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Cho Y, Jeong H, Kim B, Jang J, Song YS, Lee DY. Electrospun Poly(L-Lactic Acid)/Gelatin Hybrid Polymer as a Barrier to Periodontal Tissue Regeneration. Polymers (Basel) 2023; 15:3844. [PMID: 37765697 PMCID: PMC10537136 DOI: 10.3390/polym15183844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
Poly(L-lactic acid) (PLLA) and PLLA/gelatin polymers were prepared via electrospinning to evaluate the effect of PLLA and gelatin content on the mechanical properties, water uptake capacity (WUC), water contact angle (WCA), degradation rate, cytotoxicity and cell proliferation of membranes. As the PLLA concentration increased from 1 wt% to 3 wt%, the tensile strength increased from 5.8 MPa to 9.1 MPa but decreased to 7.0 MPa with 4 wt% PLLA doping. The WUC decreased rapidly from 594% to 236% as the PLLA content increased from 1 to 4 wt% due to the increased hydrophobicity of PLLA. As the gelatin content was increased to 3 wt% PLLA, the strength, WUC and WCA of the PLLA/gelatin membrane changed from 9.1 ± 0.9 MPa to 13.3 ± 2.3 MPa, from 329% to 1248% and from 127 ± 1.2° to 0°, respectively, with increasing gelatin content from 0 to 40 wt%. However, the failure strain decreased from 3.0 to 0.5. The biodegradability of the PLLA/gelatin blend increased from 3 to 38% as the gelatin content increased to 40 wt%. The viability of L-929 and MG-63 cells in the PLLA/gelatin blend was over 95%, and the excellent cell proliferation and mechanical properties suggested that the tunable PLLA/gelatin barrier membrane was well suited for absorbable periodontal tissue regeneration.
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Affiliation(s)
- Youngchae Cho
- Department of Biomedical Engineering, Daelim University, Anyang 13916, Republic of Korea; (Y.C.); (H.J.)
| | - Heeseok Jeong
- Department of Biomedical Engineering, Daelim University, Anyang 13916, Republic of Korea; (Y.C.); (H.J.)
| | - Baeyeon Kim
- Department of Materials Science and Engineering, Incheon National University, Incheon 22012, Republic of Korea;
| | - Juwoong Jang
- Department of R&D Center, Renewmedical Co., Ltd., Bucheon 14532, Republic of Korea;
| | - Yo-Seung Song
- Department of Materials Science and Engineering, Korea Aviation University, Goyang 10540, Republic of Korea;
| | - Deuk Yong Lee
- Department of Biomedical Engineering, Daelim University, Anyang 13916, Republic of Korea; (Y.C.); (H.J.)
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Khijmatgar S, Panda S, Das M, Arbildo-Vega H, Del Fabbro M. Recombinant factors for periodontal intrabony defects: A systematic review and network meta-analysis of preclinical studies. J Tissue Eng Regen Med 2021; 15:1069-1081. [PMID: 34585856 DOI: 10.1002/term.3250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/17/2021] [Accepted: 09/17/2021] [Indexed: 12/17/2022]
Abstract
The use of bioactive agents combined with osteoconductive scaffolds for the regeneration of periodontal intrabony defects has been the subject of intensive research in the past 20 years. Most studies reported that such agents, used in different concentrations, doses and combined with various scaffolds, might promote periodontal tissue regeneration, but evidence for the most effective combination of such agents is lacking. The objective of this study 13 was to rank the different combinations of recombinant human-derived growth and differentiation factors with/without scaffold biomaterial in the treatment of periodontal intrabony defects, through network meta-analysis of pre-clinical studies. The systematic review and network meta-analysis protocol was registered on the PROSPERO Systematic Review database with reference number: CRD42021213673. Relevant published articles were obtained after searching five electronic databases. A specific search strategy was followed by using keywords related to intrabony defects, regenerative materials, scaffolds and recombinant factors, and animal studies. All pre-clinical studies used for periodontal regeneration were included. The primary outcomes were: regeneration of junctional epithelium (mm), new cementum, connective tissue attachment, percentage of new bone formation (%), bone area (mm2 ), bone volume density (g/cm3 ) and bone height (mm) data was extracted. The analysis was carried out using network meta-analysis methods, that is illustrating network plots, contribution plots, predictive and confidence interval plot, surface under the cumulative ranking (SUCRA), multidimensional scale ranking and net funnel plots using STATA IC statistical software. An SYRCLE's tool for assessing risk of bias was used for reporting risk of bias among individual studies. A total of N = 24 for qualitative and N = 21 studies for quantitative