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Wang S, Liu J, Caroprese M, Gianfreda F, Melloni F, DE Santis D. Exploring the potential of calcium-based biomaterials for bone regeneration in dentistry: a systematic review. Minerva Dent Oral Sci 2024; 73:169-180. [PMID: 38127421 DOI: 10.23736/s2724-6329.23.04859-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Regenerative medicine emerged as a promising strategy for addressing bone defects, with several bone grafts currently being used, including autografts, allografts, xenografts and alloplasts. Calcium-based biomaterials (CaXs), a well-known class of synthetic materials, have demonstrated good biological properties and are being investigated for their potential to facilitate bone regeneration. This systematic review evaluates the current clinical applications of CaXs in dentistry for bone regeneration. EVIDENCE ACQUISITION A comprehensive search was conducted to collect information about CaXs and their applications in the dental field over the last ten years. The search was limited to relevant articles published in peer-reviewed journals. EVIDENCE SYNTHESIS A total of 72 articles were included in this scoping review, with eight studies related to periodontology, 63 in implantology and three in maxillofacial surgery respectively. The findings suggest that CaXs hold promise as an alternative intervention for minor bone regeneration in dentistry. CONCLUSIONS Calcium-based biomaterials have shown potential as a viable option for bone regeneration in dentistry. Further research is warranted to fully understand their efficacy and safety in larger bone defects. CaXs represent an exciting avenue for researchers and clinicians to explore in their ongoing efforts to advance regenerative medicine.
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Affiliation(s)
- Siwei Wang
- Department of Dental Implantology, The Affiliated Stomatological Hospital, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jianguo Liu
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Marino Caroprese
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesco Gianfreda
- Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Federica Melloni
- Section of Head and Neck Surgery, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy
| | - Daniele DE Santis
- Section of Head and Neck Surgery, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy -
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Kuznetsova VS, Vasilyev AV, Bukharova TB, Nedorubova IA, Goldshtein DV, Popov VK, Kulakov AA. Application of BMP-2 and its gene delivery vehicles in dentistry. Saudi Dent J 2024; 36:855-862. [PMID: 38883899 PMCID: PMC11178965 DOI: 10.1016/j.sdentj.2024.03.015] [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: 11/14/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 06/18/2024] Open
Abstract
The restoration of bone defects resulting from tooth loss, periodontal disease, severe trauma, tumour resection and congenital malformations is a crucial task in dentistry and maxillofacial surgery. Growth factor- and gene-activated bone graft substitutes can be used instead of traditional materials to solve these problems. New materials will overcome the low efficacy and difficulties associated with the use of traditional bone substitutes in complex situations. One of the most well-studied active components for bone graft substitutes is bone morphogenetic protein-2 (BMP-2), which has strong osteoinductive properties. The aim of this review was to examine the use of BMP-2 protein and gene therapy for bone regeneration in the oral and maxillofacial region and to discuss its future use.
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Affiliation(s)
- Valeriya Sergeevna Kuznetsova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Research Centre for Medical Genetics, Moscow, Russia
| | - Andrey Vyacheslavovich Vasilyev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Research Centre for Medical Genetics, Moscow, Russia
| | | | | | | | - Vladimir Karpovich Popov
- Federal Scientific Research Centre "Crystallography and Photonics", Russian Academy of Sciences, Moscow, Russia
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Nam JW. Efficacy of hydroxyapatite and fibrin sealant as carriers for bone morphogenetic protein-2 in maxillary sinus floor augmentation: a retrospective study. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00099-7. [PMID: 38653626 DOI: 10.1016/j.ijom.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
The aim of this retrospective study was to assess the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) with hydroxyapatite (HA) granules and fibrin sealant (FS) in maxillary sinus floor augmentation (MSFA), with a focus on the volume change. Fifty-two of 137 patients who underwent MSFA with rhBMP-2/HA grafting between June 2016 and December 2022 met the study inclusion criteria; 25 had received rhBMP-2/HA without FS and 27 had received rhBMP-2/HA with FS. Computed tomography (CT) images were obtained preoperatively, immediately following the operation, and at 6 months postoperative. These images were three-dimensionally reconstructed to measure the volumetric and height changes following MSFA. The mean ± standard deviation percentage of volumetric change at 6 months was 48.75 ± 37.44% in the group with FS and 29.77 ± 13.42% in the group without FS (P = 0.019). The vertical height measured at a specific site of the grafted area showed a mean percentage change at 6 months of 4.05 ± 12.08% in the group with FS and 6.07 ± 10.15% in the group without FS (P = 0.518). The additional use of FS as a carrier for rhBMP-2/HA in MSFA was found to improve surgical convenience and bone regeneration ability.
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Affiliation(s)
- J W Nam
- Department of Oral and Maxillofacial Surgery, Wonkwang University Sanbon Dental Hospital, Gunpo-si, Gyeonggi-do, Republic of Korea; Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan-si, Jeonbuk-do, Republic of Korea.
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Galarraga-Vinueza ME, Barootchi S, Nevins ML, Nevins M, Miron RJ, Tavelli L. Twenty-five years of recombinant human growth factors rhPDGF-BB and rhBMP-2 in oral hard and soft tissue regeneration. Periodontol 2000 2024; 94:483-509. [PMID: 37681552 DOI: 10.1111/prd.12522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
Contemporary oral tissue engineering strategies involve recombinant human growth factor approaches to stimulate diverse cellular processes including cell differentiation, migration, recruitment, and proliferation at grafted areas. Recombinant human growth factor applications in oral hard and soft tissue regeneration have been progressively researched over the last 25 years. Growth factor-mediated surgical approaches aim to accelerate healing, tissue reconstruction, and patient recovery. Thus, regenerative approaches involving growth factors such as recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and recombinant human bone morphogenetic proteins (rhBMPs) have shown certain advantages over invasive traditional surgical approaches in severe hard and soft tissue defects. Several clinical studies assessed the outcomes of rhBMP-2 in diverse clinical applications for implant site development and bone augmentation. Current evidence regarding the clinical benefits of rhBMP-2 compared to conventional therapies is inconclusive. Nevertheless, it seems that rhBMP-2 can promote faster wound healing processes and enhance de novo bone formation, which may be particularly favorable in patients with compromised bone healing capacity or limited donor sites. rhPDGF-BB has been extensively applied for periodontal regenerative procedures and for the treatment of gingival recessions, showing consistent and positive outcomes. Nevertheless, current evidence regarding its benefits at implant and edentulous sites is limited. The present review explores and depicts the current applications, outcomes, and evidence-based clinical recommendations of rhPDGF-BB and rhBMPs for oral tissue regeneration.
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Affiliation(s)
- Maria Elisa Galarraga-Vinueza
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- School of Dentistry, Universidad de las Américas (UDLA), Quito, Ecuador
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Marc L Nevins
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Myron Nevins
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Li J, Zhao Y, Chen S, Wang S, Zhong W, Zhang Q. Research Hotspots and Trends of Bone Xenograft in Clinical Procedures: A Bibliometric and Visual Analysis of the Past Decade. Bioengineering (Basel) 2023; 10:929. [PMID: 37627814 PMCID: PMC10451653 DOI: 10.3390/bioengineering10080929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/11/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Bone defect therapy is a common clinical challenge for orthopedic and clinical physicians worldwide, and the therapeutic effect affects the physiological function and healthy life quality of millions of patients. Compared with traditional autogenous bone transplants, bone xenografts are attracting attention due to their advantages of unlimited availability and avoidance of secondary damage. However, there is currently a lack of bibliometric analysis on bone xenograft. This study aimed to use bibliometric methods to analyze the literature on bone xenograft from 2013 to 2023, to explore the current status, hotspots, and future trends of research in this field, and to promote its development and progress. METHODS Using the Web of Science Core Collection database, we retrieved and collected publication data related to xenogeneic bone grafting materials worldwide from January 2013 to March 2023. Origin (2021), CiteSpace (6.2.R2 standard), and an online bibliometric platform were used for bibliometric analysis and data visualization. RESULTS A total of 3395 documents were retrieved, and 686 eligible papers were selected. The country and institutions with the highest number of publications and centrality were the United States (125 papers, centrality = 0.44) and the University of Zurich (29 papers, centrality = 0.28), respectively. The most cited author was Araujo MG (163 times), and the author with the most significant centrality was Froum SJ (centrality = 0.09). The main keyword clusters were "tissue engineering", "sinus floor elevation", "dental implants", "tooth extraction", and "bone substitutes". The most significant bursting keywords in the last three years were "platelet rich fibrin". CONCLUSIONS Research on bone xenograft is steadily growing and will continue to rise. Currently, research hotspots and directions are mainly focused on dental implants related to bone-augmentation techniques and bone tissue engineering. In the future, research hotspots and directions may focus on decellularization technology and investigations involving platelet-rich fibrin.
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Affiliation(s)
- Jiayue Li
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Yujue Zhao
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Shili Chen
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Simin Wang
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Wen Zhong
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Qing Zhang
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 51081 BT Amsterdam, The Netherlands
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Lee D, Lee J, Koo KT, Seol YJ, Lee YM. The impact of polydeoxyribonucleotide on early bone formation in lateral-window sinus floor elevation with simultaneous implant placement. J Periodontal Implant Sci 2023; 53:157-169. [PMID: 36468479 PMCID: PMC10133820 DOI: 10.5051/jpis.2202760138] [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: 06/12/2022] [Revised: 07/13/2022] [Accepted: 08/09/2022] [Indexed: 04/26/2023] Open
Abstract
PURPOSE The aim of this study was to evaluate the impact of polydeoxyribonucleotide (PDRN) on histologic outcomes when implant placement and lateral sinus floor elevation are performed simultaneously. METHODS Three bimaxillary premolars (P2, P3, and P4) were extracted from 4 beagle dogs 2 months before lateral sinus floor elevation. After lateral elevation of the sinus membrane, each sinus was allocated to either the test or control group. Sinuses underwent either 1) collagenated synthetic bone graft with PDRN following lateral sinus floor elevation (test group) or 2) collagenated synthetic bone graft without PDRN after lateral sinus floor elevation (control group). Eight weeks after the surgical procedure, all animals were euthanised for a histologic and histomorphometric assessment. Augmented height (AH), protruding height (PH), and bone-to-implant contact in pristine (BICp) and augmented (BICa) bone were measured. The composition of the augmented area, which was divided into 3 areas of interest located in coronal, middle and apical areas (AOI_C, AOI_M, and AOI_A), was calculated with 3 parameters: the area percentage of new bone (pNB), residual bone graft particle (pRBP), and fibrovascular connective tissue (pFVT). RESULTS AH, PH, BICp, BICa total, BICa coronal, and BICa middle values were not significantly different between sinuses in the control and test groups (all P>0.05). The BICa apical of sinuses in the test group (76.7%±9.3%) showed statistically higher values than those of sinuses in the control group (55.6%±22.1%) (P=0.038). pNB, pRBP, and pFVT showed statistically significant differences between the 2 groups in AOI_A (P=0.038, P=0.028, and P=0.007, respectively). pNB, pRBP, and pFVT in AOI_C and AOI_M were not significantly different between samples in the control and test groups (all P>0.05). CONCLUSIONS The histologic findings revealed that lateral sinus floor elevation with PDRN might improve early new bone formation and enable higher bone-to-implant contact.
