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Abdulghafor MA, Mahmood MK, Tassery H, Tardivo D, Falguiere A, Lan R. Biomimetic Coatings in Implant Dentistry: A Quick Update. J Funct Biomater 2023; 15:15. [PMID: 38248682 PMCID: PMC10816551 DOI: 10.3390/jfb15010015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
Biomimetic dental implants are regarded as one of the recent clinical advancements in implant surface modification. Coatings with varying thicknesses and roughness may affect the dental implant surface's chemical inertness, cell adhesion, and antibacterial characteristics. Different surface coatings and mechanical surface changes have been studied to improve osseointegration and decrease peri-implantitis. The surface medication increases surface energy, leading to enhanced cell proliferation and growth factors, and, consequently, to a rise in the osseointegration process. This review provides a comprehensive update on the numerous biomimetic coatings used to improve the surface characteristics of dental implants and their applications in two main categories: coating to improve osseointegration, including the hydroxyapatite layer and nanocomposites, growth factors (BMPs, PDGF, FGF), and extracellular matrix (collagen, elastin, fibronectin, chondroitin sulfate, hyaluronan, and other proteoglycans), and coatings for anti-bacterial performance, covering drug-coated dental implants (antibiotic, statin, and bisphosphonate), antimicrobial peptide coating (GL13K and human beta defensins), polysaccharide antibacterial coatings (natural chitosan and its coupling agents) and metal elements (silver, zinc, and copper).
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Affiliation(s)
| | - Mohammed Khalid Mahmood
- Faculty of Dentistry, Aix-Marseille University, CNRS, EFS, ADES, 13284 Marseille, France;
- College of Dentistry, The American University of Iraq, Sulaimani 46001, Kurdistan, Iraq
| | | | - Delphine Tardivo
- Faculty of Dentistry, Aix-Marseille University, CNRS, EFS, ADES, 13284 Marseille, France;
| | - Arthur Falguiere
- Oral Surgery Department, Timone Hospital, Aix-Marseille University, APHM, 13284 Marseille, France
| | - Romain Lan
- Oral Surgery Department, Timone Hospital, Aix-Marseille University, APHM, CNRS, EFS, ADES, 13284 Marseille, France;
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Wang Z, Wang J, Wu R, Wei J. Construction of functional surfaces for dental implants to enhance osseointegration. Front Bioeng Biotechnol 2023; 11:1320307. [PMID: 38033823 PMCID: PMC10682203 DOI: 10.3389/fbioe.2023.1320307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Dental implants have been extensively used in patients with defects or loss of dentition. However, the loss or failure of dental implants is still a critical problem in clinic. Therefore, many methods have been designed to enhance the osseointegration between the implants and native bone. Herein, the challenge and healing process of dental implant operation will be briefly introduced. Then, various surface modification methods and emerging biomaterials used to tune the properties of dental implants will be summarized comprehensively.
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Affiliation(s)
- Zhenshi Wang
- School of Stomatology, Nanchang University, Nanchang, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, China
| | - Jiaolong Wang
- School of Stomatology, Nanchang University, Nanchang, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, China
- College of Chemistry and Chemical Engineering, Nanchang University, Nanchang, China
| | - Runfa Wu
- School of Stomatology, Nanchang University, Nanchang, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, China
| | - Junchao Wei
- School of Stomatology, Nanchang University, Nanchang, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, China
- College of Chemistry and Chemical Engineering, Nanchang University, Nanchang, China
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Matos FG, Stremel ACA, Lipinski LC, Cirelli JA, Dos Santos FA. Dental implants in large animal models with experimental systemic diseases: A systematic review. Lab Anim 2023; 57:489-503. [PMID: 37021606 DOI: 10.1177/00236772221124972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
This systematic review aims to identify and discuss the most used methodologies in pre-clinical studies for the evaluation of the implementation of dental implants in systemically compromised pigs and sheep. This study provides support and guidance for future research, as well as for the prevention of unnecessary animal wastage and sacrifice. Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) was used as a guideline; electronic searches were performed in PubMed, Scopus, Scielo, Web of Science, Embase, Science Direct, Brazilian Bibliography of Dentistry, Latin American and Caribbean Literature in Health Sciences, Directory of Open Access Journals, Database of Abstracts of Reviews of Effects, and gray literature until January 2022 (PROSPERO/CRD42021270119). Sixty-eight articles were chosen from the 2439 results. Most studies were conducted in pigs, mainly the Göttinger and Domesticus breeds. Healthy animals with implants installed in the jaws were predominant among the pig studies. Of the studies evaluating the effect of systemic diseases on osseointegration, 42% were performed in osteoporotic sheep, 32% in diabetic sheep, and 26% in diabetic pigs. Osteoporosis was primarily induced by bilateral ovariectomy and mainly assessed by X-ray densitometry. Diabetes was induced predominantly by intravenous streptozotocin and was confirmed by blood glucose analysis. Histological and histomorphometric analyses were the most frequently employed in the evaluation of osseointegration. The animal models presented unique methodologies for each species in the studies that evaluated dental implants in the context of systemic diseases. Understanding the most commonly used techniques will help methodological choices and the performance of future studies in implantology.
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Affiliation(s)
| | | | | | - Joni Augusto Cirelli
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of São Paulo (Unesp), Brazil
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López-Valverde N, Aragoneses J, López-Valverde A, Quispe-López N, Rodríguez C, Aragoneses JM. Effectiveness of biomolecule-based bioactive surfaces, on os-seointegration of titanium dental implants: A systematic review and meta-analysis of in vivo studies. Front Bioeng Biotechnol 2022; 10:986112. [PMID: 36225604 PMCID: PMC9548556 DOI: 10.3389/fbioe.2022.986112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/12/2022] [Indexed: 12/09/2022] Open
Abstract
Titanium and alloy osseointegrated implants are used to replace missing teeth; however, some fail and are removed. Modifications of the implant surface with biologically active substances have been proposed. MEDLINE [via Pubmed], Embase and Web of Science were searched with the terms “titanium dental implants”, “surface properties”, “bioactive surface modifications”, “biomolecules”, “BMP”, “antibacterial agent”, “peptide”, “collagen”, “grown factor”, “osseointegration”, “bone apposition”, “osteogenic”, “osteogenesis”, “new bone formation”, “bone to implant contact”, “bone regeneration” and “in vivo studies”, until May 2022. A total of 10,697 references were iden-tified and 26 were included to analyze 1,109 implants, with follow-ups from 2 to 84 weeks. The ARRIVE guidelines and the SYRCLE tool were used to evaluate the methodology and scientific evidence. A meta-analysis was performed (RevMan 2020 software, Cochane Collaboration) with random effects that evaluated BIC at 4 weeks, with subgroups for the different coatings. The heterogeneity of the pooled studies was very high (95% CI, I2 = 99%). The subgroup of BMPs was the most favorable to coating. Surface modification of Ti implants by organic bioactive molecules seems to favor osseointegration in the early stages of healing, but long-term studies are necessary to corroborate the results of the experimental studies.
