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Fernandes GVO, Castro F, Pereira RM, Teixeira W, Gehrke S, Joly JC, Blanco Carrion J, Fernandes JCH. Critical-size defects reconstruction with four different bone grafts associated with e-PTFE membrane: A histomorphometric experimental in vivo study. Clin Oral Implants Res 2024; 35:167-178. [PMID: 37987205 DOI: 10.1111/clr.14210] [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: 05/08/2023] [Revised: 10/20/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES The goal of this study was to assess the newly formed bone and the remnant biomaterial by comparing four different bone grafts used to treat critical-size defects, associated or not with the non-resorbable membrane. MATERIALS AND METHODS Two calvaria critical-size bone defects were created in 50 male Wistar rats. They were divided into blood (G1), autogenous (G2), bioglass (G3), hydroxyapatite (G4), and xenograft (G5) groups, associated or not with e-PTFE. The experimental periods were 15 and 45 days. Sections were prepared for histomorphometric assessment. All data were analyzed by the mixed-effects model with multiple comparisons (significance level, p < .05). RESULTS A similar level of new bone was observed for all groups, associated with a high level of vascularization. G1 and G2 ensured sovereignty over the greater quantity of new bone. A non-significant result was reported comparing groups with and without membranes. No significant result was found between the experimental synthetic biomaterials (G3 and G4). G5L achieved 22.0% of new bone after 45 days (p > .05). All groups had a stable volume of biomaterial kept in the short term (p > .05). G2 was the best material for new bone formation and final volume of biomaterial, followed by G4 < G5 < G3. Thus, it is possible that G4 had a better degradation profile among the experimental groups. CONCLUSIONS The best results were found in the autogenous group, with higher resorption and integration; non-significative new bone was found among the experimental groups; and the regeneration of critical bone defects using an e-PTFE barrier did not present significant results on new bone formation.
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Affiliation(s)
- Gustavo Vicentis Oliveira Fernandes
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- A. T. Still University, St. Louis, Missouri, USA
| | - Filipe Castro
- FP-I3ID, FCS, Universidade Fernando Pessoa, Porto, Portugal
| | - Rafael Martins Pereira
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Wendel Teixeira
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Sérgio Gehrke
- Department of Research, Bioface/PgO/UCAM, Montevideo, Uruguay
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Chatzipetros E, Damaskos S, Tosios KI, Christopoulos P, Donta C, Kalogirou EM, Yfanti Z, Tsiourvas D, Papavasiliou A, Tsiklakis K. The effect of nano-hydroxyapatite/chitosan scaffolds on rat calvarial defects for bone regeneration. Int J Implant Dent 2021; 7:40. [PMID: 34027572 PMCID: PMC8141479 DOI: 10.1186/s40729-021-00327-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/18/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND This study aims at determining the biological effect of 75/25 w/w nano-hydroxyapatite/chitosan (nHAp/CS) scaffolds on bone regeneration, in terms of fraction of bone regeneration (FBR), total number of osteocytes (Ost), and osteocyte cell density (CD), as well as its biodegradability. METHODS Two critical-size defects (CSDs) were bilaterally trephined in the parietal bone of 36 adult Sprague-Dawley rats (18 males and 18 females); the left remained empty (group A), while the right CSD was filled with nHAp/CS scaffold (group B). Two female rats died postoperatively. Twelve, 11, and 11 rats were euthanized at 2, 4, and 8 weeks post-surgery, respectively. Subsequently, 34 specimens were resected containing both CSDs. Histological and histomorphometric analyses were performed to determine the FBR, calculated as [the sum of areas of newly formed bone in lateral and central regions of interest (ROIs)]/area of the original defect, as well as the Ost and the CD (Ost/mm2) in each ROI of both groups (A and B). Moreover, biodegradability of the nHAp/CS scaffolds was estimated via the surface area of the biomaterial (BmA) in the 2nd, 4th, and 8th week post-surgery. RESULTS The FBR of group B increased significantly from 2nd to 8th week compared to group A (P = 0.009). Both the mean CD and the mean Ost values of group B increased compared to group A (P = 0.004 and P < 0.05 respectively). Moreover, the mean value of BmA decreased from 2nd to 8th week (P = 0.001). CONCLUSIONS Based on histological and histomorphometric results, we support that 75/25 w/w nHAp/CS scaffolds provide an effective space for new bone formation.
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Affiliation(s)
- Emmanouil Chatzipetros
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, 11527, Goudi, Athens, Greece.
| | - Spyros Damaskos
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, 11527, Goudi, Athens, Greece
| | - Konstantinos I Tosios
- Department of Oral Medicine and Pathology, Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Panos Christopoulos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Catherine Donta
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, 11527, Goudi, Athens, Greece
| | - Eleni-Marina Kalogirou
- Department of Oral Medicine and Pathology, Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Zafeiroula Yfanti
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, 11527, Goudi, Athens, Greece
| | - Dimitris Tsiourvas
- Institute of Nanoscience and Nanotechnology, National Centre for Scientific Research "Demokritos", Aghia Paraskevi, Attiki, Greece
| | - Aggeliki Papavasiliou
- Institute of Nanoscience and Nanotechnology, National Centre for Scientific Research "Demokritos", Aghia Paraskevi, Attiki, Greece
| | - Kostas Tsiklakis
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, 11527, Goudi, Athens, Greece
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Wang S, Yang J, Zhao G, Liu R, Du Y, Cai Z, Luan J, Shen Y, Chen B. Current applications of platelet gels in wound healing-A review. Wound Repair Regen 2021; 29:370-379. [PMID: 33749992 DOI: 10.1111/wrr.12896] [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: 10/18/2019] [Revised: 12/27/2020] [Accepted: 01/13/2021] [Indexed: 12/21/2022]
Abstract
Human platelets play important roles in several physiologic and pathologic processes. Platelet concentrates are activated with thrombin or calcium, resulting in a viscous coagulum (platelet gel [PG]), composed of 95% platelets at least. PG is increasingly used for the treatment of a variety of soft and hard tissue defects, most notably in the management of chronic non-healing wounds. During wound healing, platelets not only play a critical role in primary hemostasis and thrombosis, but also release growth factors and cytokines to promote tissue regeneration, enhance collagen synthesis, and trigger an immune response. This review addresses a variety of aspects relevant to the functions of well-known platelet growth factors, animal and clinical studies of PG in the last decade, and different sources of platelets for PG. PG is used for non-healing chronic wounds, such as oral ulcerations related to epidermolysis bullosa and chronic graft-versus-host disease, for those, the traditional treatment effect is poor. PG maybe provide a new therapeutic direction for these diseases. Nevertheless, some uncertainty is present, the number of clinical studies is not enough. Hence, randomized controlled trials are still required to study the potential of the use of PG in the near future.
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Affiliation(s)
- Shujun Wang
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China.,Jinling Hospital Department Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
| | - Jie Yang
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Guangchao Zhao
- Jinling Hospital Department Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
| | - Ran Liu
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ying Du
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Zhimei Cai
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Jianfeng Luan
- Jinling Hospital Department Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
| | - Yanfei Shen
- School of Medicine, Southeast University, Nanjing, China
| | - Baoan Chen
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Which substances loaded onto collagen scaffolds influence oral tissue regeneration?-an overview of the last 15 years. Clin Oral Investig 2020; 24:3363-3394. [PMID: 32827278 DOI: 10.1007/s00784-020-03520-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/10/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Collagen scaffolds are widely used for guided bone or tissue regeneration. Aiming to enhance their regenerative properties, studies have loaded various substances onto these scaffolds. This review aims to provide an overview of existing literature which conducted in vitro, in vivo, and clinical testing of drug-loaded collagen scaffolds and analyze their outcome of promoting oral regeneration. MATERIALS AND METHODS PubMed, Scopus, and Ovid Medline® were systematically searched for publications from 2005 to 2019. Journal articles assessing the effect of substances on oral hard or soft tissue regeneration, while using collagen carriers, were screened and qualitatively analyzed. Studies were grouped according to their used substance type-biological medical products, pharmaceuticals, and tissue-, cell-, and matrix-derived products. RESULTS A total of 77 publications, applying 36 different substances, were included. Collagen scaffolds were demonstrating favorable adsorption behavior and release kinetics which could even be modified. BMP-2 was investigated most frequently, showing positive effects on oral tissue regeneration. BMP-9 showed comparable results at lower concentrations. Also, FGF2 enhanced bone and periodontal healing. Antibiotics improved the scaffold's anti-microbial activity and reduced the penetrability for bacteria. CONCLUSION Growth factors showed promising results for oral tissue regeneration, while other substances were investigated less frequently. Found effects of investigated substances as well as adsorption and release properties of collagen scaffolds should be considered for further investigation. CLINICAL RELEVANCE Collagen scaffolds are reliable carriers for any of the applied substances. BMP-2, BMP-9, and FGF2 showed enhanced bone and periodontal healing. Antibiotics improved anti-microbial properties of the scaffolds.
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5
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Senos R, Hankenson K. Calvaria critical-size defects in rats using piezoelectric equipment: a comparison with the classic trephine. Injury 2020; 51:1509-1514. [PMID: 32448465 PMCID: PMC8245198 DOI: 10.1016/j.injury.2020.04.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 04/17/2020] [Accepted: 04/25/2020] [Indexed: 02/02/2023]
Abstract
Calvarial critical-size defects in rats are used to study regeneration of both craniofacial bone and long-bones. For decades, the trephine technique has been used with no notable refinements in the procedure. The use of piezoelectric surgical equipment has increased in human clinical oral and maxillofacial surgery, neurosurgery, traumatology, and orthopedics, because the devices are easy to handle, and can cut bone without damaging sensitive soft tissues such as blood vessels, nerves, and membranes. This study evaluated and compared the surgical technique and bone regeneration process between a traditional hand-drill trephine and piezoelectric equipment in a critical-size calvaria defect in a rat model. Thirty SD male rats were randomly divided into two groups and had either a 7.9mm diameter circular defect created with trephine or a 7.0mm square defect using the piezoelectric device, both creating 49 mm2 defect areas. MicroCT and histology were performed at 45 and 75d after surgery. While trephine surgeries were performed faster than piezoelectric (25.5 minutes vs 38.5 minutes), the rate of complications was much higher, with 36% of trephine rats taking 20 minutes to achieve hemostasis. Although the extent of new bone formation was similar between the two surgical groups, the piezoelectric technique resulted in 50% less variability. No additional new bone formation was observed from 45 to 75d in both techniques. Piezoelectric technique represents a refined and more reproducible technique for calvarial defect generation in comparison to classic trephine methods.
