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Lee JH, Jeong SN. Long-term results of regenerative treatment of intrabony defects: a cohort study with 5-year follow-up. BMC Oral Health 2024; 24:34. [PMID: 38184515 PMCID: PMC10771644 DOI: 10.1186/s12903-023-03820-3] [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: 07/11/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND The aim of this retrospective cohort study was to evaluate the long-term clinical and radiographic outcomes and survival of teeth in periodontal regenerative treatment of intrabony defects using combined enamel matrix protein derivative (EMD) and deproteinized porcine bone mineral (DPBM) compared to EMD alone. METHODS A total of 333 intrabony defects in 176 patients (mean age: 54.7 ± 8.9 years) were followed-up for 58.6 ± 11.2 (range, 25-78) months after periodontal regenerative treatment. Changes in clinical (pocket probing depth and clinical attachment level) and radiographic (defect depth and defect width) parameters were analyzed using serial periapical radiographs. Kaplan-Meier and multivariate Cox proportional-hazards regression analyses for tooth loss were also performed. RESULTS Compared to periodontal surgery with EMD alone with a mean follow-up of 5 years, combined EMD and DPBM showed significantly better gain in clinical attachment level (EMD and DPBM: 2.8 ± 2.3 mm vs. EMD alone: 2.2 ± 2.2 mm) and reduction in probing pocket depth (EMD and DPBM: 2.8 ± 1.8 mm vs. EMD alone: 2.3 ± 1.8 mm), defect depth (EMD and DPBM: 2.5 ± 2.4 mm vs. EMD alone: 2.0 ± 2.4 mm) and defect width (EMD and DPBM: 0.6 ± 1.0 mm vs. EMD alone: 0.2 ± 1.3 mm). The overall survival rates of the teeth were 91.48% and 95.20% in the patient- and tooth-based analyses, respectively, showing no statistically significant difference. CONCLUSIONS Within the limitations of the current study, combined EMD and DPBM offered additional clinical and radiographic benefits over a mean of 5 years compared to EMD alone. However, tooth loss did not differ significantly between the two groups. CLINICAL RELEVANCE Compared to EMD alone, combined EMD and DPBM for intrabony defects has additional clinical advantages; however, patient- and tooth-related risk factors must be considered when performing periodontal regenerative surgery.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, College of Dentistry, Institute of Oral Bioscience; Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, 54896, Korea.
| | - Seong-Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
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2
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Abd El-Azeem SH, Khalil AA, Ibrahim MAM, Gamal AY. The use of integrin binding domain loaded hydrogel (RGD) with minimally invasive surgical technique in treatment of periodontal intrabony defect: a randomized clinical and biochemical study. J Appl Oral Sci 2023; 31:e20230263. [PMID: 38126565 PMCID: PMC10786453 DOI: 10.1590/1678-7757-2023-0263] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/17/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Periodontal regeneration faces multiple challenges, the most important being cellular insufficiency. In an attempt to improve defect cellularity, we aimed to demonstrate enhancing cellular attraction using arginine-glycine-aspartic acid (RGD) adhesion molecule legend blended hydrogel within the intrabony defects. METHODOLOGY Forty-five intrabony defects were selected from patients with stage III or IV - grade A or B periodontitis and divided randomly into three equal groups of 15 each: group1 (G1): received minimally invasive surgical technique (MIST) alone, group2 (G2): received MIST and placebo hydrogel injection, and group3 (G3): were treated with MIST and RGD hydrogel injection. Primary outcomes 6 months following therapy were; defect base fill (DBF) and defect width measurement (DW); secondary outcomes were clinical attachment level (CAL), pocket depth (PD), plaque index (PI), gingival index (GI), and biochemical analysis of bone morphogenetic protein (BMP-2) evaluated at 1,7,14 and 21 days following therapy. RESULTS Significant improvements in DBF, CAL, and PD were observed in the three studied groups 6 months following therapy compared to baseline (p<0.05). A significant improvement in DBF was reported in G3 compared to G1 and 2 (p=0.005). Additionally, a significantly higher CAL gain was reported in G3 compared to that of G1 (p=0.02). Group 3 was associated with a significantly higher level of BMP-2 compared to G1 and G2 in all reported periods. CONCLUSION RGD peptide carried on a hydrogel delivery agent and contained with a minimally invasive flap could be a reliable option in improving the outcomes of periodontal therapy.
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Affiliation(s)
- Shaimaa Hamdy Abd El-Azeem
- Nahda University, Faculty of Dentistry Oral Medicine, Oral Diagnosis and Periodontology Department, Beni Swef, Egypt
| | - Ahmed Abdallah Khalil
- Minia University, Faculty of Dentistry Oral Medicine, Oral Diagnosis and Periodontology Department, Minia, Egypt
| | | | - Ahmed Y Gamal
- Ain Shams Universit, Faculty of Dentistry Oral Medicine, Oral Diagnosis and Periodontology Department, Cairo, Egypt
- Misr University for Science and Technology, Faculty of Dentistry, Cairo, Egypt
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Carmona Rendón Y, Garzón HS, Bueno-Silva B, Arce RM, Suárez LJ. Cannabinoids in Periodontology: Where Are We Now? Antibiotics (Basel) 2023; 12:1687. [PMID: 38136721 PMCID: PMC10740419 DOI: 10.3390/antibiotics12121687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/25/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Cannabinoids are a well-documented treatment modality for various immune and inflammatory diseases, including asthma, chronic obstructive pulmonary disease, Crohn's disease, arthritis, multiple sclerosis, and a range of neurodegenerative conditions. However, limited information is available regarding the therapeutic potential of cannabinoids in treating periodontal disease. OBJECTIVE The objective of this study is to analyze the current evidence on the antibacterial and immunomodulatory effects of cannabis and its role in the healing and regeneration processes within periodontal tissues. RESULTS This review discusses the potential role of cannabinoids in restoring periodontal tissue homeostasis. CONCLUSIONS The examination of the endocannabinoid system and the physiological effects of cannabinoids in the periodontium suggests that they possess immunomodulatory and antibacterial properties, which could potentially promote proper tissue healing and regeneration.
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Affiliation(s)
- Yésica Carmona Rendón
- Departamento de Ciencias Básicas y Medicina Oral, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá 111321, Colombia;
| | - Hernán Santiago Garzón
- Programa de Doctorado en Ingeniería, Facultad de Ingeniería, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | - Bruno Bueno-Silva
- Departamento de Biociências, Faculdade de Odontologia de Piracicaba, Universidade de Campinas (UNICAMP), Piracicaba 13414-903, Brazil;
| | - Roger M. Arce
- Department of Periodontics and Oral Hygiene, University of Texas School of Dentistry at Houston, Houston, TX 77054, USA;
| | - Lina Janeth Suárez
- Departamento de Ciencias Básicas y Medicina Oral, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá 111321, Colombia;
- Centro de Investigaciones Odontológicas, Facultad de Odontología, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
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Roccuzzo M, Roccuzzo A, Marruganti C, Fickl S. The importance of soft tissue condition in bone regenerative procedures to ensure long-term peri-implant health. Periodontol 2000 2023; 93:129-138. [PMID: 37277923 DOI: 10.1111/prd.12496] [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: 01/29/2023] [Revised: 04/13/2023] [Accepted: 04/26/2023] [Indexed: 06/07/2023]
Abstract
Bone regenerative procedures have been widely proved to be a reliable treatment option to re-create the ideal pre-implant clinical conditions. Nevertheless, these techniques are not free from post-operative complications which might result in implant failure. Consequently, as demonstrated by the increasing recently published evidence, a careful pre- and intra-operative flap evaluation to ensure an ideal and hermetic tension-free wound closure is of paramount importance to successfully treat bony defects. In this respect, several surgical interventions mainly aimed to increase the amount of keratinized mucosa either to allow an optimal healing after a reconstructive procedure or to establish an optimal peri-implant soft tissue seal have been proposed. The present review summarizes the level of evidence on the surgical clinical aspects which have an impact on the soft tissue handling associated with bone reconstructive procedures and on the importance of soft tissue conditions to enhance and maintain peri-implant health in the long-term.
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Affiliation(s)
- Mario Roccuzzo
- Private Practice, Torino, Italy
- Division of Maxillo-Facial Surgery, University of Torino, Torino, Italy
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral and Maxillo-Facial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
- Department of Restorative, Pediatric and Preventive Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Crystal Marruganti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
- Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Stefan Fickl
- Private Practice, Fürth, Germany
- Department of Periodontology, Julius-Maximilians-University Würzburg, Würzburg, Germany
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5
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Abstract
As a widespread chronical disease, periodontitis progressively destroys tooth-supporting structures (periodontium) and eventually leads to tooth loss. Therefore, regeneration of damaged/lost periodontal tissues has been a major subject in periodontal research. During periodontal tissue regeneration, biomaterials play pivotal roles in improving the outcome of the periodontal therapy. With the advancement of biomaterial science and engineering in recent years, new biomimetic materials and scaffolding fabrication technologies have been proposed for periodontal tissue regeneration. This article summarizes recent progress in periodontal tissue regeneration from a biomaterial perspective. First, various guide tissue regeneration/guide bone regeneration membranes and grafting biomaterials for periodontal tissue regeneration are overviewed. Next, the recent development of multifunctional scaffolding biomaterials for alveolar bone/periodontal ligament/cementum regeneration is summarized. Finally, clinical care points and perspectives on the use of biomimetic scaffolding materials to reconstruct the hierarchical periodontal tissues are provided.
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Affiliation(s)
- Yuejia Deng
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX 75246, USA
| | - Yongxi Liang
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX 75246, USA
| | - Xiaohua Liu
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Dallas, TX 75246, USA.
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Unravelling Alveolar Bone Regeneration Ability of Platelet-Rich Plasma: A Systematic Review with Meta-Analysis. Bioengineering (Basel) 2022; 9:bioengineering9100506. [PMID: 36290474 PMCID: PMC9598440 DOI: 10.3390/bioengineering9100506] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background: This systematic review aims to evaluate the efficacy of the available platelet-rich plasma (PRP) products and composition to regenerate alveolar bone after tooth extraction. Methods: PubMed, Cochrane Central Register of Controlled Trials, and EBSCO databases were searched up to 2 July 2021. Only randomized clinical trials using leukocyte-rich plasma (L-PRP) or pure-platelet rich plasma (P-PRP) for bone regeneration in alveolar ridge preservation were selected. The following outcomes were considered: (1) new bone formation (primary outcome) and (2) bone density (secondary outcome). A meta-analysis for PRP, P-PRP, and L-PRP using a fixed effect model was performed with Review Manager 5.4 software. Overall evidence was qualified using GRADE. Results: Six randomized clinical trials from 2639 unique articles initially identified met the inclusion criteria. The meta-analysis showed a significant effect of the P-PRP on the outcome of new bone formation (SMD, 1.44; 95% CI, 0.84 to 2.03) for P-PRP treatment. No information was retrieved for L-PRP. A statistically significant difference was also observed in the P-PRP group for bone density outcome (SMD, 1.24; 95% CI, 0.81 to 1.68). The L-PRP treated sockets also showed higher bone density (SMD, 0.88; 95% CI, 0.31 to 1.45) in comparison to control sockets. The quality of evidence was moderate for both outcomes in the P-PRP group and low for the L-PRP group. Conclusions: Despite the limitations of the included studies, our data suggest that P-PRP, in comparison to unassisted healing, can improve alveolar bone regenerative potential. However, more high-quality clinical studies are needed.