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Affiliation(s)
- Nansi López-Valverde
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Javier Aragoneses
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Antonio López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
- Department of Dentistry, Universidad Federico Henríquez y Carvajal, Santo Domingo, Dominican Republic
- *Correspondence: Antonio López-Valverde,
| | - Norberto Quispe-López
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Cinthia Rodríguez
- Department of Dentistry, Universidad Federico Henríquez y Carvajal, Santo Domingo, Dominican Republic
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Behrens C, Kauffmann P, von Hahn N, Giesecke A, Schirmer U, Liefeith K, Schliephake H. Development of a system of heparin multilayers on titanium surfaces for dual growth factor release. J Biomed Mater Res A 2022; 110:1599-1615. [PMID: 35593380 DOI: 10.1002/jbm.a.37411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/13/2022] [Accepted: 05/05/2022] [Indexed: 12/19/2022]
Abstract
The aim of the present study was to establish a modular platform of poly-L-lysine-heparin (PLL-Hep) polyelectrolyte multilayer (PEM) coatings on titanium surfaces for dual growth factor delivery of recombinant human bone morphogenic protein 2 (rhBMP2) and recombinant human vascular endothelial growth factor 165 (rhVEGF165) in clinically relevant quantities. Release characteristics for both growth factors differed significantly depending on film architecture. rhBMP2 induced activation of alkaline phosphatase in C2C12 cells and proliferation of human mesenchymal stem cells (hMSCs). rhVEGF mediated induction of von Willebrand factor (vWF) in hMSCs and proliferation of human umbilical vein endothelial cells. Osteogenic and angiogenic effects were modified by variation in cross-linking and architecture of the PEMs. By creating multilayer films with distinct zones, release characteristics and proportion of both growth factor delivery could be tuned and surface-activity modified to enhance angiogenic or osteogenic function in various ways. In summary, the system provides a modular platform for growth factor delivery that allows for individual composition and accentuation of angiogenic and osteogenic surface properties.
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Affiliation(s)
- Christina Behrens
- Department of Oral and Maxillofacial Surgery, George-Augusta-University, Göttingen, Germany
| | - Philipp Kauffmann
- Department of Oral and Maxillofacial Surgery, George-Augusta-University, Göttingen, Germany
| | - Nikolaus von Hahn
- Department of Oral and Maxillofacial Surgery, George-Augusta-University, Göttingen, Germany
| | - Ariane Giesecke
- Department of Oral and Maxillofacial Surgery, George-Augusta-University, Göttingen, Germany
| | - Uwe Schirmer
- Institute for Bioprocessing and Analytical Measurement Techniques, Heiligenstadt, Germany
| | - Klaus Liefeith
- Institute for Bioprocessing and Analytical Measurement Techniques, Heiligenstadt, Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, George-Augusta-University, Göttingen, Germany
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Kovrlija I, Locs J, Loca D. Octacalcium phosphate: Innovative vehicle for the local biologically active substance delivery in bone regeneration. Acta Biomater 2021; 135:27-47. [PMID: 34450339 DOI: 10.1016/j.actbio.2021.08.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/09/2021] [Accepted: 08/14/2021] [Indexed: 12/29/2022]
Abstract
Disadvantages of conventional drug delivery systems (DDS), such as systemic circulation, interaction with physiochemical factors, reduced bioavailability, and insufficient drug concentration at bone defect site, have underlined the importance of developing efficacious local drug delivery systems. Octacalcium phosphate (OCP) is presumed to be the precursor of biologically formed apatite, owing to its similarity to hydroxyapatite (HAp) and readiness to convert to it. Specific crystal structure of OCP is constructed of compiled apatite layers and water layers, which make possible the incorporation of various ions in its structure, making it feasible to alter the overall effect OCP has in the system. Next to that intrinsic property, characteristics as high solubility, biodegradability and osteoconductivity have made it indispensable to tailor OCP as a carrier material. In this review, we present the main characteristics and progress done on utilizing OCP as an innovative vehicle and provide suggestions for possible research pathways and advantages for local drug delivery in bone tissue engineering. STATEMENT OF SIGNIFICANCE: Octacalcium phosphate (OCP), being a precursor to biologically formed apatite, has many assets when compared to other calcium phosphates. Owing to its highly pertinent structure, it is being used as a vehicle for biologically active substances or ions for bone regeneration. However, orchestrating drug delivery systems with OCP, in order to achieve the best possible outcome, is still a pioneering concept, and the all-encompassing data is still scarce. Although several articles have been published on this matter, to this date there is no systematic overview pointing out the benefits that OCP can bring in the field of drug delivery. Here we offer a comprehensive overview, starting from the OCP synthesis to its structure, morphology, and the biological significance OCP has.
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Damerau JM, Bierbaum S, Wiedemeier D, Korn P, Smeets R, Jenny G, Nadalini J, Stadlinger B. A systematic review on the effect of inorganic surface coatings in large animal models and meta-analysis on tricalcium phosphate and hydroxyapatite on periimplant bone formation. J Biomed Mater Res B Appl Biomater 2021; 110:157-175. [PMID: 34272804 PMCID: PMC9292919 DOI: 10.1002/jbm.b.34899] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/15/2021] [Accepted: 06/21/2021] [Indexed: 12/25/2022]
Abstract
The aim of the present systematic review was to analyse studies using inorganic implant coatings and, in a meta‐analysis, the effect of specifically tricalcium phosphate (TCP) and hydroxyapatite (HA) implant surface coatings on bone formation according to the PRISMA criteria. Inclusion criteria were the comparison to rough surfaced titanium implants in large animal studies at different time points of healing. Forty studies met the inclusion criteria for the systematic review. Fifteen of these analyzed the bone‐to‐implant contact (BIC) around the most investigated inorganic titanium implant coatings, namely TCP and HA, and were included in the meta‐analysis. The results of the TCP group show after 14 days a BIC being 3.48% points lower compared with the reference surface. This difference in BIC decreases to 0.85% points after 21–28 days. After 42–84 days, the difference in BIC of 13.79% points is in favor of the TCP‐coatings. However, the results are not statistically significant, in part due to the fact that the variability between the studies increased over time. The results of the HA group show a significant difference in mean BIC of 6.94% points after 14 days in favor of the reference surface. After 21–28 days and 42–84 days the difference in BIC is slightly in favor of the test group with 1.53% points and 1.57% points, respectively, lacking significance. In large animals, there does not seem to be much effect of TCP‐coated or HA‐coated implants over uncoated rough titanium implants in the short term.
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Affiliation(s)
- Jeanne-Marie Damerau
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Susanne Bierbaum
- Max Bergmann Center of Biomaterials, Technische Universität Dresden, Dresden, Germany.,International Medical College, Münster, Germany
| | - Daniel Wiedemeier
- Statistical Services, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Paula Korn
- Department of Oral and Maxillofacial Surgery Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gregor Jenny
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Johanna Nadalini
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Bjelić D, Finšgar M. The Role of Growth Factors in Bioactive Coatings. Pharmaceutics 2021; 13:1083. [PMID: 34371775 PMCID: PMC8309025 DOI: 10.3390/pharmaceutics13071083] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 12/26/2022] Open
Abstract
With increasing obesity and an ageing population, health complications are also on the rise, such as the need to replace a joint with an artificial one. In both humans and animals, the integration of the implant is crucial, and bioactive coatings play an important role in bone tissue engineering. Since bone tissue engineering is about designing an implant that maximally mimics natural bone and is accepted by the tissue, the search for optimal materials and therapeutic agents and their concentrations is increasing. The incorporation of growth factors (GFs) in a bioactive coating represents a novel approach in bone tissue engineering, in which osteoinduction is enhanced in order to create the optimal conditions for the bone healing process, which crucially affects implant fixation. For the application of GFs in coatings and their implementation in clinical practice, factors such as the choice of one or more GFs, their concentration, the coating material, the method of incorporation, and the implant material must be considered to achieve the desired controlled release. Therefore, the avoidance of revision surgery also depends on the success of the design of the most appropriate bioactive coating. This overview considers the integration of the most common GFs that have been investigated in in vitro and in vivo studies, as well as in human clinical trials, with the aim of applying them in bioactive coatings. An overview of the main therapeutic agents that can stimulate cells to express the GFs necessary for bone tissue development is also provided. The main objective is to present the advantages and disadvantages of the GFs that have shown promise for inclusion in bioactive coatings according to the results of numerous studies.