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Affiliation(s)
- R. Senos
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, USA,Department of Biomedical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, USA
| | - K.D. Hankenson
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, USA
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Donos N, Dereka X, Calciolari E. The use of bioactive factors to enhance bone regeneration: A narrative review. J Clin Periodontol 2019; 46 Suppl 21:124-161. [DOI: 10.1111/jcpe.13048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
| | - Xanthippi Dereka
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
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Chatzipetros E, Christopoulos P, Donta C, Tosios KI, Tsiambas E, Tsiourvas D, Kalogirou EM, Tsiklakis K. Application of nano-hydroxyapatite/chitosan scaffolds on rat calvarial critical-sized defects: A pilot study. Med Oral Patol Oral Cir Bucal 2018; 23:e625-e632. [PMID: 30148464 PMCID: PMC6167094 DOI: 10.4317/medoral.22455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/08/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The purpose of this pilot study was to evaluate for the first time the effect of 75/25 w/w nano-Hydroxyapatite/Chitosan (nHAp/CS) scaffolds on Guided Bone Regeneration (GBR) in rat calvarial critical-sized defects (CSDs). MATERIAL AND METHODS Six adult Sprague Dawley rats, 3 males and 3 females, were used. Two CSDs, full thickness and 5mm in diameter, were trephined in both sides of the parietal bone. The right CSD was filled with nHAp/CS scaffold, while the left CSD remained empty, as the control group. The wound was sutured in layers. Rats were euthanized with diethyl ether inhalation at 2, 4 and 8 weeks after surgical procedure. Histological and histomorphometric analysis was performed within distinct regions of interest (ROI): the lateral area inward of the middle sagittal seam; the lateral area outward of the middle sagittal seam and the central area. RESULTS The mean surface of newly formed bone (in μm2) in the lateral area inward of the middle sagittal seam of all rats was significantly higher (P=0.039) in the experimental group (91733.00±38855.60) than the control group (46762.17±25507.97). The NOex-c, defined as total number of osteocytes (OST) in newly formed bone surface in experimental group [experimental OST] minus the total number of osteocytes in newly formed bone surface in control group [control OST], was significantly greater (P=0.029) at 4th week post-surgery. Within the experimental group, a statistically significant increase (P=0.042) in the surface of newly formed bone was noticed in rats euthanized in 4th week compared with rats euthanized in 2nd week after surgery in the lateral area inward of the middle sagittal seam. CONCLUSIONS The results of this study suggest that 75/25 w/w nHAp/CS scaffolds should be considered as a suitable biomaterial for GBR.
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Affiliation(s)
- E Chatzipetros
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, 11527, Goudi, Athens, Greece,
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8
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Childers EP, Dreger NZ, Ellenberger AB, Wandel MB, Domino K, Xu Y, Luong D, Yu J, Orsini D, Bell RH, Premanandan C, Fening SD, Becker ML. Enhanced Rotator-Cuff Repair Using Platelet-Rich Plasma Adsorbed on Branched Poly(ester urea)s. Biomacromolecules 2018; 19:3129-3139. [DOI: 10.1021/acs.biomac.8b00725] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Erin P. Childers
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325, United States
| | - Nathan Z. Dreger
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325, United States
| | - Alex B. Ellenberger
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325, United States
| | - Mary Beth Wandel
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325, United States
| | - Karen Domino
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325, United States
| | - Yanyi Xu
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325, United States
| | - Derek Luong
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325, United States
| | - Jiayi Yu
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325, United States
| | - David Orsini
- Summa Health System, Akron, Ohio 44304, United States
| | - Robert H. Bell
- Department of Orthopaedics, Crystal Clinic, Inc., Akron, Ohio 44333, United States
| | - Christopher Premanandan
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio 43210, United States
| | - Stephen D. Fening
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - Matthew L. Becker
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325, United States
- Department of Biomedical Engineering, The University of Akron, Akron, Ohio 44325, United States
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Develos Godoy DJ, Banlunara W, Jaroenporn S, Sangvanich P, Thunyakitpisal P. Collagen and mPCL-TCP scaffolds induced differential bone regeneration in ovary-intact and ovariectomized rats. Biomed Mater Eng 2018; 29:389-399. [PMID: 29578466 DOI: 10.3233/bme-181733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The data on biomaterial-mediated bone regeneration directly comparing commercially available scaffolds in aging and osteoporotic conditions remain sparse. OBJECTIVE To investigate the effects of an absorbable collagen sponge (ACS) and a medical grade polycaprolactone-tricalcium phosphate (mPCL-TCP) scaffold on calvarial defect healing in ovary-intact and ovariectomized rats. METHODS Forty-two, 5-month old female Sprague-Dawley rats were divided into sham (OVI) or ovariectomy (OVX) groups (n=21). When rats reached 6 months old, 7 mm diameter calvarial defects were created and treated, further dividing each group into blood clot control, mPCL-TCP, or ACS subgroups (n=7). After four weeks, the calvarial specimens were evaluated using micro-computed tomography for bone volume fraction (BVF), and histopathology. RESULTS The effects of ovariectomy were confirmed by changes in body, uterine, and vaginal weight, and osteopenia in the femur. A significant increase in BVF was observed in ACS-subgroups compared with their respective control groups (p<0.05). Histopathological analysis revealed no cellular inflammatory infiltrate in any group. Fibrous tissue encapsulated the mPCL-TCP, while the ACS was well-integrated with the bone matrix. The OVX groups presented more osteoid and enlarged marrow cavities compared with the OVI groups. CONCLUSION ACS scaffold enhanced calvarial bone regeneration in OVI and OVX rats after four weeks.
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Affiliation(s)
- Dyna Jeanne Develos Godoy
- Dental Biomaterials Science Program, Graduate School, Chulalongkorn University, Thailand.,Department of Materials Science, Faculty of Science, Chulalongkorn University, Thailand
| | - Wijit Banlunara
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Thailand
| | - Sukanya Jaroenporn
- Department of Biology, Faculty of Science, Chulalongkorn University, Thailand
| | - Polkit Sangvanich
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Thailand
| | - Pasutha Thunyakitpisal
- Research Unit of Herbal Medicine, Biomaterial and Material for Dental Treatment, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Thailand
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Effects of low-level laser therapy and platelet concentrate on bone repair: Histological, histomorphometric, immunohistochemical, and radiographic study. J Craniomaxillofac Surg 2017; 45:1846-1853. [DOI: 10.1016/j.jcms.2017.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 07/03/2017] [Accepted: 08/10/2017] [Indexed: 11/21/2022] Open
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11
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Effects of Rat Bone Marrow-Derived Mesenchymal Stem Cells and Demineralized Bone Matrix on Cranial Bone Healing. Ann Plast Surg 2017; 77:249-54. [PMID: 27070677 DOI: 10.1097/sap.0000000000000274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Studies in tissue engineering about mesenchymal stem cells (MSCs) provide promising results for bone regeneration. The aim of this study was to evaluate the effects of rat bone marrow-derived MSCs (rMSCs) alone and when combined with demineralized bone matrix (DBM) on critical-sized cranial defects of rats. METHODS Ten rats were used to obtain allogeneic rMSCs. Forty rats were separated equally into 4 groups. A full-thickness circular bone defect was created in the frontal bone of the rats. Group 1 was an operative control group. In group 2 DBM, in group 3 rMSCs, and in group 4 DBM combined with rMSCs were applied into the defects. Bone regeneration was evaluated by computed tomographic analysis and immunohistochemistry. RESULTS In radiological evaluation, the percentage of area healed in group 3 at the 12th week was statistically significantly greater than in group 1. In group 3 and group 4, distributed healing patterns were observed more than in group 2 and in group 1. Immunohistochemical evaluation revealed that group 4 had the best osteoinductive potential. Osteoinductive potential of group 3 was similar to group 2 and was better than group 1. CONCLUSIONS Allogeneic rMSC applications have created a statistically significant radiologic reduction of the bone defect areas at the end of the 12 weeks. The MSC applications have also increased the bone density and changed the healing patterns. Combined use of the DBM and rMSCs has created more osteoinductive responses. This combination can provide better results in craniofacial bone reconstruction.
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12
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de Oliveira LSDS, de Araújo AA, de Araújo Júnior RF, Barboza CAG, Borges BCD, da Silva JSP. Low-level laser therapy (780 nm) combined with collagen sponge scaffold promotes repair of rat cranial critical-size defects and increases TGF-β, FGF-2, OPG/RANK and osteocalcin expression. Int J Exp Pathol 2017; 98:75-85. [PMID: 28556971 DOI: 10.1111/iep.12226] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 02/09/2017] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to evaluate the effect of collagen sponge scaffold (CSS) implantation associated with low-level laser therapy (LLLT) on repairing bone defects. A single 5-mm cranial defect was surgically created in forty Wistar rats, which then received one of the following four interventions (n = 10 per group): no treatment (G0); bone defect implanted with collagen sponge scaffold (CSS) alone (G1); defect treated with low-level laser therapy (LLLT) (wavelength 780 nm; total energy density 120 J/cm2 ; power 50 mW) alone (G2); and CSS associated with LLLT treatment (G3). After surgery, animals in each group were euthanized at 21 days and 30 days (n = 5 per euthanasia time group). Bone formation was monitored by X-ray imaging analysis. Biopsies were collected and processed for histological analysis and immunohistochemical evaluation of transforming growth factor-beta (TGF-β), fibroblast growth factor-2 (FGF-2), osteoprotegerin (OPG) and receptor activator of nuclear factor ƙ (RANK). Osteocalcin (OCN) was detected by immunofluorescence analysis. Compared to the G0 group, defects in the 30-day G3 group exhibited increased bone formation, both by increase in radiopaque areas (P < 0.01) and by histomorphometric analysis (P < 0.001). The histopathological analysis showed a decreased number of inflammatory cells (P < 0.001). The combined CCS + LLLT (G3) treatment also resulted in the most intense immunostaining for OPG, RANK, FGF-2 and TGF-β, and the most intense and diffuse OCN immunofluorescent labelling at 30 days postsurgery (G3 vs. G0 group, P < 0.05). Therefore, the use of CCS associated with LLLT could offer a synergistic advantage in improving the healing of bone fractures.
