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Blanco J, García Alonso A, Hermida-Nogueira L, Castro AB. How to explain the beneficial effects of leukocyte- and platelet-rich fibrin. Periodontol 2000 2024. [PMID: 38923566 DOI: 10.1111/prd.12570] [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: 01/24/2024] [Revised: 03/06/2024] [Accepted: 04/15/2024] [Indexed: 06/28/2024]
Abstract
The survival of an organism relies on its ability to repair the damage caused by trauma, toxic agents, and inflammation. This process involving cell proliferation and differentiation is driven by several growth factors and is critically dependent on the organization of the extracellular matrix. Since autologous platelet concentrates (APCs) are fibrin matrices in which cells, growth factors, and cytokines are trapped and delivered over time, they are able to influence that response at different levels. The present review thoroughly describes the molecular components present in one of these APCs, leukocyte- and platelet-rich fibrin (L-PRF), and summarizes the level of evidence regarding the influence of L-PRF on anti-inflammatory reactions, analgesia, hemostasis, antimicrobial capacity, and its biological mechanisms on bone/soft tissue regeneration.
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Affiliation(s)
- Juan Blanco
- Department of Surgery (Stomatology, Unit of Periodontology), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Angel García Alonso
- Platelet Proteomics Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Santiago de Compostela University, Santiago de Compostela, Spain
| | - Lidia Hermida-Nogueira
- Platelet Proteomics Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Santiago de Compostela University, Santiago de Compostela, Spain
| | - Ana B Castro
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Pabst A, Becker P, Götz W, Heimes D, Thiem DGE, Blatt S, Kämmerer PW. A comparative analysis of particulate bovine bone substitutes for oral regeneration: a narrative review. Int J Implant Dent 2024; 10:26. [PMID: 38801622 PMCID: PMC11130110 DOI: 10.1186/s40729-024-00544-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024] Open
Abstract
PURPOSE Particulate bovine bone substitutes (BS) are commonly used in oral regeneration. However, more literature is needed focusing on comparative analyses among various particulate bovine BS. This study evaluates pre-clinical and clinical data of different particulate bovine BS in oral regeneration. METHODS A narrative review was conducted by screening the PubMed database Included in the review were pre-clinical and clinical studies until 2024 comparing a minimum of two distinct particulate bovine BS. In addition to examining general data concerning manufacturing and treatment processes, biological safety, physical and chemical characteristics, and graft resorption, particular emphasis was placed on assessing pre-clinical and clinical data related to ridge preservation, sinus floor elevation, peri-implant defects, and various forms of alveolar ridge augmentation utilizing particulate bovine BS. RESULTS Various treatment temperatures ranging from 300 to 1,250 °C and the employment of chemical cleaning steps were identified for the manufacturing process of particulate bovine BS deemed to possess biosecurity. A notable heterogeneity was observed in the physical and chemical characteristics of particulate bovine BS, with minimal or negligible graft resorption. Variations were evident in particle and pore sizes and the porosity of particulate bovine BS. Pre-clinical assessments noted a marginal inclination towards favorable outcomes for particulate bovine BS subjected to higher treatment temperatures. However, clinical data are insufficient. No distinctions were observed regarding ridge preservation, while slight advantages were noted for high-temperature treated particulate bovine BS in sinus floor elevation. CONCLUSIONS Subtle variances in both pre-clinical and clinical outcomes were observed in across various particulate bovine BS. Due to inadequate data, numerous considerations related to diverse particulate bovine BS, including peri-implant defects, must be more conclusive. Additional clinical studies are imperative to address these knowledge gaps effectively.
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Affiliation(s)
- Andreas Pabst
- Department of Oral and Maxillofacial Surgery, German Armed Forces Central Hospital, Rübenacherstraße 170, 56072, Koblenz, Germany
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Philipp Becker
- Department of Oral and Maxillofacial Surgery, German Armed Forces Central Hospital, Rübenacherstraße 170, 56072, Koblenz, Germany
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Werner Götz
- Department of Orthodontics, University Hospital Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
| | - Diana Heimes
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Daniel G E Thiem
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Sebastian Blatt
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Lim KO, Kim MS, Yang KI, Lee WP, Kim BO, Yu SJ. Sinus floor augmentation using mineralized freeze-dried bone allograft combined with recombinant human bone morphogenetic protein-2 (rhBMP-2): A long-term retrospective study. J Dent Sci 2024; 19:804-812. [PMID: 38618071 PMCID: PMC11010679 DOI: 10.1016/j.jds.2023.09.022] [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: 08/10/2023] [Revised: 09/20/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose The combination of recombinant human bone morphogenetic protein-2 (rhBMP-2) with a carrier material has not been extensively studied. This study aimed to evaluate the clinical, radiological, and histomorphometric outcomes of sinus floor augmentation using a 3:7 mixture of cancellous and cortical freeze-dried bone allografts (mixed AG) combined with rhBMP-2. Materials and methods Mixed AG was used for sinus floor augmentation in a total of 21 patients with a residual alveolar bone height <5 mm. Among the total 47 sites, augmentation with and without rhBMP-2 was performed in 26 and 21 sites, respectively. Radiographic parameters were assessed using cone-beam computed tomography. After a six-month healing period, core biopsies were harvested for histomorphometric analysis. Results The bone gain after healing was 13.36 ± 3.9 mm and 12.07 ± 3.8 mm in the mixed AG alone and mixed AG with rhBMP-2 groups, respectively. The survival rate of implants in both groups was 100% during the follow-up period. The proportion of newly formed bone was 24.6 ± 10.2% and 39.7 ± 18.3% in the mixed AG alone and mixed AG with rhBMP-2 groups, respectively (P < 0.05). Moreover, the percentage of residual graft material was 21.0 ± 12.2% and 9.6 ± 10.0% in the mixed AG alone and mixed AG with rhBMP-2 groups, respectively (P < 0.05). Conclusion Mixed AG combined with rhBMP-2 could be a suitable material for sinus floor augmentation. This combination may reduce the treatment time and improve the predictability of implant placement.
