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Nam JW. Efficacy of hydroxyapatite and fibrin sealant as carriers for bone morphogenetic protein-2 in maxillary sinus floor augmentation: a retrospective study. Int J Oral Maxillofac Surg 2024; 53:795-801. [PMID: 38653626 DOI: 10.1016/j.ijom.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
The aim of this retrospective study was to assess the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) with hydroxyapatite (HA) granules and fibrin sealant (FS) in maxillary sinus floor augmentation (MSFA), with a focus on the volume change. Fifty-two of 137 patients who underwent MSFA with rhBMP-2/HA grafting between June 2016 and December 2022 met the study inclusion criteria; 25 had received rhBMP-2/HA without FS and 27 had received rhBMP-2/HA with FS. Computed tomography (CT) images were obtained preoperatively, immediately following the operation, and at 6 months postoperative. These images were three-dimensionally reconstructed to measure the volumetric and height changes following MSFA. The mean ± standard deviation percentage of volumetric change at 6 months was 48.75 ± 37.44% in the group with FS and 29.77 ± 13.42% in the group without FS (P = 0.019). The vertical height measured at a specific site of the grafted area showed a mean percentage change at 6 months of 4.05 ± 12.08% in the group with FS and 6.07 ± 10.15% in the group without FS (P = 0.518). The additional use of FS as a carrier for rhBMP-2/HA in MSFA was found to improve surgical convenience and bone regeneration ability.
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Affiliation(s)
- J W Nam
- Department of Oral and Maxillofacial Surgery, Wonkwang University Sanbon Dental Hospital, Gunpo-si, Gyeonggi-do, Republic of Korea; Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan-si, Jeonbuk-do, Republic of Korea.
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Yang L, Wang Q, Wang X, Yang Z, Ning Y, Guo Z. Horizontal ridge augmentation in the maxillary aesthetic region using the autogenous circular cortical-lamina anchoring technique: A case series study. Clin Implant Dent Relat Res 2024; 26:518-531. [PMID: 38320956 DOI: 10.1111/cid.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
AIM This case series aimed to evaluate the effectiveness of the autologous circular cortical lamina-anchoring (CCA) technique for horizontal bone augmentation in the maxillary aesthetic region. MATERIALS AND METHODS A total of 25 patients with 28 implants underwent horizontal bone augmentation using CCA followed by implant placement and crown delivery. The primary outcome measures were alveolar ridge width (ARW) and buccal bone thickness (BBT), whereas the secondary outcome measures included marginal bone loss (MBL), mid-facial mucosal margin loss (MML), clinical assessment of peri-implant and aesthetic parameters, patient-reported outcome measures (PROMs), and implant survival rates. RESULTS All 25 patients with 28 implants completed the treatment, no dropouts occurred. After CCA, the mean ARW at 1, 2, and 4 mm below the alveolar crest significantly increased from 2.38 ± 0.48, 2.85 ± 0.51, and 3.21 ± 0.53 mm to 6.80 ± 0.48, 6.99 ± 0.50, and 8.08 ± 0.52 mm, respectively. At the 3-year follow-up, the mean BBT0, BBT2, and BBT4 slightly decreased from 2.51 ± 0.26, 2.63 ± 0.31, and 2.75 ± 0.29 mm to 2.43 ± 0.27, 2.51 ± 0.30, and 2.64 ± 0.28 mm, respectively. Although the overall MBL was <0.15 mm, the results were statistically significant. The mean MML at the 3-year follow-up was 0.02 mm. All implant sites showed acceptable peri-implant and aesthetic outcomes. Incisions healed without complications, and no significant differences in PROMs observed at any time point. The 3-year follow-up showed a 100% implant survival rate. CONCLUSION The autologous CCA technique is a useful method for increasing ARW and maintaining BBT in the maxillary aesthetic region.
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Affiliation(s)
- Liqing Yang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Qing Wang
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Xinyi Wang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Zijing Yang
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Yingyuan Ning
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Zehong Guo
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
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Lee JH, Seo H, Cho YC, Sung IY, Son JH. Addition of recombinant human bone morphogenic protein-2 to the graft materials improves the clinical outcomes of implants placed in grafted maxillary sinus. J Dent Sci 2024; 19:865-870. [PMID: 38618057 PMCID: PMC11010705 DOI: 10.1016/j.jds.2023.08.020] [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: 08/02/2023] [Revised: 08/21/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose The long-term outcomes of implants placed in grafted sinuses using recombinant human bone morphogenetic protein-2 (rhBMP-2) are unclear. This study aimed to compare 3- and 5-year implant survival rates and marginal bone loss (MBL) during functional loading. Materials and methods In this retrospective study, we analyzed 63 implants inserted after maxillary sinus floor augmentation (MSFA) in 45 patients between January 2016 and April 2019. The outcome variables were: 1) 3- and 5-year cumulative survival rates of the implants and 2) MBL after functional loading. Other assessed variables included patient demographic information, preoperative residual bone height (RBH), surgical site, implant length and diameter, graft material, healing period before loading, prosthetic type, and opposing dentition. Results The cumulative 3- and 5-year survival rates of the implants were 100% in the rhBMP-2 group and 95.5% and 86.4% in the non-rhBMP-2 group, respectively. The average 3- and 5-year MBL were 1.14 ± 0.67 mm, 1.30 ± 0.74 mm in the rhBMP-2 group and 1.68 ± 0.90 mm, 2.27 ± 1.29 mm in the non-rhBMP-2 group, respectively. Significant differences were observed between 3 and 5 years between the two groups. Conclusion Addition of the rhBMP-2 to the graft materials positively affects implant placement in the grafted maxillary sinus in terms of implant survival and MBL when preoperative RBH is unfavorable.