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Affiliation(s)
- Dongseob Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea
| | - Jungwon Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Korea.
| | - Ki-Tae Koo
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea
| | - Yang-Jo Seol
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, Korea.
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Khijmatgar S, Del Fabbro M, Tumedei M, Testori T, Cenzato N, Tartaglia GM. Residual Bone Height and New Bone Formation after Maxillary Sinus Augmentation Procedure Using Biomaterials: A Network Meta-Analysis of Clinical Trials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1376. [PMID: 36837005 PMCID: PMC9962504 DOI: 10.3390/ma16041376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/26/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Different factors may affect new bone formation following maxillary sinus floor augmentation for the rehabilitation of posterior edentulous maxilla. The purpose of this study was to determine the influence of residual bone height (RBH) on new bone formation after lateral sinus augmentation utilizing different biomaterials, through a network meta-analysis (NMA). METHODS PUBMED, Scopus, and Web of Science electronic databases were searched until 31 December 2022 to obtain relevant articles. A hand search was also conducted. Randomised controlled studies on maxillary sinus augmentation comparing different grafting materials in patients with atrophic posterior maxilla, in need of prosthetic rehabilitation, were included. The risk of bias was assessed following the guidelines of the Cochrane Collaboration. The primary outcome was new bone formation (NBF), assessed histomorphometrically. The statistical analysis was performed by splitting the data according to RBH (<4 mm and ≥4 mm). RESULTS A total of 67 studies were eligible for conducting NMA. Overall, in the included studies, 1955 patients were treated and 2405 sinus augmentation procedures were performed. The biomaterials used were grouped into: autogenous bone (Auto), xenografts (XG), allografts (AG), alloplasts (AP), bioactive agents (Bio), hyaluronic acid (HA), and combinations of these. An inconsistency factor (IF) seen in the entire loop of the XG, AP, and Bio+AP was found to be statistically significant. The highest-ranked biomaterials for the <4 mm RBH outcome were XG+AG, XG+AP, and Auto. Similarly, the surface under the cumulative ranking curve (SUCRA) of biomaterials for ≥4 mm RBH was Auto, Bio+XG, and XG+Auto. CONCLUSION There is no grafting biomaterial that is consistently performing better than others. The performance of the materials in terms of NBF may depend on the RBH. While choosing a biomaterial, practitioners should consider both patient-specific aspects and sinus clinical characteristics.
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Affiliation(s)
- Shahnavaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Department of Oral Biology and Genomic Studies, AB Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore 575018, Karnataka, India
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Tiziano Testori
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Department of Implantology and Oral Rehabilitation, Dental Clinic, IRCCS Ospedale Galeazzi-Sant’Ambrogio, 20157 Milan, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Niccolò Cenzato
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Tavelli L, Barootchi S, Rasperini G, Giannobile WV. Clinical and patient-reported outcomes of tissue engineering strategies for periodontal and peri-implant reconstruction. Periodontol 2000 2023; 91:217-269. [PMID: 36166659 PMCID: PMC10040478 DOI: 10.1111/prd.12446] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/25/2022] [Accepted: 06/05/2022] [Indexed: 11/28/2022]
Abstract
Scientific advancements in biomaterials, cellular therapies, and growth factors have brought new therapeutic options for periodontal and peri-implant reconstructive procedures. These tissue engineering strategies involve the enrichment of scaffolds with living cells or signaling molecules and aim at mimicking the cascades of wound healing events and the clinical outcomes of conventional autogenous grafts, without the need for donor tissue. Several tissue engineering strategies have been explored over the years for a variety of clinical scenarios, including periodontal regeneration, treatment of gingival recessions/mucogingival conditions, alveolar ridge preservation, bone augmentation procedures, sinus floor elevation, and peri-implant bone regeneration therapies. The goal of this article was to review the tissue engineering strategies that have been performed for periodontal and peri-implant reconstruction and implant site development, and to evaluate their safety, invasiveness, efficacy, and patient-reported outcomes. A detailed systematic search was conducted to identify eligible randomized controlled trials reporting the outcomes of tissue engineering strategies utilized for the aforementioned indications. A total of 128 trials were ultimately included in this review for a detailed qualitative analysis. Commonly performed tissue engineering strategies involved scaffolds enriched with mesenchymal or somatic cells (cell-based tissue engineering strategies), or more often scaffolds loaded with signaling molecules/growth factors (signaling molecule-based tissue engineering strategies). These approaches were found to be safe when utilized for periodontal and peri-implant reconstruction therapies and implant site development. Tissue engineering strategies demonstrated either similar or superior clinical outcomes than conventional approaches for the treatment of infrabony and furcation defects, alveolar ridge preservation, and sinus floor augmentation. Tissue engineering strategies can promote higher root coverage, keratinized tissue width, and gingival thickness gain than scaffolds alone can, and they can often obtain similar mean root coverage compared with autogenous grafts. There is some evidence suggesting that tissue engineering strategies can have a positive effect on patient morbidity, their preference, esthetics, and quality of life when utilized for the treatment of mucogingival deformities. Similarly, tissue engineering strategies can reduce the invasiveness and complications of autogenous graft-based staged bone augmentation. More studies incorporating patient-reported outcomes are needed to understand the cost-benefits of tissue engineering strategies compared with traditional treatments.
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Affiliation(s)
- Lorenzo Tavelli
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Shayan Barootchi
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- IRCCS Foundation Polyclinic Ca’ Granda, University of Milan, Milan, Italy
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Long-Term Changes in Adipose Tissue in the Newly Formed Bone Induced by Recombinant Human BMP-2 In Vivo. Biomimetics (Basel) 2023; 8:biomimetics8010033. [PMID: 36648819 PMCID: PMC9844441 DOI: 10.3390/biomimetics8010033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
Recombinant human bone morphogenetic protein-2 (rhBMP-2) induces osteogenesis and adipogenesis in bone scaffolds. We evaluated rhBMP-2-induced long-term changes in adipose tissue in the newly formed bone in different scaffolds forms. Bovine bone particles and blocks were grafted along with rhBMP-2 in the subperiosteal space of a rat calvarial bone, and the formation of new bone and adipose tissue were evaluated at 6 and 16 weeks after the surgery. The bone mineral density (BMD) and trabecular thickness (TbTh) of the 16w particle group were significantly higher than those of the 6w particle group (p = 0.018 and 0.012, respectively). The BMD and TbTh gradually increased in the particle group from weeks 6 to 16. The average adipose tissue volume (ATV) of the 6w particle group was higher than that of the 16w particle group, although the difference was not significant (p > 0.05), and it decreased gradually. There were no significant changes in the bone volume (BV) and BMD between the 6w and 16w block groups. Histological analysis revealed favorable new bone regeneration in all groups. Adipose tissue was formed between the bone particles and at the center in the particle and block groups, respectively. The adipose tissue space decreased, and the proportion of new bone increased in the 16w particle group compared to that in the 6w group. To summarize, in the particle group, the adipose tissue decreased in a time-dependent manner, BMD and TbTh increased, and new bone formation increased from 6 to 16 weeks. These results suggest that rhBMP-2 effectively induces new bone formation in the long term in particle bone scaffolds.
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Wang YX, Peng ZL, Sun ZW, Pan YJ, Ai H, Mai ZH. MiR-20a promotes osteogenic differentiation in bone marrow-derived mesenchymal stem/stromal cells and bone repair of the maxillary sinus defect model in rabbits. Front Bioeng Biotechnol 2023; 11:1127908. [PMID: 37091341 PMCID: PMC10113429 DOI: 10.3389/fbioe.2023.1127908] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction: This study aimed to determine whether miR-20 promoted osteogenic differentiation in bone marrow-derived mesenchymal stem/stromal cells (BMSCs) and accelerated bone formation in the maxillary sinus bone defect model in rabbits. Methods: BMSCs were transfected with miR-20a or anti-miR-20a for 12 h, followed by detection of RUNX2, Sp7 mRNA, bone morphogenetic protein 2 (BMP2), and RUNX2 protein expression. Alkaline phosphatase (ALP) activity and Alizarin Red S staining were used to detect calcified nodule deposition. In the rabbit maxillary sinus bone defect model, miR-20a loaded with AAV and BMP2 protein were mixed with Bio-Oss bone powder for filling the bone defect. At 4 weeks and 8 weeks, bone density was detected by cone beam computed tomography (CBCT), and new bone, osteoblasts, and collagen type 1 were evaluated by hematoxylin and eosin (HE) staining and immunohistochemical (IHC) staining. Results: Overexpression of miR-20a enhanced the mRNA and protein levels of BMP2, RUNX2, and SP7, the activity of ALP, and the levels of matrix mineralization, whereas the levels and activity of the aforementioned factors were decreased by anti-miR-20a treatment of BMSCs. Furthermore, miR-20a significantly increased the bone density, the number of osteoblasts, and the secretion of collagen type 1 in bone defects compared with Bio-Oss bone powder in the rabbit maxillary sinus bone defect model. Conclusion: Overall, miR-20a can induce osteogenic differentiation in BMSCs and accelerate bone formation of maxillary sinus defects in rabbits.