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Affiliation(s)
- Kyeong-Ok Lim
- Department of Periodontology, School of Dentistry, Chosun University, Gwangju, Republic of Korea
| | - Min-Seok Kim
- Department of Periodontology, School of Dentistry, Chosun University, Gwangju, Republic of Korea
| | - Keon-Il Yang
- Department of Periodontology, School of Dentistry, Chosun University, Gwangju, Republic of Korea
| | - Won-Pyo Lee
- Department of Periodontology, School of Dentistry, Chosun University, Gwangju, Republic of Korea
| | - Byung-Ock Kim
- Department of Periodontology, School of Dentistry, Chosun University, Gwangju, Republic of Korea
| | - Sang-Joun Yu
- Department of Periodontology, School of Dentistry, Chosun University, Gwangju, Republic of Korea
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Arunjaroensuk S, Nampuksa K, Monmaturapoj N, Thunyakitpisal P, Porntaveetus T, Mattheos N, Pimkhaokham A. Gene expression, micro-CT and histomorphometrical analysis of sinus floor augmentation with biphasic calcium phosphate and deproteinized bovine bone mineral: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2024; 26:402-414. [PMID: 38317374 DOI: 10.1111/cid.13303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/08/2023] [Accepted: 01/04/2024] [Indexed: 02/07/2024]
Abstract
AIMS The aim of this randomized controlled clinical trial was to compare the gene expression, micro-CT, histomorphometrical analysis between biphasic calcium phosphate (BCP) of 70/30 ratio and deproteinized bovine bone mineral (DBBM) in sinus augmentation. MATERIALS AND METHODS Twenty-four patients in need for sinus floor augmentation through lateral approach were randomized into BCP 70/30 ratio or DBBM. After at least 6 months of healing, a total of 24 bone specimens were collected from the entire height of the augmented bone at the area of implant placement and underwent micro-CT, histomorphometric and gene expression analysis. The 12 bone specimens of BCP 70/30 ratio were equally allocated to micro-CT and histologic analysis (test group, n = 6) and gene expression analysis (test group, n = 6). Similarly, the 12 bone specimens of DBBM were also allocated to micro-CT and histologic analysis (control group, n = 6) and gene expression analysis (control group, n = 6). The newly formed bone, remaining graft materials and relative change in gene expression of four target genes were assessed. RESULTS The micro-CT results showed no statistically significant difference in the ratio of bone volume to total volume (BV/TV ratio) for the two groups (BCP 41.51% vs. DBBM 40.97%) and the same was true for residual graft material to total volume (GV/TV ratio, BCP 9.97% vs. DBBM 14.41%). Similarly, no significant difference was shown in the histological analysis in terms of bone formation, (BCP 31.43% vs. DBBM was 30.09%) and residual graft area (DBBM 40.76% vs. BCP 45.06%). With regards to gene expression, the level of ALP was lower in both groups of bone grafted specimens compared with the native bone. On the contrary, the level of OSX, IL-1B and TRAP was higher in augmented bone of both groups compared with the native bone. However, the relative difference in all gene expressions between BCP and DBBM group was not significant. CONCLUSIONS The BCP, HA/β-TCP ratio of 70/30 presented similar histological and micro-CT outcomes in terms of new bone formation and residual graft particles with DBBM. The gene expression analysis revealed different gene expression patterns between augmented and native bone, but showed no significant difference between the two biomaterials.
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Affiliation(s)
- Sirida Arunjaroensuk
- Dental Biomaterials Science Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Katanchalee Nampuksa
- Assistive Technology and Medical Devices Research Center (A-MED), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Naruporn Monmaturapoj
- Assistive Technology and Medical Devices Research Center (A-MED), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | | | - Thantrira Porntaveetus
- Center of Excellence in Genomics and Precision Dentistry, Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Miron RJ. Optimized bone grafting. Periodontol 2000 2024; 94:143-160. [PMID: 37610202 DOI: 10.1111/prd.12517] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
Bone grafting is routinely performed in periodontology and oral surgery to fill bone voids. While autogenous bone is considered the gold standard because of its regenerative properties, allografts and xenografts have more commonly been utilized owing to their availability as well as their differential regenerative/biomechanical properties. In particular, xenografts are sintered at high temperatures, which allows for their slower degradation and resorption rates and/or nonresorbable features. As a result, clinicians have combined xenografts with other classes of bone grafts (most notably allografts and autografts in various ratios) for procedures requiring better long-term stability, such as contour grafting, sinus elevation procedures, and vertical bone augmentations. This review addresses the regenerative properties of each class of bone grafts and then highlights the importance of understanding each of their biomechanical and regenerative properties for clinical applications, including extraction site management, contour augmentation, sinus grafting, and horizontal and vertical augmentation procedures. Thereafter, an introduction toward the novel production of nonresorbable bone allografts (NRBAs) via high-temperature sintering is presented. These NRBAs not only pose the advantage of being more biocompatible than xenografts owing to their origin (human vs. animal bone) but also display nonresorbable properties similar to those of xenografts. Thus, while packaging allografts with xenografts in premixtures specific to various clinical indications has never been permitted owing to cross-species contamination and FDA/CE requirements, the discovery and production of NRBAs allows premixing with standard allografts in various ratios without regulatory restrictions. Therefore, premixtures of allografts with NRBAs can be produced in various ratios for specific indications (e.g., a 1:1 ratio similar to an allograft/xenograft mixture for sinus grafting) without the need for purchasing separate classes of bone grafts. This optimized form of bone grafting could theoretically provide clinicians more precise ratios without the need to purchase separate bone grafts. This review highlights the future potential for simplified and optimized bone grafting in periodontology and implant dentistry.
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Affiliation(s)
- Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
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Nguyen M, Nguyen TT, Tran HLB, Tran DN, Ngo LTQ, Huynh NC. Effects of advanced platelet-rich fibrin combined with xenogenic bone on human periodontal ligament stem cells. Clin Exp Dent Res 2022; 8:875-882. [PMID: 35338771 PMCID: PMC9382045 DOI: 10.1002/cre2.563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/07/2022] [Accepted: 03/11/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES In this study, we aimed to investigate the effects of a mixture of advanced platelet-rich fibrin (A-PRF) and xenogenic bone substitute material (XBSM) on the proliferation and migration of human periodontal ligament stem cells (hPDLSCs) based on the in vitro release of growth factors. MATERIAL AND METHODS The concentrations of platelet-derived growth factor-AB (PDGF-AB) and vascular endothelial growth factor (VEGF) released by the A-PRF-XBSM mixture were estimated using enzyme-linked immunoassay for up to 7 d. The A-PRF-XBSM mixture exudate was incubated with hPDLSCs. At Days 1, 3, 5, and 7, cell proliferation and migration were investigated by cell counting and wound-healing assays. RESULTS PDGD-AB and VEGF were released from the A-PRF-XBSM mixture exudate for up to 7 days. hPDLSCs were cultured in media with various concentrations of the A-PRF-XBSM mixture exudate and exhibited their proliferation and migration ability. Furthermore, the factors released from the 100% A-PRF-XBSM mixture exudate had a substantial effect on cell migration, whereas those released from 4% and 20% A-PRF-XBSM mixture exudates stimulated hPDLSC proliferation. CONCLUSIONS A-PRF-XBSM mixture continuously released growth factors over 7 days and enhanced hPDLSC proliferation and migration. Therefore, A-PRF in combination with XBSM might provide potential advantages for periodontal tissue regeneration.