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7
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Huang G, Xia B, Dai Z, Yang R, Chen R, Yang H. Comparative study of DFAT cell and ADSC sheets for periodontal tissue regeneration:
in vivo
and
in vitro
evidence. J Clin Periodontol 2022; 49:1289-1303. [PMID: 35851962 DOI: 10.1111/jcpe.13705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/29/2022] [Accepted: 06/30/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Guobin Huang
- Yunnan Key Laboratory of Stomatology Kunming Medical University Kunming Yunnan PR China
- Department of Dental Research The Affiliated Stomatology Hospital of Kunming Medical University Kunming Yunnan PR China
| | - Bin Xia
- Yunnan Key Laboratory of Stomatology Kunming Medical University Kunming Yunnan PR China
- Department of Oral and Maxillofacial Surgery The Affiliated Stomatological Hospital of Kunming Medical University Kunming Yunnan P.R. China
| | - Zichao Dai
- Yunnan Key Laboratory of Stomatology Kunming Medical University Kunming Yunnan PR China
- Department of Dental Research The Affiliated Stomatology Hospital of Kunming Medical University Kunming Yunnan PR China
| | - Rongqiang Yang
- Yunnan Key Laboratory of Stomatology Kunming Medical University Kunming Yunnan PR China
- Department of Dental Research The Affiliated Stomatology Hospital of Kunming Medical University Kunming Yunnan PR China
| | - Rui Chen
- Yunnan Key Laboratory of Stomatology Kunming Medical University Kunming Yunnan PR China
- Department of Dental Research The Affiliated Stomatology Hospital of Kunming Medical University Kunming Yunnan PR China
| | - Hefeng Yang
- Yunnan Key Laboratory of Stomatology Kunming Medical University Kunming Yunnan PR China
- Department of Dental Research The Affiliated Stomatology Hospital of Kunming Medical University Kunming Yunnan PR China
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8
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Akers JA, Johnson TM, Wagner JC, Vargas SM, Colamarino AN, Jenzer AC, Lincicum AR, Hawie JB, Lancaster DD. Dental implants at sites of focal high and mixed density osseous lesions: Clinical practice guidelines. Clin Adv Periodontics 2022. [PMID: 35108460 DOI: 10.1002/cap.10192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/21/2021] [Indexed: 11/07/2022]
Abstract
FOCUSED CLINICAL QUESTION Under what circumstances may a clinician consider dental implant placement at a site exhibiting a focal high or mixed density (HMD) osseous lesion radiologically? SUMMARY Some conditions and pathologic entities exhibiting high and mixed density radiological appearance pose low risk for dental implant failure or complications following implant surgery. However, other lesions represent contraindications to implant placement, and implant surgery at such sites can result in severe morbidity. CONCLUSION Potential implant sites exhibiting focal HMD osseous lesions/conditions present varying levels of risk. In most cases, optimal management will include advanced imaging of the site, multidisciplinary consultations, and detailed informed consent to assure full understanding of procedural risks, benefits, and complications. Currently, clinical recommendations rely on case reports, opinion, and usual practice (level 3 evidence). The strength of each recommendation provided in this report is categorized as level C.
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Affiliation(s)
- Joshua A Akers
- Department of Periodontics, United States Army Dental Health Activity, Landstuhl, Germany
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Jennah C Wagner
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Sarah M Vargas
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Aaron N Colamarino
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Andrew C Jenzer
- Department of Oral and Maxillofacial Surgery, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Adam R Lincicum
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Jennifer B Hawie
- Department of Oral Pathology, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Douglas D Lancaster
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
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Cirelli JA, Fiorini T, Moreira CHC, Molon RSD, Dutra TP, Sallum EA. Periodontal regeneration: is it still a goal in clinical periodontology? Braz Oral Res 2021; 35:e09. [PMID: 34586211 DOI: 10.1590/1807-3107bor-2021.vol35.0097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/31/2021] [Indexed: 11/22/2022] Open
Abstract
In the last decades, Periodontal Regeneration has been one of the most discussed topics in Periodontics, attracting the attention of researchers and clinicians. This can be justified by the evident and continuous progress observed in the field, characterized by a better understanding of the biological mechanisms involved, significant improvement of operative and technical principles, and the emergence of a wide range of biomaterials available for this purpose. Together, these aspects put the theme much in evidence in the search for functional and esthetic therapeutic solutions for periodontal tissue destruction. Despite the evident evolution, periodontal regeneration may be challenging and require the clinician to carefully evaluate each case before making a therapeutic decision. With a critical reassessment of the clinical and preclinical literature, the present study aimed to discuss the topic to answer whether Periodontal Regeneration is still a goal in clinical periodontology. The main aspects involved in the probability of success or failure of regenerative approaches were considered. A greater focus was given to intrabony and furcation defects, clinical conditions with greater therapeutic predictability. Aspects such as more appropriate materials/approaches, long-term benefits and their justification for a higher initial cost were discussed for each condition. In general, deep intrabony defects associated with residual pockets and buccal/lingual class II furcation lesions have predictable and clinically relevant results. Careful selection of the case (based on patient and defect characteristics) and excellent maintenance are essential conditions to ensure initial and long-term success.
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Affiliation(s)
- Joni Augusto Cirelli
- Universidade Estadual Paulista - Unesp, School of Dentistry at Araraquara, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Tiago Fiorini
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Carlos Heitor Cunha Moreira
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Rafael Scaf de Molon
- Universidade Estadual Paulista - Unesp, School of Dentistry at Araraquara, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Tamires Pereira Dutra
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School - Department of Prosthodontics and Periodontics, Piracicaba, SP, Brazil
| | - Enílson Antonio Sallum
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School - Department of Prosthodontics and Periodontics, Piracicaba, SP, Brazil
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Highly Segregated Biocomposite Membrane as a Functionally Graded Template for Periodontal Tissue Regeneration. MEMBRANES 2021; 11:membranes11090667. [PMID: 34564484 PMCID: PMC8469372 DOI: 10.3390/membranes11090667] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022]
Abstract
Guided tissue regeneration (GTR) membranes are used for treating chronic periodontal lesions with the aim of regenerating lost periodontal attachment. Spatially designed functionally graded bioactive membranes with surface core layers have been proposed as the next generation of GTR membranes. Composite formulations of biopolymer and bioceramic have the potential to meet these criteria. Chitosan has emerged as a well-known biopolymer for use in tissue engineering applications due to its properties of degradation, cytotoxicity and antimicrobial nature. Hydroxyapatite is an essential component of the mineral phase of bone. This study developed a GTR membrane with an ideal chitosan to hydroxyapatite ratio with adequate molecular weight. Membranes were fabricated using solvent casting with low and medium molecular weights of chitosan. They were rigorously characterised with scanning electron microscopy, Fourier transform infrared spectroscopy in conjunction with photoacoustic sampling accessory (FTIR-PAS), swelling ratio, degradation profile, mechanical tensile testing and cytotoxicity using human osteosarcoma and mesenchymal progenitor cells. Scanning electron microscopy showed two different features with 70% HA at the bottom surface packed tightly together, with high distinction of CH from HA. FTIR showed distinct chitosan dominance on top and hydroxyapatite on the bottom surface. Membranes with medium molecular weight showed higher swelling and longer degradation profile as compared to low molecular weight. Cytotoxicity results indicated that the low molecular weight membrane with 30% chitosan and 70% hydroxyapatite showed higher viability with time. Results suggest that this highly segregated bilayer membrane shows promising potential to be adapted as a surface layer whilst constructing a functionally graded GTR membrane on its own and for other biomedical applications.
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11
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Liu B, Ouyang X, Kang J, Zhou S, Suo C, Xu L, Liu J, Liu W. Efficacy of periodontal minimally invasive surgery with and without regenerative materials for treatment of intrabony defect: a randomized clinical trial. Clin Oral Investig 2021; 26:1613-1623. [PMID: 34414521 DOI: 10.1007/s00784-021-04134-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 08/06/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The minimally invasive surgical technique was modified in suture (MISTms) in this study. The trial was to determine the efficacy of MISTms with and without regenerative materials for the treatment of intrabony defect and to identify factors influencing 1-year clinical attachment level (CAL) gain. METHODS Thirty-six patients with interdental intrabony defects were randomly assigned to MISTms (MISTms alone, 18) or MISTms plus deproteinized bovine bone mineral and collagen membrane (MISTms combined, 18). Wound healing was evaluated by early healing index (EHI) at 1, 2, 3, and 6 weeks. Probing depth (PD), CAL, gingival recession, radiographic defect depth, and distance from the base of defect to the cementoenamel junction were recorded at baseline and 1 year postoperatively. A one-year composite outcome measure based on the combination of CAL gain and post-surgery PD was evaluated. Factors influencing 1-year CAL gain were analyzed. RESULTS Fifteen patients in MISTms-alone and 16 in the MISTms-combined group finished the study. The MISTms-alone group showed significantly better wound healing at 1 week. CAL significantly gained in the MISTms-alone and MISTms-combined group, with 2.53 ± 1.80 mm and 2.00 ± 1.38 mm respectively. The radiographic bone gain was 3.00 ± 1.56 mm and 3.85 ± 1.69 mm respectively. However, there were no significant differences between the two groups about 1-year outcomes. Lower EHI (optimal wound healing) and more baseline CAL positively influenced 1-year CAL gain. CONCLUSIONS MISTms is an effective treatment for intrabony defects. The regenerative materials do not show an additional effect on 1-year outcomes. Early wound healing and baseline CAL are factors influencing 1-year CAL gain. CLINICAL RELEVANCE MISTms with and without regenerative materials are both effective treatments for intrabony defect. TRIAL REGISTRATION ClinicalTrials.gov Identifier: ChiCTR2100043272.
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Affiliation(s)
- Bei Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Xiangying Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
| | - Jun Kang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Shuangying Zhou
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Chao Suo
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Lingqiao Xu
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Jianru Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Wenyi Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
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12
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Pilloni A, Zeza B, Kuis D, Vrazic D, Domic T, Olszewska-Czyz I, Popova C, Kotsilkov K, Firkova E, Dermendzieva Y, Tasheva A, Orrù G, Sculean A, Prpić J. Treatment of Residual Periodontal Pockets Using a Hyaluronic Acid-Based Gel: A 12 Month Multicenter Randomized Triple-Blinded Clinical Trial. Antibiotics (Basel) 2021; 10:antibiotics10080924. [PMID: 34438976 PMCID: PMC8388804 DOI: 10.3390/antibiotics10080924] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/21/2021] [Accepted: 07/05/2021] [Indexed: 12/11/2022] Open
Abstract
The aim of the present study was to evaluate the adjunctive effect of hyaluronic acid (HA) gel in the treatment of residual periodontal pockets over a 12-month period. Periodontal patients presenting at least one residual periodontal pocket 5-9 mm of depth in the anterior area were recruited from six university-based centers. Each patient was randomly assigned to subgingival instrumentation (SI) with the local adjunctive use of HA for test treatment or adjunctive use of local placebo for control treatment at baseline and after 3 months. Clinical parameters ( )probing depth (PD), bleeding on probing (BoP), plaque index (PI), recession (REC), clinical attachment level (CAL)) and microbiological samples for the investigation of the total bacterial count (TBC) and presence of specific bacterial species (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum) were taken at baseline and every 3 months, until study termination. PD was determined as the primary outcome variable. From a total of 144 enrolled, 126 participants (53 males, 73 females) completed the entire protocol. Both treatments resulted in statistically significant clinical and microbiological improvements compared to baseline. Although the local application of HA showed a tendency for better results, there was a lack of statistically significant differences between the groups.