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Affiliation(s)
- Jin-Ho Lee
- Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Hyejun Seo
- Department of Dentistry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Yeong-Cheol Cho
- Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Iel-Yong Sung
- Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Jang-Ho Son
- Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
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Galarraga-Vinueza ME, Barootchi S, Nevins ML, Nevins M, Miron RJ, Tavelli L. Twenty-five years of recombinant human growth factors rhPDGF-BB and rhBMP-2 in oral hard and soft tissue regeneration. Periodontol 2000 2024; 94:483-509. [PMID: 37681552 DOI: 10.1111/prd.12522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
Contemporary oral tissue engineering strategies involve recombinant human growth factor approaches to stimulate diverse cellular processes including cell differentiation, migration, recruitment, and proliferation at grafted areas. Recombinant human growth factor applications in oral hard and soft tissue regeneration have been progressively researched over the last 25 years. Growth factor-mediated surgical approaches aim to accelerate healing, tissue reconstruction, and patient recovery. Thus, regenerative approaches involving growth factors such as recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and recombinant human bone morphogenetic proteins (rhBMPs) have shown certain advantages over invasive traditional surgical approaches in severe hard and soft tissue defects. Several clinical studies assessed the outcomes of rhBMP-2 in diverse clinical applications for implant site development and bone augmentation. Current evidence regarding the clinical benefits of rhBMP-2 compared to conventional therapies is inconclusive. Nevertheless, it seems that rhBMP-2 can promote faster wound healing processes and enhance de novo bone formation, which may be particularly favorable in patients with compromised bone healing capacity or limited donor sites. rhPDGF-BB has been extensively applied for periodontal regenerative procedures and for the treatment of gingival recessions, showing consistent and positive outcomes. Nevertheless, current evidence regarding its benefits at implant and edentulous sites is limited. The present review explores and depicts the current applications, outcomes, and evidence-based clinical recommendations of rhPDGF-BB and rhBMPs for oral tissue regeneration.
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Affiliation(s)
- Maria Elisa Galarraga-Vinueza
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- School of Dentistry, Universidad de las Américas (UDLA), Quito, Ecuador
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Marc L Nevins
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Myron Nevins
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Lim HC, Paeng KW, Jung UW, Benic GI. Vertical bone augmentation using collagenated or non-collagenated bone substitute materials with or without recombinant human bone morphogenetic protein-2 in a rabbit calvarial model. J Periodontal Implant Sci 2023; 53:429-443. [PMID: 37038830 PMCID: PMC10761281 DOI: 10.5051/jpis.2204240212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/01/2023] [Accepted: 01/17/2023] [Indexed: 03/18/2023] Open
Abstract
PURPOSE The aim of this study was to determine 1) the bone-regenerative effect of porcine bone block materials with or without collagen matrix incorporation, 2) the effect of a collagen barrier, and 3) the effect of adding recombinant human bone morphogenetic protein-2 (rhBMP-2) to the experimental groups. METHODS Four treatment modalities were applied to rabbit calvaria: 1) deproteinized bovine bone mineral blocks (DBBM), 2) porcine bone blocks with collagen matrix incorporation (PBC), 3) porcine bone blocks alone without collagen matrix incorporation (PB), and 4) PBC blocks covered by a collagen membrane (PBC+M). The experiments were repeated with the addition of rhBMP-2. The animals were sacrificed after either 2 or 12 weeks of healing. Micro-computed tomography (micro-CT), histologic, and histomorphometric analyses were performed. RESULTS Micro-CT indicated adequate volume stability in all block materials. Histologically, the addition of rhBMP-2 increased the amount of newly formed bone (NB) in all the blocks. At 2 weeks, minimal differences were noted among the NB of groups with or without rhBMP-2. At 12 weeks, the PBC+M group with rhBMP-2 presented the greatest NB (P<0.05 vs. the DBBM group with rhBMP-2), and the PBC and PB groups had greater NB than the DBBM group (P>0.05 without rhBMP-2, P<0.05 with rhBMP-2). CONCLUSIONS The addition of rhBMP-2 enhanced NB formation in vertical augmentation using bone blocks, and a collagen barrier may augment the effect of rhBMP-2.
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Affiliation(s)
- Hyun-Chang Lim
- Department of Periodontology, Kyung Hee University, College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
| | - Goran I Benic
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Institute for Research and Education in Dental Medicine, Lugano, Switzerland
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Yan S, Wang D, Zhang L, Gan T, Yao H, Zhu H, He Y, Yang K. LIPUS-S/B@NPs regulates the release of SDF-1 and BMP-2 to promote stem cell recruitment-osteogenesis for periodontal bone regeneration. Front Bioeng Biotechnol 2023; 11:1226426. [PMID: 37469445 PMCID: PMC10353878 DOI: 10.3389/fbioe.2023.1226426] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 06/26/2023] [Indexed: 07/21/2023] Open
Abstract
Purpose: Poly (lactic-co-glycolic acid)-based nanoparticles (PLGA NPs) have been widely used as the carrier for sustainable drug delivery. However, the drug release from the NPs was usually incomplete and uncontrollable. Herein, a low intensity pulsed ultrasound (LIPUS) assisted SDF-1/BMP-2@nanoparticles (S/B@NPs) system was fabricated to facilitate stem cell recruitment-osteogenesis for periodontal bone regeneration. Methods: In this work, S/B@NPs were prepared with double-emulsion synthesis method. Then the S/B release profile from NPs was evaluated with or without low intensity pulsed ultrasound treatment. Afterwards, the stem cell recruiting and osteoinductive capacities of LIPUS-S/B@NPs were detected with human periodontal ligament cells (hPDLCs) in vitro and in a rat periodontal bone defect model. Results: The results indicated that S/B@NPs were successfully prepared and LIPUS could effectively regulate the release of S/B and increase their final releasing amount. Moreover, LIPUS-S/B@NPs system significantly promoted hPDLCs migrating and osteogenesis in vitro and recruiting rBMSCs to the rat periodontal defect and facilitated bone regeneration in vivo. Conclusion: Our LIPUS assisted S/B@NPs system can effectively facilitate stem cell recruitment and periodontal bone regeneration. Considering its reliable safety and therapeutic effect on bone fracture, LIPUS, as an adjuvant therapy, holds great potential in the regulation of drug delivery systems for bone healing.