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Affiliation(s)
- Meo Nguyen
- Department of Periodontology, Faculty of Odonto‐StomatologyUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Thuy Thu Nguyen
- Department of Periodontology, Faculty of Odonto‐StomatologyUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Ha Le Bao Tran
- Laboratory of Tissue Engineering and Biomedical Materials, Department of Physiology and Animal Biotechnology, Faculty of Biology‐Biotechnology, University of ScienceVietnam National UniversityHo Chi Minh CityVietnam
| | - Dang Ngoc Tran
- Faculty of Public HealthUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Lan Thi Quynh Ngo
- Department of Dental Basic Sciences, Faculty of Odonto‐StomatologyUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Nam Cong‐Nhat Huynh
- Department of Dental Basic Sciences, Faculty of Odonto‐StomatologyUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
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Lee D, Lee Y, Kim S, Lee JT, Ahn JS. Evaluation of regeneration after the application of 2 types of deproteinized bovine bone mineral to alveolar bone defects in adult dogs. J Periodontal Implant Sci 2022; 52:370-382. [PMID: 36302644 PMCID: PMC9614180 DOI: 10.5051/jpis.2106080304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose The aim of this study was to evaluate the preclinical results of 2 types of commercially available deproteinized bovine bone mineral (DBBM) when applied to alveolar bone defects in dogs. Methods This study was conducted using 6 beagles. Alveolar defects in the mandible were formed and filled with 2 DBBMs produced by a similar procedure. Defects were randomly assigned to be filled using DBBM 1 or 2. All defects were covered with a collagen membrane and had a healing period of 12 weeks. After the dogs were sacrificed, histological, histomorphometric, and linear/volumetric analyses were performed. Results Both DBBM groups showed similar histological findings, demonstrating that bone remodeling had occurred and new bone had formed. The residual bone particles were surrounded by newly formed vital bone. In the histomorphometric analysis, the ratio of the area of vital bone and residual bone substitute in DBBM 2 (38.18% and 3.47%, respectively) was higher than that of DBBM 1 (33.74% and 3.41%, respectively), although the difference was not statistically significant. There were also no statistically significant differences between both groups in linear and volumetric analyses using micro-computed tomography scans and digitized images of dental casts. Conclusions In the present study, DBBM 1and 2, which were produced by similar processes, showed similar results in histological, histomorphometric, and volumetric analyses. Further studies are needed to identify more specific differences between the 2 DBBMs.
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Affiliation(s)
- Dajung Lee
- Department of Dental Biomaterials Science and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yoonsub Lee
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Jung-Tae Lee
- Department of Periodontics, One-Stop Specialty Center, Seoul National University, Dental Hospital, Seoul, Korea
| | - Jin-soo Ahn
- Department of Dental Biomaterials Science and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Redenski I, Guo S, Machour M, Szklanny A, Landau S, Kaplan B, Lock RI, Gabet Y, Egozi D, Vunjak‐Novakovic G, Levenberg S. Engineered Vascularized Flaps, Composed of Polymeric Soft Tissue and Live Bone, Repair Complex Tibial Defects. ADVANCED FUNCTIONAL MATERIALS 2021; 31:2008687. [DOI: 10.1002/adfm.202008687] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Idan Redenski
- Department of Biomedical Engineering Technion—Israel Institute of Technology Haifa 32000 Israel
| | - Shaowei Guo
- Department of Biomedical Engineering Technion—Israel Institute of Technology Haifa 32000 Israel
- The First Affiliated Hospital Shantou University Medical College Shantou 515000 China
| | - Majd Machour
- Department of Biomedical Engineering Technion—Israel Institute of Technology Haifa 32000 Israel
| | - Ariel Szklanny
- Department of Biomedical Engineering Technion—Israel Institute of Technology Haifa 32000 Israel
| | - Shira Landau
- Department of Biomedical Engineering Technion—Israel Institute of Technology Haifa 32000 Israel
| | - Ben Kaplan
- Department of Biomedical Engineering Technion—Israel Institute of Technology Haifa 32000 Israel
| | - Roberta I. Lock
- Department of Biomedical Engineering Columbia University New York NY 10032 USA
| | - Yankel Gabet
- Department of Anatomy and Anthropology Sackler Faculty of Medicine Tel‐Aviv University Tel‐Aviv 6997801 Israel
| | - Dana Egozi
- Department of Plastic and Reconstructive Surgery Kaplan Hospital Rehovot and the Hebrew University Jerusalem 7661041 Israel
| | | | - Shulamit Levenberg
- Department of Biomedical Engineering Technion—Israel Institute of Technology Haifa 32000 Israel
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Fujita A, Fukumoto C, Hasegawa T, Sawatani Y, Kawamata H. Morphometric and histomorphometric evaluations of high-purity macro/microporous beta-tricalcium phosphate in maxillary sinus floor elevation: preliminary results on a retrospective, multi-center, observational study. BMC Oral Health 2021; 21:448. [PMID: 34530808 PMCID: PMC8444614 DOI: 10.1186/s12903-021-01797-5] [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: 03/11/2021] [Accepted: 08/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study examined the effectiveness of high-purity macro/microporous beta-tricalcium phosphate (HPMM β-TCP) as a bone grafting material for maxillary sinus floor elevation by morphometric, histopathological, and histomorphometric evaluations. METHODS Ten unilateral maxillary sinus floor elevation procedures using 100% HPMM β-TCP were performed in 10 patients. Morphometric evaluation was carried out by computed tomography (CT) imaging immediately after augmentation and prior to dental implant placement 7 months later. Histopathological and histomorphometric evaluations were carried out by bone biopsy retrieval at the time of dental implant placement 7 months after sinus floor elevation. RESULTS All 10 sinus floor elevations were successful. Morphometric evaluation by CT showed that the vertical height and volume gained by sinus floor elevation decreased 7 months after surgery. Histopathological evaluation of bone biopsy retrieval specimens showed no signs of inflammation at the newly formed bone area and the native alveolar bone area. New bone formation was observed at the cranial side from the native alveolar bone. The newly formed bone had a trabecular structure and was in intimate contact with the HPMM β-TCP material. Histomorphometric evaluation of bone biopsy retrieval specimens showed an average new bone volume of 33.97% ± 2.79% and an average residual HPMM β-TCP volume of 15.81% ± 4.52%. CONCLUSIONS In this study, HPMM β-TCP showed osteoconductive properties for vertical augmentation of the atrophied maxilla by means of a maxillary sinus floor elevation procedure allowing subsequent dental implant placement after a 7-month healing period.
