperature. However, the role of microarchitecture and nanoarchitecture of scaffolds for osteoconduction is still elusive. To address these aspects in more detail, we produced lithography-based osteoconductive scaffolds from hydroxyapatite (HA) of identical macro- and microarchitecture and varied their nanoarchitecture, such as microporosity, by increasing the maximum sintering temperatures from 1100 to 1400 °C. The different scaffold types were characterized for microporosity, compression strength, and nanoarchitecture. The in vivo results, based on a rabbit calvarial defect model showed that bony ingrowth, as a measure of osteoconduction, was independent from scaffold’s microporosity. The same applies to in vitro osteoclastic resorbability, since on all tested scaffold types, osteoclasts formed on their surfaces and resorption pits upon exposure to mature osteoclasts were visible. Thus, for wide-open porous HA-based scaffolds, a low degree of microporosity and high mechanical strength yield optimal osteoconduction and creeping substitution. Based on our study, non-unions, the major complication during demanding bone regeneration procedures, could be prevented.
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Affiliation(s)
- Chafik Ghayor
- Center of Dental Medicine, Oral Biotechnology & Bioengineering, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (C.G.); (I.B.); (J.G.)
| | - Indranil Bhattacharya
- Center of Dental Medicine, Oral Biotechnology & Bioengineering, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (C.G.); (I.B.); (J.G.)
| | - Julien Guerrero
- Center of Dental Medicine, Oral Biotechnology & Bioengineering, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (C.G.); (I.B.); (J.G.)
| | - Mutlu Özcan
- Center of Dental Medicine, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland;
| | - Franz E. Weber
- Center of Dental Medicine, Oral Biotechnology & Bioengineering, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (C.G.); (I.B.); (J.G.)
- CABMM, Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Winterthurerstr. 190, 8057 Zurich, Switzerland
- Correspondence: ; Tel.: +41-44-634-3140
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Salamanca E, Pan YH, Sun YS, Hsueh HW, Dorj O, Yao WL, Lin JCY, Teng NC, Watanabe I, Abe S, Wu YF, Chang WJ. Magnesium Modified β-Tricalcium Phosphate Induces Cell Osteogenic Differentiation In Vitro and Bone Regeneration In Vivo. Int J Mol Sci 2022; 23:ijms23031717. [PMID: 35163639 PMCID: PMC8836187 DOI: 10.3390/ijms23031717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 01/27/2023] Open
Abstract
In vitro, in vivo, and clinical studies have shown how the physicochemical and biological properties of β-tricalcium phosphate (β-TCP) work in bone regeneration. This study aimed to improve the properties of β-TCP by achieving optimum surface and bulk β-TCP chemical/physical properties through the hydrothermal addition of magnesium (Mg) and to later establish the biocompatibility of β-TCP/Mg for bone grafting and tissue engineering treatments. Multiple in vitro and in vivo analyses were used to complete β-TCP/Mg physicochemical and biological characterization. The addition of MgO brought about a modest rise in the number of β-TCP surface particles, indicating improvements in alkaline phosphatase (ALP) activity on day 21 (p < 0.05) and in the WST-1assay on all days (p < 0.05), with a corresponding increase in the upregulation of ALP and bone sialoprotein. SEM analyses stated that the surfaces of the β-TCP particles were not altered after the addition of Mg. Micro-CT and histomorphometric analysis from rabbit calvaria critical defects resulted in β-TCP/Mg managing to reform more new bone than the control defects and β-TCP control at 2, 6, and 8 weeks (* p ≤ 0.05, ** p ≤ 0.01, *** p ≤ 0.001, and **** p ≤ 0.0001). The hydrothermal addition of MgO to the β-TCP surfaces ameliorated its biocompatibility without altering its surface roughness resulting from the elemental composition while enhancing cell viability and proliferation, inducing more bone regeneration by osteoconduction in vivo and osteoblastic differentiation in vitro.
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Affiliation(s)
- Eisner Salamanca
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
| | - Yu-Hwa Pan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Department of General Dentistry, Chang Gung Memorial Hospital, Taipei 10507, Taiwan
- Graduate Institute of Dental & Craniofacial Science, Chang Gung University, Taoyuan 33305, Taiwan
- School of Dentistry, College of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Ying-Sui Sun
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan;
| | - Hao-Wen Hsueh
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
| | - Odontuya Dorj
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Department of Dental Technology and Hygiene, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia
| | - Wan-Ling Yao
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
| | - Jerry Chin-Yi Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental, Medicine, Boston, MA 02115, USA
| | - Nai-Chia Teng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Dental Department, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Ikki Watanabe
- Department of Gerontology, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Shinichi Abe
- Department of Anatomy, Tokyo Dental College, Tokyo 101-0061, Japan;
| | - Yi-Fan Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Correspondence: (Y.-F.W.); (W.-J.C.); Tel.: +886-2-2736-1661 (ext. 5148) (Y.-F.W.); +886-2-2736-1661 (ext. 5150) (W.-J.C.)
| | - Wei-Jen Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.); (Y.-H.P.); (H.-W.H.); (O.D.); (W.-L.Y.); (J.C.-Y.L.); (N.-C.T.)
- Dental Department, Shuang-ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Correspondence: (Y.-F.W.); (W.-J.C.); Tel.: +886-2-2736-1661 (ext. 5148) (Y.-F.W.); +886-2-2736-1661 (ext. 5150) (W.-J.C.)
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In vivo efficacy of low-level laser therapy on bone regeneration. Lasers Med Sci 2022; 37:2209-2216. [PMID: 35022870 DOI: 10.1007/s10103-021-03487-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE In clinical use of low-level laser therapy for bone regeneration (LLLT), application protocol (dose, duration, and repetitions) has not been established. This study aimed to depict a reliable dosage of LLLT by evaluating the efficacy of different dosing of LLLT (diode) on the healing of rabbit cranial defects. METHODS Critical size defects were prepared in calvarias of 26 New Zealand White Rabbits in such each animal containing both test and control groups. Test groups were irradiated with 4 Joule/cm2 (j/cm2), 6 j/cm2, and 8 j/cm2. The rabbits were subjected to six times of laser treatments in 10 days. At the end of the second week, 5 rabbits were sacrificed for histopathological and immunohistochemical analyses. At the 4th and 8th weeks, 20 rabbits (10 each) were sacrificed for micro-CT and histopathological analyses. RESULTS Micro-CT evaluation revealed improved new bone formation in all test groups compared to the control group. 6 j/cm2 group demonstrated the highest bone formation. The highest bone morphogenic protein -2 levels were found in the 4 j/cm2 group. Osteocalcin expression was significantly higher in 4 j/cm2 group. CONCLUSIONS Our findings indicate that LLLT have a positive effect on new bone formation. The high efficacy of doses of 4 j/cm2 and 6 j/cm2 is promising to promote early bone healing.
