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Nauth A, Crist BD, Morshed S, Watson JT, Pape HC. Management of aseptic nonunions and severe bone defects: let us get this thing healed! OTA Int 2023; 6:e258. [PMID: 37533443 PMCID: PMC10392436 DOI: 10.1097/oi9.0000000000000258] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/29/2022] [Indexed: 08/04/2023]
Abstract
Effective nonunion and bone defect management requires consideration of multiple potential contributing factors including biomechanics, biology, metabolic, and patient factors. This article reviews these factors as well as several potential nonunion or bone defect treatments including bone grafts, bone graft substitutes, the induced membrane technique, and distraction osteogenesis. A summary of these concepts and guidelines for an overall approach to management are also provided.
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Affiliation(s)
- Aaron Nauth
- Department of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada
| | - Brett D. Crist
- Department of Orthopaedic Surgery, One Hospital, Columbia, MO
| | - Saam Morshed
- UCSF/SFGH Orthopaedic Trauma Institute, San Francisco, CA
| | - J. Tracy Watson
- Department of Orthopaedic Surgery, St. Louis University Health Science Center, Saint Louis, MO; and
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Shi J, Dai W, Gupta A, Zhang B, Wu Z, Zhang Y, Pan L, Wang L. Frontiers of Hydroxyapatite Composites in Bionic Bone Tissue Engineering. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15238475. [PMID: 36499970 PMCID: PMC9738134 DOI: 10.3390/ma15238475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 05/31/2023]
Abstract
Bone defects caused by various factors may cause morphological and functional disorders that can seriously affect patient's quality of life. Autologous bone grafting is morbid, involves numerous complications, and provides limited volume at donor site. Hence, tissue-engineered bone is a better alternative for repair of bone defects and for promoting a patient's functional recovery. Besides good biocompatibility, scaffolding materials represented by hydroxyapatite (HA) composites in tissue-engineered bone also have strong ability to guide bone regeneration. The development of manufacturing technology and advances in material science have made HA composite scaffolding more closely related to the composition and mechanical properties of natural bone. The surface morphology and pore diameter of the scaffold material are more important for cell proliferation, differentiation, and nutrient exchange. The degradation rate of the composite scaffold should match the rate of osteogenesis, and the loading of cells/cytokine is beneficial to promote the formation of new bone. In conclusion, there is no doubt that a breakthrough has been made in composition, mechanical properties, and degradation of HA composites. Biomimetic tissue-engineered bone based on vascularization and innervation show a promising future.
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Affiliation(s)
- Jingcun Shi
- Department of Oral and Maxillofacial Surgery—Head & Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai 200011, China
| | - Wufei Dai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- Shanghai Tissue Engineering Key Laboratory, Shanghai Research Institute of Plastic and Reconstructive Surgey, Shanghai 200011, China
| | - Anand Gupta
- Department of Dentistry, Government Medical College & Hospital, Chandigarh 160017, India
| | - Bingqing Zhang
- Department of Oral and Maxillofacial Surgery—Head & Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai 200011, China
| | - Ziqian Wu
- Department of Oral and Maxillofacial Surgery—Head & Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai 200011, China
| | - Yuhan Zhang
- Department of Oral and Maxillofacial Surgery—Head & Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai 200011, China
| | - Lisha Pan
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai 200011, China
| | - Lei Wang
- Department of Oral and Maxillofacial Surgery—Head & Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai 200011, China
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Diallo AM, Rota S, Boissière M, Bardonnet R, Pauthe E, Petite H, Benoist HM, Bensidhoum M, Anagnostou F. Osteoformation potential of an allogenic partially demineralized bone matrix in critical-size defects in the rat calvarium. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 127:112207. [PMID: 34225859 DOI: 10.1016/j.msec.2021.112207] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 05/06/2021] [Accepted: 05/19/2021] [Indexed: 11/27/2022]
Abstract
Allogenic demineralized bone matrix has been developed as a reliable alternative to the autologous bone graft. In the present study, we assessed the osteoformation potential of a partially demineralized bone matrix (PDBM) in a paste form obtained without an added carrier. This formulation included the preparation of cancelous bone from femoral heads after decellularision, delipidation, demineralization in HCl and autoclaving at 121 °C. Structural and biochemical characteristics of PDBM were determined using FTIR (Fourier transform infrared spectroscopy), hydroxyproline, DNA content assays, and optical ellipsometry. The osteoformation potential was evaluated in 8-, 6-, and 4-mm-diameter rat-calvarial bone defects by in vivo micro-CT analysis, performed immediately after surgery on days 0, 15, 30, 45, and 60. Moreover, histological and histomorphometric analyses were done on day 60. PDBM was compared to cancelous bone powder (BP) before its partial demineralization. The expression levels of selected inflammation-, angiogenesis-, and bone-related genes were also investigated by RT-PCR, 3, 7, and 14 days after surgery. Compared to the control group, the PDBM group exhibited a significant increase (p < 0.05) in radiopacity in 8-mm- and 6-mm-diameter defects at all time points tested. On day 60, the amount of newly-formed bone was greater (16 and 1.6 folds; p < 0.001; respectively) compared to that in control defects. No bone formation was observed in defects filled with BP regardeless of the size. In 8-mm-diameter defect, PDBM was effective enough to induce the upregulation of genes pertinent to inflammation (i.e., TNFα, IL-6, and IL-8), angiogenesis (i.e., VEGF, VWF), and osteogenesis (ALP, RUNX2, BGLAP, SP7) by day 3 after surgery. This study showed that the tested PDBM deeply influences the early critical events involved in bone regeneration and exhibits efficient osteoformation capacity, making it an attractive graft option for treating defects in periodontal and maxillofacial areas.