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Affiliation(s)
| | - Matjaž Finšgar
- Faculty of Chemistry and Chemical Engineering, University of Maribor, Smetanova ulica 17, 2000 Maribor, Slovenia;
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Kligman S, Ren Z, Chung CH, Perillo MA, Chang YC, Koo H, Zheng Z, Li C. The Impact of Dental Implant Surface Modifications on Osseointegration and Biofilm Formation. J Clin Med 2021; 10:1641. [PMID: 33921531 PMCID: PMC8070594 DOI: 10.3390/jcm10081641] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
Implant surface design has evolved to meet oral rehabilitation challenges in both healthy and compromised bone. For example, to conquer the most common dental implant-related complications, peri-implantitis, and subsequent implant loss, implant surfaces have been modified to introduce desired properties to a dental implant and thus increase the implant success rate and expand their indications. Until now, a diversity of implant surface modifications, including different physical, chemical, and biological techniques, have been applied to a broad range of materials, such as titanium, zirconia, and polyether ether ketone, to achieve these goals. Ideal modifications enhance the interaction between the implant's surface and its surrounding bone which will facilitate osseointegration while minimizing the bacterial colonization to reduce the risk of biofilm formation. This review article aims to comprehensively discuss currently available implant surface modifications commonly used in implantology in terms of their impact on osseointegration and biofilm formation, which is critical for clinicians to choose the most suitable materials to improve the success and survival of implantation.
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Affiliation(s)
- Stefanie Kligman
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Zhi Ren
- Biofilm Research Laboratories, Department of Orthodontics, Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (Z.R.); (H.K.)
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
| | - Michael Angelo Perillo
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
| | - Yu-Cheng Chang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Hyun Koo
- Biofilm Research Laboratories, Department of Orthodontics, Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (Z.R.); (H.K.)
- Center for Innovation & Precision Dentistry, School of Dental Medicine and School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zhong Zheng
- Division of Growth and Development, Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
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The Effect of Autogenous Bone Graft Mixed With Recombinant Human Vascular Endothelial Growth Factor on Bone Regeneration. J Craniofac Surg 2020; 32:2233-2237. [PMID: 33290335 DOI: 10.1097/scs.0000000000007316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Bone regeneration depends on vascularization in the pertaining site. This study aims to investigate autogenous bone grafts mixed with recombinant human vascular endothelial growth factor (rhVEGF) effect on bone regeneration in rat mandibular bone defect. MATERIAL METHODS Using 32 Wistar Albino rats, our experimental study consists of 4 groups: Group1 (control group), the defect was empty; Group 2, autogenous bone graft only; Group 3, gelatin sponge plus rhVEGF applications; Group 4, autogenous bone graft plus rhVEGF applications. The rats were sacrificed on the 28th day after the operation. New bone regeneration was analyzed histologically and immunohistochemically. RESULTS Our histological analyses revealed that new bone regeneration in Group 3 was enhanced in comparison to Group 1 and Group 2. However, autogenous bone grafts combined with rhVEGF provided the best outcome in conjunction with the increased remodeling of the new bone. CONCLUSIONS In the light of our results, it can be concluded that autogenous bone grafts in combination with rhVEGF can, potentially, enhance neovascularization and bone regeneration.
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Ghosh M, Gupta R, Jain RA, Mehra R, Verma M. Role and influence of growth factors on early osseointegration in animal jaw bone: A meta-analysis. J Indian Prosthodont Soc 2020; 20:153-161. [PMID: 32655219 PMCID: PMC7335027 DOI: 10.4103/jips.jips_385_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/25/2019] [Accepted: 02/29/2020] [Indexed: 11/20/2022] Open
Abstract
Aim: Growth factors (GFs) are polypeptides, which are intricately involved in the regulation of bone formation, preservation, and regeneration through gene expression. However, the role of these bioactive agents in osseointegration of dental implants has not been substantially proven. The objective of this systematic review (SR) and meta-analysis was to explore the effect of GFs on early osseointegration of dental implants in animal jaws. An attempt to decipher an adjunctive role of GFs in modulating predictable bone growth in peri-implant areas was done. Materials and Methods: An electronic and manual search of different databases was performed. Only randomized controlled trials (RCTs) were included and reviewed. The risk of bias (ROB) of the selected studies was assessed using the SR Centre for Laboratory Animal Experimentation (Cochrane) tool. A meta-analysis was also performed to evaluate the different study characteristics quantitatively. Statistical Analysis used: The total Weighted mean difference was evaluated using the Rev-Manv5.3 algorithm. Chi-square test and I2 test were done to assess the heterogeneity between the studies. Results: Seven RCTs were included in the study. These were associated with a high ROB. The total weighted mean difference (WMD) of the percentage of bone–implant contact was 3.25% (95% confidence interval [CI] = 1.49%–6.03%; P = 0.001; I2 = 91%) between groups with and without exogenous application of GFs. The total WMD of the percentage of newly formed bone area was 4.48% (95% CI = 2.31%–5.90%; P < 0.00001, I2 = 84%). A high level of heterogeneity (P < 0.001 for Chi-square test; I2>50 %) among comparable studies was observed. Conclusion: The ancillary application of external GFs exhibited evidence of early osseointegration, resulting in more predictable and faster results. However, a careful discernment of conclusions drawn from this SR is a must before conducting any human trials.
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Affiliation(s)
- Modhupa Ghosh
- Department of Prosthodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Rekha Gupta
- Department of Prosthodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Radhika A Jain
- Department of Prosthodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Rashmi Mehra
- Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Mahesh Verma
- Department of Prosthodontics, Guru Gobind Singh Indraprastha University, New Delhi, India
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Kumar PS, KS SK, Grandhi VV, Gupta V. The Effects of Titanium Implant Surface Topography on Osseointegration: Literature Review. JMIR BIOMEDICAL ENGINEERING 2019. [DOI: 10.2196/13237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Effect of Different Morphology of Titanium Surface on the Bone Healing in Defects Filled Only with Blood Clot: A New Animal Study Design. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4265474. [PMID: 30175131 PMCID: PMC6106843 DOI: 10.1155/2018/4265474] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/22/2018] [Indexed: 12/25/2022]
Abstract
Background The objective of the present histologic animal study was to analyze whether roughness of the titanium surface can influence and/or stimulate the bone growth in defects filled with the blood using a rabbit tibia model. Materials and Methods Forty sets (implant and abutment), dental implant (3.5 mm in diameter and 7 mm in length) plus healing abutment (2.5 mm in diameter), were inserted in the tibiae of 10 rabbits. Moreover, twenty titanium discs were prepared. The abutment and discs were treated by 4 different methods and divided into 4 groups: (group A) machined abutments (smooth); (group B) double acid etching treatment; (group C) treatment with blasting with particles of aluminum oxide blasted plus acid conditioning; (group D) treatment with thorough blasting with particles of titanium oxide plus acid conditioning. The discs were used to characterize the surfaces by a profilometer and scanning electronic microscopy. Results After 8 weeks, the new bone formation around the sets of the samples was analyzed qualitatively and quantitatively in relation to bone height from the base of the implant and presence of osteocytes. Group C (1.50±0.20 mm) and group D (1.62±0.18 mm) showed bone growth on the abutment with higher values compared to group A (0.94±0.30 mm) and group B (1.19±0.23 mm), with significant difference between the groups (P < 0.05). In addition, osteocyte presence was higher in groups with surface treatment related to machined (P < 0.05). Conclusions Within the limitations of the present study, it was possible to observe that there is a direct relationship between the roughness present on the titanium surface and the stimulus for bone formation, since the presence of larger amounts of osteocytes on SLA surfaces evidenced this fact. Furthermore, the increased formation of bone tissue in height demonstrates that there is an important difference between the physical and chemical methods used for surface treatment.