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Affiliation(s)
- Andrea Pilloni
- Department of Dental and Maxillo-Facial Sciences, Section of Periodontology, Sapienza University of Rome, 00161 Rome, Italy;
| | - Blerina Zeza
- Department of Dental and Maxillo-Facial Sciences, Section of Periodontology, Sapienza University of Rome, 00161 Rome, Italy;
- Correspondence: ; Tel.: +39-06-4991-8152; Fax: +39-06-4423-0812
| | - Davor Kuis
- Department of Periodontology, School of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.K.); (J.P.)
| | - Domagoj Vrazic
- Department of Periodontology, University of Zagreb, 10000 Zagreb, Croatia;
| | - Tomislav Domic
- Dental Polyclinic Zagreb, Perkovceva 3, 10000 Zagreb, Croatia;
| | - Iwona Olszewska-Czyz
- Department of Periodontology, Jagiellonian University Medical College, ul.Montelupich 4, 31-155 Krakow, Poland;
| | - Christina Popova
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria; (C.P.); (K.K.)
| | - Kamen Kotsilkov
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria; (C.P.); (K.K.)
| | - Elena Firkova
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Plovdiv, 4004 Plovdiv, Bulgaria; (E.F.); (Y.D.); (A.T.)
| | - Yana Dermendzieva
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Plovdiv, 4004 Plovdiv, Bulgaria; (E.F.); (Y.D.); (A.T.)
| | - Angelina Tasheva
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Plovdiv, 4004 Plovdiv, Bulgaria; (E.F.); (Y.D.); (A.T.)
| | - Germano Orrù
- Oral Biotechnology Laboratory (OBL), Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy;
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland;
| | - Jelena Prpić
- Department of Periodontology, School of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.K.); (J.P.)
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13
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Malekpour Z, Akbari V, Varshosaz J, Taheri A. Preparation and characterization of poly (lactic-co-glycolic acid) nanofibers containing simvastatin coated with hyaluronic acid for using in periodontal tissue engineering. Biotechnol Prog 2021; 37:e3195. [PMID: 34296538 DOI: 10.1002/btpr.3195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/04/2021] [Accepted: 07/18/2021] [Indexed: 01/02/2023]
Abstract
Periodontal diseases can lead to soft tissue defects. Tissue engineering can provide functional replacements for damaged tissues. Recently, electrospun nanofibers have attracted great interest for tissue engineering and drug delivery applications. This has been revealed that statins exhibit positive impacts on the proliferation and regeneration of periodontal tissues. Electrospun simvastatin loaded poly (lactic-co-glycolic acid) (SIM-PLGA-NF) were prepared using electrospinning technique. Optimal conditions for preparation of SIM-PLGA-NF (PLGA concentration of 30 wt%, voltage of 15 kV, and flow rate of 1.5 ml h-1 ) were identified using a 23 factorial design. The optimized SIM-PLGA-NFs (diameter of 640.2 ± 32.5 nm and simvastatin entrapment efficacy of 99.6 ± 1.5%) were surface modified with 1% w/v hyaluronic acid solution (1%HA- SIM-PLGA-NF) to improve their compatibility with fibroblasts and potential application as a periodontal tissue engineering scaffold. HA-SIM-PLGA NFs were analyzed using SEM, FTIR, and XRD. 1%HA-SIM-PLGA-NF had uniform, bead-free and interwoven morphology, which is similar to the extracellular matrix. The mechanical performance of SIM-PLGA-NFs and release profile of simvastatin from these nanofibers have been also greatly improved after coating with HA. In vitro cellular tests showed that the proliferation, adhesion, and differentiation of fibroblast cells positively enhanced on the surface of 1%HA- SIM-PLGA-NF. These results demonstrate the potential application of 1%HA-SIM-PLGA-NFs as a scaffold for periodontal tissue engineering.
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Affiliation(s)
- Zahra Malekpour
- Novel Drug Delivery Systems Research Center, Department of Pharmaceutics, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vajihe Akbari
- Department of Pharmaceutical Biotechnology and Isfahan Pharmaceutical Research Center, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jaleh Varshosaz
- Novel Drug Delivery Systems Research Center, Department of Pharmaceutics, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azade Taheri
- Novel Drug Delivery Systems Research Center, Department of Pharmaceutics, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
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14
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Petrović M, Kesić L, Obradović R, Stojanović S, Stojković B, Bojović M, Stanković I, Todorović K, Spasić M, Stošić N. Regenerative periodontal therapy: I part. ACTA STOMATOLOGICA NAISSI 2021. [DOI: 10.5937/asn2184304p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Under the concept of regenerative periodontal therapy, there are two approaches: the first is the passive regeneration conceptthat includes bone substituents and guided periodontal regeneration by using of biomembranes and the second concept of active regeneration that impliesthe use of growth factors. The aim of the passive regeneration, by using of bone matrix (bone substituens) has been stabilization and bone defects management, preventing epithelial tissue growth, as well as saving space for the new tissue regeneration. This concept implies the use of autogenous transplantats, xenografts, allografts, as well as alloplastic materials. The carriers for active tissue regeneration, growth factors -GF are biological mediators that regulate cellular processes and that is crucial for the tissue regeneration. Aim:Presentation ofmodern approaches to periodontal therapy thatare focused on the attachment regeneration and complete reconstruction of periodontal tissue. Conclusion: In the future, periodontal regenerative therapy with periodontalligament progenitor cells should encourage repopulation of the areas that have been affected by periodontal disease.
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15
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Fraser D, Nguyen T, Benoit DSW. Matrix Control of Periodontal Ligament Cell Activity Via Synthetic Hydrogel Scaffolds. Tissue Eng Part A 2020; 27:733-747. [PMID: 33107404 DOI: 10.1089/ten.tea.2020.0278] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Rebuilding the tooth-supporting tissues (periodontium) destroyed by periodontitis remains a clinical challenge. Periodontal ligament cells (PDLCs), multipotent cells within the periodontal ligament (PDL), differentiate and form new PDL and mineralized tissues (cementum and bone) during native tissue repair in response to specific extracellular matrix (ECM) cues. Thus, harnessing ECM cues to control PDLC activity ex vivo, and ultimately, to design a PDLC delivery vehicle for tissue regeneration is an important goal. In this study, poly(ethylene glycol) hydrogels were used as a synthetic PDL ECM to interrogate the roles of cell-matrix interactions and cell-mediated matrix remodeling in controlling PDLC activity. Results showed that PDLCs within matrix metalloproteinase (MMP)-degradable hydrogels expressed key PDL matrix genes and showed a six to eightfold increase in alkaline phosphatase (ALP) activity compared with PDLCs in nondegradable hydrogel controls. The increase in ALP activity, commonly considered an early marker of cementogenic/osteogenic differentiation, occurred independent of the presentation of the cell-binding ligand RGD or soluble media cues and remained elevated when inhibiting PDLC-matrix binding and intracellular tension. ALP activity was further increased in softer hydrogels regardless of degradability and was accompanied by an increase in PDLC volume. However, scaffolds that fostered PDLC ALP activity did not necessarily promote hydrogel ECM mineralization. Rather, matrix mineralization was greatest in stiffer, MMP-degradable hydrogels and required the presence of soluble media cues. These divergent outcomes illustrate the complexity of the PDLC response to ECM cues and the limitations of current scaffold materials. Nevertheless, key biomaterial design principles for controlling PDLC activity were identified for incorporation into scaffolds for periodontal tissue regeneration. Impact statement Engineered scaffolds are an attractive approach for delivering periodontal ligament cells (PDLCs) to rebuild the tooth-supporting tissues. Replicating key extracellular matrix (ECM) cues within tissue engineered scaffolds may maximize PDLC potential. However, the identity of important ECM cues and how they can be harnessed to control PDLC activity is still unknown. In this study, matrix degradability, cell-matrix binding, and stiffness were varied using synthetic poly(ethylene glycol) hydrogels for three-dimensional PDLC culture. PDLCs exhibited dramatic and divergent responses to these cues, supporting further investigation of ECM-replicating scaffolds for control of PDLC behavior and periodontal tissue regeneration.
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Affiliation(s)
- David Fraser
- Translational Biomedical Science, University of Rochester, Rochester, New York, USA.,Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Tram Nguyen
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
| | - Danielle S W Benoit
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA.,Department of Chemical Engineering, University of Rochester, Rochester, New York, USA.,Materials Science Program, University of Rochester, Rochester, New York, USA.,Center for Oral Biology, University of Rochester, Rochester, New York, USA.,Center for Musculoskeletal Research, University of Rochester, Rochester, New York, USA
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16
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NETs Are Double-Edged Swords with the Potential to Aggravate or Resolve Periodontal Inflammation. Cells 2020; 9:cells9122614. [PMID: 33291407 PMCID: PMC7762037 DOI: 10.3390/cells9122614] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/24/2022] Open
Abstract
Periodontitis is a general term for diseases characterised by inflammatory destruction of tooth-supporting tissues, gradual destruction of the marginal periodontal ligament and resorption of alveolar bone. Early-onset periodontitis is due to disturbed neutrophil extracellular trap (NET) formation and clearance. Indeed, mutations that inactivate the cysteine proteases cathepsin C result in the massive periodontal damage seen in patients with deficient NET formation. In contrast, exaggerated NET formation due to polymorphonuclear neutrophil (PMN) hyper-responsiveness drives the pathology of late-onset periodontitis by damaging and ulcerating the gingival epithelium and retarding epithelial healing. Despite the gingival regeneration, periodontitis progression ends with almost complete loss of the periodontal ligament and subsequent tooth loss. Thus, NETs help to maintain periodontal health, and their dysregulation, either insufficiency or surplus, causes heavy periodontal pathology and edentulism.
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17
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Matichescu A, Ardelean LC, Rusu LC, Craciun D, Bratu EA, Babucea M, Leretter M. Advanced Biomaterials and Techniques for Oral Tissue Engineering and Regeneration-A Review. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5303. [PMID: 33238625 PMCID: PMC7700200 DOI: 10.3390/ma13225303] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/15/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022]
Abstract
The reconstruction or repair of oral and maxillofacial functionalities and aesthetics is a priority for patients affected by tooth loss, congenital defects, trauma deformities, or various dental diseases. Therefore, in dental medicine, tissue reconstruction represents a major interest in oral and maxillofacial surgery, periodontics, orthodontics, endodontics, and even daily clinical practice. The current clinical approaches involve a vast array of techniques ranging from the traditional use of tissue grafts to the most innovative regenerative procedures, such as tissue engineering. In recent decades, a wide range of both artificial and natural biomaterials and scaffolds, genes, stem cells isolated from the mouth area (dental follicle, deciduous teeth, periodontal ligament, dental pulp, salivary glands, and adipose tissue), and various growth factors have been tested in tissue engineering approaches in dentistry, with many being proven successful. However, to fully eliminate the problems of traditional bone and tissue reconstruction in dentistry, continuous research is needed. Based on a recent literature review, this paper creates a picture of current innovative strategies applying dental stem cells for tissue regeneration in different dental fields and maxillofacial surgery, and offers detailed information regarding the available scientific data and practical applications.
