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Korenkov O, Sukhodub L, Kumeda M, Sukhodub L. In Vivo feature of the regenerative potential of chitosan and alginate based osteoplastic composites doped with calcium phosphates, zinc ions, and vitamin D2. Ann Anat 2024; 255:152290. [PMID: 38821427 DOI: 10.1016/j.aanat.2024.152290] [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] [Received: 11/01/2023] [Revised: 04/22/2024] [Accepted: 05/27/2024] [Indexed: 06/02/2024]
Abstract
PURPOSE In vivo comparison of the regenerative potential of two calcium phosphate-biopolymer osteoplastic composites: а) based on alginate (Alg) and hydroxyapatite (HA) - Alg/HA/CS/Zn/D2, b) based on chitosan (CS) and brushite (DCPD) - CS/DCPD/D2. MATERIALS AND METHODS 36 white male laboratory rats aged six months were used. A defect to the bone marrow canal in the middle of the femur diaphysis was made with a dental bur of 2 mm. The bone defect healed under the blood clot (control) in the different animal groups and was filled with Alg/HA/CS/Zn/D2 and CS/DCPD/D2. The regeneration of the bone defect was studied on the 30th, 90th, and 140th days by computer tomography (CT). RESULTS On the 30th day, all groups' implantation site optical density (OD) was significantly lower than that of the adjacent maternal bone (MB). Intensity of bone formation for Alg/HA/CS/Zn/D2 exceeds CS/DCPD/D2. On the 90th day, the bone trauma site OD with Alg/HA/CS/Zn/D2 (1725.4 ± 86 HU) and CS/DCPD/D2 (1484.9 ± 69 HU) exceeded the OD of the control (942.5 ± 55 HU). On the 140th day, the OD of Alg/HA/CS/Zn/D2 and CS/DCPD/D2 implantation sites was higher than Control and MB OD. Visually, the area of the past injury with the Alg/HA/CS/Zn/D2 could be detected only by the presence of an endosteal bone callus and in the case of CS/DCPD/D2 - by the shadow of the remaining biomaterial in the bone marrow canal. CONCLUSIONS According to CT data, Alg/HA/CS/Zn/D2 and CS/DCPD/D2 contribute to the complete healing of the femoral diaphysis defect in 140 days, but the regenerative potential of Alg/HA/CS/Zn/D2 from 30 days to 140 days is higher than CS/DCPD/D2 biomaterial.
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Affiliation(s)
- Olexii Korenkov
- Sumy State University, 2, Rymskogo-Korsakova st., Sumy 40007, Ukraine
| | - Liudmyla Sukhodub
- Sumy State University, 2, Rymskogo-Korsakova st., Sumy 40007, Ukraine.
| | - Mariia Kumeda
- Sumy State University, 2, Rymskogo-Korsakova st., Sumy 40007, Ukraine
| | - Leonid Sukhodub
- Sumy State University, 2, Rymskogo-Korsakova st., Sumy 40007, Ukraine
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Souza RB, Alves HDL, Oliveira LS, Pires FR, Vidigal GM, Fischer RG. Histomorphometric and microtomographic analysis of maxillary sinus augmentation surgeries with and without collagen membrane on the lateral window: A randomized clinical trial. Clin Implant Dent Relat Res 2024. [PMID: 39031555 DOI: 10.1111/cid.13331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 02/25/2024] [Accepted: 04/01/2024] [Indexed: 07/22/2024]
Abstract
OBJECTIVE To evaluate the histomorphometric and computerized microtomographic (Micro-CT) analysis of the regenerated bone tissue from maxillary sinus augmentation surgery, with and without using the collagen membrane on the external osteotomy window. MATERIALS AND METHODS Twelve patients were selected for this prospective, controlled, and randomized study. The patients were submitted to bilateral maxillary sinus surgery in a split-mouth design. On the test side, the maxillary sinus augmentation procedure included using Geistlich Bio-Oss® and a Geistlich Bio-Gide® collagen membrane covering the lateral osteotomy window. On the control side, only Geistlich Bio-Oss® was used without the presence of the membrane. After 6 months, the surgeries for implant installation were performed. In this surgical phase, specimens of the regenerated tissue were collected for histological and Micro-CT analysis. RESULTS In the histomorphometric evaluation, the mean (±SD) percentages of newly formed bone were 43.9% (±11.5) and 40.8% (±8.9) in the test and control groups, respectively. The corresponding values of the Micro-CT analysis were 36.6% (±3.4) and 37.2% (±4.7) in the test and control groups, respectively. There was no statistically significant difference between the test and control groups in the two methods. In addition, there was no statistically significant difference between the mean percentage of biomaterial remaining between the test and control groups. However, the mean percentage of newly formed bone was significantly higher and the mean percentage of remaining biomaterial was significantly lower in the histomorphometric analysis compared to the values obtained through microtomography. CONCLUSION The additional use of collagen membranes in maxillary sinus surgery does not offer advantages in newly formed bone.
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Affiliation(s)
- Ramiro Beato Souza
- Oral and Maxillofacial Surgeon of Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | | | - Fabio Ramoa Pires
- Oral Pathology, Dental School, Rio de Janeiro State University, Brazil, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Wang S, Liu J, Caroprese M, Gianfreda F, Melloni F, DE Santis D. Exploring the potential of calcium-based biomaterials for bone regeneration in dentistry: a systematic review. Minerva Dent Oral Sci 2024; 73:169-180. [PMID: 38127421 DOI: 10.23736/s2724-6329.23.04859-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Regenerative medicine emerged as a promising strategy for addressing bone defects, with several bone grafts currently being used, including autografts, allografts, xenografts and alloplasts. Calcium-based biomaterials (CaXs), a well-known class of synthetic materials, have demonstrated good biological properties and are being investigated for their potential to facilitate bone regeneration. This systematic review evaluates the current clinical applications of CaXs in dentistry for bone regeneration. EVIDENCE ACQUISITION A comprehensive search was conducted to collect information about CaXs and their applications in the dental field over the last ten years. The search was limited to relevant articles published in peer-reviewed journals. EVIDENCE SYNTHESIS A total of 72 articles were included in this scoping review, with eight studies related to periodontology, 63 in implantology and three in maxillofacial surgery respectively. The findings suggest that CaXs hold promise as an alternative intervention for minor bone regeneration in dentistry. CONCLUSIONS Calcium-based biomaterials have shown potential as a viable option for bone regeneration in dentistry. Further research is warranted to fully understand their efficacy and safety in larger bone defects. CaXs represent an exciting avenue for researchers and clinicians to explore in their ongoing efforts to advance regenerative medicine.
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Affiliation(s)
- Siwei Wang
- Department of Dental Implantology, The Affiliated Stomatological Hospital, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jianguo Liu
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Marino Caroprese
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesco Gianfreda
- Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Federica Melloni
- Section of Head and Neck Surgery, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy
| | - Daniele DE Santis
- Section of Head and Neck Surgery, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy -
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Minetti E, Palermo A, Berardini M. Comparison of Different Techniques in Post-Extractive Socket Regeneration Using Autologous Tooth Graft: Histological and Clinical Outcomes. Eur J Dent 2024; 18:477-484. [PMID: 37729934 PMCID: PMC11132773 DOI: 10.1055/s-0043-1772251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE Post-extractive socket grafting techniques reduce alveolar ridge dimensional changes. Numerous graft materials have been suggested and a growing interest in tooth material has been observed as a valuable alternative to synthetic biomaterials or xenografts. Furthermore, different clinical procedures have been proposed for the wound closure of the post-extractive site. This study aims to compare histological and clinical outcomes of two different surgical techniques to seal the post-extractive site with the use of autologous demineralized extracted tooth as graft material. MATERIALS AND METHODS Sixteen post-extractive socket without buccal and/or palatal bone walls, in sixteen healthy patients, were grafted with the autologous tooth material treated by the new Tooth Transformer device (Tooth Transformer, Milan, Italy). Alveolar socket preservation procedures were performed without flap elevation. Patients were randomly subdivided into two equal groups according to the site closure technique. In group A, the pedunculate tissue was used, while in group B ice cone technique. A bone samples were collected in each site after 4 months for histological analysis. RESULTS No significant clinical differences among the different sealing techniques were observed. In both groups, the site was filled by new bone formation after 4 months of healing. The histological analysis revealed 46.1 ± 8.07% of bone volume, 9.2 ± 9.46% of residual graft, and 35.2 ± 12.36% of vital bone in group A, while group B shows 41.22 ± 5.88% of bone volume, 7.94 ± 7.54% of residual graft, and 31.7 ± 7.52% new bone. No statistical differences were detected (p > 0.05). CONCLUSION Further studies with a large number of patients, and different observation periods will be needed to confirm the results of this pilot study; however, the interesting data obtained have shown how these techniques, mixed with the autologous dentin derived graft material, seem to promote bone regeneration and reduce physiological bone resorption during alveolar socket preservation treatments.
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Affiliation(s)
- Elio Minetti
- Department of Biomedical, Surgical, Dental Science, University of Milan, Milan, Italy
| | - Andrea Palermo
- College of Medicine and Dentistry, University of Birmingham, Birmingham, United Kingdom
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Kim S, Kim SG. Advancements in alveolar bone grafting and ridge preservation: a narrative review on materials, techniques, and clinical outcomes. Maxillofac Plast Reconstr Surg 2024; 46:14. [PMID: 38625426 PMCID: PMC11021384 DOI: 10.1186/s40902-024-00425-w] [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: 10/30/2023] [Accepted: 04/04/2024] [Indexed: 04/17/2024] Open
Abstract
This narrative review systematically explores the progression of materials and techniques in alveolar ridge preservation (ARP). We commence by delineating the evolution from traditional ARP methods to cutting-edge alternatives, including platelet-rich fibrin, injectable bone repair materials, and hydrogel systems. Critical examination of various studies reveals these innovative approaches not only accelerate bone healing but also significantly improve patient-reported outcomes, such as satisfaction, pain perception, and overall quality of life. Emphasis is placed on the correlation between advanced ARP techniques and enhanced patient comfort and clinical efficacy, underscoring their transformative potential in dental implantology. Highlighting the effectiveness of ARP, the implant survival rate over a span of 5 to 7 years was high, showcasing the reliability and success of these methods. Further, patients expressed high aesthetic satisfaction with the soft tissue outcome, evidenced by an average visual analog scale (VAS) score of 94. This positive aesthetic appraisal is linked to the clinical health of implants, potentially due to the employment of tooth-supported surgical guides. The economic analysis reveals a varied cost range for bone graft substitutes ($46.2 to $140) and socket sealing materials ($12 to $189), with a noteworthy correlation between the investment in barrier membranes and the diminished horizontal and vertical ridge resorption. This suggests that membrane usage significantly contributes to preserving ridge dimensions, offering a cost-effective strategy for enhancing ARP outcomes. In conclusion, this review illuminates the significant advancements in ARP, highlighting the shift towards innovative materials and techniques that not only promise enhanced bone regeneration and reduced healing times but also improve patient satisfaction and aesthetic outcomes. The documented high implant survival rate and the beneficial economic implications of membrane use further validate the effectiveness of contemporary ARP strategies, paving the way for their broader adoption in dental implantology.
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Affiliation(s)
- Suyoung Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 25457, Republic of Korea
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 25457, Republic of Korea.
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Arunjaroensuk S, Nampuksa K, Monmaturapoj N, Thunyakitpisal P, Porntaveetus T, Mattheos N, Pimkhaokham A. Gene expression, micro-CT and histomorphometrical analysis of sinus floor augmentation with biphasic calcium phosphate and deproteinized bovine bone mineral: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2024; 26:402-414. [PMID: 38317374 DOI: 10.1111/cid.13303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/08/2023] [Accepted: 01/04/2024] [Indexed: 02/07/2024]
Abstract
AIMS The aim of this randomized controlled clinical trial was to compare the gene expression, micro-CT, histomorphometrical analysis between biphasic calcium phosphate (BCP) of 70/30 ratio and deproteinized bovine bone mineral (DBBM) in sinus augmentation. MATERIALS AND METHODS Twenty-four patients in need for sinus floor augmentation through lateral approach were randomized into BCP 70/30 ratio or DBBM. After at least 6 months of healing, a total of 24 bone specimens were collected from the entire height of the augmented bone at the area of implant placement and underwent micro-CT, histomorphometric and gene expression analysis. The 12 bone specimens of BCP 70/30 ratio were equally allocated to micro-CT and histologic analysis (test group, n = 6) and gene expression analysis (test group, n = 6). Similarly, the 12 bone specimens of DBBM were also allocated to micro-CT and histologic analysis (control group, n = 6) and gene expression analysis (control group, n = 6). The newly formed bone, remaining graft materials and relative change in gene expression of four target genes were assessed. RESULTS The micro-CT results showed no statistically significant difference in the ratio of bone volume to total volume (BV/TV ratio) for the two groups (BCP 41.51% vs. DBBM 40.97%) and the same was true for residual graft material to total volume (GV/TV ratio, BCP 9.97% vs. DBBM 14.41%). Similarly, no significant difference was shown in the histological analysis in terms of bone formation, (BCP 31.43% vs. DBBM was 30.09%) and residual graft area (DBBM 40.76% vs. BCP 45.06%). With regards to gene expression, the level of ALP was lower in both groups of bone grafted specimens compared with the native bone. On the contrary, the level of OSX, IL-1B and TRAP was higher in augmented bone of both groups compared with the native bone. However, the relative difference in all gene expressions between BCP and DBBM group was not significant. CONCLUSIONS The BCP, HA/β-TCP ratio of 70/30 presented similar histological and micro-CT outcomes in terms of new bone formation and residual graft particles with DBBM. The gene expression analysis revealed different gene expression patterns between augmented and native bone, but showed no significant difference between the two biomaterials.