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Affiliation(s)
- Yi-Xuan Wang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhu-Li Peng
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhi-Wen Sun
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yan-Jun Pan
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hong Ai
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhi-Hui Mai
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- *Correspondence: Zhi-Hui Mai,
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Suárez-López Del Amo F, Monje A. Efficacy of biologics for alveolar ridge preservation/reconstruction and implant site development: An American Academy of Periodontology best evidence systematic review. J Periodontol 2022; 93:1827-1847. [PMID: 35841608 PMCID: PMC10092438 DOI: 10.1002/jper.22-0069] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The use of biologics may be indicated for alveolar ridge preservation (ARP) and reconstruction (ARR), and implant site development (ISD). The present systematic review aimed to analyze the effect of autologous blood-derived products (ABPs), enamel matrix derivative (EMD), recombinant human platelet-derived growth factor-BB (rhPDGF-BB), and recombinant human bone morphogenetic protein-2 (rhBMP-2), on the outcomes of ARP/ARR and ISD therapy (i.e., alveolar ridge augmentation [ARA] and maxillary sinus floor augmentation [MSFA]). METHODS An electronic search for eligible articles published from January 2000 to October 2021 was conducted. Randomized clinical trials evaluating the efficacy of ABPs, EMD, rhBMP-2, and rhPDGF-BB for ARP/ARR and ISD were included according to pre-established eligibility criteria. Data on linear and volumetric dimensional changes, histomorphometric findings, and a variety of secondary outcomes (i.e., clinical, implant-related, digital imaging, safety, and patient-reported outcome measures [PROMs]) were extracted and critically analyzed. Risk of bias assessment of the selected investigations was also conducted. RESULTS A total of 39 articles were included and analyzed qualitatively. Due to the high level of heterogeneity across studies, quantitative analyses were not feasible. Most studies in the topic of ARP/ARR revealed that the use of biologics rendered similar results compared with conventional protocols. However, when juxtaposed to unassisted healing or socket filling using collagen sponges, the application of biologics did contribute to attenuate post-extraction alveolar ridge atrophy in most investigations. Additionally, histomorphometric outcomes were positively influenced by the application of biologics. The use of biologics in ARA interventions did not yield superior clinical or radiographic outcomes compared with control therapies. Nevertheless, ABPs enhanced new bone formation and reduced the likelihood of early wound dehiscence. The use of biologics in MSFA interventions did not translate into superior clinical or radiographic outcomes. It was observed, though, that the use of some biologics may promote bone formation during earlier stages of healing. Only four clinical investigations evaluated PROMs and reported a modest beneficial impact of the use of biologics on pain and swelling. No severe adverse events in association with the use of the biologics evaluated in this systematic review were noted. CONCLUSIONS Outcomes of therapy after post-extraction ARP/ARR and ARA in edentulous ridges were comparable among different therapeutic modalities evaluated in this systematic review. Nevertheless, the use of biologics (i.e., PRF, EMD, rhPDGF-BB, and rhBMP-2) in combination with a bone graft material generally results into superior histomorphometric outcomes and faster wound healing compared with control groups.
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Affiliation(s)
| | - Alberto Monje
- Department of Periodontology, International University of Catalonia (UIC), Barcelona, Spain.,Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Division of Periodontology, CICOM-MONJE Institute, Badajoz, Spain.,Department of Periodontics, University of Bern, Bern, Switzerland
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Susin C, Lee J, Fiorini T, Koo KT, Schüpbach P, Finger Stadler A, Wikesjö UME. Screening of Hydroxyapatite Biomaterials for Alveolar Augmentation Using a Rat Calvaria Critical-Size Defect Model: Bone Formation/Maturation and Biomaterials Resolution. Biomolecules 2022; 12:1677. [PMID: 36421691 PMCID: PMC9687935 DOI: 10.3390/biom12111677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Natural (bovine-/equine-/porcine-derived) or synthetic hydroxyapatite (HA) biomaterials appear to be the preferred technologies among clinicians for bone augmentation procedures in preparation for implant dentistry. The aim of this study was to screen candidate HA biomaterials intended for alveolar ridge augmentation relative to their potential to support local bone formation/maturation and to assess biomaterial resorption using a routine critical-size rat calvaria defect model. METHODS Eighty adult male Sprague Dawley outbred rats obtained from a approved-breeder, randomized into groups of ten, were used. The calvaria defects (ø8 mm) either received sham surgery (empty control), Bio-Oss (bovine HA/reference control), or candidate biomaterials including bovine HA (Cerabone, DirectOss, 403Z013), and bovine (403Z014) or synthetic HA/ß-TCP (Reprobone, Ceraball) constructs. An 8 wk healing interval was used to capture the biomaterials' resolution. RESULTS All biomaterials displayed biocompatibility. Strict HA biomaterials showed limited, if any, signs of biodegradation/resorption, with the biomaterial area fraction ranging from 22% to 42%. Synthetic HA/ß-TCP constructs showed limited evidence of biodegradation/erosion (biomaterial area fraction ≈30%). Mean linear defect closure in the sham-surgery control approximated 40%. Mean linear defect closure for the Bio-Oss reference control approximated 18% compared with 15-35% for the candidate biomaterials without significant differences between the controls and candidate biomaterials. CONCLUSIONS None of the candidate HA biomaterials supported local bone formation/maturation beyond the native regenerative potential of this rodent model, pointing to their limitations for regenerative procedures. Biocompatibility and biomaterial dimensional stability could suggest their potential utility as long-term defect fillers.
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Affiliation(s)
- Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR), Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR), Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Tiago Fiorini
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR), Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre 90000-000, Brazil
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 110-460, Korea
| | | | - Amanda Finger Stadler
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR), Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Ulf ME Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR), Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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13
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Arias-Betancur A, Badilla-Wenzel N, Astete-Sanhueza Á, Farfán-Beltrán N, Dias FJ. Carrier systems for bone morphogenetic proteins: An overview of biomaterials used for dentoalveolar and maxillofacial bone regeneration. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:316-327. [PMID: 36281233 PMCID: PMC9587372 DOI: 10.1016/j.jdsr.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 09/14/2022] [Accepted: 10/11/2022] [Indexed: 11/27/2022] Open
Abstract
Different types of biomaterials have been used to fabricate carriers to deliver bone morphogenetic proteins (BMPs) in both dentoalveolar and maxillofacial bone regeneration procedures. Despite that absorbable collagen sponge (ACS) is considered the gold standard for BMP delivery, there is still some concerns regarding its use mainly due to its poor mechanical properties. To overcome this, novel systems are being developed, however, due to the wide variety of biomaterial combination, the heterogeneous assessment of newly formed tissue, and the intended clinical applications, there is still no consensus regarding which is more efficient in a particular clinical scenario. The combination of two or more biomaterials in different topological configurations has allowed specific controlled-release patterns for BMPs, improving their biological and mechanical properties compared with classical single-material carriers. However, more basic research is needed. Since the BMPs can be used in multiple clinical scenarios having different biological and mechanical needs, novel carriers should be developed in a context-specific manner. Thus, the purpose of this review is to gather current knowledge about biomaterials used to fabricate delivery systems for BMPs in both dentoalveolar and maxillofacial contexts. Aspects related with the biological, physical and mechanical characteristics of each biomaterial are also presented and discussed. Strategies for bone formation and regeneration are a major concern in dentistry. Topical delivery of bone morphogenetic proteins (BMPs) allows rapid bone formation. BMPs requires proper carrier system to allow controlled and sustained release. Carrier should also fulfill mechanical requirements of bone defect sites. By using complex composites, it would be possible to develop new carriers for BMPs.
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Affiliation(s)
- Alain Arias-Betancur
- Department of Integral Adult Dentistry, Research Centre for Dental Sciences (CICO-UFRO), Dental School-Facultad de Odontología, Universidad de La Frontera, Temuco 4811230, Chile
| | - Nicolás Badilla-Wenzel
- Dental School-Facultad de Odontología, Universidad de La Frontera, Temuco 4811230, Chile
| | - Álvaro Astete-Sanhueza
- Dental School-Facultad de Odontología, Universidad de La Frontera, Temuco 4811230, Chile
| | - Nicole Farfán-Beltrán
- Department of Integral Adult Dentistry, Research Centre for Dental Sciences (CICO-UFRO), Dental School-Facultad de Odontología, Universidad de La Frontera, Temuco 4811230, Chile.,Universidad Adventista de Chile, Chillán 3780000, Chile
| | - Fernando José Dias
- Department of Integral Adult Dentistry, Oral Biology Research Centre (CIBO-UFRO), Dental School-Facultad de Odontología, Universidad de La Frontera, Temuco 4811230, Chile
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14
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Han JJ, Moon JE, Lee EH, Yang HJ, Hwang SJ. Clinical and radiographic outcomes of dental implant after maxillary sinus floor augmentation with rhBMP-2/hydroxyapatite compared to deproteinized bovine bone. PLoS One 2022; 17:e0273399. [PMID: 36007001 PMCID: PMC9409565 DOI: 10.1371/journal.pone.0273399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/24/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives This study aimed to evaluate the clinical and radiographic outcomes of early implant placement and functional loading in maxillary sinus floor augmentation (MSFA) using recombinant human bone morphogenetic protein 2/hydroxyapatite (rhBMP-2/HA) and to compare these outcomes with those of the conventional protocol in MSFA using deproteinized bovine bone (DBB). Materials and methods The rhBMP-2/HA and DBB groups consisted of 14 and 13 patients who underwent MSFA with BMP and DBB, respectively. After placement of 22 implants and 21 implants in the rhBMP-2/HA and DBB groups, respectively, abutment connections were performed 3 months after implant placement for the rhBMP-2/HA group and 6 months after implant placement for the DBB group. Changes in grafted sinus height (GSH), marginal bone loss (MBL), and implant stability were evaluated up to one year after functional loading. Results Survival rates for the rhBMP-2/HA and DBB groups after one year of functional loading were 90.9% and 90.5%, respectively. Both groups exhibited no significant time-course changes in GSH until one year of functional loading (rhBMP-2/HA, p = 0.124; DBB, p = 0.075). Although significant MBL occurred after one year of functional loading for both groups (rhBMP-2/HA, p < 0.001; DBB, p < 0.001), there were no significant differences in time-course changes in MBL between the two groups (p = 0.450). The mean implant stability quotient values in the rhBMP-2/HA and DBB groups were 75.3 and 75.4 after one year of functional loading, respectively, and there were no significant differences between the two groups (p = 0.557). Conclusions MSFA using rhBMP-2/HA allowed implant rehabilitation with early implant placement and functional loading and led to a comparable survival rate and implant stability after 1 year of functional loading with acceptable MBL and stable maintenance of GSH compared to the MSFA using DBB with 6 months of healing after implant placement.
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Affiliation(s)
- Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Ji Eun Moon
- Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Eun-Hyuk Lee
- Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Republic of Korea
- * E-mail:
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Hwang Soon Jung’s Dental Clinic for Oral and Maxillofacial Surgery, Seoul, Republic of Korea
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15
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Granel H, Bossard C, Collignon AM, Wauquier F, Lesieur J, Rochefort GY, Jallot E, Lao J, Wittrant Y. Osteogenic Effect of Fisetin Doping in Bioactive Glass/Poly(caprolactone) Hybrid Scaffolds. ACS OMEGA 2022; 7:22279-22290. [PMID: 35811886 PMCID: PMC9260777 DOI: 10.1021/acsomega.2c01109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
Treating large bone defects or fragile patients may require enhancing the bone regeneration rate to overcome a weak contribution from the body. This work investigates the osteogenic potential of nutrient fisetin, a flavonoid found in fruits and vegetables, as a doping agent inside the structure of a SiO2-CaO bioactive glass-poly(caprolactone) (BG-PCL) hybrid scaffold. Embedded in the full mass of the BG-PCL hybrid during one-pot synthesis, we demonstrate fisetin to be delivered sustainably; the release follows a first-order kinetics with active fisetin concentration being delivered for more than 1 month (36 days). The biological effect of BG-PCL-fisetin-doped scaffolds (BG-PCL-Fis) has been highlighted by in vitro and in vivo studies. A positive impact is demonstrated on the adhesion and the differentiation of rat primary osteoblasts, without an adverse cytotoxic effect. Implantation in critical-size mouse calvaria defects shows bone remodeling characteristics and remarkable enhancement of bone regeneration for fisetin-doped scaffolds, with the regenerated bone volume being twofold that of nondoped scaffolds and fourfold that of a commercial trabecular bovine bone substitute. Such highly bioactive materials could stand as competitive alternative strategies involving biomaterials loaded with growth factors, the use of the latter being the subject of growing concerns.