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Liang D, Pei J, Zhang L, Ling H, Liu Y, Chen X. Treatment of pre-collapse non-traumatic osteonecrosis of the femoral head through Orthopdische Chirurgie München approach combined with autologous bone mixed with β-tricalcium phosphate porous bioceramic bone graft: a retrospective study of mid-term results. J Orthop Surg Res 2021; 16:492. [PMID: 34384470 PMCID: PMC8359556 DOI: 10.1186/s13018-021-02632-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to evaluate the clinical efficacy of femoral head and neck fenestration combined with autologous bone mixed with β-tricalcium phosphate porous bioceramic bone (light bulb procedure) through Orthopdische Chirurgie München approach (OCM approach) for pre-collapse non-traumatic osteonecrosis of the femoral head(ONFH). Methods The clinical data of 47 patients (47 hips) with ONFH were retrospectively reviewed. The Harris hip score (HHS) was used to evaluate the clinical outcomes. Imaging was assessed by X-ray. Clinical failure was defined as postoperative total hip arthroplasty (THA) or the HHS was poor (< 70). The Kaplan–Meier survival curve was used to conduct a univariate analysis of risk factors. The analysis factors included gender, age, International Association Research Circulation Osseous (ARCO) stage, etiology, body mass index (BMI), 25-hydroxyvitamin D (25(OH)D), and type I collagen carboxy-terminal peptide (CTX). The COX multivariate risk model was used to analyze the risk factors. Results All the 47 hips were followed up for 24–58 months, with an average of 45 months. The Harris score (76.29 ± 10.38) at the last follow-up was significantly higher than the preoperative HHS (64.45 ± 2.93) (P < 0.05). The postoperative HHS was excellent with a success rate of 36.17%. Postoperative imaging evaluation showed that 9 hips improved, 28 hips stabilized, and 10 hips progressed. Moreover, 17 out of 47 hips were defined as a postoperative clinical failure and the success rate was 63.83%. 25(OH)D and preoperative ARCO stage were risk factors for postoperative clinical failure (P < 0.05). The COX multivariate risk model analysis showed that IIIA stage was an independent risk factor for postoperative clinical failure (P < 0.05). Conclusions The head and neck fenestration and bone grafting via the OCM approach in the treatment of non-traumatic ONFH in the pre-collapse stage can achieve good clinical outcomes. 25(OH)D deficient patients and ARCO IIIA patients had a higher failure rate of bone graft using this approach.
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Affiliation(s)
- Dawei Liang
- Hip Disease Research Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), 82 Qiming South Road, Luoyang, 471000, Henan, China.
| | - Jia Pei
- Quality Management Department, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, 471000, China
| | - Leilei Zhang
- Hip Disease Research Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), 82 Qiming South Road, Luoyang, 471000, Henan, China
| | - Haonan Ling
- Hip Disease Research Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), 82 Qiming South Road, Luoyang, 471000, Henan, China
| | - Youwen Liu
- Hip Disease Research Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), 82 Qiming South Road, Luoyang, 471000, Henan, China
| | - Xiantao Chen
- Hip Disease Research Center, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), 82 Qiming South Road, Luoyang, 471000, Henan, China
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Surface Modified β-Tricalcium phosphate enhanced stem cell osteogenic differentiation in vitro and bone regeneration in vivo. Sci Rep 2021; 11:9234. [PMID: 33927241 PMCID: PMC8084957 DOI: 10.1038/s41598-021-88402-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/12/2021] [Indexed: 02/08/2023] Open
Abstract
A major number of studies have demonstrated Beta-tricalcium phosphate (β-TCP) biocompatibility, bioactivity, and osteoconductivity characteristics in bone regeneration. The aim of this research was to enhance β-TCP's biocompatibility, and evaluate its physicochemical properties by argon glow discharge plasma (GDP) plasma surface treatment without modifying its surface. Treated β-TCP was analyzed by scanning electron microscopy (SEM), energy-dispersive spectrometry, X-ray photoelectron spectroscopy (XPS), X-ray diffraction analysis, and Fourier transform infrared spectroscopy characterization. To evaluate treated β-TCP biocompatibility and osteoblastic differentiation, water-soluble tetrazolium salts-1 (WST-1), immunofluorescence, alkaline phosphatase (ALP) assay, and quantitative real-time polymerase chain reaction (QPCR) were done using human mesenchymal stem cells (hMSCs). The results indicated a slight enhancement of the β-TCP by GDP sputtering, which resulted in a higher Ca/P ratio (2.05) than the control. Furthermore, when compared with control β-TCP, we observed an improvement of WST-1 on all days (p < 0.05) as well as of ALP activity (day 7, p < 0.05), with up-regulation of ALP, osteocalcin, and Osteoprotegerin osteogenic genes in cells cultured with the treated β-TCP. XPS and SEM results indicated that treated β-TCP’s surface was not modified. In vivo, micro-computed tomography and histomorphometric analysis indicated that the β-TCP test managed to regenerate more new bone than the untreated β-TCP and control defects at 8 weeks (p < 0.05). Argon GDP treatment is a viable method for removing macro and micro particles of < 7 μm in size from β-TCP bigger particles surfaces and therefore improving its biocompatibility with slight surface roughness modification, enhancing hMSCs proliferation, osteoblastic differentiation, and stimulating more new bone formation.
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Microporosities in 3D-Printed Tricalcium-Phosphate-Based Bone Substitutes Enhance Osteoconduction and Affect Osteoclastic Resorption. Int J Mol Sci 2020; 21:ijms21239270. [PMID: 33291724 PMCID: PMC7731226 DOI: 10.3390/ijms21239270] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 01/01/2023] Open
Abstract
Additive manufacturing is a key technology required to realize the production of a personalized bone substitute that exactly meets a patient’s need and fills a patient-specific bone defect. Additive manufacturing can optimize the inner architecture of the scaffold for osteoconduction, allowing fast and reliable defect bridging by promoting rapid growth of new bone tissue into the scaffold. The role of scaffold microporosity/nanoarchitecture in osteoconduction remains elusive. To elucidate this relationship, we produced lithography-based osteoconductive scaffolds from tricalcium phosphate (TCP) with identical macro- and microarchitecture, but varied their nanoarchitecture/microporosity by ranging maximum sintering temperatures from 1000 °C to 1200 °C. After characterization of the different scaffolds’ microporosity, compression strength, and nanoarchitecture, we performed in vivo studies that showed that ingrowth of bone as an indicator of osteoconduction significantly decreased with decreasing microporosity. Moreover, at the 1200 °C peak sinter temperature and lowest microporosity, osteoclastic degradation of the material was inhibited. Thus, even for wide-open porous TCP-based scaffolds, a high degree of microporosity appears to be essential for optimal osteoconduction and creeping substitution, which can prevent non-unions, the major complication during bone regeneration procedures.
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Weber FE. Reconsidering Osteoconduction in the Era of Additive Manufacturing. TISSUE ENGINEERING PART B-REVIEWS 2019; 25:375-386. [PMID: 30997857 DOI: 10.1089/ten.teb.2019.0047] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Bone regeneration procedures in clinics and bone tissue engineering stand on three pillars: osteoconduction, osteoinduction, and stem cells. In the last two decades, the focus in this field has been on osteoinduction, which is realized by the use of bone morphogenetic proteins and the application of mesenchymal stem cells to treat bone defects. However, osteoconduction was reduced to a surface phenomenon because the supposedly ideal pore size of osteoconductive scaffolds was identified in the 1990s as 0.3-0.5 mm in diameter, forcing bone formation to occur predominantly on the surface. Meanwhile, additive manufacturing has evolved as a new tool to realize designed microarchitectures in bone substitutes, thereby enabling us to study osteoconduction as a true three-dimensional phenomenon. Moreover, by additive manufacturing, wide-open porous scaffolds can be produced in which bone formation occurs distant to the surface at a superior bony defect-bridging rate enabled by highly osteoconductive pores 1.2 mm in diameter. This review provides a historical overview and an updated definition of osteoconduction and related terms. In addition, it shows how additive manufacturing can be instrumental in studying and optimizing osteoconduction of bone substitutes, and provides novel optimized features and boundaries of osteoconductive microarchitectures. Impact Statement This review updates the definition of osteoconduction and draws clear lines to discriminate between osteoconduction, osseointegration, and osteoinduction. Moreover, additively manufactured libraries of scaffolds revealed that: osteoconduction is more a three-dimensional than a surface phenomenon; microarchitecture dictates defect bridging, which is the measure for osteoconduction; pore diameter or the diagonal of lattice microarchitectures of osteoconductive bone substitutes should be ∼1.2 mm.