analysis published till 2020 were included. The cumulative total number of animals included in the control and test groups were N = 162 and N = 339, respectively. The duration of the study was between 3 and 102 weeks rhBMP-2 ranked higher in SUCRA as the agent associated with the best performance for bone volume density. rhGDF-5/TCP ranked best in the bone area (mm2), rhPDGF-BB/Equine ranked best in bone height (mm), rhBMP-2 ranked best in the percentage of new bone fill, rhBMP-2/ACS ranked best in new cementum formation, and rhGDF-5/b- TCP/PLGA ranked best in connective tissue attachment and junctional epithelium. There were no adverse effects identified in the literature that could affect the different outcomes for regeneration in intrabony defects. Various recombinant factors are effective in promoting the regeneration of both soft and hard tissue supporting structures of the periodontium. However, when considering different outcomes, different agents, associated or not with biomaterials, ranked best. Keeping into account the limited transferability of results from animal studies to the clinical setting, the choice of the most appropriate formulation of bioactive agents may depend on clinical needs and purpose.
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Affiliation(s)
- Shahnawaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Department of Oral Biology and Genomic Studies, Mangalore, India
| | - Saurav Panda
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Mohit Das
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Heber Arbildo-Vega
- Department of General Dentistry, Dentistry School, Universidad San Martín de Porres, Chiclayo, Peru.,Department of General Dentistry, Dentistry School, Universidad Particular de Chiclayo, Chiclayo, Peru
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
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Farimani Z, Shamshiri AR, Asl Roosta H, Akbari S, Bohlouli M. Regenerative benefits of using growth factors in treatment of periodontal defects: A systematic review and meta-analysis with Trial Sequential Analysis on preclinical studies. J Tissue Eng Regen Med 2021; 15:964-997. [PMID: 34480421 DOI: 10.1002/term.3241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/13/2021] [Accepted: 08/28/2021] [Indexed: 02/06/2023]
Abstract
The ultimate goal in periodontal treatments is to achieve a functional and anatomical regeneration of the lost tissues. Numerous studies have in some way illustrated the beneficial effects of biologic modifiers in this process, yet they are subject to a rather large degree of diversity in their results. Thanks to the promising outcomes of bioengineering techniques in the field of periodontal regeneration, this systematic review aims to evaluate the effect of various biologic modifiers used in periodontal defects of animal models. Electronic databases (Medline, Scopus, Embase, Web of Science, and Google Scholar) were searched (March 2010-December 2020) for every study that used biomolecules for regeneration of periodontal osseous defects in animal models. Regenerated bone height or area, new cementum, new connective tissues, new regenerated periodontal ligament and the dimensions of epithelial attachment (either in mm/mm2 or percentage) were the investigated outcomes. The risk of bias of the included studies was assessed using the SYRCLE tool. In closing, there was a meta-analysis carried out on the outcomes of interest. Trial Sequential Analysis was also carried out to figure out the power of meta-analytic outcomes. From 1995 studies which were found in the initial search, 34 studies were included in this review, and 20 of them were selected for the meta-analysis. The eligible studies were categorized according to the morphology of the experimental periodontal defects as one-, two-, and three-wall intrabony defects; furcation defects, and recession-type defects. The most studied biomolecules were rhFGF-2, rhGDF-5, platelet-derived growth factor, bone morphogenetic protein-2, and enamel matrix derivative (EMD). Based on the meta-analysis findings, combined application of biomolecules with regenerative treatments could improve new bone and cementum formation near 1 mm when compared to the control groups in one, two and three-wall intrabony defect models (p < 0.001). In furcation grade II defect, the addition of biomolecules was observed to enhance bone area gain and cementum height regeneration up to almost 2 mm (p < 0.001). Trial Sequential Analysis results confirmed the significant effect in the aforementioned meta-analyses. In cases of the buccal recession model, the application of rhFGF-2 and rhGDF-5 decreased the dimension of epithelial attachments besides regenerative advantages on bone and cementum formation, but EMD deposition exerted no inhibitory effect on epithelial down-growth. Application of biologic modifiers especially FGF-2 and GDF-5, could positively improve the regeneration of periodontal tissues, particularly cementum and bone in animal models. Trial Sequential Analysis confirmed the results but the power of the evidences was high just in some subgroup meta-analyses, like bone and cementum regeneration in furcation grade II model and cementum regeneration in one-wall intrabony defects. The outcomes of this study can potentially endow clinicians with guidelines for the appropriate application of growth factors in periodontal regenerative therapies.