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Affiliation(s)
- Sirida Arunjaroensuk
- Dental Biomaterials Science Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Katanchalee Nampuksa
- Assistive Technology and Medical Devices Research Center (A-MED), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Naruporn Monmaturapoj
- Assistive Technology and Medical Devices Research Center (A-MED), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | | | - Thantrira Porntaveetus
- Center of Excellence in Genomics and Precision Dentistry, Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Grün P, Pfaffeneder-Mantai F, Bandura P, Schneider B, Bandura AS, Turhani D. A Cone Bean Computer Tomography Investigation of the Newly Formed Mandibular Anterior Ridge following the Treatment of an Extended Comminuted Fracture: A 12-Year Follow-Up. Case Rep Dent 2024; 2024:1824016. [PMID: 38419613 PMCID: PMC10901576 DOI: 10.1155/2024/1824016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/11/2023] [Accepted: 01/27/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Extensive comminuted fractures are associated with tooth loss that ultimately leads to dimensional changes in the hard and soft tissues of the alveolar ridge. Reconstruction of the lost mandibular anterior ridge is very complex due to the natural curvature of the region. Case Presentation. In this case report, the combination of the modified shell technique with autologous bone plates and the guided bone regeneration (GBR) technique was performed on an 18-year-old patient after a comminuted fracture, to ensure new bone formation in the anterior ridge with a natural curvature. After the treatment progressed without complications, three dental implants were placed. Annual cone beam computed tomography (CBCT) images were obtained and evaluated using the GNU Image Manipulation Program (GIMP© 2.10). This allowed measurements of the buccal and lingual bone around the implants, showing the annual bone loss in a twelve-year observation period. Discussion. The treatment of the comminuted fracture and the combination of the modified shell technique with autologous bone plates, the GBR technique, and implant placement can be considered successful. The three dental implants were osseointegrated in 2010, with the buccal bone level averaging 1.31 mm below the implant shoulder and the lingual bone level 1.57 mm above the implant shoulder. In 2021, the measurements showed a bone loss of 0.99 mm at the buccal implant shoulder and 0.69 mm at the lingual implant shoulder. Conclusion The combination of the modified shell technique with autologous bone plates and the GBR technique is a reliable method to ensure new bone formation in the anterior ridge. The use of CBCT is an excellent method to evaluate bone resorption around dental implants, but due to minimal bone resorption in the observation period, an annual CBCT examination is exaggerated.
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Affiliation(s)
- Pascal Grün
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Florian Pfaffeneder-Mantai
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
- Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Patrick Bandura
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Benedikt Schneider
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Anna Sophia Bandura
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
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Vigliar MFR, Marega LF, Duarte MAH, Alcalde MP, Rosso MPDO, Ferreira Junior RS, Barraviera B, Reis CHB, Buchaim DV, Buchaim RL. Photobiomodulation Therapy Improves Repair of Bone Defects Filled by Inorganic Bone Matrix and Fibrin Heterologous Biopolymer. Bioengineering (Basel) 2024; 11:78. [PMID: 38247955 PMCID: PMC10813421 DOI: 10.3390/bioengineering11010078] [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: 11/14/2023] [Revised: 12/22/2023] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Biomaterials are used extensively in graft procedures to correct bone defects, interacting with the body without causing adverse reactions. The aim of this pre-clinical study was to analyze the effects of photobiomodulation therapy (PBM) with the use of a low-level laser in the repair process of bone defects filled with inorganic matrix (IM) associated with heterologous fibrin biopolymer (FB). A circular osteotomy of 4 mm in the left tibia was performed in 30 Wistar male adult rats who were randomly divided into three groups: G1 = IM + PBM, G2 = IM + FB and G3 = IM + FB + PBM. PBM was applied at the time of the experimental surgery and three times a week, on alternate days, until euthanasia, with 830 nm wavelength, in two points of the operated site. Five animals from each group were euthanized 14 and 42 days after surgery. In the histomorphometric analysis, the percentage of neoformed bone tissue in G3 (28.4% ± 2.3%) was higher in relation to G1 (24.1% ± 2.91%) and G2 (22.2% ± 3.11%) at 14 days and at 42 days, the percentage in G3 (35.1% ± 2.55%) was also higher in relation to G1 (30.1% ± 2.9%) and G2 (31.8% ± 3.12%). In the analysis of the birefringence of collagen fibers, G3 showed a predominance of birefringence between greenish-yellow in the neoformed bone tissue after 42 days, differing from the other groups with a greater presence of red-orange fibers. Immunohistochemically, in all experimental groups, it was possible to observe immunostaining for osteocalcin (OCN) near the bone surface of the margins of the surgical defect and tartrate-resistant acid phosphatase (TRAP) bordering the newly formed bone tissue. Therefore, laser photobiomodulation therapy contributed to improving the bone repair process in tibial defects filled with bovine biomaterial associated with fibrin biopolymer derived from snake venom.
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Affiliation(s)
- Maria Fernanda Rossi Vigliar
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ/USP), Sao Paulo 05508-270, Brazil; (M.F.R.V.); (D.V.B.)
| | - Lais Furlaneto Marega
- Department of Biological Sciences, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (L.F.M.); (M.P.d.O.R.); (C.H.B.R.)
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (M.A.H.D.); (M.P.A.)
| | - Murilo Priori Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (M.A.H.D.); (M.P.A.)
| | - Marcelie Priscila de Oliveira Rosso
- Department of Biological Sciences, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (L.F.M.); (M.P.d.O.R.); (C.H.B.R.)
| | - Rui Seabra Ferreira Junior
- Center for the Study of Venoms and Venomous Animals (CEVAP), Sao Paulo State University (University Estadual Paulista, UNESP), Botucatu 18610-307, Brazil; (R.S.F.J.); (B.B.)
- Graduate Programs in Tropical Diseases and Clinical Research, Botucatu Medical School (FMB), Sao Paulo State University (UNESP–University Estadual Paulista), Botucatu 18618-687, Brazil
| | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), Sao Paulo State University (University Estadual Paulista, UNESP), Botucatu 18610-307, Brazil; (R.S.F.J.); (B.B.)
- Graduate Programs in Tropical Diseases and Clinical Research, Botucatu Medical School (FMB), Sao Paulo State University (UNESP–University Estadual Paulista), Botucatu 18618-687, Brazil
| | - Carlos Henrique Bertoni Reis
- Department of Biological Sciences, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (L.F.M.); (M.P.d.O.R.); (C.H.B.R.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Postgraduate Department, University of Marilia (UNIMAR), Marilia 17525-902, Brazil
| | - Daniela Vieira Buchaim
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ/USP), Sao Paulo 05508-270, Brazil; (M.F.R.V.); (D.V.B.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Postgraduate Department, University of Marilia (UNIMAR), Marilia 17525-902, Brazil
- Medical School, University Center of Adamantina (UNIFAI), Adamantina 17800-000, Brazil
| | - Rogerio Leone Buchaim
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ/USP), Sao Paulo 05508-270, Brazil; (M.F.R.V.); (D.V.B.)
- Department of Biological Sciences, Bauru School of Dentistry, University of Sao Paulo (FOB/USP), Bauru 17012-901, Brazil; (L.F.M.); (M.P.d.O.R.); (C.H.B.R.)
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Kniha K, Alhares J, Möhlhenrich SC, Katz MS, Winnand P, Hölzle F, Modabber A, Heitzer M. Dental Implant Placement in the Maxilla Following Ridge Augmentation with Free Iliac Bone Graft and Oral Rehabilitation with Fixed Prosthesis: a Three-Year Follow-Up Study. J Oral Maxillofac Res 2024; 15:e3. [PMID: 38812951 PMCID: PMC11131376 DOI: 10.5037/jomr.2024.15103] [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: 03/23/2024] [Accepted: 03/31/2024] [Indexed: 05/31/2024]
Abstract
Objectives This prospective follow-up study aimed to evaluate the stability values of tapered titanium implants inserted into maxilla following ridge augmentation with free iliac bone graft and crestal bone changes up to three years of follow-up. Material and Methods A total of seven patients with 34 tapered titanium implants in the maxilla with fixed protheses were enrolled in this prospective follow-up study. Patients with previously augmented maxillae using free iliac bone grafts were included. Implant stability was measured (Osstell™) for up to three months of healing. Peri-implant bone resorption was measured using radiographic images taken immediately after implant surgery and after three years. Using a clinical and radiological examination survival and success rates were evaluated. Results After implant insertion, the stability was 60.93, whereas the stability increased significantly (P = 0.0192) to 64.97 at implant exposure (after 3 months). The mean bone loss around the implants was 1.13 mm after three years. Clinical parameters revealed a mean sulcus depth of 2.76 (1.18) mm and a bleeding on probing score of 0.29 (0.58). The survival rate was 100%, and the success rate was 67.65% at the end of the study. Conclusions Tapered implants can be used in free iliac bone grafts for fixed dentures. Implant stability values were high after insertion. In terms of a success rate of 67.65%, the patient's jaw reconstruction indicated a reduced implant success when comparing the data with healthy patients without any augmentation procedures.
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Affiliation(s)
- Kristian Kniha
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30Germany.
- Private Clinic for Oral Surgery Dres, Kniha, Rosental 6, 80331 MunichGermany.
| | - Joud Alhares
- Private dental clinic Zahnmedizin Velbert, VelbertGermany.
| | | | - Marie Sophie Katz
- Private Clinic for Oral Surgery Dres, Kniha, Rosental 6, 80331 MunichGermany.
| | - Philipp Winnand
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30Germany.
| | - Frank Hölzle
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30Germany.
| | - Ali Modabber
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30Germany.
| | - Marius Heitzer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30Germany.
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10
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Tunkel J, Hoffmann F, Schmelcher Y, Kloss-Brandstätter A, Kämmerer PW. Allogeneic versus autogenous shell technique augmentation procedures: a prospective-observational clinical trial comparing surgical time and complication rates. Int J Implant Dent 2023; 9:52. [PMID: 38117445 PMCID: PMC10733239 DOI: 10.1186/s40729-023-00505-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/04/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVES Autogenous and allogeneic blocks for shell augmentation of the jaw have shown comparable results. This observational clinical study aimed to compare both materials for shell augmentation concerning surgery time and intra- and postoperative complications. MATERIAL AND METHODS Bone augmentation with the shell technique using autogenous or allogenous bone was performed in 117 patients with segmental jaw atrophy. The primary study parameter was the surgical time, comparing both materials. Subsequently, intra- and postoperative complications were recorded. RESULTS Allogeneic (n = 60), autogenous (n = 52), or both materials (n = 5) were used. The use of allogeneic material led to a significantly shorter operation time (p < 0.001). A more experienced surgeon needed significantly less time than a less experienced surgeon (p < 0.001). An increasing number of bone shells (p < 0.001), an additional sinus floor elevation, and intraoperative complications also significantly increased the operation time (p = 0.001). Combining allogeneic and autogenous shells (p = 0.02) and simultaneous sinus floor elevation (p = 0.043) significantly impacted intraoperative complications. No correlations were found between the included variables for postoperative complications (all p > 0.05). In total, 229 implants were inserted after a healing time of 4-6 months, with a survival of 99.6% after a mean follow-up duration of 9 months. CONCLUSIONS Compared to the autogenous technique, allogeneic shell augmentation has a shorter surgical time and a similar rate of intra- and postoperative complications as autogenous bone. Together with its promising clinical results, this technique can be recommended.
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Affiliation(s)
- Jochen Tunkel
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Frederik Hoffmann
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Yannik Schmelcher
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545, Bad Oeynhausen, Germany
| | - Anita Kloss-Brandstätter
- Department of Engineering & IT, Carinthia University of Applied Sciences, Europastraße 4, 9524, Villach, Austria
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Frigério PB, Quirino LC, Gabrielli MAC, Carvalho PHDA, Garcia Júnior IR, Pereira-Filho VA. Evaluation of Bone Repair Using a New Biphasic Synthetic Bioceramic (Plenum ® Oss hp) in Critical Calvaria Defect in Rats. BIOLOGY 2023; 12:1417. [PMID: 37998016 PMCID: PMC10668970 DOI: 10.3390/biology12111417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023]
Abstract
(1) Background: Biphasic bioceramics are synthetic bone substitutes that provide greater safety and better predictability in guided bone regeneration. This study aimed to evaluate the bone repair process using a new biphasic bioceramic of synthetic origin (Plenum® Osshp-70HA: 30β-TCP) in critical calvarial defects. (2) Methods: seventy-four defects were created in rat calvaria and divided into two groups-Plenum® Osshp (PO), right side, and Straumann® BoneCeramic™ (BC), left side. Euthanasia was performed at 7, 15, 30, and 60 days after surgery. (3) Results: Lower gene expression was observed for runt-related transcription factor 2 (RUNX2) and vascular endothelial growth factor (VEGF) and higher expression for Integrin Binding Sialoprotein (IBSP). The results correlated with moderate immunolabeling for osteocalcin (OCN) and slight immunolabeling for osteopontin (OPN) in the PO group. Histometry showed a greater amount of biomaterial remaining in the PO group at 60 days. The microtomographic analysis showed a lower density of bone connectivity and a greater thickness of the trabeculae for the remnants of the PO group. (4) Conclusions: the Plenum® Osshp showed no differences compared to BoneCeramic™ and is therefore considered an effective option as a synthetic bone substitute in bone regeneration.
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Affiliation(s)
- Paula Buzo Frigério
- Department of Diagnosis and Surgery, Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo 16015-050, Brazil;
| | - Lilian Caldas Quirino
- Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo 14801-903, Brazil; (L.C.Q.); (M.A.C.G.); (P.H.d.A.C.); (V.A.P.-F.)
| | - Marisa Aparecida Cabrini Gabrielli
- Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo 14801-903, Brazil; (L.C.Q.); (M.A.C.G.); (P.H.d.A.C.); (V.A.P.-F.)
| | - Pedro Henrique de Azambuja Carvalho
- Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo 14801-903, Brazil; (L.C.Q.); (M.A.C.G.); (P.H.d.A.C.); (V.A.P.-F.)
| | - Idelmo Rangel Garcia Júnior
- Department of Diagnosis and Surgery, Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo 16015-050, Brazil;
| | - Valfrido Antonio Pereira-Filho
- Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo 14801-903, Brazil; (L.C.Q.); (M.A.C.G.); (P.H.d.A.C.); (V.A.P.-F.)
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12
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Čandrlić M, Tomas M, Matijević M, Kačarević ŽP, Bićanić M, Udiljak Ž, Butorac Prpić I, Miškulin I, Čandrlić S, Včev A. Regeneration of Buccal Wall Defects after Tooth Extraction with Biphasic Calcium Phosphate in Injectable Form vs. Bovine Xenograft: A Randomized Controlled Clinical Trial. Dent J (Basel) 2023; 11:223. [PMID: 37754343 PMCID: PMC10528832 DOI: 10.3390/dj11090223] [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: 07/28/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
Bone healing after tooth extraction may be affected by defects of the alveolus buccal wall, such as fenestrations and dehiscences. Therefore, to minimize dimensional changes it is advisable to perform alveolar ridge preservation after tooth extractions. Different biomaterials are used for this purpose. The aim of this study was to investigate the qualitative and quantitative histological changes in human biopsies taken after 6 months of healing of extraction sockets with buccal wall defects. For this purpose, the defects of 36 patients (18 per group) were treated with injectable biphasic calcium phosphate (I-BCP) or bovine xenograft (BX) after extraction. After six months of healing, biopsies were taken and proceeded to the histology laboratory. No evidence of an inflammatory response of the tissue was observed in the biopsies of either group, and the newly formed bone (NB) was in close contact with the remaining biomaterial (BM). The histomorphometric results showed that there was no statistically significant difference between the groups in the mean percentage of NB (p = 0.854), BM (p = 0.129), and soft tissue (p = 0.094). To conclude, both biomaterials exhibited osteoconductivity and biocompatibility and achieved satisfactory bone regeneration of buccal wall defects after tooth extraction.