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Affiliation(s)
- Ahmad Moustapha Diallo
- CNRS, UMR 7052 - INSERM U1271, Laboratory of Osteoarticular Biology, Bioengineering and Bioimaging, Universiy of Paris, 10 Avenue de Verdun, 75010 Paris, France; Service of Periodontology, Institute of Odontology and Stomatology (IOS), University Cheikh Anta Diop (UCAD), BP 5005 Dakar-Fann, Sénégal; Faculty of Medecine, Pharmacy and Odonto-Stomatology, University Cheikh Anta Diop (UCAD), BP 5005 Dakar-Fann, Sénégal
| | - Solène Rota
- ERRMECe, Research Team on Extracellular Matrix-Cellular Relationships (EA1391), Biomaterials for Health Research Group, Institute of Materials I-MAT (FD4122), CY Tech, CY University Cergy Paris, International House of Research (MIR), rue Descartes, 95001 Neuville sur Oise cedex, France; Biobank, 3 rue Georges Charpak, 77127 Lieusaint, France
| | - Michel Boissière
- ERRMECe, Research Team on Extracellular Matrix-Cellular Relationships (EA1391), Biomaterials for Health Research Group, Institute of Materials I-MAT (FD4122), CY Tech, CY University Cergy Paris, International House of Research (MIR), rue Descartes, 95001 Neuville sur Oise cedex, France
| | | | - Emmanuel Pauthe
- ERRMECe, Research Team on Extracellular Matrix-Cellular Relationships (EA1391), Biomaterials for Health Research Group, Institute of Materials I-MAT (FD4122), CY Tech, CY University Cergy Paris, International House of Research (MIR), rue Descartes, 95001 Neuville sur Oise cedex, France
| | - Hervé Petite
- CNRS, UMR 7052 - INSERM U1271, Laboratory of Osteoarticular Biology, Bioengineering and Bioimaging, Universiy of Paris, 10 Avenue de Verdun, 75010 Paris, France
| | - Henri M Benoist
- Service of Periodontology, Institute of Odontology and Stomatology (IOS), University Cheikh Anta Diop (UCAD), BP 5005 Dakar-Fann, Sénégal; Faculty of Medecine, Pharmacy and Odonto-Stomatology, University Cheikh Anta Diop (UCAD), BP 5005 Dakar-Fann, Sénégal
| | - Morad Bensidhoum
- CNRS, UMR 7052 - INSERM U1271, Laboratory of Osteoarticular Biology, Bioengineering and Bioimaging, Universiy of Paris, 10 Avenue de Verdun, 75010 Paris, France
| | - Fani Anagnostou
- CNRS, UMR 7052 - INSERM U1271, Laboratory of Osteoarticular Biology, Bioengineering and Bioimaging, Universiy of Paris, 10 Avenue de Verdun, 75010 Paris, France; Service of Odontology, Hôpital Pitié-Salpêtrière APHP, U.F.R. of Odontology University of Paris, 47-83 Boulevard de l'Hôpital, 75013 Paris, France.
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Jang CH, Cho GW, Song AJ. Effect of Bone Powder/Mesenchymal Stem Cell/BMP2/Fibrin Glue on Osteogenesis in a Mastoid Obliteration Model. In Vivo 2021; 34:1103-1110. [PMID: 32354898 DOI: 10.21873/invivo.11881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study aimed to prospectively compare the osteogenesis of bone powder (BP) substances with and without mesenchymal stem cells (MSCs) and evaluate the synergistic effect of topically applied recombinant human bone morphogenic protein-2 (BMP2) on MSC-loaded BP using fibrin glue in a mastoid obliteration model. MATERIALS AND METHODS To determine the expression of osteocyte-specific genes, total RNA was isolated from three MSC groups: Untreated MSCs, MSCs cultured with BP, and MSCs cultured with BP and BMP2. Real-time polymerase chain reaction was carried out with specific primers of osteogenesis-related genes runt-related transcription factor 2, osteocalcin, osteoprotegerin, osterix, alkaline phosphatase, transforming growth factor beta, and type I collagen. Live/dead staining was also performed. To observe the adhesion of MSCs to the BP, MSCs were treated with BP for 2 days and the surface was observed by scanning electron microscopy (SEM). Under general anesthesia, mastoid obliteration was performed in rats using three groups: treated with BP alone, BP/MSCs, and BP/MSC/BMP2. Before decapitation at 8 weeks post operation, in vivo micro computed tomography (micro CT) was performed. The bullae were dissected, fixed, and decalcified. followed by dehydration, paraffin embedding, and staining by hematoxylin and eosin and Masson's trichrome. RESULTS SEM showed the MSCs to be well-attached to the superficial area of the BP. The expression of osteocyte-specific genes was the highest in the MSCs cultured with BP and BMP2, followed by cultured with BP only, and untreated MSCs. The BP/MSC/BMP2 group showed the highest radiodensity of bullae in microCT analysis. The microCT findings revealed that the BP/MSC/BMP2 group showed the most enhanced osteogenesis of the scaffold compared to the other two groups. No significant difference was found in osteoconductive osteogenesis between the control and BP/MSC groups. However, the BP/MSC/BMP2 group showed significantly enhanced osteoconductive osteogenesis and osteoinductive change of the BP as shown by hematoxylin and eosin staining. Histomorphometry of osteogenesis revealed that the difference between the BP/MSC/BMP2 group and the other two groups was statistically significant. CONCLUSION A small amount of BMP2 is necessary during MSC loading to enhance the osteogenesis of BP and avoid complications associated with high doses of BMP2. These results may be applicable to mastoid obliteration in clinical practice.