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Affiliation(s)
- Atsushi Fujita
- Department of Oral and Maxillofacial Surgery, Dokkyo Medical School of Medicine, 880 Kita-Kobayashi, Shimo-Tsuga, Mibu, Tochigi, 321-0293, Japan.
| | - Chonji Fukumoto
- Department of Oral and Maxillofacial Surgery, Dokkyo Medical School of Medicine, 880 Kita-Kobayashi, Shimo-Tsuga, Mibu, Tochigi, 321-0293, Japan
| | - Tomonori Hasegawa
- Department of Oral and Maxillofacial Surgery, Dokkyo Medical School of Medicine, 880 Kita-Kobayashi, Shimo-Tsuga, Mibu, Tochigi, 321-0293, Japan
| | - Yuta Sawatani
- Department of Oral and Maxillofacial Surgery, Dokkyo Medical School of Medicine, 880 Kita-Kobayashi, Shimo-Tsuga, Mibu, Tochigi, 321-0293, Japan
| | - Hitoshi Kawamata
- Department of Oral and Maxillofacial Surgery, Dokkyo Medical School of Medicine, 880 Kita-Kobayashi, Shimo-Tsuga, Mibu, Tochigi, 321-0293, Japan
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Safdari M, Bibak B, Soltani H, Hashemi J. Recent advancements in decellularized matrix technology for bone tissue engineering. Differentiation 2021; 121:25-34. [PMID: 34454348 DOI: 10.1016/j.diff.2021.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 12/11/2022]
Abstract
The native extracellular matrix (ECM) provides a matrix to hold tissue/organ, defines the cellular fate and function, and retains growth factors. Such a matrix is considered as a most biomimetic scaffold for tissue engineering due to the biochemical and biological components, 3D hierarchical structure, and physicomechanical properties. Several attempts have been performed to decellularize allo- or xeno-graft tissues and used them for bone repairing and regeneration. Decellularized ECM (dECM) technology has been developed to create an in vivo-like microenvironment to promote cell adhesion, growth, and differentiation for tissue repair and regeneration. Decellularization is mediated through physical, chemical, and enzymatic methods. In this review, we describe the recent progress in bone decellularization and their applications as a scaffold, hydrogel, bioink, or particles in bone tissue engineering. Furthermore, we address the native dECM limitations and the potential of non-bone dECM, cell-based ECM, and engineered ECM (eECM) for in vitro osteogenic differentiation and in vivo bone regeneration.
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Affiliation(s)
- Mohammadreza Safdari
- Department of Surgery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Bahram Bibak
- Department of Physiology and Pharmacology, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran; Research Center of Natural Products Safety and Medicinal Plants, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hoseinali Soltani
- Department of General Surgery, Imam Ali Hospital, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Javad Hashemi
- Research Center of Natural Products Safety and Medicinal Plants, North Khorasan University of Medical Sciences, Bojnurd, Iran; Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
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Yang BC, Lan SM, Ju CP, Chern Lin JH. Osteoporotic Goat Spine Implantation Study Using a Synthetic, Resorbable Ca/P/S-Based Bone Substitute. Front Bioeng Biotechnol 2020; 8:876. [PMID: 32850733 PMCID: PMC7417633 DOI: 10.3389/fbioe.2020.00876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/08/2020] [Indexed: 01/05/2023] Open
Abstract
One primary purpose of the present study is to clarify whether the highly porous, resorbable Ca/P/S-based bone substitute used in this study would still induce an osteoporotic bone when implanted into the osteoporotic vertebral defects of ovariectomized (OVX) goats, or the newly-grown bone would expectantly be rather healthy bone. The bone substitute material used for the study is a synthetic, 100% inorganic, highly porous and fast-resorbable Ca/P/S-based material (Ezechbone® Granule CBS-400). The results show that the OVX procedure along with a low calcium diet and breeding away from light can successfully induce osteoporosis in the present female experimental goats. The histological examination reveals a newly-formed trabecular bone network within the surgically-created defect of the CBS-400-implanted (OVX_IP) goat. This new trabecular bone network in the OVX_IP goat appears much denser than the OVX goat and comparable to the healthy control goat. Histomorphometry show that, among all the experimental goats, the OVX_IP goat has the highest trabecular thickness and lowest trabecular bone packet prevalence. The differences in trabecular plate separation, trabecular number and trabecular bone tissue area ratio between the OVX_IP goat and the control goat are not significant, indicating that the trabecular bone architecture of the OVX_IP goat has substantially recovered to the normal level in about 6 months after implantation without signs of osteoporosis-related delay in the bone maturing process. The quick and nicely recovered trabecular architecture parameters observed in the OVX_IP goat indicate that the present Ca/P/S-based bone substitute material has a high potential to treat osteoporotic fractures.