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Affiliation(s)
- Franz E Weber
- Oral Biotechnology and Bioengineering, Center of Dental Medicine Department of Cranio-Maxillofacial and Oral Surgery, University of Zurich, Zurich, Switzerland.,Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
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Li L, Li Y, Yang L, Yu F, Zhang K, Jin J, Shi J, Zhu L, Liang H, Wang X, Jiang Q. Polydopamine coating promotes early osteogenesis in 3D printing porous Ti6Al4V scaffolds. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:240. [PMID: 31317010 PMCID: PMC6603351 DOI: 10.21037/atm.2019.04.79] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 04/17/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Titanium implants are widely used in orthopedic and dental for more than 30 years. Its stable physicochemical properties and mechanical strength are indeed appropriate for implantation. However, the Bioinertia oxidized layer and higher elastic modulus often lead to the early implantation failure. METHODS In this study, we proposed a simple design of porous structure to minimize the disparity between scaffold and natural bone tissue, and introduced a one-step reaction to form a polydopamine (PDA) layer on the surface of titanium for the purpose of improving osteogenesis as well. The porous scaffolds with pore size of 400 µm and porosity of 44.66% were made by additive manufacturing. The cell behavior was tested by seeding MC3T3-E1 cells on Ti6Al4V films for 15 days. The biomechanical properties were then analyzed by finite element (FE) method and the in vivo osteogenesis effect was accordingly evaluated by implanting the scaffolds for 5 weeks in rabbits. RESULTS According to the achieved results, it was revealed that the immersion for 40 min with dopamine could significantly improve the cell adhesion. The proposed method for design of porous structure can avoid the stress shielding effect and bone growth inside the PDA coating scaffolds, which were observed at the early stage of bone healing process. CONCLUSIONS It can be concluded that the proposed PDA coating method is effective in promoting early osteogenesis, as well as being easy to operate, and can be helpful in the future clinical application of titanium implants.
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Affiliation(s)
- Lan Li
- School of Mechanical Engineering, Southeast University, Nanjing 210000, China
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital affiliated to Medical School of Nanjing University, Nanjing 210000, China
- Institute of Medical 3D Printing, Nanjing University, Nanjing 210000, China
| | - Yixuan Li
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital affiliated to Medical School of Nanjing University, Nanjing 210000, China
| | - Longfei Yang
- School of Mechanical Engineering, Southeast University, Nanjing 210000, China
| | - Fei Yu
- Drum Tower of Clinical Medicine, Nanjing Medical University, Nanjing 210000, China
| | - Kaijia Zhang
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital affiliated to Medical School of Nanjing University, Nanjing 210000, China
| | - Jing Jin
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital affiliated to Medical School of Nanjing University, Nanjing 210000, China
| | - Jianping Shi
- School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing 210000, China
| | - Liya Zhu
- School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing 210000, China
| | - Huixin Liang
- School of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210000, China
| | - Xingsong Wang
- School of Mechanical Engineering, Southeast University, Nanjing 210000, China
| | - Qing Jiang
- Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital affiliated to Medical School of Nanjing University, Nanjing 210000, China
- Institute of Medical 3D Printing, Nanjing University, Nanjing 210000, China
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Chen TH, Ghayor C, Siegenthaler B, Schuler F, Rüegg J, De Wild M, Weber FE. Lattice Microarchitecture for Bone Tissue Engineering from Calcium Phosphate Compared to Titanium. Tissue Eng Part A 2018; 24:1554-1561. [PMID: 29999466 PMCID: PMC6198759 DOI: 10.1089/ten.tea.2018.0014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Additive manufacturing of bone tissue engineering scaffolds will become a key element for personalized bone tissue engineering in the near future. Several additive manufacturing processes are based on extrusion where the deposition of the filament will result in a three-dimensional lattice structure. Recently, we studied diverse lattice structures for bone tissue engineering realized by laser sintering of titanium. In this work, we used lithography-based ceramic manufacturing of lattice structures to produce scaffolds from tricalcium phosphates (TCP) and compared them in vivo to congruent titanium scaffolds manufactured with the identical computer-aided design data to look for material-based differences in bony healing. The results show that, during a 4-week period in a noncritical-size defect in a rabbit calvarium, both scaffolds with the identical microarchitecture performed equally well in terms of bony regeneration and bony bridging of the defect. A significant increase in both parameters could only be achieved when the TCP-based scaffolds were doped with bone morphogenetic protein-2. In a critical-size defect in the calvarial bone of rabbits, however, the titanium scaffold performed significantly better than the TCP-based scaffold, most likely due to its higher mechanical stability. We conclude that titanium and TCP-based scaffolds of the same microarchitecture perform equally well in terms of bone regeneration, provided the microarchitecture meets the mechanical demand at the site of implantation.
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Affiliation(s)
- Tse-Hsiang Chen
- 1 Oral Biotechnology and Bioengineering, Center of Dental Medicine, University of Zurich , Zurich, Switzerland
| | - Chafik Ghayor
- 1 Oral Biotechnology and Bioengineering, Center of Dental Medicine, University of Zurich , Zurich, Switzerland
| | - Barbara Siegenthaler
- 1 Oral Biotechnology and Bioengineering, Center of Dental Medicine, University of Zurich , Zurich, Switzerland
| | - Felix Schuler
- 2 School of Life Sciences, Institute for Medical and Analytical Technologies, University of Applied Sciences Northwestern Switzerland , Muttenz, Switzerland
| | - Jasmine Rüegg
- 2 School of Life Sciences, Institute for Medical and Analytical Technologies, University of Applied Sciences Northwestern Switzerland , Muttenz, Switzerland
| | - Michael De Wild
- 2 School of Life Sciences, Institute for Medical and Analytical Technologies, University of Applied Sciences Northwestern Switzerland , Muttenz, Switzerland
| | - Franz E Weber
- 1 Oral Biotechnology and Bioengineering, Center of Dental Medicine, University of Zurich , Zurich, Switzerland .,3 CABMM, Center for Applied Biotechnology and Molecular Medicine, University of Zurich , Zurich, Switzerland .,4 Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich , Zurich, Switzerland
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12
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Ghayor C, Weber FE. Osteoconductive Microarchitecture of Bone Substitutes for Bone Regeneration Revisited. Front Physiol 2018; 9:960. [PMID: 30072920 PMCID: PMC6060436 DOI: 10.3389/fphys.2018.00960] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/29/2018] [Indexed: 12/11/2022] Open
Abstract
In the last three decades, all efforts in bone tissue engineering were driven by the dogma that the ideal pore size in bone substitutes lies between 0.3 and 0.5 mm in diameter. Newly developed additive manufacturing methodologies for ceramics facilitate the total control over pore size, pore distribution, bottleneck size, and bottleneck distribution. Therefore, this appears to be the method of choice with which to test the aforementioned characteristics of an ideal bone substitute. To this end, we produced a library of 15 scaffolds with diverse defined pore/bottleneck dimensions and distributions, tested them in vivo in a calvarial bone defect model in rabbits, and assessed the clinically most relevant parameters: defect bridging and bony regenerated area. Our in vivo data revealed that the ideal pore/bottleneck dimension for bone substitutes is in the range of 0.7-1.2 mm, and appears therefore to be twofold to fourfold more extended than previously thought. Pore/bottleneck dimensions of 1.5 and 1.7 mm perform significantly worse and appear unsuitable in bone substitutes. Thus, our results set the ideal range of pore/bottleneck dimensions and are likely to have a significant impact on the microarchitectural design of future bone substitutes for use in orthopedic, trauma, cranio-maxillofacial and oral surgery.