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Affiliation(s)
- Chul Ho Jang
- Department of Otolaryngology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Gwang Won Cho
- Department of Biology, College of Natural Science, Chosun University, Gwangju, Republic of Korea.,Department of Life Science, BK-21-Plus Research Team for Bioactive Control Technology, Chosun University, Gwangju, Republic of Korea
| | - An-Ji Song
- Department of Biology, College of Natural Science, Chosun University, Gwangju, Republic of Korea.,Department of Life Science, BK-21-Plus Research Team for Bioactive Control Technology, Chosun University, Gwangju, Republic of Korea
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Radiological and Histomorphometric Outcomes of Homologous Bone Graft in Postextractive Implant Sites: A 6-Year Retrospective Analysis. IMPLANT DENT 2019; 28:472-477. [PMID: 31232716 DOI: 10.1097/id.0000000000000920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim was to investigate the in vivo efficacy of a cancellous particulate allograft bone in the regeneration of postextractive atrophic sites. MATERIAL AND METHODS Ten patients were selected, and after a minimally invasive extraction of the teeth (T0), a cone beam computed tomography was performed (T1). Seven days after extraction, Puros cancellous particulate homologous graft was inserted into the elected sites together with a membrane (T2). After 4 months, a cone beam computed tomography of the sites was performed (T3). After 5 months, samples of the regenerated sites were taken contextually to implant insertion (T4). The samples were histologically and histomorphometrically analyzed. Intraoral periapical radiographs were accomplished at T4 and at the 6-year follow-up appointment (T5). RESULTS The mean vertical bone augmentation was of 4.1 mm in the lower jaw and of 3.35 mm in the maxilla at T3 appointment. The mean horizontal bone augmentation in the lower jaw was 2.02 and 2.15 mm in the maxilla. At T4, the mean total bone was 60.01% and the mature bone was 98.41. At the 6-year follow-up visit, the mean periimplant bone resorption was 0.14 mm (range 0-0.5 mm). CONCLUSIONS Cancellous particulate allograft bone demonstrated excellent bone regeneration behavior both in terms of quantity and quality, and stable results over a 6-year period. CLINICAL RELEVANCE Cancellous allograft bone can be successfully used to regenerate atrophic sites.
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Stumbras A, Kuliesius P, Januzis G, Juodzbalys G. Alveolar Ridge Preservation after Tooth Extraction Using Different Bone Graft Materials and Autologous Platelet Concentrates: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2019; 10:e2. [PMID: 31069040 PMCID: PMC6498816 DOI: 10.5037/jomr.2019.10102] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/12/2019] [Indexed: 12/25/2022]
Abstract
Objectives To review and assess the efficiency of different post extraction socket preservation techniques. Material and Methods An electronic literature search was performed on the MEDLINE and Embase databases. The review included human studies published between from January 1st, 2007 to January 1st, 2018, in English. Outcome measures included dimensional changes and/or histological evaluation of alveolar bone. Results Twenty-six full text articles were reviewed, 16 of which met the inclusion criteria and were selected for the study. Autogenous tooth graft prevented vertical resorption the most: -0.28 (SD 0.13) mm, observation period (OP): 4 months, while the least effective approach was beta tri-calcium phosphate (β-TCP): -1.72 (SD 0.56) mm, OP: 4 months. Estimating horizontal resorption, the most effective technique was biphasic calcium sulphate (BCS) with β-TCP and hydroxyapatite (HA) - BCS + TCP + HA: 0.03 (SD 2.32) mm, OP: 4 months, while β-TCP was the least efficient: -1.45 (SD 0.4) mm, OP: 4 months. Evaluating residual graft particles (RG) and newly formed bone (NFB) ratio the best results were achieved with demineralized freeze-dried bone allograft: RG: 8.88%, NFB: 38.42%, OP: 5 months, whereas magnesium-enriched hydroxyapatite was least effective: RG: 40.82%, NFB: 31.85%, OP: 4 months. Conclusions This review revealed that even though there are numerous types of biomaterials for socket preservation none of them can completely stop alveolar bone loss after tooth extraction. Furthermore, lack of information about qualitative evaluation of bone was noticed indicating that further studies regarding this topic are needed.
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Affiliation(s)
- Arturas Stumbras
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania
| | - Povilas Kuliesius
- Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania
| | - Gintaras Januzis
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania
| | - Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, KaunasLithuania
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Park JH, Jung SY, Lee CK, Ban MJ, Lee SJ, Kim HY, Oh HJ, Kim BK, Park HS, Jang SH, Kim HS. A 3D-printed polycaprolactone/β-tricalcium phosphate mandibular prosthesis: A pilot animal study. Laryngoscope 2019; 130:358-366. [PMID: 30861134 DOI: 10.1002/lary.27908] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 01/24/2019] [Accepted: 02/12/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE In this study, we assessed the effectiveness of a tonsil-derived mesenchymal stem cell (TMSC)-transplanted polycaprolactone/beta-tricalcium phosphate prosthesis (specifically designed for easier fixing and grafting with a single scaffold) on rabbit mandible osteogenesis. METHODS The mandibles of 18 rabbits were exposed, and 10 × 8-mm bone defects were made. Two rabbits did not receive implants; four were reconstructed with the scaffold control (SC) (SC group); four were reconstructed with scaffolds soaked in peripheral blood (PB) (PB group); four were reconstructed with TMSC-transplanted scaffolds (TMSC group); and four were reconstructed with differentiated osteocyte-transplanted scaffolds (DOC) (DOC group). Each rabbit was sacrificed 12 weeks after surgery, and the area of new bone formation was investigated by mechanical testing, histology, and micro-computed tomography. RESULTS More extended and denser new bone masses were observed in the TMSC and DOC groups, although fibrosis and vascular formation levels were similar in all groups, suggesting that the dual-structured scaffold alone provides a good environment for bone attachment and regeneration. The bone volumes of representative scaffolds from the SC, PB, TMSC, and DOC groups were 43.12, 48.35, 53.10, and 57.44% of the total volumes, respectively. CONCLUSION The design of the scaffold resulted in effective osteogenesis, and TMSCs showed osteogenic potency, indicating that their combination could enable effective bone regeneration. LEVEL OF EVIDENCE NA Laryngoscope, 130:358-366, 2020.