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Affiliation(s)
- Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Marko Matijević
- Community Healthcare Center of Osijek-Baranja County, 31 000 Osijek, Croatia;
| | - Željka Perić Kačarević
- Department of Anatomy, Histology, Embriology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia;
- Botiss Biomaterials GmbH, 15806 Zossen, Germany
| | - Marijana Bićanić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Žarko Udiljak
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Ivana Butorac Prpić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.Č.); (M.T.); (M.B.); (Ž.U.); (I.B.P.)
| | - Ivan Miškulin
- Department of Public Health, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Slavko Čandrlić
- Department of Interdisciplinary Areas, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31 000 Osijek, Croatia;
| | - Aleksandar Včev
- Department of Pathophysiology, Physiology and Immunology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia
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13
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Kollek NJ, Pérez-Albacete Martínez C, Granero Marín JM, Maté Sánchez de Val JE. Prospective Clinical Study with New Materials for Tissue Regeneration: A Study in Humans. Eur J Dent 2023; 17:727-734. [PMID: 36195212 PMCID: PMC10569886 DOI: 10.1055/s-0042-1753453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022] Open
Abstract
OBJECTIVE This study was performed to evaluate the clinical, radiographic, and histomorphometric outcomes of novel bone grafting materials and dental membranes and to compare the results with current data from the literature. MATERIALS AND METHODS New synthetic bone substitutes, consisting of biphasic calcium phosphate in the ratio of 60% hydroxyapatite and 40% β-tricalcium phosphate, were applied in bony defects and covered by either a novel synthetic poly(lactic-co-glycolic) acid (PLGA) or porcine collagen membrane. A sample of 51 biomaterials was placed in a total of 20 patients during different surgical protocols. Implants were simultaneously inserted, and in the case of sinus floor elevations 6 months later. Pre- and postoperative cone-beam computed tomographies were taken. Bone biopsies were harvested from augmented sides and processed for histomorphometric evaluation. STATISTICAL ANALYSIS Averages and ranges were calculated for the percentage of newly formed bone, residual biomaterial, and connective tissue. Data were submitted to analyze the radiological mean differences in length, width, and density. Paired t-tests were deployed for the analysis of differences within each group between the baseline (preoperative) and the final (postoperative) measurements. RESULTS The mean bone gain in length and width were 0.96 ± 3.33 mm (+27.59%) and 1.22 ± 1.87 mm (+30.48%), respectively. The bone density was increased by a factor of 4, reaching an average of 387.47 ± 328.86 HU. Histomorphometric evaluations revealed new bone formation of 41.44 ± 5.37%, residual biomaterial of 24.91 ± 7.31%, and connective tissue of 33.64 ± 4.81%. The mean healing period was 8.32 ± 3.00 months. CONCLUSIONS Data from this study confirmed the suitability of the tested materials in dental surgery. The biomaterials may be recommended for various clinical procedures. A satisfactory level of increase of new bone was reported in augmented sides. No significant differences were observed between the tested membranes. PLGA membranes might be superior to collagen membranes for their easier handling.
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Affiliation(s)
- Nathalie Jeannette Kollek
- Department of Implant Dentistry, International Dental Research Institute, Catholic University San Antonio of Murcia (UCAM), Murcia, Spain
| | - Carlos Pérez-Albacete Martínez
- Department of Integrated Clinic for Adults, International Dental Research Institute, Catholic University San Antonio of Murcia, Murcia, Spain
| | - José Manuel Granero Marín
- Department of Restorative Dentistry, International Dental Research Institute, Catholic University San Antonio of Murcia (UCAM), Murcia, Spain
| | - José Eduardo Maté Sánchez de Val
- Department of Implant Dentistry and Periodontology, International Dental Research Institute, Catholic University San Antonio of Murcia, Murcia, Spain
- Department of Materials Science and Engineering, International Research Institute for Biomaterials, Catholic University San Antonio of Murcia, Murcia, Spain
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14
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Morgan N, Meeus J, Shujaat S, Cortellini S, Bornstein MM, Jacobs R. CBCT for Diagnostics, Treatment Planning and Monitoring of Sinus Floor Elevation Procedures. Diagnostics (Basel) 2023; 13:diagnostics13101684. [PMID: 37238169 DOI: 10.3390/diagnostics13101684] [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: 04/12/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Sinus floor elevation (SFE) is a standard surgical technique used to compensate for alveolar bone resorption in the posterior maxilla. Such a surgical procedure requires radiographic imaging pre- and postoperatively for diagnosis, treatment planning, and outcome assessment. Cone beam computed tomography (CBCT) has become a well-established imaging modality in the dentomaxillofacial region. The following narrative review is aimed to provide clinicians with an overview of the role of three-dimensional (3D) CBCT imaging for diagnostics, treatment planning, and postoperative monitoring of SFE procedures. CBCT imaging prior to SFE provides surgeons with a more detailed view of the surgical site, allows for the detection of potential pathologies three-dimensionally, and helps to virtually plan the procedure more precisely while reducing patient morbidity. In addition, it serves as a useful follow-up tool for assessing sinus and bone graft changes. Meanwhile, using CBCT imaging has to be standardized and justified based on the recognized diagnostic imaging guidelines, taking into account both the technical and clinical considerations. Future studies are recommended to incorporate artificial intelligence-based solutions for automating and standardizing the diagnostic and decision-making process in the context of SFE procedures to further improve the standards of patient care.
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Affiliation(s)
- Nermin Morgan
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt
| | - Jan Meeus
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia
| | - Simone Cortellini
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven, 3000 Leuven, Belgium
- Department of Dentistry, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, 141 04 Huddinge, Sweden
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15
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Oguić M, Čandrlić M, Tomas M, Vidaković B, Blašković M, Jerbić Radetić AT, Zoričić Cvek S, Kuiš D, Cvijanović Peloza O. Osteogenic Potential of Autologous Dentin Graft Compared with Bovine Xenograft Mixed with Autologous Bone in the Esthetic Zone: Radiographic, Histologic and Immunohistochemical Evaluation. Int J Mol Sci 2023; 24:ijms24076440. [PMID: 37047413 PMCID: PMC10094989 DOI: 10.3390/ijms24076440] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
This prospective, randomized, controlled clinical trial reports clinical, radiographic, histologic and immunohistochemical results of autologous dentin graft (ADG) and its comparison with a mixture of bovine xenograft with autologous bone (BX+AB). After tooth extraction in the esthetic zone of maxilla, the alveolar ridge of 20 patients in the test group was augmented with ADG, while 17 patients in the control group received the combination of BX+AB. Cone beam computed tomography (CBCT) was performed before tooth extraction and after 4 months when a total of 22 bone biopsies were harvested and subjected to histological and immunohistochemical analysis. Radiological analysis showed comparable results of bone dimension loss in both groups. Quantitative histologic analysis showed comparable results with no statistically significant differences between the groups. Immunohistochemical staining with TNF-α and BMP-4 antibodies revealed immunopositivity in both groups. A statistically significant difference between the groups was found in the intensity of TNF-α in the area of newly formed bone (p = 0.0003) and around remaining biomaterial particles (p = 0.0027), and in the intensity of BMP-4 in the area around biomaterial particles (p = 0.0001). Overall, ADG showed biocompatibility and achieved successful bone regeneration in the esthetic zone of the maxilla similar to BX+AB.
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Affiliation(s)
- Matko Oguić
- Doctoral School of Biomedicine and Health, Faculty of Medicine, University of Rijeka, 51 000 Rijeka, Croatia
- Dental Clinic Rident, 51 000 Rijeka, Croatia
| | - Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Bruno Vidaković
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Marko Blašković
- Private Practice, 51 000 Rijeka, Croatia
- Department of Oral Surgery, Faculty of Dental Medicine Rijeka, University of Rijeka, 51 000 Rijeka, Croatia
| | | | - Sanja Zoričić Cvek
- Department of Anatomy, Faculty of Medicine, University of Rijeka, 51 000 Rijeka, Croatia
| | - Davor Kuiš
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Department of Periodontology, Faculty of Dental Medicine Rijeka, University of Rijeka, 51 000 Rijeka, Croatia
- Clinical Hospital Center Rijeka, 51 000 Rijeka, Croatia
| | - Olga Cvijanović Peloza
- Department of Anatomy, Faculty of Medicine, University of Rijeka, 51 000 Rijeka, Croatia
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16
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Tomas M, Karl M, Čandrlić M, Matijević M, Juzbašić M, Peloza OC, Radetić ATJ, Kuiš D, Vidaković B, Ivanišević Z, Kačarević ŽP. A Histologic, Histomorphometric, and Immunohistochemical Evaluation of Anorganic Bovine Bone and Injectable Biphasic Calcium Phosphate in Humans: A Randomized Clinical Trial. Int J Mol Sci 2023; 24:ijms24065539. [PMID: 36982613 PMCID: PMC10056509 DOI: 10.3390/ijms24065539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023] Open
Abstract
Following trauma, chronic periapical process, or tooth extraction, a large loss of bone volume is noticed during the healing process. To facilitate the placement of dental implants, various surgical procedures are used for an optimal alveolar ridge profile, while maintaining adequate bone dimensions. The main aim of this study was to determine the healing ability (histologically and immunohistologically) of alveolar bone defects during augmentation with two different biomaterials: injectable biphasic calcium phosphate (BCP) and anorganic bovine bone (ABB). Thirty-eight subjects were randomly divided into two groups. The first group received the tested bone substitute biomaterial (BSB), i.e., BCP (maxresorb inject®), and the second group received an alternative to the gold standard, i.e., ABB (Bio-Oss®). The histopathological, histomorphometric, and immunohistochemical analyses gave comparable results for these bone substitute materials in terms of newly formed bone: (BCP: 39.91 ± 8.49%, ABB: 41.73 ± 13.99%), residual biomaterial (BCP: 28.61 ± 11.38%, ABB: 31.72 ± 15.52%), and soft tissue (BCP: 31.49 ± 11.09%, ABB: 26.54 ± 7.25%), with no significant difference found between the groups (p < 0.05, t-test), proving that BCP is equally suitable and successful for alveolar bone regeneration.
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Affiliation(s)
- Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Interdisciplinary University Study of Molecular Biosciences, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Matej Karl
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Marko Matijević
- Interdisciplinary University Study of Molecular Biosciences, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Community Healthcare Center of Osijek-Baranja County, 31 000 Osijek, Croatia
| | - Martina Juzbašić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Interdisciplinary University Study of Molecular Biosciences, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Olga Cvijanović Peloza
- Department of Anatomy, Faculty of Medicine, University of Rijeka, 51 000 Rijeka, Croatia
| | | | - Davor Kuiš
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Department of Periodontology, Faculty of Dental Medicine Rijeka, Univeristy of Rijeka, 51 000 Rijeka, Croatia
- Clinical Hospital Center Rijeka, 51 000 Rijeka, Croatia
| | - Bruno Vidaković
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Zrinka Ivanišević
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Correspondence: (Z.I.); (Ž.P.K.)
| | - Željka Perić Kačarević
- Interdisciplinary University Study of Molecular Biosciences, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Department of Anatomy, Histology, Embriology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Correspondence: (Z.I.); (Ž.P.K.)
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17
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van Dijk LA, Janssen NG, Nurmohamed SJ, Muradin MSM, Longoni A, Bakker RC, de Groot FG, de Bruijn JD, Gawlitta D, Rosenberg AJWP. Osteoinductive calcium phosphate with submicron topography as bone graft substitute for maxillary sinus floor augmentation: A translational study. Clin Oral Implants Res 2023; 34:177-195. [PMID: 36645164 DOI: 10.1111/clr.14028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 11/25/2022] [Accepted: 11/30/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The aim of this study was the preclinical and clinical evaluation of osteoinductive calcium phosphate with submicron surface topography as a bone graft substitute for maxillary sinus floor augmentation (MSFA). MATERIAL AND METHODS A preclinical sheep model of MSFA was used to compare a calcium phosphate with submicron needle-shaped topography (BCPN , MagnetOs Granules, Kuros Biosciences BV) to a calcium phosphate with submicron grain-shaped topography (BCPG ) and autologous bone graft (ABG) as controls. Secondly, a 10-patient, prospective, randomized, controlled trial was performed to compare BCPN to ABG in MSFA with two-stage implant placement. RESULTS The pre-clinical study demonstrated that both BCPN and BCPG were highly biocompatible, supported bony ingrowth with direct bone apposition against the material, and exhibited bone formation as early as 3 weeks post-implantation. However, BCPN demonstrated significantly more bone formation than BCPG at the study endpoint of 12 weeks. Only BCPN reached an equivalent amount of bone formation in the available space and a greater proportion of calcified material (bone + graft material) in the maxillary sinus compared to the "gold standard" ABG after 12 weeks. These results were validated in a small prospective clinical study, in which BCPN was found comparable to ABG in implant stability, bone height, new bone formation in trephine core biopsies, and overall clinical outcome. CONCLUSION This translational work demonstrates that osteoinductive calcium phosphates are promising bone graft substitutes for MSFA, whereas their bone-forming potential depends on the design of their surface features. Netherlands Trial Register, NL6436.