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Affiliation(s)
- Chafik Ghayor
- Oral Biotechnology and Bioengineering, Department of Cranio-Maxillofacial and Oral Surgery, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Franz E. Weber
- Oral Biotechnology and Bioengineering, Department of Cranio-Maxillofacial and Oral Surgery, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Zurich, Switzerland
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13
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Manchón A, Alkhraisat MH, Rueda-Rodriguez C, Pintado C, Prados-Frutos JC, Torres J, Lopez Cabarcos E. Silicon bioceramic loaded with vancomycin stimulates bone tissue regeneration. J Biomed Mater Res B Appl Biomater 2017; 106:2307-2315. [PMID: 29098767 DOI: 10.1002/jbm.b.34040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 10/07/2017] [Accepted: 10/13/2017] [Indexed: 02/01/2023]
Abstract
Porous ceramics doped with silicon and pure β-TCP were analyzed in terms of internal microstructure, cell behavior, and the percentage of newly formed bone. Additionally the materials were tested to determine which of the two had better properties to load and release vancomycin hydrochloride. Internal pore distribution and porosity were determined through high pressure mercury porosimetry and the specific surface area was measured by the Brunauer Emmet-Teller method. The proliferation and viability of the human osteoblast-like cell line MG-63 was studied to validate both materials. The materials were tested on eight New Zealand rabbits which created defects, 10 mm in diameter, in the calvaria bone. After 8 and 12 weeks a histological and histomorphometric analysis was performed. Si-β-TCP showed a higher porosity and specific surface area. The cytocompatibility test revealed acceptable results in terms of proliferation and viability whereas the percentage of new bone was higher in Si-β-TCP with a two-time study being statistically significant with 12 weeks of healing (p < 0.05).The vancomycin loaded within the ceramic scaffolds were burst released and the material had the ability to inhibit bacterial growth. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2307-2315, 2018.
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Affiliation(s)
- Angel Manchón
- Department of Stomatology, Faculty of Health Sciences, URJC, 28922, Alcorcon-Madrid, Spain
| | - Mohammad H Alkhraisat
- Department of Physical-Chemistry II, Faculty of Pharmacy, Complutense University of Madrid, 28040, Madrid, Spain
| | - Carmen Rueda-Rodriguez
- Department of Physical-Chemistry II, Faculty of Pharmacy, Complutense University of Madrid, 28040, Madrid, Spain
| | - Concepción Pintado
- Departament of Microbiology II, Facultad de Farmacia, UCM, Madrid, Spain
| | - J C Prados-Frutos
- Department of Stomatology, Faculty of Health Sciences, URJC, 28922, Alcorcon-Madrid, Spain
| | - Jesus Torres
- Department of Stomatology, Faculty of Health Sciences, URJC, 28922, Alcorcon-Madrid, Spain
| | - Enrique Lopez Cabarcos
- Department of Physical-Chemistry II, Faculty of Pharmacy, Complutense University of Madrid, 28040, Madrid, Spain
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14
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Kubasiewicz-Ross P, Hadzik J, Seeliger J, Kozak K, Jurczyszyn K, Gerber H, Dominiak M, Kunert-Keil C. New nano-hydroxyapatite in bone defect regeneration: A histological study in rats. Ann Anat 2017; 213:83-90. [DOI: 10.1016/j.aanat.2017.05.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/09/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022]
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15
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Razavi SM, Rismanchian M, Jafari-Pozve N, Nosouhian S. Comparing the Efficacy of Three Different Nano-scale Bone Substitutes: In vivo Study. Adv Biomed Res 2017; 6:64. [PMID: 28603705 PMCID: PMC5458404 DOI: 10.4103/2277-9175.192627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Synthetic biocompatible bone substitutions have been used widely for bone tissue regeneration as they are safe and effective. The aim of this animal study is to compare the effectiveness of three different biocompatible bone substitutes, including nano-hydroxyapatite (nano-HA) nano-bioglass (nano-BG) and forstrite scaffolds. Materials and Methods: In this interventional and experimental study, four healthy dogs were anesthetized, and the first to fourth premolars were extracted in each quadrant. After healing, the linear incision on the crestal ridge from molar to anterior segment prepared in each quadrant and 16 defects in each dog were prepared. Nano-HA, nano-BG, and forstrite scaffold was prepared according to the size of defects and placed in the 12 defects randomly, four defects remained as a control group. The dogs were sacrificed in four time intervals (15, 30, 45, and 60 days after) and the percentage of different types of regenerated bones (lamellar and woven) and connective tissue were recorded in histological process. The data were analyzed using Mann–Whitney test (α = 0.05). Results: The difference in nano-HA and nano-BG with the control group was significant in three-time intervals regarding the amount of bone formation (P < 0.01). After 15 days, the nano-HA showed the highest amount of woven and lamellar bone regeneration (18.37 ± 1.06 and 30.44 ± 0.54). Conclusion: Nano-HA and nano-BG groups showed a significant amount of bone regeneration, especially after 30 days, but paying more surveys and observation to these materials as bone substitutes seem to be needed.