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Affiliation(s)
- Zeinab Farimani
- Department of Periodontics, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Ahmad Reza Shamshiri
- Department of Community Oral Health, School of Dentistry, Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoori Asl Roosta
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Solmaz Akbari
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Bohlouli
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Applications of Bone Morphogenetic Proteins in Dentistry: A Bibliometric Analysis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:5971268. [PMID: 33163536 PMCID: PMC7604587 DOI: 10.1155/2020/5971268] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/06/2020] [Accepted: 10/12/2020] [Indexed: 12/12/2022]
Abstract
Background Many articles on bone morphogenetic proteins (BMPs) have been published. Bibliometric analysis is helpful to determine the most influential studies in a specific field. This bibliometric analysis is aimed at identifying and analyzing the top 50 most-cited articles on the dental applications of BMPs. Methods An electronic search was conducted using the Web of Science (WoS) “All Databases” without any restriction of language, study design, or publication year. Of 1341 publications, the top 50 were included based on their citation count. After downloading the full texts, their bibliometric data including publication title, authorship, citation count, current citation index 2019, citation density, year of publication, country and institution of origin, journal of publication, type of BMP, study design, evidence level of publication, and keywords were extracted and analyzed. Results The citation counts for the top 50 publications ranged from 81 to 557 (median 113.5). The most prolific year was 1997 (n = 7). Wikesjö UM (n = 12) and Wozney JM (n = 11) were the major contributors in this study. Most of the articles were generated primarily from the USA (n = 24), with Loma Linda University Medical Center, USA being the most prolific institution (n = 5). Majority of the articles were published in the Clinical Oral Implants Research and Journal of Periodontology, with nine publications each. Most of the publications were animal studies (n = 30) and focused on BMP-2 (n = 39). Most of the articles were within evidence level V (n = 36). The most frequently used keyword in the top articles was “bone regeneration” (n = 23). Conclusion The present study presents insights into the past and recent trends in the applications of BMPs in dentistry. A statistically significant association was observed between citation count, citation density, and age of publication.
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Kaplani K, Koutsi S, Armenis V, Skondra FG, Karantzelis N, Champeris Tsaniras S, Taraviras S. Wound healing related agents: Ongoing research and perspectives. Adv Drug Deliv Rev 2018; 129:242-253. [PMID: 29501699 DOI: 10.1016/j.addr.2018.02.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 01/28/2018] [Accepted: 02/26/2018] [Indexed: 02/07/2023]
Abstract
Wound healing response plays a central part in chronic inflammation, affecting millions of people worldwide. It is a dynamic process that can lead to fibrosis, if tissue damage is irreversible and wound resolution is not attained. It is clear that there is a tight interconnection among wound healing, fibrosis and a variety of chronic disease conditions, demonstrating the heterogeneity of this pathology. Based on our further understanding of the cellular and molecular mechanisms underpinning tissue repair, new therapeutic approaches have recently been developed that target different aspects of the wound healing process and fibrosis. Nevertheless, several issues still need to be taken into consideration when designing modern wound healing drug delivery formulations. In this review, we highlight novel pharmacological agents that hold promise for targeting wound repair and fibrosis. We also focus on drug-delivery systems that may enhance current and future therapies.
