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Li J, Zheng Y, Yu Z, Kankala RK, Lin Q, Shi J, Chen C, Luo K, Chen A, Zhong Q. Surface-modified titanium and titanium-based alloys for improved osteogenesis: A critical review. Heliyon 2024; 10:e23779. [PMID: 38223705 PMCID: PMC10784177 DOI: 10.1016/j.heliyon.2023.e23779] [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: 04/30/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 01/16/2024] Open
Abstract
As implantable materials, titanium, and its alloys have garnered enormous interest from researchers for dental and orthopedic procedures. Despite their success in wide clinical applications, titanium, and its alloys fail to stimulate osteogenesis, resulting in poor bonding strength with surrounding bone tissue. Optimizing the surface topology and altered compositions of titanium and titanium-based alloys substantially promotes peri-implant bone regeneration. This review summarizes the utilization and importance of various osteogenesis components loaded onto titanium and its alloys. Further, different surface-modification methods and the release efficacy of loaded substances are emphasized. Finally, we summarize the article with prospects. We believe that further investigation studies must focus on identifying novel loading components, exploring various innovative, optimized surface-modification methods, and developing a sustained-release system on implant surfaces to improve peri-implant bone formation.
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Affiliation(s)
- Jingling Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Yaxin Zheng
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Zihe Yu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Ranjith Kumar Kankala
- Institute of Biomaterials and Tissue Engineering, Fujian Provincial Key Laboratory of Biochemical Technology, Huaqiao University, Xiamen, 361021, China
| | - Qianying Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Jingbo Shi
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Chao Chen
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Kai Luo
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Aizheng Chen
- Institute of Biomaterials and Tissue Engineering, Fujian Provincial Key Laboratory of Biochemical Technology, Huaqiao University, Xiamen, 361021, China
| | - Quan Zhong
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
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López-Valverde N, Aragoneses J, Rodríguez C, Aragoneses JM. Effect on osseointegration of dental implants treated with carboxyethylphosphonic acid and functionalized with BMP-2: preliminary study on a minipig model. Front Bioeng Biotechnol 2023; 11:1244667. [PMID: 37576987 PMCID: PMC10413559 DOI: 10.3389/fbioe.2023.1244667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/19/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction: Rough titanium surfaces biofunctionalised by osteogenic proteins, such as BMP-2, have been shown to accelerate the osseointegration process and reduce waiting times for prosthetic loading. The preclinical study presented here compared the bone in contact with the implant and bone neoformation and density between titanium (Ti) implants with a conventional etched surface (SLA type) and others treated with carboxyethylphosphonic acid (CEPA) and bone morphogenetic protein 2 (BMP-2), after 4 weeks of implantation in the tibia of a minipig model. Methods: Sixteen implants (eight experimental and eight control) of Ti-Al16-V4 with a tapered screw design and internal hexagonal connection were randomly inserted into the tibiae of four minipigs, four in each tibia. The experimental implants were treated with CEPA and BMP-2 and sterilised with gamma radiation (25 KG). The insertion torque was 40 N and primary stability was measured with the Osstell® device (ISQ 64 ± 2.6). Five bone parameters were evaluated: bone in contact with the implant (BIC), bone in contact with the corrected implant (BICc), new bone formation (BV/TV), bone density between threads (BAI/TA) and peri-implant bone density (BAP/TA). A histomorphometric study was performed and the samples were digitised with Adobe Photoshop Cs6. Statistical analysis of the variables was performed using SAS 9.4. Results: After a period of 4 weeks, no significant clinical signs were observed and all implants were integrated. Light microscopy of the experimental group revealed an ICB with no signs of fiber tissue, but with areas of ectopic new bone in the medullary space. Statistical analysis showed significant results for BIC and BICc (p = 0.0001 and p = 0.001, respectively). No statistical signification was found for the other parameters evaluated. Conclusion: Despite the limitations of this study, our results demonstrated that dental implant surfaces treated with CEPA and BMP-2 improve their biological response to osseointegration.
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Affiliation(s)
- Nansi López-Valverde
- Department of Surgery, Faculty of Medicine, Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Javier Aragoneses
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Cinthia Rodríguez
- Department of Dentistry, Universidad Federico Henríquez y Carvajal, Santo Domingo, Dominican Republic
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Li Y, Li D, Tang Z, Wang D, Yang Z, Liu Y. Current global research on mandibular defect: A bibliometric analysis from 2001 to 2021. Front Bioeng Biotechnol 2023; 11:1061567. [PMID: 37034253 PMCID: PMC10076558 DOI: 10.3389/fbioe.2023.1061567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
Background: Mandibular defects can result from congenital deformities, trauma, tumor resection, and osteomyelitis. The shape was irregular because the lower jaw was radians. This involves teeth and jaw functions; therefore, the difficulty of bone repair is greater than that in other body parts. Several standard treatments are available, but they result in various problems, such as difficulties in skin flap transplantation and possible zone dysfunction, artificial material boneless combining ability, and a long treatment period. This study aimed to introduce the present status of research on mandibular defects to analyze the current introduction and predict future research trends through a bibliometric study. Methods: From 2001 to 2021, publications on mandibular defects were collected for bibliometric visualization using VOSviewer, CiteSpace, and Scimago Graphica software based on the Web of Science Core Collection. Results: This study analyzed 4,377 articles, including 1,080 published in the United States, 563 in China, and 359 in Germany, with an increase in the number of articles published over the past 20 years. Wikesjoe and Ulf Mai E had the most publications (p = 36) and citations (citations = 1,553). Shanghai Jiaotong University published the highest number of papers among the research institutions (p = 88). The most productive journal was Journal of Oral and Maxillofacial Surgery, and the cited literature was primarily classified as dentistry, dermatology, and surgery. Cluster Analysis of Co-occurrence Keywords revealed that highest number of core words were mandibular defects, mandibular reconstruction, and bone regeneration. The highest cited words were head and neck cancer, accuracy, and osteogenic differentiation. High-frequency terms of Cluster Analysis of References were osteosynthesis plate, tissue engineering, and rapid distraction rate. Conclusion: Over the past 20 years, the number of studies on mandibular defects has gradually increased. New surgical procedures are increasingly being used in clinical practice. Current frontier topics mainly focus on areas such as computer-aided design, 3D printing of osteotomy and reconstruction guide plates, virtual surgical planning, and bone tissue engineering.
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Affiliation(s)
- Yongdi Li
- School of Basic Sciences, Guizhou Medical University, Guiyang, China
- School of Stomatology, Guizhou Medical University, Guiyang, China
| | - Duchenhui Li
- School of Basic Sciences, Guizhou Medical University, Guiyang, China
- School of Stomatology, Guizhou Medical University, Guiyang, China
| | - Zhenglong Tang
- School of Basic Sciences, Guizhou Medical University, Guiyang, China
- School of Stomatology, Guizhou Medical University, Guiyang, China
- *Correspondence: Zhenglong Tang,
| | - Dongxiang Wang
- School of Stomatology, Guizhou Medical University, Guiyang, China
| | - Zhishan Yang
- School of Stomatology, Guizhou Medical University, Guiyang, China
| | - Yiheng Liu
- School of Stomatology, Guizhou Medical University, Guiyang, China
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López-Valverde N, Aragoneses J, López-Valverde A, Quispe-López N, Rodríguez C, Aragoneses JM. Effectiveness of biomolecule-based bioactive surfaces, on os-seointegration of titanium dental implants: A systematic review and meta-analysis of in vivo studies. Front Bioeng Biotechnol 2022; 10:986112. [PMID: 36225604 PMCID: PMC9548556 DOI: 10.3389/fbioe.2022.986112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/12/2022] [Indexed: 12/09/2022] Open
Abstract
Titanium and alloy osseointegrated implants are used to replace missing teeth; however, some fail and are removed. Modifications of the implant surface with biologically active substances have been proposed. MEDLINE [via Pubmed], Embase and Web of Science were searched with the terms “titanium dental implants”, “surface properties”, “bioactive surface modifications”, “biomolecules”, “BMP”, “antibacterial agent”, “peptide”, “collagen”, “grown factor”, “osseointegration”, “bone apposition”, “osteogenic”, “osteogenesis”, “new bone formation”, “bone to implant contact”, “bone regeneration” and “in vivo studies”, until May 2022. A total of 10,697 references were iden-tified and 26 were included to analyze 1,109 implants, with follow-ups from 2 to 84 weeks. The ARRIVE guidelines and the SYRCLE tool were used to evaluate the methodology and scientific evidence. A meta-analysis was performed (RevMan 2020 software, Cochane Collaboration) with random effects that evaluated BIC at 4 weeks, with subgroups for the different coatings. The heterogeneity of the pooled studies was very high (95% CI, I2 = 99%). The subgroup of BMPs was the most favorable to coating. Surface modification of Ti implants by organic bioactive molecules seems to favor osseointegration in the early stages of healing, but long-term studies are necessary to corroborate the results of the experimental studies.
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Affiliation(s)
- Nansi López-Valverde
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Javier Aragoneses
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Antonio López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
- Department of Dentistry, Universidad Federico Henríquez y Carvajal, Santo Domingo, Dominican Republic
- *Correspondence: Antonio López-Valverde,
| | - Norberto Quispe-López
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Cinthia Rodríguez
- Department of Dentistry, Universidad Federico Henríquez y Carvajal, Santo Domingo, Dominican Republic
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Lupi SM, Torchia M, Rizzo S. Biochemical Modification of Titanium Oral Implants: Evidence from In Vivo Studies. MATERIALS (BASEL, SWITZERLAND) 2021; 14:2798. [PMID: 34074006 PMCID: PMC8197372 DOI: 10.3390/ma14112798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/02/2021] [Accepted: 05/19/2021] [Indexed: 12/29/2022]
Abstract
The discovery of osseointegration of titanium implants revolutionized the dental prosthesis field. Traditionally, implants have a surface that is processed by additive or subtractive techniques, which have positive effects on the osseointegration process by altering the topography. In the last decade, innovative implant surfaces have been developed, on which biologically active molecules have been immobilized with the aim of increasing stimulation at the implant-biological tissue interface, thus favoring the quality of osseointegration. Among these molecules, some are normally present in the human body, and the techniques for the immobilization of these molecules on the implant surface have been called Biochemical Modification of Titanium Surfaces (BMTiS). Different techniques have been described in order to immobilize those biomolecules on titanium implant surfaces. The aim of the present paper is to present evidence, available from in vivo studies, about the effects of biochemical modification of titanium oral implants on osseointegration.