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Zhu X, Zhang H, Zhang X, Ning C, Wang Y. In vitro study on the osteogenesis enhancement effect of BMP-2 incorporated biomimetic apatite coating on titanium surfaces. Dent Mater J 2017; 36:677-685. [PMID: 28883298 DOI: 10.4012/dmj.2016-189] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To fabricate a sustained-release delivery system of bone morphogenetic protein (BMP-2) on titanium surface, explore the effect of BMP-2 concentration on the loading/release behavior of BMP-2 and evaluate the cell compatibility of the system in vitro, pure titanium specimens were immersed into supersaturated calcium phosphate solutions (SCP) containing 4 different concentrations of BMP-2: 0, 50, 100, 200 and 400 ng/mL. Biomimetic calcium phosphate coating was formed on titanium surface and BMP-2 was incorporated into the coating through co-deposition. The release profile of BMP-2 suggested that BMP-2 were delivered sustainably up to 20 days. CCK-8 and ALP assay showed that 200 group and 400 ng/mL BMP-2 group have significant effect on promoting MC3T3-E1 cell proliferation and differentiation. The BMP-2 incorporated into the hybrid coating released in a sustained manner and significantly promoted the proliferation and differentiation of MC3T3-E1 on the titanium surface.
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Affiliation(s)
- Xiaojing Zhu
- Department of Prosthodontics, Guanghua School of Stomatology & Hospital of Stomatology, Guangdong Key Laboratory of Stomatology, Sun Yat-sen University
| | - Hui Zhang
- Department of Prosthodontics, Guanghua School of Stomatology & Hospital of Stomatology, Guangdong Key Laboratory of Stomatology, Sun Yat-sen University
| | - Xinchun Zhang
- Department of Prosthodontics, Guanghua School of Stomatology & Hospital of Stomatology, Guangdong Key Laboratory of Stomatology, Sun Yat-sen University
| | - Chengyun Ning
- School of Material Science and Engineering, South China University of Technology
| | - Yan Wang
- Department of Prosthodontics, Guanghua School of Stomatology & Hospital of Stomatology, Guangdong Key Laboratory of Stomatology, Sun Yat-sen University
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Meng HW, Chien EY, Chien HH. Dental implant bioactive surface modifications and their effects on osseointegration: a review. Biomark Res 2016. [PMID: 27999672 DOI: 10.1186/s40364‐016‐0078‐z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The purpose of this article is to review and update the current developments of biologically active dental implant surfaces and their effect on osseointegration. METHODS PubMed was searched for entries from January 2006 to January 2016. Only in-vivo studies that evaluated the effects of biomolecular coatings on titanium dental implants inserted into the bone of animals or humans were included. RESULTS Thirty four non-review studies provided data and observations were included in this review. Within the criteria, four categories of biomolecular coatings were evaluated. The potential biomolecules include bone morphogenetic proteins in 8 articles, other growth factors in 8 articles, peptides in 5 articles, and extracellular matrix in 13 articles. Most articles had a healing period of 1 to 3 months and the longest time of study was 6 months. In addition, all studies comprised of implants inserted in animals except for one, which evaluated implants placed in both animals and humans. The results indicate that dental implant surface modification with biological molecules seem to improve performance as demonstrated by histomorphometric analysis (such as percentage of bone-to-implant contact and peri-implant bone density) and biomechanical testing (such as removal torque, push-out/pull-out tests, and resonance frequency analysis). CONCLUSIONS Bioactive surface modifications on implant surfaces do not always offer a beneficial effect on osseointegration. Nevertheless, surface modifications of titanium dental implants with biomolecular coatings seem to promote peri-implant bone formation, resulting in enhanced osseointegration during the early stages of healing. However, long-term clinical studies are needed to validate this result. In addition, clinicians must keep in mind that results from animal experiments need not necessarily reflect the human clinical reality.
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Affiliation(s)
- Hsiu-Wan Meng
- Department of Periodontics, University of Texas School of Dentistry at Houston, Houston, TX USA
| | - Esther Yun Chien
- College of Dentistry, The Ohio State University, Columbus, OH USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, 305 West 12th Avenue, Columbus, OH 43210 USA
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Meng HW, Chien EY, Chien HH. Dental implant bioactive surface modifications and their effects on osseointegration: a review. Biomark Res 2016; 4:24. [PMID: 27999672 PMCID: PMC5155396 DOI: 10.1186/s40364-016-0078-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 11/29/2016] [Indexed: 01/15/2023] Open
Abstract
Background The purpose of this article is to review and update the current developments of biologically active dental implant surfaces and their effect on osseointegration. Methods PubMed was searched for entries from January 2006 to January 2016. Only in-vivo studies that evaluated the effects of biomolecular coatings on titanium dental implants inserted into the bone of animals or humans were included. Results Thirty four non-review studies provided data and observations were included in this review. Within the criteria, four categories of biomolecular coatings were evaluated. The potential biomolecules include bone morphogenetic proteins in 8 articles, other growth factors in 8 articles, peptides in 5 articles, and extracellular matrix in 13 articles. Most articles had a healing period of 1 to 3 months and the longest time of study was 6 months. In addition, all studies comprised of implants inserted in animals except for one, which evaluated implants placed in both animals and humans. The results indicate that dental implant surface modification with biological molecules seem to improve performance as demonstrated by histomorphometric analysis (such as percentage of bone-to-implant contact and peri-implant bone density) and biomechanical testing (such as removal torque, push-out/pull-out tests, and resonance frequency analysis). Conclusions Bioactive surface modifications on implant surfaces do not always offer a beneficial effect on osseointegration. Nevertheless, surface modifications of titanium dental implants with biomolecular coatings seem to promote peri-implant bone formation, resulting in enhanced osseointegration during the early stages of healing. However, long-term clinical studies are needed to validate this result. In addition, clinicians must keep in mind that results from animal experiments need not necessarily reflect the human clinical reality.
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Affiliation(s)
- Hsiu-Wan Meng
- Department of Periodontics, University of Texas School of Dentistry at Houston, Houston, TX USA
| | - Esther Yun Chien
- College of Dentistry, The Ohio State University, Columbus, OH USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, 305 West 12th Avenue, Columbus, OH 43210 USA
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Synergistic Effects of Vascular Endothelial Growth Factor on Bone Morphogenetic Proteins Induced Bone Formation In Vivo: Influencing Factors and Future Research Directions. BIOMED RESEARCH INTERNATIONAL 2016; 2016:2869572. [PMID: 28070506 PMCID: PMC5187461 DOI: 10.1155/2016/2869572] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 10/16/2016] [Accepted: 10/24/2016] [Indexed: 02/08/2023]
Abstract
Vascular endothelial growth factor (VEGF) and bone morphogenetic proteins (BMPs), as key mediators in angiogenesis and osteogenesis, are used in a combined delivery manner as a novel strategy in bone tissue engineering. VEGF has the potential to enhance BMPs induced bone formation. Both gene delivery and material-based delivery systems were incorporated in previous studies to investigate the synergistic effects of VEGF and BMPs. However, their results were controversial due to variation of methods incorporated in different studies. Factors influencing the synergistic effects of VEGF on BMPs induced bone formation were identified and analyzed in this review to reduce confusion on this issue. The potential mechanisms and directions of future studies were also proposed here. Further investigating mechanisms of the synergistic effects and optimizing these influencing factors will help to generate more effective bone regeneration.