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Affiliation(s)
- Konstantina Kaplani
- Division of Stem Cells and Regenerative Medicine, Biomedical Postgraduate Programme, School of Medicine, University of Patras, Patras 26504, Greece; Department of Physiology, School of Medicine, University of Patras, Patras 26504, Greece
| | - Stamatina Koutsi
- Division of Stem Cells and Regenerative Medicine, Biomedical Postgraduate Programme, School of Medicine, University of Patras, Patras 26504, Greece; Department of Physiology, School of Medicine, University of Patras, Patras 26504, Greece
| | - Vasileios Armenis
- Division of Stem Cells and Regenerative Medicine, Biomedical Postgraduate Programme, School of Medicine, University of Patras, Patras 26504, Greece
| | - Foteini G Skondra
- Division of Stem Cells and Regenerative Medicine, Biomedical Postgraduate Programme, School of Medicine, University of Patras, Patras 26504, Greece
| | - Nickolas Karantzelis
- Department of Physiology, School of Medicine, University of Patras, Patras 26504, Greece
| | | | - Stavros Taraviras
- Division of Stem Cells and Regenerative Medicine, Biomedical Postgraduate Programme, School of Medicine, University of Patras, Patras 26504, Greece; Department of Physiology, School of Medicine, University of Patras, Patras 26504, Greece.
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Sun X, Xu C, Wu G, Ye Q, Wang C. Poly(Lactic-co-Glycolic Acid): Applications and Future Prospects for Periodontal Tissue Regeneration. Polymers (Basel) 2017; 9:E189. [PMID: 30970881 PMCID: PMC6432161 DOI: 10.3390/polym9060189] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/08/2017] [Accepted: 05/11/2017] [Indexed: 12/28/2022] Open
Abstract
Periodontal tissue regeneration is the ultimate goal of the treatment for periodontitis-affected teeth. The success of regenerative modalities relies heavily on the utilization of appropriate biomaterials with specific properties. Poly (lactic-co-glycolic acid) (PLGA), a synthetic aliphatic polyester, has been actively investigated for periodontal therapy due to its favorable mechanical properties, tunable degradation rates, and high biocompatibility. Despite the attractive characteristics, certain constraints associated with PLGA, in terms of its hydrophobicity and limited bioactivity, have led to the introduction of modification strategies that aimed to improve the biological performance of the polymer. Here, we summarize the features of the polymer and update views on progress of its applications as barrier membranes, bone grafts, and drug delivery carriers, which indicate that PLGA can be a good candidate material in the field of periodontal regenerative medicine.
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Affiliation(s)
- Xiaoyu Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, China.
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam 1081 HV, The Netherlands.
| | - Chun Xu
- Laboratory of Regenerative Dentistry, School of Dentistry, The University of Queensland, Brisbane 4006, Australia.
| | - Gang Wu
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam 1081 HV, The Netherlands.
| | - Qingsong Ye
- Laboratory of Regenerative Dentistry, School of Dentistry, The University of Queensland, Brisbane 4006, Australia.
| | - Changning Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, China.