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Kämmerer PW, Pabst AM, Dau M, Staedt H, Al-Nawas B, Heller M. Immobilization of BMP-2, BMP-7 and alendronic acid on titanium surfaces: Adhesion, proliferation and differentiation of bone marrow-derived stem cells. J Biomed Mater Res A 2019; 108:212-220. [PMID: 31587476 DOI: 10.1002/jbm.a.36805] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 08/28/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022]
Abstract
This study analyzed the influence of titanium (TiO2 ) surface modifications with two osteogenic proteins (BMP-2, BMP-7) and an anti-osteoclastic drug (alendronic acid [AA]) on sandblasted/acid-etched (SLA) and plain TiO2 (PT) on cell adhesion, proliferation and differentiation (alkaline phosphatase [AP] and osteocalcin [OC]) of bone-marrow derived stem cells (BMSCs) after 1, 3 and 7 days in-vitro. Initially, AA surfaces showed the highest cell number and surface coverage. At day 3 and 7, BMP and AA-modified surfaces exhibited a significantly enhanced cell growth. For proliferation, at days 3 and 7, an enhancement on BMP-2, BMP-7 and AA-surfaces was seen. At day 7, SLA also showed a higher proliferation when compared to PT. Initially, AP expression was elevated on SLA and AA surfaces. At days 3 and 7, a significant increased AP expression was seen for SLA, BMP-2, BMP-7 and AA discs. For OC, SLA and AA surfaces had the highest expression after 1 day whereas after 3 and 7 days a significant difference was recorded for SLA, BMP-2, BMP-7 and AA. In conclusion, a beneficial biological effect of a chemical immobilization method of BMP-2, BMP-7 and alendronate onto titanium surfaces on BMSCs was proven.
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Affiliation(s)
- Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Andreas M Pabst
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, Koblenz, Germany
| | - Michael Dau
- Department of Oral- and Maxillofacial Surgery, University Medical Center Rostock, Rostock, Germany
| | - Henning Staedt
- Private Practice and Department of Prosthodontics and Materials Science, University Medical Center Rostock, Rostock, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Martin Heller
- Department of Gynecology, Johannes Gutenberg University Medical Center, Mainz, Germany
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Kumar PS, KS SK, Grandhi VV, Gupta V. The Effects of Titanium Implant Surface Topography on Osseointegration: Literature Review. JMIR BIOMEDICAL ENGINEERING 2019. [DOI: 10.2196/13237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Effects of Immobilizations of rhBMP-2 and/or rhPDGF-BB on Titanium Implant Surfaces on Osseointegration and Bone Regeneration. COATINGS 2017. [DOI: 10.3390/coatings8010017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kwon DH, Lee SJ, Wikesjö UME, Johansson PH, Johansson CB, Sul YT. Bone tissue response following local drug delivery of bisphosphonate through titanium oxide nanotube implants in a rabbit model. J Clin Periodontol 2017; 44:941-949. [PMID: 28703333 DOI: 10.1111/jcpe.12776] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate whether surface chemistry-controlled TiO2 nanotube structures may serve as a local drug delivery system for zoledronic acid improving implant-bone support. METHODS Twenty-four screw-shaped Ti implants with surface chemistry-controlled TiO2 nanotube structures were prepared and divided into a zoledronic acid-formatted test and a native control group. The implants were inserted into contra-lateral femoral condyles in 12 New Zealand White rabbits. Bone support was evaluated using resonance frequency analysis (RFA) and removal torque (RTQ), as well as histometric analysis following a 3-weeks healing interval. RESULTS Zoledronic acid-formatted TiO2 nanotube test implants showed significantly improved implant stability and osseointegration measured using RFA and RTQ compared with control (p < 0.05), and showed significantly enhanced new bone formation within the root of the threads compared with control (p < 0.05). CONCLUSIONS TiO2 nanotube implants may prove to be a significant delivery system for drugs or biologic agents aimed at supporting local bone formation. Additional study of candidate drugs/agents, optimized dosage and release kinetics is needed prior to evaluation in clinical settings.
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Affiliation(s)
- David H Kwon
- Department of Prosthodontics/Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Periodontics, 618th Dental Company, Camp Humphreys, Pyeongtaek, Korea
| | - Sang J Lee
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | - Ulf M E Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Departments of Periodontics and Oral Biology, Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Petra H Johansson
- Department of Prosthodontics/Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carina B Johansson
- Department of Prosthodontics/Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Young-Taeg Sul
- Department of Prosthodontics/Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Three-Dimensional Upper Lip and Nostril Sill Changes After Cleft Alveolus Reconstruction Using Autologous Bone Grafting Versus Recombinant Human Bone Morphogenetic Protein-2. J Craniofac Surg 2017; 27:913-8. [PMID: 27244210 DOI: 10.1097/scs.0000000000002652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Cleft alveolus in patients with unilateral complete cleft lip and palate has been alternatively reconstructed with recombinant human bone morphogenetic protein (rhBMP)-2. However, its effects on upper lip and nostril sill anatomy are not known. Thus, the objective of this investigation was to assess and compare upper lip and nostril sill changes after cleft alveolus reconstruction with autologous bone from the iliac crest region and rhBMP-2. Patients were randomly allocated into 2 groups. In group 1, autologous bone from the iliac crest region was used to fill the cleft alveolus (n = 4), and in group 2, rhBMP-2 was used to fill the cleft alveolus (n = 8). Preoperatively and at one after the surgery, computerized tomography (CT) was performed. Reformatted CT imaging was used to perform cephalometric linear measurements of the upper lip and nostril sill regions. Inter- and intragroup data of the pre and postoperative reformatted CT measurements of the upper lip and nostril sill regions did not show differences (P >0.05) in cutaneous upper lip height and projection, nostril sill elevation, and subnasale projection. There were no significant upper lip and nostril sill anatomical changes after cleft alveolus reconstruction using autologous bone grafting and rhBMP-2.
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Hyzy SL, Olivares-Navarrete R, Ortman S, Boyan BD, Schwartz Z. Bone Morphogenetic Protein 2 Alters Osteogenesis and Anti-Inflammatory Profiles of Mesenchymal Stem Cells Induced by Microtextured Titanium In Vitro<sup/>. Tissue Eng Part A 2017; 23:1132-1141. [PMID: 28351289 DOI: 10.1089/ten.tea.2017.0003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Microtextured titanium (Ti) induces osteoblast differentiation of mesenchymal stem cells (MSCs) in the absence of exogenous osteogenic factors; and high-energy surface modifications speed healing of microrough Ti implants. Bone morphogenetic protein 2 (BMP2) is used clinically to improve peri-implant bone formation and osseointegration but can cause inflammation and bone-related complications. In this study, we determined whether BMP2 alters human MSC differentiation, apoptosis, and inflammatory factor production when grown on Ti implants with different surface properties. MATERIALS AND METHODS Human MSCs were cultured on Ti substrates (smooth [PT], sandblasted acid-etched [SLA], hydrophilic-SLA [modSLA]), or tissue culture polystyrene (TCPS). After 7 days, inflammatory mRNAs were measured by polymerase chain reaction array. In addition, 7-day cultures were treated with exogenous BMP2 and osteogenic differentiation and production of local factors, proinflammatory interleukins, and anti-inflammatory interleukins assessed. Finally, osteogenic markers and interleukins were measured in MSCs cultured for 48 h on BMP2 dip-coated SLA and modSLA surfaces. RESULTS Expression of interleukins, chemokines, cytokines, and growth factors was affected by surface properties, particularly on modSLA. MSCs on Ti produced fewer resorptive and more osteogenic/anti-inflammatory factors than cells on TCPS. Addition of 100 ng/mL BMP2 not only increased differentiation but also increased proinflammatory and decreased anti-inflammatory/antiresorptive factors. Two hundred nanograms per milliliter BMP2 abolished osteogenesis and dramatically increased pro-osteoclastogenic factors. MSCs cultured on BMP2-dip-coated disks produced similar proinflammatory profiles with inhibited osteogenic differentiation and had increased apoptotic markers at the highest doses. CONCLUSIONS MSCs underwent osteogenesis and regulated inflammatory cytokines on microtextured Ti. Exogenous BMP2 inhibited MSC differentiation and stimulated a dose-dependent proinflammatory and apoptotic response. Use of BMP2 with microtextured metal implants may increase inflammation and possibly delay bone formation dependent on dose, suggesting that application of BMP2 clinically during implant insertion may need to be reevaluated.