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Affiliation(s)
- Lukas A van Dijk
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Regenerative Medicine Center Utrecht, Utrecht, the Netherlands
- Kuros Biosciences BV, Bilthoven, the Netherlands
| | - Nard G Janssen
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Silke J Nurmohamed
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marvick S M Muradin
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alessia Longoni
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Regenerative Medicine Center Utrecht, Utrecht, the Netherlands
| | - Robbert C Bakker
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Joost D de Bruijn
- Kuros Biosciences BV, Bilthoven, the Netherlands
- School of Materials Science and Engineering, Queen Mary University of London, London, UK
| | - Debby Gawlitta
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Regenerative Medicine Center Utrecht, Utrecht, the Netherlands
| | - Antoine J W P Rosenberg
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
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Khijmatgar S, Del Fabbro M, Tumedei M, Testori T, Cenzato N, Tartaglia GM. Residual Bone Height and New Bone Formation after Maxillary Sinus Augmentation Procedure Using Biomaterials: A Network Meta-Analysis of Clinical Trials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1376. [PMID: 36837005 PMCID: PMC9962504 DOI: 10.3390/ma16041376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/26/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Different factors may affect new bone formation following maxillary sinus floor augmentation for the rehabilitation of posterior edentulous maxilla. The purpose of this study was to determine the influence of residual bone height (RBH) on new bone formation after lateral sinus augmentation utilizing different biomaterials, through a network meta-analysis (NMA). METHODS PUBMED, Scopus, and Web of Science electronic databases were searched until 31 December 2022 to obtain relevant articles. A hand search was also conducted. Randomised controlled studies on maxillary sinus augmentation comparing different grafting materials in patients with atrophic posterior maxilla, in need of prosthetic rehabilitation, were included. The risk of bias was assessed following the guidelines of the Cochrane Collaboration. The primary outcome was new bone formation (NBF), assessed histomorphometrically. The statistical analysis was performed by splitting the data according to RBH (<4 mm and ≥4 mm). RESULTS A total of 67 studies were eligible for conducting NMA. Overall, in the included studies, 1955 patients were treated and 2405 sinus augmentation procedures were performed. The biomaterials used were grouped into: autogenous bone (Auto), xenografts (XG), allografts (AG), alloplasts (AP), bioactive agents (Bio), hyaluronic acid (HA), and combinations of these. An inconsistency factor (IF) seen in the entire loop of the XG, AP, and Bio+AP was found to be statistically significant. The highest-ranked biomaterials for the <4 mm RBH outcome were XG+AG, XG+AP, and Auto. Similarly, the surface under the cumulative ranking curve (SUCRA) of biomaterials for ≥4 mm RBH was Auto, Bio+XG, and XG+Auto. CONCLUSION There is no grafting biomaterial that is consistently performing better than others. The performance of the materials in terms of NBF may depend on the RBH. While choosing a biomaterial, practitioners should consider both patient-specific aspects and sinus clinical characteristics.
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Affiliation(s)
- Shahnavaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Department of Oral Biology and Genomic Studies, AB Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore 575018, Karnataka, India
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Tiziano Testori
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Department of Implantology and Oral Rehabilitation, Dental Clinic, IRCCS Ospedale Galeazzi-Sant’Ambrogio, 20157 Milan, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Niccolò Cenzato
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Bonardi JP, Pereira RDS, Mourão CF, Coelho Mendes B, Lowenstein A, Montemezzi P, Giubilato F, Okamoto R, Hochuli-Vieira E. Clinical Assessment of Biphasic Calcium Phosphate in Granules and Paste Forms in Human Maxillary Sinus Bone Augmentation: A Randomized, Split-Mouth Clinical Trial. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1059. [PMID: 36770066 PMCID: PMC9918988 DOI: 10.3390/ma16031059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/19/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
The aim of the present study is to compare the biphasic calcium phosphate (BCP) using two different forms-(1) granules and (2) paste-in human maxillary sinus bone reconstruction as a split-mouth study using histomorphometric and immunolabeling for osteocalcin. Ten patients with bilateral maxillary posterior partial edentulism were selected in order to reconstruct bone height. They were divided into two groups: BCPG and BCP-P. After six months of bone healing, biopsies were harvested to assess the new bone formation and immunostaining for osteocalcin. The BCP g group had the following results: mean of bone formation in pristine bone 49.4 ± 21.6%, intermediate 49.4 ± 16.2%, and apical 55.3 ± 21.4%. The group BCP-P had a mean of 41.9 ± 17.3% in the pristine bone region, 37.5 ± 7.8% for intermediate, and 39.0 ± 13.5% for apical. The osteocalcin immunolabeling was high for both groups, demonstrating bone calcification. Thus, the two biomaterials present suitable results for the placement of dental implants.
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Affiliation(s)
- João Paulo Bonardi
- Department of Oral & Maxillofacial Surgery, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil
| | - Rodrigo dos Santos Pereira
- Department of Oral & Maxillofacial Surgery, University of Grande Rio-UNIGRANRIO, Rio de Janeiro 25071-202, Brazil
| | - Carlos F. Mourão
- Department of Periodontology, Division of Dental Research Administration, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Bruno Coelho Mendes
- Department of Oral & Maxillofacial Surgery, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil
| | - Adam Lowenstein
- Department of Periodontology, Division of Dental Research Administration, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | | | - Flavio Giubilato
- Department of Human Anatomy, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil
| | - Roberta Okamoto
- Department of Human Anatomy, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil
| | - Eduardo Hochuli-Vieira
- Department of Diagnostic and Surgery, Araraquara School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil
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Accuracy and Technical Predictability of Computer Guided Bone Harvesting from the Mandible: A Cone-Beam CT Analysis in 22 Consecutive Patients. J Funct Biomater 2022; 13:jfb13040292. [PMID: 36547552 PMCID: PMC9781005 DOI: 10.3390/jfb13040292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/28/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
This study assesses the accuracy and technical predictability of a computer-guided procedure for harvesting bone from the external oblique ridge using a patient-specific cutting guide. Twenty-two patients needing bone augmentation for implant placement were subjected to mandibular osteotomy employing a case-specific stereolithographic surgical guide generated through computer aided design. Differences between planned and real cut planes were measured comparing pre- and post-operative Cone Beam Computed Tomography images of the donor site according to six validated angular and displacement indexes. Accuracy and technical predictability were assessed for 119 osteotomy planes over the study population. Three different guide fitting approaches were compared. An average root-mean-square discrepancy of 0.52 (0.30-0.97) mm was detected. The accuracy of apical and medial planes was higher than the mesial and distal planes due to occasional antero-posterior guide shift. Fitting the guide with an extra reference point on the closest tooth performed better than using only the bone surface, with two indexes significantly lower and less disperse. The study showed that the surgical plan was actualized with a 1 mm safety margin, allowing effective nerve preservation and reducing technical variability. When possible, surgical guide design should allow fitting on the closest tooth based on both radiological and/or intra-oral scan data.
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Park WB, Kang P, Park W, Han JY. Use of a Lateral Sinus Bony Window as an Intraoral Donor Site for Guided Bone Regeneration in Wide Post-Extraction Defects. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121785. [PMID: 36556988 PMCID: PMC9782459 DOI: 10.3390/medicina58121785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/24/2022] [Accepted: 12/02/2022] [Indexed: 12/11/2022]
Abstract
Maxillary sinus augmentation (MSA) and guided bone regeneration (GBR) have shown successful clinical, radiological, and histological outcomes for implant-related bone reconstruction and have been used to augment bony defects of various shapes and sizes. This study demonstrated that the lateral sinus bony window obtained during MSA can be used as an autogenous block bone graft for the augmentation of wide post-extraction defects. During the uncovering procedure performed 6 months after surgery, the grafted lateral bony window was well integrated with the adjacent native bone, and complete bone filling was observed in all bony defects around the implants. All of the implants survived. Within the limitations of this study, autogenous block bone obtained from lateral window sites can be used as novel donors for the resolution of wide bony defects around implants.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea
- Private Practice in Periodontics and Implant Dentistry, Seoul 02771, Republic of Korea
| | - Philip Kang
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY 10032, USA
| | - Wonhee Park
- Department of Prosthodontics, Division of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
- Correspondence: ; Tel.: +82-2-2290-8671
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Lahoud P, Nader N, Younes R. Sinus Augmentation Using Mineralized Bone Allografts: A 6-Month Histological and Histomorphometric Analysis. J Maxillofac Oral Surg 2022; 21:1180-1190. [PMID: 36896082 PMCID: PMC9989108 DOI: 10.1007/s12663-022-01728-z] [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: 09/13/2021] [Accepted: 04/22/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The aim of this study was to evaluate, after a six-month healing period, the histological and histomorphometric results of mineralized bone allograft used in lateral sinus augmentation procedures. Materials and Methods Twenty-one pneumatized maxillary sinuses with residual bone height ≤ 4 mm were grafted with a mixture of 1/1 cortical and cancellous mineralized bone allograft using lateral sinus floor elevation. Six months later, during implant placement, a core biopsy was retrieved for histological and histomorphometric evaluation. Results Biopsies showed mature cancellous bone with no signs of acute or chronic inflammatory reactions. Higher magnification revealed new lamellar bone, active osteocytes and normal lamellar arrangement around Haversian canals interspersed with osteocytes in lacunae. At grafted bone periphery, a high concentration of osteoblastic/osteoclastic couple was noted, indicating active bone remodeling. Histomorphometric evaluation revealed an average vital bone content of 30.32% (25.00-44.00%), and a percentage of residual non-vital bone of 18.06% (14.05-25.00%). Conclusions Histological and histomorphometric evaluation indicated that the mixture of 1 to 1 cortical and cancellous mineralized bone allograft promoted de-novo bone formation and can be predictably used for sinus augmentation procedures.
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Affiliation(s)
- Pierre Lahoud
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
- Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Nabih Nader
- Department of Oral Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Ronald Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
- Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Pomini KT, Buchaim DV, Bighetti ACC, Andreo JC, Rosso MPDO, Escudero JSB, Della Coletta BB, Alcalde MP, Duarte MAH, Pitol DL, Issa JPM, Ervolino E, Moscatel MBM, Bellini MZ, de Souza AT, Soares WC, Buchaim RL. Use of Photobiomodulation Combined with Fibrin Sealant and Bone Substitute Improving the Bone Repair of Critical Defects. Polymers (Basel) 2022; 14:polym14194170. [PMID: 36236116 PMCID: PMC9572221 DOI: 10.3390/polym14194170] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
In this preclinical protocol, an adjunct method is used in an attempt to overcome the limitations of conventional therapeutic approaches applied to bone repair of large bone defects filled with scaffolds. Thus, we evaluate the effects of photobiomodulation therapy (PBMT) on the bone repair process on defects filled with demineralized bovine bone (B) and fibrin sealant (T). The groups were BC (blood clot), BT (B + T), BCP (BC + PBMT), and BTP (B + T + PBMT). Microtomographically, BC and BCP presented a hypodense cavity with hyperdense regions adjacent to the border of the wound, with a slight increase at 42 days. BT and BTP presented discrete hyperdensing areas at the border and around the B particles. Quantitatively, BCP and BTP (16.96 ± 4.38; 17.37 ± 4.38) showed higher mean bone density volume in relation to BC and BT (14.42 ± 3.66; 13.44 ± 3.88). Histologically, BC and BCP presented deposition of immature bone at the periphery and at 42 days new bone tissue became lamellar with organized total collagen fibers. BT and BTP showed inflammatory infiltrate along the particles, but at 42 days, it was resolved, mainly in BTP. In the birefringence analysis, BT and BTP, the percentage of red birefringence increased (9.14% to 20.98% and 7.21% to 27.57%, respectively), but green birefringence was similar in relation to 14 days (3.3% to 3.5% and 3.5% to 4.2%, respectively). The number of osteocytes in the neoformed bone matrix proportionally reduced in all evaluated groups. Immunostaining of bone morphogenetic protein (BMP—2/4), osteocalcin (OCN), and vascular endothelial growth factor (VEGF) were higher in BCP and BTP when compared to the BC and BT groups (p < 0.05). An increased number of TRAP positive cells (tartrate resistant acid phosphatase) was observed in BT and BTP. We conclude that PBMT positively influenced the repair of bone defects filled with B and T.
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Affiliation(s)
- Karina Torres Pomini
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Postgraduate Department, University of Marilia (UNIMAR), Marilia 17525-902, Brazil
| | - Daniela Vieira Buchaim
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Postgraduate Department, University of Marilia (UNIMAR), Marilia 17525-902, Brazil
- Teaching and Research Coordination of the Medical School, University Center of Adamantina (UNIFAI), Adamantina 17800-000, Brazil
| | - Ana Carolina Cestari Bighetti
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
| | - Jesus Carlos Andreo
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
| | | | - José Stalin Bayas Escudero
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
| | - Bruna Botteon Della Coletta
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
| | - Murilo Priori Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo (FOB/USP), Bauru 17012-901, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo (FOB/USP), Bauru 17012-901, Brazil
| | - Dimitrius Leonardo Pitol
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Ribeirão Preto 14040-904, Brazil
| | - João Paulo Mardegan Issa
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Ribeirão Preto 14040-904, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16066-840, Brazil
| | | | - Márcia Zilioli Bellini
- Pro-Rectory of Research and Graduate Studies, University Center of Adamantina (UNIFAI), Adamantina 17800-000, Brazil
| | | | - Wendel Cleber Soares
- Vice-Rector/President, University Center of Adamantina (UNIFAI), Adamantina 17800-000, Brazil
| | - Rogerio Leone Buchaim
- Department of Biological Sciences, Bauru School of Dentistry (FOB/USP), University of São Paulo, Bauru 17012-901, Brazil
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of São Paulo (FMVZ/USP), São Paulo 05508-270, Brazil
- Correspondence: ; Tel.: +55-14-3235-8220
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McKenna GJ, Gjengedal H, Harkin J, Holland N, Moore C, Srinivasan M. EFFECT OF AUTOGENOUS BONE GRAFT SITE ON DENTAL IMPLANT SURVIVAL AND DONOR SITE COMPLICATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2022; 22:101731. [PMID: 36162883 DOI: 10.1016/j.jebdp.2022.101731] [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] [Received: 10/06/2021] [Revised: 03/10/2022] [Accepted: 03/30/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This systematic review and meta-analysis was undertaken to answer the following focus questions: Is the implant survival in augmented bone utilizing iliac crest bone grafts the same as while using intraoral autologous bone grafts? Is the incidence of postoperative donor site complications the same when using iliac crest bone grafts as opposed to intraoral grafts? METHODS Systematic searches of electronic databases (PubMed, Embase, CENTRAL) were performed to identify studies which reported on implant survival and postoperative complications for dental implants placed in grafted partially/completely edentulous human jaws. Studies were included if: they reported on 2-piece micro-rough surface root form dental implants placed in bone-augmented completely or partially edentulous human jaws, and the jaws must have been augmented with autologous bone graft materials. Time and nature of postoperative complications must have been reported. Two investigators performed data extraction and a Cohen's unweighted kappa was calculated for inter-investigator reliability. A meta-analysis was performed for the extracted data on implant survival rate in both iliac crest grafts and intra-oral grafts. A qualitative analysis was performed on the information extracted on graft donor site complications. Quality assessment of the included studies were done using the Cochrane collaboration tool and the Newcastle-Ottawa scales. RESULTS A total of 23 studies were included in the final analysis. The calculated kappa ranged between 0.77-0.89 for the literature search and identification process. Fourteen studies were included with data on implant survival including five randomized controlled clinical trials. The meta-analysis of included studies revealed that the implant survival rate of dental implants placed in jaws augmented with iliac crest grafts was lower than those placed in jaws augmented with intra-oral bone grafts at 6-months [ICG = 95.8% IOG = 98.4%; P < .001], 12-months [ICG = 97.0%, IOG = 98.4%; P < .001], 24-months [ICG = 85.9%, IOG = 98.2%; P < .001], 60-months [ICG = 90.0%, IOG = 91.5%; P < .001], and at 120-months [ICG = 88.8%, IOG = 95.2%; P < .001] follow-up periods. Iliac crest grafts were also frequently associated with donor site complications including pain / discomfort, gait disturbance, and sensory disturbance. CONCLUSIONS This systematic review and meta-analysis demonstrates that implant survival is consistently higher in bone harvested from intraoral sites compared to iliac crest grafts. Donor site complications seemed to be a frequent finding with iliac crest grafts and mental grafts. FUNDING None. REGISTRATION The review protocol was registered with PROSPERO: International prospective register of systematic reviews (CRD42021283738).