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Affiliation(s)
- Anamaria Matichescu
- Department of Preventive Dentistry, Community and Oral Health, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania;
| | - Lavinia Cosmina Ardelean
- Department of Technology of Materials and Devices in Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Laura-Cristina Rusu
- Department of Oral Pathology, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.-C.R.); (D.C.); (M.B.)
| | - Dragos Craciun
- Department of Oral Pathology, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.-C.R.); (D.C.); (M.B.)
| | - Emanuel Adrian Bratu
- Department of Implant Supported Restorations, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Marius Babucea
- Department of Oral Pathology, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (L.-C.R.); (D.C.); (M.B.)
| | - Marius Leretter
- Department of Prosthodontics, “Victor Babeș” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania;
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18
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Rasperini G, Tavelli L, Barootchi S, McGuire MK, Zucchelli G, Pagni G, Stefanini M, Wang HL, Giannobile WV. Interproximal attachment gain: The challenge of periodontal regeneration. J Periodontol 2020; 92:931-946. [PMID: 33152103 DOI: 10.1002/jper.20-0587] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/27/2020] [Accepted: 10/24/2020] [Indexed: 11/08/2022]
Abstract
The new classification of periodontal diseases recognizes the key role of the interdental clinical attachment for defining the periodontal status and the extent of disease severity. Regenerating interdental clinical attachment not only improves the prognosis of the tooth, but it also lessens the severity of the disease condition. This manuscript provides a state-of-the-art review on surgical reconstructive approaches for treating papillary deficiency associated with soft and hard tissue interproximal defects. Combination therapy of papilla preservation, connective tissue grafting, and coronally advanced flaps may result in regeneration of the intrabony defect coupled with root coverage. Future research highlighted here may have the potential, especially in combination approaches, to repair challenging interproximal soft and hard tissue deficiencies.
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Affiliation(s)
- Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca' Granda Policlinic, Milan, Italy.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Lorenzo Tavelli
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Shayan Barootchi
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Michael K McGuire
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Private practice, Houston, TX, USA.,Department of Periodontics, Dental Branch Houston and Health Science Center at San Antonio, University of Texas, San Antonio, TX, USA
| | - Giovanni Zucchelli
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giorgio Pagni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca' Granda Policlinic, Milan, Italy
| | - Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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19
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Al-Khateeb R, Olszewska-Czyz I. Biological molecules in dental applications: hyaluronic acid as a companion biomaterial for diverse dental applications. Heliyon 2020; 6:e03722. [PMID: 32280803 PMCID: PMC7139111 DOI: 10.1016/j.heliyon.2020.e03722] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/02/2020] [Accepted: 03/30/2020] [Indexed: 12/19/2022] Open
Abstract
Objectives The application of hyaluronic acid (HA) in dental treatments is relatively new, and modified-HA products can be vastly different from each other. This study aims to provide a basis for bridging specific characteristics of HA with its potential applications in dental treatments, evaluating and comparing different types of HA products and for future research on HA applications in dentistry. Data sources Information from the existing literature on HA applications has been cited. Study selection Furthermore, this study is specifically oriented to provide oral health care providers with a scientific basis for HA use along with the clinical aspects of HA. Conclusions Outcomes from existing and future studies cannot be generalised for HA use in dental applications. Therefore, we have proposed a scheme to bridge HA specific characteristics to its applications in dental treatments and compare different HA products used for the same clinical application to identify the most suitable one. Clinical significance Highlighting the use of HA in dental treatments and providing a basis for developing new methods, protocols, and products specifically oriented for dentistry.
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Affiliation(s)
- Rami Al-Khateeb
- Elaf Medical Supplies®, Al-Madena Al Monawara Street, Rana Centre, 5th Floor, PO. Box 1348, Zip 11941, Amman, Jordan
| | - Iwona Olszewska-Czyz
- Jagiellonian University, Medical College, Department of Periodontology and Clinical Oral Pathology, Cracow, Poland
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20
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Goyal J, Sachdeva S, Salaria SK, Vakil N, Mittal A. Comparative assessment of periodontal regeneration in periodontal intraosseous defects treated with PepGen P-15 unaided or in blend with platelet-rich fibrin: A clinical and high-resolution computed tomography scan-assisted volumetric analysis. J Indian Soc Periodontol 2020; 24:156-162. [PMID: 32189844 PMCID: PMC7069113 DOI: 10.4103/jisp.jisp_351_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/22/2019] [Accepted: 12/29/2019] [Indexed: 11/18/2022] Open
Abstract
Background: PepGen P-15, a xenograft, has proven its periodontal regenerative potential. Platelet-rich fibrin (PRF) is an autologous platelet concentrate which too contributes to periodontal redevelopment through the release of different polypeptide progression factors. The present study intended to evaluate the regenerative potential of PepGen P-15 xenograft when used unaccompanied or in blend with PRF in periodontal intraosseous defects in humans through clinical and a novel computed tomography (CT) scan analysis technique. Materials and Methods: Twelve chronic periodontitis individuals with paired periodontal intraosseous defects were randomly treated either with PepGen P-15 exclusively (Control/Group A) or in concoction with PRF (Test/Group B) utilizing split-mouth study design. Pocket probing depth (PPD), relative attachment level (RAL), and relative position of gingival margin were assessed at 3- and 6-month interval, whereas the linear and volumetric bone defect regeneration were assessed at 6 months postoperatively using CT scan. Results: Both the groups validated statistically significant PPD reduction, RAL gain at 3 and 6 months, but on intergroup comparison, test group CT images revealed significantly greater linear bone gain and volumetric bone gain, with mean difference of 0.73 ± 0.28 (P = 0.018) and 2.70 ± 1.36 (P = 0.06) at 6 months in comparison to the baseline data. Conclusions: PepGen P-15 and PRF blend had better regeneration potential for the management of intrabony defects. Further long-term investigations on large sample size are recommended to authenticate the same.
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Affiliation(s)
- Jyotsna Goyal
- Department of Periodontology, Luxmi Bai Institute of Dental Sciences and Hospital, Patiala, Punjab, India
| | - Surinder Sachdeva
- Department of Periodontology, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar University, Mullana, Haryana, India
| | - Sanjeev Kumar Salaria
- Department of Periodontology and Implantology, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
| | - Nishu Vakil
- Department of Periodontology, Indira Gandhi Government Dental College, Jammu, Jammu and Kashmir, India
| | - Amit Mittal
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar University, Mullana, Haryana, India
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21
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Lee JH, Kim DH, Jeong SN. Adjunctive use of enamel matrix derivatives to porcine-derived xenograft for the treatment of one-wall intrabony defects: Two-year longitudinal results of a randomized controlled clinical trial. J Periodontol 2019; 91:880-889. [PMID: 31811645 PMCID: PMC7497188 DOI: 10.1002/jper.19-0432] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 12/12/2022]
Abstract
Background The purpose of this study was to evaluate the potential advantages of adjunctive use of enamel matrix protein derivative (EMD) in combination with demineralized porcine bone matrix (DPBM) for the treatment of one‐wall intrabony defects in the molar regions, in comparison with the use of DPBM alone, through a randomized controlled clinical trial. Methods Forty‐two participants were randomly assigned to two groups: one where DPBM with the adjunctive use of EMD (test group, n = 20) was applied and the other without EMD (control group, n = 22). Changes in the clinical and radiographic parameters from baseline at 6, 12, and 24 months were measured (probing pocket depth, clinical attachment loss, defect depth, and defect width). Postoperative discomfort (severity/duration of pain and swelling) and early soft tissue wound healing (dehiscence/fenestration, persistent swelling, spontaneous bleeding, and ulceration) were also assessed. Results Both treatment modalities, with and without EMD, resulted in significant improvement of clinical and radiographic outcomes without any severe adverse events. However, no statistically significant differences in any of the measured parameters were found when the two groups were compared. Early wound healing outcomes and the severity of swelling did not differ between the groups, but the severity of pain (P = 0.046), duration (P = 0.033), and swelling (P = 0.022) were significantly lower in the test group. Conclusions DPBM has been verified for biocompatibility and can be used as a scaffold to enhance the clinical and radiographic outcomes of periodontal regeneration of one‐wall intrabony defects. In particular, the adjunctive use of EMD significantly reduced the postoperative discomfort.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Do-Hyung Kim
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Seong-Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, Korea
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22
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Armitage GC. A brief history of periodontics in the United States of America: Pioneers and thought-leaders of the past, and current challenges. Periodontol 2000 2019; 82:12-25. [PMID: 31850629 DOI: 10.1111/prd.12303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper summarizes historical events in periodontology in the United States over the past 200 years. The contributions of some of the key thought-leaders of the past are highlighted. Throughout the 20th century, the evolution of thought, leading to the views currently held regarding the pathogenesis and treatment of periodontal diseases, was significantly influenced by: (1) major changes in health-care education; (2) the emergence of periodontics as a specialty of dentistry; (3) the publication of peer-reviewed journals with an emphasis on periodontology; (4) formation of the National Institute of Dental and Craniofacial Research (NIDCR); and (5) expansion of periodontal research programs by the NIDCR. The two major future challenges facing periodontal research are development of a better understanding of the ecological complexities of host-microbial interactions in periodontal health and disease, and identification of the relevant mechanisms involved in the predictable regeneration of damaged periodontal tissues.
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Affiliation(s)
- Gary C Armitage
- Division of Periodontology, Department of Orofacial Sciences, University of California San Francisco, San Francisco, California, USA
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23
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Yoshida W, Matsugami D, Murakami T, Bizenjima T, Imamura K, Seshima F, Saito A. Combined effects of systemic parathyroid hormone (1-34) and locally delivered neutral self-assembling peptide hydrogel in the treatment of periodontal defects: An experimental in vivo investigation. J Clin Periodontol 2019; 46:1030-1040. [PMID: 31292977 DOI: 10.1111/jcpe.13170] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/05/2019] [Accepted: 07/06/2019] [Indexed: 12/13/2022]
Abstract
AIM To evaluate in vivo combination therapy of systemic parathyroid hormone (PTH) and locally delivered neutral self-assembling peptide (SAP) hydrogel for periodontal treatment. MATERIALS AND METHODS Viability/proliferation of rat periodontal ligament cells in a neutral SAP nanofibre hydrogel (SPG-178) was evaluated using WST-1 assay. Periodontal defects were created mesially to the maxillary first molars in 40 Wistar rats. Defects were filled with 1.5% SPG-178 or left unfilled. Animals received PTH (1-34) or saline injections every 2 days. Microcomputed tomography, histological, and immunohistochemical examinations were used to evaluate healing at 2 or 4 weeks postoperative. RESULTS At 72 hr, cells in 1.5% SPG-178 showed increased viability/proliferation compared to cells in 0.8% SPG-178 or untreated controls. In vivo, systemic PTH resulted in significantly greater bone volume in the Unfilled group at 2 weeks (p = .01) and 4 weeks (p < .0001) than in the saline control. At 4 weeks, a significantly greater bone volume was observed in the PTH/SPG-178 (p = .0003) and PTH/Unfilled (p = .004) groups than in Saline/SPG-178 group. Histologically, greater bone formation was observed in PTH/SPG-178 at 4 weeks than in other groups. In the PTH/SPG-178 group, increased proportions of PCNA-, VEGF-, and Osterix-positive cells were observed in the treated sites. CONCLUSIONS These findings suggest that intermittent systemic PTH and locally delivered neutral SAP hydrogel enhance periodontal healing.