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Affiliation(s)
- Shujin Yan
- Ministry of Education Key Laboratory of Child Development and Disorders, Pediatric Research Institute, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Engineering Research Center of Stem Cell Therapy, Children’s Hospital of Chongqing Medical University, Chongqing, China
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dong Wang
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liang Zhang
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tian Gan
- Department of Ultrasound, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Huan Yao
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hui Zhu
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yiman He
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ke Yang
- Ministry of Education Key Laboratory of Child Development and Disorders, Pediatric Research Institute, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Engineering Research Center of Stem Cell Therapy, Children’s Hospital of Chongqing Medical University, Chongqing, China
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Jiang F, Qi X, Wu X, Lin S, Shi J, Zhang W, Jiang X. Regulating macrophage-MSC interaction to optimize BMP-2-induced osteogenesis in the local microenvironment. Bioact Mater 2023; 25:307-318. [PMID: 36844362 PMCID: PMC9947106 DOI: 10.1016/j.bioactmat.2023.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 02/12/2023] Open
Abstract
Bone morphogenetic protein (BMP-2) has been approved by the FDA to promote bone regeneration, but uncertain osteogenic effect and dose-dependent side effects may occur. Osteoimmunomodulation plays an important role in growth factor-based osteogenesis. Here, we explored how proinflammatory signals affect the dose-dependent osteogenic potential of BMP-2. We observed that the expression level of local IL-1β did not increase with the dose of BMP-2 in the mouse osteogenesis model. A low dose of BMP-2 could not promote new bone formation, but trigger the release of IL-1β from M1 macrophages. As the dose of BMP-2 increased, the IL-1β expression and M1 infiltration in local microenvironment were inhibited by IL-1Ra from MSCs under osteogenic differentiation induced by BMP-2, and new bone tissues formed, even excessively. Anti-inflammatory drugs (Dexamethasone, Dex) promoted osteogenesis via inhibiting M1 polarization and enhancing BMP-2-induced MSC osteo-differentiation. Thus, we suggest that the osteogenic effect of BMP-2 involves macrophage-MSC interaction that is dependent on BMP-2 dose and based on IL-1R1 ligands, including IL-1β and IL-1Ra. The dose of BMP-2 could be reduced by introducing immunoregulatory strategies.
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Affiliation(s)
- Fei Jiang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, No.639, Zhizaoju Road, Shanghai, 200011, China
- Jiangsu Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, No. 140, Han Zhong Road, Nanjing, 210029, China
- Department of General Dentistry, Affiliated Hospital of Stomatology, Nanjing Medical University, No. 136, Han Zhong Road, Nanjing, 210029, China
| | - Xuanyu Qi
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, No.639, Zhizaoju Road, Shanghai, 200011, China
| | - Xiaolin Wu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, No.639, Zhizaoju Road, Shanghai, 200011, China
| | - Sihan Lin
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, No.639, Zhizaoju Road, Shanghai, 200011, China
| | - Junfeng Shi
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, No.639, Zhizaoju Road, Shanghai, 200011, China
| | - Wenjie Zhang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, No.639, Zhizaoju Road, Shanghai, 200011, China
| | - Xinquan Jiang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, No.639, Zhizaoju Road, Shanghai, 200011, China
- Corresponding author. Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639, Zhizaoju Road, Shanghai, 200011, China.
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Tavelli L, Barootchi S, Rasperini G, Giannobile WV. Clinical and patient-reported outcomes of tissue engineering strategies for periodontal and peri-implant reconstruction. Periodontol 2000 2023; 91:217-269. [PMID: 36166659 PMCID: PMC10040478 DOI: 10.1111/prd.12446] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/25/2022] [Accepted: 06/05/2022] [Indexed: 11/28/2022]
Abstract
Scientific advancements in biomaterials, cellular therapies, and growth factors have brought new therapeutic options for periodontal and peri-implant reconstructive procedures. These tissue engineering strategies involve the enrichment of scaffolds with living cells or signaling molecules and aim at mimicking the cascades of wound healing events and the clinical outcomes of conventional autogenous grafts, without the need for donor tissue. Several tissue engineering strategies have been explored over the years for a variety of clinical scenarios, including periodontal regeneration, treatment of gingival recessions/mucogingival conditions, alveolar ridge preservation, bone augmentation procedures, sinus floor elevation, and peri-implant bone regeneration therapies. The goal of this article was to review the tissue engineering strategies that have been performed for periodontal and peri-implant reconstruction and implant site development, and to evaluate their safety, invasiveness, efficacy, and patient-reported outcomes. A detailed systematic search was conducted to identify eligible randomized controlled trials reporting the outcomes of tissue engineering strategies utilized for the aforementioned indications. A total of 128 trials were ultimately included in this review for a detailed qualitative analysis. Commonly performed tissue engineering strategies involved scaffolds enriched with mesenchymal or somatic cells (cell-based tissue engineering strategies), or more often scaffolds loaded with signaling molecules/growth factors (signaling molecule-based tissue engineering strategies). These approaches were found to be safe when utilized for periodontal and peri-implant reconstruction therapies and implant site development. Tissue engineering strategies demonstrated either similar or superior clinical outcomes than conventional approaches for the treatment of infrabony and furcation defects, alveolar ridge preservation, and sinus floor augmentation. Tissue engineering strategies can promote higher root coverage, keratinized tissue width, and gingival thickness gain than scaffolds alone can, and they can often obtain similar mean root coverage compared with autogenous grafts. There is some evidence suggesting that tissue engineering strategies can have a positive effect on patient morbidity, their preference, esthetics, and quality of life when utilized for the treatment of mucogingival deformities. Similarly, tissue engineering strategies can reduce the invasiveness and complications of autogenous graft-based staged bone augmentation. More studies incorporating patient-reported outcomes are needed to understand the cost-benefits of tissue engineering strategies compared with traditional treatments.