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Porous magnesium/PLGA composite scaffolds for enhanced bone regeneration following tooth extraction. Acta Biomater 2015; 11:543-53. [PMID: 25234156 DOI: 10.1016/j.actbio.2014.09.008] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/15/2014] [Accepted: 09/08/2014] [Indexed: 12/12/2022]
Abstract
Sixty percent of implant-supported dental prostheses require bone grafting to enhance bone quantity and quality prior to implant placement. We have developed a metallic magnesium particle/PLGA composite scaffold to overcome the limitations of currently used dental bone grafting materials. This is the first report of porous metallic magnesium/PLGA scaffolds synthesized using a solvent casting, salt leaching method. We found that incorporation of varying amounts of magnesium into the PLGA scaffolds increased the compressive strength and modulus, as well as provided a porous structure suitable for cell infiltration, as measured by mercury intrusion porosimetry. Additionally, combining basic-degrading magnesium with acidic-degrading PLGA led to an overall pH buffering effect and long-term release of magnesium over the course of a 10-week degradation assay, as measured with inductively coupled plasma-atomic emission spectroscopy. Using an indirect proliferation assay adapted from ISO 10993:5, it was found that extracts of medium from degrading magnesium/PLGA scaffolds increased bone marrow stromal cell proliferation in vitro, a phenomenon observed by other groups investigating magnesium's impact on cells. Finally, magnesium/PLGA scaffold biocompatibility was assessed in a canine socket preservation model. Micro-computed tomography and histological analysis showed the magnesium/PLGA scaffolds to be safer and more effective at preserving bone height than empty controls. Three-dimensional magnesium/PLGA composite scaffolds show promise for dental socket preservation and also, potentially, orthopedic bone regeneration. These scaffolds could decrease inflammation observed with clinically used PLGA devices, as well as enhance osteogenesis, as observed with previously studied magnesium devices.
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Lee J, Wikesjö UM. Growth/differentiation factor-5: pre-clinical and clinical evaluations of periodontal regeneration and alveolar augmentation - review. J Clin Periodontol 2014; 41:797-805. [DOI: 10.1111/jcpe.12260] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Department of Periodontics; Georgia Regents University College of Dental Medicine; Augusta GA USA
| | - Ulf M.E. Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Departments of Periodontics & Oral Biology; Georgia Regents University College of Dental Medicine; Augusta GA USA
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Díaz-Sánchez RM, Yáñez-Vico RM, Fernández-Olavarría A, Mosquera-Pérez R, Iglesias-Linares A, Torres-Lagares D. Current Approaches of Bone Morphogenetic Proteins in Dentistry. J ORAL IMPLANTOL 2013; 41:337-42. [PMID: 24175931 DOI: 10.1563/aaid-joi-d-13-00012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Bone morphogenic proteins (BMPs) are a group of osteoinductive proteins obtained from nonmineralized bone matrix; they are capable of stimulating the differentiation of pluripotent mesenchymal cells to osteoprogenitor cells. They have become a likely treatment option, given their action on regeneration and remodeling of bone lesions and increasing the bone response around alloplastic materials. It may be feasible in the near future for BMPs to replace autologous and allogenic bone grafts. The application of specific growth factors for osteoinduction without using a bone graft constitutes a real impact on bone regeneration. The use of BMP is not only focused on osteogenic regeneration: There are a variety of studies investigating other properties, such as periodontal or dental regeneration from the conservative viewpoint. In this review, we will highlight the role of the BMP in bone, periodontal and dental regeneration.