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Affiliation(s)
| | - Aurigena Antunes de Araújo
- Department of Biophysics and Pharmacology, Post Graduation Program in Public Health/Post Graduation Program in Pharmaceutical Science, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Raimundo Fernandes de Araújo Júnior
- Department of Morphology, Post Graduation Program in Health Science/Post Graduation Program in Functional and Structural Biology, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Carlos Augusto Galvão Barboza
- Department of Morphology, Post-Graduation Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Boniek Castillo Dutra Borges
- Department of Dentistry, Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - José Sandro Pereira da Silva
- Department of Dentistry, Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Effect of Resorbable Collagen Plug on Bone Regeneration in Rat Critical-Size Defect Model. IMPLANT DENT 2017; 25:163-70. [PMID: 26901636 DOI: 10.1097/id.0000000000000396] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The purpose of this investigation was to examine the effect of resorbable collagen plug (RCP) on bone regeneration in rat calvarial critical-size defects. METHODS About 5-mm-diameter calvarial defects were created in forty 12-week-old male Sprague-Dawley rats and implanted with or without RCP. Animals were killed at 1, 2, 4, and 8 weeks postoperatively. After being killed, specimens were collected and subjected to micro-computed tomography (μCT) and histological analysis. RESULTS The μCT showed a significant increase of newly formed bone volume/tissue volume in RCP-implanted defect compared with controls at all designated time points. After 8 weeks, the defects implanted with RCP displayed almost complete closure. Hematoxylin and eosin staining of the decalcified sections confirmed these observations and evidenced active bone regeneration in the RCP group. In addition, Masson's trichrome staining demonstrated that RCP implantation accelerated the process of collagen maturation. CONCLUSIONS The RCP enhances bone regeneration in rat critical-size cranial defects, which suggest it might be a desired material for bone defect repair.
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Abreu MCD, Ponzoni D, Langie R, Artuzi FE, Puricelli E. Effects of a buried magnetic field on cranial bone reconstruction in rats. J Appl Oral Sci 2016; 24:162-70. [PMID: 27119765 PMCID: PMC4836924 DOI: 10.1590/1678-775720150336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 01/20/2016] [Indexed: 01/28/2023] Open
Abstract
The understanding of bone repair phenomena is a fundamental part of dentistry and maxillofacial surgery.
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Affiliation(s)
- Maíra Cavallet de Abreu
- Departamento de Cirurgia Oral e Maxilofacial, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Deise Ponzoni
- Departamento de Cirurgia Oral e Maxilofacial, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Renan Langie
- Departamento de Cirurgia Oral e Maxilofacial, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Felipe Ernesto Artuzi
- Departamento de Cirurgia Oral e Maxilofacial, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Edela Puricelli
- Departamento de Cirurgia Oral e Maxilofacial, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Childers EP, Peterson GI, Ellenberger AB, Domino K, Seifert GV, Becker ML. Adhesion of Blood Plasma Proteins and Platelet-rich Plasma on l-Valine-Based Poly(ester urea). Biomacromolecules 2016; 17:3396-3403. [DOI: 10.1021/acs.biomac.6b01195] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Erin P. Childers
- Department of Polymer Science and ‡Department of Biomedical Engineering, The University of Akron, Akron, Ohio 44325, United States
| | - Gregory I. Peterson
- Department of Polymer Science and ‡Department of Biomedical Engineering, The University of Akron, Akron, Ohio 44325, United States
| | - Alex B. Ellenberger
- Department of Polymer Science and ‡Department of Biomedical Engineering, The University of Akron, Akron, Ohio 44325, United States
| | - Karen Domino
- Department of Polymer Science and ‡Department of Biomedical Engineering, The University of Akron, Akron, Ohio 44325, United States
| | - Gabrielle V. Seifert
- Department of Polymer Science and ‡Department of Biomedical Engineering, The University of Akron, Akron, Ohio 44325, United States
| | - Matthew L. Becker
- Department of Polymer Science and ‡Department of Biomedical Engineering, The University of Akron, Akron, Ohio 44325, United States
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Bertolai R, Catelani C, Signorini M, Rossi A, Giannini D. Mesenchymal stem cells in post-surgical cavities of large maxillary bone lesions. CLINICAL CASES IN MINERAL AND BONE METABOLISM : THE OFFICIAL JOURNAL OF THE ITALIAN SOCIETY OF OSTEOPOROSIS, MINERAL METABOLISM, AND SKELETAL DISEASES 2016; 13:214-220. [PMID: 28228785 PMCID: PMC5318175 DOI: 10.11138/ccmbm/2016.13.3.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Recent studies have highlighted that MSCs are capable of regenerating large bone defects when used in combination with bone substitutes and increasing allo-graft osteointegration. We investigated the hypothesis that autologous MSCs may lead to increased bone regeneration and reduced healing time in post-surgical cavities of large maxillary bone lesions. METHODS This study involved 10 patients (TEST GROUP) (6 males and 4 females). All patients had expansive mandibular lesions larger than 3 cm. From the surgical point of view, the 10 patients were treated with MSCs (withdrawal of the iliac crest bone marrow BMMSs) directly into the post-surgical cavity, without the addition of filler. RESULTS and radiological data, in the postoperative, were compared to those of patients who did not receive any grafting of MSCs. The 7 patients with mandibular lesions showed a rapid and very good healing with an 85-90% ossification of the major defect at 12 months. CONCLUSIONS Through the use of stem cells a greater ossification of the residual cavity (85-90%) was observed at 12 months after surgical enucleation in contenitive defects.
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Affiliation(s)
- Roberto Bertolai
- University of Florence, School of Human Health Sciences, Surgery and Translational Medicine Department (DCMT), Head and Neck Unit, Florence, Italy
| | - Carlo Catelani
- University of Florence, School of Human Health Sciences, Surgery and Translational Medicine Department (DCMT), Head and Neck Unit, Florence, Italy
| | - Mattia Signorini
- University of Florence, School of Human Health Sciences, Surgery and Translational Medicine Department (DCMT), Head and Neck Unit, Florence, Italy
| | - Alessandro Rossi
- University of Florence, School of Human Health Sciences, Surgery and Translational Medicine Department (DCMT), Head and Neck Unit, Florence, Italy
| | - Domenico Giannini
- University of Florence, School of Human Health Sciences, Surgery and Translational Medicine Department (DCMT), Head and Neck Unit, Florence, Italy
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Kim RW, Kim JH, Moon SY. Effect of hydroxyapatite on critical-sized defect. Maxillofac Plast Reconstr Surg 2016; 38:26. [PMID: 27441185 PMCID: PMC4932121 DOI: 10.1186/s40902-016-0072-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background Xenologous or synthetic graft materials are commonly used as an alternative for autografts for guided bone regeneration. The purpose of this study was to evaluate effectiveness of carbonate apatite on the critical-size bone defect of rat’s calvarium. Methods Thirty-six critical-size defects were created on 18 adult male Sprague-Dawley rat calvaria under general anesthesia. Calvarial bones were grinded with 8 mm in daimeter bilaterally and then filled with (1) no grafts (control, n = 10 defects), (2) bovine bone mineral (Bio-Oss®, Geistlich Pharma Ag. Swiss, n = 11 defects), and (3) hydroxyapatite (Bongros®, Bio@ Inc., Seongnam, Korea, n = 15 defects). At 4 and 8 weeks after surgery, the rats were sacrificed and all samples were processed for histological and histomorphometric analysis. Results At 4 weeks after surgery, group 3 (42.90 ± 9.33 %) showed a significant difference (p < 0.05) compared to the control (30.50 ± 6.05 %) and group 2 (28.53 ± 8.62 %). At 8 weeks after surgery, group 1 (50.21 ± 6.23 %), group 2 (54.12 ± 10.54 %), and group 3 (50.92 ± 6.05 %) showed no significant difference in the new bone formation. Conclusions Bongros®-HA was thought to be the available material for regenerating the new bone formation.