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Affiliation(s)
- Jae Hong Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Soonchunhyang University, Chuncheon
| | - Soo Yeon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul
| | - Chi-Kyou Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Soonchunhyang University, Chuncheon
| | - Myung Jin Ban
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Soonchunhyang University, Chuncheon
| | - Sang Jin Lee
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A
| | - Ha Yeong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul.,Department of Molecular Medicine, College of Medicine, Ewha Womans University, Seoul
| | | | - Byeong Kook Kim
- Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea
| | - Hae Sang Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon
| | - Si-Hyong Jang
- Department of Pathology, College of Medicine , Soonchunhyang University, Chuncheon
| | - Han Su Kim
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A
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Edelmann AR, Patel D, Allen RK, Gibson CJ, Best AM, Bencharit S. Retrospective analysis of porous tantalum trabecular metal-enhanced titanium dental implants. J Prosthet Dent 2018; 121:404-410. [PMID: 30396711 DOI: 10.1016/j.prosdent.2018.04.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM The design of porous tantalum trabecular metal-enhanced titanium (TM) dental implants promises improved osseointegration, especially when grafting materials such as demineralized bone matrix are used; however, studies are lacking. PURPOSE The purpose of this retrospective study was to compare TM implants with conventional titanium alloy (Ti) implants with and without demineralized bone matrix in terms of peri-implant bone remodeling in the first year after implant loading. MATERIAL AND METHODS A chart review was used for all patients receiving Tapered Screw-Vent Ti and TM implants. Implants were placed and restored by a single provider between 2011 and 2015. Peri-implant bone remodeling was compared by using a paired t test (α=.05). RESULTS A total of 82 patients received 205 implants, 44 TM and 161 Ti implants (control). No implants failed in the TM group (survival rate of 100%), and 3 implants in total, 1 immediate, failed in the Ti groups (survival rate of 98.1%). TM implants exhibited a 0.28-mm bone gain on average, whereas the control group demonstrated 0.20 mm of marginal bone loss after the first year of implant loading. Multivariate logistic regression analysis demonstrated that the odds of having bone loss was 64% less (odds ratio: 0.36; 95% confidence interval: 0.14-0.94) in the TM group than in the Ti group after controlling for bone grafting, implant location, immediate placement, bone type, and pretreatment bone level. CONCLUSIONS TM implants exhibited less peri-implant bone loss than the control Ti implants.
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Affiliation(s)
- Alexander R Edelmann
- Resident, Department of Orthodontics, School of Dentistry, University of Texas Health Science Center, Houston, Texas
| | - Devang Patel
- Former doctoral student, Department of Prosthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Riley K Allen
- Research Assistant, Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Chad J Gibson
- Undergraduate Research Assistant, Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Al M Best
- Professor and Director of Faculty Research Development, Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Sompop Bencharit
- Associate Professor and Director of Digital Dentistry Technologies, Department of General Practice and Department of Oral and Maxillofacial Surgery, School of Dentistry; and Department of Biomedical Engineering, School of Engineering, Virginia Commonwealth University, Richmond, Va.
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Kawecki F, Clafshenkel WP, Fortin M, Auger FA, Fradette J. Biomimetic Tissue-Engineered Bone Substitutes for Maxillofacial and Craniofacial Repair: The Potential of Cell Sheet Technologies. Adv Healthc Mater 2018; 7:e1700919. [PMID: 29280323 DOI: 10.1002/adhm.201700919] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/02/2017] [Indexed: 12/21/2022]
Abstract
Maxillofacial defects are complex lesions stemming from various etiologies: accidental, congenital, pathological, or surgical. A bone graft may be required when the normal regenerative capacity of the bone is exceeded or insufficient. Surgeons have many options available for bone grafting including the "gold standard" autologous bone graft. However, this approach is not without drawbacks such as the morbidity associated with harvesting bone from a donor site, pain, infection, or a poor quantity and quality of bone in some patient populations. This review discusses the various bone graft substitutes used for maxillofacial and craniofacial repair: allografts, xenografts, synthetic biomaterials, and tissue-engineered substitutes. A brief overview of bone tissue engineering evolution including the use of mesenchymal stem cells is exposed, highlighting the first clinical applications of adipose-derived stem/stromal cells in craniofacial reconstruction. The importance of prevascularization strategies for bone tissue engineering is also discussed, with an emphasis on recent work describing substitutes produced using cell sheet-based technologies, including the use of thermo-responsive plates and the self-assembly approach of tissue engineering. Indeed, considering their entirely cell-based design, these natural bone-like substitutes have the potential to closely mimic the osteogenicity, osteoconductivity, osteoinduction, and osseointegration properties of autogenous bone for maxillofacial and craniofacial reconstruction.
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Affiliation(s)
- Fabien Kawecki
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Center‐Université Laval Québec QC G1J 1Z4 Canada
- Department of Surgery Faculty of Medicine Université Laval Québec QC G1V 0A6 Canada
| | - William P. Clafshenkel
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Center‐Université Laval Québec QC G1J 1Z4 Canada
- Department of Surgery Faculty of Medicine Université Laval Québec QC G1V 0A6 Canada
| | - Michel Fortin
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Center‐Université Laval Québec QC G1J 1Z4 Canada
- Department of Oral and Maxillofacial Surgery Faculty of Dentistry Université Laval Québec QC G1V 0A6 Canada
| | - François A. Auger
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Center‐Université Laval Québec QC G1J 1Z4 Canada
- Department of Surgery Faculty of Medicine Université Laval Québec QC G1V 0A6 Canada
| | - Julie Fradette
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Center‐Université Laval Québec QC G1J 1Z4 Canada
- Department of Surgery Faculty of Medicine Université Laval Québec QC G1V 0A6 Canada
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Berberi A, Amkhadova MA, Samarani A, Aoun G. PHYSICOCHEMICAL CHARACTERIZATION: COMPARATIVE EVALUATION OF ALLOGRAFT BIOMATERIALS AND AUTOGENOUS BONE. RUSSIAN JOURNAL OF DENTISTRY 2017; 21:233-237. [DOI: 10.18821/1728-2802-2017-21-5-233-237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Objectives: bone substitutes used in oral surgery include allografts, xenografts and synthetic materials that are frequently used to compensate bone loss or to reinforce repaired bone by encouraging new bone ingrowth into the defect site. The aim of this study was to evaluate a number ofphysical and chemical properties in a variety of allografts biomaterials used in oral surgery and to compare them with those of autogenous bone. Materials and methods: autogenous bone andfive different allograft biomaterials were studied by high-resolution X-ray diffractometry, atomic absorption spectrometry, laser diffraction, and checked for their chemical composition, calcium release concentration, crystallinity and granulation size. Results: the highest calcium release concentration was 24.94 mg/gforPuros® and the lowest one was 4.05 mg/gfor OsteoSponge® compared to 20.15 mg/g to natural bone. The range ofparticles size, in term of median size D50, varied between 394.24 pm for DIZG Spongiosa® and 902.41 pm for OsteoSponge®, compared to 282.1 pm for natural bone. Bone and Puros® displayed a hexagonal shape as bone except and OsteoSponge® which showed a triclinic shape and all the rest showed monoclinic shape. Conclusion: a bone substitute of choice depends largely on its clinical application that is associated to its biological and mechanical performance. These morphological differences between biomaterials greatly influence their in-vivo behavior of biomaterials. Significant differences were detected in terms of calcium concentration, particles size, and crystallinity.