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Affiliation(s)
- Henri Granel
- INRAE,
Human Nutrition Unit (UNH), ECREIN Team, TSA 50400, 28 Place Henri Dunant, Clermont-Ferrand, Auvergne-Rhone-Alpes 63001, France
| | - Cédric Bossard
- Université
Clermont Auvergne, Laboratoire De Physique De Clermont Ferrand, 4 Avenue Blaise Pascal, Clermont-Ferrand, Auvergne-Rhône-Alpes 63001, France
| | - Anne-Margaux Collignon
- Descartes
University of Paris Faculty of Dental Surgery, Laboratoires Pathologies,
Imagerie et Biothérapies Orofaciales,1 Rue Maurice Arnoux, Montrouge, Île-De-France 92120, France
| | - Fabien Wauquier
- INRAE,
Human Nutrition Unit (UNH), ECREIN Team, TSA 50400, 28 Place Henri Dunant, Clermont-Ferrand, Auvergne-Rhone-Alpes 63001, France
| | - Julie Lesieur
- Descartes
University of Paris Faculty of Dental Surgery, Laboratoires Pathologies,
Imagerie et Biothérapies Orofaciales,1 Rue Maurice Arnoux, Montrouge, Île-De-France 92120, France
| | - Gael Y. Rochefort
- Descartes
University of Paris Faculty of Dental Surgery, Laboratoires Pathologies,
Imagerie et Biothérapies Orofaciales,1 Rue Maurice Arnoux, Montrouge, Île-De-France 92120, France
| | - Edouard Jallot
- Université
Clermont Auvergne, Laboratoire De Physique De Clermont Ferrand, 4 Avenue Blaise Pascal, Clermont-Ferrand, Auvergne-Rhône-Alpes 63001, France
| | - Jonathan Lao
- Université
Clermont Auvergne, Laboratoire De Physique De Clermont Ferrand, 4 Avenue Blaise Pascal, Clermont-Ferrand, Auvergne-Rhône-Alpes 63001, France
| | - Yohann Wittrant
- INRAE,
Human Nutrition Unit (UNH), ECREIN Team, TSA 50400, 28 Place Henri Dunant, Clermont-Ferrand, Auvergne-Rhone-Alpes 63001, France
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16
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Su CJ, Murugan A, Linton JM, Yeluri A, Bois J, Klumpe H, Langley MA, Antebi YE, Elowitz MB. Ligand-receptor promiscuity enables cellular addressing. Cell Syst 2022; 13:408-425.e12. [PMID: 35421362 PMCID: PMC10897978 DOI: 10.1016/j.cels.2022.03.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 11/08/2021] [Accepted: 03/16/2022] [Indexed: 12/24/2022]
Abstract
In multicellular organisms, secreted ligands selectively activate, or "address," specific target cell populations to control cell fate decision-making and other processes. Key cell-cell communication pathways use multiple promiscuously interacting ligands and receptors, provoking the question of how addressing specificity can emerge from molecular promiscuity. To investigate this issue, we developed a general mathematical modeling framework based on the bone morphogenetic protein (BMP) pathway architecture. We find that promiscuously interacting ligand-receptor systems allow a small number of ligands, acting in combinations, to address a larger number of individual cell types, defined by their receptor expression profiles. Promiscuous systems outperform seemingly more specific one-to-one signaling architectures in addressing capability. Combinatorial addressing extends to groups of cell types, is robust to receptor expression noise, grows more powerful with increases in the number of receptor variants, and is maximized by specific biochemical parameter relationships. Together, these results identify design principles governing cellular addressing by ligand combinations.
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Affiliation(s)
- Christina J Su
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Arvind Murugan
- Department of Physics, University of Chicago, Chicago, IL 60637, USA
| | - James M Linton
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Akshay Yeluri
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Justin Bois
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Heidi Klumpe
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA; Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Matthew A Langley
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Yaron E Antebi
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 76100, Israel.
| | - Michael B Elowitz
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA; Department of Applied Physics, California Institute of Technology, Pasadena, CA 91125, USA; Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA.
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17
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Han JJ, Chang AR, Ahn J, Jung S, Hong J, Oh HK, Hwang SJ. Efficacy and safety of rhBMP/β-TCP in alveolar ridge preservation: a multicenter, randomized, open-label, comparative, investigator-blinded clinical trial. Maxillofac Plast Reconstr Surg 2021; 43:42. [PMID: 34928477 PMCID: PMC8688599 DOI: 10.1186/s40902-021-00328-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this multicenter, randomized, open-label, comparative, investigator-blinded study was to investigate the efficacy and safety of recombinant human bone morphogenetic protein 2 (rhBMP-2) combined with β-TCP (rhBMP-2/β-TCP) in alveolar ridge preservation. Materials and methods Eighty-four subjects from three centers were enrolled in this clinical trial. After tooth extraction, rhBMP-2/β-TCP (n = 41, test group) or β-TCP (n = 43, control group) were grafted to the extraction socket with an absorbable barrier membrane for alveolar ridge preservation. Using computed tomography images obtained immediately after and 12 weeks after surgery, changes in the alveolar bone height and width were analyzed for each group and compared between the two groups. Results Both the test and control groups showed a significant decrease in alveolar bone height in the 12 weeks after surgery (both groups, p < 0.0001). However, the test group exhibited a significantly lower decrease in alveolar bone height than the control group (p = 0.0004). Alveolar bone width also showed significantly less resorption in the test group than in the control group for all extraction socket levels (ESL) (p = 0.0152 for 75% ESL; p < 0.0001 for 50% ESL; p < 0.0001 for 25% ESL). There were no statistically significant differences in the incidence of adverse events between the two groups. No severe adverse events occurred in either group. Conclusions The results of this study suggest that rhBMP-2/β-TCP is a safe graft material that provides a high alveolar bone preservation effect in patients receiving dental extraction. Trial registration Clinicaltrials.gov, NCT02714829, Registered 22 March 2016
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Affiliation(s)
- Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ah Ryum Chang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jaemyung Ahn
- Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seunggon Jung
- Department of Oral and Maxillofacial Surgery, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Jongrak Hong
- Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee-Kyun Oh
- Department of Oral and Maxillofacial Surgery, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea. .,Hwang Soon Jung's Dental Clinic for Oral and Maxillofacial Surgery, 349, Woonam Building 2, 3F, Gangnam-daero, Seocho-gu, Seoul, 06626, Republic of Korea.
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18
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Comparison of Bone Regeneration in Different Forms of Bovine Bone Scaffolds with Recombinant Human Bone Morphogenetic Protein-2. Int J Mol Sci 2021; 22:ijms222011121. [PMID: 34681785 PMCID: PMC8537640 DOI: 10.3390/ijms222011121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to compare the bone regeneration ability of particle and block bones, acting as bone scaffolds, with recombinant human bone morphogenetic protein (rhBMP)-2 and evaluate them as rhBMP-2 carriers. Demineralized bovine bone particles, blocks, and rhBMP-2 were grafted into the subperiosteal space of a rat calvarial bone, and the rats were randomly divided into four groups: particle, block, P (particle)+BMP, and B (block)+BMP groups. The bone volume of the B+BMP group was significantly higher than that of the other groups (p < 0.00), with no significant difference in bone mineral density. The average adipose tissue volume of the B+BMP group was higher than that of the P+BMP group, although the difference was not significant. Adipose tissue formation was observed in the rhBMP-2 application group. Histologically, the particle and B+BMP groups showed higher formation of a new bone. However, adipose tissue and void spaces were also formed, especially in the B+BMP group. Hence, despite the formation of a large central void space, rhBMP-2 could be effectively used with block bone scaffolds and showed excellent new bone formation. Further studies are required to evaluate the changes in adipose tissue.
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19
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Bone Morophogenetic Protein Application as Grafting Materials for Bone Regeneration in Craniofacial Surgery: Current Application and Future Directions. J Craniofac Surg 2021; 32:787-793. [PMID: 33705037 DOI: 10.1097/scs.0000000000006937] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
ABSTRACT Rebuilding atrophied alveolar ridges can present a significant challenge for the maxillofacial surgeons. A multitude of treatment options including guided bone regeneration, onlay block grafting, and distraction osteogenesis are today available as safe procedures.The recent Food and Drug Administration approval of recombinant human bone morphogenetic proteins (rhBMPs) has given clinicians an added treatment option for reconstructing localized and large jaw defects. Currently, several patients have been successfully treated with the combination of bone graft and rhBMP-2 and the results have been documented as predictable and safe by clinical and radiologic examinations follow-up. In this study, a literature review was conducted using Medline, Medpilot, and Cochrane Database of Systematic Reviews. It was concentrated on manuscripts and overviews published in the last 20 years (2000-2020). The key terms employed were platelet-rich plasma, rhBMPs, and their combinations with the common scaffolds used for bone regeneration techniques. The results of clinical studies and animal trials were especially emphasized. The statements from the literature were compared with authors' own clinical data.The potential to reconstruct these large bone defects with a growth factor thus limiting or even avoiding a secondary harvest site is exciting and it represents a new frontier in the field of surgery. This study data confirm how there are excellent documents about the possible combination of using substitute materials and growth factor for treating large and minor craniofacial bone defects.
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20
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Zhu G, Zhang T, Chen M, Yao K, Huang X, Zhang B, Li Y, Liu J, Wang Y, Zhao Z. Bone physiological microenvironment and healing mechanism: Basis for future bone-tissue engineering scaffolds. Bioact Mater 2021; 6:4110-4140. [PMID: 33997497 PMCID: PMC8091181 DOI: 10.1016/j.bioactmat.2021.03.043] [Citation(s) in RCA: 149] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/19/2021] [Accepted: 03/28/2021] [Indexed: 02/06/2023] Open
Abstract
Bone-tissue defects affect millions of people worldwide. Despite being common treatment approaches, autologous and allogeneic bone grafting have not achieved the ideal therapeutic effect. This has prompted researchers to explore novel bone-regeneration methods. In recent decades, the development of bone tissue engineering (BTE) scaffolds has been leading the forefront of this field. As researchers have provided deep insights into bone physiology and the bone-healing mechanism, various biomimicking and bioinspired BTE scaffolds have been reported. Now it is necessary to review the progress of natural bone physiology and bone healing mechanism, which will provide more valuable enlightenments for researchers in this field. This work details the physiological microenvironment of the natural bone tissue, bone-healing process, and various biomolecules involved therein. Next, according to the bone physiological microenvironment and the delivery of bioactive factors based on the bone-healing mechanism, it elaborates the biomimetic design of a scaffold, highlighting the designing of BTE scaffolds according to bone biology and providing the rationale for designing next-generation BTE scaffolds that conform to natural bone healing and regeneration.