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Affiliation(s)
- Bing-Chen Yang
- Department of Materials Science and Engineering, College of Engineering, National Cheng-Kung University, Tainan, Taiwan
| | - Sheng-Min Lan
- Department of Orthopedics, National Cheng-Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan
| | - Chien-Ping Ju
- Department of Materials Science and Engineering, College of Engineering, National Cheng-Kung University, Tainan, Taiwan
| | - Jiin-Huey Chern Lin
- Department of Materials Science and Engineering, College of Engineering, National Cheng-Kung University, Tainan, Taiwan
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12
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Physical/Chemical Properties and Resorption Behavior of a Newly Developed Ca/P/S-Based Bone Substitute Material. MATERIALS 2020; 13:ma13163458. [PMID: 32764505 PMCID: PMC7475886 DOI: 10.3390/ma13163458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 12/11/2022]
Abstract
Properly regulating the resorption rate of a resorbable bone implant has long been a great challenge. This study investigates a series of physical/chemical properties, biocompatibility and the behavior of implant resorption and new bone formation of a newly developed Ca/P/S-based bone substitute material (Ezechbone® Granule CBS-400). Experimental results show that CBS-400 is comprised majorly of HA and CSD, with a Ca/P/S atomic ratio of 54.6/39.2/6.2. After immersion in Hank’s solution for 7 days, the overall morphology, shape and integrity of CBS-400 granules remain similar to that of non-immersed samples without showing apparent collapse or disintegration. With immersion time, the pH value continues to increase to 6.55 after 7 days, and 7.08 after 14 days. Cytotoxicity, intracutaneous reactivity and skin sensitization tests demonstrate the good biocompatibility features of CBS-400. Rabbit implantation/histological observations indicate that the implanted granules are intimately bonded to the surrounding new bone at all times. The implant is not merely a degradable bone substitute, but its resorption and the formation of new cancellous bone proceed at the substantially same pace. After implantation for 12 weeks, about 85% of the implant has been resorbed. The newly-formed cancellous bone ratio quickly increases to >40% at 4 weeks, followed by a bone remodeling process toward normal cancellous bone, wherein the new cancellous bone ratio gradually tapers down to about 30% after 12 weeks.
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13
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Mansour A, Abu Nada L, El-Hadad AA, Mezour MA, Ersheidat A, Al-Subaie A, Moussa H, Laurenti M, Kaartinen MT, Tamimi F. Biomimetic trace metals improve bone regenerative properties of calcium phosphate bioceramics. J Biomed Mater Res A 2020; 109:666-681. [PMID: 32608184 DOI: 10.1002/jbm.a.37051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 06/07/2020] [Accepted: 06/12/2020] [Indexed: 01/01/2023]
Abstract
The bone regenerative capacity of synthetic calcium phosphates (CaPs) can be enhanced through the enrichment with selected metal trace ions. However, defining the optimal elemental composition required for bone formation is challenging due to many possible concentrations and combinations of these elements. We hypothesized that the ideal elemental composition exists in the inorganic phase of the bone extracellular matrix (ECM). To study our hypothesis, we first obtained natural hydroxyapatite through the calcination of bovine bone, which was then investigated its reactivity with acidic phosphates to produce CaP cements. Bioceramic scaffolds fabricated using these cements were assessed for their composition, properties, and in vivo regenerative performance and compared with controls. We found that natural hydroxyapatite could react with phosphoric acid to produce CaP cements with biomimetic trace metals. These cements present significantly superior in vivo bone regenerative performance compared with cements prepared using synthetic apatite. In summary, this study opens new avenues for further advancements in the field of CaP bone biomaterials by introducing a simple approach to develop biomimetic CaPs. This work also sheds light on the role of the inorganic phase of bone and its composition in defining the regenerative properties of natural bone xenografts.
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Affiliation(s)
- Alaa Mansour
- Faculty of dentistry, McGill University, Montreal, Canada.,Resident, Periodontics department, School of Dental Medicine, University at Buffalo, Buffalo, New York, USA
| | - Lina Abu Nada
- Faculty of dentistry, McGill University, Montreal, Canada
| | - Amir A El-Hadad
- Faculty of dentistry, McGill University, Montreal, Canada.,Faculty of Science, Al-Azhar University, Cairo, Egypt
| | | | - Ala' Ersheidat
- Faculty of dentistry, McGill University, Montreal, Canada.,Royal Medical Services, Jordanian Armed Forces, Amman, Jordan
| | - Ahmed Al-Subaie
- Faculty of dentistry, McGill University, Montreal, Canada.,College of Dentistry, Imam Abdulrahman Bin Faisal University, Saudi Arabia
| | - Hanan Moussa
- Faculty of dentistry, McGill University, Montreal, Canada.,Faculty of Dentistry, Benghazi University, Benghazi, Libya
| | - Marco Laurenti
- Faculty of Pharmacy, Universidad complutense de Madrid, Spain
| | | | - Faleh Tamimi
- Faculty of dentistry, McGill University, Montreal, Canada.,College of Dental Medicine, Qatar University, Doha, Qatar
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Tarallo F, Mancini L, Pitzurra L, Bizzarro S, Tepedino M, Marchetti E. Use of Platelet-Rich Fibrin in the Treatment of Grade 2 Furcation Defects: Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9072104. [PMID: 32635413 PMCID: PMC7408882 DOI: 10.3390/jcm9072104] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023] Open
Abstract
In periodontitis patients, furcation defects are crucial sites to regenerate due to their complex anatomy. Various modern surgical techniques and use of biomaterials have been suggested in the literature. Among all, platelet-rich fibrin (PRF) has potential in tissue regeneration thanks to its role in the release of growth factors. Therefore, the purpose of this study was to evaluate the beneficial effect of the addition of PRF to open flap debridement (OFD) or as an adjuvant to other biomaterials such as bone grafts in the treatment of grade 2 mandibular furcation defects. Systematic research was carried out on the databases Medline, Scopus, Embase, and Cochrane Library and registered on PROSPERO (CRD42020167662). According to the PICO guidelines by Cochrane, randomized trials and prospective non-randomized trials were evaluated, with a minimum follow-up period of 6 months. The inclusion criteria were the absence of systemic diseases, non-smoking patients, and a population aged from 18 to 65 years. Vertical pocket probing depth (PPD), vertical clinical attachment level (VCAL), and gingival recession (REC) were the primary outcomes. Vertical furcation depth (VFD), and the percentage of bone defect fill (%v-BDF) were considered as secondary outcomes. A meta-analysis of the primary and secondary outcomes was performed. Publication bias was assessed through a funnel plot. Eighty-four articles were initially extracted. Eight randomized clinical trials were analyzed according to the exclusion and inclusion criteria. The Quality assessment instrument (QAI) revealed four articles at low risk of bias, one at moderate, and three at high risk of bias. The metanalysis showed significant data regarding PPD, VCAL, VFD and %v-BDF in the comparison between PRF + OFD vs. OFD alone. The adjunct of PRF to a bone graft showed a significant difference for VCAL and a not statistically significant result for the other involved parameters. In conclusion, the adjunctive use of PRF to OFD seems to enhance the periodontal regeneration in the treatment of grade 2 furcation defects. The combination of PRF and bone graft did not show better clinical results, except for VCAL, although the amount of literature with low risk of bias is scarce. Further well-designed studies to evaluate the combination of these two materials are therefore needed.
