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Kojima K, Kamata Y, Shimizu T, Sato S, Suzuki S, Takanashi Y, Hojo S, Yoshino T, Fuchida S, Tamura T, Minabe M, Kodama T, Kessoku T, Oyamada S. Recombinant human fibroblast growth factor and autogenous bone for periodontal regeneration: Alone or in combination? A randomized clinical trial. J Periodontal Res 2024. [PMID: 38853125 DOI: 10.1111/jre.13310] [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: 01/04/2024] [Revised: 05/22/2024] [Accepted: 05/26/2024] [Indexed: 06/11/2024]
Abstract
AIM To compare the outcomes of therapy using recombinant human fibroblast growth factor (rhFGF)-2 combined with autologous bone grafting (ABG) therapy with those of rhFGF-2 alone and ABG alone in the treatment of periodontal intraosseous defects. METHODS Periodontal intraosseous defects were randomized to receive rhFGF-2 therapy + ABG, rhFGF-2 therapy alone, or ABG alone. Periodontal examination and periapical radiography were performed preoperatively and at 3, 6, and 12 months postoperatively. RESULTS At the 12 months follow-up, all three groups showed significant improvement in the clinical attachment level (CAL): 5.6 ± 1.6, 5.8 ± 1.7, and 5.2 ± 1.6 mm in the rhFGF-2 + ABG, rhFGF-2 alone, and ABG alone groups, respectively, with no significant inter-group differences (p < .05). rhFGF-2 therapy (alone or in combination) resulted in greater bone defect filling (BDF) (2.3 ± 1.2 mm and 2.6 ± 1.9 mm, respectively) than ABG therapy alone (1.2 ± 1.2 mm). Gingival recession was lesser in the ABG alone (1.2 ± 1.1 mm) and rhFGF-2 + ABG groups (1.4 ± 0.8 mm) than in the rhFGF-2 alone group (2.2 ± 1.2 mm). CONCLUSION The results of this study showed that at 12 months postoperatively, all treatments resulted in statistically significant clinical improvements compared to the baseline. From these results, it can be concluded that rhFGF-2 promotes hard tissue regeneration in intraosseous defects.
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Affiliation(s)
- Kosuke Kojima
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Yohei Kamata
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Tomoko Shimizu
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Satsuki Sato
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Sota Suzuki
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Yuya Takanashi
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Sawako Hojo
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Takeshi Yoshino
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Shinya Fuchida
- Department of Education Planning, Kanagawa Dental University, Yokosuka, Japan
| | - Toshiyuki Tamura
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | | | - Toshiro Kodama
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Takaomi Kessoku
- Department of Gastroenterology, International University Health and Welfare Graduate School of Medicine, Chiba, Japan
| | - Shunsuke Oyamada
- Department of Biostatistics, JORTC Data Center 2-54-6-302, Tokyo, Japan
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Sexton B, Han Y, Dal-Fabbro R, Xu J, Kaigler D, Bottino MC. The role of fibroblast growth factor-2 in modulating the differentiation of periodontal ligament and alveolar bone-derived stem cells. Arch Oral Biol 2024; 165:106027. [PMID: 38870610 DOI: 10.1016/j.archoralbio.2024.106027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE This study examined how range concentrations of Fibroblast Growth Factor-2 (FGF-2) influence the differentiation and activity of human-derived periodontal ligament (hPDLSCs) and alveolar bone-derived stem cells (haBMSCs). DESIGN hPDLSCs and haBMSCs were cultured with varying concentrations of FGF-2 (0, 1, 2.5, 5, 10, 20 ng/mL) and monitored for osteogenic differentiation through alkaline phosphatase (ALP) activity and quantification of gene expression (qRT-PCR) for osteogenesis markers. Additionally, alizarin red staining and a hydroxyproline colorimetric assay evaluated and quantified osteogenic matrix mineralization and collagen deposition. Statistical analyses were performed using one-way ANOVA or two-way ANOVA for multiple comparisons between groups. RESULTS At low FGF-2 concentrations, hPDLSCs differentiated toward an osteogenic lineage, whereas higher concentrations of FGF-2 inhibited osteogenesis and promoted fibroblastic differentiation. The effect of FGF-2 at the lowest concentration tested (1 ng/mL) led to significantly higher ALP activity than osteogenically induced positive controls at early time points and equivalent RUNX2 expression at early and later time points. FGF-2 supplementation of haBMSC cultures was sufficient, at all concentrations, to increase ALP activity at an earlier time point. Mineralization of haBMSC cultures increased significantly within 5-20 ng/mL FGF-2 concentrations under basal growth media conditions (α-minimal essential medium supplemented with 15 % fetal bovine serum and 1 % penicillin/streptomycin). CONCLUSIONS FGF-2 has a dual capacity in promoting osteogenic and fibroblastic differentiation within hPDLSCs contingent upon the dosage and timing of administration, alongside supporting osteogenic differentiation in haBMSCs. These findings underscore the need for precision growth factors dosing when considering the design of biomaterials for periodontal regeneration.
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Affiliation(s)
- Benjamin Sexton
- Department of Biologic and Materials Science, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Yuanyuan Han
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Renan Dal-Fabbro
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Jinping Xu
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Darnell Kaigler
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States; Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, United States; Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, United States.
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De Lauretis A, Øvrebø Ø, Romandini M, Lyngstadaas SP, Rossi F, Haugen HJ. From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2308848. [PMID: 38380549 PMCID: PMC11077667 DOI: 10.1002/advs.202308848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/23/2024] [Indexed: 02/22/2024]
Abstract
Periodontitis is a dysbiosis-driven inflammatory disease affecting the tooth-supporting tissues, characterized by their progressive resorption, which can ultimately lead to tooth loss. A step-wise therapeutic approach is employed for periodontitis. After an initial behavioral and non-surgical phase, intra-bony or furcation defects may be amenable to regenerative procedures. This review discusses the regenerative technologies employed for periodontal regeneration, highlighting the current limitations and future research areas. The search, performed on the MEDLINE database, has identified the available biomaterials, including biologicals (autologous platelet concentrates, hydrogels), bone grafts (pure or putty), and membranes. Biologicals and bone grafts have been critically analyzed in terms of composition, mechanism of action, and clinical applications. Although a certain degree of periodontal regeneration is predictable in intra-bony and class II furcation defects, complete defect closure is hardly achieved. Moreover, treating class III furcation defects remains challenging. The key properties required for functional regeneration are discussed, and none of the commercially available biomaterials possess all the ideal characteristics. Therefore, research is needed to promote the advancement of more effective and targeted regenerative therapies for periodontitis. Lastly, improving the design and reporting of clinical studies is suggested by strictly adhering to the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.
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Affiliation(s)
- Angela De Lauretis
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Øystein Øvrebø
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Mario Romandini
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
| | - Ståle Petter Lyngstadaas
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
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Sawada K, Shimomura J, Takedachi M, Murata M, Morimoto C, Kawasaki K, Kawakami K, Iwayama T, Murakami S. Activation of periodontal ligament cell cytodifferentiation by juxtacrine signaling from cementoblasts. J Periodontol 2024; 95:256-267. [PMID: 37492992 DOI: 10.1002/jper.23-0211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/12/2023] [Accepted: 07/22/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND New cementum forms from existing cementum during periodontal tissue regeneration, indicating that cementoblasts may interact with progenitor cells in the periodontal ligament to enhance cementogenesis. However, the molecular mechanisms of this process are currently unknown. This study aims to clarify the role of cell-cell interactions between cementoblasts and periodontal ligament cells in differentiation into cementoblasts. METHODS To analyze the role of human cementoblast-like cells (HCEMs) on human periodontal ligament cells (HPDLs), we mixed cell suspensions of enhanced green fluorescent protein-tagged HPDLs and HCEMs, and then seeded and cultured them in single wells (direct co-cultures). We sorted co-cultured HPDLs and analyzed their characteristics, including the expression of cementum-related genes. In addition, we cultured HPDLs and HCEMs in a non-contact environment using a culture system composed of an upper insert and a lower well separated by a semi-permeable membrane (indirect co-cultures), and similar analysis was performed. Gene expression of integrin-binding sialoprotein (IBSP) in cementoblasts was confirmed in mouse periodontal tissues. We also investigated the effect of Wingless-type (Wnt) signaling on the differentiation of HPDLs into cementoblasts. RESULTS Direct co-culture of HPDLs with HCEMs significantly upregulated the expression of cementoblast-related genes in HPDLs, whereas indirect co-culture exerted no effect. Wnt3A stimulation significantly upregulated IBSP expression in HPDLs, whereas inhibition of canonical Wnt signaling suppressed the effects of co-culture. CONCLUSION Our results suggest that direct cell interactions with cementoblasts promote periodontal ligament cell differentiation into cementoblasts. Juxtacrine signaling via the canonical Wnt pathway plays a role in this interaction.
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Affiliation(s)
- Keigo Sawada
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Junpei Shimomura
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Masahide Takedachi
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Mari Murata
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Chiaki Morimoto
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Kohsuke Kawasaki
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Kazuma Kawakami
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Tomoaki Iwayama
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Shinya Murakami
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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Sabeti M, Ghobrial D, Zanjir M, da Costa BR, Young Y, Azarpazhooh A. Treatment outcomes of regenerative endodontic therapy in immature permanent teeth with pulpal necrosis: A systematic review and network meta-analysis. Int Endod J 2024; 57:238-255. [PMID: 37966465 DOI: 10.1111/iej.13999] [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: 12/16/2022] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
AIM The aim of this study was to assess which treatment modality regarding scaffold selection for immature permanent teeth with pulpal necrosis will be the most successful for regenerative endodontic treatment (RET). METHODOLOGY PubMed, Cochrane, Web of Science and Embase, and additional records until August 2022 were searched providing a total of 3021 articles, and nine of these articles were included for quantitative synthesis. The reviewers selected eligible randomized controlled trials and extracted pertinent data. Network meta-analysis was conducted to estimate treatment effects for primary outcomes (clinical and radiographic healing) and secondary outcomes (apical closure, root length and root wall thickness increase) following RET [mean difference (MD); 95% credible interval (CrI) and surface under the cumulative ranking curve (SUCRA)]. The quality of the included studies was appraised by the revised Cochrane risk of bias tool, and the quality of evidence was assessed using the GRADE approach. RESULTS Six interventions from nine included studies were identified: blood clot scaffold (BC), blood clot scaffold with basic fibroblast growth factor, blood clot scaffold with collagen, platelet pellet, platelet-rich plasma (PRP) and platelet-rich fibrin (PRF). The PRP scaffold showed the greatest increase in root lengthening at 6-12 months (MD = 4.2; 95% CrI, 1.2 to 6.8; SUCRA = 89.0%, very low confidence). PRP or PRF achieved the highest level of success for primary and secondary outcomes at 1-6 and 6-12 months. Blood clot scaffold (with collagen or combined with basic fibroblast growth factor (bFGF)) achieved the highest level of success for secondary outcomes beyond 12 months follow-up. A very low to low quality of evidence suggests that both PRP and PRF exhibit the greatest success evaluating primary and secondary outcomes within 12 months postoperatively compared to the traditional blood clot scaffold protocol. CONCLUSION Limited evidence suggests both PRP and PRF exhibit success in the short-term, not long-term. The value of this information stems in its recommendation for future randomized trials prioritizing both of these materials in their protocol.
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Affiliation(s)
- Mohammad Sabeti
- Department of Preventive and Restorative Dental Science, UCSF School of Dentistry, San Francisco, California, USA
| | - Daniel Ghobrial
- PG Endodontic Resident, UCSF School of Dentistry, San Francisco, California, USA
| | - Maryam Zanjir
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Bruno R da Costa
- Clinical Epidemiology & Health Care Research, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Yating Young
- UCSF School of Dentistry, San Francisco, California, USA
| | - Amir Azarpazhooh
- Head Division of Endodontics and Research, Director, Department of Dentistry, Faculty of Advanced Training Program in Orofacial, Faculty of Dentistry, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada
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Koidou VP, Hagi-Pavli E, Nibali L, Donos N. Elucidating the molecular healing of intrabony defects following non-surgical periodontal therapy: A pilot study. J Periodontal Res 2024; 59:53-62. [PMID: 38010805 DOI: 10.1111/jre.13207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE To elucidate the molecular healing of intrabony defects following non-surgical periodontal therapy (NSPT) using gingival crevicular fluid (GCF). BACKGROUND DATA Currently limited information is available regarding the GCF of intrabony defects and the change in biomarker levels in the GCF at early time points following treatment interventions. METHODS Twenty-one patients (Periodontitis Stage III or IV) who have received NSPT, contributing one intrabony defect and one healthy site were included in this study. GCF sampling was performed at baseline, 1 day, 5 days and 3 months after NSPT. Multiplex bead immunoassays allowed the profiling of GCF for 27 markers, associated with inflammation and repair/regeneration. A mixed effects model with Bonferroni correction for multiple comparisons was employed to compare the changes in the levels of GCF markers over time. RESULTS Following NSPT, changes were observed for several GCF markers, marked by significant increases 1 day post-intervention, before returning to baseline levels by 3 months. Specifically, GCF concentrations of IL-2, IL-4, IL-6, IL-8, MMP-1, MMP-3, TIMP-1 and FGFb significantly increased 1 day after NSPT. Signs of activation of cellular senescence were observed 1 day following treatment of intrabony defects, rapidly regressing by 5 days. CONCLUSION Significant molecular changes are observed as early as 1 day following NSPT in intrabony defects, along with activation of cellular senescence.