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Affiliation(s)
- Guanyin Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Tianxu Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Miao Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Ke Yao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Xinqi Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Bo Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Yazhen Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Jun Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
| | - Yunbing Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610041, PR China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China
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Han S, Paeng KW, Park S, Jung UW, Cha JK, Hong J. Programmed BMP-2 release from biphasic calcium phosphates for optimal bone regeneration. Biomaterials 2021; 272:120785. [PMID: 33819813 DOI: 10.1016/j.biomaterials.2021.120785] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/20/2021] [Accepted: 03/25/2021] [Indexed: 01/09/2023]
Abstract
This study aimed to fabricate a multi-layered biphasic calcium phosphate (BCP) platform for programmed bone morphogenetic protein-2 (BMP-2) release, which means to block the initial burst release and promote releasing during the differentiation phase of osteogenic cells. And it is to confirm in vivo whether this platform has osteogenic inductivity even when extremely low doses of BMP-2 are loaded compared to the conventional soaking method. Our strategy consisted of preparing a multilayer coating on BCP to minimize the contact between BMP-2 and BCP and allow the loading of BMP-2. The multilayer, which is surface-modified on BCP, is composed of an organosilicate and a natural polymer-based layer-by-layer (LbL) film. We applied (3-Aminopropyl)triethoxysilane (APTES) as an organosilicate was used for amine-functionalized BCP and (collagen/heparin)5 film was used to delay and sustain BMP-2 release. The coated multilayer not only reduced the initial burst release by more than 50% but also loaded more BMP-2. For in vivo experiment, histomorphometric analysis, it was observed that the BCP platform loaded with extremely low concentration BMP-2 (0.01 mg/ml) induced a significantly larger amount of new bones at 8 weeks compared to the conventional soaking method in the rabbit calvarium onlay graft model.
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Affiliation(s)
- Seora Han
- Department of Chemical and Biomolecular Engineering, Yonsei University, Seoul, 03722, Republic of Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sohyeon Park
- Department of Chemical and Biomolecular Engineering, Yonsei University, Seoul, 03722, Republic of Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea.
| | - Jinkee Hong
- Department of Chemical and Biomolecular Engineering, Yonsei University, Seoul, 03722, Republic of Korea.
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Elangovan S, Gajendrareddy P, Ravindran S, Salem AK. Emerging local delivery strategies to enhance bone regeneration. ACTA ACUST UNITED AC 2020; 15:062001. [PMID: 32647095 PMCID: PMC10148649 DOI: 10.1088/1748-605x/aba446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In orthopedics and dentistry there is an increasing need for novel biomaterials and clinical strategies to achieve predictable bone regeneration. These novel molecular strategies have the potential to eliminate the limitations of currently available approaches. Specifically, they have the potential to reduce or eliminate the need to harvest autogenous bone, and the overall complexity of the clinical procedures. In this review, emerging tissue engineering strategies that have been, or are currently being, developed based on the current understanding of bone biology, development and wound healing will be discussed. In particular, protein/peptide based approaches, DNA/RNA therapeutics, cell therapy, and the use of exosomes will be briefly covered. The review ends with a summary of the current status of these approaches, their clinical translational potentials and their challenges.
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Affiliation(s)
- Satheesh Elangovan
- Department of Periodontics, The University of Iowa College of Dentistry, Iowa City, IA 52242, United States of America
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Sinus Floor Augmentation Using Recombinant Human Bone Morphogenetic Protein-2 With Hydroxyapatite: Volume Assessment. J Craniofac Surg 2020; 31:912-915. [PMID: 32068727 DOI: 10.1097/scs.0000000000006251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The aim of this study was to assess the efficacy of using bone morphogenetic protein-2 with hydroxyapatite granules (BMP-2/hydroxyapatite) during augmentation of maxillary sinus floor, with respect to changes in volume, relative to conventional bone graft materials. METHOD AND MATERIALS Twenty of 25 patients in the BMP-2/hydroxyapatite group, and 16 of 33 patients in the conventional materials group met the criteria for inclusion in this study. Computed tomography scans were performed preoperatively, immediately postoperatively, and at follow-up, approximately 6 months postoperatively. Changes in volume and height of both grafted materials were measured using 3-dimensional reconstruction software; these changes were compared between groups. RESULTS The mean (standard deviation) volumetric changes were 0.25 (0.11) cc and -0.07 (0.35) cc, and the mean rates of volumetric changes were 26.44% (7.78%) and -2.92% (30.92%) in BMP-2/hydroxyapatite and conventional materials groups, respectively. The mean height changes were 0.34 (0.73) mm and -0.63 (1.07) mm, and the mean rates of height changes were 3.67% (7.57%) and -5.95% (9.98%) in BMP-2/hydroxyapatite and conventional materials groups, respectively. CONCLUSION Compared with the conventional materials group, the BMP-2/hydroxyapatite group showed better maxillary sinus floor augmentation results in terms of volumetric changes and grafted material densities, and can provide predictably reliable outcomes.
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Which substances loaded onto collagen scaffolds influence oral tissue regeneration?-an overview of the last 15 years. Clin Oral Investig 2020; 24:3363-3394. [PMID: 32827278 DOI: 10.1007/s00784-020-03520-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/10/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Collagen scaffolds are widely used for guided bone or tissue regeneration. Aiming to enhance their regenerative properties, studies have loaded various substances onto these scaffolds. This review aims to provide an overview of existing literature which conducted in vitro, in vivo, and clinical testing of drug-loaded collagen scaffolds and analyze their outcome of promoting oral regeneration. MATERIALS AND METHODS PubMed, Scopus, and Ovid Medline® were systematically searched for publications from 2005 to 2019. Journal articles assessing the effect of substances on oral hard or soft tissue regeneration, while using collagen carriers, were screened and qualitatively analyzed. Studies were grouped according to their used substance type-biological medical products, pharmaceuticals, and tissue-, cell-, and matrix-derived products. RESULTS A total of 77 publications, applying 36 different substances, were included. Collagen scaffolds were demonstrating favorable adsorption behavior and release kinetics which could even be modified. BMP-2 was investigated most frequently, showing positive effects on oral tissue regeneration. BMP-9 showed comparable results at lower concentrations. Also, FGF2 enhanced bone and periodontal healing. Antibiotics improved the scaffold's anti-microbial activity and reduced the penetrability for bacteria. CONCLUSION Growth factors showed promising results for oral tissue regeneration, while other substances were investigated less frequently. Found effects of investigated substances as well as adsorption and release properties of collagen scaffolds should be considered for further investigation. CLINICAL RELEVANCE Collagen scaffolds are reliable carriers for any of the applied substances. BMP-2, BMP-9, and FGF2 showed enhanced bone and periodontal healing. Antibiotics improved anti-microbial properties of the scaffolds.
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Choi SH, Koo JW, Choe D, Hur JM, Kim DH, Kang CN. Interbody fusion in degenerative lumbar spinal stenosis with additional posterolateral fusion using Escherichia coli-derived bone morphogenetic protein-2: A Pilot study. Medicine (Baltimore) 2020; 99:e20477. [PMID: 32541470 PMCID: PMC7302626 DOI: 10.1097/md.0000000000020477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This case series investigated the efficacy and optimal dose of Escherichia coli-derived bone morphogenetic protein-2 (E.BMP-2) as a bone graft substitute for additional posterolateral spinal fusion, accompanying interbody fusion procedures, for treating lumbar degenerative spinal stenosis. This study focused on the optimal dose for each segment and the efficacy of E.BMP-2 as a substitute for autogenous iliac bone graft.Ten patients were enrolled from January 2015 to December 2015, and underwent an additional posterolateral fusion procedure, with 2.5 mg of E.BMP-2 followed by decompression, transpedicular fixation, and interbody fusion. The mean follow-up period was 13.9 months, and regular radiological examinations were performed in every case. Clinical outcomes were measured with a visual analog scale for back pain (VAS-BP), and leg pain (VAS-LP) and the Korean Oswestry Disability Index (K-ODI). All parameters were assessed preoperatively and postoperatively at 12 months.All 18 segments treated with E.BMP-2 completely fused in 6 months as observed on both simple radiography and computed tomography. The mean fusion period was 4.5 months on simple radiography. At 12 months follow-up, VAS-BP, VAS-LP, and K-ODI scores (1.9 ± 1.5, 1.9 ± 1.9, 11.0 ± 6.6, respectively) had improved significantly compared to preoperative scores (5.5 ± 1.9, 6.5 ± 1.9, and 49.9 ± 11.5, respectively, P < .05). There were no postoperative wound infections, neurological symptoms, or complications associated with the use of E.BMP-2 during the follow-up period.E.BMP-2 could be used to enhance the outcomes in posterolateral spinal fusion following interbody fusion surgery. In the present study, 2.5 mg of the E.BMP-2 per segment was sufficient to obtain bony union in posterolateral fusion surgery. Further large-scale trials with long-term follow-up are necessary to evaluate the various complications related to the use of E.BMP-2.
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Affiliation(s)
- Sung Hoon Choi
- Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Republic of Korea
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26
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Ramly EP, Alfonso AR, Kantar RS, Wang MM, Siso JRD, Ibrahim A, Coelho PG, Flores RL. Safety and Efficacy of Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2) in Craniofacial Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2347. [PMID: 31592029 PMCID: PMC6756658 DOI: 10.1097/gox.0000000000002347] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 05/29/2019] [Indexed: 12/18/2022]
Abstract
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is one of the most commonly used osteogenic agents in the craniofacial skeleton. This study reviews the safety and efficacy of rhBMP-2 as applied to craniofacial reconstruction and assesses the level of scientific evidence currently available.