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Affiliation(s)
- Ryoe-Woon Kim
- Graduate School of Dentistry, Chosun University, Gwangju, South Korea
| | - Ji-Hyoung Kim
- Graduate School of Dentistry, Chosun University, Gwangju, South Korea
| | - Seong-Yong Moon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, 309, Pilmun-daero, Dong-gu, 501-759 Gwangju, South Korea
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18
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Bertolai R, Catelani C, Aversa A, Rossi A, Giannini D, Bani D. Bone graft and mesenchimal stem cells: clinical observations and histological analysis. ACTA ACUST UNITED AC 2015; 12:183-7. [PMID: 26604947 DOI: 10.11138/ccmbm/2015.12.2.183] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Autologous bone, for its osteoconductive, osteoinductive and osteogenetic properties, has been considered to be the gold standard for maxillary sinus augmentation procedures. Autograft procedures bring also some disadvantages: sometimes the limited amount of available intraoral bone makes necessary to obtain bone from an extraoral site, and this carries an associated morbidity. To overcome this problem we started using homologous freeze-dried bone in maxillary sinus augmentation procedures. This bone is industrially processed with γ-irradiation to eliminate its disease transmission potential and it's considered safe, but this treatment also eliminates the osteoinductive and osteogenetic properties, making it just an inert scaffold for regeneration. Mesenchymal stem cells are successfully used in and orthopedic surgery for their amplification potential of healing mechanisms. We assumed that mesenchymal stem cells can restore the osteogenetic and osteoinductive properties in homologous bone grafts. The aim of this study was an histological evaluation of bone regeneration in maxillary sinus elevation using: 1) mesenchymal stem cells engineered freeze-dried bone allografts; 2) freeze-dried bone allografts. Twenty patients (10M, 10F) with a mean age of 55.2 years affected by severe maxillary atrophy were treated with bilateral maxillary sinus floor elevation. For each patient were randomly assigned a "test" side and a "control" side, different from each other exclusively in the composition of the graft material. The "control" sides were composed by corticocancellous freeze-dried bone chips and the "test" sides were composed by corticocancellous freeze-dried bone chips engineered in a bone marrow mesenchymal stem cells concentrate. After three months bone biopsies were performed on the grafts and histological specimens were made in order to evaluate the healed bone from an histological point of view. Histologically all the specimens showed active remodelling signs and all the tissues were free of inflammatory cells. "Control" side specimens showed a substantial persistence of the grafted bone and, with the interposition of connective tissue, a considerable amount of newly formed bone. "Test" side specimens showed a much more represented cellular component compared to the "control" sides. The grafted bone trabeculae, when detectable, were completely imprisoned inside new formed bone, in direct contact with it and without interposition of connective tissue. Freeze-dried bone can be used successfully as graft material in the treatment of maxillary atrophy. The same bone engineered with stem cells showed a greater histological integration potential comparable with autografts histological morphology. Further studies are needed to confirm these hypotheses.
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Affiliation(s)
- Roberto Bertolai
- Surgery and Translational Medicine Department, Maxillofacial Unit, Health School of Human Sciences, University of Florence, Florence, Italy
| | - Carlo Catelani
- Surgery and Translational Medicine Department, Maxillofacial Unit, Health School of Human Sciences, University of Florence, Florence, Italy
| | - Alessandro Aversa
- Surgery and Translational Medicine Department, Maxillofacial Unit, Health School of Human Sciences, University of Florence, Florence, Italy
| | - Alessandro Rossi
- Surgery and Translational Medicine Department, Maxillofacial Unit, Health School of Human Sciences, University of Florence, Florence, Italy
| | - Domenico Giannini
- Surgery and Translational Medicine Department, Maxillofacial Unit, Health School of Human Sciences, University of Florence, Florence, Italy
| | - Daniele Bani
- Department of Experimental and Clinical Medicine, Health School of Human Sciences, University of Florence, Florence, Italy
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Jovani-Sancho MDM, Sheth CC, Marqués-Mateo M, Puche-Torres M. Platelet-Rich Plasma: A Study of the Variables that May Influence Its Effect on Bone Regeneration. Clin Implant Dent Relat Res 2015; 18:1051-1064. [PMID: 26130314 DOI: 10.1111/cid.12361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Currently, the use of platelet-rich plasma in bone regeneration is a real option, although more than one opinion has alerted us to the absence of clinical benefits. PURPOSE Analysis of the factors able to modify the characteristics of the platelet preparation obtained by Curasan, Plasma Rich in Growth Factors (PRGF), Platelet Concentrate Collection System (PCCS) and SmartPrep systems, relating them to the type of clinical application and the final bone regeneration achieved. MATERIALS AND METHODS A search was conducted in PubMed using the keywords "platelet-rich plasma," "PRP," "platelet rich growth factors," and "oral bone regeneration." Four widely accepted protocols for the obtention of PRP (above) were analyzed. Any clinical studies with controls, using the four preparation protocols and with a 4 to 6 weeks follow-up period were compared. The protocols were also grouped according to the type of PRP application: PRP-alone, with bone, or with bone substitutes. RESULTS Bone regeneration was not achieved in any of the cases using PRP obtained by Curasan and PCCS systems, whereas PRP obtained by SmartPrep achieved it only in one in three published cases and PRGF in one in six. CONCLUSION Based on the poor results observed in current literature, the use of PRP in oral surgery cannot be recommended.
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Affiliation(s)
| | - Chirag C Sheth
- Department of Biomedical Sciences, Faculty of Health Sciences, Universidad CEU Cardenal Herrera, Valencia, Spain
| | - Mariano Marqués-Mateo
- Department of Oral and Maxillofacial Surgery, Hospital Clínico Universitario, Valencia, Spain
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Atalay Y, Bozkurt MF, Gonul Y, Cakmak O, Agacayak KS, Köse I, Hazman O, Keles H, Turamanlar O, Eroglu M. The effects of amlodipine and platelet rich plasma on bone healing in rats. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:1973-81. [PMID: 25897207 PMCID: PMC4396585 DOI: 10.2147/dddt.s80778] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aim The aim of this study was to evaluate the effects of calcium channel blocker (CCB) amlodipine (AML), platelet rich plasma (PRP), and a mixture of both materials on bone healing. Materials and methods Fifty-six male Wistar rats were randomly divided into four groups: group A, tibia defect model with no treatment; group B, tibia defect model treated with AML, 0.04 mg daily by oral gavage; group C, tibia defect model treated with local PRP; group D, tibia defect model treated with local PRP and AML, 0.04 mg daily by oral gavage. Results At day 21, bone healing was significantly better in groups C and D compared to group A (P<0.05), but comparisons showed no statistically significant difference in group B (P>0.05). At day 30, groups B and C showed no statistically significant difference (P>0.05) compared to group A, but bone healing in group D was significantly better than in group A (P<0.05). Statistically, AML did not affect alkaline phosphatase (ALP) activity at 21 and 30 days (P>0.05), but PRP and AML + PRP increased ALP activity statistically (P<0.05). Conclusion It can be concluded that AML had neither a positive nor a negative effect on bone healing, but when used in combination with PRP, it may be beneficial.
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Affiliation(s)
- Yusuf Atalay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Mehmet Fatih Bozkurt
- Department of Pathology, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Yucel Gonul
- Department of Anatomy, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Omer Cakmak
- Department of Periodontology, Faculty of Dentistry, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Kamil Serkan Agacayak
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Ibrahim Köse
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adıyaman University, Adıyaman, Turkey
| | - Omer Hazman
- Department of Biochemistry, Faculty of Sciences, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Hikmet Keles
- Department of Pathology, Faculty of Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Ozan Turamanlar
- Department of Anatomy, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Mehmet Eroglu
- Department of Orthopedics and Traumatology, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
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21
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Messora MR, Nagata MJH, Fucini SE, Pola NM, Campos N, de Oliveira GCV, Bosco AF, Garcia VG, Furlaneto FAC. Effect of Platelet-Rich Plasma on the Healing of Mandibular Defects Treated With Fresh Frozen Bone Allograft: A Radiographic Study in Dogs. J ORAL IMPLANTOL 2014; 40:533-41. [DOI: 10.1563/aaid-joi-d-12-00175] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to radiographically analyze the effect of autologous platelet rich plasma (PRP) on the healing of fresh frozen bone allograft (FFBA) placed in surgically created resection defects in mandibles of dogs. Bilateral resection defects measuring 1.5 cm × 1 cm were surgically created on the inferior border of the mandible in 10 adult male dogs. The defects were randomly divided into three groups: C, FFBA, and FFBA/PRP. In Group C, the defect was filled by blood clot only. In Group FFBA, the defect was filled with particulate fresh frozen bone allograft. In Group FFBA/PRP, it was filled with particulate fresh frozen bone allograft combined with PRP. At 90 days postoperative, standardized radiographs of the mandibles were obtained and results were quantitatively evaluated. Analysis of digitized radiographs indicated that non-PRP grafts were significantly less dense than the PRP grafts. Group FFBA/PRP also presented a statistically greater mineralized tissue area than Groups C and FFBA. Within the limits of this study, it can be concluded that PRP enhanced the healing of FFBA in resection defects in mandibles of dogs.
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Affiliation(s)
- Michel R. Messora
- Division of Periodontics, Department of Surgery and Bucco-Maxillofacial Traumatology and Periodontology, School of Dentistry of Ribeirão Preto, USP - University of São Paulo, Ribeirão Preto-SP, Brazil
| | - Maria J. H. Nagata
- Division of Periodontics, Department of Surgery and Integrated Clinic, Dental School of Araçatuba, UNESP – Univ. Estadual Paulista, Araçatuba-SP, Brazil
| | - Stephen E. Fucini
- Division of Periodontics, Department of Surgery and Integrated Clinic, Dental School of Araçatuba, UNESP – Univ. Estadual Paulista, Araçatuba-SP, Brazil
- Private Practice, Hanover, NH
| | | | - Natália Campos
- Division of Periodontics, Department of Surgery and Integrated Clinic, Dental School of Araçatuba, UNESP – Univ. Estadual Paulista, Araçatuba-SP, Brazil
| | - Guillermo C. V. de Oliveira
- Division of Anesthesiology, Medical School of Botucatu, UNESP – Univ. Estadual Paulista, Botucatu-SP, Brazil
| | - Alvaro F. Bosco
- Division of Periodontics, Department of Surgery and Integrated Clinic, Dental School of Araçatuba, UNESP – Univ. Estadual Paulista, Araçatuba-SP, Brazil
| | - Valdir G. Garcia
- Division of Periodontics, Department of Surgery and Integrated Clinic, Dental School of Araçatuba, UNESP – Univ. Estadual Paulista, Araçatuba-SP, Brazil
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Platelet-rich plasma in bone regeneration: engineering the delivery for improved clinical efficacy. BIOMED RESEARCH INTERNATIONAL 2014; 2014:392398. [PMID: 25050347 PMCID: PMC4094865 DOI: 10.1155/2014/392398] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/18/2014] [Accepted: 06/01/2014] [Indexed: 12/25/2022]
Abstract
Human bone is a tissue with a fairly remarkable inherent capacity for regeneration; however, this regenerative capacity has its limitations, and defects larger than a critical size lack the ability to spontaneously heal. As such, the development and clinical translation of effective bone regeneration modalities are paramount. One regenerative medicine approach that is beginning to gain momentum in the clinical setting is the use of platelet-rich plasma (PRP). PRP therapy is essentially a method for concentrating platelets and their intrinsic growth factors to stimulate and accelerate a healing response. While PRP has shown some efficacy in both in vitro and in vivo scenarios, to date its use and delivery have not been optimized for bone regeneration. Issues remain with the effective delivery of the platelet-derived growth factors to a localized site of injury, the activation and temporal release of the growth factors, and the rate of growth factor clearance. This review will briefly describe the physiological principles behind PRP use and then discuss how engineering its method of delivery may ultimately impact its ability to successfully translate to widespread clinical use.