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Devi R, Dixit J. Clinical Evaluation of Insulin like Growth Factor-I and Vascular Endothelial Growth Factor with Alloplastic Bone Graft Material in the Management of Human Two Wall Intra-Osseous Defects. J Clin Diagn Res 2016; 10:ZC41-ZC46. [PMID: 27790578 DOI: 10.7860/jcdr/2016/21333.8476] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/10/2016] [Indexed: 02/01/2023]
Abstract
INTRODUCTION In recent years, emphasis on the use of growth factors for periodontal healing is gaining great momentum. Several growth factors showed promising results in periodontal regeneration. AIM This study was designed to compare the clinical outcomes of 0.8μg recombinant human Vascular Endothelial Growth Factor (rh-VEGF) and 10μg recombinant human Insulin Like Growth Factor-I (rh-IGF-I) with β-Tricalcium Phosphate (β-TCP) and Polylactide-Polyglycolide Acid (PLGA) membrane in two wall intra-osseous defects. MATERIALS AND METHODS A total of 29 intra-osseous defects in 27 subjects were randomly divided into 3 test and 1 control group. Test group I (n=8) received rh-VEGF+ rh-IGF-I, Test group II (n=7) rh-VEGF, Test group III (n=7) rh-IGF-I and control group (n=7) with no growth factor, β-TCP and PLGA membrane was used in all the groups. Baseline soft tissue parameters including Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), and Gingival Recession (GR) at selected sites were recorded at baseline and at 6 months. Intrasurgically, intra-osseous component was calculated as a) Cemento-Enamel Junction to Bone Crest (CEJ to BC), b) Bone Crest to Base of the Defect (BC to BD) at baseline and at re-entry. The mean changes at baseline and after 6 months within each group were compared using Wilcoxon Signed Rank Test. The mean changes for each parameter between groups were compared using Mann-Whitney U test. RESULTS After 6 months, maximum mean PPD reduction occurred in test group I followed by test group II, III and control group. Similar trend was observed in CAL gain. Non-significant GR was present in test group I and control group whereas in test group II and III GR was absent. The use of rh-VEGF+ rhIGF-I exhibited 95.8% osseous fill as compared to 54.8% in test group II, 52.7% in test group III and 41.1 % in the control group. CONCLUSION Within the limitations of this study, it can be concluded that, rh-IGF-I+rh-VEGF treated sites resulted in greater improvement in PPD reduction, CAL gain as well as in osseous fill after 6 months when compared with rh-VEGF, rh-IGF-I and control sites.
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Affiliation(s)
- Renu Devi
- Demonstrator, Department of Periodontics and Oral Implantology, Postgraduate Institute of Dental Sciences , Rohtak, Haryana, India
| | - Jaya Dixit
- Professor and Head of Department, Department of Periodontology, Faculty of Dental Sciences, King George's Medical University , Lucknow, Uttar Pradesh, India
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Galli S, Andersson M, Jinno Y, Karlsson J, He W, Xue Y, Mustafa K, Wennerberg A, Jimbo R. Magnesium release from mesoporous carriers on endosseus implants does not influence bone maturation at 6 weeks in rabbit bone. J Biomed Mater Res B Appl Biomater 2016; 105:2118-2125. [PMID: 27405685 DOI: 10.1002/jbm.b.33752] [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: 02/11/2016] [Revised: 06/20/2016] [Accepted: 06/26/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The release of magnesium ions (Mg2+ ) from titanium surfaces has been shown to boost the initial biological response of peri-implant bone and to increase the biomechanical strength of osseointegration. The objective of the present paper was to investigate if the initial improvement in osseointegration would influence the bone remodeling also during the maturation stage of bone healing. METHODS Titanium implants were coated with mesoporous titania layers and either loaded with Mg2+ (test group) or left untreated (control group). The implants were inserted in the tibiae of 10 New Zealand White rabbits. Osseointegration was assessed after 6 weeks by means of biomechanical testing (RTQ), non-decalcified histology and histomorphometry (BIC%, BA%, NBA%). The expression of genes involved in the bone formation and remodeling was quantified using qPCR. RESULTS Mg2+ releasing mesoporous titania coatings showed, on average, higher removal torques and histomorphometrical outcomes (RTQ: 17.2 Ncm vs. 15 Ncm; BIC: 38.8% vs. 32.1%; BA%: 71.6% vs. 64%; NBA% 62.5% vs. 54% for the tests vs the controls); however, the differences were not statistically significant. Three osteogenic markers, osteocalcin (OC), collagen 1 alpha 1 (COL1A1), and alkalin phosphatase (ALPL), were respectively 2-fold, 1.53-fold, and 1.13-fold up-regulated in the control group compared to the test. The expression of COL1A1 was particularly high in both groups, while the biomarkers for remodeling and inflammation showed a low expression in both groups. SIGNIFICANCE The results suggested that the initial enhancement in osseointegration induced by magnesium release from mesoporous titania coatings has no detrimental effects during bone maturation. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2118-2125, 2017.
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Affiliation(s)
- Silvia Galli
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden
| | - Martin Andersson
- Department of Chemistry and Chemical Engineering, Applied Chemistry, Chalmers University of Technology, 412 96, Gothenburg, Sweden
| | - Yohei Jinno
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden
| | - Johan Karlsson
- Department of Chemistry and Chemical Engineering, Applied Chemistry, Chalmers University of Technology, 412 96, Gothenburg, Sweden
| | - Wenxiao He
- Department of Chemistry and Chemical Engineering, Applied Chemistry, Chalmers University of Technology, 412 96, Gothenburg, Sweden
| | - Ying Xue
- Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Norway
| | - Kamal Mustafa
- Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Norway
| | - Ann Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden
| | - Ryo Jimbo
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden.,Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden
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Impact of Dental Implant Surface Modifications on Osseointegration. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6285620. [PMID: 27478833 PMCID: PMC4958483 DOI: 10.1155/2016/6285620] [Citation(s) in RCA: 297] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 05/22/2016] [Accepted: 06/06/2016] [Indexed: 11/18/2022]
Abstract
Objective. The aim of this paper is to review different surface modifications of dental implants and their effect on osseointegration. Common marketed as well as experimental surface modifications are discussed. Discussion. The major challenge for contemporary dental implantologists is to provide oral rehabilitation to patients with healthy bone conditions asking for rapid loading protocols or to patients with quantitatively or qualitatively compromised bone. These charging conditions require advances in implant surface design. The elucidation of bone healing physiology has driven investigators to engineer implant surfaces that closely mimic natural bone characteristics. This paper provides a comprehensive overview of surface modifications that beneficially alter the topography, hydrophilicity, and outer coating of dental implants in order to enhance osseointegration in healthy as well as in compromised bone. In the first part, this paper discusses dental implants that have been successfully used for a number of years focusing on sandblasting, acid-etching, and hydrophilic surface textures. Hereafter, new techniques like Discrete Crystalline Deposition, laser ablation, and surface coatings with proteins, drugs, or growth factors are presented. Conclusion. Major advancements have been made in developing novel surfaces of dental implants. These innovations set the stage for rehabilitating patients with high success and predictable survival rates even in challenging conditions.