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Affiliation(s)
- Sharon L Hyzy
- 1 Department of Biomedical Engineering, Virginia Commonwealth University , Richmond, Virginia
| | - Rene Olivares-Navarrete
- 1 Department of Biomedical Engineering, Virginia Commonwealth University , Richmond, Virginia
| | - Sarah Ortman
- 2 Department of Biomedical Engineering, Georgia Institute of Technology , Atlanta, Georgia
| | - Barbara D Boyan
- 1 Department of Biomedical Engineering, Virginia Commonwealth University , Richmond, Virginia.,2 Department of Biomedical Engineering, Georgia Institute of Technology , Atlanta, Georgia
| | - Zvi Schwartz
- 1 Department of Biomedical Engineering, Virginia Commonwealth University , Richmond, Virginia.,3 Department of Periodontics, University of Texas Health Science Center at San Antonio , San Antonio, Texas
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Meng HW, Chien EY, Chien HH. Dental implant bioactive surface modifications and their effects on osseointegration: a review. Biomark Res 2016. [PMID: 27999672 DOI: 10.1186/s40364‐016‐0078‐z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The purpose of this article is to review and update the current developments of biologically active dental implant surfaces and their effect on osseointegration. METHODS PubMed was searched for entries from January 2006 to January 2016. Only in-vivo studies that evaluated the effects of biomolecular coatings on titanium dental implants inserted into the bone of animals or humans were included. RESULTS Thirty four non-review studies provided data and observations were included in this review. Within the criteria, four categories of biomolecular coatings were evaluated. The potential biomolecules include bone morphogenetic proteins in 8 articles, other growth factors in 8 articles, peptides in 5 articles, and extracellular matrix in 13 articles. Most articles had a healing period of 1 to 3 months and the longest time of study was 6 months. In addition, all studies comprised of implants inserted in animals except for one, which evaluated implants placed in both animals and humans. The results indicate that dental implant surface modification with biological molecules seem to improve performance as demonstrated by histomorphometric analysis (such as percentage of bone-to-implant contact and peri-implant bone density) and biomechanical testing (such as removal torque, push-out/pull-out tests, and resonance frequency analysis). CONCLUSIONS Bioactive surface modifications on implant surfaces do not always offer a beneficial effect on osseointegration. Nevertheless, surface modifications of titanium dental implants with biomolecular coatings seem to promote peri-implant bone formation, resulting in enhanced osseointegration during the early stages of healing. However, long-term clinical studies are needed to validate this result. In addition, clinicians must keep in mind that results from animal experiments need not necessarily reflect the human clinical reality.
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Affiliation(s)
- Hsiu-Wan Meng
- Department of Periodontics, University of Texas School of Dentistry at Houston, Houston, TX USA
| | - Esther Yun Chien
- College of Dentistry, The Ohio State University, Columbus, OH USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, 305 West 12th Avenue, Columbus, OH 43210 USA
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Meng HW, Chien EY, Chien HH. Dental implant bioactive surface modifications and their effects on osseointegration: a review. Biomark Res 2016; 4:24. [PMID: 27999672 PMCID: PMC5155396 DOI: 10.1186/s40364-016-0078-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 11/29/2016] [Indexed: 01/15/2023] Open
Abstract
Background The purpose of this article is to review and update the current developments of biologically active dental implant surfaces and their effect on osseointegration. Methods PubMed was searched for entries from January 2006 to January 2016. Only in-vivo studies that evaluated the effects of biomolecular coatings on titanium dental implants inserted into the bone of animals or humans were included. Results Thirty four non-review studies provided data and observations were included in this review. Within the criteria, four categories of biomolecular coatings were evaluated. The potential biomolecules include bone morphogenetic proteins in 8 articles, other growth factors in 8 articles, peptides in 5 articles, and extracellular matrix in 13 articles. Most articles had a healing period of 1 to 3 months and the longest time of study was 6 months. In addition, all studies comprised of implants inserted in animals except for one, which evaluated implants placed in both animals and humans. The results indicate that dental implant surface modification with biological molecules seem to improve performance as demonstrated by histomorphometric analysis (such as percentage of bone-to-implant contact and peri-implant bone density) and biomechanical testing (such as removal torque, push-out/pull-out tests, and resonance frequency analysis). Conclusions Bioactive surface modifications on implant surfaces do not always offer a beneficial effect on osseointegration. Nevertheless, surface modifications of titanium dental implants with biomolecular coatings seem to promote peri-implant bone formation, resulting in enhanced osseointegration during the early stages of healing. However, long-term clinical studies are needed to validate this result. In addition, clinicians must keep in mind that results from animal experiments need not necessarily reflect the human clinical reality.
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Affiliation(s)
- Hsiu-Wan Meng
- Department of Periodontics, University of Texas School of Dentistry at Houston, Houston, TX USA
| | - Esther Yun Chien
- College of Dentistry, The Ohio State University, Columbus, OH USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, 305 West 12th Avenue, Columbus, OH 43210 USA
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Jenny G, Jauernik J, Bierbaum S, Bigler M, Grätz KW, Rücker M, Stadlinger B. A systematic review and meta-analysis on the influence of biological implant surface coatings on periimplant bone formation. J Biomed Mater Res A 2016; 104:2898-910. [PMID: 27301790 DOI: 10.1002/jbm.a.35805] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/07/2016] [Indexed: 11/11/2022]
Abstract
This systematic review and meta-analysis evaluated the influence of biological implant surface coatings on periimplant bone formation in comparison to an uncoated titanium reference surface in experimental large animal models. The analysis was structured according to the PRISMA criteriae. Of the1077 studies, 30 studies met the inclusion criteriae. Nineteen studies examined the bone implant contact (BIC) and were included in the meta-analysis. Overall, the mean increase in BIC for the test surfaces compared to the reference surfaces was 3.7 percentage points (pp) (95% CI -3.9-11.2, p = 0.339). Analyzing the increase in BIC for specific coated surfaces in comparison to uncoated reference surfaces, inorganic surface coatings showed a significant mean increase in BIC of 14.7 pp (95% CI 10.6-18.9, p < 0.01), extracellular matrix (ECM) surface coatings showed an increase of 10.0 pp (95% CI 4.4-15.6, p < 0.001), and peptide coatings showed a statistical trend with 7.1 pp BIC increase (95% CI -0.8-15.0, p = 0.08). In this review, no statistically significant difference could be found for growth factor surface coatings (observed difference -3.3 pp, 95% CI -16.5-9.9, p = 0.6). All analyses are exploratory in nature. The results show a statistically significant effect of inorganic and ECM coatings on periimplant bone formation. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2898-2910, 2016.
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Affiliation(s)
- Gregor Jenny
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland
| | - Johanna Jauernik
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland
| | - Susanne Bierbaum
- Max-Bergmann Center of Biomaterials, Technische Universität Dresden, Budapester Str. 27, D-01969 Dresden, Germany
| | - Martin Bigler
- SAKK Schweizerische Arbeitsgemeinschaft Für Klinische Krebsforschung, Bern, Effingerstr. 32, CH-3008 Bern, Switzerland
| | - Klaus W Grätz
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland
| | - Martin Rücker
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland.
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Effects of Osseointegration by Bone Morphogenetic Protein-2 on Titanium Implants In Vitro and In Vivo. Bioinorg Chem Appl 2016; 2016:3837679. [PMID: 26977141 PMCID: PMC4761669 DOI: 10.1155/2016/3837679] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 12/22/2015] [Indexed: 01/18/2023] Open
Abstract
This study designed a biomimetic implant for reducing healing time and achieving early osseointegration to create an active surface. Bone morphogenetic protein-2 (BMP-2) is a strong regulator protein in osteogenic pathways. Due to hardly maintaining BMP-2 biological function and specificity, BMP-2 efficient delivery on implant surfaces is the main challenge for the clinic application. In this study, a novel method for synthesizing functionalized silane film for superior modification with BMP-2 on titanium surfaces is proposed. Three groups were compared with and without BMP-2 on modified titanium surfaces in vitro and in vivo: mechanical grinding; electrochemical modification through potentiostatic anodization (ECH); and sandblasting, alkali heating, and etching (SMART). Cell tests indicated that the ECH and SMART groups with BMP-2 markedly promoted D1 cell activity and differentiation compared with the groups without BMP-2. Moreover, the SMART group with a BMP-2 surface markedly promoted early alkaline phosphatase expression in the D1 cells compared with the other surface groups. Compared with these groups in vivo, SMART silaning with BMP-2 showed superior bone quality and created contact areas between implant and surrounding bones. The SMART group with BMP-2 could promote cell mineralization in vitro and osseointegration in vivo, indicating potential clinical use.
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16
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Effect of sustained release of rhBMP-2 from dried and wet hyaluronic acid hydrogel carriers compared with direct dip coating of rhBMP-2 on peri-implant osteogenesis of dental implants in canine mandibles. J Craniomaxillofac Surg 2015; 44:116-25. [PMID: 26732636 DOI: 10.1016/j.jcms.2015.11.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 10/19/2015] [Accepted: 11/25/2015] [Indexed: 12/13/2022] Open
Abstract
Hyaluronic acid (HA) hydrogel has been used as a carrier of recombinant human bone morphogenetic protein (rhBMP)-2 for sustained delivery. To enhance peri-implant osteogenesis, a dried coating of rhBMP-2 HA hydrogel (BMP-HAH) on dental implants was designed; this approach provides the advantage of omitting in situ preparation of wet HA hydrogel. Sustained release of rhBMP-2 was more efficient for dried hydrogel over wet hydrogel. For both types, the released rhBMP-2 consistently led to enhanced alkaline phosphatase activity and osterix expression in human mesenchymal stromal cells. Histomorphometric analysis 4 weeks after placement of a dental implant in canine mandibles showed that the dried coating of BMP-HAH (10 μg/ml, n = 6) resulted in a significantly greater bone area (BA) than the wet BMP-HAH (10 μg/ml, n = 6) (p = 0.006) and implants without any coating (n = 6) (p = 0.022), while simple dip coating with rhBMP-2 (10 μg/ml, n = 6) resulted in significantly greater BA than the other three groups (p < 0.0005). Bone-to-implant contact (BIC) was significantly different only between the dried and wet coating of BMP-HAH (p = 0.014). Our results suggest that a simple dip coating of rhBMP-2 is more effective for increased peri-implant osteogenesis compared to a coating of BMP-HAH with sustained release.