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Affiliation(s)
- Wataru Yoshida
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | | | - Tasuku Murakami
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | | | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Fumi Seshima
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
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Clark D, Rajendran Y, Paydar S, Ho S, Cox D, Ryder M, Dollard J, Kao RT. Advanced platelet-rich fibrin and freeze-dried bone allograft for ridge preservation: A randomized controlled clinical trial. J Periodontol 2019; 89:379-387. [PMID: 29683498 DOI: 10.1002/jper.17-0466] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 10/01/2017] [Accepted: 10/05/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Advanced platelet-rich fibrin (A-PRF) is an autogenous blood product with applications in dento-alveolar surgery. However, there is minimal information regarding its optimal clinical application or efficacy. The aim of this multi-arm parallel randomized controlled clinical trial was to evaluate the efficacy of A-PRF alone or with freeze-dried bone allograft (FDBA) in improving vital bone formation and alveolar dimensional stability during ridge preservation. METHODS Forty patients requiring extraction of non-molar teeth and replacement with dental implants were randomized into one of four ridge preservation approaches: A-PRF, A-PRF+FDBA, FDBA, or blood clot. A-PRF was prepared at 1,300 rpm for 8 minutes. Non-traumatic extractions and ridge preservation was performed. After an average of 15 weeks healing, bone core samples were harvested at the time of implant placement for micro-CT and histomorphometric analysis. Ridge dimensions were measured immediately after extraction and before implant placement. RESULTS Significantly greater loss of ridge height was noted in the blood clot group (3.8 ± 2.0 mm) compared to A-PRF (1.8 ± 2.1 mm) and A-PRF+FDBA (1.0 ± 2.3 mm) groups (P < 0.05). No significant differences in ridge width reduction were noted between groups. Significantly more vital bone was present in the A-PRF group (46% ± 18%) compared to the FDBA group (29% ± 14%) (P < 0.05). Bone mineral density was significantly greater in the FDBA group (551 ± 58 mg/cm3 ) compared to blood clot (487 ± 64 mg/cm3 ) (P < 0.05). CONCLUSIONS This study demonstrates A-PRF alone or augmented with FDBA is a suitable biomaterial for ridge preservation. This study represents the first randomized controlled clinical trial comparing A-PRF with and without FDBA to FDBA alone for ridge preservation.
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Affiliation(s)
- Daniel Clark
- Department of Orofacial Sciences, Division of Periodontology, University of California San Francisco, San Francisco, CA
| | - Yogalakshmi Rajendran
- Department of Orofacial Sciences, Division of Periodontology, University of California San Francisco, San Francisco, CA
| | - Sarmad Paydar
- Department of Orofacial Sciences, Division of Periodontology, University of California San Francisco, San Francisco, CA
| | - Sunita Ho
- Department of Preventive and Restorative Dental Sciences , Division of Biomaterials and Bioengineering University of California San Francisco, San Francisco, CA
| | - Darren Cox
- Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA
| | - Mark Ryder
- Department of Orofacial Sciences, Division of Periodontology, University of California San Francisco, San Francisco, CA
| | - John Dollard
- Department of Orofacial Sciences, Division of Periodontology, University of California San Francisco, San Francisco, CA
| | - Richard T Kao
- Department of Orofacial Sciences, Division of Periodontology, University of California San Francisco, San Francisco, CA.,Private Practice , Cupertino , CA
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Liu C, Qi X, Alhabeil J, Lu H, Zhou Z. Activation of cannabinoid receptors promote periodontal cell adhesion and migration. J Clin Periodontol 2019; 46:1264-1272. [PMID: 31461164 DOI: 10.1111/jcpe.13190] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/21/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Medical and recreational cannabis use is increasing significantly, but its impacts on oral health remain unclear. The aim of this study is to investigate the effects of tetrahydrocannabinol (THC), the major active component in cannabis, on periodontal fibroblast cell adhesion and migration to explore its role in periodontal regeneration and wound healing. MATERIAL AND METHODS The different distribution of cannabinoid receptors 1 (CB1) and 2 (CB2) was characterized in the mouse periodontium. Human periodontal fibroblast cell (HPLF) adhesion and migration was analysed by in vitro wound healing assay with and without THC. The focal adhesion kinase (FAK) signalling pathway was investigated to uncover the underlying cellular mechanism. The receptor dependency of cannabinoid effects was examined by using selective antagonists to block THC. RESULTS Both CB1 and CB2 were expressed in periodontal tissues but with different expression patterns. Tetrahydrocannabinol promoted periodontal cell wound healing by inducing HPLF cell adhesion and migration. This was mediated by focal adhesion kinase (FAK) activation and its modulation of MAPK activities. The effect of cannabinoids on periodontal fibroblast cell adhesion and migration was mainly dependent on the CB2. CONCLUSION These results suggested that cannabinoids may contribute to developing new therapeutics for periodontal regeneration and wound healing.
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Affiliation(s)
- Chunyan Liu
- School of Dentistry, University of Detroit Mercy, Detroit, MI, USA.,School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang, China
| | - Xia Qi
- School of Dentistry, University of Detroit Mercy, Detroit, MI, USA.,School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang, China
| | - Jamal Alhabeil
- School of Dentistry, University of Detroit Mercy, Detroit, MI, USA
| | - Haiyan Lu
- School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang, China
| | - Zheng Zhou
- School of Dentistry, University of Detroit Mercy, Detroit, MI, USA
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26
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Górski B, Kaczyński T, Górska R. The association between early postoperative healing and the 12-month clinical and radiographic outcomes of guided tissue regeneration in aggressive periodontitis patients. POSTEP HIG MED DOSW 2019. [DOI: 10.5604/01.3001.0013.4669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study evaluates the influence of early healing on clinical and radiological outcomes of guided tissue regeneration (GTR) procedures of vertical intrabony defects in patients with aggressive periodontitis (AgP) in a 12-month follow-up. The influence of patient-related, site-specific and technical aspects on optimal early wound healing was also assessed.
This analysis included 25 patients with 61 intrabony defects. All sites were treated according to guidelines of minimally invasive surgical technique with the use of bone grafts and collagen membranes. Early post-operative healing was evaluated using the Early Wound-Healing Index (EHI). Changes in clinical and radiological parameters were assessed 12 months postoperatively.
After 2 weeks, primary healing (EHI ≤3) was observed in 44 sites (72.13%) and secondary healing was present in 17 sites (22.87%) (EHI = 4). The presence of thin gingival phenotype was significantly associated with an increased risk of secondary healing (OR = 0.203; p = 0.014). At 12 months, GTR resulted in a significant clinical attachment level gain, as well as probing pocket depth reduction and radiographic defect depth reduction. Primary or secondary healing did not affect these outcomes.
Thick gingival biotype might be a prerequisite for optimal early wound healing. However, the type of early healing seems not to affect the long-term outcomes after regenerative treatment in aggressive periodontitis patients.
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Affiliation(s)
- Bartłomiej Górski
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, Warszawa, Poland
| | - Tomasz Kaczyński
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, Warszawa, Poland
| | - Renata Górska
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, Warszawa, Poland
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27
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Ausenda F, Rasperini G, Acunzo R, Gorbunkova A, Pagni G. New Perspectives in the Use of Biomaterials for Periodontal Regeneration. MATERIALS 2019; 12:ma12132197. [PMID: 31288437 PMCID: PMC6651816 DOI: 10.3390/ma12132197] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 02/05/2023]
Abstract
Periodontitis is a disease with a high prevalence among adults. If not treated, it can lead to loss of teeth. Periodontal therapy aims at maintaining patient’s teeth through infection control and correction of non-maintainable anatomies including—when possible—regeneration of lost periodontal tissues. The biological regenerative potential of the periodontium is high, and several biomaterials can be utilized to improve the outcome of periodontal therapy. Use of different natural and synthetic materials in the periodontal field has been studied for many years. The main materials used today in periodontology analyzed in this review are: Resorbable and non-resorbable barrier membranes; autogenous, allogeneic, xenogeneic, and alloplastic bone substitutes; biological agents, such as amelogenins; platelet-derived growth factor; bone morphogenic proteins; rh fibroblast growth factor 2; teriparatide hormone; platelet concentrates; and 3D scaffolds. With the development of new surgical techniques some concepts on periodontal regeneration that were strictly applied in the past seem to be not so critical today. This can have an impact on the materials that are needed when attempting to regenerate lost periodontal structures. This review aims at presenting a rationale behind the use of biomaterials in modern periodontal regeneration
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Affiliation(s)
- Federico Ausenda
- Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS C'a Granda, 20142 Milan, Italy
| | - Giulio Rasperini
- Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS C'a Granda, 20142 Milan, Italy
| | - Raffaele Acunzo
- Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS C'a Granda, 20142 Milan, Italy
| | - Angelina Gorbunkova
- Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS C'a Granda, 20142 Milan, Italy
| | - Giorgio Pagni
- Unit of Periodontology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS C'a Granda, 20142 Milan, Italy.
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28
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Passos PC, Moro J, Barcelos RCS, Da Rosa HZ, Vey LT, Bürguer ME, Maciel RM, Danesi CC, Edwards PC, Bottino MC, Kantorski KZ. Nanofibrous antibiotic-eluting matrices: Biocompatibility studies in a rat model. J Biomed Mater Res B Appl Biomater 2019; 108:306-315. [PMID: 31016876 DOI: 10.1002/jbm.b.34389] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/18/2019] [Accepted: 04/04/2019] [Indexed: 12/17/2022]
Abstract
This study evaluated the biocompatibility of degradable polydioxanone (PDS) electrospun drug delivery systems (hereafter referred as matrices) containing metronidazole (MET) or ciprofloxacin (CIP) after subcutaneous implantation in rats. Sixty adult male rats were randomized into six groups: SHAM (sham surgery); PDS (antibiotic-free matrix); 1MET (one 25 wt% MET matrix); 1CIP (one 25 wt% CIP matrix); 2MET (two 25 wt% MET matrices); and 2CIP (two 25 wt% CIP matrices). At 3 and 30 days, animals were assessed for inflammatory cell response (ICR), collagen fibers degradation, and oxidative profile (reactive oxygen species [ROS]; lipid peroxidation [LP]; and protein carbonyl [PC]). At 3 days, percentages of no/discrete ICR were 100, 93.3, 86.7, 76.7, 50, and 66.6 for SHAM, PDS, 1MET, 1CIP, 2MET, and 2CIP, respectively. At 30 days, percentages of no/discrete ICR were 100% for SHAM, PDS, 1MET, and 1CIP and 93.3% for 2MET and 2CIP. Between 3 and 30 days, SHAM, 1CIP, and 2CIP produced collagen, while 1MET and 2MET were unchanged. At 30 days, the collagen fiber means percentages for SHAM, PDS, 1MET, 1CIP, 2MET, and 2CIP were 63.7, 60.7, 56.6, 62.6, 51.8, and 61.7, respectively. Antibiotic-eluting matrices showed similar or better oxidative behavior when compared to PDS, except for CIP-eluting matrices, which showed higher levels of PC compared to SHAM or PDS at 30 days. Collectively, our findings indicate that antibiotic-eluting matrices may be an attractive biocompatible drug delivery system to fight periodontopathogens. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B, 2019.