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Affiliation(s)
- Lorenzo Tavelli
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Shayan Barootchi
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- IRCCS Foundation Polyclinic Ca’ Granda, University of Milan, Milan, Italy
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Assem NZ, Pazmiño VFC, Caliente EA, Dalben GDS, Soares S, Santiago Júnior JF, de Almeida ALPF, de Almeida ALPF. Bone substitutes vs. autogenous bone graft for regeneration of the anterior maxillary alveolar process with horizontal bone resorption: systematic review. J ORAL IMPLANTOL 2022; 49:102-113. [PMID: 36913696 DOI: 10.1563/aaid-joi-d-22-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 07/26/2022] [Accepted: 08/20/2022] [Indexed: 12/12/2022]
Abstract
The objective of this systematic review was to identify the available scientific evidence on bone substitutes (BS) compared to autogenous bone grafts (ABG) for regeneration of horizontal bone resorption in the anterior maxillary alveolar process, aiming at rehabilitation with endosseous implants. This review was performed according to the PRISMA guidelines (2020) and registered in the database PROSPERO (CRD: 42017070574) . The databases searched were PUBMED/MEDLINE, EMBASE, SCOPUS, SCIENCE DIRECT, WEB OF SCIENCE, and CENTRAL COCHRANE, in the English language. The Australian National Health and Medical Research Council (NHMRC) and Cochrane Risk of Bias Tool were used to assess the study's quality and risk of bias. 544 papers were found. After the selection process, six studies were selected for review. A total of 182 patients were followed for a period of 6 to 48 months. The mean age of patients was 46.46 years, 152 implants were installed in the anterior region. Two studies achieved a reduced graft and implant failure rate, while the remaining four studies had no losses. It may be concluded that both the use of ABG and some BS are viable alternatives for the rehabilitation with implants in individuals with anterior horizontal bone loss. However, additional RCTs are warranted due to the limited number of papers.
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Affiliation(s)
- Naida Zanini Assem
- Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Eliana Aparecida Caliente
- Postgraduate Student at the Department of Dentistry, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Gisele da Silva Dalben
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Simone Soares
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Joel Ferreira Santiago Júnior
- Sacred Heart University - Bauru Assistant Professor Health Sciences 10-50 Irmã Arminda BRAZIL Bauru São Paulo 17011160 551421077112
| | - Ana Lúcia Pompéia Fraga de Almeida
- Associate Professor, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Arnal HM, Angioni CD, Gaultier F, Urbinelli R, Urban IA. Horizontal guided bone regeneration on knife-edge ridges: A retrospective case-control pilot study comparing two surgical techniques. Clin Implant Dent Relat Res 2022; 24:211-221. [PMID: 35167184 DOI: 10.1111/cid.13073] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/04/2022] [Accepted: 01/31/2022] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Studies evaluating guided bone regeneration (GBR) on knife-edge ridges using absorbable membranes with staged approaches have reported various horizontal bone gains. This study compared the horizontal bone gain obtained via a conventional technique of GBR and a recently-reported technique. Bone loss during the healing process was also measured. METHODS Consecutive patients who underwent GBR on knife-edge ridges via a conventional technique (control group) or the Sausage Technique (test group) were included in this study. GBR was performed using a collagen membrane and deproteinized bovine bone mineral combined with an autogenous graft at a 1:1 ratio. Cone-beam computed tomography (CBCT) was performed preoperatively, postoperatively, and after the patient healed. Horizontal bone width was measured on CBCT images 2 mm apical from the top of the crest. The preoperative CBCT and posthealing CBCT were superimposed to calculate the bone gain after healing, and the preoperative and postoperative CBCT scans were superimposed to calculate the bone gain after surgery. Bone loss during healing was calculated by subtracting the width of the ridge after healing from the postoperative width. RESULTS The mean horizontal bone gain was significantly lower in the control group (2.7 ± 1.8 mm; 83.2%) than in the test group (5.3 ± 2.3 mm; 216.8%) (p = 0.003). The average horizontal bone loss between regeneration and implant placement was 0.9 mm in the control group (27.9%) and 2.1 mm in the test group (29.4%). While the absolute bone loss was significantly different (p = 0.012), the percentage of bone resorption was not (p = 0.608). CONCLUSION The new technique resulted in significantly more bone gain than a conventional GBR technique. The rate of graft resorption during healing was stable regardless of the amount of grafted material.
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Affiliation(s)
- Helene M Arnal
- Department of Oral Medicine and Oral Surgery, APHP Henri Mondor Hospital, University of Paris, Paris, France.,Cabinet de chirurgie dentaire Villiers, Paris, France
| | - Charles D Angioni
- Cabinet de chirurgie dentaire Villiers, Paris, France.,Department of Periodontics, APHP Henri Mondor Hospital, University of Paris, Paris, France
| | - Frederick Gaultier
- Department of Oral Medicine and Oral Surgery, APHP Henri Mondor Hospital, University of Paris, Paris, France
| | | | - Istvan A Urban
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,School of Dentistry, University of Szeged, Szeged, Hungary.,Urban Regeneration Institute, Budapest, Hungary
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11
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Oliveira JE, Suzuki MF, Damiani R, Lima ER, Amaral KC, Santos AMS, Magalhães GS, Faverani LP, Pereira LAVD, Bartolini P. Synthesis of Human Bone Morphogenetic Protein-2 (hBMP-2) in E. coli Periplasmic Space: Its Characterization and Preclinical Testing. Cells 2021; 10:3525. [PMID: 34944033 PMCID: PMC8699916 DOI: 10.3390/cells10123525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/19/2021] [Accepted: 11/08/2021] [Indexed: 11/24/2022] Open
Abstract
Human BMP-2, a homodimeric protein that belongs to the TGF- β family, is a recognized osteoinductor due to its capacity of inducing bone regeneration and ectopic bone formation. The administration of its recombinant form is an alternative to autologous bone grafting. A variety of E. coli-derived hBMP-2 has been synthesized through refolding of cytoplasmic inclusion bodies. The present work reports the synthesis, purification, and characterization of periplasmic hBMP-2, obtained directly in its correctly folded and authentic form, i.e., without the initial methionine typical of the cytoplasmic product that can induce undesired immunoreactivity. A bacterial expression vector was constructed including the DsbA signal peptide and the cDNA of hBMP-2. The periplasmic fluid was extracted by osmotic shock and analyzed via SDS-PAGE, Western blotting, and reversed-phase high-performance liquid chromatography (RP-HPLC). The purification was carried out by heparin affinity chromatography, followed by high-performance size-exclusion chromatography (HPSEC). HPSEC was used for qualitative and quantitative analysis of the final product, which showed >95% purity. The classical in vitro bioassay based on the induction of alkaline phosphatase activity in myoblastic murine C2C12 cells and the in vivo bioassay consisting of treating calvarial critical-size defects in rats confirmed its bioactivity, which matched the analogous literature data for hBMP-2.