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Affiliation(s)
- Vasiliki P Koidou
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Centre for Immunobiology and Regenerative Medicine, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Eleni Hagi-Pavli
- Centre for Immunobiology and Regenerative Medicine, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Luigi Nibali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Periodontology Unit, Centre for Host Microbiome Interactions, King's College London, London, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Centre for Immunobiology and Regenerative Medicine, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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Bizenjima T, Irokawa D, Yamada S, Saito A, Tomita S. A Case Report of Periodontal Regenerative Therapy Using Recombinant Human Fibroblast Growth Factor 2 and Deproteinized Bovine Bone Mineral with Non-incised Papillae Surgical Approach (NIPSA) for Angular Bone Defect in Patient with Stage III Grade C Periodontitis. THE BULLETIN OF TOKYO DENTAL COLLEGE 2023; 64:145-155. [PMID: 37967939 DOI: 10.2209/tdcpublication.2023-0011] [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] [Indexed: 11/17/2023]
Abstract
This report describes a case of Stage III Grade C periodontitis requiring periodontal regenerative therapy. The patient was a 19-year-old woman who presented with the chief complaint of gingival recession in the incisor region. An initial examination revealed that 45.3% of sites had a probing depth of ≥4 mm and 45.8% bleeding on probing. Radiographic examination showed angular bone resorption in #25, 26, 31, 36, and 46 and horizontal resorption in other regions. Initial periodontal therapy was implemented based on a clinical diagnosis of Stage III Grade C periodontitis (generalized aggressive periodontitis). Occlusal adjustment was also performed at sites showing premature contact (#26 and 36) after suppression of inflammation. Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF) -2 was performed on #25, 26, and 46. Combination therapy with rhFGF-2 and deproteinized bovine bone mineral (DBBM) was performed on #31 and 36. A non-incised papillae surgical approach (NIPSA) was used on #31. Periodontal conditions were then re-evaluated and the patient placed on supportive periodontal therapy. Regenerative therapy using rhFGF-2 and DBBM with NIPSA yielded an improvement in clinical parameters and bone resorption. This improvement has been adequately maintained over a 12-month period. Continued care is needed to maintain stable periodontal conditions.
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Saito Y, Imamura K, Seshima F, Nakazaki T, Tomita S, Saito A. Periodontal Regenerative Therapy with Recombinant Human Fibroblast Growth Factor (rhFGF) -2 for Stage III Grade C Periodontitis: A Case Report with 6-month Follow-up. THE BULLETIN OF TOKYO DENTAL COLLEGE 2023; 64:135-144. [PMID: 37967937 DOI: 10.2209/tdcpublication.2023-0018] [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] [Indexed: 11/17/2023]
Abstract
This report describes a case of generalized chronic periodontitis requiring periodontal regenerative therapy. The patient was a 56-year-old woman visiting the Tokyo Dental College Suidobashi Hospital with the chief complaint of swelling in the maxillary right gingiva. An initial examination revealed 34.0% of sites with a probing depth (PD) of ≥4 mm. The prevalence of sites with bleeding on probing was 32.7%. The plaque control record (PCR) score was 65.7%. Radiographic examination revealed angular bone resorption at #18 and 48. Horizontal absorption was also observed in other areas. The percent bone loss/age at #48 was 1.07. A clinical diagnosis of generalized chronic periodontitis (Stage III, Grade C) was made. Based on the clinical diagnosis of severe chronic periodontitis, initial periodontal therapy was performed. An improvement was observed in periodontal conditions at re-evaluation. The PCR score was 16.7%. Periodontal surgery was performed for teeth with a residual PD of ≥4 mm. Periodontal regenerative therapy using rhFGF-2 were performed on intrabony defects in #18 and 48. Open flap debridement was performed on #16, 26, and 27. Following evaluation, oral function was restored using all-ceramic crowns (#46). At 6 months postoperatively, the patient was transitioned to supportive periodontal therapy (SPT). During the 6-month SPT, stable periodontal conditions that facilitated a favourable level of plaque control were maintained.
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Affiliation(s)
| | | | - Fumi Seshima
- Department of Periodontology, Tokyo Dental College
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Krasilnikova O, Yakimova A, Ivanov S, Atiakshin D, Kostin AA, Sosin D, Shegay P, Kaprin AD, Klabukov I. Gene-Activated Materials in Regenerative Dentistry: Narrative Review of Technology and Study Results. Int J Mol Sci 2023; 24:16250. [PMID: 38003439 PMCID: PMC10671237 DOI: 10.3390/ijms242216250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Treatment of a wide variety of defects in the oral and maxillofacial regions requires the use of innovative approaches to achieve best outcomes. One of the promising directions is the use of gene-activated materials (GAMs) that represent a combination of tissue engineering and gene therapy. This approach implies that biocompatible materials will be enriched with gene-carrying vectors and implanted into the defect site resulting in transfection of the recipient's cells and secretion of encoded therapeutic protein in situ. GAMs may be presented in various designs depending on the type of material, encoded protein, vector, and way of connecting the vector and the material. Thus, it is possible to choose the most suitable GAM design for the treatment of a particular pathology. The use of plasmids for delivery of therapeutic genes is of particular interest. In the present review, we aimed to delineate the principle of work and various designs of plasmid-based GAMs and to highlight results of experimental and clinical studies devoted to the treatment of periodontitis, jaw bone defects, teeth avulsion, and other pathologies in the oral and maxillofacial regions.
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Affiliation(s)
- Olga Krasilnikova
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia
| | - Anna Yakimova
- A. Tsyb Medical Radiological Research Centre—Branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Zhukov St. 10, 249031 Obninsk, Russia
| | - Sergey Ivanov
- A. Tsyb Medical Radiological Research Centre—Branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Zhukov St. 10, 249031 Obninsk, Russia
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples’ Friendship University of Russia (RUDN University), Miklukho-Maklay St. 6, 117198 Moscow, Russia
| | - Dmitri Atiakshin
- Scientific and Educational Resource Center for Innovative Technologies of Immunophenotyping, Digital Spatial Profiling and Ultrastructural Analysis, Patrice Lumumba Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Andrey A. Kostin
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples’ Friendship University of Russia (RUDN University), Miklukho-Maklay St. 6, 117198 Moscow, Russia
| | - Dmitry Sosin
- Centre for Strategic Planning and Management of Biomedical Health Risks of the Federal Medical Biological Agency, 119121 Moscow, Russia
| | - Peter Shegay
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia
| | - Andrey D. Kaprin
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples’ Friendship University of Russia (RUDN University), Miklukho-Maklay St. 6, 117198 Moscow, Russia
| | - Ilya Klabukov
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples’ Friendship University of Russia (RUDN University), Miklukho-Maklay St. 6, 117198 Moscow, Russia
- Obninsk Institute for Nuclear Power Engineering, National Research Nuclear University MEPhI, Studgorodok 1, 249039 Obninsk, Russia
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Nagayasu-Tanaka T, Anzai J, Takedachi M, Kitamura M, Harada T, Murakami S. Effects of combined application of fibroblast growth factor (FGF)-2 and carbonate apatite for tissue regeneration in a beagle dog model of one-wall periodontal defect. Regen Ther 2023; 23:84-93. [PMID: 37122358 PMCID: PMC10141504 DOI: 10.1016/j.reth.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/14/2023] [Accepted: 04/06/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction There has been an increasing desire for the development of predictive periodontal regenerative therapy for severe periodontitis. In this study, we investigated the effect of the combined use of fibroblast growth factor-2 (FGF-2), a drug for periodontal regeneration approved in Japan, and carbonated apatite (CO3Ap), bioresorbable and osteoconductive scaffold, on periodontal regeneration in beagle dog model of one-wall periodontal defect (severe intraosseous defect) for 24 weeks in comparison with CO3Ap or vehicle alone. Methods One-wall periodontal defects were created (mesiodistal width × depth: 4 × 4 mm) on the mesial portion of the mandibular first molar (M1) of beagle dogs on both side. Mixture of FGF-2 and CO3Ap, vehicle and CO3Ap, or vehicle alone were administered to the defects and designated as groups FGF-2+CO3Ap, CO3Ap, and control, respectively. To assess the periodontal regeneration, radiographic analysis over time for 24 weeks, and micro computed tomography (μCT) and histological evaluation at 6 and 24 weeks were performed. Results For the regenerated tissue in the defect site, the mineral content of the FGF-2+CO3Ap group was higher than that of the CO3Ap group in the radiographic analysis at 6-24 weeks. In the context of new bone formation and replacement, the FGF-2+CO3Ap group exhibited significantly greater new bone volume and smaller CO3Ap volume than the CO3Ap group in the μCT analysis at 6 and 24 weeks. Furthermore, the density of the new bone in the FGF-2+CO3Ap group at 24 weeks was similar to those in the control and CO3Ap groups. Histological evaluation revealed that the length of the new periodontal ligament and cementum in the FGF-2+CO3Ap group was greater than that in the CO3Ap group at 6 weeks. We also examined the effect of the combined use of the FGF-2 and CO3Ap on the existing bone adjacent to the defect and demonstrated that the existing bone height and volume in the FGF-2+CO3Ap group remained significantly greater than those in the CO3Ap group. Conclusion This study demonstrated that the combination of FGF-2 and CO3Ap was effective not only in enhancing new bone formation and replacing scaffold but also in maintaining the existing bone adjacent to the defect site in a beagle dog model of one-wall periodontal defect. Additionally, new periodontal tissues induced by FGF-2 and CO3Ap may follow a maturation process similar to that formed by spontaneous healing. This suggests that the combined use of FGF-2 and CO3Ap would promote periodontal regeneration in severe bony defects of periodontitis patient.
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Affiliation(s)
- Toshie Nagayasu-Tanaka
- Pharmacology Department, Drug Research Center, Kaken Pharmaceutical Co., LTD., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto, 607-8042, Japan
| | - Jun Anzai
- Pharmacology Department, Drug Research Center, Kaken Pharmaceutical Co., LTD., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto, 607-8042, Japan
| | - Masahide Takedachi
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masahiro Kitamura
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tatsuhiro Harada
- Pharmacology Department, Drug Research Center, Kaken Pharmaceutical Co., LTD., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto, 607-8042, Japan
| | - Shinya Murakami
- Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
- Corresponding author. Shinya Murakami Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
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11
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Takayama T, Imamura K, Yamano S. Growth Factor Delivery Using a Collagen Membrane for Bone Tissue Regeneration. Biomolecules 2023; 13:biom13050809. [PMID: 37238679 DOI: 10.3390/biom13050809] [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: 03/24/2023] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
The use of biomaterials and bioactive agents has shown promise in bone defect repair, leading to the development of strategies for bone regeneration. Various artificial membranes, especially collagen membranes (CMs) that are widely used for periodontal therapy and provide an extracellular matrix-simulating environment, play a significant role in promoting bone regeneration. In addition, numerous growth factors (GFs) have been used as clinical applications in regenerative therapy. However, it has been established that the unregulated administration of these factors may not work to their full regenerative potential and could also trigger unfavorable side effects. The utilization of these factors in clinical settings is still restricted due to the lack of effective delivery systems and biomaterial carriers. Hence, considering the efficiency of bone regeneration, both spaces maintained using CMs and GFs can synergistically create successful outcomes in bone tissue engineering. Therefore, recent studies have demonstrated a significant interest in the potential of combining CMs and GFs to effectively promote bone repair. This approach holds great promise and has become a focal point in our research. The purpose of this review is to highlight the role of CMs containing GFs in the regeneration of bone tissue, and to discuss their use in preclinical animal models of regeneration. Additionally, the review addresses potential concerns and suggests future research directions for growth factor therapy in the field of regenerative science.