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Affiliation(s)
- Gerald J McKenna
- Clinical Reader / Consultant in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Harald Gjengedal
- Institute of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Jennifer Harkin
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Nicola Holland
- Specialty Registrar in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Ciaran Moore
- Specialty Registrar in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Murali Srinivasan
- Clinic of General-, Special care and Geriatric Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland.
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De Marco AC, Cavassini Torquato L, Camacho Ribeiro T, Moretto Nunes C, Vicensotto Bernardo A, Martins Maciel CC, Alberto Pereira K, Neves Jardini MA, Pedrine Santamaria M. Effect of Photobiomodulation Therapy Associated With Biphasic Phosphate Calcium on Bone Repair: A Histomorphometric Study in Rats. J Lasers Med Sci 2022; 13:e33. [PMID: 36743134 PMCID: PMC9841385 DOI: 10.34172/jlms.2022.33] [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: 10/29/2021] [Accepted: 06/30/2022] [Indexed: 01/27/2023]
Abstract
Introduction: This study aimed to investigate the effects of photobiomodulation (PBM) therapy associated with biphasic calcium phosphate on calvaria critical defects in rats. Methods: Forty-eight (90 days old) adult male rats (Rattus norvegicus, Albinus variation, Wistar) received critical defects of 5 mm in diameter, which were made on their skull, and they were randomly assigned into the following groups: C-blood clot, B-biphasic calcium phosphate, L-photobiomodulation therapy, and B + L-biphasic calcium phosphate + photobiomodulation therapy. A low-level a gallium aluminum arsenide (GaAlAs) laser was applied in a single dose during surgery, in a wavelength of 660 nm and total energy density of 45 J/cm2. On 30th and 60th days, the animals from each group were euthanized. Histological and histomorphometric analyses were performed. Results:In 30 days, almost all specimens (C, L, B and B + L) showed bone neoformation areas in regions near the borders of the surgical defect. In 60 days, in many specimens (C, L, B, B + L), it was possible to see a narrow neoformed bone structure along almost the whole extension of the surgical defect, though it was thinner than the original calvary bone. Data were recorded as mean ± standard deviation, and after normality was tested, a suitable statistical test was applied (α = 5%). On day 60, there was a statistically significant difference when comparing the proportion of neoformation area between group L (0.52%±0.13) and group B+L (0.20%±0.08). Group L showed a difference compared with all the groups when we compared the remaining distance between the edges of neoformed bone (C×L, P=0.0431; B × L, P=0.0386; L×B+L, P=0.0352), demonstrating a great defect closure. Conclusion: Our findings suggest that although biphasic calcium phosphate exerts some osteogenic activity during bone repair, PBM therapy is not able to modulate this process.
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Affiliation(s)
- Andréa Carvalho De Marco
- Assistant Professor, Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University (UNESP), Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil,Correspondence to Andréa Carvalho De Marco, ,
| | - Letícia Cavassini Torquato
- Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University (UNESP), Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil
| | | | - Camilla Moretto Nunes
- Professor, Division of Periodontology Pre-clinical, Faculdade Santo Antônio, Caçapava, Brazil
| | | | - Clarissa Carvalho Martins Maciel
- Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University (UNESP), Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil
| | - Kauê Alberto Pereira
- Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University (UNESP), Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil
| | - Maria Aparecida Neves Jardini
- Associated Professor, Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University UNESP, Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil
| | - Mauro Pedrine Santamaria
- Associated Professor, Department of Diagnosis and Surgery – Division of Periodontology, Sao Paulo State University UNESP, Institute of Science and Technology, Campus Sao Jose dos Campos, Brazil
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Rohr N, Brunner C, Bellon B, Fischer J, de Wild M. Characterization of a cotton-wool like composite bone graft material. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:61. [PMID: 35849225 PMCID: PMC9293850 DOI: 10.1007/s10856-022-06682-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
Bone graft materials are applied in patients to augment bone defects and enable the insertion of an implant in its ideal position. However, the currently available augmentation materials do not meet the requirements of being completely resorbed and replaced by new bone within 3 to 6 months. A novel electrospun cotton-wool like material (Bonewool®, Zurich Biomaterials LLC, Zurich, Switzerland) consisting of biodegradable poly(lactic-co-glycolic) acid (PLGA) fibers with incorporated amorphous ß-tricalcium phosphate (ß-TCP) nanoparticles has been compared to a frequently used bovine derived hydroxyapatite (Bio-Oss®, Geistlich Pharma, Wolhusen, Switzerland) in vitro. The material composition was determined and the degradation behavior (calcium release and pH in different solutions) as well as bioactivity has been measured. Degradation behavior of PLGA/ß-TCP was generally more progressive than for Bio-Oss®, indicating that this material is potentially completely resorbable. Graphical abstract.
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Affiliation(s)
- Nadja Rohr
- Biomaterials and Technology, Clinic for Reconstructive Dentistry, University Center for Dental Medicine Basel, Basel, Switzerland.
| | - Claudia Brunner
- Biomaterials and Technology, Clinic for Reconstructive Dentistry, University Center for Dental Medicine Basel, Basel, Switzerland
- Private Practice, Oberentfelden, Switzerland
| | - Benjamin Bellon
- Department of Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland
| | - Jens Fischer
- Biomaterials and Technology, Clinic for Reconstructive Dentistry, University Center for Dental Medicine Basel, Basel, Switzerland
| | - Michael de Wild
- School of Life Sciences, Institute for Medical Engineering and Medical Informatics IM², University of Applied Sciences Northwestern Switzerland, Muttenz, Switzerland
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Zhu W, Chen R, Wang W, Liu Y, Shi C, Tang S, Tang G. Fabrication of Naturally Derived Double-Network Hydrogels With a Sustained Aspirin Release System for Facilitating Bone Regeneration. Front Chem 2022; 10:874985. [PMID: 35419346 PMCID: PMC8995466 DOI: 10.3389/fchem.2022.874985] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/08/2022] [Indexed: 12/20/2022] Open
Abstract
Continuous efforts on pursuit of effective drug delivery systems for engineering hydrogel scaffolds is considered a promising strategy for the bone-related diseases. Here, we developed a kind of acetylsalicylic acid (aspirin, ASA)–based double-network (DN) hydrogel containing the positively charged natural chitosan (CS) and methacrylated gelatin (GelMA) polymers. Combination of physical chain-entanglement, electrostatic interactions, and a chemically cross-linked methacrylated gelatin (GelMA) network led to the formation of a DN hydrogel, which had a suitable porous structure and favorable mechanical properties. After in situ encapsulation of aspirin agents, the resulting hydrogels were investigated as culturing matrices for adipose tissue–derived stromal cells (ADSCs) to evaluate their excellent biocompatibility and biological capacities on modulation of cell proliferation and differentiation. We further found that the long-term sustained ASA in the DN hydrogels could contribute to the anti-inflammation and osteoinductive properties, demonstrating a new strategy for bone tissue regeneration.
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Affiliation(s)
- Wenfeng Zhu
- Department of Orthopedics, Shanghai Post and Telecommunication Hospital, Shanghai, China
| | - Rui Chen
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Weiheng Wang
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yi Liu
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Changgui Shi
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, China
- *Correspondence: Changgui Shi, ; Songjun Tang, ; Guoke Tang,
| | - Songjun Tang
- Department of Orthopedics, Shanghai Post and Telecommunication Hospital, Shanghai, China
- *Correspondence: Changgui Shi, ; Songjun Tang, ; Guoke Tang,
| | - Guoke Tang
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
- *Correspondence: Changgui Shi, ; Songjun Tang, ; Guoke Tang,
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Kamolratanakul P, Mattheos N, Yodsanga S, Jansisyanont P. The impact of deproteinized bovine bone particle size on histological and clinical bone healing outcomes in the augmented sinus: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:361-371. [PMID: 35320619 DOI: 10.1111/cid.13083] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The effect of different deproteinized bovine bone mineral (DBBM) particle sizes on bone healing in maxillary sinus floor augmentation remains unclear. This study compared the newly formed tissue and angiogenesis-related bone healing after sinus floor augmentation using large or small DBBM particles. MATERIALS AND METHODS Overall 32 patients were randomly divided into two groups using either large (1-2 mm) or small (0.25-1 mm) DBBM particles for sinus floor augmentation. After 6 months, the mineralized tissue volume was calculated using micro-computed tomography (micro-CT) analysis. The newly formed tissue composition was histomorphometrically analyzed. Angiogenesis was also examined by means of vascular endothelial growth factor (VEGF) expression. Implant failure and marginal bone loss were measured at a 1-year follow-up. Statistical analysis was performed using independent samples t-test. RESULTS Micro-CT analysis demonstrated that grafting with large particles resulted in higher bone volume (6.99 ± 2.72 mm3 , p = 0.002) and Bone Volume/Tissue Volume (0.25 ± 0.1, p = 0.03) compared with small particles (3.76 ± 1.83 mm3 and 0.14 ± 0.13, respectively). Small particles showed higher non-mineralized tissue volume (26.31 mm3 ) compared with large particle group (17.4 ± 5.34 mm3 ) with p = 0.001. The histological data revealed significantly higher area of newly formed bone (32.15% ± 14.04% for the large particle and 15.99% ± 14.12% for the small particle groups, p = 0.004). Likewise, non-mineralized tissue was significantly greater in the small particle group (66.48% ± 20.97%) compared with the large particle group (44.36%, p = 0.016). Moreover, use of large particles resulted in a significantly higher VEGF staining intensity score and VEFG positive cells. No implant failure was recorded in both groups, while no difference was found in terms of marginal bone loss at the 1-year follow-up. CONCLUSIONS Sinus floor augmentation using large DBBM particles resulted in more angiogenesis expression, higher bone volume, and new bone formation at 6 months after sinus augmentation. However, clinical outcomes with regards to implant placement were similar in both groups.
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Affiliation(s)
- Paksinee Kamolratanakul
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Somchai Yodsanga
- Faculty of Dentistry, The Center of Excellence on Biomaterial, Chulalongkorn University, Bangkok, Thailand
| | - Pornchai Jansisyanont
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand
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Customized Allogeneic Bone Augmentation Improves Esthetic Outcome in Anteromaxillary Dental Implantation. Case Rep Dent 2022; 2022:6943930. [PMID: 35360384 PMCID: PMC8964193 DOI: 10.1155/2022/6943930] [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: 06/15/2021] [Revised: 02/04/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose In cases of severe atrophic maxilla or maxillary involution, augmentation is necessary for implant-supported prosthetics. Using bone grafts is a standard procedure, and using customized allogeneic bone blocks may be a predictable alternative before dental implantation. Clinical Findings. This case study shows the digital workflow, including a preimplantological augmentation by a customized allogeneic block, followed by soft tissue optimization and template-based dental implantation, after six months of healing. It is part of a three-year follow-up study on the resorption rate of allogeneic bone blocks. Outcomes. Allogeneic bone augmentation is an alternative treatment option to autologous bone grafts. It allows predictable advanced backward planning (ABP) even in the maxillary esthetic zone. Diameter-reduced implants show long-term stability of a minimum of three years after loading and excellent results of prosthetic fixtures. Conclusion Prefabricated customized allogeneic blocks for augmentation may increase the fitting accuracy of the graft, decrease morbidity, and reduce the operation time in esthetic maxillary rehabilitation.
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Kawecki F, Jann J, Fortin M, Auger FA, Faucheux N, Fradette J. Preclinical Evaluation of BMP-9-Treated Human Bone-like Substitutes for Alveolar Ridge Preservation following Tooth Extraction. Int J Mol Sci 2022; 23:ijms23063302. [PMID: 35328724 PMCID: PMC8952786 DOI: 10.3390/ijms23063302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
The success of dental implant treatment after tooth extraction is generally maximized by preserving the alveolar ridge using cell-free biomaterials. However, these treatments can be associated with inflammatory reactions, leading to additional bone volume loss hampering dental implant positioning. Our group developed a self-assembled bone-like substitute constituted of osteogenically induced human adipose-derived stromal/stem cells (hASCs). We hypothesized that a bone morphogenetic protein (BMP) supplementation could improve the in vitro osteogenic potential of the bone-like substitute, which would subsequently translate into enhanced alveolar bone healing after tooth extraction. ASCs displayed a better osteogenic response to BMP-9 than to BMP-2 in monolayer cell culture, as shown by higher transcript levels of the osteogenic markers RUNX2, osterix (OSX/SP7), and alkaline phosphatase after three and six days of treatment. Interestingly, BMP-9 treatment significantly increased OSX transcripts and alkaline phosphatase activity, as well as pro-angiogenic angiopoietin-1 gene expression, in engineered bone-like substitutes after 21 days of culture. Alveolar bone healing was investigated after molar extraction in nude rats. Microcomputed tomography and histological evaluations revealed similar, or even superior, global alveolar bone preservation when defects were filled with BMP-9-treated bone-like substitutes for ten weeks compared to a clinical-grade biomaterial, with adequate gingival re-epithelialization in the absence of resorption.
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Affiliation(s)
- Fabien Kawecki
- Centre de Recherche en Organogénèse Expérimentale de l’Université Laval, LOEX, Division of Regenerative Medicine, CHU de Québec Research Center-Université Laval, Quebec City, QC G1V 0A6, Canada; (F.K.); (M.F.); (F.A.A.)