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Affiliation(s)
- João E. Oliveira
- Instituto de Pesquisas Energéticas e Nucleares, IPEN–CNEN, Av. Prof. Lineu Prestes 2242, São Paulo 05508-000, SP, Brazil; (J.E.O.); (M.F.S.); (K.C.A.)
| | - Miriam F. Suzuki
- Instituto de Pesquisas Energéticas e Nucleares, IPEN–CNEN, Av. Prof. Lineu Prestes 2242, São Paulo 05508-000, SP, Brazil; (J.E.O.); (M.F.S.); (K.C.A.)
| | - Renata Damiani
- Biosintesis P & D, São Paulo 05508-000, SP, Brazil; (R.D.); (E.R.L.)
| | - Eliana R. Lima
- Biosintesis P & D, São Paulo 05508-000, SP, Brazil; (R.D.); (E.R.L.)
| | - Kleicy C. Amaral
- Instituto de Pesquisas Energéticas e Nucleares, IPEN–CNEN, Av. Prof. Lineu Prestes 2242, São Paulo 05508-000, SP, Brazil; (J.E.O.); (M.F.S.); (K.C.A.)
| | - Anderson M. S. Santos
- Department of Diagnosis and Surgery, School of Dentistry, Sao Paulo State University, UNESP, Araçatuba 16015-050, SP, Brazil; (A.M.S.S.); (L.P.F.)
| | - Geraldo S. Magalhães
- Immunopathology Laboratory, Instituto Butantan, São Paulo 05503-900, SP, Brazil;
| | - Leonardo P. Faverani
- Department of Diagnosis and Surgery, School of Dentistry, Sao Paulo State University, UNESP, Araçatuba 16015-050, SP, Brazil; (A.M.S.S.); (L.P.F.)
| | - Luís A. V. D. Pereira
- Department of Biochemistry and Tissue Biology, Institute of Biology, State University of Campinas, UNICAMP, Campinas 13083-970, SP, Brazil;
| | - Paolo Bartolini
- Instituto de Pesquisas Energéticas e Nucleares, IPEN–CNEN, Av. Prof. Lineu Prestes 2242, São Paulo 05508-000, SP, Brazil; (J.E.O.); (M.F.S.); (K.C.A.)
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12
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Comparison of Bone Regeneration in Different Forms of Bovine Bone Scaffolds with Recombinant Human Bone Morphogenetic Protein-2. Int J Mol Sci 2021; 22:ijms222011121. [PMID: 34681785 PMCID: PMC8537640 DOI: 10.3390/ijms222011121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to compare the bone regeneration ability of particle and block bones, acting as bone scaffolds, with recombinant human bone morphogenetic protein (rhBMP)-2 and evaluate them as rhBMP-2 carriers. Demineralized bovine bone particles, blocks, and rhBMP-2 were grafted into the subperiosteal space of a rat calvarial bone, and the rats were randomly divided into four groups: particle, block, P (particle)+BMP, and B (block)+BMP groups. The bone volume of the B+BMP group was significantly higher than that of the other groups (p < 0.00), with no significant difference in bone mineral density. The average adipose tissue volume of the B+BMP group was higher than that of the P+BMP group, although the difference was not significant. Adipose tissue formation was observed in the rhBMP-2 application group. Histologically, the particle and B+BMP groups showed higher formation of a new bone. However, adipose tissue and void spaces were also formed, especially in the B+BMP group. Hence, despite the formation of a large central void space, rhBMP-2 could be effectively used with block bone scaffolds and showed excellent new bone formation. Further studies are required to evaluate the changes in adipose tissue.
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13
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Lim HC, Paeng KW, Jung UW, Benic GI. Effectiveness of xenogeneic and synthetic bone-block substitute materials with/without recombinant human bone morphogenetic protein-2: A preclinical study using a rabbit calvarium model. J Clin Periodontol 2021; 48:1126-1136. [PMID: 34109662 DOI: 10.1111/jcpe.13480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 03/17/2021] [Accepted: 04/20/2021] [Indexed: 12/17/2022]
Abstract
AIM To investigate new bone (NB) formation by using bone-block substitute materials with/without recombinant human bone morphogenetic protein-2 (rhBMP-2). MATERIALS AND METHODS Three synthetic bone-block substitute materials [biphasic calcium phosphate (BCP); nanostructured hydroxyapatite (NH); 3D-printed tricalcium phosphate/hydroxyapatite (3DP)] and one xenogeneic deproteinized bovine bone mineral (DBBM) block substitute were affixed to rabbit calvarium using osteosynthesis screws, either with rhBMP-2 (n = 12) or without rhBMP-2 (n = 16). At 2 or 12 weeks (n = 6 with rhBMP-2 and n = 8 without rhBMP-2 for each week), histologic, histomorphometric and microcomputed tomography analyses were performed. RESULTS The application of rhBMP-2 increased NB formation in all experimental groups at both weeks. DBBM resulted in a greater area of NB compared with synthetic blocks either with or without rhBMP-2 at 2 weeks (2.8 ± 0.9 vs. 1.4 ± 0.5-1.9 ± 1.4 mm2 ; 1.4 ± 1.0 vs. 0.6 ± 0.3-0.9 ± 0.5 mm2 ) and without rhBMP-2 at 12 weeks (3.0 ± 0.8 vs. 1.7 ± 0.7-2.6 ± 1.5 mm2 ) (p > 0.05). NB formation did not differ significantly for DBBM and the three types of synthetic block with rhBMP-2 at 12 weeks (4.5 ± 2.0 vs. 3.8 ± 0.7-5.1 ± 1.1 mm2 ; p > 0.05). CONCLUSIONS rhBMP-2 enhanced NB in all blocks. DBBM blocks yielded more NB than synthetic blocks without rhBMP-2. The application of rhBMP-2 appears to compensate for differences in late healing.