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Affiliation(s)
- Tadahiro Takayama
- Department of Periodontology, Nihon University School of Dentistry, Tokyo 101-8310, Japan
- Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo 101-8310, Japan
| | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, Tokyo 101-0061, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Seiichi Yamano
- Department of Prosthodontics, New York University College of Dentistry, New York, NY 10010, USA
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12
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Pouliou MM, Fragkioudakis I, Doufexi AE, Batas L. The role of rhFGF-2 in periodontal defect bone fill: A systematic review of the literature. J Periodontal Res 2023. [PMID: 37130815 DOI: 10.1111/jre.13131] [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: 02/22/2023] [Revised: 04/06/2023] [Accepted: 04/20/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Growth factors have been used with success in periodontal regeneration, especially in intrabony defects. Among those, the recombined form of fibroblast growth factor-2 (rhFGF-2) has been also examined. OBJECTIVE To address the outcomes of periodontal regeneration using rhFGF-2 alone or in combination with bone substitutes primarily in terms of Radiographic Bone Fill (RBF%) and secondary Probing Pocket Depth (PPD), and Probing Attachment Levels (PAL). MATERIAL AND METHODS A search in MEDLINE and EMBASE using the Ovid interface was conducted from 2000 up to and including the 12th of November 2022. Starting from the initially identified 1289 articles, 34 studies were selected for further analysis. Following the full-text screening, 7 of the 34 studies met the inclusion criteria and thus were included in the systematic review after assessing their quality according to the Newcastle-Ottawa scale (NOS). Clinical and radiographic results (bone gain, pocket depth, and clinical attachment level) after the application of FGF-2 alone or in combination with different carriers were studied in patients with intrabony defects of at least one wall and pocket depth greater than 4 mm. RESULTS Primary outcomes: RBF% was higher in studies using a combination of rhFGF-2 and bone substitutes (74.6 ± 20.0%) compared to others using the specific growth factor alone or negative controls (22.7 ± 20.7%). In terms of secondary outcomes, the analysis failed to show an additional benefit from the use of the rhFGF-2 alone or in combination with bone substitutes. CONCLUSION rhFGF-2 can improve RBF% in the treatment of periodontal defects, especially when it is used in combination with a bone substitute.
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Affiliation(s)
| | - Ioannis Fragkioudakis
- Department of Preventive Dentistry, Periodontology, and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini-Elisavet Doufexi
- Department of Preventive Dentistry, Periodontology, and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Leonidas Batas
- Department of Preventive Dentistry, Periodontology, and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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13
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Yoneyama Y, Matsuno T, Fujioka-Kobayashi M, Satomi T. In vitro and in vivo evaluation of surface functionalization of titanium with H 2 O 2 hydrothermal treatment and FGF-2. J Biomed Mater Res B Appl Biomater 2023; 111:646-655. [PMID: 36245283 DOI: 10.1002/jbm.b.35183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 01/21/2023]
Abstract
The goals of the study were to investigate the effects on bone bioactivity of a titanium dioxide layer formed by hydrothermal oxidation of a titanium surface with hydrogen peroxide (H2 O2 ) and loading with fibroblast growth factor-2 (FGF-2) in vitro and in vivo. Ti-6Al-4V discs were hydrothermally oxidized with H2 O2 and then loaded with FGF-2. After cytotoxicity testing, Ti-6Al-4V mini-implants were subjected to the same treatment, and their osteogenic potential was evaluated histologically in a rat model. H2 O2 hydrothermal oxidation resulted in a dense porous network structure and hydrophilic changes, which improved retention of FGF-2. Morphologically, the cell density was higher, cell elongation was more pronounced, and the cell adhesion area was significantly higher in FGF-2-loaded cells than in those without FGF-2. In a cell proliferation assay using mouse osteoblast-like cells, absorbance tended to increase over time, especially in the FGF-2 group after 7 and 14 days, and in a bone differentiation assay based on ALP activity, there was a significant increase in the FGF-2 group after 14 days. In the rat model, H2 O2 hydrothermal oxidation and FGF-2 loading both resulted in more laminar bone tissue in the bone marrow around the mini-implant. These results suggest that titanium surface functionalization by H2 O2 hydrothermal oxidation and FGF-2 may promote initial cell adhesion, proliferation, and osteodifferentiation, and enhance bone bioactivity. These effects all contribute to early bonding of an implant with the surrounding bone.
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Affiliation(s)
- Yuya Yoneyama
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Tokyo, Fujimi, Japan
| | - Tomonori Matsuno
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Tokyo, Fujimi, Japan
| | - Masako Fujioka-Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Tokyo, Fujimi, Japan
| | - Takafumi Satomi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Tokyo, Fujimi, Japan
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14
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Qin S, Zhu J, Zhang G, Sui Q, Niu Y, Ye W, Ma G, Liu H. Research progress of functional motifs based on growth factors in cartilage tissue engineering: A review. Front Bioeng Biotechnol 2023; 11:1127949. [PMID: 36824354 PMCID: PMC9941568 DOI: 10.3389/fbioe.2023.1127949] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/20/2023] [Indexed: 02/10/2023] Open
Abstract
Osteoarthritis is a chronic degenerative joint disease that exerts significant impacts on personal life quality, and cartilage tissue engineering is a practical treatment in clinical. Various growth factors are involved in cartilage regeneration and play important roles therein, which is the focus of current cartilage repair strategy. To compensate for the purification difficulty, high cost, poor metabolic stability, and circulating dilution of natural growth factors, the concept of functional motifs (also known as mimetic peptides) from original growth factor was introduced in recent studies. Here, we reviewed the selection mechanisms, biological functions, carrier scaffolds, and modification methods of growth factor-related functional motifs, and evaluated the repair performance in cartilage tissue engineering. Finally, the prospects of functional motifs in researches and clinical application were discussed.
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Affiliation(s)
- Shengao Qin
- School of Stomatology, Dalian Medical University, Dalian, China,Academician Laboratory of Immune and Oral Development and Regeneration, Dalian Medical University, Dalian, China
| | - Jiaman Zhu
- Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China,Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Guangyong Zhang
- School of Stomatology, Dalian Medical University, Dalian, China,Academician Laboratory of Immune and Oral Development and Regeneration, Dalian Medical University, Dalian, China
| | - Qijia Sui
- School of Stomatology, Dalian Medical University, Dalian, China,Academician Laboratory of Immune and Oral Development and Regeneration, Dalian Medical University, Dalian, China
| | - Yimeng Niu
- School of Stomatology, Dalian Medical University, Dalian, China,Academician Laboratory of Immune and Oral Development and Regeneration, Dalian Medical University, Dalian, China
| | - Weilong Ye
- School of Stomatology, Dalian Medical University, Dalian, China,Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China,*Correspondence: Weilong Ye, ; Guowu Ma, ; Huiying Liu,
| | - Guowu Ma
- School of Stomatology, Dalian Medical University, Dalian, China,Academician Laboratory of Immune and Oral Development and Regeneration, Dalian Medical University, Dalian, China,*Correspondence: Weilong Ye, ; Guowu Ma, ; Huiying Liu,
| | - Huiying Liu
- School of Stomatology, Dalian Medical University, Dalian, China,Academician Laboratory of Immune and Oral Development and Regeneration, Dalian Medical University, Dalian, China,*Correspondence: Weilong Ye, ; Guowu Ma, ; Huiying Liu,
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15
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Kitamura M, Yamashita M, Miki K, Ikegami K, Takedachi M, Kashiwagi Y, Nozaki T, Yamanaka K, Masuda H, Ishihara Y, Murakami S. An exploratory clinical trial to evaluate the safety and efficacy of combination therapy of REGROTH® and Cytrans® granules for severe periodontitis with intrabony defects. Regen Ther 2022; 21:104-113. [PMID: 35785043 PMCID: PMC9234541 DOI: 10.1016/j.reth.2022.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/06/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Currently, flap operation (FOP) using REGROTH® (0.3% basic fibroblast growth factor [FGF-2]) is the standard treatment for periodontal regenerative therapy in Japan. However, the periodontal tissue regenerative effect with REGROTH® monotherapy is inadequate for severe alveolar bone defects. Therefore, in this study, we evaluated the safety and effectiveness of periodontal regenerative therapy for patients with severe periodontitis using REGROTH® (test medicine) combined with Cytrans® Granules (test device: carbonated apatite granules), which is a new artificial bone. Methods The study participants included 10 patients with severe periodontitis (mean age: 47.4 years). All participants provided written informed consents. In each patient, the intrabony defect site (mean bone defect depth: 5.7 mm) was defined as the test site. FOP was performed for the test site after the baseline investigation; moreover, the test medicine and test device were administered simultaneously. Furthermore, the observation of subjects’ general condition and test sites was conducted and the blood, urine, and periodontal tissue tests were performed up to 36 weeks after FOP. The rate of bone increase (%), clinical attachment level (CAL), probing pocket depth (PPD), bleeding on probing (BOP), tooth mobility (Mo), width of keratinized gingiva (KG), gingival recession (REC), gingival index (GI), and plaque index (PlI) were evaluated during the periodontal tissue investigation. Results As the primary endpoint, no adverse events related to the test medicine and test device occurred during the entire observation period of this study. Regarding the secondary endpoints, there was a significant increase in new alveolar bone (p = 0.003) and CAL acquisition (p = 0.001) as well as decrease in PPD (p = 0.002) and BOP (p = 0.016) at 36 weeks after administration of the test medicine and test device compared with the preoperative values. Furthermore, at 36 weeks after surgery, the Mo, GI, and PlI decreased to preoperative levels at 40%, 60%, and 30% of sites, respectively. However, at 36 weeks after surgery, there was no difference in KG and REC compared with their preoperative values. Conclusions The safety of periodontal regenerative therapy using the test medicine in combination with the abovementioned test device was confirmed. In addition, it was suggested that this periodontal regenerative therapy is effective for tissue regeneration in severe alveolar bone defects. This clinical trial was conducted after registering and publicizing as a specified clinical trial in the Japan registry of clinical trials (jRCTs051190045). The safety of flap operation using 0.3% FGF-2 and carbonated apatite was confirmed. The administration of 0.3% FGF-2 and carbonated apatite improved periodontitis. Combining 0.3% FGF-2 and carbonated apatite for severe alveolar bone defects. Periodontal regenerative therapy combining both could be effective.
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16
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Seshima F, Bizenjima T, Aoki H, Imamura K, Kita D, Irokawa D, Matsugami D, Kitamura Y, Yamashita K, Sugito H, Tomita S, Saito A. Periodontal Regenerative Therapy Using rhFGF-2 and Deproteinized Bovine Bone Mineral versus rhFGF-2 Alone: 4-Year Extended Follow-Up of a Randomized Controlled Trial. Biomolecules 2022; 12:1682. [PMID: 36421696 PMCID: PMC9688011 DOI: 10.3390/biom12111682] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 08/06/2023] Open
Abstract
The aim of this study was to evaluate longitudinal outcomes of recombinant human fibroblast growth factor (rhFGF)-2 plus deproteinized bovine bone mineral (DBBM) therapy in comparison with rhFGF-2 alone for treating periodontal intrabony defects. This study describes 4-year follow-up outcomes of the original randomized controlled trial. Intrabony defects in periodontitis patients were treated with rhFGF-2 (control) or rhFGF-2 plus DBBM (test). Clinical, radiographic, and patient-reported outcome (PRO) measures were used to evaluate the outcomes. Thirty-two sites were able to be followed up. At 4 years postoperatively, clinical attachment level (CAL) gains in the test and control groups were 3.5 ± 1.4 mm and 2.7 ± 1.4 mm, respectively, showing significant improvement from preoperative values but no difference between groups. Both groups showed an increase in radiographic bone fill (RBF) over time. At 4 years, the mean value for RBF in the test group (62%) was significantly greater than that in the control group (42%). In 1-2-wall defects, the test treatment yielded significantly greater RBF than the control treatment. No significant difference in PRO scores was noted between the groups. Although no significant difference in CAL gain was found between the groups at the 4-year follow-up, the combination treatment significantly enhanced RBF. Favorable clinical, radiographic outcomes, and PRO in both groups can be maintained for at least 4 years.