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Affiliation(s)
- Sayed Mohammad Razavi
- Dental Implants Research Center, Department of Oral Pathology, School of Dentitry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansour Rismanchian
- Dental Implants Research Center, Department of Prosthodontics, School of Dentitry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasim Jafari-Pozve
- Department of Oral and Maxillofacial Radiology, School of Dentitry, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Oral and Maxillofacial Radiology, School of Dentitry, Islamic Azad University, Khorasgan Branch, Isfahan, Iran
| | - Saied Nosouhian
- Dental Implants Research Center, Department of Prosthodontics, School of Dentitry, Isfahan University of Medical Sciences, Isfahan, Iran
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16
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Sadeghi R, Najafi M, Semyari H, Mashhadiabbas F. Histologic and histomorphometric evaluation of bone regeneration using nanocrystalline hydroxyapatite and human freeze-dried bone graft : An experimental study in rabbit. J Orofac Orthop 2017; 78:144-152. [PMID: 28130564 DOI: 10.1007/s00056-016-0067-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 10/07/2016] [Indexed: 01/23/2023]
Abstract
PURPOSE Bone regeneration is an important concern in periodontal treatment and implant dentistry. Different biomaterials and surgical techniques have been used for this purpose. The aim of the present study was to compare the effect of nanocrystalline hydroxyapatite and human freeze-dried bone graft (FDBG) in regeneration of rabbit calvarium bony defects by histologic and histomorphometric evaluation. METHODS In this experimental study, three similar defects, measuring 8 mm in diameter, were created in the calvaria of 16 white New Zealand rabbits. Two defects were filled with FDBG and nanocrystalline hydroxyapatite silica gel, while the other one remained unfilled to be considered as control. All the defects were covered with collagen membranes. During the healing period, two animals perished; so 14 rabbits were divided into two groups: half of them were euthanized after 6 weeks of healing and the other half after 12 weeks. The specimens were subjected to histologic and histomorphometric examinations for assessment of the following variables: percentage of bone formation and residual graft material, inflammation scores, patterns of bone formation and type of newly formed bone. RESULTS The percentages of new bone formation after 6 weeks were 14.22 ± 7.85, 21.57 ± 6.91, and 20.54 ± 10.07% in FDBG, NanoBone, and control defects. These values were 27.54 ± 20.19, 23.86 ± 6.27, and 26.48 ± 14.18% in 12-week specimens, respectively. No significant differences were found in the amount of bone formation between the groups. With regard to inflammation, the control and NanoBone groups showed significantly less inflammation compared to FDBG at the 6-week healing phase (P = 0.04); this difference was not significant in the 12-week specimens. CONCLUSIONS Based on the results of this experimental study, both NanoBone and FDBG exhibited a similar effect on bone formation.
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Affiliation(s)
- Rokhsareh Sadeghi
- Department of Periodontics, Faculty of Dentistry, Shahed University, 37, Italia St., Vesal Ave., Tehran, 1417755351, Iran.
| | - Mohammad Najafi
- Department of Periodontics, Faculty of Dentistry, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
| | - Hassan Semyari
- Department of Periodontics, Faculty of Dentistry, Shahed University, 37, Italia St., Vesal Ave., Tehran, 1417755351, Iran
| | - Fatemeh Mashhadiabbas
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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17
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Damlar I, Arpağ OF, Tatli U, Altan A. Effects of Hypericum perforatum on the healing of xenografts: a histomorphometric study in rabbits. Br J Oral Maxillofac Surg 2016; 55:383-387. [PMID: 28007487 DOI: 10.1016/j.bjoms.2016.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 12/05/2016] [Indexed: 12/12/2022]
Abstract
The aim of this study was to investigate effects of the Hypericum perforatum (St John's Wort) on bone healing in rabbit calvarium. Ten male New Zealand rabbits each had three bicortical defects made in the calvarial bones, which were filled with xenograft, xenograft+H perforatum oil extract, and autogenous graft. Four weeks postoperatively all rabbits were killed and the bony defects examined histomorphometrically. Tissue compartments including new bone (p<0.001), marrow space (p<0.001), and residual bone grafts (p=0.014) differed significantly among groups. The volume of residual graft was significantly decreased in the xenograft/H perforatum group compared with those with xenografts alone (p=0.0147). The differences in microarchitectural variables of de novo bone formation were also significant (trabecular thickness (p<0.001), trabecular width (p<0.001), trabecular separation (p=0.001). There were no significant differences in node:terminus ratio between the xenograft/H perforatum group and the other two groups. However, the difference in node:terminus ratio between the autogenous graft and xenograft group was significant (p=0.001) Oil extracts of H perforatum improved bony healing in defects filled with bovine-derived xenografts.
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Affiliation(s)
- I Damlar
- Mustafa Kemal University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Hatay, Turkey.
| | - O F Arpağ
- Mustafa Kemal University, Faculty of Dentistry, Department of Periodontology, Hatay, Turkey
| | - U Tatli
- Cukurova University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Adana, Turkey
| | - A Altan
- Gaziosmanpasa University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Tokat, Turkey
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18
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Zhang J, Wang H, Shi J, Wang Y, Lai K, Yang X, Chen X, Yang G. Combination of simvastatin, calcium silicate/gypsum, and gelatin and bone regeneration in rabbit calvarial defects. Sci Rep 2016; 6:23422. [PMID: 26996657 PMCID: PMC4800449 DOI: 10.1038/srep23422] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 03/07/2016] [Indexed: 11/29/2022] Open
Abstract
The present study was performed to determine whether simvastatin improves bone regeneration when combined with calcium silicate/gypsum and gelatin (CS-GEL). The surface morphology was determined using field-emission scanning electron microscopy (FSEM). Degradation in vitro was evaluated by monitoring the weight change of the composites soaked in phosphate buffered saline (PBS). Drug release was evaluated using high-performance liquid chromatography (HPLC). Cytotoxicity testing was performed to assess the biocompatibility of composites. Four 5 mm-diameter bone defects were created in rabbit calvaria. Three sites were filled with CS-GEL, 0.5 mg simvastatin-loaded CS-GEL (SIM-0.5) and 1.0 mg simvastatin-loaded CS-GEL (SIM-1.0), respectively, and the fourth was left empty as the control group. Micro-computed tomography (micro-CT) and histological analysis were carried out at 4 and 12 weeks postoperatively. The composites all exhibited three-dimensional structures and showed the residue with nearly 80% after 4 weeks of immersion. Drug release was explosive on the first day and then the release rate remained stable. The composites did not induce any cytotoxicity. The results in vivo demonstrated that the new bone formation and the expressions of BMP-2, OC and type I collagen were improved in the simvastatin-loaded CS-GEL group. It was concluded that the simvastatin-loaded CS-GEL may improve bone regeneration.
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Affiliation(s)
- Jing Zhang
- Department of Implantology, Stomatology Hospital, School of Medical, Zhejiang University, Yan’an Road, Hangzhou, P. R. China
| | - Huiming Wang
- Department of Implantology, Stomatology Hospital, School of Medical, Zhejiang University, Yan’an Road, Hangzhou, P. R. China
| | - Jue Shi
- Department of Implantology, Stomatology Hospital, School of Medical, Zhejiang University, Yan’an Road, Hangzhou, P. R. China
| | - Ying Wang
- Department of Endodontics, Stomatology Hospital, School of Medical, Zhejiang University, Yan’an Road, Hangzhou, P. R. China
| | - Kaichen Lai
- Department of Implantology, Stomatology Hospital, School of Medical, Zhejiang University, Yan’an Road, Hangzhou, P. R. China
| | - Xianyan Yang
- Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Xiaoyi Chen
- Clinical Research Institute, Zhejiang Provincial People’s Hospital, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China
| | - Guoli Yang
- Department of Implantology, Stomatology Hospital, School of Medical, Zhejiang University, Yan’an Road, Hangzhou, P. R. China
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19
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Calvo-Guirado JL, Garces M, Delgado-Ruiz RA, Ramirez Fernandez MP, Ferres-Amat E, Romanos GE. Biphasic β-TCP mixed with silicon increases bone formation in critical site defects in rabbit calvaria. Clin Oral Implants Res 2015; 26:891-897. [PMID: 24863557 DOI: 10.1111/clr.12413] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of this study was to assess the bone regeneration of critical size defects in rabbit calvarias filled with β-TCP doped with silicon. MATERIALS AND METHODS Twenty-one New Zealand rabbits were used in this study. Two critical size defects were created in the parietal bones. Three experimental groups were evaluated: Test A (HA/β-TCP granules alone), Test B (HA/β-TCP granules plus 3% silicon), Control (empty defect). The animals were sacrificed at 8 and 12 weeks. Evaluation was performed by μCT analysis and histomorphometry. RESULTS μCT evaluation showed higher volume reduction in Test A group compared with Test B (P < 0.05). The Test B group showed the highest values for cortical closure and bone formation around the particles, followed by Test A and controls (P < 0.05). CONCLUSIONS Within the limitations of this animal study, it can be concluded that HA/β-TCP plus 3% silicon increases bone formation in critical size defects in rabbit calvarias, and the incorporation of 3% silicon reduces the resorption rate of the HA/β-TCP granules.