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Affiliation(s)
- Elie P Ramly
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Allyson R Alfonso
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Rami S Kantar
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Maxime M Wang
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - J Rodrigo Diaz Siso
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Amel Ibrahim
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Paulo G Coelho
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Roberto L Flores
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
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BMP-2 Gene Delivery-Based Bone Regeneration in Dentistry. Pharmaceutics 2019; 11:pharmaceutics11080393. [PMID: 31387267 PMCID: PMC6723260 DOI: 10.3390/pharmaceutics11080393] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/22/2019] [Accepted: 08/02/2019] [Indexed: 02/06/2023] Open
Abstract
Bone morphogenetic protein-2 (BMP-2) is a potent growth factor affecting bone formation. While recombinant human BMP-2 (rhBMP-2) has been commercially available in cases of non-union fracture and spinal fusion in orthopaedics, it has also been applied to improve bone regeneration in challenging cases requiring dental implant treatment. However, complications related to an initially high dosage for maintaining an effective physiological concentration at the defect site have been reported, although an effective and safe rhBMP-2 dosage for bone regeneration has not yet been determined. In contrast to protein delivery, BMP-2 gene transfer into the defect site induces BMP-2 synthesis in vivo and leads to secretion for weeks to months, depending on the vector, at a concentration of nanograms per milliliter. BMP-2 gene delivery is advantageous for bone wound healing process in terms of dosage and duration. However, safety concerns related to viral vectors are one of the hurdles that need to be overcome for gene delivery to be used in clinical practice. Recently, commercially available gene therapy has been introduced in orthopedics, and clinical trials in dentistry have been ongoing. This review examines the application of BMP-2 gene therapy for bone regeneration in the oral and maxillofacial regions and discusses future perspectives of BMP-2 gene therapy in dentistry.
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Yang HJ, Hwang SJ. Void space and long-term volumetric changes of maxillary sinus floor augmentation with comparison between hydroxyapatite soaked with bone morphogenetic protein 2 and anorganic bovine xenograft alone. J Craniomaxillofac Surg 2019; 47:1626-1632. [PMID: 31395420 DOI: 10.1016/j.jcms.2019.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/07/2019] [Accepted: 07/14/2019] [Indexed: 11/17/2022] Open
Abstract
PURPOSE We hypothesized that the void volume after maxillary sinus floor augmentation (MSFA) with recombinant human bone morphogenetic protein-2 (rhBMP-2) would be larger than that without rhBMP-2, and filled with bone in the long term. The aim of this study was to analyze the occurrence of void space and long-term volumetric changes after MSFA with rhBMP-2 and hydroxyapatite (BMP-2/H). MATERIAL AND METHODS In 25 subjects, MSFA was performed with BMP-2/H (group I) or an anorganic bovine xenograft (group II). Computed tomography scans were taken twice, at 3 months (T1) and at least 24 months (T2) after surgery. Total volume (TV), bone volume (BV), and void volume (VV) were measured and analysed statistically. RESULTS While similar amounts of graft material were used, the TV was significantly larger in group I than in group II (p = 0.014). The VV showed a tendency to be larger in group I than in group II. VV reduction up to T2 was significantly greater in group I than in group II. Consequently, the BV at T2 was significantly greater in group I than in group II by 36% (p = 0.014). CONCLUSION This study showed that our hypothesis was valid. rhBMP-2 is effective for long-term bone regeneration after MSFA.
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Affiliation(s)
- Hoon Joo Yang
- Orthognathic Surgery Center, Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Soon Jung Hwang
- Hwang Soon Jung's Dental Clinic for Oral and Maxillofacial Surgery, Woonam Building, 2,3 F, 349, Gangnam-daero, Seocho-gu, Seoul, 06626, Republic of Korea.
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Al-Moraissi EA, Alkhutari AS, Abotaleb B, Altairi NH, Del Fabbro M. Do osteoconductive bone substitutes result in similar bone regeneration for maxillary sinus augmentation when compared to osteogenic and osteoinductive bone grafts? A systematic review and frequentist network meta-analysis. Int J Oral Maxillofac Surg 2019; 49:107-120. [PMID: 31230768 DOI: 10.1016/j.ijom.2019.05.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 01/30/2023]
Abstract
The purpose of this network meta-analysis was to identify the most effective biomaterials producing higher new bone formation (NBF) and lower residual graft (RG) and connective tissue (CT) following maxillary sinus augmentation (MSA), and to generate a ranking based on their performance. The MEDLINE, Embase, and CENTRAL databases were searched to identify randomized controlled trials (RCTs) published until March 2018, evaluating histomorphometric outcomes after MSA. Predictor variables were autogenous bone (AB), allografts (AG), xenografts (XG), alloplastic bone (AP), AB+XG, AB+AP, AG+XG, XG+AP, and grafts combined with autologous platelet concentrates/recombinant growth factors, mesenchymal stem cells (MSCs), or recombinant bone morphogenetic proteins (BMPs). Outcome variables were NBF%, RG%, and CT%. Healing time was considered. The weighted mean difference (WMD) with 95% confidence interval (CI) was calculated via frequentist network meta-analysis using Stata software. Fifty-two RCTs (1483 biopsies) were included. At a healing time <6 months, AB was superior to AP (WMD-10.66%, 95% CI-16.38% to -4.94%) and XG (WMD-7.93%, 95% CI-15.11% to -0.75%) for NBF. Regarding CT, AB was superior to XG+AP, AP, MSCs, and XG. At a healing time ≥6 months, NBF was higher for AB than AP (WMD-7.06%, 95% CI-12.59% to -1.52%). RG was lower in AB than AP (WMD 12.03%, 95% CI 3.04% to 21.03%), XG (WMD 14.62%, 95% CI 4.25% to 24.98%), and growth factors (WMD 12.32%, 95% CI 0.04% to 24.60%). The three highest ranked biomaterials for increasing NBF were AG+XG (95%, very low quality evidence), growth factors (69.9%, low quality evidence), and AB alone (69.8%, moderate quality evidence). The three highest ranked biomaterials for decreasing RG were BMPs (88.8%, very low quality evidence), AB alone (81.5%, moderate quality evidence), and AB+AP (58.9%, very low quality evidence). Finally, XG+AP (84.7%, low quality evidence), AP alone (77.7%, moderate quality evidence), and MSCs (76.1%, low quality evidence), were the three highest ranked biomaterials for decreasing the amount of CT. Network meta-analysis provided moderate quality evidence that AB alone is probably the best option to obtain greater NBF after MSA in the first 6 months after surgery. Additionally, the results of this network meta-analysis support the hypothesis that osteoconductive bone substitute materials should be combined with osteogenic or osteoinductive grafts for superior histomorphometric outcomes in MSA.
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Affiliation(s)
- E A Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen.
| | - A S Alkhutari
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen
| | - B Abotaleb
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - N H Altairi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen
| | - M Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy; IRCCS Orthopedic Institute Galeazzi, Milan, Italy
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Donos N, Dereka X, Calciolari E. The use of bioactive factors to enhance bone regeneration: A narrative review. J Clin Periodontol 2019; 46 Suppl 21:124-161. [DOI: 10.1111/jcpe.13048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
| | - Xanthippi Dereka
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
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Efficacy of Recombinant Human BMP2 and PDGF-BB in Orofacial Bone Regeneration: A Systematic Review and Meta-analysis. Sci Rep 2019; 9:8073. [PMID: 31147568 PMCID: PMC6542831 DOI: 10.1038/s41598-019-44368-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/28/2019] [Indexed: 02/05/2023] Open
Abstract
With the rapid development of tissue engineering therapies, there is a growing interest in the application of recombinant human growth factors (rhGFs) to regenerate human orofacial bones. However, despite reports of their ability to promote orofacial bone regeneration in animal experiments, their benefits in human clinical treatments remain unclear. Furthermore, the appropriate concentrations or indications of a specific rhGF remain ambiguous. Therefore it is essential to collect data from diverse clinical trials to evaluate their effects more precisely. Here we reviewed randomized clinical trials (RCT) that focused on the utilization of rhGFs in orofacial bone regeneration. Data from included studies were extracted, pooled and then quantitatively analyzed according to a pre-established protocol. Our results indicate that all current concentrations of rhBMP-2 produces insufficient effect on promoting either tooth extraction socket healing, sinus augmentation or reconstruction of alveolar clefts. However, 0.3 mg/ml rhPDGF-BB promotes the healing of tooth extraction sockets, though the effect does not reach a level of statistical significance. Summarily, we recommend concentrations of 0.3 mg/ml rhPDGF-BB only for the healing of tooth extraction sockets.
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Jo DW, Cho YD, Seol YJ, Lee YM, Lee HJ, Kim YK. A randomized controlled clinical trial evaluating efficacy and adverse events of different types of recombinant human bone morphogenetic protein-2 delivery systems for alveolar ridge preservation. Clin Oral Implants Res 2019; 30:396-409. [PMID: 30883942 DOI: 10.1111/clr.13423] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 01/29/2019] [Accepted: 01/29/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This 12-week clinical trial evaluated efficacy and adverse events for two recombinant human bone morphogenetic protein-2 (rhBMP-2) delivery systems in alveolar ridge preservation. MATERIALS AND METHODS Sixty-four patients had a single tooth that required replacement with an implant, surrounded by > 50% alveolar bone height. Two cohorts (n = 32 patients each) were randomized to receive a rhBMP-2-soaked absorbable collagen sponge (test group), or β-tricalcium phosphate and hydroxyapatite particles (control group) immersed in rhBMP-2, at the implant site. Bone height and width changes at 25%, 50%, and 75% of extraction socket level (ESL) were compared. Adverse events were assessed in the same period. In addition to the randomized controlled clinical trial, histological analysis of 21 patients (test group [n = 12], control group [n = 9]) was conducted, 4 months after alveolar ridge preservation. A non-inferiority test was used to analyze changes in alveolar bone height between groups (p = 0.05). A Wilcoxon rank-sum test was used to analyze changes in alveolar bone width and histomorphometric results between groups (p = 0.05). RESULTS All patients showed good healing without severe adverse events. The lower limit of the one-sided 97.5% confidence interval in the difference between the two groups was 0.0033 (non-inferiority margin: -0.185); thus, the test group showed non-inferiority to the control group. Wilcoxon rank-sum test analysis did not show statistically significant differences between groups with regard to changes in alveolar bone width and histomorphometric analysis. CONCLUSIONS The delivery systems showed similar efficacy for alveolar ridge preservation without severe adverse events.