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Affiliation(s)
- Fumi Seshima
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | | | - Hideto Aoki
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo 1010061, Japan
| | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo 1010061, Japan
| | - Daichi Kita
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Daisuke Irokawa
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Daisuke Matsugami
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Yurie Kitamura
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Keiko Yamashita
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Hiroki Sugito
- Department of Dental Hygiene, Tokyo Dental Junior College, Tokyo 1010061, Japan
- Department of Operative Dentistry, Cariology and Pulp Biology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Sachiyo Tomita
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo 1010061, Japan
- Oral Health Science Center, Tokyo Dental College, Tokyo 1010061, Japan
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17
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Nagahara T, Takeda K, Inoue S, Wada K, Shiba H. Successful regenerative response of a severe bone defect in a right lower central incisor affected by a cemental tear. Clin Case Rep 2022; 10:e6472. [PMCID: PMC9637247 DOI: 10.1002/ccr3.6472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Takayoshi Nagahara
- Nippon Kokan Fukuyama Hospital Hiroshima Japan
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Katsuhiro Takeda
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | | | | | - Hideki Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
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Hautmann A, Kedilaya D, Stojanović S, Radenković M, Marx CK, Najman S, Pietzsch M, Mano JF, Groth T. Free-standing multilayer films as growth factor reservoirs for future wound dressing applications. BIOMATERIALS ADVANCES 2022; 142:213166. [PMID: 36306555 DOI: 10.1016/j.bioadv.2022.213166] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/12/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Chronic skin wounds place a high burden on patients and health care systems. The use of angiogenic and mitogenic growth factors can facilitate the healing but growth factors are quickly inactivated by the wound environment if added exogenously. Here, free-standing multilayer films (FSF) are fabricated from chitosan and alginate as opposing polyelectrolytes in an alternating manner using layer-by-layer technique. One hundred bilayers form an about 450 μm thick, detachable free-standing film that is subsequently crosslinked by either ethyl (dimethylaminopropyl) carbodiimide combined with N-hydroxysuccinimide (E-FSF) or genipin (G-FSF). The characterization of swelling, oxygen permeability and crosslinking density shows reduced swelling and oxygen permeability for both crosslinked films compared to non-crosslinked films (N-FSF). Loading of fibroblast growth factor 2 (FGF2) into the films results in a sustained release from crosslinked FSF in comparison to non-crosslinked FSF. Biocompatibility studies in vitro with human dermal fibroblasts cultured underneath the films demonstrate increased cell growth and cell migration for all films with and without FGF2. Especially G-FSF loaded with FGF2 greatly increases cell proliferation and migration. In vivo biocompatibility studies by subcutaneous implantation in mice show that E-FSF causes an inflammatory tissue response that is absent in the case of G-FSF. N-FSF also represents a biocompatible film but shows early degradation. All FSF possess antibacterial properties against gram+ and gram- bacteria demonstrated by an agar diffusion disc assay. In summary, FSF made of alginate and chitosan crosslinked with genipin can act as a reservoir for the sustained release of FGF2, possessing high biocompatibility in vitro and in vivo. Moreover, G-FSF promotes growth and migration of human dermal fibroblasts and has antibacterial properties, which makes it an interesting candidate for bioactive wound.
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Affiliation(s)
- Adrian Hautmann
- Department of Biomedical Materials, Institute of Pharmacy, Martin Luther University Halle-Wittenberg, Heinrich-Damerow-Strasse 4, 06120 Halle (Saale), Germany
| | - Devaki Kedilaya
- Department of Biomedical Materials, Institute of Pharmacy, Martin Luther University Halle-Wittenberg, Heinrich-Damerow-Strasse 4, 06120 Halle (Saale), Germany
| | - Sanja Stojanović
- Department for Cell and Tissue Engineering, Scientific Research Center for Biomedicine, Faculty of Medicine, University of Niš, Blvd. Dr Zorana Đinđića 81, 18000, Niš, Serbia; Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Milena Radenković
- Department for Cell and Tissue Engineering, Scientific Research Center for Biomedicine, Faculty of Medicine, University of Niš, Blvd. Dr Zorana Đinđića 81, 18000, Niš, Serbia
| | - Christian K Marx
- Department of Downstream Processing, Institute of Pharmacy, Martin Luther University Halle-Wittenberg, Weinbergweg 22, 06120 Halle (Saale), Germany
| | - Stevo Najman
- Department for Cell and Tissue Engineering, Scientific Research Center for Biomedicine, Faculty of Medicine, University of Niš, Blvd. Dr Zorana Đinđića 81, 18000, Niš, Serbia; Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Markus Pietzsch
- Department of Downstream Processing, Institute of Pharmacy, Martin Luther University Halle-Wittenberg, Weinbergweg 22, 06120 Halle (Saale), Germany
| | - João F Mano
- CICECO-Aveiro Institute of Materials, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Thomas Groth
- Department of Biomedical Materials, Institute of Pharmacy, Martin Luther University Halle-Wittenberg, Heinrich-Damerow-Strasse 4, 06120 Halle (Saale), Germany; Interdisciplinary Center of Material Research, Martin Luther University Halle-Wittenberg, Germany.
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Swanson WB, Yao Y, Mishina Y. Novel approaches for periodontal tissue engineering. Genesis 2022; 60:e23499. [PMID: 36086991 PMCID: PMC9787372 DOI: 10.1002/dvg.23499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 12/30/2022]
Abstract
The periodontal complex involves the hard and soft tissues which support dentition, comprised of cementum, bone, and the periodontal ligament (PDL). Periodontitis, a prevalent infectious disease of the periodontium, threatens the integrity of these tissues and causes irreversible damage. Periodontal therapy aims to repair and ultimately regenerate these tissues toward preserving native dentition and improving the physiologic integration of dental implants. The PDL contains multipotent stem cells, which have a robust capacity to differentiate into various types of cells to form the PDL, cementum, and alveolar bone. Selection of appropriate growth factors and biomaterial matrices to facilitate periodontal regeneration are critical to recapitulate the physiologic organization and function of the periodontal complex. Herein, we discuss the current state of clinical periodontal regeneration including a review of FDA-approved growth factors. We will highlight advances in preclinical research toward identifying additional growth factors capable of robust repair and biomaterial matrices to augment regeneration similarly and synergistically, ultimately improving periodontal regeneration's predictability and long-term efficacy. This review should improve the readers' understanding of the molecular and cellular processes involving periodontal regeneration essential for designing comprehensive therapeutic approaches.
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Affiliation(s)
- W. Benton Swanson
- Department of Biologic and Materials Science, Division of ProsthodonticsUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Yao Yao
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA,Biointerfaces InstituteUniversity of MichiganAnn ArborMichiganUSA
| | - Yuji Mishina
- Department of Biologic and Materials Science, Division of ProsthodonticsUniversity of Michigan School of DentistryAnn ArborMichiganUSA
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Liu Y, Guo L, Li X, Liu S, Du J, Xu J, Hu J, Liu Y. Challenges and tissue engineering strategies of periodontal guided tissue regeneration. Tissue Eng Part C Methods 2022; 28:405-419. [PMID: 35838120 DOI: 10.1089/ten.tec.2022.0106] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Periodontitis is a chronic infectious oral disease with a high prevalence rate in the world, and is a major cause of tooth loss. Nowadays, people have realized that the local microenvironment that includes proteins, cytokines, and extracellular matrix has a key influence on the functions of host immune cells and periodontal ligament stem cells during a chronic infectious disease such as periodontitis. The above pathological process of periodontitis will lead to a defect of periodontal tissues. Through the application of biomaterials, biological agents, and stem cells therapy, guided tissue regeneration (GTR) makes it possible to reconstruct healthy periodontal ligament tissue after local inflammation control. To date, substantial advances have been made in periodontal guided tissue regeneration. However, the process of periodontal remodeling experiences complex microenvironment changes, and currently periodontium regeneration still remains to be a challenging feat. In this review, we summarized the main challenges in each stage of periodontal regeneration, and try to put forward appropriate biomaterial treatment mechanisms or potential tissue engineering strategies that provide a theoretical basis for periodontal tissue engineering regeneration research.
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Affiliation(s)
- Yitong Liu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Lijia Guo
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China;
| | - Xiaoyan Li
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Siyan Liu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Juan Du
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Junji Xu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Jingchao Hu
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China;
| | - Yi Liu
- Capital Medical University School of Stomatology, Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction,, Tian Tan Xi Li No.4, Beijing, Beijing , China, 100050;
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21
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Shirakata Y, Setoguchi F, Sena K, Nakamura T, Imafuji T, Shinohara Y, Iwata M, Noguchi K. Comparison of periodontal wound healing/regeneration by recombinant human fibroblast growth factor-2 combined with β-tricalcium phosphate, carbonate apatite, or deproteinized bovine bone mineral in a canine one-wall intra-bony defect model. J Clin Periodontol 2022; 49:599-608. [PMID: 35322457 DOI: 10.1111/jcpe.13619] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/02/2022] [Accepted: 03/19/2022] [Indexed: 01/29/2023]
Abstract
AIM To evaluate periodontal wound healing/regeneration of one-wall intra-bony defects treated with recombinant human fibroblast growth factor-2 (rhFGF-2) and beta-tricalcium phosphate (β-TCP), carbonate apatite (CO3 Ap), or deproteinized bovine bone mineral (DBBM) in dogs. MATERIALS AND METHODS The stability of rhFGF-2 adsorbed onto the bone substitutes was evaluated by Enzyme-Linked Immunosorbent Assay (ELISA). One-wall intra-bony defects (5 × 5 × 5 mm) created in five adult male beagle dogs were treated with rhFGF-2 alone (rhFGF-2), rhFGF-2 with β-TCP (rhFGF-2/β-TCP), rhFGF-2 with CO3 Ap (rhFGF-2/CO3 Ap), or rhFGF-2 with DBBM (rhFGF-2/DBBM). Histological outcomes (e.g., linear length of new cementum adjacent to the newly formed bone with inserting collagen fibres [NA] as the primary outcome) were evaluated at 10 weeks post surgery. RESULTS Significantly higher amount of rhFGF-2 was adsorbed onto CO3 Ap compared with β-TCP. Among the treatment groups, the rhFGF-2/DBBM group showed the highest amount of periodontal tissue regeneration. The rhFGF-2/DBBM group showed significantly greater formation of NA (3.22 ± 0.40 mm) compared with rhFGF-2 (1.17 ± 1.00 mm, p < .01) group. Additionally, new bone area in the rhFGF-2/DBBM group (9.78 ± 2.30 mm2 ) was significantly higher than that in the rhFGF-2 (5.08 ± 1.26 mm2 , p < .01), rhFGF-2/β-TCP (5.91 ± 1.27 mm2 , p < .05), and rhFGF-2/CO3 Ap (6.51 ± 1.49 mm2 , p < .05) groups. Slight ankylosis was found in the rhFGF-2/β-TCP (1/9 sites), rhFGF-2/CO3 Ap (3/10 sites), and rhFGF-2/DBBM (1/9 sites) groups. CONCLUSIONS Within their limitations, the present data indicate that DBBM seems to be a suitable carrier for rhFGF-2 and that rhFGF-2/DBBM treatment promotes favourable periodontal regeneration compared with rhFGF-2, rhFGF-2/β-TCP, and rhFGF-2/CO3 Ap treatments in one-wall intra-bony defects.
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Affiliation(s)
- Yoshinori Shirakata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Fumiaki Setoguchi
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kotaro Sena
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Toshiaki Nakamura
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takatomo Imafuji
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yukiya Shinohara
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masayuki Iwata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kazuyuki Noguchi
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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22
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Periodontal tissue regeneration by transplantation of autologous adipose tissue-derived multi-lineage progenitor cells. Sci Rep 2022; 12:8126. [PMID: 35581234 PMCID: PMC9114023 DOI: 10.1038/s41598-022-11986-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 04/12/2022] [Indexed: 12/04/2022] Open
Abstract
Periodontitis is a chronic inflammatory disease that destroys tooth-supporting periodontal tissue. Current periodontal regenerative therapies have unsatisfactory efficacy; therefore, periodontal tissue engineering might be established by developing new cell-based therapies. In this study, we evaluated the safety and efficacy of adipose tissue-derived multi-lineage progenitor cells (ADMPC) autologous transplantation for periodontal tissue regeneration in humans. We conducted an open-label, single-arm exploratory phase I clinical study in which 12 periodontitis patients were transplanted with autologous ADMPCs isolated from subcutaneous adipose tissue. Each patient underwent flap surgery during which autologous ADMPCs were transplanted into the bone defect with a fibrin carrier material. Up to 36 weeks after transplantation, we performed a variety of clinical examinations including periodontal tissue inspection and standardized dental radiographic analysis. A 36-week follow-up demonstrated no severe transplantation-related adverse events in any cases. ADMPC transplantation reduced the probing pocket depth, improved the clinical attachment level, and induced neogenesis of alveolar bone. Therapeutic efficiency was observed in 2- or 3-walled vertical bone defects as well as more severe periodontal bone defects. These results suggest that autologous ADMPC transplantation might be an applicable therapy for severe periodontitis by inducing periodontal regeneration.
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23
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Physiological and histological studies of dental response of Luxate tooth with application of VEGF. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns2.6058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background During luxate injury many dental tissue will be involved including pulp, periodontal ligament ,mucosa, hard dental tissue and alveolar bone with affecting the nerve and dental blood supplement. Growth factors may involved in healing process after replantation of tooth in its socket and the Vascular endothelial factor (VEGF ) is a potent one that increase angiogenesis and accelerate repairing and healing of dental pulp and the supporting tissues. The study was designed to illustrate the effect of application of growth factor on healing process of luxate molar tooth of rat. Materials & Methods Twenty male Wistar rats with luxate lower right first molar teeth were included in this study. The control were injected with normal saline (0.5μl ) around the apex of mesial root .Experimental group injected with VEGF (0.5μl ). Histological assessment of physiological responses of (dental pulp, cementum, periodontal ligament (PDL) and alveolar bone in both control and experimental groups with Receptor activator of nuclear factor kappa-Β ligand (RANKL) expression evaluation were recorded during the healing period in the examined tissue.