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Affiliation(s)
- Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Goran I Benic
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Institute for Research and Education in Dental Medicine, Lugano, Switzerland
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A Prosthetic and Surgical Approach for Full-Arch Rehabilitation in Atrophic Maxilla Previously Affected by Peri-Implantitis. Case Rep Dent 2021; 2021:6637500. [PMID: 33859846 PMCID: PMC8026321 DOI: 10.1155/2021/6637500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/19/2021] [Accepted: 03/24/2021] [Indexed: 11/30/2022] Open
Abstract
Rehabilitation of atrophic maxilla with dental implants is still a challenge in clinical practice especially in cases of alveolar bone resorption due to peri-implantitis and pneumatization of the maxillary sinuses. Several surgical approaches have been employed to reconstruct the lost tissues allowing the proper tridimensional position of the implants. In this context, the aim of this case report is to describe a surgical and prosthetic approach to fully rehabilitate the atrophic maxilla with dental implants. The patient presented with unsatisfactory functional and esthetical implant-supported prosthesis with some of the implants already lost by peri-implantitis. The remaining three implants were also affected by peri-implantitis. Reversal prosthetic planning was performed, and a provisional prosthesis was fabricated and anchored in two short implants. Sinus floor augmentation procedure and onlay bone graft were then accomplished. After a healing period of 8 months, digital-guided surgery approach was performed to place the implants. Finally, a definitive prosthesis was installed. One-year follow-up has revealed stabilization of the bone tissue level, successful osseointegration, and a pleasant esthetic and functional result. A proper diagnosis and careful planning play an important role to enhance precision and to achieve patient esthetic and functional outcomes.
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15
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Imafuji T, Shirakata Y, Shinohara Y, Nakamura T, Noguchi K. Enhanced bone formation of calvarial bone defects by low-intensity pulsed ultrasound and recombinant human bone morphogenetic protein-9: a preliminary experimental study in rats. Clin Oral Investig 2021; 25:5917-5927. [PMID: 33755786 DOI: 10.1007/s00784-021-03897-6] [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: 11/23/2020] [Accepted: 03/18/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the combined effects of recombinant human bone morphogenetic protein - 9 (rhBMP-9) loaded onto absorbable collagen sponges (ACS) and low-intensity pulsed ultrasound (LIPUS) on bone formation in rat calvarial defects. MATERIALS AND METHODS Circular calvarial defects were surgically created in 18 Wistar rats, which were divided into LIPUS-applied (+) and LIPUS-non-applied (-) groups. The 36 defects in each group received ACS implantation (ACS group), ACS with rhBMP-9 (rhBMP-9/ACS group), or surgical control (control group), yielding the following six groups: ACS (+/-), rhBMP-9/ACS (+/-), and control (+/-). The LIPUS-applied groups received daily LIPUS exposure starting immediately after surgery. At 4 weeks, animals were sacrificed and their defects were investigated histologically and by microcomputed tomography. RESULTS Postoperative clinical healing was uneventful at all sites. More new bone was observed in the LIPUS-applied groups compared with the LIPUS-non-applied groups. Newly formed bone area (NBA)/total defect area (TA) in the ACS (+) group (46.49 ± 7.56%) was significantly greater than that observed in the ACS (-) (34.31 ± 5.68%) and control (-) (31.13 ± 6.74%) groups (p < 0.05). The rhBMP-9/ACS (+) group exhibited significantly greater bone volume, NBA, and NBA/TA than the rhBMP-9/ACS (-) group (2.46 ± 0.65 mm3 vs. 1.76 ± 0.44 mm3, 1.25 ± 0.31 mm2 vs. 0.88 ± 0.22 mm2, and 62.80 ± 11.87% vs. 42.66 ± 7.03%, respectively) (p < 0.05). Furthermore, the rhBMP-9/ ACS (+) group showed the highest level of bone formation among all groups. CONCLUSION Within their limits, it can be concluded that LIPUS had osteopromotive potential and enhanced rhBMP-9-induced bone formation in calvarial defects of rats. CLINICAL RELEVANCE The use of rhBMP-9 with LIPUS stimulation can be a potential bone regenerative therapy for craniofacial/peri-implant bone defects.
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Affiliation(s)
- Takatomo Imafuji
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Yoshinori Shirakata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Yukiya Shinohara
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Toshiaki Nakamura
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Kazuyuki Noguchi
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
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16
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Sousa DND, Roriz VM, Oliveira GJPLD, Duarte WR, Pinto LNDMP, Vianna LMDS, Carneiro FP, Ferreira VMM. Local effect of simvastatin combined with different osteoconductive biomaterials and collagen sponge on new bone formation in critical defects in rat calvaria. Acta Cir Bras 2020; 35:e202000102. [PMID: 32215463 PMCID: PMC7092666 DOI: 10.1590/s0102-865020200010000002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 12/14/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose To evaluate the local effect of simvastatin (SVT) combined with deproteinized bovine bone (DBB) with hydroxyapatite/β-tricalcium phosphate biphasic ceramics (HA/TCP) and with collagen sponge (CS) on bone repair in critical size defects (CSDs) in rat calvaria. Methods Forty-two 5-mm diameter CSDs were made bilaterally in the calvaria of 18 rats. The animals were allocated according to the type of biomaterial and associations used to fill the CSD. After 8 weeks, the animals were euthanized, and their calvaria were evaluated for repaired tissue composition using histologic and histometric analyses. Results In the histometric analysis, the use of SVT showed to increase bone formation in the CSDs when combined with all the bone substitutes tested in this study (p<0.05). Greater bone formation was observed in the groups with SVT compared to the groups without SVT. Conclusions The use of SVT without the need for a vehicle and combined with a commercially available biomaterial may be a cheaper way to potentiate the formation of bone tissue without the need to produce new biomaterials. Therefore, SVT combined with DBB induced significantly greater new bone formation than did the other treatments.