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Affiliation(s)
- José Luis Calvo-Guirado
- General & Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Miguel Garces
- Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
- National University of San Juan, San Juan, Argentine
| | - Rafael Arcesio Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, Stony Brook University, School of Dental Medicine, Stony Brook, NY, USA
| | | | | | - Georgios E Romanos
- Department of Dental Medicine, Stony Brook University, School of Dental Medicine, Stony Brook, NY, USA
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20
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Dau M, Kämmerer PW, Henkel KO, Gerber T, Frerich B, Gundlach KKH. Bone formation in mono cortical mandibular critical size defects after augmentation with two synthetic nanostructured and one xenogenous hydroxyapatite bone substitute - in vivo animal study. Clin Oral Implants Res 2015; 27:597-603. [PMID: 26039281 DOI: 10.1111/clr.12628] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Healing characteristics as well as level of tissue integration and degradation of two different nanostructured hydroxyapatite bone substitute materials (BSM) in comparison with a deproteinized hydroxyapatite bovine BSM were evaluated in an in vivo animal experiment. MATERIAL AND METHODS In the posterior mandible of 18 minipigs, bilateral mono cortical critical size bone defects were created. Randomized augmentation procedures with NanoBone(®) (NHA1), Ostim(®) (NHA2) or Bio-Oss(®) (DBBM) were conducted (each material n = 12). Samples were analyzed after five (each material n = 6) and 8 months (each material n = 6). Defect healing, formation of soft tissue and bone as well as the amount of remaining respective BSM were quantified both macro- and microscopically. RESULTS For NHA2, the residual bone defect after 5 weeks was significantly less compared to NHA1 or DBBM. There was no difference in residual BSM between NHA1 and DBBM, but the amount in NHA2 was significantly lower. NHA2 also showed the least amount of soft tissue and the highest amount of new bone after 5 weeks. Eight months after implantation, no significant differences in the amount of residual bone defects, in soft tissue or in bone formation were detected between the groups. Again, NHA2 showed significant less residual material than NHA1 and DBBM. DISCUSSION We observed non-significant differences in the biological hard tissue response of NHA1 and DBBM. The water-soluble NHA2 initially induced an increased amount of new bone but was highly compressed which may have a negative effect in less stable augmentations of the jaw.
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Affiliation(s)
- Michael Dau
- Department of Oral and Maxillofacial Surgery, University of Rostock, Rostock, Germany.,Department of Oral and Maxillofacial Surgery, Federal Army Hospital Hamburg-Wandsbek, Hamburg, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University of Rostock, Rostock, Germany.,Department of Oral and Maxillofacial Surgery, Federal Army Hospital Hamburg-Wandsbek, Hamburg, Germany
| | - Kai-Olaf Henkel
- Department of Oral and Maxillofacial Surgery, Federal Army Hospital Hamburg-Wandsbek, Hamburg, Germany
| | - Thomas Gerber
- Department of Physics, Faculty of Mathematics and Natural Sciences, Rostock University, Rostock, Germany
| | - Bernhard Frerich
- Department of Oral and Maxillofacial Surgery, University of Rostock, Rostock, Germany.,Department of Oral and Maxillofacial Surgery, Federal Army Hospital Hamburg-Wandsbek, Hamburg, Germany
| | - Karsten K H Gundlach
- Department of Oral and Maxillofacial Surgery, University of Rostock, Rostock, Germany.,Department of Oral and Maxillofacial Surgery, Federal Army Hospital Hamburg-Wandsbek, Hamburg, Germany
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21
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Delgado-Ruiz RA, Calvo Guirado JL, Romanos GE. Bone grafting materials in critical defects in rabbit calvariae. A systematic review and quality evaluation using ARRIVE guidelines. Clin Oral Implants Res 2015; 29:620-634. [DOI: 10.1111/clr.12614] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - José Luis Calvo Guirado
- International Dentistry Research Cathedra; San Antonio Catholic University of Murcia (UCAM); Murcia Spain
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22
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Weigand A, Beier JP, Hess A, Gerber T, Arkudas A, Horch RE, Boos AM. Acceleration of vascularized bone tissue-engineered constructs in a large animal model combining intrinsic and extrinsic vascularization. Tissue Eng Part A 2015; 21:1680-94. [PMID: 25760576 DOI: 10.1089/ten.tea.2014.0568] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
During the last decades, a range of excellent and promising strategies in Bone Tissue Engineering have been developed. However, the remaining major problem is the lack of vascularization. In this study, extrinsic and intrinsic vascularization strategies were combined for acceleration of vascularization. For optimal biomechanical stability of the defect site and simplifying future transition into clinical application, a primary stable and approved nanostructured bone substitute in clinically relevant size was used. An arteriovenous (AV) loop was microsurgically created in sheep and implanted, together with the bone substitute, in either perforated titanium chambers (intrinsic/extrinsic) for different time intervals of up to 18 weeks or isolated Teflon(®) chambers (intrinsic) for 18 weeks. Over time, magnetic resonance imaging and micro-computed tomography (CT) analyses illustrate the dense vascularization arising from the AV loop. The bone substitute was completely interspersed with newly formed tissue after 12 weeks of intrinsic/extrinsic vascularization and after 18 weeks of intrinsic/extrinsic and intrinsic vascularization. Successful matrix change from an inorganic to an organic scaffold could be demonstrated in vascularized areas with scanning electron microscopy and energy dispersive X-ray spectroscopy. Using the intrinsic vascularization method only, the degradation of the scaffold and osteoclastic activity was significantly lower after 18 weeks, compared with 12 and 18 weeks in the combined intrinsic-extrinsic model. Immunohistochemical staining revealed an increase in bone tissue formation over time, without a difference between intrinsic/extrinsic and intrinsic vascularization after 18 weeks. This study presents the combination of extrinsic and intrinsic vascularization strategies for the generation of an axially vascularized bone substitute in clinically relevant size using a large animal model. The additional extrinsic vascularization promotes tissue ingrowth and remodeling processes of the bone substitute. Extrinsic vessels contribute to faster vascularization and finally anastomose with intrinsic vasculature, allowing microvascular transplantation of the bone substitute after a shorter prevascularization time than using the intrinsic method only. It can be reasonably assumed that the usage of perforated chambers can significantly reduce the time until transplantation of bone constructs. Finally, this study paves the way for further preclinical testing for proof of the concept as a basis for early clinical applicability.