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24
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Bartold PM, Ivanovski S. P4 Medicine as a model for precision periodontal care. Clin Oral Investig 2022; 26:5517-5533. [PMID: 35344104 PMCID: PMC9474478 DOI: 10.1007/s00784-022-04469-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/17/2022] [Indexed: 12/15/2022]
Abstract
Objectives P4 Medicine is based on a proactive approach for clinical patient care incorporating the four “pillars” of prediction, prevention, personalization, and participation for patient management. The purpose of this review is to demonstrate how the concepts of P4 medicine can be incorporated into the management of periodontal diseases (particularly periodontitis) termed P4 periodontics. Methods This is a narrative review that used current literature to explore how P4 periodontics can be aligned with the 2018 Classification of Periodontal Diseases, current periodontal treatment paradigms, and periodontal regenerative technologies. Results The proposed model of P4 periodontics is highly aligned with the 2018 Classification of Periodontal Diseases and represents a logical extension of this classification into treatment paradigms. Each stage of periodontitis can be related to a holistic approach to clinical management. The role of “big data” in future P4 periodontics is discussed and the concepts of a treat-to-target focus for treatment outcomes are proposed as part of personalized periodontics. Personalized regenerative and rejuvenative periodontal therapies will refocus our thinking from risk management to regenerative solutions to manage the effects of disease and aging. Conclusions P4 Periodontics allows us to focus not only on early prevention and intervention but also allow for personalized late-stage reversal of the disease trajectory and the use of personalized regenerative procedures to reconstruct damaged tissues and restore them to health. Clinical Significance P4 Periodontics is a novel means of viewing a holistic, integrative, and proactive approach to periodontal treatment.
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Affiliation(s)
- P Mark Bartold
- University of Queensland, 1 Milton Avenue, Beaumont, South Australia, 5066, Australia.
| | - Sašo Ivanovski
- University of Queensland, 1 Milton Avenue, Beaumont, South Australia, 5066, Australia
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25
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Cell-Based Double-Screening Method to Identify a Reliable Candidate for Osteogenesis-Targeting Compounds. Biomedicines 2022; 10:biomedicines10020426. [PMID: 35203635 PMCID: PMC8962348 DOI: 10.3390/biomedicines10020426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 01/15/2023] Open
Abstract
Small-molecule compounds strongly affecting osteogenesis can form the basis of effective therapeutic strategies in bone regenerative medicine. A cell-based high-throughput screening system might be a powerful tool for identifying osteoblast-targeting candidates; however, this approach is generally limited with using only one molecule as a cell-based sensor that does not always reflect the activation of the osteogenic phenotype. In the present study, we used the MC3T3-E1 cell line stably transfected with the green fluorescent protein (GFP) reporter gene driven by a fragment of type I collagen promoter (Col-1a1GFP-MC3T3-E1) to evaluate a double-screening system to identify osteogenic inducible compounds using a combination of a cell-based reporter assay and detection of alkaline phosphatase (ALP) activity. Col-1a1GFP-MC3T3-E1 cells were cultured in an osteogenic induction medium after library screening of 1280 pharmacologically active compounds (Lopack1280). After 7 days, GFP fluorescence was measured using a microplate reader. After 14 days of osteogenic induction, the cells were stained with ALP. Library screening using the Col-1a1/GFP reporter and ALP staining assay detected three candidates with significant osteogenic induction ability. Furthermore, leflunomide, one of the three detected candidates, significantly promoted new bone formation in vivo. Therefore, this double-screening method could identify candidates for osteogenesis-targeting compounds more reliably than conventional methods.
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26
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Oral bone biology. J Oral Biosci 2022; 64:8-17. [DOI: 10.1016/j.job.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 11/18/2022]
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27
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Furuhata M, Takayama T, Yamamoto T, Ozawa Y, Senoo M, Ozaki M, Yamano S, Sato S. Real-time assessment of guided bone regeneration in critical size mandibular bone defects in rats using collagen membranes with adjunct fibroblast growth factor-2. J Dent Sci 2021; 16:1170-1181. [PMID: 34484585 PMCID: PMC8403809 DOI: 10.1016/j.jds.2021.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/14/2021] [Indexed: 10/27/2022] Open
Abstract
Background/purpose Fibroblast growth factor-2 (FGF-2) regulates bone formation. The concept of guided bone regeneration using a resorbable collagen membrane (RCM) is generally accepted in implant dentistry. This study aimed to investigate the bone healing pattern in rat mandibular bone defects in real-time with and without RCM containing FGF-2 (RCM/FGF-2). Materials and methods Critical-size circular bone defects (4.0 mm diameter) were created on both sides of the rat mandibular bone. The defects were randomly divided into the following groups: control, RCM alone, RCM containing low (0.5 μg) or high (2.0 μg) concentration of FGF-2. We performed real-time in vivo micro-computerized tomography scans at the baseline and at 2, 4, and 6 weeks, and measured the volume of newly formed bone (NFB), bone mineral density (BMD) of NFB, and the closure percentage of the NFB area. At 6 weeks, the mandibular specimens were assessed histologically and histomorphometrically to evaluate the area of new bone regeneration. Results Real-time assessment revealed a significant increase in the volume, BMD, and closure percentage of the NFB area in the RCM/FGF-2-treated groups than that in the control and RCM groups. In the H-FGF-2 group, the volume and BMD of NFB exhibited a significant increase at 6 weeks than that at the baseline. Histological evaluation revealed the presence of osteoblasts, osteocytes, and blood vessels within the NFB. Conclusion The real-time in vivo experiment demonstrated that RCM/FGF-2 effectively promoted bone regeneration within the critical-size mandibular defects in rats and verified new bone formation starting in the early postoperative phase.
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Affiliation(s)
- Mitsuaki Furuhata
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, Tokyo, Japan
| | - Tadahiro Takayama
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Takanobu Yamamoto
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan
| | - Yasumasa Ozawa
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan
| | - Motoki Senoo
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, Tokyo, Japan
| | - Manami Ozaki
- Department of Oral Health Sciences, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Seiichi Yamano
- Department of Prosthodontics, New York University College of Dentistry, NY, USA
| | - Shuichi Sato
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
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28
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Panda S, Khijmatgar S, Das M, Arbildo-Vega H, Del Fabbro M. Recombinant Human Derived Growth and Differentiating Factors in treatment of periodontal intrabony defects: Systematic review and network meta-analysis. J Tissue Eng Regen Med 2021; 15:900-914. [PMID: 34370897 DOI: 10.1002/term.3236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/17/2021] [Accepted: 07/22/2021] [Indexed: 11/07/2022]
Abstract
The introduction of recombinant human growth and differentiation factors (rhGFs) for intrabony defects regeneration has represented a considerable breakthrough in recent years. However, they have been used in different concentrations, doses and combined with various scaffolds, and there is no evidence on which the most effective formulation for periodontal regeneration is. Therefore, we aimed to evaluate and rank the various formulations of such bioactive agents through network meta-analysis of clinical studies. The protocol registration was done on PROSPERO with registration ID CRD42020213753. To report NMA, we followed PRISMA guidelines and searched PUBMED, Embase, Web of Science and Cochrane Central electronic databases. Studies were screened based on specific inclusion criteria. Primary outcomes extracted from included studies were the most common indexes for periodontal regeneration (PPD, CAL, %bone filling). The NMA analysis included network plots, contribution plots, inconsistency plots (if eligible to form the loop), predictive interval plots, SUCRA rankings and multidimensional scale ranking (MDS) plots. SUCRA would demonstrate the rankings of multiple competing bioactive agents based on their best performance. Twelve clinical studies for qualitative and quantitative analysis were considered. Network meta-analysis found that rhFGF + hydroxyapatite was ranked highest in PPD and CAL outcome. rhPDGF-BB+β-tricalcium phosphate was ranked highest in the percentage of bone filling. In addition, all bioactive agents performed better than control groups without rhGFs. Despite clear benefits deriving from rhGFs for periodontal regeneration, the present results should be interpreted with caution due to several confounding factors affecting the outcome. Nevertheless, further well designed randomized clinical trials will allow establishing guidelines for an appropriate indication of the use of rhGFs.
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Affiliation(s)
- Sourav Panda
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Shahnawaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Department of Oral Biology and Genomic Studies, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Mangalore, India
| | - Mohit Das
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Heber Arbildo-Vega
- Department of General Dentistry, Dentistry School, Universidad San Martín de Porres, Chiclayo, Peru
- Department of General Dentistry, Dentistry School, Universidad Particular de Chiclayo, Chiclayo, Peru
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
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Kuroda Y, Tanaka T, Miyagawa T, Hamada H, Abe H, Ito-Ihara T, Asada R, Fujimoto Y, Takahashi D, Tetsunaga T, Kaneuji A, Takagi M, Inaba Y, Morita S, Sugano N, Tanaka S, Matsuda S, Akiyama H. Recombinant human FGF-2 for the treatment of early-stage osteonecrosis of the femoral head: TRION, a single-arm, multicenter, Phase II trial. Regen Med 2021; 16:535-548. [PMID: 34075804 DOI: 10.2217/rme-2021-0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: This study aimed to evaluate the 2-year outcomes from a clinical trial of recombinant human FGF-2 (rhFGF-2) for osteonecrosis of the femoral head (ONFH). Patients & methods: Sixty-four patients with nontraumatic, precollapse and large ONFHs were percutaneously administered with 800 μg rhFGF-2 contained in gelatin hydrogel. Setting the end point of radiological collapse, we analyzed the joint preservation period of the historical control. Changes in two validated clinical scores, bone regeneration and safety were evaluated. Results: Radiological joint preservation time was significantly higher in the rhFGF-2 group than in the control group. The ONFHs tended to improve to smaller ONFHs. The postoperative clinical scores significantly improved. Thirteen serious adverse events showed recovery. Conclusion: rhFGF-2 treatment increases joint preservation time with clinical efficacy, radiological bone regeneration and safety.
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Affiliation(s)
- Yutaka Kuroda
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takeyuki Tanaka
- Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Takaki Miyagawa
- Department of Orthopedic Surgery, Gifu University, Gifu, 501-1194, Japan
| | - Hidetoshi Hamada
- Department of Orthopedic Surgery, Osaka University, Osaka, 565-0871, Japan
| | - Hiroyasu Abe
- Department of Biomedical Statistics & Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, 606-8507, Japan
| | - Toshiko Ito-Ihara
- The Clinical & Translational Research Center, Kyoto Prefectural University of Medicine, Kyoto, 602-0841, Japan
| | - Ryuta Asada
- Innovative & Clinical Research Promotion Center, Graduate School of Medicine, Gifu University, Gifu, 501-1194, Japan
| | - Yusuke Fujimoto
- Department of Medical Joint Materials, Graduate School of Medical & Dental Sciences, Kagoshima University, Kagoshima, 890-8520, Japan
| | - Daisuke Takahashi
- Department of Orthopedic Surgery, Faculty of Medicine & Graduate School of Medicine, Hokkaido University, Hokkaido, 060-8648, Japan
| | - Tomonori Tetsunaga
- Department of Orthopedic Surgery, Okayama University, Okayama, 700-0914, Japan
| | - Ayumi Kaneuji
- Department of Orthopedic Surgery, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Michiaki Takagi
- Department of Orthopedic Surgery, Yamagata University Faculty of Medicine, Yamagata, 990-2331, Japan
| | - Yutaka Inaba
- Department of Orthopedic Surgery, Yokohama City University, Kanagawa, 236-0004, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics & Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, 606-8507, Japan
| | - Nobuhiko Sugano
- Department of Orthopedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
| | - Sakae Tanaka
- Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Shuichi Matsuda
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Haruhiko Akiyama
- Department of Orthopedic Surgery, Gifu University, Gifu, 501-1194, Japan
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Murakami T, Matsugami D, Yoshida W, Imamura K, Bizenjima T, Seshima F, Saito A. Healing of Experimental Periodontal Defects Following Treatment with Fibroblast Growth Factor-2 and Deproteinized Bovine Bone Mineral. Biomolecules 2021; 11:biom11060805. [PMID: 34072351 PMCID: PMC8226676 DOI: 10.3390/biom11060805] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to investigate the effects of fibroblast growth factor (FGF)-2 used in combination with deproteinized bovine bone mineral (DBBM) on the healing of experimental periodontal defects. Periodontal defects created in rats were treated by FGF-2, DBBM, FGF-2 + DBBM, or left unfilled. Microcomputed tomography, histological, and immunohistochemical examinations were used to evaluate healing. In vitro cell viability/proliferation on DBBM with/without FGF-2 was assessed by WST-1. Cell behavior was analyzed using scanning electron and confocal laser scanning microscopy. Osteogenic differentiation was evaluated by staining with alkaline phosphatase and alizarin red. Bone volume fraction was significantly greater in FGF-2 and FGF-2 + DBBM groups than in other groups at 2 and 4 weeks postoperatively. In histological assessment, newly formed bone in FGF-2 and FGF-2 + DBBM groups appeared to be greater than other groups. Significantly greater levels of proliferating cell nuclear antigen-, vascular endothelial growth factor-, and osterix-positive cells were observed in FGF-2 and FGF-2 + DBBM groups compared to Unfilled group. In vitro, addition of FGF-2 to DBBM promoted cell viability/proliferation, attachment/spreading, and osteogenic differentiation. The combination therapy using FGF-2 and DBBM was similarly effective as FGF-2 alone in the healing of experimental periodontal defects. In certain bone defect configurations, the combined use of FGF-2 and DBBM may enhance healing via promotion of cell proliferation, angiogenesis, and osteogenic differentiation.