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Affiliation(s)
- Francesco Tarallo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy; (L.M.); (E.M.)
- Correspondence:
| | - Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy; (L.M.); (E.M.)
| | - Luciano Pitzurra
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (L.P.); (S.B.)
| | - Sergio Bizzarro
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (L.P.); (S.B.)
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy;
| | - Enrico Marchetti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Coppito, Italy; (L.M.); (E.M.)
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15
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da Silva HF, Goulart DR, Sverzut AT, Olate S, de Moraes M. Comparison of two anorganic bovine bone in maxillary sinus lift: a split-mouth study with clinical, radiographical, and histomorphometrical analysis. Int J Implant Dent 2020; 6:17. [PMID: 32372226 PMCID: PMC7200963 DOI: 10.1186/s40729-020-00214-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/23/2020] [Indexed: 12/21/2022] Open
Abstract
Background Anorganic bovine bone (Bio-Oss®) has been extensively used for reconstruction of posterior area of maxilla in sinus lift procedure; however, a new graft material (Lumina-Bone Porous®), that has a different manufacturing process, has not been yet compared in clinical and histological terms. The manufacturing process of bovine bone graft is related to size and porosity of the particles, and this can change osteoconductive property of the material and bone formation. The use of Lumina-Porus® could improve bone formation, reduce the remaining particles of the biomaterial using a low-cost material. The aim of this research was to compare the clinical, radiological, and histomorphometrical results from maxillary sinus lift with two different anorganic bovine bone substitutes Bio-Oss® (control) and Lumina-Bone Porous® (test). Results A split-mouth study was performed with 13 volunteers. The mean bone ridge height in the deepest portion of maxillary sinuses floor was 3.11 ± 0.83 mm in the Bio-Oss® and 2.38 ± 0.75 mm in the Lumina-Bone Porous®. After sinus lift, the Bio-Oss® group shows bone ridge height of 11.56 ± 2.03 mm and Lumina-Bone® of 10.62 ± 1.93 mm. The increase in alveolar bone height scores was significant between pre-augmentation and 6 months after SL in both groups (p < 0.001). No statistical significant difference in newly formed bone in the Bio-Oss® group (20.4 ± 5.4%), and Lumina-Bone Porous® (22.8 ± 8.5%) was histomorphological observed (p > 0.05). On the other hand, the residual graft particles showed significant difference between the Bio-Oss® group (19.9 ± 8.6%) and Lumina-Bone Porous® (14.6 ± 5.6%) (p < 0.05). The survival rate of dental implants for augmented area with Lumina Bone Porous® was 88.88%, while for Bio-Oss® group was 100%. Conclusion Both materials Bio-Oss® and Lumina-Bone Porous® can be used in the maxillary sinus floor augmentation with good predictability in clinical, radiographical, and histological point of view.
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Affiliation(s)
- Heitor Fontes da Silva
- Division of Oral and Maxillofacial Surgery, Department of Oral Diagnosis, Piracicaba Dental School, Campinas State University Unicamp, Av. Limeira, 901, Areiao, Piracicaba, São Paulo, 13414-903, Brazil
| | - Douglas Rangel Goulart
- Division of Oral and Maxillofacial Surgery, Department of Oral Diagnosis, Piracicaba Dental School, Campinas State University Unicamp, Av. Limeira, 901, Areiao, Piracicaba, São Paulo, 13414-903, Brazil. .,Dental School University of Goiás - UFG, Goiânia, Brazil.
| | - Alexander Tadeu Sverzut
- Division of Oral and Maxillofacial Surgery, Department of Oral Diagnosis, Piracicaba Dental School, Campinas State University-Unicamp, São Paulo, Brazil
| | - Sergio Olate
- Department of Oral, Facial and Maxillofacial Surgery and Center of Excellence in Surgical and Morphological Studies, University of La Frontera, Temuco, Chile
| | - Márcio de Moraes
- Division of Oral and Maxillofacial Surgery, Department of Oral Diagnosis, Piracicaba Dental School, Campinas State University-Unicamp, São Paulo, Brazil
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16
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Kyyak S, Blatt S, Pabst A, Thiem D, Al-Nawas B, Kämmerer PW. Combination of an allogenic and a xenogenic bone substitute material with injectable platelet-rich fibrin - A comparative in vitro study. J Biomater Appl 2020; 35:83-96. [PMID: 32237950 DOI: 10.1177/0885328220914407] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The aim of the in vitro study was a comparison of an allogenic (ABSM) and a xenogenic bone substitute material (XBSM) with and without injectable platelet-rich fibrin (ABSM-i-PRF & XBSM-i-PRF) on cell characteristics of human osteoblasts (HOB). Here, ABSM and XBSM (+ i-PRF = test; - i-PRF = control) were incubated with HOB for 3, 7 and 10 days. HOB viability, migration, proliferation and differentiation (RT-PCR on alkaline phosphatase (AP), bone morphogenetic protein 2 (BMP-2) and osteonectin (OCN)) were measured and compared between groups. At day 3, an increased viability, migration and proliferation was seen for ABSM-i-PRF. For viability and proliferation (days 7 and 10) and for migration (day 10), ABSM-i-PRF/XBSM-i-PRF showed higher values compared to ABSM/XBSM with maximum values for ABSM-i-PRF and minimum values for XBSM. At days 3 and 7, the highest expression of AP was detected in ABSM-i-PRF/XBSM-i-PRF when compared to ABSM/XBSM, whereas at day 10, AP expression levels were elevated in ABSM-i-PRF/ABSM. The highest BMP-2 expression was seen in ABSM-i-PRF whereas OCN expression showed higher levels in ABSM-i-PRF/XBSM-i-PRF at days 3 and 7 with lowest expression for ABSM. Later on, elevated OC levels were detected for ABSM-i-PRF only. In conclusion, i-PRF in combination with ABSM enhances HOB activity when compared to XBSM-i-PRF or untreated BSM in vitro. Therefore, addition of i-PRF to ABSM and - to a lower extent - to XBSM may influence osteoblast activity in vivo.