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Jenny G, Jauernik J, Bierbaum S, Bigler M, Grätz KW, Rücker M, Stadlinger B. A systematic review and meta-analysis on the influence of biological implant surface coatings on periimplant bone formation. J Biomed Mater Res A 2016; 104:2898-910. [PMID: 27301790 DOI: 10.1002/jbm.a.35805] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/07/2016] [Indexed: 11/11/2022]
Abstract
This systematic review and meta-analysis evaluated the influence of biological implant surface coatings on periimplant bone formation in comparison to an uncoated titanium reference surface in experimental large animal models. The analysis was structured according to the PRISMA criteriae. Of the1077 studies, 30 studies met the inclusion criteriae. Nineteen studies examined the bone implant contact (BIC) and were included in the meta-analysis. Overall, the mean increase in BIC for the test surfaces compared to the reference surfaces was 3.7 percentage points (pp) (95% CI -3.9-11.2, p = 0.339). Analyzing the increase in BIC for specific coated surfaces in comparison to uncoated reference surfaces, inorganic surface coatings showed a significant mean increase in BIC of 14.7 pp (95% CI 10.6-18.9, p < 0.01), extracellular matrix (ECM) surface coatings showed an increase of 10.0 pp (95% CI 4.4-15.6, p < 0.001), and peptide coatings showed a statistical trend with 7.1 pp BIC increase (95% CI -0.8-15.0, p = 0.08). In this review, no statistically significant difference could be found for growth factor surface coatings (observed difference -3.3 pp, 95% CI -16.5-9.9, p = 0.6). All analyses are exploratory in nature. The results show a statistically significant effect of inorganic and ECM coatings on periimplant bone formation. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2898-2910, 2016.
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Affiliation(s)
- Gregor Jenny
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland
| | - Johanna Jauernik
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland
| | - Susanne Bierbaum
- Max-Bergmann Center of Biomaterials, Technische Universität Dresden, Budapester Str. 27, D-01969 Dresden, Germany
| | - Martin Bigler
- SAKK Schweizerische Arbeitsgemeinschaft Für Klinische Krebsforschung, Bern, Effingerstr. 32, CH-3008 Bern, Switzerland
| | - Klaus W Grätz
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland
| | - Martin Rücker
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland.
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El-Gammal MY, Salem AS, Anees MM, Tawfik MA. Clinical and Radiographic Evaluation of Immediate Loaded Dental Implants With Local Application of Melatonin: A Preliminary Randomized Controlled Clinical Trial. J ORAL IMPLANTOL 2016; 42:119-25. [DOI: 10.1563/aaid-joi-d-14-00277] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Immediate loading of dental implants in situations where low bone density exist, such as the posterior maxillary region, became possible recently after the introduction of biomimetic agents. This 1-year preliminary clinical trial was carried out to clinically and radiographically evaluate immediate-loaded 1-piece implants with local application of melatonin in the osteotomy site as a biomimetic material. 14 patients with missing maxillary premolars were randomized to receive 14 implants of 1-piece type that were subjected to immediate loading after 2 weeks of initial placement. Group I included 7 implants with acid-etched surface while group II included 7 implants with acid-etched surface combined with local application of melatonin gel at the osteotomy site. Patients were recalled for follow up at 1, 3, 6, and 12 months after loading. All implants were considered successful after 12 months of follow-up. Significant difference (P < 0.05) was found between both groups at 1 month of implant loading when considering the implant stability. At 1 and 3 months there were significant differences in the marginal bone level between the 2 groups. These results suggest that the local application of melatonin at the osteotomy site is associated with good stability and minimal bone resorption. However, more studies for longer follow-up periods are required to confirm the effect of melatonin hormone on osseointegration of dental implants.
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Affiliation(s)
- Mona Y. El-Gammal
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ahmed S. Salem
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Mohamed M. Anees
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mohamed A. Tawfik
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Raphel J, Karlsson J, Galli S, Wennerberg A, Lindsay C, Haugh MG, Pajarinen J, Goodman SB, Jimbo R, Andersson M, Heilshorn SC. Engineered protein coatings to improve the osseointegration of dental and orthopaedic implants. Biomaterials 2016; 83:269-82. [PMID: 26790146 PMCID: PMC4771523 DOI: 10.1016/j.biomaterials.2015.12.030] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/19/2015] [Accepted: 12/29/2015] [Indexed: 01/10/2023]
Abstract
Here we present the design of an engineered, elastin-like protein (ELP) that is chemically modified to enable stable coatings on the surfaces of titanium-based dental and orthopaedic implants by novel photocrosslinking and solution processing steps. The ELP includes an extended RGD sequence to confer bio-signaling and an elastin-like sequence for mechanical stability. ELP thin films were fabricated on cp-Ti and Ti6Al4V surfaces using scalable spin and dip coating processes with photoactive covalent crosslinking through a carbene insertion mechanism. The coatings withstood procedures mimicking dental screw and hip replacement stem implantations, a key metric for clinical translation. They promoted rapid adhesion of MG63 osteoblast-like cells, with over 80% adhesion after 24 h, compared to 38% adhesion on uncoated Ti6Al4V. MG63 cells produced significantly more mineralization on ELP coatings compared to uncoated Ti6Al4V. Human bone marrow mesenchymal stem cells (hMSCs) had an earlier increase in alkaline phosphatase activity, indicating more rapid osteogenic differentiation and mineral deposition on adhesive ELP coatings. Rat tibia and femur in vivo studies demonstrated that cell-adhesive ELP-coated implants increased bone-implant contact area and interfacial strength after one week. These results suggest that ELP coatings withstand surgical implantation and promote rapid osseointegration, enabling earlier implant loading and potentially preventing micromotion that leads to aseptic loosening and premature implant failure.
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Affiliation(s)
- Jordan Raphel
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, USA
| | - Johan Karlsson
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Silvia Galli
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ann Wennerberg
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christopher Lindsay
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, USA
| | - Matthew G Haugh
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, USA
| | - Jukka Pajarinen
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Ryo Jimbo
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Martin Andersson
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Sarah C Heilshorn
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, USA.
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Spiller KL, Vunjak-Novakovic G. Clinical translation of controlled protein delivery systems for tissue engineering. Drug Deliv Transl Res 2016; 5:101-15. [PMID: 25787736 DOI: 10.1007/s13346-013-0135-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Strategies that utilize controlled release of drugs and proteins for tissue engineering have enormous potential to regenerate damaged organs and tissues. The multiple advantages of controlled release strategies merit overcoming the significant challenges to translation, including high costs and long, difficult regulatory pathways. This review highlights the potential of controlled release of proteins for tissue engineering and regenerative medicine. We specifically discuss treatment modalities that have reached preclinical and clinical trials, with emphasis on controlled release systems for bone tissue engineering, the most advanced application with several products already in clinic. Possible strategies to address translational and regulatory concerns are also discussed.