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Affiliation(s)
- Patrícia C Passos
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Juliana Moro
- Post-Graduate Program in Oral Science (Pathology Unit), School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Raquel Cristine Silva Barcelos
- Post-Graduate Program in Oral Science (Pathology Unit), School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Higor Z Da Rosa
- Post-Graduate Program in Pharmacology, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Luciana T Vey
- Post-Graduate Program in Pharmacology, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Marilise Escobar Bürguer
- Post-Graduate Program in Pharmacology, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Roberto M Maciel
- Post-Graduate Program in Oral Science (Pathology Unit), School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Cristiane C Danesi
- Post-Graduate Program in Oral Science (Pathology Unit), School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - Paul C Edwards
- Department of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Karla Z Kantorski
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
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29
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Capetillo JF, Coleman BG, Johnson TM. Combination Bone Replacement Graft with Dense Polytetrafluoroethylene Barrier Membrane for Treatment of an Infrabony Periodontal Defect. Clin Adv Periodontics 2018. [DOI: 10.1002/cap.10026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Joseph F. Capetillo
- Department of Periodontics; Korea Dental Health Activity; United States Army; Seoul Republic of Korea
| | - Brandon G. Coleman
- United States Army Advanced Education Program in Periodontics; Fort Gordon GA
- Department of Periodontics; Army Postgraduate Dental School; Uniformed Services University of the Health Sciences; Fort Gordon GA
| | - Thomas M. Johnson
- United States Army Advanced Education Program in Periodontics; Fort Gordon GA
- Department of Periodontics; Army Postgraduate Dental School; Uniformed Services University of the Health Sciences; Fort Gordon GA
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30
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Cai X, Yang F, Walboomers XF, Wang Y, Jansen JA, van den Beucken JJJP, Plachokova AS. Periodontal regeneration via chemoattractive constructs. J Clin Periodontol 2018; 45:851-860. [PMID: 29779212 PMCID: PMC6055718 DOI: 10.1111/jcpe.12928] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 04/04/2018] [Accepted: 05/14/2018] [Indexed: 11/29/2022]
Abstract
Aim Chemoattractants, such as stromal cell‐derived factor‐1α (SDF‐1α), can offer an advantage for periodontal regeneration by recruiting the patient’s own stem cells to stimulate self‐repair. We here developed a chemoattractive construct for periodontal regeneration using SDF‐1α and evaluated its efficacy in vivo. Materials and Methods SDF‐1α was loaded on gelatin sponge and tested in vitro for SDF‐1α release. Subsequently, SDF‐1α constructs were implanted into rat periodontal defects for 1 and 6 weeks, with unloaded materials and empty defects as controls. The regenerative efficacy was evaluated by micro‐CT, histological and histomorphometrical analyses. Results In vitro results showed limited SDF‐1α release up to 35 days. In contrast, SDF‐1α constructs significantly improved periodontal defect regeneration in terms of alveolar bone height, new bone area and functional ligament length. Additionally, SDF‐1α constructs decreased the inflammatory response at Week 6. Conclusion Chemoattractive constructs significantly improved periodontal regeneration in terms of alveolar bone height, new bone area and functional ligament length.
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Affiliation(s)
- Xinjie Cai
- Department of Biomaterials, Radboudumc, Nijmegen, the Netherlands.,The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Yang
- Department of Biomaterials, Radboudumc, Nijmegen, the Netherlands
| | | | - Yining Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - John A Jansen
- Department of Biomaterials, Radboudumc, Nijmegen, the Netherlands
| | | | - Adelina S Plachokova
- Department of Implantology and Periodontology, Radboudumc, Nijmegen, the Netherlands
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31
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Yamamoto T, Ugawa Y, Kawamura M, Yamashiro K, Kochi S, Ideguchi H, Takashiba S. Modulation of microenvironment for controlling the fate of periodontal ligament cells: the role of Rho/ROCK signaling and cytoskeletal dynamics. J Cell Commun Signal 2018; 12:369-378. [PMID: 29086204 PMCID: PMC5842188 DOI: 10.1007/s12079-017-0425-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 10/17/2017] [Indexed: 12/20/2022] Open
Abstract
Cells behave in a variety of ways when they perceive changes in their microenvironment; the behavior of cells is guided by their coordinated interactions with growth factors, niche cells, and extracellular matrix (ECM). Modulation of the microenvironment affects the cell morphology and multiple gene expressions. Rho/Rho-associated coiled-coil-containing protein kinase (ROCK) signaling is one of the key regulators of cytoskeletal dynamics and actively and/or passively determines the cell fate, such as proliferation, migration, differentiation, and apoptosis, by reciprocal communication with the microenvironment. During periodontal wound healing, it is important to recruit the residential stem cells into the defect site for regeneration and homeostasis of the periodontal tissue. Periodontal ligament (PDL) cells contain a heterogeneous fibroblast population, including mesenchymal stem cells, and contribute to the reconstruction of tooth-supporting tissues. Therefore, bio-regeneration of PDL cells has been the ultimate goal of periodontal therapy for decades. Recent stem cell researches have shed light on intrinsic ECM properties, providing paradigm shifts in cell fate determination. This review focuses on the role of ROCK activity and the effects of Y-27632, a specific inhibitor of ROCK, in the modulation of ECM-microenvironment. Further, it presents the current understanding of how Rho/ROCK signaling affects the fate determination of stem cells, especially PDL cells. In addition, we have also discussed in detail the underlying mechanisms behind the reciprocal response to the microenvironment.
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Affiliation(s)
- Tadashi Yamamoto
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Yuki Ugawa
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Mari Kawamura
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Keisuke Yamashiro
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Shinsuke Kochi
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Hidetaka Ideguchi
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Shogo Takashiba
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan.
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32
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Salamanca E, Pan YH, Tsai AI, Lin PY, Lin CK, Huang HM, Teng NC, Wang PD, Chang WJ. Enhancement of Osteoblastic-Like Cell Activity by Glow Discharge Plasma Surface Modified Hydroxyapatite/β-Tricalcium Phosphate Bone Substitute. MATERIALS (BASEL, SWITZERLAND) 2017; 10:E1347. [PMID: 29168776 PMCID: PMC5744282 DOI: 10.3390/ma10121347] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/11/2017] [Accepted: 11/21/2017] [Indexed: 11/17/2022]
Abstract
Glow discharge plasma (GDP) treatments of biomaterials, such as hydroxyapatite/β-tricalcium phosphate (HA/β-TCP) composites, produce surfaces with fewer contaminants and may facilitate cell attachment and enhance bone regeneration. Thus, in this study we used argon glow discharge plasma (Ar-GDP) treatments to modify HA/β-TCP particle surfaces and investigated the physical and chemical properties of the resulting particles (HA/β-TCP + Ar-GDP). The HA/β-TCP particles were treated with GDP for 15 min in argon gas at room temperature under the following conditions: power: 80 W; frequency: 13.56 MHz; pressure: 100 mTorr. Scanning electron microscope (SEM) observations showed similar rough surfaces of HA/β-TCP + Ar-GDP HA/β-TCP particles, and energy dispersive spectrometry analyses showed that HA/β-TCP surfaces had more contaminants than HA/β-TCP + Ar-GDP surfaces. Ca/P mole ratios in HA/β-TCP and HA/β-TCP + Ar-GDP were 1.34 and 1.58, respectively. Both biomaterials presented maximal intensities of X-ray diffraction patterns at 27° with 600 a.u. At 25° and 40°, HA/β-TCP + Ar-GDP and HA/β-TCP particles had peaks of 200 a.u., which are similar to XRD intensities of human bone. In subsequent comparisons, MG-63 cell viability and differentiation into osteoblast-like cells were assessed on HA/β-TCP and HA/β-TCP + Ar-GDP surfaces, and Ar-GDP treatments led to improved cell growth and alkaline phosphatase activities. The present data indicate that GDP surface treatment modified HA/β-TCP surfaces by eliminating contaminants, and the resulting graft material enhanced bone regeneration.
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Affiliation(s)
- Eisner Salamanca
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Yu-Hwa Pan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei 105, Taiwan.
- Graduate Institute of Dental & Craniofacial Science, Chang Gung University, Taoyuan 333, Taiwan.
- School of Dentistry, College of Medicine, China Medical University, Taichung 404, Taiwan.
| | - Aileen I Tsai
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei 105, Taiwan.
| | - Pei-Ying Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Ching-Kai Lin
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei 105, Taiwan.
| | - Haw-Ming Huang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
- Graduate Institute of Biomedical Materials & Tissue Engineering, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Nai-Chia Teng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
- Dental Department, Taipei Medical University Hospital, Taipei 110, Taiwan.
| | - Peter D Wang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
- Dental Department, Taipei Medical University Hospital, Taipei 110, Taiwan.
| | - Wei-Jen Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
- Dental Department, Taipei Medical University, Shuang-Ho Hospital, Taipei 235, Taiwan.
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33
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Engineered scaffolds and cell-based therapy for periodontal regeneration. J Appl Biomater Funct Mater 2017; 15:e303-e312. [PMID: 29131300 DOI: 10.5301/jabfm.5000389] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The main objective of regenerative periodontal therapy is to completely restore the periodontal tissues lost. This review summarizes the most recent evidence in support of scaffold- and cell-based tissue engineering, which are expected to play a relevant role in next-generation periodontal regenerative therapy. METHODS A literature search (PubMed database) was performed to analyze more recently updated articles regarding periodontal regeneration, scaffolds and cell-based technologies. RESULTS Evidence supports the importance of scaffold physical cues to promote periodontal regeneration, including scaffold multicompartmentalization and micropatterning. The in situ delivery of biological mediators and/or cell populations, both stem cells and already differentiated cells, has shown promising in vivo efficacy. CONCLUSIONS Porous scaffolds are pivotal for clot stabilization, wound compartmentalization, cell homing and cell nutrients delivery. Given the revolutionary introduction of rapid prototyping technique and cell-based therapies, the fabrication of custom-made scaffolds is not far from being achieved.