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Affiliation(s)
- Annika Weigand
- 1 Department of Plastic and Hand Surgery, University Hospital of Erlangen , Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
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23
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Wu X, Miao L, Yao Y, Wu W, Liu Y, Chen X, Sun W. Electrospun fibrous scaffolds combined with nanoscale hydroxyapatite induce osteogenic differentiation of human periodontal ligament cells. Int J Nanomedicine 2014; 9:4135-43. [PMID: 25206304 PMCID: PMC4157625 DOI: 10.2147/ijn.s65272] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Periodontal repair is a complex process in which regeneration of alveolar bone is a vital component. The aim of this study was to develop a biodegradable scaffold with good biocompatibility and osteoinductive ability. Two types of composite fibrous scaffolds were produced by electrospinning, ie, type I collagen/poly(ε-caprolactone) (COL/PCL) and type I collagen/poly(ε-caprolactone)/nanoscale hydroxyapatite (COL/PCL/nHA) with an average fiber diameter of about 377 nm. After a simulated body fluid (SBF) immersion test, the COL/PCL/nHA-SBF scaffold developed a rough surface because of the calcium phosphate deposited on the fibers, suggesting that the presence of nHA promoted the mineralization potential of the scaffold. Energy dispersive X-ray spectroscopy clearly showed the calcium and phosphorus content in the COL/PCL/nHA and COL/PCL/nHA-SBF scaffolds, confirming the findings of nHA and calcium phosphate precipitation on scanning electron micrographs. Water contact analysis revealed that nHA could improve the hydrophilic nature of the COL/PCL/nHA-SBF scaffold. The morphology of periodontal ligament cells cultured on COL/PCL-SBF and COL/PCL/nHA-SBF was evaluated by scanning electron microscopy. The results showed that cells adhered to either type of scaffold and were slightly spindle-shaped in the beginning, then extended gradually with stretched filopodia, indicating an ability to fill the fiber pores. A Cell Counting Kit-8 assay showed that both scaffolds supported cell proliferation. However, real-time quantitative polymerase chain reaction analysis showed that expression of the bone-related markers, alkaline phosphatase and osteocalcin, was upregulated only on the COL/PCL/nHA-SBF scaffold, indicating that this scaffold had the ability to induce osteogenic differentiation of periodontal ligament cells. In this study, COL/PCL/nHA-SBF produced by electrospinning followed by biomimetic mineralization had combined electrospun fibers with nHA in it. This scaffold has good biocompatibility and osteoinductive ability as a result of the characteristics of nHA, so could be innovatively applied to periodontal tissue engineering as a potential scaffold.
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Affiliation(s)
- Xiaonan Wu
- Department of Periodontology, Hospital of Stomatology, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Leiying Miao
- Department of Cariology and Endodontics, Hospital of Stomatology, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Yingfang Yao
- Eco-materials and Renewable Energy Research Center, Department of Materials Science and Engineering, National Laboratory of Solid State Microstructures, Nanjing University, Nanjing, People's Republic of China
| | - Wenlei Wu
- Department of Periodontology, Hospital of Stomatology, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Yu Liu
- Department of Periodontology, Hospital of Stomatology, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Xiaofeng Chen
- Department of Periodontology, Hospital of Stomatology, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Weibin Sun
- Department of Periodontology, Hospital of Stomatology, Medical School of Nanjing University, Nanjing, People's Republic of China
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24
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Thoma DS, Kruse A, Ghayor C, Jung RE, Weber FE. Bone augmentation using a synthetic hydroxyapatite/silica oxide-based and a xenogenic hydroxyapatite-based bone substitute materials with and without recombinant human bone morphogenetic protein-2. Clin Oral Implants Res 2014; 26:592-8. [PMID: 25138542 DOI: 10.1111/clr.12469] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2014] [Indexed: 12/01/2022]
Abstract
AIM To test whether or not bone regeneration using deproteinized bovine bone mineral (DBBM) is comparable to hydroxyapatite/silica oxide (HA/SiO) and to test the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) as an adjunct to DBBM for localized bone regeneration. MATERIALS AND METHODS In each of the 10 rabbits, 4 titanium cylinders were placed on the external cortical plates of their calvaria. Four treatment modalities were randomly allocated: (i) empty, (ii) HA/SiO, (iii) DBBM, and (iv) DBBM plus rhBMP-2 (DBBM/BMP). The animals were sacrificed at week 8. Descriptive histology and histomorphometric assessment using a superimposed test grid of points and cycloids were performed. RESULTS The mean number of points of the test grid coinciding with bone within the cylinder reached 124 ± 35 bone points for empty controls, 92 ± 40 bone points for DBBM, 98 ± 44 bone points for synthetic HA/SiO, and 146 ± 34 bone points DBBM/BMP. The P-value for DBBM with and without BMP reached a borderline statistical significance of 0.051. However, the area of bone regeneration within the cylinders peaked for DBBM/BMP and was statistically significantly higher compared with empty cylinders (P < 0.05). The bone-to-bone substitute contact ranged between 32.9% ± 21.7 for DBBM, 39.6 ± 18.4% for HA/SiO, and 57.8% ± 10.2 for DBBM/BMP. The differences between DBBM/BMP and controls (DBBM, HA/SiO) were statistically significant (P < 0.05). CONCLUSIONS DBBM and HA/SiO rendered comparable amounts of bone regeneration. The addition of rhBMP-2 to DBBM resulted in more favorable outcomes with respect to the area of bone regeneration and to bone-to-implant contact, thereby indicating the potential of this growth factor to enhance bone regeneration within this animal model.
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Affiliation(s)
- D S Thoma
- Department of Fixed and Removable Prothodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland
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25
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Karfeld-Sulzer LS, Ghayor C, Siegenthaler B, Gjoksi B, Pohjonen TH, Weber FE. Comparative study of NMP-preloaded and dip-loaded membranes for guided bone regeneration of rabbit cranial defects. J Tissue Eng Regen Med 2014; 11:425-433. [PMID: 24919954 DOI: 10.1002/term.1926] [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] [Received: 07/29/2013] [Revised: 04/23/2014] [Accepted: 05/05/2014] [Indexed: 11/07/2022]
Abstract
Guided bone regeneration (GBR) has been utilized for several decades for the healing of cranio-maxillofacial bone defects and, particularly in the dental field, by creating space with a barrier membrane to exclude soft tissue and encourage bone growth in the membrane-protected volume. Although the first membranes were non-resorbable, a new generation of GBR membranes aims to biodegrade and provide bioactivity for better overall results. The Inion GTR™ poly(lactide-co-glycolide) (PLGA) membrane is not only resorbable but also bioactive, since it includes N-methylpyrrolidone (NMP), which has been shown to promote bone regeneration. In this study, the effects of loading different amounts of NMP onto the membrane through chemical vapour deposition or dipping have been explored. In vitro release demonstrated that lower levels of NMP led to lower NMP concentrations and slower release, based on total NMP loaded in the membrane. The dipped membrane released almost all of the NMP within 15 min, leading to a high NMP concentration. For the in vivo studies in rabbits, 6 mm calvarial defects were created and left untreated or covered with an ePTFE membrane or PLGA membranes dipped in, or preloaded with, NMP. Evaluation of the bony regeneration revealed that the barrier membranes improved bony healing and that a decrease in NMP content improved the performance. Overall, we have demonstrated the potential of these PLGA membranes with a more favourable NMP release profile and the significance of exploring the effect of NMP on these PLGA membranes with regard to bone ingrowth. Copyright © 2014 John Wiley & Sons, Ltd.