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Affiliation(s)
- Tasuku Murakami
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
| | - Daisuke Matsugami
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
- Oral Health Science Center, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan
| | - Wataru Yoshida
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
| | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
- Oral Health Science Center, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan
| | - Takahiro Bizenjima
- Chiba Dental Center, Tokyo Dental College, Mihama-ku, Chiba 2618502, Japan;
| | - Fumi Seshima
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
- Oral Health Science Center, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan
- Correspondence:
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31
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Liu HN, Yeung AWK, Leung WK. A bibliometric study of the top cited papers related to periodontal regeneration. J Oral Sci 2021; 63:201-208. [PMID: 34039827 DOI: 10.2334/josnusd.20-0565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This report identifies the top cited papers in the field of periodontal regeneration since inception of the concept. Using the H-classics approach, 132 papers published between 1970 and 2012 were identified, with 230.0 ± 175.6 (mean ± SD) citations and 10.4 ± 11.5 citations/year. There were 46 clinical reports, 28 animal studies, 23 in vitro studies, 30 reviews, 3 systematic reviews, and 2 combined animal and in vitro studies. Analysis of covariance showed that institution number (≥3, P = 0.011), journal impact factor at publication (>3.0, P = 0.001) and study type (in vitro/reviews vs. clinical trials/animal studies, P = 0.024) were significantly associated with citations/year. This study has characterized the most influential literature in the field of periodontal regeneration and serves as a quick reference resource.
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Affiliation(s)
- Hin Nam Liu
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong
| | - Andy W K Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong
| | - W Keung Leung
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong
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Bizenjima T, Irokawa D, Tanaka K, Saito A, Tomita S. Periodontal Regenerative Therapy with Recombinant Human Fibroblast Growth Factor-2 and Deproteinized Bovine Bone Mineral in Patient with Chronic Periodontitis: An 18-month Follow-up Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2021; 62:107-117. [PMID: 33994421 DOI: 10.2209/tdcpublication.2020-0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This report describes a case of generalized chronic periodontitis requiring periodontal regenerative therapy. The patient was a 62-year-old man who presented with the chief complaint of gingival swelling in the molar region. An initial examination revealed that 31.6% of sites had a probing depth of ≥4 mm and 18.5% bleeding on probing. Radiographic examination revealed vertical bone resorption in #14, 25, 26, 27, 32, 37, 45, and 47, and horizontal resorption in other regions. Based on a clinical diagnosis of moderate chronic periodontitis, initial periodontal therapy consisting of plaque control and scaling and root planing was performed. Occlusal adjustment of premature contact sites was performed after inflammation was suppressed. Surgical periodontal therapy was subsequently performed at selected sites. Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF)-2 was performed on #14, 25, 26, 32, and 37. Combination therapy with rhFGF-2 and deproteinized bovine bone mineral (DBBM) was performed on #45 and 47. Other sites with residual periodontal pockets were treated by open flap debridement, and #27 was extracted due to a bone defect exceeding the root apex. Progress was then reevaluated and the patient placed on supportive periodontal therapy. Periodontal regenerative therapy using rhFGF-2 in combination with DBBM resulted in an improvement in clinical parameters and vertical bone resorption. This improvement has been adequately maintained over an 18-month period. The periodontal treatment provided resulted in a marked improvement in the patient's oral health-related quality of life.
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Novais A, Chatzopoulou E, Chaussain C, Gorin C. The Potential of FGF-2 in Craniofacial Bone Tissue Engineering: A Review. Cells 2021; 10:cells10040932. [PMID: 33920587 PMCID: PMC8073160 DOI: 10.3390/cells10040932] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/10/2021] [Accepted: 04/15/2021] [Indexed: 12/21/2022] Open
Abstract
Bone is a hard-vascularized tissue, which renews itself continuously to adapt to the mechanical and metabolic demands of the body. The craniofacial area is prone to trauma and pathologies that often result in large bone damage, these leading to both aesthetic and functional complications for patients. The "gold standard" for treating these large defects is autologous bone grafting, which has some drawbacks including the requirement for a second surgical site with quantity of bone limitations, pain and other surgical complications. Indeed, tissue engineering combining a biomaterial with the appropriate cells and molecules of interest would allow a new therapeutic approach to treat large bone defects while avoiding complications associated with a second surgical site. This review first outlines the current knowledge of bone remodeling and the different signaling pathways involved seeking to improve our understanding of the roles of each to be able to stimulate or inhibit them. Secondly, it highlights the interesting characteristics of one growth factor in particular, FGF-2, and its role in bone homeostasis, before then analyzing its potential usefulness in craniofacial bone tissue engineering because of its proliferative, pro-angiogenic and pro-osteogenic effects depending on its spatial-temporal use, dose and mode of administration.
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Affiliation(s)
- Anita Novais
- Pathologies, Imagerie et Biothérapies Orofaciales, Université de Paris, URP2496, 1 rue Maurice Arnoux, 92120 Montrouge, France; (A.N.); (E.C.); (C.C.)
- AP-HP Département d’Odontologie, Services d’odontologie, GH Pitié Salpêtrière, Henri Mondor, Paris Nord, Hôpital Rothschild, Paris, France
| | - Eirini Chatzopoulou
- Pathologies, Imagerie et Biothérapies Orofaciales, Université de Paris, URP2496, 1 rue Maurice Arnoux, 92120 Montrouge, France; (A.N.); (E.C.); (C.C.)
- AP-HP Département d’Odontologie, Services d’odontologie, GH Pitié Salpêtrière, Henri Mondor, Paris Nord, Hôpital Rothschild, Paris, France
- Département de Parodontologie, Université de Paris, UFR Odontologie-Garancière, 75006 Paris, France
| | - Catherine Chaussain
- Pathologies, Imagerie et Biothérapies Orofaciales, Université de Paris, URP2496, 1 rue Maurice Arnoux, 92120 Montrouge, France; (A.N.); (E.C.); (C.C.)
- AP-HP Département d’Odontologie, Services d’odontologie, GH Pitié Salpêtrière, Henri Mondor, Paris Nord, Hôpital Rothschild, Paris, France
| | - Caroline Gorin
- Pathologies, Imagerie et Biothérapies Orofaciales, Université de Paris, URP2496, 1 rue Maurice Arnoux, 92120 Montrouge, France; (A.N.); (E.C.); (C.C.)
- AP-HP Département d’Odontologie, Services d’odontologie, GH Pitié Salpêtrière, Henri Mondor, Paris Nord, Hôpital Rothschild, Paris, France
- Correspondence: ; Tel./Fax: +33-(0)1-5807-6724
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Mohammadipour HS, Forouzanfar F, Forouzanfar A. The Role of Type 2 Fibroblast Growth Factor in Periodontal Therapy. Curr Drug Targets 2021; 22:310-317. [PMID: 33153420 DOI: 10.2174/1389450121999201105152639] [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: 06/12/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 11/22/2022]
Abstract
The prevalence of periodontitis is around 20-50% in the global population. If it is not treated, it can cause tooth loss. Periodontal treatment aims at preserving the patient's teeth from various damages, including infection control and restoring lost periodontal tissue. The periodontium has great biological regenerative potential, and several biomaterials can be used to improve the outcome of periodontal treatment. To achieve the goal of periodontal tissue regeneration, numerous studies have used fibroblast growth factor 2 (FGF2) to stimulate the regeneration of both the soft tissue and bone. FGF2 induced a significant increment in the percentage of bone fill, bone mineral levels of the defect sites, length of the regenerated periodontal ligament, angiogenesis, connective tissue formation on the root surface, formation of dense fibers bound to the alveolar bone and newly synthesized cementum in teeth. This review will open further avenues to better understand the FGF2 therapy for periodontal regeneration.
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Affiliation(s)
| | - Fatemeh Forouzanfar
- Medical Toxicology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Forouzanfar
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Cheah E, Wu Z, Thakur SS, O'Carroll SJ, Svirskis D. Externally triggered release of growth factors - A tissue regeneration approach. J Control Release 2021; 332:74-95. [PMID: 33600882 DOI: 10.1016/j.jconrel.2021.02.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/22/2022]
Abstract
Tissue regeneration aims to achieve functional restoration following injury by creating an environment to enable the body to self-repair. Strategies for regeneration rely on the introduction of biomaterial scaffolding, cells and bioactive molecules into the body, at or near the injury site. Of these bioactive molecules, growth factors (GFs) play a pivotal role in directing regenerative pathways for many cell populations. However, the therapeutic use of GFs has been limited by the complexity of biological injury and repair, and the properties of the GFs themselves, including their short half-life, poor tissue penetration, and off-target side effects. Externally triggered delivery systems have the potential to facilitate the delivery of GFs into the target tissues with considerations of the timing, sequence, amount, and location of GF presentation. This review briefly discusses the challenges facing the therapeutic use of GFs, then, we discuss approaches to externally trigger GF release from delivery systems categorised by stimulation type; ultrasound, temperature, light, magnetic fields and electric fields. Overall, while the use of GFs for tissue regeneration is still in its infancy, externally controlled GF delivery technologies have the potential to achieve robust and effective solutions to present GFs to injured tissues. Future technological developments must occur in conjunction with a comprehensive understanding of the biology at the injury site to ensure translation of promising technologies into real world benefit.
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Affiliation(s)
- Ernest Cheah
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Zimei Wu
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Sachin S Thakur
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Simon J O'Carroll
- Department of Anatomy and Medical Imaging, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Darren Svirskis
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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Effect of Aging on Homeostasis in the Soft Tissue of the Periodontium: A Narrative Review. J Pers Med 2021; 11:jpm11010058. [PMID: 33477537 PMCID: PMC7831085 DOI: 10.3390/jpm11010058] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/06/2021] [Accepted: 01/15/2021] [Indexed: 12/12/2022] Open
Abstract
Aging is characterized by a progressive decline or loss of physiological functions, leading to increased susceptibility to disease or death. Several aging hallmarks, including genomic instability, cellular senescence, and mitochondrial dysfunction, have been suggested, which often lead to the numerous aging disorders. The periodontium, a complex structure surrounding and supporting the teeth, is composed of the gingiva, periodontal ligament, cementum, and alveolar bone. Supportive and protective roles of the periodontium are very critical to sustain life, but the periodontium undergoes morphological and physiological changes with age. In this review, we summarize the current knowledge of molecular and cellular physiological changes in the periodontium, by focusing on soft tissues including gingiva and periodontal ligament.
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Chandra RV, Sneha K, Pushpalatha S, Chakravarthy Y. Efficacy of recombinant human fibroblast growth factor 2 impregnated absorbable collagen membrane in the treatment of Miller's Class I and II gingival recession defects Preliminary results from the first in human clinical trial. J Indian Soc Periodontol 2021; 24:541-546. [PMID: 33424171 PMCID: PMC7781258 DOI: 10.4103/jisp.jisp_76_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/16/2020] [Accepted: 06/05/2020] [Indexed: 11/09/2022] Open
Abstract
Aims: This study was a single-arm trial to obtain preliminary data on the efficacy of collagen membranes impregnated with recombinant human fibroblast growth factor-2 (rhFGF-2) in the treatment of Miller's Class I and II gingival recessions. Materials and Methods: Twenty-one individuals (34 sites) presenting with localized Miller's Class I and II gingival recessions were included in this study. Following a standard surgical protocol, rhFGF-2-impregnated membranes were placed in sites with gingival recession. Clinical parameters such as width of keratinized gingiva (wKG), recession depth (RD), and probing depth were measured at baseline and after therapy completion at 3 and 6 months. Results: Most of the sites exhibited favorable clinical healing; the most common complications were persistent edematous and inflamed gingivae beyond 1 week (n = 3), development of residual periodontal pockets (n = 2), and no reduction in RDs (n = 2). Significant improvements in wKG and RD were noted from baseline to 6 months. Conclusion: rhFGF-2-impregnated collagen membranes showed promising results in terms of increasing the wKG and recession coverage. A comparison with other standard therapies and agents in subsequent trials may shed more light on the clinical efficacy of this material.
