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Souza ATP, Freitas GP, Lopes HB, Weffort D, Adolpho LF, Gomes MPO, Oliveira FS, Almeida ALG, Beloti MM, Rosa AL. Efficacy of mesenchymal stem cell-based therapy on the bone repair of hypertensive rats. Oral Dis 2024. [PMID: 38764359 DOI: 10.1111/odi.15004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/14/2024] [Accepted: 05/07/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE Hypertension disrupts the bone integrity and its repair ability. This study explores the efficiency of a therapy based on the application of mesenchymal stem cells (MSCs) to repair bone defects of spontaneously hypertensive rats (SHR). METHODS First, we evaluated SHR in terms of bone morphometry and differentiation of MSCs into osteoblasts. Then, the effects of the interactions between MSCs from normotensive rats (NTR-MSCs) cocultured with SHR (SHR-MSCs) on the osteoblast differentiation of both cell populations were evaluated. Also, bone formation into calvarial defects of SHR treated with NTR-MSCs was analyzed. RESULTS Hypertension induced bone loss evidenced by reduced bone morphometric parameters of femurs of SHR compared with NTR as well as decreased osteoblast differentiation of SHR-MSCs compared with NTR-MSCs. NTR-MSCs partially restored the capacity of SHR-MSCs to differentiate into osteoblasts, while SHR-MSCs exhibited a slight negative effect on NTR-MSCs. An enhanced bone repair was observed in defects treated with NTR-MSCs compared with control, stressing this cell therapy efficacy even in bones damaged by hypertension. CONCLUSION The use of MSCs derived from a heathy environment can be in the near future a smart approach to treat bone loss in the context of regenerative dentistry for oral rehabilitation of hypertensive patients.
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Affiliation(s)
- Alann Thaffarell Portilho Souza
- Bone Research Lab, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
- School of Dentistry, Metropolitan University Center of the Amazon (UNIFAMAZ), Belém, Brazil
| | - Gileade Pereira Freitas
- Bone Research Lab, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
- School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | - Helena Bacha Lopes
- Bone Research Lab, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - Denise Weffort
- Bone Research Lab, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - Leticia Faustino Adolpho
- Bone Research Lab, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | | | - Marcio Mateus Beloti
- Bone Research Lab, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - Adalberto Luiz Rosa
- Bone Research Lab, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
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Robo I, Heta S, Papakozma D, Ostreni V. Modification of implant surfaces to stimulate mesenchymal cell activation. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2022; 46:52. [PMID: 35261541 PMCID: PMC8894561 DOI: 10.1186/s42269-022-00743-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The process of osteointegration, as key point has the activation of mesenchymal cells at implant-bone interspace, their differentiation into osteoblasts and connection between the implant surface and the surrounding bone. MAIN TEXT Implant surfaces composed by biocompatible, organism-friendly materials require changes in content and surface morphology; changes that may further stimulate mesenchymal cell activation. The way the implant surfaces are affected with advantages and disadvantages, that typically bring each methodology, is also the purpose of this study. The study is of review type, based on finding articles about implant surface modification, with the aim of promoting the mesenchymal cell activation, utilizing keyword combination. CONCLUSIONS Implant success beyond the human element of the practicioner and the protocol element of implant treatment, also relies on the application of the right type of implant, at the right implant site, in accordance with oral and individual health status of the patient. Implant success does not depend on type of "coating" material of the implants. Based at this physiological process, the success or implant failure is not a process depending on the type of selected implant, because types of synthetic or natural materials that promote osteointegration are relatively in large number.
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Affiliation(s)
- Ilma Robo
- Faculty of Dental Medicine, University of Medicine, Tiranë, Albania
| | - Saimir Heta
- Pediatric Surgery, Pediatric Surgeon, University Hospital, QSUT, Tiranë, Albania
| | | | - Vera Ostreni
- Pediatric Surgery, Pediatric Surgeon, University Hospital, QSUT, Tiranë, Albania
- Department of Morphology, University of Medicine, Tiranë, Albania
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3
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Role of Stem Cells in Augmenting Dental Implant Osseointegration: A Systematic Review. COATINGS 2021. [DOI: 10.3390/coatings11091035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Dental implants are a widely used treatment modality for oral rehabilitation. Implant failures can be a result of many factors, with poor osseointegration being the main culprit. The present systematic review aimed to assess the effect of stem cells on the osseointegration of dental implants. An electronic search of the MEDLINE, LILACS, and EMBASE databases was conducted. We examined quantitative preclinical studies that reported on the effect of mesenchymal stem cells on bone healing after implant insertion. Eighteen studies that fulfilled the inclusion criteria were included. Various surface modification strategies, sites of placement, and cell origins were analyzed. The majority of the selected studies showed a high risk of bias, indicating that caution must be exercised in their interpretation. All the included studies reported that the stem cells used with graft material and scaffolds promoted osseointegration with higher levels of new bone formation. The mesenchymal cells attached to the implant surface facilitated the expression of bio-functionalized biomaterial surfaces, to boost bone formation and osseointegration at the bone–implant interfaces. There was a promotion of osteogenic differentiation of human mesenchymal cells and osseointegration of biomaterial implants, both in vitro and in vivo. These results highlight the significance of biomodified implant surfaces that can enhance osseointegration. These innovations can improve the stability and success rate of the implants used for oral rehabilitation.