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34
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Varoni EM, Vijayakumar S, Canciani E, Cochis A, De Nardo L, Lodi G, Rimondini L, Cerruti M. Chitosan-Based Trilayer Scaffold for Multitissue Periodontal Regeneration. J Dent Res 2017; 97:303-311. [PMID: 29045803 DOI: 10.1177/0022034517736255] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Periodontal regeneration is still a challenge for periodontists and tissue engineers, as it requires the simultaneous restoration of different tissues-namely, cementum, gingiva, bone, and periodontal ligament (PDL). Here, we synthetized a chitosan (CH)-based trilayer porous scaffold to achieve periodontal regeneration driven by multitissue simultaneous healing. We produced 2 porous compartments for bone and gingiva regeneration by cross-linking with genipin either medium molecular weight (MMW) or low molecular weight (LMW) CH and freeze-drying the resulting scaffolds. We synthetized a third compartment for PDL regeneration by CH electrochemical deposition; this allowed us to produce highly oriented microchannels of about 450-µm diameter intended to drive PDL fiber growth toward the dental root. In vitro characterization showed rapid equilibrium water content for MMW-CH and LMW-CH compartments (equilibrium water content after 5 min >85%). The MMW-CH compartment degraded more slowly and provided significantly more resistance to compression (28% ± 1% of weight loss at 4 wk; compression modulus HA = 18 ± 6 kPa) than the LMW-CH compartment (34% ± 1%; 7.7 ± 0.8 kPa) as required to match the physiologic healing rates of bone and gingiva and their mechanical properties. More than 90% of all human primary periodontal cell populations tested on the corresponding compartment survived during cytocompatibility tests, showing active cell metabolism in the alkaline phosphatase and collagen deposition assays. In vivo tests showed high biocompatibility in wild-type mice, tissue ingrowth, and vascularization within the scaffold. Using the periodontal ectopic model in nude mice, we preseeded scaffold compartments with human gingival fibroblasts, osteoblasts, and PDL fibroblasts and found a dense mineralized matrix within the MMW-CH region, with weakly mineralized deposits at the dentin interface. Together, these results support this resorbable trilayer scaffold as a promising candidate for periodontal regeneration.
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Affiliation(s)
- E M Varoni
- 1 Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italy.,2 Department of Materials Engineering, McGill University, Montreal, Canada
| | - S Vijayakumar
- 2 Department of Materials Engineering, McGill University, Montreal, Canada
| | - E Canciani
- 1 Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italy
| | - A Cochis
- 1 Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italy.,3 Dipartimento di Scienze della Salute, Università del Piemonte Orientale, Novara, Italy
| | - L De Nardo
- 4 Department of Chemistry, Materials, and Chemical Engineering "G. Natta," Politecnico di Milano, Milano, Italy.,5 INSTM, Consorzio Nazionale di Scienza e Tecnologia dei Materiali, Firenze, Italy
| | - G Lodi
- 1 Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italy
| | - L Rimondini
- 3 Dipartimento di Scienze della Salute, Università del Piemonte Orientale, Novara, Italy
| | - M Cerruti
- 2 Department of Materials Engineering, McGill University, Montreal, Canada
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Hosoya A, Takahama A, Nakamura H. Localization of RELM-β/FIZZ2 Is Associated with Cementum Formation. Anat Rec (Hoboken) 2017; 300:1865-1874. [PMID: 28681425 DOI: 10.1002/ar.23636] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/16/2017] [Accepted: 01/27/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Akihiro Hosoya
- Department of Oral Histology; Matsumoto Dental University; Nagano Japan
| | - Akira Takahama
- Department of Oral Histology; Matsumoto Dental University; Nagano Japan
| | - Hiroaki Nakamura
- Department of Oral Histology; Matsumoto Dental University; Nagano Japan
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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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Babo PS, Pires RL, Santos L, Franco A, Rodrigues F, Leonor I, Reis RL, Gomes ME. Platelet Lysate-Loaded Photocrosslinkable Hyaluronic Acid Hydrogels for Periodontal Endogenous Regenerative Technology. ACS Biomater Sci Eng 2017; 3:1359-1369. [DOI: 10.1021/acsbiomaterials.6b00508] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Pedro S. Babo
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics, University of Minho, Avepark−Zona Industrial da Gandra, 4806-017 Barco GMR, Portugal
- ICVS/3B’s−PT
Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - Ricardo L. Pires
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics, University of Minho, Avepark−Zona Industrial da Gandra, 4806-017 Barco GMR, Portugal
- ICVS/3B’s−PT
Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - Lívia Santos
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics, University of Minho, Avepark−Zona Industrial da Gandra, 4806-017 Barco GMR, Portugal
- ICVS/3B’s−PT
Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - Albina Franco
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics, University of Minho, Avepark−Zona Industrial da Gandra, 4806-017 Barco GMR, Portugal
- ICVS/3B’s−PT
Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - Fernando Rodrigues
- ICVS/3B’s−PT
Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
- Life
and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga 4710-057, Portugal
| | - Isabel Leonor
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics, University of Minho, Avepark−Zona Industrial da Gandra, 4806-017 Barco GMR, Portugal
- ICVS/3B’s−PT
Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - Rui L. Reis
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics, University of Minho, Avepark−Zona Industrial da Gandra, 4806-017 Barco GMR, Portugal
- ICVS/3B’s−PT
Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - Manuela E. Gomes
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics, University of Minho, Avepark−Zona Industrial da Gandra, 4806-017 Barco GMR, Portugal
- ICVS/3B’s−PT
Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
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Rheological, mechanical and degradable properties of injectable chitosan/silk fibroin/hydroxyapatite/glycerophosphate hydrogels. J Mech Behav Biomed Mater 2016; 64:161-72. [DOI: 10.1016/j.jmbbm.2016.07.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 07/04/2016] [Accepted: 07/06/2016] [Indexed: 11/22/2022]
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Lee CT, Hum L, Chen YW. The effect of regenerative periodontal therapy in preventing periodontal defects after the extraction of third molars. J Am Dent Assoc 2016; 147:709-719.e4. [DOI: 10.1016/j.adaj.2016.03.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 03/05/2016] [Accepted: 03/08/2016] [Indexed: 10/22/2022]
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Zhu Y, Wang J, Wu J, Zhang J, Wan Y, Wu H. Injectable hydrogels embedded with alginate microspheres for controlled delivery of bone morphogenetic protein-2. Biomed Mater 2016; 11:025010. [DOI: 10.1088/1748-6041/11/2/025010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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41
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A Novel HA/β-TCP-Collagen Composite Enhanced New Bone Formation for Dental Extraction Socket Preservation in Beagle Dogs. MATERIALS 2016; 9:ma9030191. [PMID: 28773317 PMCID: PMC5456700 DOI: 10.3390/ma9030191] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/07/2016] [Accepted: 03/09/2016] [Indexed: 01/22/2023]
Abstract
Past studies in humans have demonstrated horizontal and vertical bone loss after six months following tooth extraction. Many biomaterials have been developed to preserve bone volume after tooth extraction. Type I collagen serves as an excellent delivery system for growth factors and promotes angiogenesis. Calcium phosphate ceramics have also been investigated because their mineral chemistry resembles human bone. The aim of this study was to compare the performance of a novel bioresorbable purified fibrillar collagen and hydroxyapatite/β-tricalcium phosphate (HA/β-TCP) ceramic composite versus collagen alone and a bovine xenograft-collagen composite in beagles. Collagen plugs, bovine graft-collagen composite and HA/β-TCP-collagen composite were implanted into the left and right first, second and third mandibular premolars, and the fourth molar was left empty for natural healing. In total, 20 male beagle dogs were used, and quantitative and histological analyses of the extraction ridge was done. The smallest width reduction was 19.09% ± 8.81% with the HA/β-TCP-collagen composite at Week 8, accompanied by new bone formation at Weeks 4 and 8. The HA/β-TCP-collagen composite performed well, as a new osteoconductive and biomimetic composite biomaterial, for socket bone preservation after tooth extraction.
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Lee BS, Lee CC, Wang YP, Chen HJ, Lai CH, Hsieh WL, Chen YW. Controlled-release of tetracycline and lovastatin by poly(D,L-lactide-co-glycolide acid)-chitosan nanoparticles enhances periodontal regeneration in dogs. Int J Nanomedicine 2016; 11:285-97. [PMID: 26848264 PMCID: PMC4723100 DOI: 10.2147/ijn.s94270] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Chronic periodontitis is characterized by inflammation of periodontal tissues, leading to bone resorption and tooth loss. The goal of treatment is to regenerate periodontal tissues including bone and cementum lost as a consequence of disease. The local delivery of tetracycline was proven to be effective in controlling localized periodontal infection without apparent side effects. Previous studies suggested that lovastatin has a significant role in new bone formation; however, the local delivery of lovastatin might enhance its therapeutic effects. A number of local delivery devices have been developed recently, including poly(D,L-lactide-co-glycolide acid) (PLGA) nanoparticles. The aim of this study was to develop a local delivery device, PLGA-lovastatin-chitosan-tetracycline nanoparticles, which allows the sequential release of tetracycline and lovastatin to effectively control local infection and promote bone regeneration in periodontitis. The size and microstructure of nanoparticles were examined by transmission electron microscopy, Nanoparticle Size Analyzer, and Fourier transform infrared spectroscopy. The release of tetracycline and lovastatin was quantified using a UV-Vis spectrophotometer. Furthermore, the cytotoxic effect and alkaline phosphatase activity of the nanoparticles in osteoblast cell cultures as well as antibacterial activity against periodontal pathogens were investigated. Finally, the bone regeneration potential of PLGA nanoparticles in three-walled defects in beagle dogs was investigated. The results indicated that PLGA-lovastatin-chitosan-tetracycline nanoparticles showed good biocompatibility, antibacterial activity, and increased alkaline phosphatase activity. The volumetric analysis from micro-CT revealed significantly increased new bone formation in defects filled with nanoparticles in dogs. This novel local delivery device might be useful as an adjunctive treatment in periodontal regenerative therapy.
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Affiliation(s)
- Bor-Shiunn Lee
- Graduate Institute of Oral Biology, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Chen Lee
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ping Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiao-Jan Chen
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chern-Hsiung Lai
- College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Ling Hsieh
- Graduate Institute of Oral Biology, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Wen Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
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Age-related decline in the matrix contents and functional properties of human periodontal ligament stem cell sheets. Acta Biomater 2015; 22:70-82. [PMID: 25922305 DOI: 10.1016/j.actbio.2015.04.024] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 04/16/2015] [Accepted: 04/19/2015] [Indexed: 02/08/2023]
Abstract
In this study, periodontal ligament (PDL) stem cells (PDLSCs) derived from different-aged donors were used to evaluate the effect of aging on cell sheet formation. The activity of PDLSCs was first determined based on their colony-forming ability, surface markers, proliferative/differentiative potentials, senescence-associated β-galactosidase (SA-βG) staining, and expression of pluripotency-associated transcription factors. The ability of these cells to form sheets, based on their extracellular matrix (ECM) contents and their functional properties necessary for osteogenic differentiation, was evaluated to predict the age-related changes in the regenerative capacity of the cell sheets in their further application. It was found that human PDLSCs could be isolated from the PDL tissue of different-aged subjects. However, the ability of the PDLSCs to proliferate and to undergo osteogenic differentiation and their expression of pluripotency-associated transcription factors displayed age-related decreases. In addition, these cells exhibited an age-related increase in SA-βG expression. Aged cells showed an impaired ability to form functional cell sheets, as determined by morphological observations and Ki-67 immunohistochemistry staining. Based on the production of ECM proteins, such as fibronectin, integrin β1, and collagen type I; alkaline phosphatase (ALP) activity; and the expression of osteogenic genes, such as ALP, Runt-related transcription factor 2, and osteocalcin, cell sheets formed by PDLSCs derived from older donors demonstrated a less potent osteogenic capacity compared to those formed by PDLSCs from younger donors. Our data suggest that the age-associated decline in the matrix contents and osteogenic properties of PDLSC sheets should be taken into account in cell sheet engineering research and clinical periodontal regenerative therapy.