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Affiliation(s)
- Lindsay S Karfeld-Sulzer
- Oral Biotechnology and Bioengineering, Department of Cranio-maxillofacial and Oral Surgery, University Hospital Zurich, and Center for Dental Medicine, University of Zurich, Switzerland
| | - Chafik Ghayor
- Oral Biotechnology and Bioengineering, Department of Cranio-maxillofacial and Oral Surgery, University Hospital Zurich, and Center for Dental Medicine, University of Zurich, Switzerland
| | - Barbara Siegenthaler
- Oral Biotechnology and Bioengineering, Department of Cranio-maxillofacial and Oral Surgery, University Hospital Zurich, and Center for Dental Medicine, University of Zurich, Switzerland.,Zurich Centre for Integrative Human Physiology, University of Zurich, Switzerland
| | - Bebeka Gjoksi
- Oral Biotechnology and Bioengineering, Department of Cranio-maxillofacial and Oral Surgery, University Hospital Zurich, and Center for Dental Medicine, University of Zurich, Switzerland
| | | | - Franz E Weber
- Oral Biotechnology and Bioengineering, Department of Cranio-maxillofacial and Oral Surgery, University Hospital Zurich, and Center for Dental Medicine, University of Zurich, Switzerland.,Zurich Centre for Integrative Human Physiology, University of Zurich, Switzerland.,Centre for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Switzerland
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26
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Rustamov IR, Dyatlov VA, Grebeneva TA, Dyatlov AV, Zaitsev VV, Maleev VI. Polycyanoacrylate porous material for bone tissue substitution. J Mater Chem B 2014; 2:4310-4317. [PMID: 32261569 DOI: 10.1039/c4tb00554f] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A proof of concept study has been conducted for the design of a porous biodegradable material containing nanocapsules and two actives with independent release-bimodal drug-eluting implants. Completely safe synthetic material free from risk of prion and virus contamination was tested in vivo, and a method for controlling the rate of biodegradation of poly-2-cyanoacrylic polymer was developed. Novel perfluorinated 2-cyanoacrylic esters have been applied for the chemical modification of polyethyl-2-cyanoacrlylate copolymers. Internal imide-cycle formation has been used to retard the rate of enzymatic hydrolysis of the 2-cyanoacrylic copolymer main chain.
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Affiliation(s)
- I R Rustamov
- D. Mendeleev University of Chemical Technology of Russia, Russia
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27
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Manchón A, Alkhraisat M, Rueda-Rodriguez C, Torres J, Prados-Frutos JC, Ewald A, Gbureck U, Cabrejos-Azama J, Rodriguez-González A, López-Cabarcos E. Silicon calcium phosphate ceramic as novel biomaterial to simulate the bone regenerative properties of autologous bone. J Biomed Mater Res A 2014; 103:479-88. [DOI: 10.1002/jbm.a.35196] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 03/22/2014] [Accepted: 03/31/2014] [Indexed: 11/08/2022]
Affiliation(s)
- A. Manchón
- Department of Physical-Chemistry II, Faculty of Pharmacy; Complutense University of Madrid; 28040 Madrid Spain
| | - M. Alkhraisat
- Department of Stomatology, Faculty of Health Sciences; URJC; 28922 Alcorcon-Madrid Spain
| | - C. Rueda-Rodriguez
- Department of Stomatology, Faculty of Health Sciences; URJC; 28922 Alcorcon-Madrid Spain
| | - J. Torres
- Department of Physical-Chemistry II, Faculty of Pharmacy; Complutense University of Madrid; 28040 Madrid Spain
| | - J. C. Prados-Frutos
- Department of Physical-Chemistry II, Faculty of Pharmacy; Complutense University of Madrid; 28040 Madrid Spain
| | - A. Ewald
- Functional Materials for Medicine and Dentistry; Würzburg University; 97070 Würzburg Germany
| | - U. Gbureck
- Functional Materials for Medicine and Dentistry; Würzburg University; 97070 Würzburg Germany
| | - J. Cabrejos-Azama
- Department of Stomatology, Faculty of Health Sciences; URJC; 28922 Alcorcon-Madrid Spain
| | - A. Rodriguez-González
- Department of Physical-Chemistry II, Faculty of Pharmacy; Complutense University of Madrid; 28040 Madrid Spain
| | - E. López-Cabarcos
- Department of Stomatology, Faculty of Health Sciences; URJC; 28922 Alcorcon-Madrid Spain
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28
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Biological Response to β-Tricalcium Phosphate/Calcium Sulfate Synthetic Graft Material. IMPLANT DENT 2014; 23:37-43. [DOI: 10.1097/id.0000000000000030] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Modification of Xenogeneic Graft Materials for Improved Release of P-15 Peptides in a Calvarium Defect Model. J Craniofac Surg 2014; 25:70-6. [DOI: 10.1097/scs.0b013e3182a2dfe7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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30
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de Wild M, Schumacher R, Mayer K, Schkommodau E, Thoma D, Bredell M, Kruse Gujer A, Grätz KW, Weber FE. Bone regeneration by the osteoconductivity of porous titanium implants manufactured by selective laser melting: a histological and micro computed tomography study in the rabbit. Tissue Eng Part A 2013; 19:2645-54. [PMID: 23895118 DOI: 10.1089/ten.tea.2012.0753] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The treatment of large bone defects still poses a major challenge in orthopaedic and cranio-maxillofacial surgery. One possible solution could be the development of personalized porous titanium-based implants that are designed to meet all mechanical needs with a minimum amount of titanium and maximum osteopromotive properties so that it could be combined with growth factor-loaded hydrogels or cell constructs to realize advanced bone tissue engineering strategies. Such implants could prove useful for mandibular reconstruction, spinal fusion, the treatment of extended long bone defects, or to fill in gaps created on autograft harvesting. The aim of this study was to determine the mechanical properties and potential of bone formation of light weight implants generated by selective laser melting (SLM). We mainly focused on osteoconduction, as this is a key feature in bone healing and could serve as a back-up for osteoinduction and cell transplantation strategies. To that end, defined implants were produced by SLM, and their surfaces were left untreated, sandblasted, or sandblasted/acid etched. In vivo bone formation with the different implants was tested throughout calvarial defects in rabbits and compared with untreated defects. Analysis by micro computed tomography (μCT) and histomorphometry revealed that all generatively produced porous Ti structures were well osseointegrated into the surrounding bone. The histomorphometric analysis revealed that bone formation was significantly increased in all implant-treated groups compared with untreated defects and significantly increased in sand blasted implants compared with untreated ones. Bone bridging was significantly increased in sand blasted acid-etched scaffolds. Therefore, scaffolds manufactured by SLM should be surface treated. Bone augmentation beyond the original bone margins was only seen in implant-treated defects, indicating an osteoconductive potential of the implants that could be utilized clinically for bone augmentation purposes. Therefore, designed porous, lightweight structures have potential for bone regeneration and augmentation purposes, especially when complex and patient-specific geometries are essential.
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Affiliation(s)
- Michael de Wild
- 1 Institute for Medical and Analytical Technologies, School of Life Sciences, University of Applied Sciences Northwestern Switzerland , Muttenz, Switzerland
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31
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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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32
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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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