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Affiliation(s)
- Deuk-Won Jo
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young-Dan Cho
- Department of Periodontology & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yang-Jo Seol
- Department of Periodontology & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Long-Term Effects of Bone Morphogenetic Protein-2-Loaded Calcium Phosphate on Maxillary Sinus Lift Surgery for Delayed and Simultaneous Dental Implantation. J Craniofac Surg 2018; 29:e58-e61. [PMID: 29040148 DOI: 10.1097/scs.0000000000004039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Maxillary sinus lift surgery (MSLS) is considered to be a useful treatment method for patients with atrophic alveolar bone. Choosing a suitable surgical procedure to simultaneously decrease graft absorption and obtain long-term survival of dental implants is still a challenge. In this study, 20 patients received MSLS with graft of bone morphogenetic protein 2 (BMP2)-loaded calcium phosphate. Dental implants were placed simultaneously in 10 patients receiving MSLS (1-stage group), and in 10 patients receiving dental implants with a 3 to 6 months delay (2-stage group). The effects were evaluated based on clinical and radiographic examination during a 4 to 5 years follow-up. The results showed that only 1 perforation of the maxillary sinus mucosa was observed in 1-stage group, and was patched with a collagen membrane. An average bone gain of 6.8 mm was observed, and all implants exhibited no looseness, peri-implantitis, or fracture, all of which were stable during the follow-up and exhibited nice dental function during a 4 to 5 years follow-up. The loss of peri-implant bone height was 1.12 ± 0.47 and 1.10 ± 0.39 mm, the probing depth of periodontal pocket was 1.79 ± 0.62 and 1.81 ± 0.71 mm, the sulcular bleeding index was 1.63 ± 0.47 and 1.72 ± 0.54 in 1-stage group and 2-stage group, respectively, and no significant differences existed between these 2 groups. These findings implied that BMP2-loaded calcium phosphate may be a suitable material for MSLS, especially for patients with minimal bone height. Clinicians can use the 1- or 2-stage technique based on clinical condition, patients' choice and clinicians' experience. In patients where implants cannot be stabilized for patients with minimal bone height, 2-stage surgery may be more suitable.
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Kwak EJ, Cha IH, Nam W, Yook JI, Park YB, Kim HJ. Effects of locally administered rhBMP-2 and bisphosphonate on bone regeneration in the rat fibula. Oral Dis 2018; 24:1042-1056. [DOI: 10.1111/odi.12864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 02/23/2018] [Accepted: 03/16/2018] [Indexed: 12/25/2022]
Affiliation(s)
- E-J Kwak
- Department of Oral and Maxillofacial Surgery; College of Dentistry; Yonsei University; Seoul Korea
| | - I-H Cha
- Department of Oral and Maxillofacial Surgery; College of Dentistry; Yonsei University; Seoul Korea
| | - W Nam
- Department of Oral and Maxillofacial Surgery; College of Dentistry; Yonsei University; Seoul Korea
| | - JI Yook
- Department of Oral Pathology; College of Dentistry; Yonsei University; Seoul Korea
| | - Y-B Park
- Department of Prosthodontics; College of Dentistry; Yonsei University; Seoul Korea
| | - HJ Kim
- Department of Oral and Maxillofacial Surgery; College of Dentistry; Yonsei University; Seoul Korea
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da Rosa WLDO, da Silva TM, da Silva AF, Piva E. Bioactive treatments in bone grafts for implant-based rehabilitation: Systematic review and meta-analysis. Clin Implant Dent Relat Res 2018; 20:251-260. [PMID: 29105932 DOI: 10.1111/cid.12552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/08/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND The use of bioactive proteins, such as rhBMP-2, may improve bone regeneration in oral and maxillofacial surgery. PURPOSE Analyze the effect of using bioactive proteins for bone regeneration in implant-based rehabilitation. MATERIALS AND METHODS Seven databases were screened. Only clinical trials that evaluated the use of heterologous sources of bioactive proteins for bone formation prior to implant-based rehabilitation were included. Statistical analyses were carried out using a random-effects model by comparing the standardized mean difference between groups for bone formation, and risk ratio for implant survival (P ≤ .05). RESULTS Seventeen studies were included in the qualitative analysis, and 16 in the meta-analysis. For sinus floor augmentation, bone grafts showed higher amounts of residual bone graft particles than bioactive treatments (P ≤ .05). While for alveolar ridge augmentation bioactive treatments showed a higher level of bone formation than control groups (P ≤ .05). At 3 years of follow-up, no statistically significant differences were observed for implant survival (P > .05). CONCLUSIONS Bioactive proteins may improve bone formation in alveolar ridge augmentation, and reduce residual bone grafts in sinus floor augmentation. Further studies are needed to evaluate the long-term effect of using bioactive treatments for implant-based rehabilitation.
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Affiliation(s)
| | | | - Adriana Fernandes da Silva
- Department of Restorative Dentistry, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Evandro Piva
- Department of Restorative Dentistry, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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de Oliveira GJPL, Aroni MAT, Medeiros MC, Marcantonio E, Marcantonio RAC. Effect of low-level laser therapy on the healing of sites grafted with coagulum, deproteinized bovine bone, and biphasic ceramic made of hydroxyapatite and β-tricalcium phosphate. In vivo study in rats. Lasers Surg Med 2018; 50:651-660. [PMID: 29331041 DOI: 10.1002/lsm.22787] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of low-level laser therapy (LLLT) on the healing of biomaterial graft areas (i.e., coagulum, deproteinized bovine bone, and biphasic ceramics comprising hydroxyapatite and β-tricalcium phosphate). MATERIAL AND METHODS Ninety rats were divided into two groups according to laser irradiation use (λ 808 nm, 100 mW, φ ∼600 μm, seven sessions with 28 J of irradiation dose in total): a laser group and a control group. Each of these groups was divided into three subgroups of 15 animals each according to the type of biomaterial used: Coagulum (COA), deproteinized bovine bone (DBB), and hydroxyapatite/β-tricalcium phosphate (HA/βTCP). Biomaterials were inserted into Teflon domes, and these domes were grafted to the lateral aspect of the mandibular branch of the rats. The animals were sacrificed after 30, 60, and 90 days. Scarring patterns were evaluated by microtomography and histometry. The expression levels of BMP2, osteocalcin (OCN), and alkaline phosphatase (ALP) were evaluated by immunohistochemistry. The mRNA expression levels of ALP, BMP2, Jagged1, Osterix, Runx2, and TGFβ1 were determined by RT-qPCR. RESULTS The animals treated with LLLT exhibited increased mineralized tissues and bone, particularly after 90 days. These increases were associated with increased BMP2, OCN, and ALP protein expression and ALP, BMP2, and Jagged1 mRNA expression. CONCLUSION LLLT improved the osteoconductive potential of DBB and HA/βTCP grafts and bone formation in ungrafted areas. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Guilherme J P L de Oliveira
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Maurício A T Aroni
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Marcell C Medeiros
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Rosemary A C Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
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Kim HS, Park JC, Yun PY, Kim YK. Evaluation of bone healing using rhBMP-2 soaked hydroxyapatite in ridge augmentation: a prospective observational study. Maxillofac Plast Reconstr Surg 2017; 39:40. [PMID: 29302589 PMCID: PMC5742315 DOI: 10.1186/s40902-017-0138-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/20/2017] [Indexed: 11/16/2022] Open
Abstract
Background The goal of this study is to evaluate complication and effectiveness of alveolar ridge augmentations using a hydroxyapatite-based alloplastic bony substitute with rhBMP-2. Methods A total of 10 patients (4 males, 6 females; 58.5 ± 8.6 years) participated in this clinical research. Alveolar ridge augmentations were performed in edentulous (4 maxillary posterior, 5 mandibular posterior, and 1 mandibular anterior) regions. Anorganic bovine bone (ABB; Bio-Oss®, Geistlich Pharma AG, Wolhusen, Switzerland) was used as the bone graft material in the control group (n = 5)) while hydroxyapatite-based alloplastic bony substitute with rhBMP-2(HA+rhBMP-2; NOVOSIS®-Dent, CGBio Inc., Seongnam, Korea) was used in the experimental group (n = 5). In order to evaluate relative changes in bone volume and resorption rate of the bone graft material, CBCT radiographs were taken immediately and at 4 months after the bone graft in all subjects. Among the 10 patients, 8 received dental implants in Seoul National University Bundang Hospital, while the others received in local clinics. Bone specimens for further histomorphometric examinations were gained from these 8 patients using trephine burs during the implant placements. Clinical, radiographic, and histomorphometric evaluations were focused because of the small sample size. Results When CBCT radiographs were compared between immediately and at 4.07 ± 0.13 months after the bone graft, both alveolar bone widths (ABB 2.52 ± 0.18 mm, HA+rhBMP-2 1.75 ± 0.85 mm) and heights (ABB 1.68 ± 0.17 mm, HA+rhBMP-2 1.57 ± 0.28 mm) increased in the two groups. Resorption rates of transplanted bone graft material in the alveolar bone widths and heights were (ABB 29.7 ± 8.8%, HA+rhBMP-2 31.5 ± 7.4%) and (ABB 39.2 ± 21.8%, HA+rhBMP-2 52.6 ± 6.5%), respectively. Histomorphometrically, ABB group showed bone formation via osteoconduction and HA+rhBMP-2 group via osteoinduction. HA+rhBMP-2 group showed more bone formation around the bone graft materials than the ABB group. Postoperative complications were not found in all subjects. Conclusions Our study had following conclusions: (1) Ridge augmentations using HA+rhBMP-2 could be clinically useful to supplement implant placements in edentulous regions. (2) Serious postoperative complications related to the graft material did not occur. Electronic supplementary material The online version of this article (10.1186/s40902-017-0138-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hyun-Suk Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyunggi-do South Korea
| | - Ju-Cheol Park
- Department of Oral Histology, School of Dentistry, Seoul National University, Daehak-ro 101, Jongno-gu, Seoul, 03080 South Korea.,Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Daehak-ro 101, Jongno-gu, Seoul, 03080 South Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyunggi-do South Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyunggi-do South Korea.,Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Daehak-ro 101, Jongno-gu, Seoul, 03080 South Korea
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Chang AR, Cho TH, Hwang SJ. Receptor Activator of Nuclear Factor Kappa-B Ligand-Induced Local Osteoporotic Canine Mandible Model for the Evaluation of Peri-Implant Bone Regeneration. Tissue Eng Part C Methods 2017; 23:781-794. [DOI: 10.1089/ten.tec.2017.0196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Ah Ryum Chang
- Department of Oral and Maxillofacial Surgery, BK 21 Plus, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Tae Hyung Cho
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, BK 21 Plus, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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Nam J, Khureltogtokh S, Choi H, Lee A, Park Y, Kim H. Randomised controlled clinical trial of augmentation of the alveolar ridge using recombinant human bone morphogenetic protein 2 with hydroxyapatite and bovine-derived xenografts: comparison of changes in volume. Br J Oral Maxillofac Surg 2017; 55:822-829. [DOI: 10.1016/j.bjoms.2017.07.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 07/27/2017] [Indexed: 11/27/2022]
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Repair of large saddle defects of the mandibular ridge using dual growth factor release-An experimental pilot study in minipigs. J Clin Periodontol 2017; 44:854-863. [DOI: 10.1111/jcpe.12739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2017] [Indexed: 01/27/2023]
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Haimov H, Yosupov N, Pinchasov G, Juodzbalys G. Bone Morphogenetic Protein Coating on Titanium Implant Surface: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2017; 8:e1. [PMID: 28791077 PMCID: PMC5541986 DOI: 10.5037/jomr.2017.8201] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/27/2017] [Indexed: 01/06/2023]
Abstract
Objectives The purpose of the study is to systematically review the osseointegration process improvement by bone morphogenetic protein coating on titanium implant surface. Material and Methods An electronic literature search was conducted through the MEDLINE (PubMed) and EMBASE databases. The search was restricted for articles published during the last 10 years from October 2006 to September 2016 and articles were limited to English language. Results A total of 41 articles were reviewed, and 8 of the most relevant articles that are suitable to the criteria were selected. Articles were analysed regarding concentration of bone morphogenetic protein (BMP), delivery systems, adverse reactions and the influence of the BMP on the bone and peri-implant surface in vivo. Finally, the present data included 340 implants and 236 models. Conclusions It’s clearly shown from most of the examined studies that bone morphogenetic protein increases bone regeneration. Further studies should be done in order to induce and sustain bone formation activity. Osteogenic agent should be gradually liberated and not rapidly released with priority to three-dimension reservoir (incorporated) titanium implant surface in order to avoid following severe side effects: inflammation, bleeding, haematoma, oedema, erythema, and graft failure.