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Jessica Jann
- Clinical Research Center of CHU de Sherbrooke, Department of Chemical and Biotechnological Engineering, Pharmacology Institute of Sherbrooke, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (J.J.); (N.F.)
| | - Michel Fortin
- Centre de Recherche en Organogénèse Expérimentale de l’Université Laval, LOEX, Division of Regenerative Medicine, CHU de Québec Research Center-Université Laval, Quebec City, QC G1V 0A6, Canada; (F.K.); (M.F.); (F.A.A.)
- Faculty of Dentistry, Université Laval, Quebec City, QC G1V 0A6, Canada
- Service of Oral and Maxillofacial Surgery, CHU de Québec-Université Laval, Quebec City, QC G1V 0A6, Canada
| | - François A. Auger
- Centre de Recherche en Organogénèse Expérimentale de l’Université Laval, LOEX, Division of Regenerative Medicine, CHU de Québec Research Center-Université Laval, Quebec City, QC G1V 0A6, Canada; (F.K.); (M.F.); (F.A.A.)
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Nathalie Faucheux
- Clinical Research Center of CHU de Sherbrooke, Department of Chemical and Biotechnological Engineering, Pharmacology Institute of Sherbrooke, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (J.J.); (N.F.)
| | - Julie Fradette
- Centre de Recherche en Organogénèse Expérimentale de l’Université Laval, LOEX, Division of Regenerative Medicine, CHU de Québec Research Center-Université Laval, Quebec City, QC G1V 0A6, Canada; (F.K.); (M.F.); (F.A.A.)
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Correspondence:
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Čandrlić M, Tomas M, Karl M, Malešić L, Včev A, Perić Kačarević Ž, Matijević M. Comparison of Injectable Biphasic Calcium Phosphate and a Bovine Xenograft in Socket Preservation: Qualitative and Quantitative Histologic Study in Humans. Int J Mol Sci 2022; 23:ijms23052539. [PMID: 35269686 PMCID: PMC8910217 DOI: 10.3390/ijms23052539] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 02/04/2023] Open
Abstract
This study is the first histologic evaluation of an injectable biphasic calcium phosphate (IBCP) in humans six months after socket preservation according to the principles of guided bone regeneration. After tooth extraction, the alveolar ridge of 21 patients was augmented with IBCP (maxresorb® inject) in the test group, while 20 patients in the control group received a bovine xenograft (BX) (cerabone®). Six months after augmentation, a reentry procedure was performed to collect biopsies of regenerated bone for qualitative and quantitative histologic analysis. A total of 20 biopsies were taken for analysis. Qualitative histologic analysis showed complete integration of the biomaterial and no inflammatory tissue reaction, indicating the biocompatibility of the bone grafts and the surrounding tissue in both groups. Histomorphometric analysis showed comparable results in terms of newly formed bone (IBCP: 26.47 ± 14.71%, BX: 30.47 ± 16.39%) and residual biomaterial (IBCP: 13.1 ± 14.07%, BX: 17.89 ± 11.81%), with no significant difference found across groups (p > 0.05, Mann—Whitney U test). Statistical significance between groups was found in the result of soft tissue percentage (IBCP: 60.43 ± 12.73%, BX: 51.64 ± 14.63%, p = 0.046, Mann—Whitney U test). To conclude, IBCP and BX showed good osteoconductivity and biocompatibility with comparable new bone formation six months after alveolar ridge preservation.
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Affiliation(s)
- Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.Č.); (M.T.); (M.K.)
- Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.Č.); (M.T.); (M.K.)
| | - Matej Karl
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia; (M.Č.); (M.T.); (M.K.)
- Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia
- Private Dental Practice Matej Karl, Prilaz Vilka Ivekovića 1, 31511 Belišće, Croatia
| | - Lucija Malešić
- Department of Anatomy, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia;
| | - Aleksandar Včev
- Department of Pathophysiology, Physiology and Immunology, Faculty of Dental medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Željka Perić Kačarević
- Department of Anatomy, Histology, Embriology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia
- Correspondence: (Ž.P.K.); (M.M.)
| | - Marko Matijević
- Community Healthcare Center of Osijek-Baranja County, 31000 Osijek, Croatia
- Correspondence: (Ž.P.K.); (M.M.)
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Hatt LP, Thompson K, Helms JA, Stoddart MJ, Armiento AR. Clinically relevant preclinical animal models for testing novel cranio-maxillofacial bone 3D-printed biomaterials. Clin Transl Med 2022; 12:e690. [PMID: 35170248 PMCID: PMC8847734 DOI: 10.1002/ctm2.690] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/01/2021] [Accepted: 12/15/2021] [Indexed: 12/19/2022] Open
Abstract
Bone tissue engineering is a rapidly developing field with potential for the regeneration of craniomaxillofacial (CMF) bones, with 3D printing being a suitable fabrication tool for patient‐specific implants. The CMF region includes a variety of different bones with distinct functions. The clinical implementation of tissue engineering concepts is currently poor, likely due to multiple reasons including the complexity of the CMF anatomy and biology, and the limited relevance of the currently used preclinical models. The ‘recapitulation of a human disease’ is a core requisite of preclinical animal models, but this aspect is often neglected, with a vast majority of studies failing to identify the specific clinical indication they are targeting and/or the rationale for choosing one animal model over another. Currently, there are no suitable guidelines that propose the most appropriate animal model to address a specific CMF pathology and no standards are established to test the efficacy of biomaterials or tissue engineered constructs in the CMF field. This review reports the current clinical scenario of CMF reconstruction, then discusses the numerous limitations of currently used preclinical animal models employed for validating 3D‐printed tissue engineered constructs and the need to reduce animal work that does not address a specific clinical question. We will highlight critical research aspects to consider, to pave a clinically driven path for the development of new tissue engineered materials for CMF reconstruction.
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Affiliation(s)
- Luan P Hatt
- Regenerative Orthopaedics Program, AO Research Institute Davos, Davos, Platz, Switzerland.,Department of Health Sciences and Techonology, Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
| | - Keith Thompson
- Regenerative Orthopaedics Program, AO Research Institute Davos, Davos, Platz, Switzerland
| | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford University, Palo Alto, California
| | - Martin J Stoddart
- Regenerative Orthopaedics Program, AO Research Institute Davos, Davos, Platz, Switzerland
| | - Angela R Armiento
- Regenerative Orthopaedics Program, AO Research Institute Davos, Davos, Platz, Switzerland
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Oliveira VXRD, Pinotti FE, Marcantonio RAC, Marcantonio Jr E, Oliveira GJPLD. Comparison of osseointegration in areas grafted with different osteoconductive biomaterials. Preclinical study. Braz Dent J 2022; 33:105-111. [DOI: 10.1590/0103-6440202204378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract This study evaluated osseointegration in areas grafted with deproteinized bovine bone (DBB) and biphasic ceramic based on hydroxyapatite and beta-tricalcium phosphate (HA/TCP) in rat tibias. Noncritical bone defects were made in the tibias of 28 rats that were randomly assigned to 2 groups: DBB: DBB-filled defects and HA/TCP: HA/TCP-filled defects. Bone defects were made in the tibias bilaterally and filled with biomaterials. After 60 days, the implants were inserted, and the animals were euthanized 15 and 45 days after the implants were installed. Osseointegration was evaluated by biomechanical, microtomographic and histometric analysis. Implants installed in the defects filled with DBB presented higher removal torque forces (2.33 ± 0.51 Ncm vs. 1.50 ± 0.54 Ncm) and mineralized tissue volume around implants at 15 days (34.96 ± 3.68 % vs. 25.61 ± 2.95 %) and greater bone-implant contact (20.87 ± 8.28 % vs. 11.52 ± 7.42 %) and bone area within implant threads (26.83 ± 12.35 % vs. 11.98 ± 7.56 %) at 45 days compared to the measurements of implants in areas grafted with HA/TCP. Implants installed in defects in areas grafted with DBB had a better osseointegration pattern than implants placed in defects in areas grafted with HA/TCP.
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Inchingolo F, Hazballa D, Inchingolo AD, Malcangi G, Marinelli G, Mancini A, Maggiore ME, Bordea IR, Scarano A, Farronato M, Tartaglia GM, Lorusso F, Inchingolo AM, Dipalma G. Innovative Concepts and Recent Breakthrough for Engineered Graft and Constructs for Bone Regeneration: A Literature Systematic Review. MATERIALS 2022; 15:ma15031120. [PMID: 35161065 PMCID: PMC8839672 DOI: 10.3390/ma15031120] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 02/06/2023]
Abstract
Background: For decades, regenerative medicine and dentistry have been improved with new therapies and innovative clinical protocols. The aim of the present investigation was to evaluate through a critical review the recent innovations in the field of bone regeneration with a focus on the healing potentials and clinical protocols of bone substitutes combined with engineered constructs, growth factors and photobiomodulation applications. Methods: A Boolean systematic search was conducted by PubMed/Medline, PubMed/Central, Web of Science and Google scholar databases according to the PRISMA guidelines. Results: After the initial screening, a total of 304 papers were considered eligible for the qualitative synthesis. The articles included were categorized according to the main topics: alloplastic bone substitutes, autologous teeth derived substitutes, xenografts, platelet-derived concentrates, laser therapy, microbiota and bone metabolism and mesenchymal cells construct. Conclusions: The effectiveness of the present investigation showed that the use of biocompatible and bio-resorbable bone substitutes are related to the high-predictability of the bone regeneration protocols, while the oral microbiota and systemic health of the patient produce a clinical advantage for the long-term success of the regeneration procedures and implant-supported restorations. The use of growth factors is able to reduce the co-morbidity of the regenerative procedure ameliorating the post-operative healing phase. The LLLT is an adjuvant protocol to improve the soft and hard tissues response for bone regeneration treatment protocols.
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Affiliation(s)
- Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Maria Elena Maggiore
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Farronato
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (D.H.); (A.D.I.); (G.M.); (G.M.); (A.M.); (M.E.M.); (A.M.I.)
- Correspondence: (F.I.); (F.L.); (G.D.); Tel.: +39-3312111104 (F.I.); +39-3282132586 (F.L.); +39-3396989939 (G.D.)
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Buchaim DV, Andreo JC, Pomini KT, Barraviera B, Ferreira Júnior RS, Duarte MAH, Alcalde MP, Reis CHB, Teixeira DDB, Bueno CRDS, Detregiachi CRP, Araujo AC, Buchaim RL. A biocomplex to repair experimental critical size defects associated with photobiomodulation therapy. J Venom Anim Toxins Incl Trop Dis 2022; 28:e20210056. [PMID: 35261617 PMCID: PMC8863337 DOI: 10.1590/1678-9199-jvatitd-2021-0056] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/16/2021] [Indexed: 02/14/2023] Open
Affiliation(s)
- Daniela Vieira Buchaim
- University of Marilia, Brazil; University Center of Adamantina, Brazil; São Paulo State University, Brazil
| | | | | | - Benedito Barraviera
- São Paulo State University, Brazil; São Paulo State University, Brazil; São Paulo State University, Brazil
| | - Rui Seabra Ferreira Júnior
- São Paulo State University, Brazil; São Paulo State University, Brazil; São Paulo State University, Brazil
| | | | | | | | | | | | | | | | - Rogério Leone Buchaim
- São Paulo State University, Brazil; University of São Paulo, Brazil; University of São Paulo, Brazil
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Comparison of Bone Regeneration in Different Forms of Bovine Bone Scaffolds with Recombinant Human Bone Morphogenetic Protein-2. Int J Mol Sci 2021; 22:ijms222011121. [PMID: 34681785 PMCID: PMC8537640 DOI: 10.3390/ijms222011121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to compare the bone regeneration ability of particle and block bones, acting as bone scaffolds, with recombinant human bone morphogenetic protein (rhBMP)-2 and evaluate them as rhBMP-2 carriers. Demineralized bovine bone particles, blocks, and rhBMP-2 were grafted into the subperiosteal space of a rat calvarial bone, and the rats were randomly divided into four groups: particle, block, P (particle)+BMP, and B (block)+BMP groups. The bone volume of the B+BMP group was significantly higher than that of the other groups (p < 0.00), with no significant difference in bone mineral density. The average adipose tissue volume of the B+BMP group was higher than that of the P+BMP group, although the difference was not significant. Adipose tissue formation was observed in the rhBMP-2 application group. Histologically, the particle and B+BMP groups showed higher formation of a new bone. However, adipose tissue and void spaces were also formed, especially in the B+BMP group. Hence, despite the formation of a large central void space, rhBMP-2 could be effectively used with block bone scaffolds and showed excellent new bone formation. Further studies are required to evaluate the changes in adipose tissue.
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Jerbić Radetić AT, Zoričić Cvek S, Tomas M, Erjavec I, Oguić M, Perić Kačarević Ž, Cvijanović Peloza O. CSBD Healing in Rats after Application of Bovine Xenogeneic Biomaterial Enriched with Magnesium Alloy. Int J Mol Sci 2021; 22:ijms22169089. [PMID: 34445794 PMCID: PMC8396602 DOI: 10.3390/ijms22169089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/14/2021] [Accepted: 08/20/2021] [Indexed: 01/10/2023] Open
Abstract
Xenogeneic biomaterials Cerbone® and OsteoBiol® are widely used in oral implantology. In dental practice, xenogeneic biomaterial is usually combined with autologous bone to provide bone volume stability needed for long-term dental implants. Magnesium alloy implants dissolve and form mineral corrosion layer that is directly in contact with bone tissue, allowing deposition of the newly formed bone. CSBD heals by intramembranous ossification and therefore is a convenient model for analyses of ostoconductive and osteoinductive properties of different type of biomaterials. Magnesium alloy-enriched biomaterials have not yet been applied in oral implantology. Therefore, the aim of the current study was to investigate biological properties of potentially new bovine xenogeneic biomaterial enriched with magnesium alloy in a 5 mm CSBD model. Osteoconductive properties of Cerabone®, Cerabone® + Al. bone, and OsteoBiol® were also analyzed. Dynamics of bone healing was followed up on the days 3, 7, 15, 21, and 30. Calvary bone samples were analyzed by micro-CT, and values of the bone morphometric parameters were assessed. Bone samples were further processed for histological and immunohistochemical analyses. Histological observation revealed CSBD closure at day 30 of the given xenogeneic biomaterial groups, with the exception of the control group. TNF-α showed high intensity of expression at the sites of MSC clusters that underwent ossification. Osx was expressed in pre-osteoblasts, which were differentiated into mature osteoblasts and osteocytes. Results of the micro-CT analyses showed linear increase in bone volume of all xenogeneic biomaterial groups and also in the control. The highest average values of bone volume were found for the Cerabone® + Mg group. In addition, less residual biomaterial was estimated in the Cerabone® + Mg group than in the Cerabone® group, indicating its better biodegradation during CSBD healing. Overall, the magnesium alloy xenogeneic biomaterial demonstrated key properties of osteoinduction and biodegradidibility during CSBD healing, which is the reason why it should be recommended for application in clinical practice of oral implantology.