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Affiliation(s)
- Solomiya Kyyak
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Sebastian Blatt
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Andreas Pabst
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, Koblenz, Germany
| | - Daniel Thiem
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
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17
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Teng F, Wei L, Yu D, Deng L, Zheng Y, Lin H, Liu Y. Vertical bone augmentation with simultaneous implantation using deproteinized bovine bone block functionalized with a slow delivery of BMP-2. Clin Oral Implants Res 2020; 31:215-228. [PMID: 31730250 DOI: 10.1111/clr.13558] [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: 05/14/2018] [Revised: 09/01/2019] [Accepted: 10/30/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We hypothesized that a biomimetic calcium phosphate (CaP) coating which incorporates morphogenetic protein 2 (BMP-2) on the deproteinized bovine bone (DBB) blocks could be used to enhance the vertical alveolar ridge augmentation for the one-stage onlay surgery with simultaneous implants insertion. We aimed to test this hypothesis in vivo. MATERIAL AND METHODS Beagles dogs were used for the study (n = 6 specimens per group). One month after building the edentulous animal model, 4 mm vertical alveolar bone loss were surgically created and four groups of blocks (W × L × H: 7 mm × 10 mm × 4 mm) were randomly fixed onto the reduced alveolar ridge by implants: (a) DBB blocks alone (negative control group); (b) DBB blocks with superficial adsorption of 50 μg BMP-2 (ad.BMP-2 group); (c) DBB blocks coated by biomimetic CaP coating which incorporates 50 μg BMP-2 (inc.BMP-2 group); and (d) autologous bone blocks (positive control group). After 3 months of healing, samples were harvested for micro-CT and histomorphometric analyses. RESULTS In histomorphometry, the inc.BMP-2 group showed a significantly thicker (coronal-apically) and wider (buccal-lingually) augmented bone area, better bone-to-implant contact than the negative control group. In both the micro-CT and histomorphometry, the inc.BMP-2 group showed more mineralized tissue than the negative control group and the inc.BMP-2 group also showed significantly more newly formed bone and residual grafts than the negative control group in the upper half of the blocks. In micro-CT, the inc.BMP-2 group showed significantly more bone-to-graft contact percentage than the ad.BMP-2 group. In both micro-CT and histomorphometry, the inc.BMP-2 group showed significantly more percentage of mineralized tissue than the ad.BMP-2 group. No significant differences were found between the inc.BMP-2 group and the positive control group either in micro-CT or in histomorphometry. CONCLUSIONS The DBB blocks with coating-delivered BMP-2 significantly enhanced the efficacy of vertical alveolar bone augmentation, compared with the unloaded blocks and blocks with adsorbed BMP-2, in the one-stage onlay surgery with simultaneous implant insertion.
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Affiliation(s)
- Fei Teng
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China.,Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Lingfei Wei
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.,Department of Oral Implantology, Yantai Stomatological Hospital, Yantai, China
| | - Dedong Yu
- 2nd Dental Center, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Liquan Deng
- School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuanna Zheng
- School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China
| | - Haiyan Lin
- Hangzhou Dental Hospital, Hangzhou, China
| | - Yuelian Liu
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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18
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Verardi S, Lombardi T, Stacchi C. Clinical and Radiographic Evaluation of Nanohydroxyapatite Powder in Combination with Polylactic Acid/Polyglycolic Acid Copolymer as Bone Replacement Graft in the Surgical Treatment of Intrabony Periodontal Defects: A Retrospective Case Series Study. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E269. [PMID: 31936143 PMCID: PMC7014298 DOI: 10.3390/ma13020269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/22/2019] [Accepted: 01/06/2020] [Indexed: 01/25/2023]
Abstract
The aim of this retrospective case series was to evaluate the clinical efficacy of nanohydroxyapatite powder (NHA) in combination with polylactic acid/polyglycolic acid copolymer (PLGA) as a bone replacement graft in the surgical treatment of intrabony periodontal defects. Medical charts were screened following inclusion and exclusion criteria. Periodontal parameters and periapical radiographs taken before surgery and at 12-month follow-up were collected. Intra-group comparisons were performed using a two-tailed Wilcoxon signed-rank test. Twenty-five patients (13 males, 12 females, mean age 55.1 ± 10.5 years) were included in the final analysis. Mean probing depth (PD) and clinical attachment level (CAL) at baseline were 8.32 ± 1.41 mm and 9.96 ± 1.69 mm, respectively. Twelve months after surgery, mean PD was 4.04 ± 0.84 mm and CAL was 6.24 ± 1.71 mm. Both PD and CAL variations gave statistically significant results (p < 0.00001). The mean radiographic defect depth was 5.54 ± 1.55 mm and 1.48 ± 1.38 mm at baseline and at 12-month follow-up, respectively (p < 0.0001). This case series, with the limitations inherent in the study design, showed that the combination of NHA and PLGA, used as bone replacement graft in intrabony periodontal defects, may give significant improvements of periodontal parameters at 12-month follow-up.
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Affiliation(s)
- Simone Verardi
- Department of Periodontics, University of Washington, Seattle, WA 98195, USA;
| | - Teresa Lombardi
- Department of Health Sciences, University of “Magna Græcia”, 88100 Catanzaro, Italy;
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy
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19
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Loin J, Kün-Darbois JD, Guillaume B, Badja S, Libouban H, Chappard D. Maxillary sinus floor elevation using Beta-Tricalcium-Phosphate (beta-TCP) or natural bone: same inflammatory response. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:97. [PMID: 31440845 DOI: 10.1007/s10856-019-6299-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023]
Abstract
Sinus elevation is a common procedure to increase bone volume in the atrophic maxilla to allow placement of dental implants. Autogenous bone is the gold standard but is limited in quantity and causes morbidity at the donor site. β-TCP is a synthetic biomaterial commonly used in that purpose. It appears to induce a poor inflammatory response. This study aimed to evaluate the degree of edema of the sinus mucosa after sinus lift surgery according to the type of biomaterial. Forty sinuses (20 patients) were included retrospectively and divided into 2 groups according to the biomaterial that was used: synthetic biomaterial (BTCP group), natural bone (BONE group). A control group (CTRL group) was constituted by the non-grafted maxillary sinuses. Twelve measurements per sinus were realized on pre- and post-operative computed tomography and averaged to provide the sinus membrane thickness value (SM.Th). SM.Th was thicker post-operatively in the BTCP and BONE groups in comparison with the CTRL group and in comparison with pre-operative measurements. No difference was found post operatively between the BTCP and BONE groups. We found that a synthetic biomaterial (β-TCP) induced the same degree of edema, and thus of inflammation, as natural bone. It constitutes therefore an interesting alternative to autogenous bone for maxillary sinus lifts.