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Pelaez M, Susin C, Lee J, Fiorini T, Bisch FC, Dixon DR, McPherson JC, Buxton AN, Wikesjö UM. Effect of rhBMP-2 dose on bone formation/maturation in a rat critical-size calvarial defect model. J Clin Periodontol 2014; 41:827-36. [DOI: 10.1111/jcpe.12270] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2014] [Indexed: 01/25/2023]
Affiliation(s)
- Manuel Pelaez
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Regents University College of Dental Medicine; Augusta GA USA
- US Army Dental Activity; Fort Bragg NC USA
| | - Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Regents University College of Dental Medicine; Augusta GA USA
| | - Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Regents University College of Dental Medicine; Augusta GA USA
| | - Tiago Fiorini
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Regents University College of Dental Medicine; Augusta GA USA
- Section of Periodontology; School of Dentistry; Federal University; Porto Alegre Rio Grande do Sul Brazil
| | | | | | | | | | - Ulf M.E. Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Regents University College of Dental Medicine; Augusta GA USA
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DeNicolo PJ, Guyton MK, Cuenin MF, Hokett SD, Sharawy M, Borke J, McPherson JC. Histologic Evaluation of Osseous Regeneration Following Combination Therapy With Platelet-Rich Plasma and Bio-Oss in a Rat Calvarial Critical-Size Defect Model. J ORAL IMPLANTOL 2013; 41:543-9. [PMID: 24003871 DOI: 10.1563/aaid-joi-d-12-00075] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Platelet-rich plasma (PRP) is an autogenous source of growth factors shown to facilitate human bone growth. Bio-Oss, an osteoconductive xenograft, is used clinically to regenerate periodontal defects, restore dental alveolar ridges, and facilitate sinus-lift procedures. The purpose of this study was to analyze whether a combination of PRP and Bio-Oss would enhance bone regeneration better than either material alone. PRP and/or Bio-Oss were administered in an 8-mm critical-size defect (CSD) rat calvarial model of bone defect between 2 polytetrafluoroethylene membranes to prevent soft tissue incursion. Eight weeks after the induction of the CSD, histologic sections were stained with hematoxylin and eosin stain and analyzed via light microscopy. Qualitative analyses revealed new bone regeneration in all 4 groups. The Bio-Oss and PRP plus Bio-Oss groups demonstrated greater areas of closure in the defects than the control or PRP-only groups because of the space-maintaining ability of Bio-Oss. The groups grafted with Bio-Oss showed close contact with new bone growth throughout the defects, suggesting a stronger graft. The use of PRP alone or in combination with Bio-Oss, however, did not appear to enhance osseous regeneration at 8 weeks. Areas grafted with Bio-Oss demonstrated greater space-maintaining capacity than controls, and PRP was an effective vehicle for placement of the Bio-Oss. However, at 8 weeks this study was unable to demonstrate a significant advantage of using PRP plus Bio-Oss over using Bio-Oss alone.
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Affiliation(s)
- Philip J DeNicolo
- 1 US Army Dental Activity, Dental and Trauma Research Detachment, Fort Sam Houston, San Antonio, Tex
| | - M Kelly Guyton
- 2 Department of Clinical Investigation, D. D. Eisenhower Army Medical Center, Fort Gordon, Ga
| | | | | | - Mohamed Sharawy
- 5 Department of Oral Biology, Medical College of Georgia, Augusta, Ga
| | - James Borke
- 6 College of Dental Medicine, Western University of Health Sciences, Pomona, Calif
| | - James C McPherson
- 2 Department of Clinical Investigation, D. D. Eisenhower Army Medical Center, Fort Gordon, Ga
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Vajgel A, Mardas N, Farias BC, Petrie A, Cimões R, Donos N. A systematic review on the critical size defect model. Clin Oral Implants Res 2013; 25:879-93. [DOI: 10.1111/clr.12194] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2013] [Indexed: 01/01/2023]
Affiliation(s)
- André Vajgel
- Oral and Maxillofacial Department; University of Pernambuco (FOP/UPE); Recife Brazil
- CAPES Foundation; Ministry of Education of Brazil; Brasília Brazil
- Periodontology Unit; UCL Eastman Dental Institute; London UK
| | - Nikos Mardas
- Periodontology Unit; UCL Eastman Dental Institute; London UK
| | - Bruna Carvalho Farias
- CAPES Foundation; Ministry of Education of Brazil; Brasília Brazil
- Periodontology Unit; UCL Eastman Dental Institute; London UK
- Postgraduate Department; Federal University of Pernambuco (UFPE); Recife Brazil
| | - Aviva Petrie
- Biostatistics Unit; UCL Eastman Dental Institute; London UK
| | - Renata Cimões
- Department of Prosthesis and Oral and Facial Surgery; Federal University of Pernambuco (UFPE); Recife Brazil
| | - Nikolaos Donos
- Periodontology Unit; UCL Eastman Dental Institute; London UK
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26
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Santo VE, Gomes ME, Mano JF, Reis RL. Controlled release strategies for bone, cartilage, and osteochondral engineering--Part II: challenges on the evolution from single to multiple bioactive factor delivery. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:327-52. [PMID: 23249320 DOI: 10.1089/ten.teb.2012.0727] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The development of controlled release systems for the regeneration of bone, cartilage, and osteochondral interface is one of the hot topics in the field of tissue engineering and regenerative medicine. However, the majority of the developed systems consider only the release of a single growth factor, which is a limiting step for the success of the therapy. More recent studies have been focused on the design and tailoring of appropriate combinations of bioactive factors to match the desired goals regarding tissue regeneration. In fact, considering the complexity of extracellular matrix and the diversity of growth factors and cytokines involved in each biological response, it is expected that an appropriate combination of bioactive factors could lead to more successful outcomes in tissue regeneration. In this review, the evolution on the development of dual and multiple bioactive factor release systems for bone, cartilage, and osteochondral interface is overviewed, specifically the relevance of parameters such as dosage and spatiotemporal distribution of bioactive factors. A comprehensive collection of studies focused on the delivery of bioactive factors is also presented while highlighting the increasing impact of platelet-rich plasma as an autologous source of multiple growth factors.
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Affiliation(s)
- Vítor E Santo
- 3Bs Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
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Pandit N, Malik R, Philips D. Tissue engineering: A new vista in periodontal regeneration. J Indian Soc Periodontol 2012; 15:328-37. [PMID: 22368355 PMCID: PMC3283928 DOI: 10.4103/0972-124x.92564] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 11/28/2011] [Indexed: 01/14/2023] Open
Abstract
Tissue engineering is a highly promising field of reconstructive biology that draws on recent advances in medicine, surgery, molecular and cellular biology, polymer chemistry, and physiology. The objective of using tissue engineering as therapeutic application has been to harness its ability to exploit selected and primed cells together with an appropriate mix of regulatory factors, to allow growth and specialization of cells and matrix. The authors reviewed controlled clinical trials which also included histological studies that evaluated the potential of tissue engineering as a clinical tool in regeneration. PubMed/MEDLINE databases were searched for studies up to and including June 2010 to identify appropriate articles. A comprehensive search was designed, and the articles were independently screened for eligibility. Articles with authentic controls and proper randomization and pertaining specifically to their role in periodontal regeneration were included. Studies demonstrated that the periodontal regeneration with the use of combination of tissue engineered products with an osteoconductive matrix improve the beneficial effect of these materials by accelerating cellular in growth and revascularization of the wound site. Studies have suggested the use of rh Platelet-derived growth factor + beta tricalcium phosphate for regeneration of the periodontal attachment apparatus in combination with collagen membranes as an acceptable alternative to connective tissue graft for covering gingival recession defects. The studies concluded that growth factors promote true regeneration of the periodontal attachment apparatus and the use of combination protein therapeutics which is commercially available can provide more predictable, faster, less invasive, less traumatic, and efficient outcome for the patient.