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Three-Dimensional Changes of Maxilla after Secondary Alveolar Cleft Repair: Differences Between rhBMP-2 and Autologous Iliac Crest Bone Grafting. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e451. [PMID: 26301140 PMCID: PMC4527625 DOI: 10.1097/gox.0000000000000417] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 05/13/2015] [Indexed: 02/05/2023]
Abstract
Background: Recombinant human bone morphogenetic protein (rhBMP)-2 has been used as an alternative to autologous bone transferring, a standard method of treatment. However, its potential adverse effect on anterior maxillary arch is unknown. Thus, the purpose of this study was to quantify sagittal and transversal changes of anterior maxilla after secondary alveolar cleft repair using traditional iliac crest bone grafting versus rhBMP-2. Methods: Twelve unilateral complete cleft lip and palate patients were randomly divided into 2 groups. In group 1, patients underwent traditional iliac crest bone grafting transferring (n = 4), and in group 2, patients underwent alveolar cleft reconstruction using collagen matrix with lyophilized rhBMP-2 (n = 8). Computed tomography (CT) imaging was performed preoperatively and at 1 year postoperatively, using a previously standardized protocol. A three-dimensional (3D) CT cephalometric analysis of the linear and angular measurements of the sagittal and transverse maxilla planes was performed to assess intra- and intergroup maxillary changes. Results: Intra- and intergroup comparisons of the pre- and postoperative 3D CT cephalometric linear and angular measurements of the sagittal and transverse maxilla planes showed no significant (all P > 0.05) differences among all studied variables. Conclusions: There were no significant anterior maxilla changes after maxillary cleft repair either using iliac crest bone grafting or rhBMP-2.
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18
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Improving osteoblast functions and bone formation upon BMP-2 immobilization on titanium modified with heparin. Carbohydr Polym 2014; 114:123-132. [DOI: 10.1016/j.carbpol.2014.08.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 08/04/2014] [Accepted: 08/05/2014] [Indexed: 12/21/2022]
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Al-Hezaimi K, Nevins M, Kim SW, Fateh A, Kim DM. Efficacy of growth factor in promoting early osseointegration. J ORAL IMPLANTOL 2014; 40:543-8. [PMID: 24946082 DOI: 10.1563/aaid-joi-d-13-00304] [Citation(s) in RCA: 10] [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
A preclinical study was conducted to evaluate the feasibility of 2 different topical formulations of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) to promote early osseointegration and enhanced bone-to-implant contact (BIC) for dental implants placed in an edentulous ridge. Six female beagle dogs were divided into 3 groups. The control group included 4 implants with no coating; test group A included 10 implants with commercially available rhPDGF-BB formulation coating; and second test group B included 10 implants with prototype viscous rhPDGF-BB coating. Three dogs were sacrificed at 3 weeks (12 implants) and the remaining 3 dogs at 6 weeks after implant placement (12 implants). The specimens were retrieved for histological evaluation, and revealed an uneventful healing of all implants without any sign of an inflammatory response at the different time intervals. Furthermore, the bone was in very close contact with the implants' surfaces with no evidence of intervening fibrous tissue layers. At 3 weeks, new bone formation between most implant threads on rhPDGF-BB coated implants was evident, whereas in the control group only a thin and sparse amount of new bone was noted. At 6 weeks, the commercially available rhPDGF-BB formulation coated implant group (Group A) showed more trabecular bone and higher BIC compared to the other 2 groups. Histologically, the results in this study showed that use of conventionally available rhPDGF-BB formulation as the implant surface treatment may accelerate the process of osseointegration and enhance BIC.
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Affiliation(s)
- Khalid Al-Hezaimi
- 1 Department of Periodontology, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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20
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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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Herberg S, Susin C, Pelaez M, Howie RN, Moreno de Freitas R, Lee J, Cray JJ, Johnson MH, Elsalanty ME, Hamrick MW, Isales CM, Wikesjö UME, Hill WD. Low-dose bone morphogenetic protein-2/stromal cell-derived factor-1β cotherapy induces bone regeneration in critical-size rat calvarial defects. Tissue Eng Part A 2014; 20:1444-53. [PMID: 24341891 DOI: 10.1089/ten.tea.2013.0442] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Increasing evidence suggests that stromal cell-derived factor-1 (SDF-1/CXCL12) is involved in bone formation, though underlying molecular mechanisms remain to be fully elucidated. Also, contributions of SDF-1β, the second most abundant splice variant, as an osteogenic mediator remain obscure. We have shown that SDF-1β enhances osteogenesis by regulating bone morphogenetic protein-2 (BMP-2) signaling in vitro. Here we investigate the dose-dependent contribution of SDF-1β to suboptimal BMP-2-induced local bone formation; that is, a dose that alone would be too low to significantly induce bone formation. We utilized a critical-size rat calvarial defect model and tested the hypotheses that SDF-1β potentiates BMP-2 osteoinduction and that blocking SDF-1 signaling reduces the osteogenic potential of BMP-2 in vivo. In preliminary studies, radiographic analysis at 4 weeks postsurgery revealed a dose-dependent relationship in BMP-2-induced new bone formation. We then found that codelivery of SDF-1β potentiates suboptimal BMP-2 (0.5 μg) osteoinduction in a dose-dependent order, reaching comparable levels to the optimal BMP-2 dose (5.0 μg) without apparent adverse effects. Blocking the CXC chemokine receptor 4 (CXCR4)/SDF-1 signaling axis using AMD3100 attenuated the osteoinductive potential of the optimal BMP-2 dose, confirmed by qualitative histologic analysis. In conclusion, SDF-1β provides potent synergistic effects that support BMP-induced local bone formation and thus appears a suitable candidate for optimization of bone augmentation using significantly lower amounts of BMP-2 in spine, orthopedic, and craniofacial settings.
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Shah NJ, Hyder MN, Moskowitz JS, Quadir MA, Morton SW, Seeherman HJ, Padera RF, Spector M, Hammond PT. Surface-mediated bone tissue morphogenesis from tunable nanolayered implant coatings. Sci Transl Med 2014; 5:191ra83. [PMID: 23803705 DOI: 10.1126/scitranslmed.3005576] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The functional success of a biomedical implant critically depends on its stable bonding with the host tissue. Aseptic implant loosening accounts for more than half of all joint replacement failures. Various materials, including metals and plastic, confer mechanical integrity to the device, but often these materials are not suitable for direct integration with the host tissue, which leads to implant loosening and patient morbidity. We describe a self-assembled, osteogenic, polymer-based conformal coating that promotes stable mechanical fixation of an implant in a surrogate rodent model. A single modular, polymer-based multilayered coating was deposited using a water-based layer-by-layer approach, by which each element was introduced on the surface in nanoscale layers. Osteoconductive hydroxyapatite (HAP) and osteoinductive bone morphogenetic protein-2 (BMP-2) contained within the nanostructured coating acted synergistically to induce osteoblastic differentiation of endogenous progenitor cells within the bone marrow, without indications of a foreign body response. The tuned release of BMP-2, controlled by a hydrolytically degradable poly(β-amino ester), was essential for tissue regeneration, and in the presence of HAP, the modular coating encouraged the direct deposition of highly cohesive trabecular bone on the implant surface. In vivo, the bone-implant interfacial tensile strength was significantly higher than standard bioactive bone cement, did not fracture at the interface, and had long-term stability. Collectively, these results suggest that the multilayered coating system promotes biological fixation of orthopedic and dental implants to improve surgical outcomes by preventing loosening and premature failure.
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Affiliation(s)
- Nisarg J Shah
- Department of Chemical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
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Lai RF, Zhou ZY, Chen T. Accelerating bone generation and bone mineralization in the Interparietal sutures of rats using an rhBMP-2/ACS composite after rapid expansion. Exp Anim 2014; 62:189-96. [PMID: 23903053 PMCID: PMC4160950 DOI: 10.1538/expanim.62.189] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
This study aims to investigate the effects of rhBMP-2/ACS composite on bone regeneration and mineralization during expansion of the interparietal suture in rats. Forty 10-week-old Sprague-Dawley rats were divided into four groups (n=10). The first group (intact group) did not receive any intervention. The second group (expansion control group) received an expansion force of 60 g. The remaining two groups received an expansion force of 60 g and were implanted with an atelo-type I absorbable collagen sponge and rhBMP-2/ACS composite positioned on the suture beneath the periosteum. The relapse, relapse ratio, relevant bone remodelling, and calcium and osteocalcin contents were evaluated. Bone regeneration in the interparietal suture was estimated by the histological method. The osteocalcin content was measured by radioimmunoassay, and the calcium content was measured by atomic absorption spectrophotometry. Bone regeneration was more active in the suture after application of the expansion force compared with that of the suture without any intervention. Bone bridges formed in the rhBMP-2/collagen composite group. Both osteocalcin and calcium content were higher in the rhBMP-2/collagen composite group than in the other three groups (P<0.01). The relapse ratio in the rhBMP-2/collagen group was much lower than that in the other two expansion groups (P<0.01). RhBMP-2/ACS composite can promote bone regeneration and bone mineralization in the expanded suture and decrease the relapse ratio. Thus, the rhBMP-2/ACS composite may be therapeutically beneficial to the inhibition of relapse and shortening of the retention period during rapid expansion.
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Affiliation(s)
- Ren-Fa Lai
- The Medical Centre of Stomatology, The 1st Affiliated Hospital Jinan University, No. 613 Huangpu Road, Tianhe District, Guangzhou 510630, PR China
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Erdogan Ö, Üstün Y, Tatli U, Damlar I, Daglıoglu K. A Pig Model for the Histomorphometric Evaluation of Hard Tissue Around Dental Implants. J ORAL IMPLANTOL 2013; 39:551-7. [DOI: 10.1563/aaid-joi-d-11-00009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study aimed to evaluate the frontal bone of Swiss Domestic pigs as an animal model for the histologic-histomorphometric examination of bony tissue around dental implants. We inserted SLA surface implants 4.1 mm in diameter and 10 mm in length into the frontal bones of 9 Swiss-Domestic pigs. Histologic and histomorphometric studies were conducted on the undecalcified sections. Histologic examinations showed that the specimens contain a sufficient amount of bone to provide homogenous bone coverage for standard diameter dental implant placement. The mean bone to implant contact was 61.9% ± 8.7%. Other histomorphometric parameters revealed the regular trabecular architecture at this site. Pigs' frontal bone appears to be a suitable animal model in short-term dental implant studies because it provides a sufficient amount of bone and favorable bone microarchitecture.