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Kim YT, Wikesjö UM, Jung UW, Lee JS, Kim TG, Kim CK. Comparison Between a β-Tricalcium Phosphate and an Absorbable Collagen Sponge Carrier Technology for rhGDF-5–Stimulated Periodontal Wound Healing/Regeneration. J Periodontol 2013; 84:812-20. [DOI: 10.1902/jop.2012.120307] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Reynolds MA, Aichelmann-Reidy ME. Protein and peptide-based therapeutics in periodontal regeneration. J Evid Based Dent Pract 2013; 12:118-26. [PMID: 23040343 DOI: 10.1016/s1532-3382(12)70023-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
UNLABELLED Protein and peptide-based therapeutics provide a unique strategy for controlling highly specific and complex biologic actions that cannot be accomplished by simple devices or chemical compounds. This article reviews some of the key characteristics and summarizes the clinical effectiveness of protein and peptide-based therapeutics targeting periodontal regeneration. EVIDENCE ACQUISITION A literature search was conducted of randomized clinical trials and systematic reviews evaluating protein and peptide-based therapeutics for the regeneration of periodontal tissues of at least 6 months duration. Data sources included PubMed and Embase electronic databases, hand-searched journals, and the ClinicalTrials.gov registry. EVIDENCE SYNTHESIS Commercially marketed protein and peptide-based therapeutics for periodontal regeneration provide gains in clinical attachment level and bone formation that are comparable or superior to other regenerative approaches. Results from several clinical trials indicate that protein and peptide-based therapies can accelerate repair and regeneration when compared with other treatments and that improvements in clinical parameters continue beyond 12 months. Protein and peptide-based therapies also exhibit the capacity to increase the predictability of treatment outcomes. CONCLUSIONS Clinical and histologic studies support the effectiveness of protein- and peptide-based therapeutics for periodontal regeneration. Emerging evidence suggests that the delivery devices/scaffolds play a critical role in determining the effectiveness of this class of therapeutics.
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Affiliation(s)
- Mark A Reynolds
- Department of Periodontics, University of Maryland, School of Dentistry, Baltimore, MD 21201, USA.
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12
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Inukai T, Katagiri W, Yoshimi R, Osugi M, Kawai T, Hibi H, Ueda M. Novel application of stem cell-derived factors for periodontal regeneration. Biochem Biophys Res Commun 2012. [PMID: 23206704 DOI: 10.1016/j.bbrc.2012.11.074] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The effect of conditioned medium from cultured mesenchymal stem cells (MSC-CM) on periodontal regeneration was evaluated. In vitro, MSC-CM stimulated migration and proliferation of dog MSCs (dMSCs) and dog periodontal ligament cells (dPDLCs). Cytokines such as insulin-like growth factor, vascular endothelial growth factor, transforming growth factor-β1, and hepatocyte growth factor were detected in MSC-CM. In vivo, one-wall critical-size, intrabony periodontal defects were surgically created in the mandible of dogs. Dogs with these defects were divided into three groups that received MSC-CM, PBS, or no implants. Absorbable atelo-collagen sponges (TERUPLUG®) were used as a scaffold material. Based on radiographic and histological observation 4 weeks after transplantation, the defect sites in the MSC-CM group displayed significantly greater alveolar bone and cementum regeneration than the other groups. These findings suggest that MSC-CM enhanced periodontal regeneration due to multiple cytokines contained in MSC-CM.
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Affiliation(s)
- Takeharu Inukai
- Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Japan.
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13
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Park JC, Wikesjö UME, Koo KT, Lee JS, Kim YT, Pippig SD, Bastone P, Kim CS, Kim CK. Maturation of alveolar bone following implantation of an rhGDF-5/PLGA composite into 1-wall intra-bony defects in dogs: 24-week histometric observations. J Clin Periodontol 2012; 39:565-73. [DOI: 10.1111/j.1600-051x.2012.01868.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Jung-Chul Park
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul; Korea
| | - Ulf M. E. Wikesjö
- Departments of Periodontics and Oral Biology; Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Health Sciences University College of Dental Medicine; Augusta; GA; USA
| | - Ki-Tae Koo
- Department of Periodontology; College of Dentistry; Seoul National University; Seoul; Korea
| | - Jung-Seok Lee
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul; Korea
| | - Yong-Tae Kim
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul; Korea
| | | | | | - Chang-Sung Kim
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul; Korea
| | - Chong-Kwan Kim
- Department of Periodontology; Research Center for Orofacial Hard Tissue Regeneration (MRC); College of Dentistry; Yonsei University; Seoul; Korea