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Affiliation(s)
- Nymphea Pandit
- Department of Periodontics and Oral Implantology, D.A.V (C) Dental College and Hospital, Yamuna Nagar, Haryana, India
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Stancoven BW, Lee J, Dixon DR, McPherson JC, Bisch FC, Wikesjö UME, Susin C. Effect of bone morphogenetic protein-2, demineralized bone matrix and systemic parathyroid hormone (1-34) on local bone formation in a rat calvaria critical-size defect model. J Periodontal Res 2012; 48:243-51. [PMID: 22970744 DOI: 10.1111/jre.12001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2012] [Indexed: 10/27/2022]
Abstract
AIM To determine the potential of recombinant human bone morphogenetic protein-2 (rhBMP-2) soak-loaded on to an absorbable collagen sponge (ACS) to induce local bone formation compared with the clinical reference demineralized bone matrix (DBM) and to investigate potential additive/synergistic effects of exogenous parathyroid hormone (PTH). METHODS Critical-size (8 mm), through-through calvaria osteotomy defects in 160 adult male Sprague-Dawley rats were randomized to receive one of eight interventions: rhBMP-2/ACS, DBM, ACS, or serve as controls (empty defects) combined or not with systemic PTH. Ten animals from each group were followed for 4 and 8 wks for radiographic and histometric analysis. Multivariable analysis was used to assess the effect of experimental intervention and healing time on local bone formation. RESULTS In the multivariable analysis, rhBMP-2/ACS exhibited significantly greater histologic bone formation than control (β ± SE: 54.76 ± 5.85, p < 0.001) and ACS (β ± SE: 9.14 ± 3.31, p = 0.007) whereas DBM showed significantly less bone formation than control (β ± SE: -32.32 ± 8.23, p < 0.001). Overall, PTH did not show a significant effect on bone formation (β ± SE: 2.72 ± 6.91, p = 0.70). No significant differences in histological defect closure were observed between 4 and 8 wks for all but the control group without PTH. CONCLUSION rhBMP-2/ACS significantly stimulates local bone formation whereas bone formation appears significantly limited by DBM. Systemic application of PTH provided no discernible additive/synergistic effects on local bone formation.
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Affiliation(s)
- B W Stancoven
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR), Departments of Periodontics and Oral Biology, Georgia Health Sciences University, Augusta, GA 30912, USA
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COMPARATIVE STUDY ON USE OF PLATELET-RICH PLASMA ALONE AND IN COMBINATION WITH ALPHA-TRICALCIUM PHOSPHATE CEMENT FOR BONE REPAIR IN RATS. Rev Bras Ortop 2012; 47:505-12. [PMID: 27047859 PMCID: PMC4799469 DOI: 10.1016/s2255-4971(15)30137-3] [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: 05/25/2011] [Accepted: 07/31/2011] [Indexed: 11/20/2022] Open
Abstract
Objectives: To evaluate the effect of alpha-tricalcium phosphate (α-TCP) cement combined with platelet-rich plasma (PRP) on osteogenesis, and to compare the results with use of PRP alone. Methods: A bilateral defect was produced in rat femurs and was filled with one of two types of treatments (PRP or α-TCP + PRP). The outcomes were evaluated after four and eight weeks. Radiographic images provided values for the lesion area, and histology (picrosirius staining) indicated the area of new bone formation. Results: The means relating to the lesion area of the α-TCP + PRP group (2.64 ± 2.07 and 1.91 ± 0.93 mm2, after four and eight weeks, respectively) showed numerically better but non-significant results (p > 0.05) than those seen in the PRP group (5.59 mm 2 ± 2.69 and 3.23 ± 1.46 mm 2, after four and eight weeks, respectively). The mean new bone formation rates were 62.7% ± 12.1 and 79.01% ± 6.25 in the PRP group, and 73.3% ± 12.7 and 85.86% ± 10.45 in α-TCP + PRP group, after four and eight weeks, respectively (p > 0.05). Conclusion: The data from this study suggest that treatment with α-TCP cement combined with PRP does not show any significant difference in comparison with PRP alone. However, there is a possible early effect on bone regeneration when the two biomaterials are applied together.
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Bateman JP, Safadi FF, Susin C, Wikesjö UME. Exploratory study on the effect of osteoactivin on bone formation in the rat critical-size calvarial defect model. J Periodontal Res 2011; 47:243-7. [DOI: 10.1111/j.1600-0765.2011.01428.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Simsek SB, Keles GC, Baris S, Cetinkaya BO. Comparison of mesenchymal stem cells and autogenous cortical bone graft in the treatment of class II furcation defects in dogs. Clin Oral Investig 2010; 16:251-8. [PMID: 21086003 DOI: 10.1007/s00784-010-0486-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 10/28/2010] [Indexed: 12/31/2022]
Abstract
The purpose of this study was to compare the effectiveness of mesenchymal stem cells (MSCs) with platelet-rich plasma (PRP) as scaffold and autogenous cortical bone (ACB) graft with and without PRP in the regenerative treatment of class II furcation defects in dogs. The mandibular second, third, and fourth premolars (P2, P3, P4) and maxillary P3 and P4 of both sides in three dogs were selected for experimentation. Class II furcation defects (5 mm in height and 2 mm in depth) were surgically created. Five weeks after the first operation, scaling + root planning (group 1), PRP (group 2), ACB (group 3), combination of ACB/PRP (group 4), and combination of MSCs/PRP (group 5) treatments were performed during open flap debridement. The percentage of cementum and alveolar bone formation was evaluated by histomorphometric analysis after a healing period of 8 weeks. There was new cementum along with periodontal ligament and coronal growth of alveolar bone in all groups. Cementum formation was significantly higher in groups 3, 4, and 5 compared to the control group (P < 0.05) with no significant difference between groups 2, 3, 4, and 5. Alveolar bone formation was similar in all groups (P > 0.05). It can be concluded that periodontal regeneration with complete filling of class II furcation defects with cementum, alveolar bone, and periodontal ligament is obtained 8 weeks after ACB, ACB/PRP, and MSCs/PRP treatments; however, efficacy of none is higher than another.
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Oliveira Filho MAD, Nassif PAN, Malafaia O, Ribas Filho JM, Ribas CAPM, Camacho AC, Stieven Filho E, Giovanini AF. Effects of a highly concentrated platelet-rich plasma on the bone repair using non-critical defects in the calvaria of rabbits. Acta Cir Bras 2010; 25:28-33. [PMID: 20126884 DOI: 10.1590/s0102-86502010000100008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Accepted: 11/18/2009] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To verify the effect of highly concentrated platelet-rich plasma (hPRP) in the pathways of bone repair using non-critical defects in the calvaria of rabbits. METHODS The hPRP was produced from collected venous blood of 21 rabbits. Four non-critical defects of 8 mm in diameter were created on the calvaria of each animal. The defects were all treated differently: autogenous particled bone (APB, group 1), autogenous particled bone associated with hPRP (APB + hPRP, group 2), isolated hPRP (group 3), and blood clot (control, group 4). Animals were submitted to euthanasia on the 2nd, 4th and 6th week postoperatively. Histological and histomorphometric analysis were carried through. RESULTS After two weeks, groups 1 and 2 were in more advanced stage of repair than 3 and 4. At this period, comparing the groups 1 and 2, no significant differences were found between both, which also happened between the groups 3 and 4. However, after four and six weeks, the group 1 showed a more advanced stage of repair among all the other studied groups, while group 2 was in more advanced signs of bone repair than groups 3 and 4. Comparing groups 3 and 4, after four and six weeks, the least advanced stage of bone repair was found to be within group 3. CONCLUSION The use of a highly concentrated PRP was considered prejudicial to the repair of non-critical defects in the calvaria of rabbits, either in the association of autogenous particled bone, when compared to autogenous particled bone alone, or in its isolated form, when compared to blood clot (control).
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Marukawa E, Oshina H, Iino G, Morita K, Omura K. Reduction of bone resorption by the application of platelet-rich plasma (PRP) in bone grafting of the alveolar cleft. J Craniomaxillofac Surg 2010; 39:278-83. [PMID: 20542707 DOI: 10.1016/j.jcms.2010.04.017] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 03/08/2010] [Accepted: 04/23/2010] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE We evaluated the effectiveness of platelet-rich plasma (PRP) on the regeneration of autogenous cancellous bone and marrow grafted in the alveolar cleft. DESIGN Twenty patients with alveolar clefts were examined; 6 were the control group and received cancellous bone and marrow grafts without PRP, while the remaining 14 comprised the PRP group and received grafts with PRP. Prior to surgery, 50 ml of blood was withdrawn and 5 ml of PRP gel produced through centrifugal separation. The bone graft mixed with PRP was then packed into the alveolar cleft. Postoperative bone density was assessed as the aluminium-equivalent value on occlusal X-ray films in a qualitative analysis. Quantitative evaluation of regenerated bone was made with computed tomography and panoramic radiographs at 1 month, 6 months and 1 year after surgery. RESULTS Satisfactory bone bridging formation was observed in all patients without any complications. The bone density of the PRP group was lower than that of the control group at 1 week, but the same after 1 month. The added PRP reduced the resorption of regenerated bone postoperatively. CONCLUSION Autogenous cancellous bone grafting with PRP, which significantly reduces postoperative bone resorption, is a reliable technique for alveolar bone grafting of cleft patients.
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Affiliation(s)
- Eriko Marukawa
- Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
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Kim ES, Kim JJ, Park EJ. Angiogenic factor-enriched platelet-rich plasma enhances in vivo bone formation around alloplastic graft material. J Adv Prosthodont 2010; 2:7-13. [PMID: 21165181 PMCID: PMC2984511 DOI: 10.4047/jap.2010.2.1.7] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Revised: 03/02/2010] [Accepted: 03/09/2010] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Although most researchers agree that platelet-rich plasma (PRP) is a good source of autogenous growth factors, its effect on bone regeneration is still controversial. The purpose of this study was to evaluate whether increasing angiogenic factors in the human PRP to enhance new bone formation through rapid angiogenesis. MATERIAL AND METHODS In vitro, the human platelets were activated with application of shear stress, 20 µg/ml collagen, 2 mM CaCl(2) and 10U thrombin/1 × 10(9) platelets. Level of vascular endothelial growth factor (VEGF) and platelet microparticle (PMP) in the activated platelets were checked. In the animal study, human angiogenic factors-enriched PRP was tested in 28 athymic rat's cranial critical bone defects with β-TCP. Angiogenesis and osteogenesis were evaluated by laser Doppler perfusion imaging, histology, dual energy X-ray densinometry, and micro-computed tomography. RESULTS In vitro, this human angiogenic factors-enriched PRP resulted in better cellular proliferation and osteogenic differentiation. In vivo, increasing angiogenic potential of the PRP showed significantly higher blood perfusion around the defect and enhanced new bone formation around acellular bone graft material. CONCLUSION Angiogenic factor-enriched PRP leads to faster and more extensive new bone formation in the critical size bone defect. The results implicate that rapid angiogenesis in the initial healing period by PRP could be supposed as a way to overcome short term effect of the rapid angiogenesis.