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Guo S, Liu N, Liu K, Li Y, Zhang W, Zhu B, Gu B, Wen N. Effects of carbon and nitrogen plasma immersion ion implantation on bioactivity of zirconia. RSC Adv 2020; 10:35917-35929. [PMID: 35517098 PMCID: PMC9056952 DOI: 10.1039/d0ra05853j] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/06/2020] [Indexed: 01/11/2023] Open
Abstract
Zirconia is considered the most promising alternative material to titanium implants. However, zirconia is a biologically inert material and its surface modification is essential to obtain efficient osseointegration. Plasma immersion ion implantation (PIII) is a controllable and flexible approach that constructs functional groups on the surface of biomaterials and enhances osteogenic ability of host osteoclast cells. Zirconia disks were randomly divided into 4 groups (n = 50/group): (1) Blank, (2) C60N0, (3) C60N6, and (4) C60N18. Carbon and nitrogen plasma immersion ion implantation on zirconia (C and N2-PIII) surface modification was completed with the corresponding parameters. When zirconia was modified by carbon and nitrogen plasma implantation, a new chemical structure was formed on the material surface while the surface roughness of the material remained unaltered. The nitrogen-containing functional groups with high potential were introduced but the bulk crystal structure of zirconia was not changed, indicating that the stability of zirconia was not affected. In vitro data showed that zirconia with high surface potential promoted adhesion, proliferation, and osteogenic differentiation of BMSCs. C60N6 was found to be superior to the other groups. Our results demonstrate that a zirconia surface modified by C and N2-PIII can introduce desirable nitrogen functional groups and create a suitable extracellular environment to promote BMSCs biological activity. Taken together, these results suggest that C and N2-PIII modified zirconia is a promising material for use in the field of medical implantation. Zirconia is considered the most promising alternative material to titanium implants.![]()
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Affiliation(s)
- Shuqin Guo
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947.,Department of Stomatology, Beijing Railway Construction Hospital, China Railway Construction Corporation 40 Fuxing Road, Haidian District Beijing 100855 China
| | - Na Liu
- Department of Stomatology, Hainan Hospital, Chinese PLA General Hospital Sanya 572013 Hainan Province China
| | - Ke Liu
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Beijing 100190 China
| | - Ying Li
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
| | - Wei Zhang
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Beijing 100190 China
| | - Biao Zhu
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
| | - Bin Gu
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
| | - Ning Wen
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
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Shimizu S, Tsuchiya S, Hirakawa A, Kato K, Ando M, Mizuno M, Osugi M, Okabe K, Katagiri W, Hibi H. Design of a Randomized Controlled Clinical Study of tissue-engineered osteogenic materials using bone marrow-derived mesenchymal cells for Maxillomandibular bone defects in Japan: the TEOM study protocol. BMC Oral Health 2019; 19:69. [PMID: 31039763 PMCID: PMC6492409 DOI: 10.1186/s12903-019-0753-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 04/03/2019] [Indexed: 01/01/2023] Open
Abstract
Background Maxillomandibular bone defects arise from maxillofacial injury or tumor/cyst removal. While the standard therapy for bone regeneration is transplantation with autologous bone or artificial bone, these therapies are still unsatisfactory. Autologous bone harvesting is invasive and occasionally absorbed at the implanted site. The artificial bone takes a long time to ossify and it often gets infected. Therefore, we have focused on regenerative therapy consisting of autologous bone marrow-derived mesenchymal cells (BM-MSCs), which decreases the burden on patients. Based on our previous research in patients with maxillomandibular bone defects or alveolar bone atrophy using a mixture of BM-MSCs, platelet-rich plasma (PRP), thrombin, and calcium, we confirmed the efficacy and acceptable safety profile of this treatment. In this investigator-initiated clinical study (the TEOM study), we intended to add β-tricalcium phosphate (β-TCP) owing to large defect with patients. The TEOM study aimed to evaluate the efficacy and safety of bone regeneration using mixtures of BM-MSCs in patients with bone defects resulting from maxillofacial injury, and tumor/cyst removal in the maxillomandibular region. Methods The TEOM study is an open-label, single-center, randomized controlled study involving a total of 83 segments by the Fédération Dentaire Internationale numbering system in maxillomandibular bone defects that comprise over 1/3 of the maxillomandibular area with a remaining bone height of ≤10 mm. The primary endpoint is rate of procedure sites with successful bone regeneration defined as a computed tomography (CT) value of more than 400 and a bone height of more than 10 mm. Our specific hypothesis is that the number of required regions was calculated assuming that the rate of procedure sites with successful bone regeneration is similar and the non-inferiority margin is 15.0%. Discussion The TEOM study is the first randomized controlled study of regenerative treatment using BM-MSCs for large maxillomandibular bone defects. We will evaluate the efficacy and safety in this study to provide an exploratory basis for the necessity of BM-MSCs for these patients. Trial registration This trial was registered at the University Hospital Medical information Network Clinical Trials Registry (UMIN-CTR Unique ID: UMIN000020398; Registration Date: Jan 15, 2016; URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000016543).