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Affiliation(s)
- Haim Haimov
- Department of Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania
| | - Natali Yosupov
- Department of Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania
| | - Ginnady Pinchasov
- Department of Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania
| | - Gintaras Juodzbalys
- Department of Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania
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Bone Regeneration Using N-Methyl-2-pyrrolidone as an Enhancer for Recombinant Human Bone Morphogenetic Protein-2 in a Rabbit Sinus Augmentation Model. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4153073. [PMID: 28680881 PMCID: PMC5478818 DOI: 10.1155/2017/4153073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 04/06/2017] [Indexed: 11/17/2022]
Abstract
The aim of this study was to determine whether N-methyl-2-pyrrolidone (NMP) can decrease the dose of recombinant human bone morphogenetic protein-2 (rhBMP-2) in sinus augmentation of rabbits. In each of 15 rabbits, 2 sinuses were randomly grafted using 1 of 3 treatment modalities: (i) biphasic calcium phosphate (BCP; control), (ii) rhBMP-2-coated BCP (BMP), or (iii) rhBMP-2-coated BCP soaked in NMP solution (BMP/NMP). The rabbits were sacrificed 2 weeks postoperatively. Histologic and histomorphometric analyses were performed. Bone formation in all groups was predominantly located close to the access window and the lateral walls. Newly formed bone within the total augmented area (NBTA) was greatest in BMP/NMP (1.94 ± 0.69 mm2), followed by BMP (1.50 ± 0.72 mm2) and BCP (1.28 ± 0.52 mm2) (P > 0.05). In the center of the augmentation (NBROI_C) and the area close to the sinus membrane (NBROI_M), BMP/NMP produced the largest area of NB (NBROI_C: 0.10 ± 0.11 mm2; NBROI_M: 0.17 ± 0.08 mm2); the corresponding NB values for BCP were 0.05 ± 0.05 mm2 and 0.08 ± 0.09 mm2, respectively (P > 0.05 for all comparisons). The effect of NMP on bone regeneration was inconsistent between the specimens. Adding NMP as an adjunct to rhBMP-2-coated BCP produced inconsistent effects on bone regeneration, resulting in no significant benefit compared to controls.
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Danesh-Sani SA, Engebretson SP, Janal MN. Histomorphometric results of different grafting materials and effect of healing time on bone maturation after sinus floor augmentation: a systematic review and meta-analysis. J Periodontal Res 2016; 52:301-312. [PMID: 27534916 DOI: 10.1111/jre.12402] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 01/11/2023]
Abstract
The aim of this systematic review was to evaluate histomorphometric variables, the amount of new bone (NB), residual graft (RG) particles and soft tissue (ST), related to various grafting materials and assess the effect of graft healing time on different histomorphometric outcomes. Studies that were published before October 2015 were electronically and manually searched in three databases. We included human studies that reported the amount of NB, RG and ST in the biopsies taken from the grafted sinuses. Based on the applied grafting materials, extracted data were categorized into different groups. Furthermore, extracted data were classified into three groups based on healing time: (i) ≤ 4.5 mo; (ii) 4.5-9 mo; and (iii) ≥ 9-13.5 mo. The search provided 791 titles. Full text analysis was performed for 258 articles resulting in 136 studies that met the inclusion criteria. Autogenous bone (AB) resulted in the highest amount of NB and lowest amount of RG compared to other grafting materials. Based on this meta-analysis, a significant difference was noticed in the amount of NB formation in grafts with a healing time of > 4.5 mo when compared to the grafts with less healing time. However, when comparing biopsies taken at 4.5-9 mo of healing (average = 6.22 mo) to the ones taken at ≥ 9-13.5 mo (average = 10.36 mo), no significant difference was noticed in the amount of NB formation of various grafts except allografts that resulted in a significantly higher percentage of NB at 9.5 mo of healing. Based on histomorphometric analysis, AB results in the highest amount of NB formation in comparison to the other grafting materials. Bone substitute materials (allografts, alloplastic materials and xenografts) seem to be good alternatives to autogenous bone and can be considered as grafting materials to avoid disadvantages related to AB, including morbidity rate, limited availability and high volumetric change. Combining AB with alloplastic materials and xenografts brings no significant advantages regarding NB formation.
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Affiliation(s)
- S A Danesh-Sani
- Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY, USA
| | - S P Engebretson
- Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY, USA
| | - M N Janal
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY, USA
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Ceresoli V, Mainieri D, Del Fabbro M, Weinstein R, Pedrazzini E. A Fusion between Domains of the Human Bone Morphogenetic Protein-2 and Maize 27 kD γ-Zein Accumulates to High Levels in the Endoplasmic Reticulum without Forming Protein Bodies in Transgenic Tobacco. FRONTIERS IN PLANT SCIENCE 2016; 7:358. [PMID: 27047526 PMCID: PMC4805588 DOI: 10.3389/fpls.2016.00358] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 03/07/2016] [Indexed: 05/12/2023]
Abstract
Human Bone Morphogenetic Protein-2 (hBMP2) is an osteoinductive agent physiologically involved in bone remodeling processes. A commercialized recombinant hBMP2 produced in mammalian cell lines is available in different clinical applications where bone regeneration is needed, but widespread use has been hindered due to an unfavorable cost/effective ratio. Protein bodies are very large insoluble protein polymers that originate within the endoplasmic reticulum by prolamine accumulation during the cereal seed development. The N-terminal domain of the maize prolamin 27 kD γ-zein is able to promote protein body biogenesis when fused to other proteins. To produce high yield of recombinant hBMP2 active domain (ad) in stably transformed tobacco plants we have fused it to the γ-zein domain. We show that this zein-hBMP2ad fusion is retained in the endoplasmic reticulum without forming insoluble protein bodies. The accumulation levels are above 1% of total soluble leaf proteins, indicating that it could be a rapid and suitable strategy to produce hBMP2ad at affordable costs.
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Affiliation(s)
- Valentina Ceresoli
- Istituto di Biologia e Biotecnologia Agraria, Consiglio Nazionale Delle RicercheMilano, Italy
- Dipartimento Scienze Biomediche, Chirurgiche e Odontoiatriche, Università Degli Studi di MilanoMilano, Italy
- IRCCS Istituto Ortopedico GaleazziMilano, Italy
| | - Davide Mainieri
- Istituto di Biologia e Biotecnologia Agraria, Consiglio Nazionale Delle RicercheMilano, Italy
| | - Massimo Del Fabbro
- Dipartimento Scienze Biomediche, Chirurgiche e Odontoiatriche, Università Degli Studi di MilanoMilano, Italy
- IRCCS Istituto Ortopedico GaleazziMilano, Italy
| | - Roberto Weinstein
- Dipartimento Scienze Biomediche, Chirurgiche e Odontoiatriche, Università Degli Studi di MilanoMilano, Italy
- IRCCS Istituto Ortopedico GaleazziMilano, Italy
| | - Emanuela Pedrazzini
- Istituto di Biologia e Biotecnologia Agraria, Consiglio Nazionale Delle RicercheMilano, Italy
- *Correspondence: Emanuela Pedrazzini
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Lin GH, Lim G, Chan HL, Giannobile WV, Wang HL. Recombinant human bone morphogenetic protein 2 outcomes for maxillary sinus floor augmentation: a systematic review and meta-analysis. Clin Oral Implants Res 2015; 27:1349-1359. [DOI: 10.1111/clr.12737] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Guo-Hao Lin
- Graduate Periodontics; Department of Periodontics & Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI USA
| | - Glendale Lim
- Graduate Periodontics; Department of Periodontics & Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI USA
| | - Hsun-Liang Chan
- Graduate Periodontics; Department of Periodontics & Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI USA
| | - William V. Giannobile
- Graduate Periodontics; Department of Periodontics & Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI USA
- Department of Biomedical Engineering; College of Engineering; University of Michigan; Ann Arbor MI USA
| | - Hom-Lay Wang
- Graduate Periodontics; Department of Periodontics & Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI USA
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Larsson L, Decker AM, Nibali L, Pilipchuk SP, Berglundh T, Giannobile WV. Regenerative Medicine for Periodontal and Peri-implant Diseases. J Dent Res 2015; 95:255-66. [PMID: 26608580 DOI: 10.1177/0022034515618887] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The balance between bone resorption and bone formation is vital for maintenance and regeneration of alveolar bone and supporting structures around teeth and dental implants. Tissue regeneration in the oral cavity is regulated by multiple cell types, signaling mechanisms, and matrix interactions. A goal for periodontal tissue engineering/regenerative medicine is to restore oral soft and hard tissues through cell, scaffold, and/or signaling approaches to functional and aesthetic oral tissues. Bony defects in the oral cavity can vary significantly, ranging from smaller intrabony lesions resulting from periodontal or peri-implant diseases to large osseous defects that extend through the jaws as a result of trauma, tumor resection, or congenital defects. The disparity in size and location of these alveolar defects is compounded further by patient-specific and environmental factors that contribute to the challenges in periodontal regeneration, peri-implant tissue regeneration, and alveolar ridge reconstruction. Efforts have been made over the last few decades to produce reliable and predictable methods to stimulate bone regeneration in alveolar bone defects. Tissue engineering/regenerative medicine provide new avenues to enhance tissue regeneration by introducing bioactive models or constructing patient-specific substitutes. This review presents an overview of therapies (e.g., protein, gene, and cell based) and biomaterials (e.g., resorbable, nonresorbable, and 3-dimensionally printed) used for alveolar bone engineering around teeth and implants and for implant site development, with emphasis on most recent findings and future directions.
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Affiliation(s)
- L Larsson
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA Department of Periodontology, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
| | - A M Decker
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - L Nibali
- Periodontology Unit and Department of Clinical Research, UCL Eastman Dental Institute, London, UK
| | - S P Pilipchuk
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
| | - T Berglundh
- Department of Periodontology, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
| | - W V Giannobile
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
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