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Affiliation(s)
- Eun-Seok Kim
- Department of Oral & Maxillofacial Surgery, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Jae-Jin Kim
- Department of Oral & Maxillofacial Surgery, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Eun-Jin Park
- Division of Prosthodontics, School of Medicine, Ewha Womans University, Seoul, Korea
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Plachokova AS, van den Dolder J, van den Beucken JJJP, Jansen JA. Bone regenerative properties of rat, goat and human platelet-rich plasma. Int J Oral Maxillofac Surg 2009; 38:861-9. [PMID: 19443180 DOI: 10.1016/j.ijom.2009.04.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Accepted: 04/17/2009] [Indexed: 11/30/2022]
Abstract
To explore the reported contradictory osteogenic capacity of platelet-rich plasma (PRP), the aim of the study was to examine and compare the bone regenerative effect of: PRPs of different species (rat, goat, human); human bone graft (HB) vs. HB combined with human PRP (HB+hPRP); and HB+hPRP vs. synthetic hydroxyapatite-tricalcium phosphate bone substitute combined with hPRP (HA/TCP+hPRP). For this purpose, 72 implants, divided into 6 groups (n=6) were inserted in critical-sized defects of immunodeficient rats. After 2 and 4 weeks, descriptive and quantitative histological, and micro-CT analyses were performed on the specimens. Rat and goat PRP combined with HA/TCP did not enhance bone regeneration compared with HA/TCP. In contrast, human PRP combined with HA/TCP resulted in significantly increased bone fill compared to HA/TCP. The addition of human PRP to human bone graft increased significantly the amount of newly formed bone after 2 weeks. HB+hPRP demonstrated enhanced bone healing compared to HA/TCP+hPRP. In conclusion, rat and goat PRP had no effect on bone formation. Human PRP improved the initial osteogenic response of human bone graft. Human PRP combined with human bone graft had better osteogenic capacity than human PRP combined with synthetic bone substitute.
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Affiliation(s)
- A S Plachokova
- Department of Periodontology and Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
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Ogino Y, Ayukawa Y, Kukita T, Atsuta I, Koyano K. Platelet-rich plasma suppresses osteoclastogenesis by promoting the secretion of osteoprotegerin. J Periodontal Res 2009; 44:217-24. [DOI: 10.1111/j.1600-0765.2008.01109.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Umoh JU, Sampaio AV, Welch I, Pitelka V, Goldberg HA, Underhill TM, Holdsworth DW. In vivomicro-CT analysis of bone remodeling in a rat calvarial defect model. Phys Med Biol 2009; 54:2147-61. [DOI: 10.1088/0031-9155/54/7/020] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Comparison of platelet pellet with or without guided tissue regeneration in the treatment of class II furcation defects in dogs. Clin Oral Investig 2008; 13:393-400. [DOI: 10.1007/s00784-008-0245-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Accepted: 12/08/2008] [Indexed: 10/21/2022]
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Park JW, Bae SR, Suh JY, Lee DH, Kim SH, Kim H, Lee CS. Evaluation of bone healing with eggshell-derived bone graft substitutes in rat calvaria: A pilot study. J Biomed Mater Res A 2008; 87:203-14. [DOI: 10.1002/jbm.a.31768] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Torres J, Tamimi FM, Tresguerres IF, Alkhraisat MH, Khraisat A, Lopez-Cabarcos E, Blanco L. Effect of solely applied platelet-rich plasma on osseous regeneration compared to Bio-Oss: a morphometric and densitometric study on rabbit calvaria. Clin Implant Dent Relat Res 2008; 10:106-12. [PMID: 18462207 DOI: 10.1111/j.1708-8208.2007.00068.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The use of platelet-rich plasma (PRP) in bone augmentation procedures is well documented; however, the exact benefit of this material is not yet established. PURPOSE This study aimed to evaluate the benefits of using PRP, when only used, and compare it to Bio-Oss (Geistlich Biomaterials, Wolhusen, Switzerland) in vertical bone augmentation capacity. MATERIALS AND METHODS The study was performed in calvaria of eight adult female New Zealand rabbits using titanium bone conduction cylinder. Two titanium cylinders were fixed into perforated slits made on the parietal bone of each rabbit. On each rabbit, one chamber was grafted with Bio-Oss, and the contralateral was filled with PRP. Animals were sacrificed 4 weeks after intervention and biopsies were taken. Densitometric, histological, and histomorphometric analyses were performed to evaluate bone mineral density, vertical bone augmentation, and remaining graft volume, respectively. Statistical analyses were performed with Mann-Whitney test, using a significance level of p < .05. RESULTS Densitometric and histomorphometric data analysis revealed that mean bone mineral densities and bone augmentation were significantly lower in the cylinders treated with PRP (p < .0001) 4 weeks after implantation. CONCLUSION This study showed no beneficial effect of using PRP on osseous regeneration. In addition, it was emphasized that Bio-Oss presents good osteoconductive properties by achieving suitable bone volume values.
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Affiliation(s)
- Jesús Torres
- Department of Health Sciences III, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Spain
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Tcacencu I, Wendel M. Collagen-hydroxyapatite composite enhances regeneration of calvaria bone defects in young rats but postpones the regeneration of calvaria bone in aged rats. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2008; 19:2015-2021. [PMID: 17952564 DOI: 10.1007/s10856-007-3284-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Accepted: 09/18/2007] [Indexed: 05/25/2023]
Abstract
The potential differences in bone repair of calvaria defects treated with a collagen sponge (HELISTAT) or a collagen-hydroxyapatite composite (HEALOS) in young and aged rats were evaluated at 8 weeks after surgery. A histomorphometric analysis of new bone formation and an evaluation of angiogenesis, mast cell, and eosinophil local infiltration were performed. Evaluation showed that HELISTAT induced a similar amount of new bone in both young and aged rats. However this occurred to a lesser degree than in young rats treated with HEALOS. The largest number of blood vessels was present in the defects of aged rats treated with HEALOS, and the number of mast cells was highest in the defects treated with HELISTAT in both young and aged rats. Eosinophils were present to the greatest extent in defects treated with HEALOS in comparison to defects treated with HELISTAT in both young and aged rats. Collagen-hydroxyapatite composite (HEALOS) enhances calvarial bone repair more than collagen sponge alone (HELISTAT) in young rats but not in aged rats at 8 weeks after surgery. HEALOS appears to induce a more intense inflammatory response than HELISTAT especially in aged rats.
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Affiliation(s)
- Ion Tcacencu
- Centre for Oral Biology, Institute of Odontology, Karolinska Institutet, P.O. Box 4064, 14104, Huddinge, Sweden.
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Pieri F, Lucarelli E, Corinaldesi G, Iezzi G, Piattelli A, Giardino R, Bassi M, Donati D, Marchetti C. Mesenchymal stem cells and platelet-rich plasma enhance bone formation in sinus grafting: a histomorphometric study in minipigs. J Clin Periodontol 2008; 35:539-46. [PMID: 18422697 DOI: 10.1111/j.1600-051x.2008.01220.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Autologous, allogenic, and alloplastic materials for sinus augmentation have specific drawbacks, which has stimulated an ongoing search for new materials and tissue-engineering constructs. We investigated whether mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) seeded on a fluorohydroxyapatite (FH) scaffold can improve bone formation and bone-to-implant contact (BIC) in maxillary sinus grafting. MATERIAL AND METHODS Bilateral sinus augmentation procedures were performed in eight minipigs. MSCs, PRP, and FH scaffold (test site) or FH alone (control site) were grafted in each maxillary sinus. Distal to the osteotomy, one dental implant per sinus was placed in the grafting material through the facial sinus wall. The animals were killed 3 months after grafting, and block sections of the implant sites were harvested and prepared for histomorphometric analysis. RESULTS After 12 weeks, a significant increase in bone formation occurred in the test sites compared with the control sites (42.51%versus 18.98%; p=0.001). In addition, BIC was significantly greater in the test sites compared with the control sites in the regenerated area (23.71%versus 6.63%; p=0.028). CONCLUSIONS These findings show that sinus augmentation with MSCs-PRP, combined with FH may enhance bone formation and osseointegration of dental implants compared with FH alone in minipigs.
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Affiliation(s)
- Francesco Pieri
- Department of Odontostomatological Sciences, University of Bologna, Bologna, Italy.
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Messora MR, Nagata MJH, Mariano RC, Dornelles RCM, Bomfim SRM, Fucini SE, Garcia VG, Bosco AF. Bone healing in critical-size defects treated with platelet-rich plasma: a histologic and histometric study in rat calvaria. J Periodontal Res 2008; 43:217-23. [PMID: 18302625 DOI: 10.1111/j.1600-0765.2007.01017.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE The purpose of this study was to analyze histologically the influence of autologous platelet-rich plasma on bone healing in surgically created critical-size defects in rat calvaria. MATERIAL AND METHODS Thirty-two rats were divided into two groups: the control group (group C) and the platelet-rich plasma group. An 8-mm-diameter critical-size defect was created in the calvarium of each animal. In group C the defect was filled by a blood clot only. In the platelet-rich plasma group, 0.35 mL of platelet-rich plasma was placed in the defect and covered by 0.35 mL of platelet-poor plasma. Both groups were divided into subgroups (n = 8) and killed at either 4 or 12 wk postoperatively. Histometric (using image-analysis software) and histologic analyses were performed. The amount of new bone formed was calculated as a percentage of the total area of the original defect. Percentage data were transformed into arccosine for statistical analysis (analysis of variance, Tukey, p < 0.05). RESULTS No defect completely regenerated with bone. The platelet-rich plasma group had a statistically greater amount of bone formation than group C at both 4 wk (17.68% vs. 7.20%, respectively) and 12 wk (24.69% vs. 11.65%, respectively) postoperatively. CONCLUSION Within the limits of this study, it can be concluded that platelet-rich plasma placed in the defects and covered by platelet-poor plasma significantly enhanced bone healing in critical-size defects in rat calvaria.