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Affiliation(s)
- Shinobu Shimizu
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Shuhei Tsuchiya
- Department of Oral and Maxillofacial Surgery, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.
| | - Akihiro Hirakawa
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.,Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Katsuyoshi Kato
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Masaaki Mizuno
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Masashi Osugi
- Department of Oral and Maxillofacial Surgery, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.,Department of Oral and Maxillofacial Surgery, Fujieda Heisei Memorial Hospital, 123-1 Mizukami, Fujieda, Shizuoka, 426-8662, Japan
| | - Kazuto Okabe
- Department of Oral and Maxillofacial Surgery, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Wataru Katagiri
- Department of Oral and Maxillofacial Surgery, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.,Division of Reconstructive Surgery and Oral and Maxillofacial Region, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hideharu Hibi
- Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
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6
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Solakoglu Ö, Götz W, Kiessling MC, Alt C, Schmitz C, Alt EU. Improved guided bone regeneration by combined application of unmodified, fresh autologous adipose derived regenerative cells and plasma rich in growth factors: A first-in-human case report and literature review. World J Stem Cells 2019; 11:124-146. [PMID: 30842809 PMCID: PMC6397807 DOI: 10.4252/wjsc.v11.i2.124] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/07/2018] [Accepted: 01/10/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Novel strategies are needed for improving guided bone regeneration (GBR) in oral surgery prior to implant placement, particularly in maxillary sinus augmentation (GBR-MSA) and in lateral alveolar ridge augmentation (LRA). This study tested the hypothesis that the combination of freshly isolated, unmodified autologous adipose-derived regenerative cells (UA-ADRCs), fraction 2 of plasma rich in growth factors (PRGF-2) and an osteoinductive scaffold (OIS) (UA-ADRC/PRGF-2/OIS) is superior to the combination of PRGF-2 and the same OIS alone (PRGF-2/OIS) in GBR-MSA/LRA. CASE SUMMARY A 79-year-old patient was treated with a bilateral external sinus lift procedure as well as a bilateral lateral alveolar ridge augmentation. GBR-MSA/LRA was performed with UA-ADRC/PRGF-2/OIS on the right side, and with PRGF-2/OIS on the left side. Biopsies were collected at 6 wk and 34 wk after GBR-MSA/LRA. At the latter time point implants were placed. Radiographs (32 mo follow-up time) demonstrated excellent bone healing. No radiological or histological signs of inflammation were observed. Detailed histologic, histomorphometric, and immunohistochemical analysis of the biopsies evidenced that UA-ADRC/PRGF-2/OIS resulted in better and faster bone regeneration than PRGF-2/OIS. CONCLUSION GBR-MSA with UA-ADRCs, PRGF-2, and an OIS shows effectiveness without adverse effects.