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Bencharit S, Allen RK, Whitley D. Utilization of Demineralized Bone Matrix to Restore Missing Buccal Bone During Single Implant Placement: Clinical Report. J ORAL IMPLANTOL 2016; 42:490-497. [DOI: 10.1563/aaid-joi-d-16-00054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Sompop Bencharit
- Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Riley K. Allen
- Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Daniel Whitley
- Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
- Department of General Practice, School of Dentistry; and Department of Biomedical Engineering, School of Engineering, Virginia Commonwealth University, Richmond, Va
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Berberi A, Nader N. In Response. IMPLANT DENT 2016; 25:729-730. [PMID: 27861216 DOI: 10.1097/01.id.0000510825.24224.a7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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van Houdt CIA, Cardoso DA, van Oirschot BAJA, Ulrich DJO, Jansen JA, Leeuwenburgh SCG, van den Beucken JJJP. Porous titanium scaffolds with injectable hyaluronic acid-DBM gel for bone substitution in a rat critical-sized calvarial defect model. J Tissue Eng Regen Med 2016; 11:2537-2548. [DOI: 10.1002/term.2151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 11/01/2015] [Accepted: 12/22/2015] [Indexed: 12/20/2022]
Affiliation(s)
- C. I. A. van Houdt
- Department of Biomaterials; Radboud University Medical Centre; Nijmegen The Netherlands
| | | | | | - D. J. O. Ulrich
- Department of Plastic Surgery; Radboud University Medical Centre; Nijmegen The Netherlands
| | - J. A. Jansen
- Department of Biomaterials; Radboud University Medical Centre; Nijmegen The Netherlands
| | - S. C. G. Leeuwenburgh
- Department of Biomaterials; Radboud University Medical Centre; Nijmegen The Netherlands
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Incorporation of nanostructured hydroxyapatite and poly(N-isopropylacrylamide) in demineralized bone matrix enhances osteoblast and human mesenchymal stem cell activity. Biointerphases 2015; 10:041001. [PMID: 26443012 DOI: 10.1116/1.4931882] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Demineralized bone matrix (DBM) is currently used in many clinical applications for bone augmentation and repair. DBM is normally characterized by the presence of bone morphogenetic proteins. In this study, the authors have optimized methods to obtain DBM under good manufacturing practice, resulting in enhanced bioactivity. The processed DBM can be used alone, together with nanostructured hydroxyapatite (nanoHA), or dispersed in a physiological carrier or hydrogel. In this study, osteoblasts (MG-63) and human bone marrow derived mesenchymal stem cells (hMSCs) were cultured on DBM pastes made in phosphate buffered saline solution or poly(N-isopropylacrylamide) (PNIPAAM) hydrogels with or without nanoHA. The authors observed that the presence of PNIPAAM reduced osteoblast adhesion, while the addition of nanoHA increased osteoblast adhesion, proliferation, interleukin-6 (IL-6) production, and reduced lactate dehydrogenase (LDH) production. Increasing concentrations of PNIPAAM in combination with nanoHA further increased osteoblast proliferation, and decreased IL-6 and LDH production. Incorporation of PNIPAAM in DBM enhanced hMSCs proliferation and collagen type-I production. Furthermore, a combination of PNIPAAM and nanoHA further increased alkaline phosphatase and osteocalcin production in hMSCs, independently from the concentration of PNIPAAM. This study shows that combinations of DBM with nanoHA and PNIPAAM seem to offer a promising route to enhance cell activity and induce osteogenic differentiation.
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Abstract
Acute fractures, nonunions, and nonunions with bone defects or osteomyelitis often need bone graft to facilitate union. There are several factors to consider when it is determined that a bone graft is needed. These factors include the source of the bone graft (autograft vs. allograft), proper timing for placement of the bone graft, strategies to avoid further complications (particularly in the setting of osteomyelitis), and with the development of a variety of bone graft substitutes, whether alternatives to autograft are available and appropriate for the task at hand. Autograft bone has commonly been referred to as the "gold standard" of bone grafts, against which the efficacy of other grafts has been measured. The best timing for when to place a bone graft or substitute is also somewhat controversial, particularly after an open fracture or a potentially contaminated bed. The treatment of infected nonunions, particularly those that require a graft to facilitate healing, can be quite challenging. Typically, the infection is completely eradicated before placement of a bone graft, but achieving a sterile bed and the timing of a bone graft require strategic thinking and planning. This review outlines the benefits of autografts, the most suitable sites for harvesting bone grafts, the timing of bone graft procedures, the potential risks and benefits of grafting in the face of infection, and the currently available bone graft extenders.