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Affiliation(s)
- Kara L Spiller
- Department of Biomedical Engineering, Columbia University, 622 West 168th Street Vanderbilt Clinic 12-234, New York, NY, 10032, USA
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25
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Yan X, Yuan F, Chen X, Dong C. Bioinformatics analysis to identify the differentially expressed genes of glaucoma. Mol Med Rep 2015; 12:4829-36. [PMID: 26135629 PMCID: PMC4581750 DOI: 10.3892/mmr.2015.4030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 05/06/2015] [Indexed: 12/23/2022] Open
Abstract
The aim of the present study was to screen the differentially expressed genes (DEGs) associated with glaucoma and investigate the changing patterns of the expression of these genes. The GSE2378 gene microarray data of glaucoma was downloaded from the Gene Expression Omnibus database, which included seven normal samples and eight glaucoma astrocyte samples. Taking into account the corresponding associations between the probe ID and gene symbols, the DEGs were identified prior to and subsequent to the summation of probe level values using the Limma package in R language, followed by Gene Ontology (GO) and pathway enrichment analyses. Interaction networks of the DEGs were constructed using the Biomolecular Interaction Network Database, and cluster analysis of the genes in the networks was performed using ClusterONE. Subsequent to the summation of probe value, a total of 223 genes were identified as DEGs between the normal and glaucoma samples, including 74 downregulated and 149 upregulated genes. In addition, the DEGs were found to be associated with several functions, including response to wounding, extracellular region part and calcium ion binding. The most significantly enriched pathways were complement and coagulation cascades, arrhythmogenic right ventricular cardiomyopathy and extracellular matrix (ECM)-receptor interaction. Furthermore, interaction networks were constructed of the DEGs prior to and subsequent to the summation of probe values, and HNF4A and CEBPD were identified as hub genes. Additionally, 37 and 31 GO terms were identified to be enriched in the two DEGs of the networks prior to and subsequent to summation, respectively. The results indicated the identified genes associated with ECM as important, and the CEBPD gene was considered to be a critical gene in glaucoma. The findings of the present study offer a potential reference value in further investigations of glaucoma at the gene level.
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Affiliation(s)
- Xiang Yan
- Department of Ophthalmology, Pudong District Gongli Hospital, Shanghai 200135, P.R. China
| | - Fei Yuan
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Xiuping Chen
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Chunqiong Dong
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
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Choi AH, Ben-Nissan B. Calcium phosphate nanocoatings and nanocomposites, part I: recent developments and advancements in tissue engineering and bioimaging. Nanomedicine (Lond) 2015; 10:2249-61. [PMID: 26119630 DOI: 10.2217/nnm.15.57] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A number of materials have been applied as implant coatings and as tissue regeneration materials. Calcium phosphate holds a special consideration, due to its chemical similarity to human bone and, most importantly, its dissolution characteristics, which allow for bone growth and regeneration. The applications of molecular and nanoscale-based biological materials have been and will continue to play an ever increasing role in enhancing and improving the osseointegration of dental and orthopedic implants. More recently, extensive research efforts have been focused on the development and applications of fluorescent nanoparticles and nanocoatings for in vivo imaging and diagnostics as well as devising methods of adding luminescent or fluorescent capabilities to enhance the in vivo functionality of calcium phosphate-based biomedical materials.
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Affiliation(s)
- Andy H Choi
- Faculty of Science, University of Technology, Sydney, NSW, Australia
| | - Besim Ben-Nissan
- Faculty of Science, University of Technology, Sydney, NSW, Australia
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Schliephake H, Rublack J, Förster A, Schwenzer B, Reichert J, Scharnweber D. Functionalization of titanium implants using a modular system for binding and release of VEGF enhances bone-implant contact in a rodent model. J Clin Periodontol 2015; 42:302-10. [PMID: 25640057 DOI: 10.1111/jcpe.12370] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 11/28/2022]
Abstract
AIMS To test the immobilization of vascular endothelial growth factor (VEGF165 ) on the surface of titanium implants using DNA oligonucleotide (ODN) anchor strands for the ability to enhance periimplant bone formation. MATERIALS AND METHODS DNA oligonucleotides were anchored to the surface of sandblasted acid-etched (SAE) titanium screw implants and were hybridized with complementary strands of ODN conjugated to rhVEGF165 . The implants were tested against blank SAE implants and SAE implants with nano-anchored ODN. The implants were inserted into the tibiae of 36 Sprague-Dawley rats. Primary outcome parameters were bone-implant contact (BIC), amount of new bone formation and periimplant bone density (BD). density after 1, 4 and 13 weeks. Unit of analysis has been the individual implant. RESULTS Implants with rhVEGF165 hybridized to ODN anchor strands exhibited significantly increased average BIC after 1 month compared to blank implants and implants with anchored ODN strands. CONCLUSIONS It is concluded that rhVEGF165 immobilized on the surface of titanium implants through nano-anchored oligonucleotide strands can accelerate BIC of sandblasted and etched titanium implants to a certain extent. The radius of effect of the growth factor appears to be limited to tissue immediately adjacent to the implant surface.
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Affiliation(s)
- Henning Schliephake
- Department of Oral and Maxillofacial Surgery, George-Augusta-University, Göttingen, Germany
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Moest T, Koehler F, Prechtl C, Schmitt C, Watzek G, Schlegel KA. Bone formation in peri-implant defects grafted with microparticles: a pilot animal experimental study. J Clin Periodontol 2014; 41:990-8. [PMID: 25131387 DOI: 10.1111/jcpe.12295] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2014] [Indexed: 01/01/2023]
Abstract
AIM This study aimed to evaluate the healing of peri-implant defects grafted with microparticles (MPs). MATERIAL AND METHODS Six domestic pigs received nine standardized defects at the calvaria, and an implant was inserted in the middle of each defect. The space between the implant and lateral bone portion was filled with MP pellets (n = 18) or MP supernatant (n = 18) or left unfilled (n = 18). After 14 and 28 days, three animals were sacrificed and specimens removed for further processing. Samples were microradiographically and histologically analysed. In addition, we immunohistochemically stained for anti-vWF as a marker of angiogenesis. RESULTS In the case of bone regeneration and vessel formation, the null hypothesis can be partially rejected. After 14 and 28 days, no significant difference was observed within groups regarding de novo bone formation, bone density and osseointegration. However, superior vessel formation was found at both time points. CONCLUSION Microparticles represent a promising treatment option to accelerate peri-implant vessel formation. Further studies are needed to investigate the regenerative properties of MPs more precisely.
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Affiliation(s)
- Tobias Moest
- Oral and Maxillofacial Surgery, University Hospital Erlangen, Erlangen, Germany
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Ramazanoglu M, Lutz R, Rusche P, Trabzon L, Kose GT, Prechtl C, Schlegel KA. Bone response to biomimetic implants delivering BMP-2 and VEGF: an immunohistochemical study. J Craniomaxillofac Surg 2013; 41:826-35. [PMID: 23434516 DOI: 10.1016/j.jcms.2013.01.037] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 12/18/2012] [Accepted: 01/15/2013] [Indexed: 10/27/2022] Open
Abstract
This animal study evaluated bone healing around titanium implant surfaces biomimetically coated with bone morphogenic protein-2 (BMP-2) and/or vascular endothelial growth factor (VEGF) by examining bone matrix proteins and mineralisation. Five different implant surfaces were established: acid-etched surface (AE), biomimetic calcium phosphate surface (CAP), BMP-2 loaded CAP surface, VEGF loaded CAP surface and dual BMP-2 + VEGF loaded CAP surface. The implants were inserted into calvariae of adult domestic pigs. For the comparison of osteoconductive capacity of each surface, bone mineral density and expression of bone matrix proteins (collagen I, BMP-2/4, osteocalcin and osteopontin) inside defined chambers around the implant were assessed using light microscopy and microradiography and immunohistochemical analysis at 1, 2 and 4 weeks. In the both groups delivering BMP-2, the bone mineral density was significantly enhanced after 2 weeks and the highest value was measured for the group BMP + VEGF. In the group VEGF, collagen I and BMP-2/4 expressions were significantly up-regulated at the first and second weeks. The percentage of BMP-2/4 positive cells in the group BMP + VEGF was significantly enhanced compared with the groups AE and CAP at the second week. Although the highest osteocalcin and osteopontin expression values were observed for the group BMP + VEGF after 2 weeks, no statistically significant difference in osteocalcin and osteopontin expressions was found between all groups at any time. It was concluded that combined delivery of BMP-2 and VEGF favoured bone mineralisation and expression of important bone matrix proteins that might explain synergistic interaction between both growth factors.