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Affiliation(s)
- Rampalli Viswa Chandra
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Kidambi Sneha
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Sabbani Pushpalatha
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Yarabham Chakravarthy
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
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Santana LG, Marques LS. Do adjunctive interventions in patients undergoing rapid maxillary expansion increase the treatment effectiveness? Angle Orthod 2021; 91:119-128. [PMID: 33289794 DOI: 10.2319/051320-431.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/01/2020] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To evaluate the clinical effectiveness of adjunctive interventions in individuals undergoing rapid maxillary expansion (RME). MATERIALS AND METHODS MEDLINE, Web of Science, Cochrane, Scopus, LILACS, and Google Scholar were searched without restrictions up to June 2020. Trials involving participants undergoing orthopedic or surgical RME, along with adjunctive interventions, were included. Risk-of-bias assessments were performed using the Cochrane tool for randomized trials-2. The certainty level of evidence was assessed through the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS Six randomized clinical trials, with low to high risk of bias, were included. Low certainty of the evidence suggested that low-level laser facilitated opening of the midpalatal suture during the active phase of RME. Likewise, moderate certainty demonstrated that low-level laser accelerated the healing process of the suture during the retention phase. The clinical impact of this outcome, that is, stability and retention time, was not evaluated. Very low evidence indicated that osteoperforations along the midpalatal suture increased maxillary transverse skeletal gains in young adults undergoing RME. Low evidence suggested that platelet-rich plasma therapy did not minimize the vertical and thickness bone loss after RME in the short term. CONCLUSIONS Based on currently available information, the use of low-level laser associated with maxillary expansion seems to provide a more efficient suture opening and bone healing. Limited evidence suggests that osteoperforations improve the skeletal effects of RME in non-growing individuals. There are no adjunctive interventions capable of reducing the periodontal side effects of RME.
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Abstract
This chapter provides an overview of the growth factors active in bone regeneration and healing. Both normal and impaired bone healing are discussed, with a focus on the spatiotemporal activity of the various growth factors known to be involved in the healing response. The review highlights the activities of most important growth factors impacting bone regeneration, with a particular emphasis on those being pursued for clinical translation or which have already been marketed as components of bone regenerative materials. Current approaches the use of bone grafts in clinical settings of bone repair (including bone grafts) are summarized, and carrier systems (scaffolds) for bone tissue engineering via localized growth factor delivery are reviewed. The chapter concludes with a consideration of how bone repair might be improved in the future.
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40
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Nakayama Y, Matsuda H, Itoh S, Iwai Y, Takai H, Mezawa M, Yoshino S, Ogata Y. Impact of adjunctive procedures on recombinant human fibroblast growth factor-2-mediated periodontal regeneration therapy: A retrospective study. J Periodontol 2020; 92:983-994. [PMID: 33128399 DOI: 10.1002/jper.20-0481] [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: 07/23/2020] [Revised: 09/19/2020] [Accepted: 10/02/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Human fibroblast growth factor-2 (rhFGF-2) therapy has been used for periodontal tissue regeneration. However, few studies have reported their adjunctive procedures based on strategy of tissue engineering. The aim of this retrospective study is to assess the adjunctive effects of modified papilla preservation technique (mPPT) and combination with autogenous bone grafts (AG) on the rhFGF-2 therapy. METHODS Total of 44 sites underwent rhFGF-2 therapies and the evaluations in the survey periods. The primary outcome was set to the radiographic bone fill by radiographic examinations at 6 and 12 months after surgeries. We analyzed the correlation between influencing factors and the primary outcome, and differences of therapeutic effect by combination therapy with mPPT and that with AG. RESULTS After surgeries, probing depth (PD), clinical attachment level (CAL) and bone defects significantly improved. The improvements of radiographic bone fill were significantly positive correlated with a number of bone walls, combination with mPPT, and AG at 6 months after surgeries, and with combination with mPPT and AG at 12 months after surgeries. The significant differences of improvements of radiographic bone fill were demonstrated between combination with or without mPPT at 12 months after surgeries, and with or without AG at 6 and 12 months after surgeries. Moreover, the multiple linear regression analysis for the radiographic bone fill indicated the significant regression coefficient with conducts of mPPT. CONCLUSIONS mPPT and AG had powerfully adjunctive effects on rhFGF-2 therapy. Further studies are needed in order to verify by randomized clinical trials.
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Affiliation(s)
- Yohei Nakayama
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan.,Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - Hideo Matsuda
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - Shoichi Itoh
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - Yasunobu Iwai
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - Hideki Takai
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan.,Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - Masaru Mezawa
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan.,Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - Shoichi Yoshino
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - Yorimasa Ogata
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan.,Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
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Aoki H, Bizenjima T, Seshima F, Sato M, Irokawa D, Yoshikawa K, Yoshida W, Imamura K, Matsugami D, Kitamura Y, Kita D, Sugito H, Tomita S, Saito A. Periodontal surgery using rhFGF-2 with deproteinized bovine bone mineral or rhFGF-2 alone: 2-year follow-up of a randomized controlled trial. J Clin Periodontol 2020; 48:91-99. [PMID: 33030228 PMCID: PMC7984167 DOI: 10.1111/jcpe.13385] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 12/11/2022]
Abstract
AIM To compare outcomes of rhFGF-2 + DBBM therapy with rhFGF-2 alone in the treatment of intrabony defects. This study provides 2-year follow-up results from the previous randomized controlled trial. MATERIALS AND METHODS Defects were randomly allocated to receive rhFGF-2 + DBBM (test) or rhFGF-2 (control). Treated sites were re-evaluated at 2 years postoperatively, using original clinical and patient-centred measures. RESULTS Thirty-eight sites were available for re-evaluation. At 2 years, both groups showed a significant improvement in clinical attachment level (CAL) from baseline. A gain in CAL of 3.4 ± 1.3 mm in the test group and 3.1 ± 1.5 mm in the control group was found. No significant inter-group difference was noted. Both groups showed a progressive increase in radiographic bone fill (RBF). The test treatment yielded greater RBF (56%) compared with the control group (41%). The control treatment performed better in contained defects in terms of CAL and RBF. There was no significant difference in patient-reported outcomes between groups. CONCLUSIONS At 2-year follow-up, the test and cotrol treatments were similarly effective in improving CAL, whereas the test treatment achieved a significantly greater RBF. In both treatments, favourable clinical, radiographic, and patient-reported outcomes can be sustained for at least 2 years. TRIAL REGISTRATION The University Hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) 000025257.
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Affiliation(s)
- Hideto Aoki
- 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
| | - Masahiro Sato
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Daisuke Irokawa
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Kouki Yoshikawa
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Wataru Yoshida
- 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
| | - Daisuke Matsugami
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Yurie Kitamura
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Daichi Kita
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Hiroki Sugito
- Department of Dental Hygiene, Tokyo Dental Junior College, Tokyo, Japan
| | - Sachiyo Tomita
- 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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Distinct Osteogenic Potentials of BMP-2 and FGF-2 in Extramedullary and Medullary Microenvironments. Int J Mol Sci 2020; 21:ijms21217967. [PMID: 33120952 PMCID: PMC7662681 DOI: 10.3390/ijms21217967] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/24/2020] [Accepted: 10/24/2020] [Indexed: 12/14/2022] Open
Abstract
Bone morphogenetic protein-2 (BMP-2) and fibroblast growth factor-2 (FGF-2) have been regarded as the major cytokines promoting bone formation, however, several studies have reported unexpected results with failure of bone formation or bone resorption of these growth factors. In this study, BMP-2 and FGF-2 adsorbed into atellocollagen sponges were transplanted into bone defects in the bone marrow-scarce calvaria (extramedullary environment) and bone marrow-abundant femur (medullary environment) for analysis of their in vivo effects not only on osteoblasts, osteoclasts but also on bone marrow cells. The results showed that BMP-2 induced high bone formation in the bone marrow-scarce calvaria, but induced bone resorption in the bone marrow-abundant femurs. On the other hand, FGF-2 showed opposite effects compared to those of BMP-2. Analysis of cellular dynamics revealed numerous osteoblasts and osteoclasts present in the newly-formed bone induced by BMP-2 in calvaria, but none were seen in either control or FGF-2-transplanted groups. On the other hand, in the femur, numerous osteoclasts were observed in the vicinity of the BMP-2 pellet, while a great number of osteoblasts were seen near the FGF-2 pellets or in the control group. Of note, FCM analysis showed that both BMP-2 and FGF-2 administrated in the femur did not significantly affect the hematopoietic cell population, indicating a relatively safe application of the two growth factors. Together, these results indicate that BMP-2 could be suitable for application in extramedullary bone regeneration, whereas FGF-2 could be suitable for application in medullary bone regeneration.
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Takayama SI, Murakami S. Efficacy of FGF-2 in Periodontal Regeneration in a Case of Severe Intrabony Defect and Furcation Involvement With 15-Month Follow-Up. Clin Adv Periodontics 2020; 11:74-79. [PMID: 33075207 DOI: 10.1002/cap.10127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/08/2020] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Several studies have demonstrated that basic fibroblast growth factor (FGF-2) is one of the most effective growth factors for periodontal regeneration. The Ministry of Health, Labor and Welfare in Japan have approved 0.3% human recombinant FGF-2 for periodontal regeneration, and it has been commercially available since 2016. In this case report, a patient was treated with this periodontal regenerative medicine and demonstrated success at 15-month follow-up, as confirmed by dental X-ray and on cone-beam computed tomography (CBCT). CASE PRESENTATION A 42-year-old woman with a one by two walled intrabony defect and Class III furcation involvement in tooth #19, and Class II furcation involvement in tooth #18 (lingual) underwent periodontal regenerative surgery with FGF-2 without any bone graft materials. Favorable clinical and radiographic outcomes were noted 15 months after the procedure. The vertical bone defect in tooth #19 showed a clinical attachment level gain of 8 mm. Moreover, CBCT analysis revealed considerable new bone formation in the Class II furcation involvement in tooth #18 and limited bone formation in the Class III furcation involvement in tooth #19. CONCLUSIONS This case report indicates that FGF-2 showed a positive outcome in terms of periodontal regeneration in a case of one by two wall intrabony defects with Class III furcation involvement. A complete recovery of Class II furcation involvement was observed without artificial bone graft materials.
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Affiliation(s)
- Shin-Ichi Takayama
- Private practice, Takayama Dental Clinic, Shiga, Japan.,Department of Periodontology, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Shinya Murakami
- Department of Periodontology, Graduate School of Dentistry, Osaka University, Osaka, Japan
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Cellular responses to deproteinized bovine bone mineral biofunctionalized with bone-conditioned medium. Clin Oral Investig 2020; 25:2159-2173. [PMID: 32870390 PMCID: PMC7966141 DOI: 10.1007/s00784-020-03528-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/13/2020] [Indexed: 01/30/2023]
Abstract
OBJECTIVES The aim of the study was to investigate whether the osteoinductive properties of bone-conditioned medium (BCM) harvested from cortical bone chips within a clinically relevant short-term period can enhance the biologic characteristics of deproteinized bovine bone mineral (DBBM) in vitro. MATERIALS AND METHODS To assess the biofunctionalization of DBBM, the adhesive, proliferative, and differentiation properties of mesenchymal stromal ST2, pre-osteoblastic MC3T3-E1, and primary bone-derived cells grown on BCM-coated DBBM were examined by crystal violet staining of adherent cells, BrdU ELISA, and qRT-PCR, respectively. RESULTS BCM extracted within 20 min or 24 h in either Ringer's solution (BCM-RS) or RS mixed with autologous serum (BCM-RS + S) increased the adhesive properties of all three cell types seeded on DBBM. The 20-min BCM-RS preparation appeared more potent than the 24-h preparation. BCM-RS made within 20 min or 24 h had strong pro-proliferative effects on all cell types grown on DBBM. RS + S alone exhibited a considerable pro-proliferative effect, suggesting an impact of the serum on cellular growth. DBBM coated with BCM-RS or BCM-RS + S, made within 20 min or 24 h each, caused a significant induction of osteogenic differentiation marker expression with a higher potency of the BCM-RS + S. Finally, a strong additive effect of fresh bone chips combined with BCM-coated DBBM on the osteogenic differentiation of the three cell types was observed. CONCLUSIONS Altogether, the data strongly support the biofunctionalization of DBBM with BCM extracted within a clinically relevant time window of 20 min. CLINICAL RELEVANCE Pre-activation of non-osteoinductive biomaterials with BCM, prepared from autologous bone chips during a guided bone regeneration (GBR) procedure, bears the potential of an optimal treatment modality for bone defects in daily practice.