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Chuenjitkuntaworn B, Osathanon T, Nowwarote N, Supaphol P, Pavasant P. The efficacy of polycaprolactone/hydroxyapatite scaffold in combination with mesenchymal stem cells for bone tissue engineering. J Biomed Mater Res A 2015; 104:264-71. [DOI: 10.1002/jbm.a.35558] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/12/2015] [Accepted: 09/03/2015] [Indexed: 12/27/2022]
Affiliation(s)
| | - Thanaphum Osathanon
- Mineralized Tissue Research Unit, Faculty of Dentistry; Chulalongkorn University; Bangkok 10330 Thailand
- Department of Anatomy, Faculty of Dentistry; Chulalongkorn University; Bangkok Pathumwan 10330 Thailand
| | - Nunthawan Nowwarote
- Mineralized Tissue Research Unit, Faculty of Dentistry; Chulalongkorn University; Bangkok 10330 Thailand
| | - Pitt Supaphol
- The Petroleum and Petrochemical College; Chulalongkorn University; Bangkok Pathumwan 10330 Thailand
| | - Prasit Pavasant
- Mineralized Tissue Research Unit, Faculty of Dentistry; Chulalongkorn University; Bangkok 10330 Thailand
- Department of Anatomy, Faculty of Dentistry; Chulalongkorn University; Bangkok Pathumwan 10330 Thailand
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17
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Jing W, Smith AA, Liu B, Li J, Hunter DJ, Dhamdhere G, Salmon B, Jiang J, Cheng D, Johnson CA, Chen S, Lee K, Singh G, Helms JA. Reengineering autologous bone grafts with the stem cell activator WNT3A. Biomaterials 2015; 47:29-40. [DOI: 10.1016/j.biomaterials.2014.12.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 11/29/2014] [Accepted: 12/16/2014] [Indexed: 01/12/2023]
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18
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Bencharit S, Byrd WC, Hosseini B. Immediate placement of a porous-tantalum, trabecular metal-enhanced titanium dental implant with demineralized bone matrix into a socket with deficient buccal bone: a clinical report. J Prosthet Dent 2015; 113:262-9. [PMID: 25702965 DOI: 10.1016/j.prosdent.2014.09.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 09/18/2014] [Accepted: 09/18/2014] [Indexed: 11/28/2022]
Abstract
A missing or deficient buccal alveolar bone plate is often an important limiting factor for immediate implant placement. Titanium dental implants enhanced with porous tantalum-based trabecular metal material (PTTM) are designed for osseoincorporation, a combination of vascularized bone ingrowth and osseointegration (bone on-growth). Demineralized bone matrix (DBM) contains growth factors with good handling characteristics. However, the combination of these 2 materials in facial alveolar bone regeneration associated with immediate implant therapy has not been reported. A 65-year-old Asian woman presented with a failing central incisor. Most of the buccal alveolar bone plate of the socket was missing. A PTTM enhanced implant was immediately placed with DBM. Cone beam computed tomography scans 12 months after the insertion of the definitive restoration showed regeneration of buccal alveolar bone. A combination of a PTTM enhanced implant, DBM, and a custom healing abutment may have an advantage in retaining biologically active molecules and form a scaffold for neovascularization and osteogenesis. This treatment protocol may be a viable option for immediate implant therapy in a failed tooth with deficient buccal alveolar bone.
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Affiliation(s)
- Sompop Bencharit
- Assistant Professor, Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC.
| | - Warren C Byrd
- Research Fellow, Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Bashir Hosseini
- Former Resident, Department of Endodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
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19
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Abstract
Many orthobiologic adjuvants are available and widely utilized for general skeletal restoration. Their use for the specific task of osteoporotic fracture augmentation is less well recognized. Common conductive materials are reviewed for their value in this patient population including the large group of allograft adjuvants categorically known as the demineralized bone matrices (DBMs). Another large group of alloplastic materials is also examined-the calcium phosphate and sulfate ceramics. Both of these materials, when used for the proper indications, demonstrate efficacy for these patients. The inductive properties of bone morphogenic proteins (BMPs) and platelet concentrates show no clear advantages for this group of patients. Systemic agents including bisphosphonates, receptor activator of nuclear factor κβ ligand (RANKL) inhibitors, and parathyroid hormone augmentation all demonstrate positive effects with this fracture cohort. Newer modalities, such as trace ion bioceramic augmentation, are also reviewed for their positive effects on osteoporotic fracture healing.
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Affiliation(s)
- J Tracy Watson
- Orthopaedic Trauma Service, Department of Orthopaedic Surgery, Saint Louis University School of Medicine, 3635 Vista Ave., 7th Floor Desloge Towers, St. Louis, MO, 63110, USA,
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20
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Physicochemical characteristics of bone substitutes used in oral surgery in comparison to autogenous bone. BIOMED RESEARCH INTERNATIONAL 2014; 2014:320790. [PMID: 25143936 PMCID: PMC4119630 DOI: 10.1155/2014/320790] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 06/08/2014] [Indexed: 11/17/2022]
Abstract
Bone substitutes used in oral surgery include allografts, xenografts, and synthetic materials that are frequently used to compensate bone loss or to reinforce repaired bone, but little is currently known about their physicochemical characteristics. The aim of this study was to evaluate a number of physical and chemical properties in a variety of granulated mineral-based biomaterials used in dentistry and to compare them with those of autogenous bone. Autogenous bone and eight commercial biomaterials of human, bovine, and synthetic origins were studied by high-resolution X-ray diffraction, atomic absorption spectrometry, and laser diffraction to determine their chemical composition, calcium release concentration, crystallinity, and granulation size. The highest calcium release concentration was 24. 94 mg/g for Puros and the lowest one was 2.83 mg/g for Ingenios β-TCP compared to 20.15 mg/g for natural bone. The range of particles sizes, in terms of median size D50, varied between 1.32 μm for BioOss and 902.41 μm for OsteoSponge, compared to 282.1 μm for natural bone. All samples displayed a similar hexagonal shape as bone, except Ingenios β-TCP, Macrobone, and OsteoSponge, which showed rhomboid and triclinic shapes, respectively. Commercial bone substitutes significantly differ in terms of calcium concentration, particle size, and crystallinity, which may affect their in vivo performance.