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17
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Suzuki MF, Oliveira JE, Damiani R, Lima ER, Amaral KC, Santos AMDS, Magalhães GS, Faverani LP, Pereira LAVD, Silva FM, Bartolini P. Human bone morphogenetic protein-2 (hBMP-2) characterization by physical-chemical, immunological and biological assays. AMB Express 2020; 10:34. [PMID: 32067115 PMCID: PMC7026339 DOI: 10.1186/s13568-020-0964-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 01/27/2020] [Indexed: 11/18/2022] Open
Abstract
Commercially available preparations of methionyl-human BMP-2 and CHO-derived hBMP-2, which belongs to the transforming growth factor β (TGF-β) superfamily, were used for a complete characterization. This protein is an extremely efficient osteoinductor that plays an important role during bone regeneration and embryonic development. Characterization was carried out via SDS-PAGE and Western blotting, followed by reversed-phase HPLC, size-exclusion HPLC and MALDI-TOF-MS. The classical in vitro bioassay, based on the induction of alkaline phosphatase activity in C2C12 cells, confirmed that hBMP-2 biological activity is mostly related to the dimeric form, being ~ 4-fold higher for the CHO-derived glycosylated form when compared with the E. coli counterpart. The E. coli-derived met-hBMP-2 has shown, by MALDI-TOF-MS, a large presence of the bioactive dimer. A more complex molecular mass (MM) distribution was found for the CHO-derived product, whose exact MM has never been reported because of its variable glycosylation. A method based on RP-HPLC was set up, allowing a quantitative and qualitative hBMP-2 determination even directly on ongoing culture media. Considering that hBMP-2 is highly unstable, presenting moreover an extremely high aggregate value, we believe that these data pave the way to a necessary characterization of this important factor when synthesized by DNA recombinant techniques in different types of hosts.
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18
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Naenni N, Lim HC, Papageorgiou SN, Hämmerle CHF. Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:287-306. [DOI: 10.1111/jcpe.13052] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/09/2018] [Accepted: 12/01/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Hyun-Chang Lim
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
- Department of Periodontology; Periodontal-Implant Clinical Research Institute; School of Dentistry; Kyung Hee University; Seoul Republic of Korea
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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19
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Titanium mesh associated with rhBMP-2 in alveolar ridge reconstruction. Int J Oral Maxillofac Surg 2019; 48:546-553. [DOI: 10.1016/j.ijom.2018.09.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 09/26/2018] [Accepted: 09/28/2018] [Indexed: 11/20/2022]
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20
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ARONI MAT, COSTA NETO PFD, OLIVEIRA GJPLD, MARCANTONIO RAC, MARCANTONIO JUNIOR E. Bone repair induced by different bone graft substitutes in critical-sized defects in rat calvaria. REVISTA DE ODONTOLOGIA DA UNESP 2019. [DOI: 10.1590/1807-2577.04119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction The use of bone substitutes in grafting procedures as an alternative of the use of autogenous bone graft has been indicated, however, the direct comparison between these biomaterials has been little explored. Objective To evaluate the effect of different osteoconductive bone substitutes on the bone repair in critical-sized defects (CSDs) in rat calvaria. Material and method One CSD with an 8 mm diameter was made in each of the 40 rats used in this study. The animals were randomly allocated into 5 groups (n=8), according to the type of bone substitute used to fill the CSD: COA (Coagulum); AUT (autogenous bone); DBB (deproteinized bovine bone graft); HA/TCP (biphasic ceramic composed of hydroxyapatite and β-phosphate tricalcium); and TCP (β-phosphate tricalcium). A microtomographic analysis was performed to evaluate the remaining defect linear length (DLL) of the CSD and the volume of the mineralized tissues (MT) within the CSD at 3, 7, 15 and 30 days after the surgical procedure. In addition, a histometric analysis was performed to evaluate the composition of the repaired bone tissue (% Bone and % Biomaterial) at the 30-day period. Result It was shown that the COA had the lowest DLL and MT within the CSD. In addition, the COA presented the highest % of bone in CSD. The DBB had a higher MT and a higher % of bone substitute particles in the CSD than the AUT and TCP groups. The DBB and AUT groups presented higher % of bone in the CSD than the TCP group. Conclusion The use of the DBB promoted a better pattern of bone volume gain and formation compared to TCP and HA / TCP but was biologically inferior to the AUT.
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21
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Sinus Floor Augmentation With Ambient Blood and an Absorbable Collagen Sponge: A Prospective Pilot Clinical Study. IMPLANT DENT 2018; 26:674-681. [PMID: 28696960 DOI: 10.1097/id.0000000000000631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to clinically, radiologically, and histologically evaluate a sinus augmentation technique using a resorbable collagen sponge to maintain space between the Schneiderian membrane and the residual crestal bone. MATERIALS AND METHODS Patients with partially edentulous maxillae were clinically and radiographically evaluated for implant placement. A total of 10 consecutive patients with the bone height for implant placement (<4.0 mm) were enrolled in the study. The lateral maxillary wall was surgically exposed and the Schneiderian membrane was carefully elevated. A collagen wound dressing was placed in the antral area between the sinus floor and the raised membrane. The vertical sinus floor height was calculated using cone-beam computed tomography before the surgical procedure (baseline) and at 6 months postoperative. Immediately after the second scan, a core biopsy was removed for histological evaluation. The biopsy site was then further prepared for implant placement in the same location. RESULTS Biopsies showed mature cancellous bone with a predominantly lamellar structure. Well-vascularized intertrabecular spaces were filled with connective tissue and bone marrow. Analysis of bone height changes showed significant mean (SD) differences before and after procedures in anterior (2.67 ± 0.62 mm and 11.15 ± 1.1 mm), medial (2.98 ± 0.55 mm and 10.96 ± 0.77 mm), and posterior (3.17 ± 0.91 mm and 10.63 ± 0.51 mm) maxillary jaw locations (P = 0.005). CONCLUSION The collagen sponge provided an effective substrate for osseous regeneration of the sinus floor.