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Affiliation(s)
- Özgür Erdogan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Yakup Üstün
- Private Practice, Oral and Maxillofacial Surgery, Adana, Turkey
| | - Ufuk Tatli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Ibrahim Damlar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Kenan Daglıoglu
- Experimental Medical Research Center, Çukurova University, Adana, Turkey
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Zuffetti F, Testori T, Capelli M, Rossi MC, Del Fabbro M. The topical administration of bisphosphonates in implant surgery: a randomized split-mouth prospective study with a follow-up up to 5 years. Clin Implant Dent Relat Res 2013; 17 Suppl 1:e168-76. [PMID: 24107257 DOI: 10.1111/cid.12151] [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: 11/30/2022]
Abstract
OBJECTIVE To evaluate the efficacy of the topical administration of bisphosphonates in implant therapy. MATERIALS AND METHODS Thirty-nine consecutive patients were selected for a split-mouth study. Inclusion criteria were: presence of a bilateral or total edentulism, ability to tolerate conventional implant procedures, older than 18 years. Ten patients were smokers. Ten patients were fully edentulous in both maxilla and mandible, 12 patients had fully edentulous maxilla or mandible, and 17 were bilaterally partially edentulous (9 in the mandible and 8 in the maxilla). A one-stage procedure was adopted in all cases. The prosthetic phase started 10 weeks after implant insertion. Each patient received implants on the control side and the test side, with insertion performed in the conventional way on the control side; on the test side, a 3% clodronate solution mixed with a surfactant (Tween-20) at a 1:3 ratio was topically administered both at the implant surface and at the implant site. RESULTS One hundred fifty-five implants were inserted. The test and control groups included 75 and 80 implants, respectively. The implant insertion torque was no less than 30 Ncm. A total of 7 implants failed in the control group (6 before loading and one after 12 months of loading). No failure occurred on the test side. By the 5-year follow-up, no further implant failure had been recorded. Overall, implant survival rates at 5 years for the test and control groups were, respectively, 100% and 91.3%, the difference being significant (p < .01). Mean marginal bone loss was 0.85 ± 0.71 mm in the test group and 1.12 ± 0.85 mm in the control group after 1 year of loading and stable thereafter. The difference was not significant. CONCLUSIONS The topical administration of bisphosphonates may positively affect implant survival in the preloading and postloading phases in partially and fully edentulous patients. However, a larger study population is needed to verify these promising clinical results.
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Affiliation(s)
- Francesco Zuffetti
- Section of Implant Dentistry and Oral Rehabilitation, Dental Clinic, Department of Biomedical, Surgical and Dental Sciences, IRCCS Galeazzi Orthopedic Institute, University of Milan, Italy
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Freitas RMD, Spin-Neto R, Marcantonio Junior E, Pereira LAVD, Wikesjö UME, Susin C. Alveolar ridge and maxillary sinus augmentation using rhBMP-2: a systematic review. Clin Implant Dent Relat Res 2013; 17 Suppl 1:e192-201. [PMID: 24102703 DOI: 10.1111/cid.12156] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this systematic review was to evaluate clinical and safety data for recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge (ACS) carrier when used for alveolar ridge/maxillary sinus augmentation in humans. MATERIALS AND METHODS Clinical studies/case series published 1980 through June 2012 using rhBMP-2/ACS were searched. Studies meeting the following criteria were considered eligible for inclusion: >10 subjects at baseline and maxillary sinus or alveolar ridge augmentation not concomitant with implant placement. RESULTS Seven of 69 publications were eligible for review. rhBMP-2/ACS yielded clinically meaningful bone formation for maxillary sinus augmentation that would allow placement of regular dental implants without consistent differences between rhBMP-2 concentrations. Nevertheless, the statistical analysis showed that sinus augmentation following autogenous bone graft was significantly greater (mean bone height: 1.6 mm, 95% CI: 0.5-2.7 mm) than for rhBMP-2/ACS (rhBMP-2 at 1.5 mg/mL). In extraction sockets, rhBMP-2/ACS maintained alveolar ridge height while enhancing alveolar ridge width. Safety reports did not represent concerns for the proposed indications. CONCLUSIONS rhBMP-2/ACS appears a promising alternative to autogenous bone grafts for alveolar ridge/maxillary sinus augmentation; dose and carrier optimization may expand its efficacy, use, and clinical application.
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Affiliation(s)
- Rubens Moreno de Freitas
- Department of Oral Diagnosis and Surgery - Periodontics, UNESP - Universidade Estadual Paulista, Araraquara Dental School, Araraquara, SP, Brazil; Laboratory for Applied Periodontal & Craniofacial Regeneration, Department of Periodontics and Oral Biology, College of Dental Medicine, Department of Orthopedic Surgery, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
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Lu SX, Fiorini T, Lee J, Prasad HS, Buxton AN, Bisch FC, Dixon DR, Susin C, Wikesjö UME. Evaluation of a compression resistant matrix for recombinant human bone morphogenetic protein-2. J Clin Periodontol 2013; 40:688-97. [DOI: 10.1111/jcpe.12109] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Sheldon X. Lu
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Regents University College of Dental Medicine; Augusta GA USA
- U.S. Army Advanced Education Program in Periodontics; Fort Gordon GA USA
| | - Tiago Fiorini
- 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
| | - Hari S. Prasad
- Hard Tissue Research Laboratory; University of Minnesota; Minneapolis MN USA
| | | | - Fredrick C. Bisch
- U.S. Army Advanced Education Program in Periodontics; Fort Gordon GA USA
| | - Douglas R. Dixon
- U.S. Army Advanced Education Program in Periodontics; Fort Gordon GA USA
| | - Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Regents University College of Dental Medicine; Augusta GA USA
| | - 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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Ramazanoglu M, Lutz R, Rusche P, Trabzon L, Kose GT, Prechtl C, Schlegel KA. Bone response to biomimetic implants delivering BMP-2 and VEGF: an immunohistochemical study. J Craniomaxillofac Surg 2013; 41:826-35. [PMID: 23434516 DOI: 10.1016/j.jcms.2013.01.037] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 12/18/2012] [Accepted: 01/15/2013] [Indexed: 10/27/2022] Open
Abstract
This animal study evaluated bone healing around titanium implant surfaces biomimetically coated with bone morphogenic protein-2 (BMP-2) and/or vascular endothelial growth factor (VEGF) by examining bone matrix proteins and mineralisation. Five different implant surfaces were established: acid-etched surface (AE), biomimetic calcium phosphate surface (CAP), BMP-2 loaded CAP surface, VEGF loaded CAP surface and dual BMP-2 + VEGF loaded CAP surface. The implants were inserted into calvariae of adult domestic pigs. For the comparison of osteoconductive capacity of each surface, bone mineral density and expression of bone matrix proteins (collagen I, BMP-2/4, osteocalcin and osteopontin) inside defined chambers around the implant were assessed using light microscopy and microradiography and immunohistochemical analysis at 1, 2 and 4 weeks. In the both groups delivering BMP-2, the bone mineral density was significantly enhanced after 2 weeks and the highest value was measured for the group BMP + VEGF. In the group VEGF, collagen I and BMP-2/4 expressions were significantly up-regulated at the first and second weeks. The percentage of BMP-2/4 positive cells in the group BMP + VEGF was significantly enhanced compared with the groups AE and CAP at the second week. Although the highest osteocalcin and osteopontin expression values were observed for the group BMP + VEGF after 2 weeks, no statistically significant difference in osteocalcin and osteopontin expressions was found between all groups at any time. It was concluded that combined delivery of BMP-2 and VEGF favoured bone mineralisation and expression of important bone matrix proteins that might explain synergistic interaction between both growth factors.
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Affiliation(s)
- Mustafa Ramazanoglu
- Department of Oral Surgery, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey.
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Huh JB, Kim SE, Kim HE, Kang SS, Choi KH, Jeong CM, Lee JY, Shin SW. Effects of anodized implants coated with Escherichia coli-derived rhBMP-2 in beagle dogs. Int J Oral Maxillofac Surg 2012; 41:1577-84. [DOI: 10.1016/j.ijom.2012.04.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 02/20/2012] [Accepted: 04/05/2012] [Indexed: 11/26/2022]
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Lee BC, Yeo IS, Kim DJ, Lee JB, Kim SH, Han JS. Bone formation around zirconia implants combined with rhBMP-2 gel in the canine mandible. Clin Oral Implants Res 2012; 24:1332-8. [PMID: 22934611 DOI: 10.1111/clr.12004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to estimate the effects of zirconia implants and recombinant human bone morphogenetic protein-2 (rhBMP-2) gel on the acceleration of local bone formation and osseointegration in the canine mandible. MATERIALS AND METHODS Four groups of 48 implants with identical geometry were installed in the mandibles of beagle dogs: alumina-blasted zirconia implants applied with rhBMP-2, alumina-blasted zirconia implants applied with demineralized bone matrix (DBM), alumina-blasted zirconia implants, and resorbable blast media-treated titanium (Ti) implants. For the first two groups, zirconia implants were inserted after the surgical sites were filled with rhBMP-2 or DBM gel. For the other two groups, zirconia or Ti implants were installed with no adjunctive treatment. Fluorescent bone markers were administered to monitor bone remodeling at weeks 2, 4, and 5 postimplantation. After healing periods of 3 weeks and 6 weeks, the animals were sacrificed, and fluorescent microscopy, histology, and histomorphometric analyses were performed. RESULTS Fluorescent microscopy showed that bone formation around the zirconia implants installed with rhBMP-2 gel was the most prominent at 2 weeks postimplantation, while the Ti implants acquired bone apposition mainly at week 5. No significant differences were found in bone area among the groups (P > 0.05). The zirconia implants showed similar bone-to-implant contact to the Ti implants. There were no significant differences in bone-to-implant contact between the zirconia implants with rhBMP-2 gel and those with DBM (P > 0.05). CONCLUSIONS The zirconia implants with alumina-blasted surfaces may achieve osseointegration in much the same manner as the well-established Ti implants. The area influenced by rhBMP-2 gel, including the alveolar crest, may cause active remodeling and early bone formation.