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21
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Augmentation of intramembranous bone in rabbit calvaria using an occlusive barrier in combination with demineralized bone matrix (DBM): A pilot study. Int J Surg 2014; 12:378-83. [DOI: 10.1016/j.ijsu.2014.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 02/01/2014] [Accepted: 03/13/2014] [Indexed: 11/18/2022]
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Abstract
PURPOSE To evaluate its efficacy and predictability in immediate extraction sockets, this case series used demineralized bone matrix in a puttylike carrier (DBM putty) with and without mineralized bone chips. Each preparation was made from the long bones of the same tissue donor; the only excipient material was water. MATERIAL AND METHODS A single failing tooth was atraumatically extracted from each study subject, and the socket was debrided. Intact sockets were grafted with DBM putty (n = 6), and sockets with buccal defects were grafted with DBM putty with bone chips (n = 6). A bovine pericardium membrane was draped over the graft site, and tension-free primary closure was obtained. After 6 months of healing, a trephine biopsy was taken from the center of each graft, and then, a dental implant was placed. Two subjects were withdrawn, and histologic data could not be obtained from 2 other patients. RESULTS Mean new bone fill was 40.28% for DBM putty (n = 5) and 44.60% for DBM putty with bone chips (n = 4). CONCLUSIONS Both preparations maintained ridge dimensions and, despite ongoing bone turnover, produced adequate mineralized tissue that enabled implant placement at 6 months. This finding warrants further research.
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23
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Comparative in vitro study of four commercial biomaterials used for bone grafting. J Appl Biomater Funct Mater 2013; 11:e80-8. [PMID: 23728538 DOI: 10.5301/jabfm.5000149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2012] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This work aimed to study and compare the behavior of macrophages and human osteoclast-like cells cultured in contact with four commercial bone substitute materials used as graft for ridge augmentation techniques. Two materials are of natural origin and two are synthetic bone substitutes. METHODS Macrophage activation and cytokine release were assessed using SEM analysis and a sandwich ELISA kit while the activity of human osteoclast-like cells was studied quantifying calcium released from the substrata studied together with SEM analysis of cell morphology and pit formation on the bone substitutes. RESULTS Hydroxyapatite proved to be the greatest macrophage activator, while the bovine derived material turned out to be the only bone substitute that does not induce macrophages to release IFNγ. No material had direct induction of osteoclast precursor differentiation even if mature osteoclasts showed the highest activity on the human derived material followed by bone ceramic, while the bovine derived material was the substrate with the least osteoclast activity. CONCLUSIONS The four materials reacted differently with the cells tested and between them, the bovine derived bone, being the lowest macrophage and osteoclast activator may be considered a good bone substitute for clinical situations requiring greater time of permanence of the material at the site of implantation, while human derived bone will be more suitable for clinical applications that require lower time of permanence.
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24
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Kirk JF, Ritter G, Finger I, Sankar D, Reddy JD, Talton JD, Nataraj C, Narisawa S, Millán JL, Cobb RR. Mechanical and biocompatible characterization of a cross-linked collagen-hyaluronic acid wound dressing. BIOMATTER 2013; 3:25633. [PMID: 23896569 PMCID: PMC3866196 DOI: 10.4161/biom.25633] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Collagen scaffolds have been widely employed as a dermal equivalent to induce fibroblast infiltrations and dermal regeneration in the treatment of chronic wounds and diabetic foot ulcers. Cross-linking methods have been developed to address the disadvantages of the rapid degradation associated with collagen-based scaffolds. To eliminate the potential drawbacks associated with glutaraldehyde cross-linking, methods using a water soluble carbodiimide have been developed. In the present study, the glycosaminoglycan (GAG) hyaluronic acid (HA), was covalently attached to an equine tendon derived collagen scaffold using 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide (EDC) to create ntSPONGE™. The HA was shown to be homogeneously distributed throughout the collagen matrix. In vitro analyses of the scaffold indicated that the cross-linking enhanced the biological stability by decreasing the enzymatic degradation and increasing the thermal denaturation temperature. The material was shown to support the attachment and proliferation of mouse L929 fibroblast cells. In addition, the cross-linking decreased the resorption rate of the collagen as measured in an intramuscular implant model in rabbits. The material was also shown to be biocompatible in a variety of in vitro and in vivo assays. These results indicate that this cross-linked collagen-HA scaffold, ntSPONGE™, has the potential for use in chronic wound healing.
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Affiliation(s)
- James F Kirk
- Research and Development Department; Nanotherapeutics, Inc.; Alachua, FL USA
| | - Gregg Ritter
- Research and Development Department; Nanotherapeutics, Inc.; Alachua, FL USA
| | - Isaac Finger
- Research and Development Department; Nanotherapeutics, Inc.; Alachua, FL USA
| | - Dhyana Sankar
- Research and Development Department; Nanotherapeutics, Inc.; Alachua, FL USA
| | - Joseph D Reddy
- Research and Development Department; Nanotherapeutics, Inc.; Alachua, FL USA
| | - James D Talton
- Research and Development Department; Nanotherapeutics, Inc.; Alachua, FL USA
| | | | - Sonoko Narisawa
- Sanford-Burnham Medical Research Institute; La Jolla, CA USA
| | | | - Ronald R Cobb
- Research and Development Department; Nanotherapeutics, Inc.; Alachua, FL USA
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25
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Supronowicz P, Gill E, Trujillo A, Thula T, Zhukauskas R, Perry R, Cobb RR. Multipotent adult progenitor cell-loaded demineralized bone matrix for bone tissue engineering. J Tissue Eng Regen Med 2013; 10:275-83. [PMID: 23413005 DOI: 10.1002/term.1706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 11/28/2012] [Accepted: 12/20/2012] [Indexed: 11/10/2022]
Abstract
Multipotent adult progenitor cells (MAPCs) from bone marrow have been shown to be capable of forming bone, cartilage and other connective tissues. In addition, MAPCs differentiate into lineages that are different from their germ layers of origin. Previous studies showed the ability of MAPCs to improve cardiac function and control allogenic-reactive responses associated with acute graft versus host disease. In the current study, we evaluated the ability of MAPCs to produce bone matrix on demineralized bone allograft substrates. Specifically, MAPCs expressed alkaline phosphatase, produced extracellular matrix proteins and deposited calcium-containing mineral on demineralized bone matrices. Furthermore, the addition of MAPCs on demineralized bone matrix (DBM) scaffolds enhanced osteoinductivity of the carrier in a rat ectopic pouch model. These results demonstrated the potential of MAPCs as a new approach for bone repair in tissue-engineering applications.