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Sadowsky SJ, Brunski JB. Are teeth superior to implants? A mapping review. J Prosthet Dent 2020; 126:181-187. [PMID: 32862999 DOI: 10.1016/j.prosdent.2020.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
STATEMENT OF PROBLEM There is a long-held assumption that teeth are superior to implants because the periodontal ligament (PDL) confers a preeminent defense against biologic and mechanical challenges. However, adequate analysis of the literature is lacking. As a result, differential treatment planning of tooth- and implant-supported restorations has been compromised. PURPOSE Given an abundance and diversity of research, the purpose of this mapping review was to identify basic scientific gaps in the knowledge of how teeth and implants respond to biologic and mechanical loads. The findings will offer enhanced evidence-based clinical decision-making when considering replacement of periodontally compromised teeth and the design of implant prostheses. MATERIAL AND METHODS The online databases PubMed, Science Direct, and Web of Science were searched. Published work from 1965 to 2020 was collected and independently analyzed by both authors for inclusion in this review. RESULTS A total of 108 articles met the inclusion criteria of clinical, in vivo, and in vitro studies in the English language on the periradicular and peri-implant bone response to biologic and mechanical loads. The qualitative analysis found that the PDL's enhanced vascularity, stem cell ability, and resident cells that respond to inflammation allow for a more robust defense against biologic threats compared with implants. While the suspensory PDL acts to mediate moderate loads to the bone, higher compressive stress and strain within the PDL itself can initiate a biologic sequence of osteoclastic activity that can affect changes in the adjacent bone. Conversely, the peri-implant bone is more resistant to similar loads and the threshold for overload is higher because of the absence of a stress or strain sensitivity inherent in the PDL. CONCLUSIONS Based on this mapping review, teeth are superior to implants in their ability to resist biologic challenges, but implants are superior to teeth in managing higher compressive loads without prompting bone resorption.
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Affiliation(s)
- Steven J Sadowsky
- Professor, Preventive and Restorative Department, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, Calif.
| | - John B Brunski
- Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, Calif
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Yang R, Guo S, Xiao S, Ding Y. Enhanced wound healing and osteogenic potential of photodynamic therapy on human gingival fibroblasts. Photodiagnosis Photodyn Ther 2020; 32:101967. [PMID: 32835879 DOI: 10.1016/j.pdpdt.2020.101967] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/06/2020] [Accepted: 08/17/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Photodynamic therapy (PDT) has shown ideal antibacterial effects in clinical treatment of periodontal diseases. However, little is known about the specific potential of PDT on human gingival fibroblasts (HGFs) especially cells in the inflamed state, which may contribute to the repairi of periodontal tissue. METHODS The effect of PDT with different concentrations of methylene blue (5 μM, 10 μM, 20 μM) on cell vitality of healthy and inflamed human gingival fibroblasts was evaluated by CCK-8, and cell migration was assessed by cell scratching assay. The gene expression of interleukin-6 (IL-6), interleukin-8 (IL-8), type I collagen (Col I), fibronectin (FN) and basic fibroblast growth factor (bFGF) were measured with real-time fluorescent quantitative polymerase chain reaction. The alkaline phosphatase (ALP) production and alizarin red staining of mineralized nodules in healthy and inflamed human gingival fibroblasts was evaluated to explore the effect on osteogenic differentiation. RESULTS PDT with relatively low concentration of methylene blue (5 μM) inhibited the cell vitality of inflamed human gingival fibroblasts (I-HGFs) slightly (P < 0.05), but had no adverse effect on healthy human gingival fibroblasts (H-HGFs) (P > 0.05). As the concentration increased, PDT with 20 μM methylene blue had significantly negative effect on both healthy and inflamed cells. Further, PDT with 5 μM methylene blue was observed to be able to promote the migration of HGFs especially the healthy state, and increases the expression of wound healing related genes including IL-6, COL1, FN, bFGF in healthy and inflamed HGFs (P < 0.05). PDT with 5 μM methylene blue was also capable of increasing the production of ALP and mineralized nodules (P < 0.05), although the better effect was observed in the laser treatment group. CONCLUSIONS The relatively low concentration of methylene blue mediated PDT is conducive to the growth of H-HGFs while inhibiting the I-HGFs, and it also has the potential to promote the wound healing and osteogenic related functions of both healthy and inflamed HGFs.
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Affiliation(s)
- Ruqian Yang
- Department of Periodontics, West China College of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Shujuan Guo
- Department of Periodontics, West China College of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Shimeng Xiao
- Department of Periodontics, West China College of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Yi Ding
- Department of Periodontics, West China College of Stomatology, Sichuan University, Chengdu, China; State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.
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The Platelet Concentrates Therapy: From the Biased Past to the Anticipated Future. Bioengineering (Basel) 2020; 7:bioengineering7030082. [PMID: 32751638 PMCID: PMC7552713 DOI: 10.3390/bioengineering7030082] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 12/23/2022] Open
Abstract
The ultimate goal of research on platelet concentrates (PCs) is to develop a more predictable PC therapy. Because platelet-rich plasma (PRP), a representative PC, was identified as a possible therapeutic agent for bone augmentation in the field of oral surgery, PRP and its derivative, platelet-rich fibrin (PRF), have been increasingly applied in a regenerative medicine. However, a rise in the rate of recurrence (e.g., in tendon and ligament injuries) and adverse (or nonsignificant) clinical outcomes associated with PC therapy have raised fundamental questions regarding the validity of the therapy. Thus, rigorous evidence obtained from large, high-quality randomized controlled trials must be presented to the concerned regulatory authorities of individual countries or regions. For the approval of the regulatory authorities, clinicians and research investigators should understand the real nature of PCs and PC therapy (i.e., adjuvant therapy), standardize protocols of preparation (e.g., choice of centrifuges and tubes) and clinical application (e.g., evaluation of recipient conditions), design bias-minimized randomized clinical trials, and recognize superfluous brand competitions that delay sound progress. In this review, we retrospect the recent past of PC research, reconfirm our ultimate goals, and discuss what will need to be done in future.
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Nawrocka D, Krzyscik MA, Opaliński Ł, Zakrzewska M, Otlewski J. Stable Fibroblast Growth Factor 2 Dimers with High Pro-Survival and Mitogenic Potential. Int J Mol Sci 2020; 21:ijms21114108. [PMID: 32526859 PMCID: PMC7312490 DOI: 10.3390/ijms21114108] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 01/03/2023] Open
Abstract
Fibroblast growth factor 2 (FGF2) is a heparin-binding growth factor with broad mitogenic and cell survival activities. Its effector functions are induced upon the formation of 2:2 FGF2:FGFR1 tetrameric complex. To facilitate receptor activation, and therefore, to improve the FGF2 biological properties, we preorganized dimeric ligand by a covalent linkage of two FGF2 molecules. Mutations of the FGF2 WT protein were designed to obtain variants with a single surface-exposed reactive cysteine for the chemical conjugation via maleimide-thiol reaction with bis-functionalized linear PEG linkers. We developed eight FGF2 dimers of defined topology, differing in mutual orientation of individual FGF2 molecules. The engineered proteins remained functional in terms of FGFR downstream signaling activation and were characterized by the increased stability, mitogenic potential and anti-apoptotic activity, as well as induced greater migration responses in normal fibroblasts, as compared to FGF2 monomer. Importantly, biological activity of the dimers was much less dependent on the external heparin administration. Moreover, some dimeric FGF2 variants internalized more efficiently into FGFR overexpressing cancer cells. In summary, in the current work, we showed that preorganization of dimeric FGF2 ligand increased the stability of the growth factor, and therefore, enhanced its biological activity.
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Affiliation(s)
- Daria Nawrocka
- Department of Protein Engineering, Faculty of Biotechnology, University of Wroclaw, Joliot-Curie 14a, 50-383 Wroclaw, Poland; (D.N.); (M.A.K.); (Ł.O.); (M.Z.)
| | - Mateusz Adam Krzyscik
- Department of Protein Engineering, Faculty of Biotechnology, University of Wroclaw, Joliot-Curie 14a, 50-383 Wroclaw, Poland; (D.N.); (M.A.K.); (Ł.O.); (M.Z.)
- Department of Protein Biotechnology, Faculty of Biotechnology, University of Wroclaw, Joliot-Curie 14a, 50-383 Wroclaw, Poland
| | - Łukasz Opaliński
- Department of Protein Engineering, Faculty of Biotechnology, University of Wroclaw, Joliot-Curie 14a, 50-383 Wroclaw, Poland; (D.N.); (M.A.K.); (Ł.O.); (M.Z.)
| | - Malgorzata Zakrzewska
- Department of Protein Engineering, Faculty of Biotechnology, University of Wroclaw, Joliot-Curie 14a, 50-383 Wroclaw, Poland; (D.N.); (M.A.K.); (Ł.O.); (M.Z.)
| | - Jacek Otlewski
- Department of Protein Engineering, Faculty of Biotechnology, University of Wroclaw, Joliot-Curie 14a, 50-383 Wroclaw, Poland; (D.N.); (M.A.K.); (Ł.O.); (M.Z.)
- Correspondence: ; Tel.: +48-71-375-28-24
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Liang Y, Luan X, Liu X. Recent advances in periodontal regeneration: A biomaterial perspective. Bioact Mater 2020; 5:297-308. [PMID: 32154444 PMCID: PMC7052441 DOI: 10.1016/j.bioactmat.2020.02.012] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 12/12/2022] Open
Abstract
Periodontal disease (PD) is one of the most common inflammatory oral diseases, affecting approximately 47% of adults aged 30 years or older in the United States. If not treated properly, PD leads to degradation of periodontal tissues, causing tooth movement, and eventually tooth loss. Conventional clinical therapy for PD aims at eliminating infectious sources, and reducing inflammation to arrest disease progression, which cannot achieve the regeneration of lost periodontal tissues. Over the past two decades, various regenerative periodontal therapies, such as guided tissue regeneration (GTR), enamel matrix derivative, bone grafts, growth factor delivery, and the combination of cells and growth factors with matrix-based scaffolds have been developed to target the restoration of lost tooth-supporting tissues, including periodontal ligament, alveolar bone, and cementum. This review discusses recent progresses of periodontal regeneration using tissue-engineering and regenerative medicine approaches. Specifically, we focus on the advances of biomaterials and controlled drug delivery for periodontal regeneration in recent years. Special attention is given to the development of advanced bio-inspired scaffolding biomaterials and temporospatial control of multi-drug delivery for the regeneration of cementum-periodontal ligament-alveolar bone complex. Challenges and future perspectives are presented to provide inspiration for the design and development of innovative biomaterials and delivery system for new regenerative periodontal therapy.
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Affiliation(s)
- Yongxi Liang
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX, 75246, USA
| | - Xianghong Luan
- Department of Periodontics, Texas A&M University College of Dentistry, Dallas, TX, 75246, USA
| | - Xiaohua Liu
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX, 75246, USA
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Guo B, Tang C, Wang M, Zhao Z, Shokoohi-Tabrizi HA, Shi B, Andrukhov O, Rausch-Fan X. In vitro biocompatibility of biohybrid polymers membrane evaluated in human gingival fibroblasts. J Biomed Mater Res B Appl Biomater 2020; 108:2590-2598. [PMID: 32096606 PMCID: PMC7383566 DOI: 10.1002/jbm.b.34591] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 02/11/2020] [Indexed: 12/14/2022]
Abstract
The biohybrid polymer membrane (BHM) is a new biomaterial designed for the treatment of soft periodontal tissue defects. We aimed to evaluate the in vitro biocompatibility of the membrane in human gingival fibroblasts and the capability to induce cell adhesion, migration, differentiation and improving the production of the extracellular matrix. BHM and Mucograft® collagen matrix (MCM) membranes were punched into 6 mm diameter round discs and placed in 96‐well plates. Human primary gingival fibroblasts were seeded on the membranes or tissue culture plastic (TCP) serving as the control. Cell proliferation/viability and morphology were evaluated after 3, 7, and 14 days of culture by cell counting kit (CCK)‐8 assay and scanning electron microscopy, respectively. Additionally, the gene expression of transforming growth factor (TGF)‐β1, focal adhesion kinase (FAK), collagen type 1 (Col1), alpha‐smooth muscle actin (α‐SMA), and fibroblasts growth factor (FGF)‐2 was analyzed at 3, 7, and 14 days of culture by qPCR. Cell proliferation on BHM was significantly higher than on MCM and similar to TCP. Gene expression of TGF‐β1, FAK, Col1, and α‐SMA were significantly increased on BHM compared to TCP at most investigated time points. However, the gene expression of FGF‐2 was significantly decreased on BHM at Day 7 and recovered at Day 14 to the levels similar to TCP. The finding of this study showed that BHM is superior for gingival fibroblasts in terms of adhesion, proliferation, and gene expression, suggesting that this membrane may promote the healing of soft periodontal tissue.
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Affiliation(s)
- Bin Guo
- Department of Stomatology, Jinan Central Hospital affiliated to Shandong University, Jinan, Shandong, China.,Division of Periodontology and Conservative Dentistry, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Chuhua Tang
- Division of Periodontology and Conservative Dentistry, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Stomatology, PLA Strategic Support Force Characteristic Medical Center, Beijing, China
| | - Mingguo Wang
- Department of Stomatology, Jinan Central Hospital affiliated to Shandong University, Jinan, Shandong, China
| | - Zhongqi Zhao
- Division of Periodontology and Conservative Dentistry, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Hassan A Shokoohi-Tabrizi
- Division of Periodontology and Conservative Dentistry, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Bin Shi
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Oleh Andrukhov
- Division of Periodontology and Conservative Dentistry, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Division of Periodontology and Conservative Dentistry, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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