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Affiliation(s)
- Byung-Chul Lee
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
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Leknes KN, Yang J, Qahash M, Polimeni G, Susin C, Wikesjö UME. Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor -5 (rhGDF-5). Radiographic observations. Clin Oral Implants Res 2012; 24:1185-91. [PMID: 22882602 DOI: 10.1111/j.1600-0501.2012.02564.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Application of growth factors onto dental implant surfaces is being considered to support local bone formation. Bone morphogenetic protein-2 (BMP-2) and BMP-7 have been shown to support local bone formation, but are also associated with adverse events including seroma formation, extensive bone remodeling, and implant displacement captured in the radiographic evaluation. This report presents mineralized tissue formation and associated adverse events following implantation of recombinant human growth/differentiation factor-5 (rhGDF-5) coated onto a purpose-designed titanium porous-oxide implant surface. MATERIAL AND METHODS Twelve young adult Labrador dogs were used. Three 10-mm titanium implants/jaw quadrant were placed 5 mm into the alveolar ridge in the posterior mandible following surgical extraction of the premolar teeth and reduction of the alveolar ridge. Six animals received implants coated with rhGDF-5 at 30 or 60 μg/implant in contralateral jaw quadrants. Six animals received implants coated with rhGDF-5 at 120 μg/implant or uncoated implants (sham-surgery control) using the same split-mouth design. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants. Radiographic recordings were made immediately postsurgery (baseline), and at week 4 and 8 (end of study). Two masked examiners performed the analysis using computer enhanced radiographic images. RESULTS rhGDF-5 coated implants displayed mineralized tissue formation significantly exceeding that of the sham-surgery control in a dose-dependent order. The greatest increase was observed for implants coated with rhGDF-5 at 60 μg and 120 μg amounting to approximately 2.2 mm for both groups at 8 weeks. Importantly, none of the implants showed evidence of peri-implant bone remodeling, implant displacement, or seroma formation. The newly formed mineralized tissues assumed characteristics of the resident bone. CONCLUSIONS rhGDF-5 coated onto a titanium porous-oxide implant surface exhibits a dose-dependent potential to stimulate local mineralized tissue formation. Application of rhGDF-5 appears safe as it is associated with limited, if any, adverse events.
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Affiliation(s)
- Knut N Leknes
- Department of Clinical Dentistry - Periodontology, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Effect of different concentrations of Escherichia Coli-derived rhBMP-2 coating on osseointegration of implants in dogs. Tissue Eng Regen Med 2012. [DOI: 10.1007/s13770-012-0319-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Kim JE, Kang SS, Choi KH, Shim JS, Jeong CM, Shin SW, Huh JB. The effect of anodized implants coated with combined rhBMP-2 and recombinant human vascular endothelial growth factors on vertical bone regeneration in the marginal portion of the peri-implant. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 115:e24-31. [PMID: 23706924 DOI: 10.1016/j.oooo.2011.10.040] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 09/30/2011] [Accepted: 10/27/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of anodized implants coated with combined rhBMP-2 and recombinant human vascular endothelial growth factors (rhVEGFs) on vertical bone regeneration in the marginal portion of the peri-implant. STUDY DESIGN Supra-alveolar defects were created in 3 male beagle dogs. Each animal received 8 implants that were either coated with a single growth factor (rhBMP-2) or combined growth factors (rhBMP-2 + rhVEGF), or an anodized implant (the control group). The amount of the vertical bone regeneration, the bone-implant contact, and the intrathread bone density were investigated using histomorphometric analysis at 8 weeks. RESULTS The bone morphogenetic protein (BMP) group and the BMP-VEGF group showed vertical alveolar bone regeneration and enhanced bone-implant contact in the microthread compared with the control group (P < .05). CONCLUSIONS Anodized implants coated with rhBMP-2 and rhBMP - 2 + rhVEGF can induce vertical alveolar bone regeneration, but the combined effect of rhBMP-2 and rhVEGF was not verified.
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Affiliation(s)
- Jong-Eun Kim
- Graduate Student, Advanced Prosthodontics, Postgraduate School of Clinical Dentistry, Institute for Clinical Dental Research, Korea University, Seoul, Korea
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Yadav S, Upadhyay M, Liu S, Roberts E, Neace WP, Nanda R. Microdamage of the cortical bone during mini-implant insertion with self-drilling and self-tapping techniques: A randomized controlled trial. Am J Orthod Dentofacial Orthop 2012; 141:538-46. [DOI: 10.1016/j.ajodo.2011.12.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 12/01/2011] [Accepted: 12/01/2011] [Indexed: 10/28/2022]
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Mueller CK, Thorwarth M, Schmidt M, Schlegel KA, Schultze-Mosgau S. Comparative analysis of osseointegration of titanium implants with acid-etched surfaces and different biomolecular coatings. ACTA ACUST UNITED AC 2011; 112:726-36. [DOI: 10.1016/j.tripleo.2011.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Revised: 12/07/2010] [Accepted: 01/01/2011] [Indexed: 10/18/2022]
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Stadlinger B, Hintze V, Bierbaum S, Möller S, Schulz MC, Mai R, Kuhlisch E, Heinemann S, Scharnweber D, Schnabelrauch M, Eckelt U. Biological functionalization of dental implants with collagen and glycosaminoglycans-A comparative study. J Biomed Mater Res B Appl Biomater 2011; 100:331-41. [PMID: 22102613 DOI: 10.1002/jbm.b.31953] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 06/14/2011] [Accepted: 08/06/2011] [Indexed: 11/06/2022]
Abstract
Biological implant surface coatings are an emerging technology to increase bone formation. Such an approach is of special interest in anatomical regions like the maxilla. In the present study, we hypothesized that the coating of titanium implants with components of the organic extracellular matrix increases bone formation and implant stability compared to an uncoated reference. The implants were coated using collagen-I with either two different concentrations of chondroitin sulfate (CS) or two differentially sulfated hyaluronans. Implant coatings were characterized biochemically and with atomic force microscopy. Histomorphometry was used to assess bone-implant contact (BIC) and bone-volume density (BVD) after 4 and 8 weeks of submerged healing in the maxilla of 20 minipigs. Further, implant stability was measured by resonance frequency analysis (RFA). Implants containing the lower CS concentration had significantly more BIC, compared to the uncoated reference at both times of interest. No significant increase was measured from week 4 to 8. Differences in BVD and RFA were statistically not significant. A higher concentration of CS and the application of sulfated hyaluronans showed no comparable increase in BIC. This study demonstrates a positive effect of a specific collagen-glycosaminoglycan combination on early bone formation in vivo.
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Affiliation(s)
- Bernd Stadlinger
- Department of Oral and Maxillofacial Surgery, University of Technology Dresden, Faculty of Medicine, Fetscherstr. 74, D-01307 Dresden, Germany.
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Huh JB, Park CK, Kim SE, Shim KM, Choi KH, Kim SJ, Shim JS, Shin SW. Alveolar ridge augmentation using anodized implants coated with Escherichia coli–derived recombinant human bone morphogenetic protein 2. ACTA ACUST UNITED AC 2011; 112:42-9. [DOI: 10.1016/j.tripleo.2010.09.063] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 08/24/2010] [Accepted: 09/22/2010] [Indexed: 02/05/2023]
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Schuckert KH, Jopp S, Osadnik M. The use of platelet rich plasma, bone morphogenetic protein-2 and different scaffolds in oral and maxillofacial surgery - literature review in comparison with own clinical experience. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2011; 2:e2. [PMID: 24421984 PMCID: PMC3886066 DOI: 10.5037/jomr.2011.2102] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 01/18/2011] [Indexed: 12/16/2022]
Abstract
Objectives The purpose of this article was to review and critically assess the use of
platelet rich plasma, recombinant human bone morphogenetic protein-2 and
different scaffolds (i.e. tricalciumphosphate, polycaprolactone,
demineralized bone matrix and anorganic bovine bone mineral) in oral and
maxillofacial surgery comparing the relevant literature and own clinical
experience. Material and Methods A literature review was conducted using MEDLINE, MEDPILOT and COCHRANE
DATABASE OF SYSTEMATIC REVIEWS. It concentrated on manuscripts and overviews
published in the last five years (2006-2010). The key terms employed were
platelet rich plasma, bone morphogenetic proteins and their combinations
with the above mentioned scaffolds. The results of clinical studies and
animal trials were especially emphasized. The statements from the literature
were compared with authors’ own clinical data. Results New publications and overviews demonstrate the advantages of platelet rich
plasma in bone regeneration. The results from the literature review were
discussed and compared with the publications detailing authors' own
experiences. Conclusions A favourable outcome concerning newly grown bone was achieved combining
platelet rich plasma in addition to optimal matrices with or without
recombinant human bone morphogenetic protein-2, depending on the clinical
case. As a consequence, the paradigm shift from transplantation of
autogenous bone to bone tissue engineering appears promising.