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Affiliation(s)
| | - Sanja Zoričić Cvek
- Department of Anatomy, Medical Faculty, University of Rijeka, 51 000 Rijeka, Croatia; (A.T.J.R.); (S.Z.C.)
| | - Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia;
| | - Igor Erjavec
- Medical Faculty, University of Zagreb, 10 000 Zagreb, Croatia;
| | | | - Željka Perić Kačarević
- Department of Anatomy, Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia;
| | - Olga Cvijanović Peloza
- Department of Anatomy, Medical Faculty, University of Rijeka, 51 000 Rijeka, Croatia; (A.T.J.R.); (S.Z.C.)
- Correspondence: ; Tel.: +385-91-8998-421
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Tomas M, Čandrlić M, Juzbašić M, Ivanišević Z, Matijević N, Včev A, Cvijanović Peloza O, Matijević M, Perić Kačarević Ž. Synthetic Injectable Biomaterials for Alveolar Bone Regeneration in Animal and Human Studies. MATERIALS 2021; 14:ma14112858. [PMID: 34073551 PMCID: PMC8197881 DOI: 10.3390/ma14112858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/13/2021] [Accepted: 05/22/2021] [Indexed: 01/18/2023]
Abstract
After tooth extraction, the alveolar ridge undergoes dimensional changes. Different bone regeneration biomaterials are used to reduce bone loss. The aim of this article was to systematically review the literature on the effect of injectable synthetic biomaterials and their advantages and disadvantages for new bone formation in the maxilla and mandible in animals and humans. A literature search was conducted in November 2020 via MEDLINE PubMed, Cochrane, and Embase. Of the 501 records screened, abstract analysis was performed on 49 articles, resulting in 21 studies that met the inclusion criteria. Animal studies have shown heterogeneity in terms of animal models, follow-up time, composition of the injectable biomaterial, and different outcome variables such as bone–implant contact, newly formed bone, and peri-implant bone density. Heterogeneity has also been demonstrated by human studies. The following outcomes were observed: newly formed bone, connective tissue, residual injectable bone graft substitute, radiographic density, residual bone height, and different follow-up periods. Further studies, especially in humans, based on the histological and biomechanical properties of the injectable delivery form, are needed to draw more concrete conclusions that will contribute to a better understanding of the benefits of this type of biomaterials and their role in bone regeneration.
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Affiliation(s)
- Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.T.); (M.Č.); (M.J.); (Z.I.); (N.M.)
- Interdisciplinary University Study of Molecular Biosciences, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.T.); (M.Č.); (M.J.); (Z.I.); (N.M.)
- Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Martina Juzbašić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.T.); (M.Č.); (M.J.); (Z.I.); (N.M.)
- Interdisciplinary University Study of Molecular Biosciences, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Zrinka Ivanišević
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.T.); (M.Č.); (M.J.); (Z.I.); (N.M.)
| | - Nikola Matijević
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.T.); (M.Č.); (M.J.); (Z.I.); (N.M.)
- Interdisciplinary University Study of Molecular Biosciences, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
| | - Aleksandar Včev
- Department of Pathophysiology, Physiology and Immunology, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia;
| | - Olga Cvijanović Peloza
- Department of Anatomy, Medical Faculty of the University of Rijeka, 51 000 Rijeka, Croatia;
| | - Marko Matijević
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia; (M.T.); (M.Č.); (M.J.); (Z.I.); (N.M.)
- Correspondence: (M.M.); (Ž.P.K.)
| | - Željka Perić Kačarević
- Department of Anatomy, Histology, Embriology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Correspondence: (M.M.); (Ž.P.K.)
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Kaba YN, Öner Nİ, Amuk M, Bilge S, Soylu E, Demirbaş AE. Evaluation of trabecular bone healing using fractal dimension analysis after augmentation of alveolar crests with autogenous bone grafts: a preliminary study. Oral Radiol 2021; 38:139-146. [PMID: 34003449 DOI: 10.1007/s11282-021-00536-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/08/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate bone remodeling after alveolar crest augmentation with autogenous bone grafts. METHODS 50 patients who were applied augmentation due to alveolar deficiency were included in this study. Fractal dimensions were measured on the radiographs in the preoperative, postoperative, follow-up periods. The ROI was selected specific to each patient, but repeated in a standardized manner on subsequent radiographs. RESULTS A total of 50 patients were included in the study; There were 31 females and 19 males. Implants were placed in all patients without any complications. The mean fractal dimensions on the graft recipient side were statistically higher in the postoperative 5th month compared to the postoperative 1st week (p = 0.002). The mean fractal dimensions on the donor side were statistically higher in the preoperative and postoperative 5th month compared to the postoperative 1st week (p < 0.001). CONCLUSION Any clinical imaging method cannot fully reflect the histological microstructures of the bone. Evaluating the fractal analysis together with the clinical results can demonstrate adequate bone healing and quality prior to implant placement. Fractal analysis is a non-invasive, reproducible, method but further, prospective, randomized, controlled clinical studies are needed to estimate bone quality prior to implant placement.
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Affiliation(s)
- Yusuf Nuri Kaba
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
| | - Neşe İspekter Öner
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey. .,Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey.
| | - Mehmet Amuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
| | - Suheyb Bilge
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
| | - Emrah Soylu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
| | - Ahmet Emin Demirbaş
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Melikgazi, Turkey
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Tang G, Liu Z, Liu Y, Yu J, Wang X, Tan Z, Ye X. Recent Trends in the Development of Bone Regenerative Biomaterials. Front Cell Dev Biol 2021; 9:665813. [PMID: 34026758 PMCID: PMC8138062 DOI: 10.3389/fcell.2021.665813] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/01/2021] [Indexed: 12/12/2022] Open
Abstract
The goal of a biomaterial is to support the bone tissue regeneration process at the defect site and eventually degrade in situ and get replaced with the newly generated bone tissue. Biomaterials that enhance bone regeneration have a wealth of potential clinical applications from the treatment of non-union fractures to spinal fusion. The use of bone regenerative biomaterials from bioceramics and polymeric components to support bone cell and tissue growth is a longstanding area of interest. Recently, various forms of bone repair materials such as hydrogel, nanofiber scaffolds, and 3D printing composite scaffolds are emerging. Current challenges include the engineering of biomaterials that can match both the mechanical and biological context of bone tissue matrix and support the vascularization of large tissue constructs. Biomaterials with new levels of biofunctionality that attempt to recreate nanoscale topographical, biofactor, and gene delivery cues from the extracellular environment are emerging as interesting candidate bone regenerative biomaterials. This review has been sculptured around a case-by-case basis of current research that is being undertaken in the field of bone regeneration engineering. We will highlight the current progress in the development of physicochemical properties and applications of bone defect repair materials and their perspectives in bone regeneration.
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Affiliation(s)
- Guoke Tang
- Department of Orthopedic Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Spine Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medical CSU, Hunan, China
- Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Zhiqin Liu
- Department of Spine Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medical CSU, Hunan, China
| | - Yi Liu
- Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jiangming Yu
- Department of Orthopedic Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xing Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Zhihong Tan
- Department of Spine Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medical CSU, Hunan, China
| | - Xiaojian Ye
- Department of Orthopedic Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Leocádio ADCS, Silva M, de Oliveira GJPL, Marcantonio É. Osseointegration of different implant surfaces in areas grafted with deproteinized bovine bone associated or not with fresh bone marrow-Preclinical study in rabbits. Clin Oral Implants Res 2021; 32:767-775. [PMID: 33749041 DOI: 10.1111/clr.13746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 12/28/2020] [Accepted: 03/03/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To assess the influence of two different implant surfaces on osseointegration in maxillary sinuses of rabbits previously grafted with deproteinized bovine bone (DBB) associated or not with fresh bone marrow (BM). MATERIAL AND METHODS Sixteen New Zealand albino rabbits (males, 3.5/4.5 kg and 9-12 months old) were randomly divided into two groups with 8 rabbits each, according to the type of association of biomaterials used to fill the animals' maxillary sinuses: DBB (Deproteinized Bovine Bone) and DBB/BM (Deproteinized bovine bone associated with fresh autologous bone marrow). Ninety (90) days following the grafting procedure, the animals received implants in the area with two different microstructures (SA-Sandblasting + acid attack and SA-H-Sandblasting + acid attack + immersion in 0.9% sodium chloride isotonic solution). All rabbits were euthanized 90 days after implant placement. The microtomographic analysis was performed to verify the number of mineralized tissues around the implants throughout their length (%BV/TV), while the histomorphometric analysis was performed to verify the percentage of bone-implant contact around the implants throughout their length (%BIC). RESULTS We observed no differences in the quantity for %BV/TV (DBB-SA:33.25 ± 19.67; DBB-SA-H:35.15 ± 22.17; DBB/BM-SA:39.71 ± 24.21; DBB/BM-SA-H:36.40 ± 23.07) and %BIC (DBB-SA:58.94 ± 24.37; DBB-SA-H:52.52 ± 24.36; DBB/BM-SA: 61.66 ± 14.60; DBB/BM-SA-H: 64.06 ± 23.30) between the groups assessed. CONCLUSIONS The addition of BM and the type of surface did not influence the osseointegration of implants installed in areas grafted with sintered deproteinized bovine bone at high temperatures in the late period assessed.
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Affiliation(s)
| | - Matusalém Silva
- Post Graduation Course in Implantology, Instituto Latino-americano de pesquisa odontológica (ILAPEO), Curitiba, Brazil
| | | | - Élcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Univ Est Paulista/UNESP, Araraquara, Brazil.,Post Graduation Course in Implantology, Instituto Latino-americano de pesquisa odontológica (ILAPEO), Curitiba, Brazil
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Park WB, Han JY, Kang KL. Long-Term Comparison of Survival and Marginal Bone of Implants with and without Sinus Augmentation in Maxillary Molars within the Same Patients: A 5.8- to 22-Year Retrospective Study. J Clin Med 2021; 10:jcm10071360. [PMID: 33806214 PMCID: PMC8036778 DOI: 10.3390/jcm10071360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/13/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022] Open
Abstract
Maxillary sinus floor augmentation (MSFA) is widely used and considered a predictable procedure for implant placement. However, the influence of MSFA on implant survival and marginal bone loss (MBL) is still inconclusive. The purpose of this retrospective observational study is to evaluate the long-term genuine influence of MSFA on the survival and MBL of implants by comparing those with and without MSFA only in maxillary molars within the same patients. Thirty-eight patients (28 male and 10 female), with a total of 119 implants, received implants with and without MSFA, and were followed up for 5.8 to 22 years. Patient- and implant-related factors were assessed with a frailty model for implant survival and with generalized estimation equations (GEE) for MBL around the implant. No variables showed a statistical significance for implant failure in the frailty model. In GEE analysis for MBL, MSFA did not show any statistical significance. In conclusion, MSFA demonstrated no significant influence on implant failure and MBL in posterior maxilla in this study.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul 05278, Korea;
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea;
| | - Kyung-Lhi Kang
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul 05278, Korea;
- Correspondence: ; Tel.: +82-2-440-7515; Fax: +82-2-440-7549
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Toledano-Serrabona J, Romeu-I-Fontanet A, Gay-Escoda C, Camps-Font O, Sánchez-Garcés MÁ. Clinical and histological outcomes of maxillary sinus floor augmentation with synthetic bone substitutes for dental implant treatment: A meta-analysis. J ORAL IMPLANTOL 2021; 48:158-167. [PMID: 33465775 DOI: 10.1563/aaid-joi-d-20-00202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of the present review was to gather all available human randomized clinical trials comparing the clinical and histological results of synthetic bone substitutes used in maxillary sinus floor augmentation. Authors electronically searched in Pubmed/Medline, Scopus and Cochrane databases to analyse the success of endosseous dental implant, implant failure, peri-implant marginal bone loss, newly formed bone and residual bone graft material. After the search, ten randomized clinical trials were included. Four studies ranging from low to unclear risk of bias were used for meta-analysis, being able to compare only biphasic calcium phosphate (BCP) and deproteinized bovine bone (DBB). A greater amount of residual graft material (mean difference -MD- 4.80 mm; 95% CI, 9.35 to 0.26; P= 0.040) was found in DBB group. No other statistically significant differences were found between BCP and DBB for the rest of outcomes. Thus, our results suggested that BCP can be considered a suitable alternative to DBB in maxillary sinus floor augmentation due to its clinical and histological results.
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Affiliation(s)
- Jorge Toledano-Serrabona
- Institut d'Investigacio Biomedica de Bellvitge Oral Surgery C/Feixa Llarga s/n SPAIN Barcelona Barcelona 08907 Institut d'Investigacio Biomedica de Bellvitge
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Intapibool P, Monmaturapoj N, Nampuksa K, Thongkorn K, Khongkhunthian P. Bone regeneration of a polymeric sponge technique-Alloplastic bone substitute materials compared with a commercial synthetic bone material (MBCP+TM technology): A histomorphometric study in porcine skull. Clin Exp Dent Res 2021; 7:726-738. [PMID: 33410285 PMCID: PMC8543482 DOI: 10.1002/cre2.394] [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] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 12/13/2020] [Accepted: 12/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background Polymeric sponge technique is recommended for developing the desired porosity of Biphasic calcium phosphate (BCP) which may favor bone regeneration. Purpose To investigate the healing of BCP with ratio of HA30/β‐TCP70 (HA30) and HA70/β‐TCP30 (HA70) polymeric sponge preparation, compare to commercial BCP (MBCP+TM). Materials and Methods Materials were tested X‐ray diffraction (XRD) pattern and scanning electron microscope (SEM) analysis. In eight male pigs, six calvarial defects were created in each subject. The defects were the filled with 1 cc of autogenous bone, MBCP+TM (MBCP), HA30, HA70, and left empty (negative group). The new bone formations, residual material particles and bone‐to‐graft contacts were analyzed at 4, 8, 12 and 16 weeks. Results Fabricated BCP showed well‐distributed porosity. At 16 weeks, new bone formations were 45.26% (autogenous), 33.52% (MBCP), 24.34% (HA30), 19.43% (HA70) and 3.37% (negative). Residual material particles were 1.88% (autogenous), 17.58% (MBCP), 26.74% (HA30) and 37.03% (HA70). These values were not significant differences (Bonferroni correction <0.005). Bone‐to‐graft contacts were 73.68% (MBCP), which was significantly higher than 41.68% (HA30) and 14.32% (HA70; Bonferroni correction <0.017). Conclusions Polymeric sponge technique offers well‐distributed porosity. The new bone formation and residual material particles were comparable to MBCP+TM, but the bone‐to‐graft contact was lower than MBCP+TM.