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14
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Detection and characterization of interleukin-6 gene variants in Canis familiaris: Association studies with periodontal disease. Gene 2011; 485:139-45. [DOI: 10.1016/j.gene.2011.06.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 06/09/2011] [Accepted: 06/11/2011] [Indexed: 12/14/2022]
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15
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Stavropoulos A, Windisch P, Gera I, Capsius B, Sculean A, Wikesjö UME. A phase IIa randomized controlled clinical and histological pilot study evaluating rhGDF-5/β-TCP for periodontal regeneration. J Clin Periodontol 2011; 38:1044-54. [DOI: 10.1111/j.1600-051x.2011.01778.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2011] [Indexed: 01/20/2023]
Affiliation(s)
| | - Peter Windisch
- Department of Periodontology; Semmelweis University; Budapest; Hungary
| | - Istvan Gera
- Department of Periodontology; Semmelweis University; Budapest; Hungary
| | | | - Anton Sculean
- Department of Periodontology; University of Berne; Bern; Switzerland
| | - Ulf M. E. Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Departments of Periodontics and Oral Biology; Georgia Health Sciences University College of Dental Medicine and College of Graduate Studies; Augusta; GA; USA
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16
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Sun HH, Qu TJ, Zhang XH, Yu Q, Chen FM. Designing biomaterials for in situ periodontal tissue regeneration. Biotechnol Prog 2011; 28:3-20. [PMID: 21913341 DOI: 10.1002/btpr.698] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 07/11/2011] [Indexed: 01/25/2023]
Abstract
The regeneration of periodontal tissue poses a significant challenge to biomaterial scientists, tissue engineers and periodontal clinicians. Recent advances in this field have shifted the focus from the attempt to recreate tissue replacements/constructs ex vivo to the development of biofunctionalized biomaterials that incorporate and release regulatory signals in a precise and near-physiological fashion to achieve in situ regeneration. The molecular and physical information coded within the biomaterials define a local biochemical and mechanical niche with complex and dynamic regulation that establishes key interactions with host endogenous cells and, hence, may help to unlock latent regenerative pathways in the body by instructing cell homing and regulating cell proliferation/differentiation. In the future, these innovative principles and biomaterial devices promise to have a profound impact on periodontal reconstructive therapy and are also likely to reconcile the clinical and commercial pressures on other tissue engineering endeavors.
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Affiliation(s)
- Hai-Hua Sun
- Department of Operative Dentistry & Endodontics, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, PR China
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Giannobile WV, Hollister SJ, Ma PX. Future Prospects for Periodontal Bioengineering Using Growth Factors. Clin Adv Periodontics 2011; 1:88-94. [PMID: 26500808 DOI: 10.1902/cap.2011.110041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 05/23/2011] [Indexed: 02/07/2023]
Abstract
Polypeptide growth factors have demonstrated strong potential to repair defects associated with teeth and dental implants. Over the past two decades, intense research efforts have led to the clinical development of several growth factors or biologic agents, including bone morphogenetic proteins, platelet-derived growth factor, fibroblast growth factors, and enamel matrix proteins. Several of these growth factors are now being used clinically for a variety of applications, such as the promotion of periodontal regeneration, sinus floor augmentation, and root coverage procedures. Although clinical results have been promising and growth factors add another dimension to clinical care, optimization of growth factor targeting approaches to periodontal wounds remains a challenge. Enhancement of growth factor local application to improve bioavailability, bioactivity, and allowance of three-dimensional reconstruction of complex anatomic defects is a goal. This article will highlight developments for growth factor delivery to better stimulate the wound healing response for periodontal and bone regeneration in the maxillofacial region.
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Affiliation(s)
- William V Giannobile
- Department of Periodontics and Oral Medicine and Michigan Center for Oral Health Research, School of Dentistry, University of Michigan, Ann Arbor, MI.,Department of Biomedical Engineering, College of Engineering, University of Michigan
| | - Scott J Hollister
- Department of Biomedical Engineering, College of Engineering, University of Michigan.,Department of Surgery, School of Medicine, University of Michigan
| | - Peter X Ma
- Department of Biomedical Engineering, College of Engineering, University of Michigan.,Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan
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