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Affiliation(s)
- Karl-Heinz Schuckert
- Institute Indente - Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering Hannover Germany
| | - Stefan Jopp
- Institute Indente - Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering Hannover Germany
| | - Magdalena Osadnik
- Institute Indente - Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering Hannover Germany
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Ramazanoglu M, Lutz R, Ergun C, von Wilmowsky C, Nkenke E, Schlegel KA. The effect of combined delivery of recombinant human bone morphogenetic protein-2 and recombinant human vascular endothelial growth factor 165 from biomimetic calcium-phosphate-coated implants on osseointegration. Clin Oral Implants Res 2011; 22:1433-9. [PMID: 21418332 DOI: 10.1111/j.1600-0501.2010.02133.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The delivery of growth factors for enhanced osseointegration depends on the effectiveness of the carrier systems at the bone-implant interface. This study evaluated the effect of solo and dual delivery of recombinant human bone morphogenetic protein-2 (rhBMP-2) and recombinant human vascular endothelial growth factor (rhVEGF(165) ) from biomimetically octacalcium phosphate-coated implants on osseointegration. MATERIALS AND METHODS Biomimetic implants, bearing either a single growth factor (BMP or VEGF) or their combination (BMP+VEGF), were established, and compared with acid-etched (AE, control) and biomimetic implants without growth factor (CAP). Implants were placed into frontal skulls of nine domestic pigs. The quality of osseointegration was evaluated using microradiographic and histomorphometric analysis of bone formation inside four defined bone chambers of the experimental implant at 1, 2 and 4 weeks. RESULTS Biomimetic implants, either with or without growth factor, showed enhanced bone volume density (BVD) values after 2 and 4 weeks. This enhancement was significant for the BMP and BMP+VEGF group compared with the control AE group after 2 weeks (P<0.05). All biomimetic calcium-phosphate (Ca-P) coatings exhibited significantly enhanced bone-implant contact (BIC) rates compared with the uncoated control surface after 2 weeks (P<0.05). However, the combined delivery of BMP-2 and VEGF did not significantly enhance BIC at the final observation period. CONCLUSION It was concluded that the combined delivery of BMP-2 and VEGF enhances BVD around implants, but not BIC. Therefore, it may be assumed that changes in the surface characteristics should be considered when designing growth factor-delivering surfaces.
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Affiliation(s)
- Mustafa Ramazanoglu
- Department of Oral Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
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Decker JF, Lee J, Cortella CA, Polimeni G, Rohrer MD, Wozney JM, Hall J, Susin C, Wikesjö UME. Evaluation of implants coated with recombinant human bone morphogenetic protein-2 and vacuum-dried using the critical-size supraalveolar peri-implant defect model in dogs. J Periodontol 2010; 81:1839-49. [PMID: 20629551 DOI: 10.1902/jop.2010.100220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Endosseous implants coated with recombinant human bone morphogenetic protein-2 (rhBMP-2) in a laboratory bench setting and air-dried induce relevant bone formation but also resident bone remodeling. Thus, the objective of this study is to evaluate the effect of implants fully or partially coated with rhBMP-2 and vacuum-dried using an industrial process on local bone formation and resident bone remodeling. METHODS Twelve male adult Hound Labrador mongrel dogs were used. Critical-size, supraalveolar, peri-implant defects received titanium porous oxide surface implants coated in their most coronal aspect with rhBMP-2 (coronal-load, six animals), or by immersion of the entire implant in a rhBMP-2 solution (soak-load, six animals) for a total of 30 μg rhBMP-2 per implant. All implants were vacuum-dried. The animals were sacrificed at 8 weeks for histometric evaluation. RESULTS Clinical healing was unremarkable. Bone formation was not significantly affected by the rhBMP-2 application protocol. New bone height and area averaged (± SE) 3.2 ± 0.5 versus 3.6 ± 0.3 mm, and 2.3 ± 0.5 versus 2.6 ± 0.8 mm(2) for coronal-load and soak-load implants, respectively (P >0.05). The corresponding bone density and bone-implant contact registrations averaged 46.7% ± 5.8% versus 31.6% ± 4.4%, and 28% ± 5.6% versus 36.9% ± 3.4% (P >0.05). In contrast, resident bone remodeling was significantly influenced by the rhBMP-2 application protocol. Peri-implant bone density averaged 72.2% ± 2.1% for coronal-load versus 60.6% ± 4.7% for soak-load implants (P <0.05); the corresponding bone-implant contact averaged 70.7% ± 6.1% versus 47.2% ± 6.0% (P <0.05). CONCLUSIONS Local application of rhBMP-2 and vacuum-drying using industrial process seems to be a viable technology to manufacture implants that support local bone formation and osseointegration. Coronal-load implants obviate resident bone remodeling without compromising local bone formation.
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Affiliation(s)
- John F Decker
- Department of Periodontics, School of Dentistry, Medical College of Georgia, Augusta, GA 30912, USA
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Polimeni G, Wikesjö UME, Susin C, Qahash M, Shanaman RH, Prasad HS, Rohrer MD, Hall J. Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5: histologic observations. J Clin Periodontol 2010; 37:759-68. [PMID: 20500538 DOI: 10.1111/j.1600-051x.2010.01579.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In vitro and in vivo preclinical studies suggest that growth/differentiation factor-5 (GDF-5) may induce local bone formation. The objective of this study was to evaluate the potential of recombinant human GDF-5 (rhGDF-5) coated onto an oral implant with a purpose-designed titanium porous oxide surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. MATERIALS AND METHODS Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with 30 or 60 microg rhGDF-5, and six animals received implants coated with 120 microg rhGDF-5 or left uncoated (control). Treatments were alternated between jaw quadrants. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7, and 8 post-surgery when they were euthanized for histologic evaluation. RESULTS The clinical examination showed no noteworthy differences between implants coated with rhGDF-5. The cover screw and implant body were visible/palpable through the alveolar mucosa for both rhGDF-5-coated and control implants. There was a small increase in induced bone height for implants coated with rhGDF-5 compared with the control, induced bone height averaging (+/-SD) 1.6+/-0.6 mm for implants coated with 120 microg rhGDF-5 versus 1.2+/-0.5, 1.2+/-0.6, and 0.6+/-0.2 mm for implants coated with 60 microg rhGDF-5, 30 microg rhGDF-5, or left uncoated, respectively (p<0.05). Bone formation was predominant at the lingual aspect of the implants. Narrow yellow and orange fluorescent markers throughout the newly formed bone indicate relatively slow new bone formation within 3-4 weeks. Implants coated with rhGDF-5 displayed limited peri-implant bone remodelling in the resident bone; the 120 microg dose exhibiting more advanced remodelling than the 60 and 30 microg doses. All treatment groups exhibited clinically relevant osseointegration. CONCLUSIONS rhGDF-5-coated oral implants display a dose-dependent osteoinductive and/or osteoconductive effect, bone formation apparently benefiting from local factors. Application of rhGDF-5 appears to be safe as it is associated with limited, if any, adverse effects.
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Affiliation(s)
- Giuseppe Polimeni
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Department of Periodontics & Oral Biology, Medical College of Georgia School of Dentistry, Augusta, GA 30912, USA.
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Schuckert KH, Jopp S, Osadnik M. Modern bone regeneration instead of bone transplantation: a combination of recombinant human bone morphogenetic protein-2 and platelet-rich plasma for the vertical augmentation of the maxillary bone-a single case report. Tissue Eng Part C Methods 2010; 16:1335-46. [PMID: 20302447 DOI: 10.1089/ten.tec.2010.0020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This publication describes the clinical case of a 75-year-old woman. She suffered from total alveolar ridge atrophy due to 20 years of wearing dentures. Bone transplantation, including harvesting of the iliac crest, was rejected by another clinic due to various existing diseases and risk of blood loss on donor side. Moreover, the minimal residual alveolar ridge did not allow bone fixation using screws nor did it allow osteodistraction. Before deciding which bone tissue engineering techniques should best be employed in this surgical treatment, cardiological and internistic consultations and treatments were carried out. In addition, anesthetic preparations were made. The surgical treatment was performed implementing special bridge flap techniques to preserve the periosteum. Tricalcium phosphate blocks soaked with recombinant human bone morphogenetic protein-2 and platelet-rich plasma were implanted on the narrow alveolar ridge. They were attached by tightening the soft tissue, including the periosteum. Four months later, after complication-free wound healing and bone regeneration, six dental implants were inserted into the new alveolar ridge. The histology of all bone samples showed vital lamellar bone. Three months after implantation, a new dental structure was fixed on the implants. The patient's quality of life improved significantly with this new situation.
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Affiliation(s)
- Karl-Heinz Schuckert
- Institute Indente-Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering, Hannover, Germany.
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Lee J, Decker JF, Polimeni G, Cortella CA, Rohrer MD, Wozney JM, Hall J, Susin C, Wikesjö UME. Evaluation of implants coated with rhBMP-2 using two different coating strategies: a critical-size supraalveolar peri-implant defect study in dogs. J Clin Periodontol 2010; 37:582-90. [PMID: 20345393 DOI: 10.1111/j.1600-051x.2010.01557.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Implants coated with recombinant human bone morphogenetic protein-2 (rhBMP-2) induce relevant bone formation but also resident bone remodelling. OBJECTIVES To compare the effect of implants fully or partially coated with rhBMP-2 on new bone formation and resident bone remodelling. MATERIALS AND METHODS Twelve, male, adult, Hound Labrador mongrel dogs were used. Critical-size, supraalveolar, peri-implant defects received titanium porous oxide surface implants coated in their most coronal aspect with rhBMP-2 (coronal-load/six animals) or by immersion of the entire implant in an rhBMP-2 solution (soak-load/six animals) for a total of 30 mug rhBMP-2/implant. All implants were air-dried. The animals were euthanized at 8 weeks for histometric evaluation. RESULTS Clinical healing was uneventful. Supraalveolar bone formation was not significantly affected by the rhBMP-2 application protocol. New bone height and area averaged (+/- SE) 3.4 +/- 0.2 versus 3.5 +/- 0.4 mm and 2.6 +/- 0.4 versus 2.5 +/- 0.7 mm(2) for coronal-load and soak-load implants, respectively (p>0.05). The corresponding bone density and bone-implant contact (BIC) recordings averaged 38.0 +/- 3.8%versus 34.4 +/- 5.6% and 25.0 +/- 3.8%versus 31.2 +/- 3.3% (p>0.05). In contrast, resident bone remodelling was significantly influenced by the rhBMP-2 application protocol. Bone density outside the implants threads averaged 74.7 +/- 3.8% and 50.8 +/- 4.1% for coronal-load and soak-load implants, respectively (p<0.05); bone density within the thread area averaged 51.8 +/- 1.2% and 37.8 +/- 2.9%, and BIC 70.1 +/- 6.7% and 43.3 +/- 3.9% (p<0.05). CONCLUSION Local application of rhBMP-2 appears to be a viable technology to support local bone formation and osseointegration. Coronal-load implants obviate resident bone remodelling without compromising new bone formation.