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Affiliation(s)
- Punyada Intapibool
- Faculty of Dentistry, Center of Excellence for Dental Implantology, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Kriangkrai Thongkorn
- Faculty of Veterinary Medicine, Department of Companion Animal and Wildlife Clinic, Chiang Mai University, Chiang Mai, Thailand
| | - Pathawee Khongkhunthian
- Faculty of Dentistry, Center of Excellence for Dental Implantology, Chiang Mai University, Chiang Mai, Thailand
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Safety and Efficacy Results of BonoFill First-in-Human, Phase I/IIa Clinical Trial for the Maxillofacial Indication of Sinus Augmentation and Mandibular Bone Void Filling. J Oral Maxillofac Surg 2020; 79:787-798.e2. [PMID: 33434518 DOI: 10.1016/j.joms.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE The gold standard for bone regeneration of bone deficiencies is still an autologous bone graft, which has considerable disadvantages; namely, the need for a second major surgery and the limited volume of bone available for harvesting. BonoFill (BF) is a novel, tissue-engineered, bone graft with intrinsic osteoinductive, osteoconductive, and osteogenic properties, consisting of the patient's own adipose tissue-derived mesenchymal stem cells, attached to hydroxyapatite particles. Here, we present the safety and efficacy results of BF first-in-human clinical study for maxillofacial bone tissue regeneration. MATERIALS AND METHODS Eleven eligible male and female subjects, aged 49-65 years, were enrolled into the clinical study in 2 clinical indications: Bone augmentation and bone void grafting in the jaws. Clinical follow-up was performed throughout a period of 6 months after BF treatment and included clinical examination, blood tests, CT scans, and biopsies collected from the transplantation site to assess chronic bone infection, changes in complete blood count, and adequate bone augmentation for implant placement. RESULTS The study results demonstrated that BF promoted adequate bone tissue regeneration without complications. Per our evaluation, there were no incidents of chronic bone infection, or significant changes in complete blood count, and the patients reported overall good health for the duration of the study. At trial end, in the sinus augmentation indication, the BF treated sites residual bone was augmented at an average of 6.36 mm (Δ new bone, n = 10) and the total bone height at the treated area was on average 11.44 mm (n = 10). In the indication of filling of bone voids, the patient's average residual bone height of 2.91 mm was 15.76 mm (n = 1) at trial end. CONCLUSIONS BF treatment was shown to be safe and resulted in newly generated bone, which provided adequate bone height for placement of dental implants. Thus, BF is a promising novel autologous bone graft for bone tissue repair.
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Dos Santos Trento G, Hassumi JS, Buzo Frigério P, Farnezi Bassi AP, Okamoto R, Gabrielli MAC, Pereira-Filho VA. Gene expression, immunohistochemical and microarchitectural evaluation of bone formation around two implant surfaces placed in bone defects filled or not with bone substitute material. Int J Implant Dent 2020; 6:80. [PMID: 33258065 PMCID: PMC7704835 DOI: 10.1186/s40729-020-00279-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/06/2020] [Indexed: 11/19/2022] Open
Abstract
Objective The aim of this study is to evaluate through gene expression, immunohistochemical and microtomographic (micro-CT) analysis the response of peri-implant bone tissue around titanium implants with different surface treatments, placed in bone defects filled or not with bone substitute materials. In addition, to investigate the hypothesis that porous-hydrophilic surface induces a faster bone formation. Materials and methods Twenty-six animals were divided into two groups according to implant surface treatment. In each tibia, a bone defect was created followed by the placement of one implant. On the left tibia, the defect was filled with blood clot (BC), and on the right tibia, the defect was filled with biphasic hydroxyapatite/β-tricalcium-phosphate (HA/TCP) generating four subgroups: BC-N: bone defect filled with blood clot and porous surface titanium implant installed; BC-A: bone defect filled with blood clot and porous-hydrophilic surface titanium implant installed; HA/TCP-N: bone defect filled with bone substitute material and porous surface titanium implant installed; and HA/TCP-A: bone defect filled with bone substitute material and porous-hydrophilic surface titanium implant installed. The animals were submitted to euthanasia at 15, 30, and 60 days after implant installation. The expression of two genes was evaluated: RUNX2 and BSP. Immunohistochemical analyses were performed for detection of RUNX2, OPN, OCN, OPG, and RANKL antibodies and bone matrix proteins. Finally, four parameters were chosen for micro-CT analysis: trabecular number, separation and thickness, and connectivity density. Results Descriptive analysis showed similar findings among the experimental groups. Moreover, porous-hydrophilic surfaces presented a higher expression of RUNX2, which is probably an indicative of better osteogenesis; although the data from this study may be considered an insufficient support for a concrete statement. Conclusion Porous hydrophilic surface can improve and accelerate protein expression and bone formation.
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Affiliation(s)
- Guilherme Dos Santos Trento
- Department of Diagnosis and Surgery, School of Dentistry, Sao Paulo State University (Unesp), 1680th Humaitá Street, Araraquara, SP, 14801-903, Brazil.
| | - Jaqueline Suemi Hassumi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Paula Buzo Frigério
- Department of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Ana Paula Farnezi Bassi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Roberta Okamoto
- Department of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University (Unesp), Araçatuba, Brazil
| | - Marisa Aparecida Cabrini Gabrielli
- Department of Diagnosis and Surgery, School of Dentistry, Sao Paulo State University (Unesp), 1680th Humaitá Street, Araraquara, SP, 14801-903, Brazil
| | - Valfrido Antonio Pereira-Filho
- Department of Diagnosis and Surgery, School of Dentistry, Sao Paulo State University (Unesp), 1680th Humaitá Street, Araraquara, SP, 14801-903, Brazil
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Starch-Jensen T, Deluiz D, Bruun NH, Tinoco EMB. Maxillary Sinus Floor Augmentation with Autogenous Bone Graft Alone Compared with Alternate Grafting Materials: a Systematic Review and Meta-Analysis Focusing on Histomorphometric Outcome. J Oral Maxillofac Res 2020; 11:e2. [PMID: 33262881 PMCID: PMC7644272 DOI: 10.5037/jomr.2020.11302] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/10/2020] [Indexed: 11/16/2022]
Abstract
Objectives The objective of present systematic review was to test the hypothesis of no difference in histomorphometric outcome after maxillary sinus floor augmentation with autogenous bone graft alone compared with alternate grafting materials applying the lateral window technique. Material and Methods MEDLINE (PubMed), Embase and Cochrane library search in combination with hand-search of relevant journals were conducted. Human studies published in English until the 25th of March, 2020 were included. Histomorphometric outcomes were evaluated by descriptive statistics and meta-analysis including 95% confidence interval (CI). Results Electronic search and hand-searching resulted in 1902 entries. Sixteen randomized controlled trials with unclear risk of bias fulfilled the inclusion criteria. Descriptive statistics showed comparable or improved histomorphometric outcomes with autogenous bone graft. Meta-analysis revealed a mean difference of -7.1% (CI = -11.0 to -3.2) indicating a significant higher amount of bone after maxillary sinus floor augmentation with autogenous bone graft compared with alternate grafting materials. Subgroup analysis demonstrated a non-significantly differences of -3.7% (CI = -10.9 to 3.4), -11.5% (CI = -25.9 to 2.8), 2.2% (CI = -16.9 to 21.3), and -4.6% (CI = -14.4 to 5.2), when autogenous bone graft was compared with allogeneic bone graft, xenograft, composite grafting materials involving xenograft or synthetic biomaterial mixed with autogenous bone graft, respectively. Conclusions Maxillary sinus floor augmentation with autogenous bone graft seems to facilitate improved histomorphometric outcomes compared with alternate grafting materials. However, the included studies were characterised by an unclear risk of bias and various methodological confounding factors. Hence, the conclusions drawn from the results of present study should be interpreted with caution.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
| | - Daniel Deluiz
- Department of Periodontology, Rio de Janeiro State University, Rio de JaneiroBrazil
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, AalborgDenmark
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Würdinger R, Donkiewicz P. Allogeneic cortical struts and bone granules for challenging alveolar reconstructions: An innovative approach toward an established technique. J ESTHET RESTOR DENT 2020; 32:747-756. [PMID: 32920939 DOI: 10.1111/jerd.12639] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/16/2020] [Accepted: 07/26/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The shell technique is a well-established procedure for GBR with which extensive osseous defects can be predictably restored by using cortical bone struts harvested from various intraoral aspects. Recent publications have demonstrated comparable results for autologous and allogeneic bone grafts, whereas the evidence on allogeneic cortical struts remains limited. CLINICAL CONSIDERATIONS In this case series, we demonstrate the regeneration of five complex alveolar bone defects in four patients with subsequent insertion of fixed dental implants. In all cases, cortical struts made from human donor bone were applied in combination with allogeneic bone granules and collagen membranes. CONCLUSIONS Similar to autologous cortical shells, the allogeneic struts functioned by creating an immobile container with which the osseous defects in all patients could be successfully restored, enabling placement of dental implants in accordance with the treatment plan. Even when the containers were solely filled with allogeneic granules, vascularized healthy tissue was present at re-entry, demonstrating the vast potential of these materials for applications in dentistry. CLINICAL SIGNIFICANCE Especially when it comes to regeneration of complex alveolar bone defects, autologous bone grafts are often outlined as the only treatment modality. Here we show that innovative biomaterials like allogeneic bone grafts hold the potential to mimic the functions of autologous bone transplants and provide excellent clinical results without the requirement of a second surgical side for bone harvesting and no risk of donor-site morbidity.
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Affiliation(s)
| | - Phil Donkiewicz
- Department of Oral Surgery and Dental Emergency Care, Faculty of Health, School of Dentistry Witten/Herdecke University, North Rhine-Westphalia, Germany
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Cellular responses to deproteinized bovine bone mineral biofunctionalized with bone-conditioned medium. Clin Oral Investig 2020; 25:2159-2173. [PMID: 32870390 PMCID: PMC7966141 DOI: 10.1007/s00784-020-03528-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/13/2020] [Indexed: 01/30/2023]
Abstract
OBJECTIVES The aim of the study was to investigate whether the osteoinductive properties of bone-conditioned medium (BCM) harvested from cortical bone chips within a clinically relevant short-term period can enhance the biologic characteristics of deproteinized bovine bone mineral (DBBM) in vitro. MATERIALS AND METHODS To assess the biofunctionalization of DBBM, the adhesive, proliferative, and differentiation properties of mesenchymal stromal ST2, pre-osteoblastic MC3T3-E1, and primary bone-derived cells grown on BCM-coated DBBM were examined by crystal violet staining of adherent cells, BrdU ELISA, and qRT-PCR, respectively. RESULTS BCM extracted within 20 min or 24 h in either Ringer's solution (BCM-RS) or RS mixed with autologous serum (BCM-RS + S) increased the adhesive properties of all three cell types seeded on DBBM. The 20-min BCM-RS preparation appeared more potent than the 24-h preparation. BCM-RS made within 20 min or 24 h had strong pro-proliferative effects on all cell types grown on DBBM. RS + S alone exhibited a considerable pro-proliferative effect, suggesting an impact of the serum on cellular growth. DBBM coated with BCM-RS or BCM-RS + S, made within 20 min or 24 h each, caused a significant induction of osteogenic differentiation marker expression with a higher potency of the BCM-RS + S. Finally, a strong additive effect of fresh bone chips combined with BCM-coated DBBM on the osteogenic differentiation of the three cell types was observed. CONCLUSIONS Altogether, the data strongly support the biofunctionalization of DBBM with BCM extracted within a clinically relevant time window of 20 min. CLINICAL RELEVANCE Pre-activation of non-osteoinductive biomaterials with BCM, prepared from autologous bone chips during a guided bone regeneration (GBR) procedure, bears the potential of an optimal treatment modality for bone defects in daily practice.
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Souza EQM, Costa Klaus AE, Espósito Santos BF, Carvalho da Costa M, Ervolino E, Coelho de Lima D, Fernandes LA. Evaluations of hydroxyapatite and bioactive glass in the repair of critical size bone defects in rat calvaria. J Oral Biol Craniofac Res 2020; 10:422-429. [PMID: 32775186 DOI: 10.1016/j.jobcr.2020.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/10/2020] [Accepted: 07/19/2020] [Indexed: 01/02/2023] Open
Abstract
To overcome the morbidity of autogenous graft removal and limitations of allogeneic and xenogeneic grafts, a great interest exists in the development of biomaterials of synthetic origin. OBJECTIVE The aim of this study was to evaluate the biological behavior of a novel bioactive glass (60% SiO2- 36% CaO-4% P2O5) as bone substitute in critical calvaria defects of rats, in comparison to hydroxyapatite. METHODS Sixty male Wistar rats were divided in three groups, according to the treatment: Control Group (C) - blood clot; Hydroxyapatite (HA) - particulate hydroxyapatite (≤0,5 mm); and Bioactive Glass (BG) - particulate bioactive glass (0.04-1 mm). RESULTS From the intergroup analysis, it was observed that Group C presented a greater newly formed bone area (NBA) when compared to Groups HA and BG. In addition, Group HA showed higher NBA when compared to Group BG at 30 and 60 days (P < 0.05). Immunohistochemistry revealed that groups HA and BG presented high and moderate osteocalcin immunolabeling respectively. Group HA displayed a greater number of TRAP-positive cells compared to Groups C and BG at 30 and 60 days (p < 0.05). CONCLUSION From these results, we can conclude that the resorption rate of hydroxyapatite is higher than the novel bioactive glass, which maintained significant higher volume until the last experimental period. Both of the tested biomaterials acted as osteoconductors during bone repair, and their physical characteristics importantly influenced this process.
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Affiliation(s)
| | | | | | | | - Edilson Ervolino
- Professor of Integral Dedication to the Doctrine and Research - São Paulo State University "Júlio de Mesquita Filho" (UNESP), Brazil
| | - Daniela Coelho de Lima
- Doctor in Public Health, Adjunct Professor IV - Federal University of Alfenas (UNIFAL-MG), Brazil
| | - Leandro Araújo Fernandes
- Doctor in Periodontics, Adjunct Professor IV - Federal University of Alfenas (UNIFAL-MG), Brazil
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