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Affiliation(s)
- Mustafa Ramazanoglu
- Department of Oral Surgery, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey.
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Sánchez-Ilárduya MB, Trouche E, Tejero R, Orive G, Reviakine I, Anitua E. Time-dependent release of growth factors from implant surfaces treated with plasma rich in growth factors. J Biomed Mater Res A 2012; 101:1478-88. [DOI: 10.1002/jbm.a.34428] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 08/01/2012] [Accepted: 08/06/2012] [Indexed: 12/22/2022]
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Verron E, Bouler J, Guicheux J. Controlling the biological function of calcium phosphate bone substitutes with drugs. Acta Biomater 2012; 8:3541-51. [PMID: 22729019 DOI: 10.1016/j.actbio.2012.06.022] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 06/12/2012] [Accepted: 06/18/2012] [Indexed: 01/05/2023]
Abstract
There is a growing interest in bone tissue engineering for bone repair after traumatic, surgical or pathological injury, such as osteolytic tumor or osteoporosis. In this regard, calcium phosphate (CaP) bone substitutes have been used extensively as bone-targeting drug-delivery systems. This localized approach improves the osteogenic potential of bone substitutes by delivering bone growth factors, thus extending their biofunctionality to any pathological context, including infection, irradiation, tumor and osteoporosis. This review briefly describes the physical and chemical processes implicated in the preparation of drug-delivering CaPs. It also describes the impact of these processes on the intrinsic properties of CaPs, especially in terms of the drug-release profile. In addition, this review focuses on the potential influence of drugs on the resorption rate of CaPs. Interestingly, by modulating the resorption parameters of CaP biomaterials, it should be possible to control the release of bone-stimulating ions, such as inorganic phosphate, in the vicinity of bone cells. Finally, recent in vitro and in vivo evaluations are extensively reported.
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Kim JE, Kang SS, Choi KH, Shim JS, Jeong CM, Shin SW, Huh JB. The effect of anodized implants coated with combined rhBMP-2 and recombinant human vascular endothelial growth factors on vertical bone regeneration in the marginal portion of the peri-implant. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 115:e24-31. [PMID: 23706924 DOI: 10.1016/j.oooo.2011.10.040] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 09/30/2011] [Accepted: 10/27/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of anodized implants coated with combined rhBMP-2 and recombinant human vascular endothelial growth factors (rhVEGFs) on vertical bone regeneration in the marginal portion of the peri-implant. STUDY DESIGN Supra-alveolar defects were created in 3 male beagle dogs. Each animal received 8 implants that were either coated with a single growth factor (rhBMP-2) or combined growth factors (rhBMP-2 + rhVEGF), or an anodized implant (the control group). The amount of the vertical bone regeneration, the bone-implant contact, and the intrathread bone density were investigated using histomorphometric analysis at 8 weeks. RESULTS The bone morphogenetic protein (BMP) group and the BMP-VEGF group showed vertical alveolar bone regeneration and enhanced bone-implant contact in the microthread compared with the control group (P < .05). CONCLUSIONS Anodized implants coated with rhBMP-2 and rhBMP - 2 + rhVEGF can induce vertical alveolar bone regeneration, but the combined effect of rhBMP-2 and rhVEGF was not verified.
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Affiliation(s)
- Jong-Eun Kim
- Graduate Student, Advanced Prosthodontics, Postgraduate School of Clinical Dentistry, Institute for Clinical Dental Research, Korea University, Seoul, Korea
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Yilgor P, Yilmaz G, Onal MB, Solmaz I, Gundogdu S, Keskil S, Sousa RA, Reis RL, Hasirci N, Hasirci V. Anin vivostudy on the effect of scaffold geometry and growth factor release on the healing of bone defects. J Tissue Eng Regen Med 2012; 7:687-96. [DOI: 10.1002/term.1456] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 11/01/2011] [Accepted: 11/24/2011] [Indexed: 01/09/2023]
Affiliation(s)
| | - G. Yilmaz
- Department of Pathology; Gazi University Faculty of Medicine; Ankara; Turkey
| | - M. B. Onal
- Department of Neurosurgery; Gulhane Military Medical Academy; Ankara; Turkey
| | - I. Solmaz
- Department of Neurosurgery; Gulhane Military Medical Academy; Ankara; Turkey
| | - S. Gundogdu
- Department of Radiology; Ufuk University Faculty of Medicine; Ankara; Turkey
| | - S. Keskil
- Department of Neurosurgery; Bayindir Medical Centre; Kavaklidere; Ankara; Turkey
| | - R. A. Sousa
- 3Bs Research Group; University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; Guimarães; Portugal
| | - R. L. Reis
- 3Bs Research Group; University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine; Guimarães; Portugal
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Schlegel KA, Prechtl C, Möst T, Seidl C, Lutz R, von Wilmowsky C. Osseointegration of SLActive implants in diabetic pigs. Clin Oral Implants Res 2011; 24:128-34. [PMID: 22111960 DOI: 10.1111/j.1600-0501.2011.02380.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Diabetes mellitus is currently classified as a relative contraindication for implant treatment because of microangiopathies with the consequence of impaired bone regeneration and higher rates of implant failure. The study aim was to investigate peri-implant bone formation in a diabetic animal model in comparison to healthy animals and to evaluate the differences between conventional (SLA(®) ) and modified (SLActive(®) ) titanium implant surfaces on osseointegration. MATERIAL AND METHODS Each six implants were placed in the calvaria of 11 diabetic and 4 healthy domestic pigs. At 30 and 90 days after implant placement, the bone-to-implant contact (BIC) and bone density (BD) were appraised. Additionally, the expression of the bone-matrix proteins collagen type I and osteocalcin was evaluated at both points in time by using immunohistochemical staining methods. RESULTS Overall, BIC was reduced in the diabetic group at 30 and 90 days. After 90 days, the SLActive(®) implants showed significantly higher BICs compared with the SLA(®) implants in diabetic animals. Peri-implant BD was higher in the SLActive(®) group at 30 and 90 days in healthy and diabetic animals. Collagen type I protein expression was higher using SLA(®) implants in diabetic pigs at 30 days. Values for osteocalcin expression were not consistent. CONCLUSIONS The results indicate the negative effect of untreated diabetes mellitus on early osseointegration of dental implants. The modified SLA(®) surface (SLActive(®) ) elicited an accelerated osseointegration of dental implants, suggesting that a better prognosis for implant treatment of diabetic patients is possible.
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Affiliation(s)
- K A Schlegel
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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Schmitt C, Lutz R, Doering H, Lell M, Ratky J, Schlegel KA. Bio-Oss® blocks combined with BMP-2 and VEGF for the regeneration of bony defects and vertical augmentation. Clin Oral Implants Res 2011; 24:450-60. [DOI: 10.1111/j.1600-0501.2011.02351.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2011] [Indexed: 11/29/2022]
Affiliation(s)
- Christian Schmitt
- Department of Oral and Maxillofacial Surgery; University of Erlangen-Nuremberg; Erlangen; Germany
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery; University of Erlangen-Nuremberg; Erlangen; Germany
| | - Hendrik Doering
- Department of Oral and Maxillofacial Surgery; University of Erlangen-Nuremberg; Erlangen; Germany
| | - Michael Lell
- Department of Radiology; University of Erlangen-Nuremberg; Erlangen; Germany
| | - Jozsef Ratky
- Research Institute for Animal Breeding and Nutrition; Herceghalom; Hungary
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery; University of Erlangen-Nuremberg; Erlangen; Germany
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