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Affiliation(s)
- Jaebum Lee
- Department of Periodontics, Medical College of Georgia School of Dentistry, Augusta, GA 30912, USA.
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Susin C, Qahash M, Polimeni G, Lu PH, Prasad HS, Rohrer MD, Hall J, Wikesjö UME. Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): histological observations. J Clin Periodontol 2010; 37:574-81. [PMID: 20345394 DOI: 10.1111/j.1600-051x.2010.01554.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pre-clinical studies have shown that recombinant human bone morphogenetic protein-2 (rhBMP-2) coated onto purpose-designed titanium porous-oxide surface implants induces clinically relevant bone formation and osseointegration. The objective of this study was to examine the potential of rhBMP-7, also known as recombinant human osteogenic protein-1 (rhOP-1), coated onto titanium porous-oxide surface implants to support vertical alveolar ridge augmentation and implant osseointegration. MATERIALS AND METHODS Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in six young adult Hound Labrador mongrel dogs. The animals received implants coated with rhBMP-7 at 1.5 or 3.0 mg/ml randomized to contra-lateral jaw quadrants. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at 3, 4, 7, and 8 weeks post-surgery when they were euthanized for histological evaluation. RESULTS Without striking differences between treatments, the implant sites exhibited a swelling that gradually regressed to become hard to palpation disguising the implant contours. The histological evaluation showed robust bone formation; the newly formed bone assuming characteristics of the contiguous resident bone, bone formation (height and area) averaging 4.1+/-1.0 versus 3.6+/-1.7 mm and 3.6+/-1.9 versus 3.1+/-1.8 mm(2); and bone density 56%versus 50% for implants coated with rhBMP-7 at 1.5 and 3.0 mg/ml, respectively. Both treatments exhibited clinically relevant osseointegration, the corresponding bone-implant contact values averaging 51% and 47%. Notable peri-implant resident bone remodelling was observed for implants coated with rhBMP-7 at 3.0 mg/ml. CONCLUSIONS rhBMP-7 coated onto titanium porous-oxide surface implants induces clinically relevant local bone formation including osseointegration and vertical augmentation of the alveolar ridge, the higher concentration/dose associated with some local side effects.
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Affiliation(s)
- Cristiano Susin
- Medical College of Georgia School of Dentistry, Augusta, GA, USA.
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Lee J, Tran Q, Seeba G, Wikesjö UME, Susin C. The critical-size supraalveolar peri-implant defect model: reproducibility in histometric data acquisition of alveolar bone formation and osseointegration. J Clin Periodontol 2010; 36:1067-74. [PMID: 19929958 DOI: 10.1111/j.1600-051x.2009.01487.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this report is to present the reproducibility of outcomes assessments in the Critical-Size Supraalveolar Peri-Implant Defect Model. MATERIALS AND METHODS Two examiners without specific experience in histological analysis and one experienced examiner performed the histometric evaluation. A comprehensive training program in data acquisition and histological analysis was established, the inexperienced examiners underwent approximately 12 h of training over multiple sessions. A custom-designed image analysis software macro and a computer-based image system were used to analyse digital images generated by a microscope camera system. Nine parameters for newly formed and resident bone were evaluated. Examiners performed histometric analysis using 36 histologic sections selected from critical-size supraalveolar peri-implant defects in 12 male Hound Labrador Mongrel dogs. Buccal and lingual measurements were performed in 72 sites. Intra- and inter-examiner reproducibility were evaluated using the concordance correlation coefficient (CCC) and means +/- SD of the differences. Systematic errors were evaluated using an F-test for equality of means and variances. RESULTS Intra-examiner reproducibility was high for all parameters evaluated, the lowest CCC observed being 0.87. Inter-examiner reproducibility was also high, most CCCs exceeding 0.90. Minor systematic errors for intra- and inter-examiner comparisons were occasionally observed. The results imply a high temporal stability because recordings were performed 3 months apart. Measurement errors were stable throughout the range of observations for all parameters. CONCLUSIONS High examiner reproducibility and temporal stability can be achieved for histometric data acquisition using the Critical-Size Supraalveolar Peri-Implant Defect Model. Examiner reproducibility should be routinely assessed, reported, and accounted for to assure the quality of evidence generated by preclinical studies.
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Affiliation(s)
- Jaebum Lee
- Laboratory for Applied Periodontal and Craniofacial Regeneration, Departments of Periodontics and Oral Biology, Medical College of Georgia, School of Dentistry, Augusta, GA, USA
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Junker R, Dimakis A, Thoneick M, Jansen JA. Effects of implant surface coatings and composition on bone integration: a systematic review. Clin Oral Implants Res 2009; 20 Suppl 4:185-206. [PMID: 19663965 DOI: 10.1111/j.1600-0501.2009.01777.x] [Citation(s) in RCA: 290] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of the present review was to evaluate the bone integration efficacy of recently developed and marketed oral implants as well as experimental surface alterations. MATERIALS AND METHODS A PubMed search was performed for animal studies, human reports and studies presenting bone-to-implant contact percentage or data regarding mechanical testing. RESULTS For recently developed and marketed oral implants, 29 publications and for experimental surface alterations 51 publications fulfilled the inclusion criteria for this review. CONCLUSIONS As demonstrated in the available literature dealing with recently developed and marketed oral implants, surface-roughening procedures also affect the surface chemical composition of oral implants. There is sufficient proof that surface roughening induces a safe and predictable implant-to-bone response, but it is not clear whether this effect is due to the surface roughness or to the related change in the surface composition. The review of the experimental surface alterations revealed that thin calcium phosphate (CaP) coating technology can solve the problems associated with thick CaP coatings, while they still improve implant bone integration compared with non-coated titanium implants. Nevertheless, there is a lack of human studies in which the success rate of thin CaP-coated oral implants is compared with just roughened oral implants. No unequivocal evidence is available that suggests a positive effect on the implant bone integration of peptide sequences or growth factors coated on titanium oral implants. In contrast, the available literature suggests that bone morphogenetic protein-2 coatings might even impede the magnitude of implant-to-bone response.
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Affiliation(s)
- Rüdiger Junker
- Department of Periodontology and Biomaterials, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Pellegrini G, Seol YJ, Gruber R, Giannobile WV. Pre-clinical models for oral and periodontal reconstructive therapies. J Dent Res 2009; 88:1065-76. [PMID: 19887682 DOI: 10.1177/0022034509349748] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The development of new medical formulations (NMF) for reconstructive therapies has considerably improved the available treatment options for individuals requiring periodontal repair or oral implant rehabilitation. Progress in tissue engineering and regenerative medicine modalities strongly depends on validated pre-clinical research. Pre-clinical testing has contributed to the recent approval of NMF such as GEM 21S and INFUSE bone grafts for periodontal and oral regenerative therapies. However, the selection of a suitable pre-clinical model for evaluation of the safety and efficacy of a NMF remains a challenge. This review is designed to serve as a primer to choose the appropriate pre-clinical models for the evaluation of NMF in situations requiring periodontal or oral reconstruction. Here, we summarize commonly used pre-clinical models and provide examples of screening and functional studies of NMF that can be translated into clinical use.
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Affiliation(s)
- G Pellegrini
- Department Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48106, USA
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Wikesjö UME, Qahash M, Huang YH, Xiropaidis A, Polimeni G, Susin C. Bone morphogenetic proteins for periodontal and alveolar indications; biological observations - clinical implications. Orthod Craniofac Res 2009; 12:263-70. [PMID: 19627529 DOI: 10.1111/j.1601-6343.2009.01461.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Surgical placement of endosseous oral implants is governed by the prosthetic design and by the morphology and quality of the alveolar bone. Nevertheless, often implant placement may be complexed, if at all possible, by alveolar ridge irregularities resulting from periodontal disease, and chronic and acute trauma. In consequence, implant positioning commonly necessitates bone augmentation procedures. One objective of our laboratory is to evaluate the biologic potential of bone morphogenetic proteins (BMP) and other candidate biologics, bone biomaterials, and devices for alveolar ridge augmentation and implant fixation using discriminating large animal models. This focused review illustrates the unique biologic potential, the clinical relevance and perspectives of recombinant human BMP-2 (rhBMP-2) using a variety of carrier technologies to induce local bone formation and implant osseointegration for inlay and onlay indications. Our studies demonstrate a clinically relevant potential of a purpose-designed titanium porous oxide implant surface as stand-alone technology to deliver rhBMP-2 for alveolar augmentation. In perspective, merits and shortcomings of current treatment protocol including bone biomaterials and guided bone regeneration are addressed and explained. We demonstrate that rhBMP-2 has unparalleled potential to augment alveolar bone, and support implant osseointegration and long-term functional loading. Inclusion of rhBMP-2 for alveolar augmentation and osseointegration will not only enhance predictability of existing clinical protocol but also radically change current treatment paradigms.
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Affiliation(s)
- U M E Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Department of Periodontics, Medical College of Georgia School of Dentistry, Augusta, GA 30912, USA.
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Wikesjö UME, Qahash M, Polimeni G, Susin C, Shanaman RH, Rohrer MD, Wozney JM, Hall J. Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2: histologic observations. J Clin Periodontol 2008; 35:1001-10. [DOI: 10.1111/j.1600-051x.2008.01321.x] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wikesjö UME, Huang YH, Xiropaidis AV, Sorensen RG, Rohrer MD, Prasad HS, Wozney JM, Hall J. Bone formation at recombinant human bone morphogenetic protein-2-coated titanium implants in the posterior maxilla (Type IV bone) in non-human primates. J Clin Periodontol 2008; 35:992-1000. [DOI: 10.1111/j.1600-051x.2008.01322.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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