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Affiliation(s)
- Peter Supronowicz
- Biotechnology Development Department, RTI Biologics, Alachua, FL, USA
| | - Elise Gill
- Biotechnology Development Department, RTI Biologics, Alachua, FL, USA
| | - Angelica Trujillo
- Biotechnology Development Department, RTI Biologics, Alachua, FL, USA
| | - Taili Thula
- Biotechnology Development Department, RTI Biologics, Alachua, FL, USA
| | | | | | - Ronald R Cobb
- Biotechnology Development Department, RTI Biologics, Alachua, FL, USA
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26
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Renth AN, Detamore MS. Leveraging "raw materials" as building blocks and bioactive signals in regenerative medicine. TISSUE ENGINEERING. PART B, REVIEWS 2012; 18:341-62. [PMID: 22462759 PMCID: PMC3458620 DOI: 10.1089/ten.teb.2012.0080] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 03/28/2012] [Indexed: 01/15/2023]
Abstract
Components found within the extracellular matrix (ECM) have emerged as an essential subset of biomaterials for tissue engineering scaffolds. Collagen, glycosaminoglycans, bioceramics, and ECM-based matrices are the main categories of "raw materials" used in a wide variety of tissue engineering strategies. The advantages of raw materials include their inherent ability to create a microenvironment that contains physical, chemical, and mechanical cues similar to native tissue, which prove unmatched by synthetic biomaterials alone. Moreover, these raw materials provide a head start in the regeneration of tissues by providing building blocks to be bioresorbed and incorporated into the tissue as opposed to being biodegraded into waste products and removed. This article reviews the strategies and applications of employing raw materials as components of tissue engineering constructs. Utilizing raw materials holds the potential to provide both a scaffold and a signal, perhaps even without the addition of exogenous growth factors or cytokines. Raw materials contain endogenous proteins that may also help to improve the translational success of tissue engineering solutions to progress from laboratory bench to clinical therapies. Traditionally, the tissue engineering triad has included cells, signals, and materials. Whether raw materials represent their own new paradigm or are categorized as a bridge between signals and materials, it is clear that they have emerged as a leading strategy in regenerative medicine. The common use of raw materials in commercial products as well as their growing presence in the research community speak to their potential. However, there has heretofore not been a coordinated or organized effort to classify these approaches, and as such we recommend that the use of raw materials be introduced into the collective consciousness of our field as a recognized classification of regenerative medicine strategies.
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Affiliation(s)
- Amanda N. Renth
- Bioengineering Program, University of Kansas, Lawrence, Kansas
| | - Michael S. Detamore
- Bioengineering Program, University of Kansas, Lawrence, Kansas
- Department of Chemical and Petroleum Engineering, University of Kansas, Lawrence, Kansas
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Tian M, Yang Z, Kuwahara K, Nimni ME, Wan C, Han B. Delivery of demineralized bone matrix powder using a thermogelling chitosan carrier. Acta Biomater 2012; 8:753-62. [PMID: 22079781 DOI: 10.1016/j.actbio.2011.10.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 10/20/2011] [Accepted: 10/23/2011] [Indexed: 12/22/2022]
Abstract
Demineralized bone matrix (DBM) powder is widely used for bone regeneration due to its osteoinductivity and osteoconductivity. However, difficulties with handling, its tendency to migrate from graft sites, and lack of stability after surgery can sometimes limit the clinical utility of this material. In this work, the possibility of using a thermogelling chitosan carrier to deliver DBM powder was assessed. The DBM-thermogelling putty improved handling and formed a gel-like composite in situ at body temperature within a clinically relevant time period. The properties of the formed composite, including morphology, porosity, mechanical properties, equilibrium swelling as well as degradability, are significantly influenced by the ratio of DBM to thermogelling chitosan. The in vitro study showed that the alkaline phosphatase activity of C2C12 cells encapsulated in the composite was steadily increased with culture time. The in vivo study showed that increased DBM content in the DBM-thermogelling chitosan induced ectopic bone formation in a nude rat model. The diffusion of growth factor from the DBM-thermogelling chitosan as well as the host-implant interactions are discussed.
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Affiliation(s)
- Meng Tian
- Department of Biomedical Engineering, College of Polymer Science & Engineering, Sichuan University, Chengdu, People's Republic of China
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28
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Liu X, Liu HY, Lian X, Shi XL, Wang W, Cui FZ, Zhang Y. Osteogenesis of mineralized collagen bone graft modified by PLA and calcium sulfate hemihydrate: in vivo study. J Biomater Appl 2012; 28:12-9. [PMID: 22274876 DOI: 10.1177/0885328211433618] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this study, the biocompatibility and bone regeneration performance of nano-hydroxyapatite/collagen/poly(L-lactide) (nHAC/PLA) and nano-hydroxyapatite/collagen/calcium sulfate hemihydrate (nHAC/CSH) as bone-filling materials were evaluated and compared in a critical box-shaped defect model in the mandible of the rabbits. In vivo results indicated that there was significant difference in early bone remodeling between two types of bone substitutes. nHAC/PLA has shown excellent biocompatibility, but no adequate handling properties. The addition of CSH to nHAC provided better manipulability compared to nHAC/PLA. Furthermore, nHAC/CSH possesses superior properties in restoring critical-sized bone defects of maxillofacial region at the early stage of remodeling over nHAC/PLA. Our results suggested that nHAC/CSH could be an alternative to the conventionally used bone tissue engineering materials.
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Affiliation(s)
- Xi Liu
- State Key Laboratory of New Ceramic and Fine Processing, Department of Materials Science and Engineering, Tsinghua University, Beijing, China
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