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22
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da Rosa WLDO, da Silva TM, da Silva AF, Piva E. Bioactive treatments in bone grafts for implant-based rehabilitation: Systematic review and meta-analysis. Clin Implant Dent Relat Res 2018; 20:251-260. [PMID: 29105932 DOI: 10.1111/cid.12552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/08/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND The use of bioactive proteins, such as rhBMP-2, may improve bone regeneration in oral and maxillofacial surgery. PURPOSE Analyze the effect of using bioactive proteins for bone regeneration in implant-based rehabilitation. MATERIALS AND METHODS Seven databases were screened. Only clinical trials that evaluated the use of heterologous sources of bioactive proteins for bone formation prior to implant-based rehabilitation were included. Statistical analyses were carried out using a random-effects model by comparing the standardized mean difference between groups for bone formation, and risk ratio for implant survival (P ≤ .05). RESULTS Seventeen studies were included in the qualitative analysis, and 16 in the meta-analysis. For sinus floor augmentation, bone grafts showed higher amounts of residual bone graft particles than bioactive treatments (P ≤ .05). While for alveolar ridge augmentation bioactive treatments showed a higher level of bone formation than control groups (P ≤ .05). At 3 years of follow-up, no statistically significant differences were observed for implant survival (P > .05). CONCLUSIONS Bioactive proteins may improve bone formation in alveolar ridge augmentation, and reduce residual bone grafts in sinus floor augmentation. Further studies are needed to evaluate the long-term effect of using bioactive treatments for implant-based rehabilitation.
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Affiliation(s)
| | | | - Adriana Fernandes da Silva
- Department of Restorative Dentistry, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Evandro Piva
- Department of Restorative Dentistry, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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Thoma DS, Payer M, Jakse N, Bienz SP, Hüsler J, Schmidlin PR, Jung UW, Hämmerle CH, Jung RE. Randomized, controlled clinical two-centre study using xenogeneic block grafts loaded with recombinant human bone morphogenetic protein-2 or autogenous bone blocks for lateral ridge augmentation. J Clin Periodontol 2017; 45:265-276. [DOI: 10.1111/jcpe.12841] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Michael Payer
- Department of Oral Surgery and Radiology; School of Dentistry; Medical University Graz; Graz Austria
| | - Norbert Jakse
- Department of Oral Surgery and Radiology; School of Dentistry; Medical University Graz; Graz Austria
| | - Stefan P. Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Jürg Hüsler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Patrick R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Ui-Won Jung
- Department of Periodontology; Research Institute for Periodontal Regeneration; Yonsei University College of Dentistry; Seoul Korea
| | - Christoph H.F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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Susin C, Fiorini T, Lee J, de Freitas RM, Chiu HC, Prasad HS, Buxton AN, Wikesjö UME. Sinus augmentation using a mini-pig model: Effect of ceramic and allogeneic bone biomaterials. J Clin Periodontol 2017. [PMID: 28644556 DOI: 10.1111/jcpe.12766] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Present clinical practice broadly relies on off-the-shelf allogeneic, xenogeneic or synthetic bone biomaterials in support of sinus augmentation. Also, recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support clinically relevant bone formation when used to augment the maxillary sinus. OBJECTIVES To evaluate local bone formation/dental implant osseointegration following implantation of two particulate bone biomaterials using the mini-pig sinus augmentation model. METHODS Nine adult Göttingen mini-pigs were used for evaluation of a biphasic ceramic (15%/85% HA/ß-TCP) and an allogeneic mineralized bone biomaterial. Treatments randomized to contralateral sinus sites included sham-surgery (control) and biomaterials. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each sinus site. The animals were euthanized at 8 weeks for histologic analysis. RESULTS Execution of the surgical protocol and healing was unremarkable. Limited infraorbital swelling was observed until suture removal. The biphasic ceramic and allogeneic bone biomaterials produced significantly increased bone formation (5.2 ± 1.9 mm and 4.9 ± 1.6 mm vs. 2.6 ± 0.5 mm, p < 0.05) and osseointegration (18.0 ± 6.0% and 25.1 ± 18.2% vs. 10.1 ± 8.0%, p < 0.05) over the sham-surgery control. No significant differences were observed between biomaterials. CONCLUSIONS Implantation of biphasic ceramic or allogeneic bone biomaterials enhances bone formation in the mini-pig maxillary sinus, however, dental implant bone support is incomplete resulting in overall limited osseointegration.
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Affiliation(s)
- Cristiano Susin
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Tiago Fiorini
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Jaebum Lee
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Rubens Moreno de Freitas
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Hsien-Chung Chiu
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Hari S Prasad
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Amanda N Buxton
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Ulf M E Wikesjö
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
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Hyaluronic Acid Promotes the Osteogenesis of BMP-2 in an Absorbable Collagen Sponge. Polymers (Basel) 2017; 9:polym9080339. [PMID: 30971019 PMCID: PMC6418576 DOI: 10.3390/polym9080339] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 07/24/2017] [Accepted: 07/31/2017] [Indexed: 11/20/2022] Open
Abstract
(1) Background: We tested the hypothesis that hyaluronic acid (HA) can significantly promote the osteogenic potential of BMP-2/ACS (absorbable collagen sponge), an efficacious product to heal large oral bone defects, thereby allowing its use at lower dosages and, thus, reducing its side-effects due to the unphysiologically-high doses of BMP-2; (2) Methods: In a subcutaneous bone induction model in rats, we first sorted out the optimal HA-polymer size and concentration with micro CT. Thereafter, we histomorphometrically quantified the effect of HA on new bone formation, total construct volume, and densities of blood vessels and macrophages in ACS with 5, 10, and 20 μg of BMP-2; (3) Results: The screening experiments revealed that the 100 µg/mL HA polymer of 48 kDa molecular weight could yield the highest new bone formation. Eighteen days post-surgery, HA could significantly enhance the total volume of newly-formed bone by approximately 100%, and also the total construct volume in the 10 μg BMP-2 group. HA could also significantly enhance the numerical area density of blood vessels in 5 μg BMP-2 and 10 μg BMP-2 groups. HA did not influence the numerical density of macrophages; and (4) Conclusions: An optimal combined administration of HA could significantly promote osteogenic and angiogenic activity of BMP-2/ACS, thus potentially minimizing its potential side-effects.
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