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Affiliation(s)
- M R Messora
- Division of Periodontics, Department of Surgery and Integrated Clinic, Dental School of Araçatuba, São Paulo State University, Brazil
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Lee Y, Schmid MJ, Marx DB, Beatty MW, Cullen DM, Collins ME, Reinhardt RA. The effect of local simvastatin delivery strategies on mandibular bone formation in vivo. Biomaterials 2008; 29:1940-9. [PMID: 18255137 DOI: 10.1016/j.biomaterials.2007.12.045] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Accepted: 12/22/2007] [Indexed: 01/02/2023]
Abstract
Systemic simvastatin is known to reduce cholesterol and stimulate modest bone formation, but local surgical placement in polylactic acid domes causes robust bone formation and local swelling. A less invasive and more flexible injection protocol was studied to evaluate the bone-inducing effects compared to surgical implantation. Bone formation rate, short- and long-term bone augmentation histology, and mechanical properties were evaluated to characterize the new bone in a rat bilateral mandible model (test and control sides in same animal). Results demonstrated that multiple (3) injections of 0.5 mg simvastatin effectively reduced soft tissue swelling while preserving bone growth (60% increase of bone width at 24 days) compared to simvastatin dome placement (43% increase at 24 days). Compared to controls, bone formation rate was significantly higher on the simvastatin side, especially in the dome. Three-point bending tests revealed higher maximum force to fracture and stiffness at 24 days with simvastatin injections. Long-term evaluation showed that 55% of maximum new bone formed 24 days post-injection was retained at 90 days.
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Affiliation(s)
- Yeonju Lee
- Department of Surgical Specialties and Oral Biology, University of Nebraska Medical Center, College of Dentistry, Lincoln, NE 68583, USA.
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Effects of Activated and Nonactivated Platelet-Rich Plasma on Proliferation of Human Osteoblasts In Vitro. J Oral Maxillofac Surg 2008; 66:297-301. [DOI: 10.1016/j.joms.2007.05.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2006] [Revised: 04/20/2007] [Accepted: 05/17/2007] [Indexed: 11/23/2022]
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Döri F, Huszár T, Nikolidakis D, Arweiler NB, Gera I, Sculean A. Effect of platelet-rich plasma on the healing of intra-bony defects treated with a natural bone mineral and a collagen membrane. J Clin Periodontol 2007; 34:254-61. [PMID: 17257158 DOI: 10.1111/j.1600-051x.2006.01044.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Regenerative periodontal therapy with a combination of platelet-rich plasma (PRP)+a natural bone mineral (NBM)+guided tissue regeneration (GTR) has been shown to result in significantly higher probing depth reductions and clinical attachment-level gains compared with treatment with open flap debridement alone. However, at present, it is unknown to what extent the use of PRP may additionally enhance the clinical outcome of the therapy compared with treatment with NBM+GTR. AIM To clinically compare treatment of deep intra-bony defects with NBM+PRP+GTR with NBM+GTR. MATERIAL AND METHODS Thirty patients suffering from advanced periodontal disease, and each of whom displayed one advanced intra-bony defect were randomly treated with a combination of either NBM+PRP+collagen membrane (GTR) or NBM+GTR. The following clinical parameters were evaluated at baseline and at 1 year after treatment: plaque index, gingival index, bleeding on probing, probing depth (PD), gingival recession and clinical attachment level (CAL). CAL changes were used as the primary outcome variable. RESULTS No differences in any of the investigated parameters were observed at baseline between the two groups. Healing was uneventful in all patients. At 1 year after therapy, the sites treated with NBM+PRP+GTR showed a reduction in mean PD from 8.9+/-2.3 mm to 3.4+/-2.0 mm (p<0.001) and a change in mean CAL from 10.9+/-2.2 mm to 6.4+/-1.8 mm (p<0.001). In the group treated with NBM+GTR, the mean PD was reduced from 8.9+/-2.5 mm to 3.4+/-2.3 mm (p<0.001), and the mean CAL changed from 11.1+/-2.5 mm to 6.5+/-2.3 mm (p<0.001). In both groups, all sites gained at least 3 mm of CAL. CAL gains of > or = 4 mm were measured in 80% (i.e. in 12 out of 15 defects) of the cases treated with NBM+PRP+GTR and in 87% (i.e. in 13 out of 15 defects) treated with NBM+GTR. No statistically significant differences in any of the investigated parameters were observed between the two groups. CONCLUSIONS Within its limits, the present study has shown that (i) at 1 year after regenerative surgery with both NBM+PRP+GTR and NBM+GTR, significant PD reductions and CAL gains were found, and (ii) the use of PRP has failed to improve the results obtained with NBM+GTR.
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Affiliation(s)
- Ferenc Döri
- Department of Periodontology, Semmelweis University, Budapest, Hungary
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Keles GC, Cetinkaya BO, Albayrak D, Koprulu H, Acikgoz G. Comparison of platelet pellet and bioactive glass in periodontal regenerative therapy. Acta Odontol Scand 2006; 64:327-33. [PMID: 17123908 DOI: 10.1080/00016350600758651] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE In recent years, platelet-rich plasma combined with graft materials has been used for periodontal regeneration. The individual role of blood products with guided tissue regeneration in periodontal regenerative therapy is unclear and needs to be elucidated. The purpose of this study was to compare the clinical and radiological effectiveness of platelet pellet/guided tissue regeneration (PP/GTR) and bioactive glass/GTR (BG/GTR) treatments in patients with periodontal disease. MATERIAL AND METHODS Using a split mouth design, 15 chronic periodontitis patients with pocket depths > or = 6 mm following periodontal initial therapy were randomly assigned to treatment with a combination of PP/GTR or BG/GTR in contralateral dentition areas. An absorbable membrane of polylactic acid was used GTR. The criteria for the comparative study were preoperative and postoperative 6 months pocket depth, clinical attachment level, and radiological alveolar bone level. RESULTS Both treatment modalities resulted in significant pocket depth reduction and gain in clinical attachment and alveolar bone level compared to the preoperative values (p < 0.01). Reduction in pocket depth, gain in clinical attachment and alveolar bone level were 4(3-6), 4.1+/-0.7, 4.9+/-1.4 mm in the PP/GTR group and 4(3-7), 4.1+/-1.2, 5.9+/-1.7 mm in the BG/GTR group, respectively. The differences between the two groups were not statistically significant (p > 0.05). CONCLUSIONS Within the limits of this study, it was concluded that PP may be effective as a bioactive glass graft material and used as a graft material for treating intrabony defects. PP thus appears to be a suitable alternative in the regenerative treatment of intrabony periodontal defects.
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Affiliation(s)
- Gonca Cayir Keles
- Department of Periodontology, Ondokuzmayis University, Faculty of Dentistry, Samsun, Turkey.
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Pryor ME, Susin C, Wikesjö UME. Validity of radiographic evaluations of bone formation in a rat calvaria osteotomy defect model. J Clin Periodontol 2006; 33:455-60. [PMID: 16677336 DOI: 10.1111/j.1600-051x.2006.00921.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the validity of radiographic evaluations of bone formation in a critical-size rat calvaria osteotomy defect model. METHODS Bilateral, critical-size ( [symbol in text] 6 mm) calvaria osteotomy defects in 30 adult Sprague-Dawley rats treated with a rat platelet-rich plasma preparation or control treatments were evaluated by radiographic and histometric measures following a 4- or 8-week healing interval. Standardized radiographic images of the rat calvaria gross specimens were used to assess bone formation within the defect sites by visual evaluation of the grey scale by three masked examiners. The most central portion of each defect site was subject to histometric analysis using a PC-based image analysis system. Kappa statistics and percentage agreement between the radiographic and histometric analysis were estimated. RESULTS Radiographic evaluations of bone formation are associated with significant weaknesses poorly representing actual healing events; kappa statistics (0.17) denoting slight agreement beyond chance. Perfect agreement between the histologic and radiographic analysis for defect sites showing complete and partial histologic bone fill was achieved 63% and 50% of the time, respectively. Agreement reached only 20% for sites with no/limited bone fill. When no/limited and partial bone fill occurred, the radiographic analysis tended to overestimate bone fill and underestimate bone fill when complete closure of the defect sites was observed in the histologic analysis. CONCLUSION Low accuracy was observed when radiographic evaluations were employed in identifying and characterizing bone fill in the rat calvaria osteotomy defects. Assessment of bone healing in animal models aiming at treatment recommendations for clinical application must not solely be based on radiographic analysis, but should be confirmed using histologic observations.
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Affiliation(s)
- Mary E Pryor
- Marquette University School of Dentistry - Surgical Sciences/Periodontics, Milwaukee, WI, USA.
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Boyan BD, Ranly DM, Schwartz Z. Use of growth factors to modify osteoinductivity of demineralized bone allografts: lessons for tissue engineering of bone. Dent Clin North Am 2006; 50:217-28, viii. [PMID: 16530059 DOI: 10.1016/j.cden.2005.11.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Biologically active bone graft substitute materials are needed for repair and regeneration of skeletal tissues. Current approaches are focused on the use of osteoinductive agents, including bone morphogenetic proteins (BMP) in combination with biodegradable carriers. Demineralized freeze-dried bone allograft (DFDBA) can provide an osteoconductive surface and, at the same time, function as a time-release carrier for BMP. Donor variability, however, limits the predictability of DFDBA as an osteoinductive material. This article examines the use of growth factors, including platelet-rich plasma, platelet-derived growth factor, enamel matrix derivatives, and BMP-2, to enhance the osteoinductive properties of human DFDBA.
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Affiliation(s)
- Barbara D Boyan
- Georgia Institute of Technology, Atlanta, GA 30332-0363, USA.
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