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Affiliation(s)
- Önder Solakoglu
- External Visiting Lecturer, Dental Department of the University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
- Clinic for Periodontology and Implantology, Hamburg 22453, Germany.
| | - Werner Götz
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn 53111, Germany
| | - Maren C Kiessling
- Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich 80336, Germany
| | | | - Christoph Schmitz
- Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich 80336, Germany
| | - Eckhard U Alt
- InGeneron GmbH, Munich 80331, Germany
- InGeneron, Inc., Houston, TX 77054, United States
- Isar Klinikum Munich, 80331 Munich, Germany
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7
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Shahi S, Özcan M, Maleki Dizaj S, Sharifi S, Al-Haj Husain N, Eftekhari A, Ahmadian E. A review on potential toxicity of dental material and screening their biocompatibility. Toxicol Mech Methods 2019; 29:368-377. [PMID: 30642212 DOI: 10.1080/15376516.2019.1566424] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES A wide range of compounds are utilized in dentistry such as dental composites, resins, and implants. The successful clinical use of dental materials relies on theirm physiochemical properties as well as biological and toxicological reliability. Different local and systemic toxicities of dental materials have been reported. Placement of these materials in oral cavity for a long time period might yield unwanted reactions. An extensive variety of materials is used in dentistry including filling materials, restorative materials, intracanal medicines, prosthetic materials, different types of implants, liners, and irrigants. The increasing rate in development of the novel materials with applications in the dental field has led to an increased consciousness of the biological risks and tempting restrictions of these materials. The biocompatibility of a biomaterial used for the replacement or filling of biological tissue such as teeth always had a high concern within the health care disciplines for patients. MATERIALS AND METHODS Any material used in humans should be tested before clinical application. There are many tests evaluating biocompatibility of these materials at the point of in vitro, in vivo, and clinical investigations. RESULTS The current review discusses the potential toxicity of dental material and screening of their biocompatibility. CLINICAL RELEVANCE It is essential to use healthy and safe materials medical approaches. In dentistry, application of different materials in long-term oral usage demands low or nontoxic agents gains importance for both patients and the staff. Furthermore, screening tests should evaluate any potential toxicity before clinical application.
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Affiliation(s)
- Shahriar Shahi
- a Dental and Periodontal Research Center , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mutlu Özcan
- b Dental Materials Unit, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science , University of Zürich , Zurich , Switzerland
| | - Solmaz Maleki Dizaj
- a Dental and Periodontal Research Center , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Simin Sharifi
- a Dental and Periodontal Research Center , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Nadin Al-Haj Husain
- c Specialization Candidate, Department of Reconstructive Dentistry and Gerodontology , School of Dental Medicine, University of Bern , Bern , Switzerland
| | - Aziz Eftekhari
- d Pharmacology and Toxicology Department , Maragheh University of Medical Sciences , Maragheh , Iran
| | - Elham Ahmadian
- a Dental and Periodontal Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.,e Students' Research Committee , Tabriz University of Medical Sciences , Tabriz , Iran
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Bou Assaf R, Fayyad-Kazan M, Al-Nemer F, Makki R, Fayyad-Kazan H, Badran B, Berbéri A. Evaluation of the Osteogenic Potential of Different Scaffolds Embedded with Human Stem Cells Originated from Schneiderian Membrane: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2868673. [PMID: 30766881 PMCID: PMC6350594 DOI: 10.1155/2019/2868673] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 11/07/2018] [Accepted: 01/01/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Novel treatments for bone defects, particularly in patients with poor regenerative capacity, are based on bone tissue engineering strategies which include mesenchymal stem cells (MSCs), bioactive factors, and convenient scaffold supports. OBJECTIVE In this study, we aimed at comparing the potential for different scaffolds to induce osteogenic differentiation of human maxillary Schneiderian sinus membrane- (hMSSM-) derived cells. Methods. hMSSM-derived cells were seeded on gelatin, collagen, or Hydroxyapatite β-Tricalcium phosphate-Fibrin (Haβ-TCP-Fibrin) scaffolds. Cell viability was determined using an MTT assay. Alizarin red staining method, Alkaline phosphatase (ALP) activity assay, and quantitative real-time PCR analysis were performed to assess hMSSM-derived cells osteogenic differentiation. RESULTS Cell viability, calcium deposition, ALP activity, and osteoblastic markers transcription levels were most striking in gelatin scaffold-embedded hMSSM-derived cells. CONCLUSION Our findings suggest a promising potential for gelatin-hMSSM-derived cell construct for treating bone defects.
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Affiliation(s)
- Rita Bou Assaf
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Lebanese University, Beirut, Lebanon
| | - Mohammad Fayyad-Kazan
- Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Hadath- Beirut, Lebanon
| | - Fatima Al-Nemer
- Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Hadath- Beirut, Lebanon
| | - Rawan Makki
- Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Hadath- Beirut, Lebanon
| | - Hussein Fayyad-Kazan
- Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Hadath- Beirut, Lebanon
| | - Bassam Badran
- Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences-I, Lebanese University, Hadath- Beirut, Lebanon
| | - Antoine Berbéri
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Lebanese University, Beirut, Lebanon
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