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de Santana RB, de Santana CMM. Human intrabony defect regeneration with rhFGF-2 and hyaluronic acid - a randomized controlled clinical trial. J Clin Periodontol 2015; 42:658-65. [DOI: 10.1111/jcpe.12406] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 01/12/2023]
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45
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Rezende MLRD, Cunha PDO, Damante CA, Santana ACP, Greghi SLA, Zangrando MSR. Cyanoacrylate Adhesive as an Alternative Tool for Membrane Fixation in Guided Tissue Regeneration. J Contemp Dent Pract 2015; 16:512-518. [PMID: 26323456 DOI: 10.5005/jp-journals-10024-1714] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM To report a well succeeded use of cyanoacrylate adhesive for fixating a resorbable membrane during a guided tissue regeneration procedure (GTR). BACKGROUND The immobilization of membranes in GTR is essential for establishing proper environment for cell differentiation and tissue regeneration. However, some membranes are very difficult to be kept in position by sutures and its fixation by mini screws or pins may be time consuming and expensive. CASE DESCRIPTION A 47-year-old woman presenting a vertical bone defect at the palatal aspect of the left central incisor was treated by GTR using particulate autogenous bone graft associated to a collagen membrane. The membrane was glued to the bone surrounding the defect and to the tooth surface with cyanoacrylate adhesive. The postoperative period was uneventful and 4 years later, excellent results in terms of radiographic filling of the defect and reduction of the probing depth were seen. For illustrative purposes, histological findings obtained during a previous experiment in calvaria of guinea pigs is shown, characterizing a foreign body granuloma and proving that the cyanoacrylate adhesive is a safe tool in GTR. CONCLUSION The use of a membrane glued with cyanoacrylate to immobilize membranes in GTR is viable and safe from both technical and biological standpoints and may be advantageous for clinical and research purposes. CLINICAL SIGNIFICANCE The alternative method for membrane fixation shown in this case report can contribute to simplify the technique in GTR procedures.
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Affiliation(s)
- Maria Lúcia Rubo de Rezende
- Department of Prosthodontics, Division of Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, Alameda Octavio Pinheiro Brisolla, 9-75/Vila Universitaria, Bauru, SP Zip Code: 17012-901, Brazil, e-mail:
| | - Paula de Oliveira Cunha
- Department of Prosthodontics, Division of Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Carla Andreotti Damante
- Department of Prosthodontics, Division of Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Adriana C P Santana
- Department of Prosthodontics, Division of Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Sebastião L A Greghi
- Department of Prosthodontics, Division of Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Mariana S R Zangrando
- Department of Prosthodontics, Division of Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
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Salamanca E, Lee WF, Lin CY, Huang HM, Lin CT, Feng SW, Chang WJ. A Novel Porcine Graft for Regeneration of Bone Defects. MATERIALS 2015. [PMCID: PMC5455581 DOI: 10.3390/ma8052523] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Bone regeneration procedures require alternative graft biomaterials to those for autogenous bone. Therefore, we developed a novel porcine graft using particle sizes of 250–500 μm and 500–1000 μm in rabbit calvarial bone defects and compared the graft properties with those of commercial hydroxyapatite (HA)/beta-tricalcium phosphate (β-TCP) over eight weeks. Surgery was performed in 20 adult male New Zealand white rabbits. During a standardized surgical procedure, four calvarial critical-size defects of 5 mm diameter and 3 mm depth were prepared. The defects were filled with HA/β-TCP, 250–500 μm or 500–1000 μm porcine graft, and control defects were not filled. The animals were grouped for sacrifice at 1, 2, 4, and 8 weeks post-surgery. Subsequently, sample blocks were prepared for micro-computed tomography (micro-CT) scanning and histological sectioning. Similar bone formations were observed in all three treatment groups, although the 250–500 μm porcine graft performed slightly better. Rabbit calvarial bone tissue positively responded to porcine grafts and commercial HA/β-TCP, structural analyses showed similar crystallinity and porosity of the porcine and HA/β-TCP grafts, which facilitated bone formation through osteoconduction. These porcine grafts can be considered as graft substitutes, although further development is required for clinical applications.
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Affiliation(s)
- Eisner Salamanca
- School of Dentistry, College of Oral Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan; E-Mails: (E.S.); (C.-Y.L.); (C.-T.L.); (S.-W.F.)
| | - Wei-Fang Lee
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan; E-Mail:
| | - Chin-Yi Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan; E-Mails: (E.S.); (C.-Y.L.); (C.-T.L.); (S.-W.F.)
| | - Haw-Ming Huang
- Graduate Institute of Biomedical Materials & Tissue Engineering, College of Oral Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan; E-Mail:
| | - Che-Tong Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan; E-Mails: (E.S.); (C.-Y.L.); (C.-T.L.); (S.-W.F.)
| | - Sheng-Wei Feng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan; E-Mails: (E.S.); (C.-Y.L.); (C.-T.L.); (S.-W.F.)
| | - Wei-Jen Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan; E-Mails: (E.S.); (C.-Y.L.); (C.-T.L.); (S.-W.F.)
- Dental Department of Taipei Medical University, Shuang-Ho Hospital, Taipei 110, Taiwan
- Author to whom correspondence should be addressed; E-Mail: cweijen1@ tmu.edu.tw; Tel.: +886-2-2736-1661 (ext. 5148); Fax: +886-2-2736-2295
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Bartold PM, Gronthos S, Ivanovski S, Fisher A, Hutmacher DW. Tissue engineered periodontal products. J Periodontal Res 2015; 51:1-15. [PMID: 25900048 DOI: 10.1111/jre.12275] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2015] [Indexed: 01/25/2023]
Abstract
Attainment of periodontal regeneration is a significant clinical goal in the management of advanced periodontal defects arising from periodontitis. Over the past 30 years numerous techniques and materials have been introduced and evaluated clinically and have included guided tissue regeneration, bone grafting materials, growth and other biological factors and gene therapy. With the exception of gene therapy, all have undergone evaluation in humans. All of the products have shown efficacy in promoting periodontal regeneration in animal models but the results in humans remain variable and equivocal concerning attaining complete biological regeneration of damaged periodontal structures. In the early 2000s, the concept of tissue engineering was proposed as a new paradigm for periodontal regeneration based on molecular and cell biology. At this time, tissue engineering was a new and emerging field. Now, 14 years later we revisit the concept of tissue engineering for the periodontium and assess how far we have come, where we are currently situated and what needs to be done in the future to make this concept a reality. In this review, we cover some of the precursor products, which led to our current position in periodontal tissue engineering. The basic concepts of tissue engineering with special emphasis on periodontal tissue engineering products is discussed including the use of mesenchymal stem cells in bioscaffolds and the emerging field of cell sheet technology. Finally, we look into the future to consider what CAD/CAM technology and nanotechnology will have to offer.
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Affiliation(s)
- P M Bartold
- Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Adelaide, SA, Australia
| | - S Gronthos
- School of Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - S Ivanovski
- Griffith Health Institute, School of Dentistry and Oral Health, Griffith University, Gold Coast, Qld, Australia
| | - A Fisher
- Griffith Health Institute, School of Dentistry and Oral Health, Griffith University, Gold Coast, Qld, Australia
| | - D W Hutmacher
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
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Susin C, Fiorini T, Lee J, De Stefano JA, Dickinson DP, Wikesjö UME. Wound healing following surgical and regenerative periodontal therapy. Periodontol 2000 2015; 68:83-98. [DOI: 10.1111/prd.12057] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 12/17/2022]
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49
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Giannobile WV, McClain PK. Enhancing Periodontal Health Through Regenerative Approaches. J Periodontol 2015; 86:S1-3. [DOI: 10.1902/jop.2015.140525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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50
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Suzuki E, Ochiai-Shino H, Aoki H, Onodera S, Saito A, Saito A, Azuma T. Akt activation is required for TGF-β1-induced osteoblast differentiation of MC3T3-E1 pre-osteoblasts. PLoS One 2014; 9:e112566. [PMID: 25470129 PMCID: PMC4254279 DOI: 10.1371/journal.pone.0112566] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 10/08/2014] [Indexed: 12/30/2022] Open
Abstract
Background We have previously reported that repeated treatment of human periodontal ligament cells and murine pre-osteoblast MC3T3-E1 cells with transforming growth factor-beta 1 (TGF-β1) inhibited their osteoblastic differentiation because of decreased insulin-like growth factor-1 (IGF-1) secretion. We also found that IGF-1/PI3K signaling plays an important role in osteoblast differentiation induced by TGF-β1 treatment; however, the downstream signaling controlling this remains unknown. The aim of this current study is to investigate whether Akt activation is required for osteoblast differentiation. Methodology/Principal Findings MC3T3-E1 cells were cultured in osteoblast differentiation medium (OBM) with or without 0.1 ng/mL TGF-β1. OBM containing TGF-β1 was changed every 12 h to provide repeated TGF-β1 administration. MC3T3-E1 cells were infected with retroviral vectors expressing constitutively active (CA) or dominant-negative (DN)-Akt. Alkaline phosphatase (ALP) activity and osteoblastic marker mRNA levels were substantially decreased by repeated TGF-β1 treatment compared with a single TGF-β1 treatment. However, expression of CA-Akt restored ALP activity following TGF-β1 treatment. Surprisingly, ALP activity increased following multiple TGF-β1 treatments as the number of administrations of TGF-β1 increased. Activation of Akt significantly enhanced expression of osteocalcin, but TGF-β1 treatment inhibited this. Mineralization of MC3T3-E1 cells was markedly enhanced by CA-Akt expression under all medium conditions. Exogenous IGF-1 restored the down-regulation of osteoblast-related gene expression by repeated TGF-β1 administration. However, in cells expressing DN-Akt, these levels remained inhibited regardless of IGF-1 treatment. These findings indicate that Akt activation is required for the early phase of osteoblast differentiation of MC3T3-E1 cells induced by TGF-β1. However, Akt activation is insufficient to reverse the inhibitory effects of TGF-β1 in the late stages of osteoblast differentiation. Conclusions TGF-β1 could be an inducer or an inhibitor of osteoblastic differentiation of MC3T3-E1 cells depending on the state of Akt phosphorylation. Our results indicate that Akt is the molecular switch for TGF-β1-induced osteoblastic differentiation of MC3T3-E1 cells.
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Affiliation(s)
- Eiichi Suzuki
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | | | - Hideto Aoki
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Shoko Onodera
- Department of Biochemistry, Tokyo Dental College, Tokyo, Japan
| | - Akiko Saito
- Department of Biochemistry, Tokyo Dental College, Tokyo, Japan
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Toshifumi Azuma
- Department of Biochemistry, Tokyo Dental College, Tokyo, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
- * E-mail:
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