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Affiliation(s)
- Justine Loin
- Service de Chirurgie Maxillo-faciale et stomatologie, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex, France
| | - Jean-Daniel Kün-Darbois
- Service de Chirurgie Maxillo-faciale et stomatologie, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex, France.
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France.
| | - Bernard Guillaume
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
- Centre Français d'Implantologie CFI, 6 rue de Rome, 75008, Paris, France
| | - Smail Badja
- Service de Chirurgie Maxillo-faciale et stomatologie, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex, France
| | - Hélène Libouban
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
| | - Daniel Chappard
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA 4658, SFR 4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
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20
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Xu Y, Qiu J, Sun Q, Yan S, Wang W, Yang P, Song A. One-Year Results Evaluating the Effects of Concentrated Growth Factors on the Healing of Intrabony Defects Treated with or without Bone Substitute in Chronic Periodontitis. Med Sci Monit 2019; 25:4384-4389. [PMID: 31188801 PMCID: PMC6585537 DOI: 10.12659/msm.917025] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background The restoration of damaged periodontium, especially one-wall intrabony defects, is a major challenge for clinicians. Concentrated growth factors (CGF) are a 100% autologous fibrin with multiple concentrated growth factors. The rigid fibrin structure of CGF makes it possible to preserve or reconstruct the initial bone volume. The aim of this study was to evaluate the clinical healing patterns after surgical application of CGF with and without a Bio-Oss graft in one-wall infrabony defects. Material/Methods We randomly divided 120 one-wall intrabony defects in 54 patients into 4 groups: flap surgery alone (Group 1), flap surgery with autologous CGF (Group 2), flap surgery with Bio-Oss (Group 3), and flap surgery with CGF+Bio-Oss (Group 4). Clinical parameters such as probing depth (PD) and clinical attachment level (CAL) change were recorded at baseline and at 6 and 12 months postoperatively. Results At 12 months postoperatively, Group 2 showed significant improvement in clinical parameters over Group 1 (P<0.05) and the results were significantly greater in Groups 3 and 4 compared to the other groups (P<0.05). Although no significant difference was noted between Groups 3 and 4 in clinical parameters (P>0.05) compared to Group 3, the mean change of CAL at 6–12 months in Group 4 was not significant (P>0.05). Conclusions CGF reduced periodontal intrabony defects depth and, when mixed with Bio-Oss, CGF showed better results in the early period and the effect was more stable.
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Affiliation(s)
- Yan Xu
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland).,Jinan Stomatological Hospital, Jinan, Shandong, China (mainland)
| | - Jiling Qiu
- Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland)
| | - Qinfeng Sun
- Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland)
| | - Shiguo Yan
- Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland)
| | - Wenxia Wang
- Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland)
| | - Pishan Yang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland).,Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland)
| | - Aimei Song
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland).,Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong, China (mainland)
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21
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Rodriguez AE, Nowzari H. The long-term risks and complications of bovine-derived xenografts: A case series. J Indian Soc Periodontol 2019; 23:487-492. [PMID: 31543624 PMCID: PMC6737859 DOI: 10.4103/jisp.jisp_656_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The frequency of dental implant related surgeries that involve soft tissue and bone augmentation procedures has increased significantly. Bovine-derived substitutes have been by far the most commonly used xenografts in dentistry. Albeit literature is replete with clinical studies in favor of bovine-derived graft materials, bibliographical data reporting on risks and clinical complications is scarce. Clinical impression and concern for patient safety led to the report we have provided. The aim of the present case series was to raise awareness on the long-term risks and late clinical complications of bovine-derived graft materials. Patients were referred to a private practice due to bone augmentation complications. Demographics, significant medical and dental findings are reported. Complications included sinus and maxillary bone pathoses, displacement of the graft materials, oroantral communications, implant failure, foreign body reactions, encapsulation, chronic inflammation, soft tissue fenestrations and associated cysts. Bovine-derived graft materials were not biodegradable. Resolution of the associated lesions and symptoms was achieved after the removal of the bone graft materials. The surgical removal of the xenograft materials may require advanced clinical skills because of the different configurations clinicians might encounter of the non-resorbed and migrated particles. The authors’ concern is that patient morbidity may not be reduced with xenografts, due to the inherent risks and associated complications. Clinicians seeking to provide functional and esthetic outcomes should be aware of the complications of the bovine-derived graft materials. The long-term safety of xenografts and their potential association with disease are valid concerns.
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22
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Cohen DJ, Hyzy SL, Haque S, Olson LC, Boyan BD, Saul JM, Schwartz Z. Effects of Tunable Keratin Hydrogel Erosion on Recombinant Human Bone Morphogenetic Protein 2 Release, Bioactivity, and Bone Induction. Tissue Eng Part A 2018; 24:1616-1630. [PMID: 29905087 DOI: 10.1089/ten.tea.2017.0471] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPACT STATEMENT Recombinant human bone morphogenetic protein 2 (rhBMP-2) delivery from collagen sponges for bone formation is an important clinical example of growth factors in tissue engineering. Side effects from rhBMP-2 burst release and rapid collagen resorption have led to investigation of alternative carriers. Here, keratin carriers with tunable erosion rates were formulated by varying disulfide crosslinking via ratios of oxidatively (keratose) to reductively (kerateine) extracted keratin. In vitro rhBMP-2 bioactivity increased with kerateine content, reaching levels greater than with collagen. Heterotopic bone formation in a mouse model depended on the keratin formulation, highlighting the importance of the growth factor carrier.
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Affiliation(s)
- David Joshua Cohen
- 1 Department of Biomedical Engineering, Virginia Commonwealth University , Richmond, Virginia
| | - Sharon L Hyzy
- 1 Department of Biomedical Engineering, Virginia Commonwealth University , Richmond, Virginia
| | - Salma Haque
- 2 Department of Chemical, Paper and Biomedical Engineering, College of Engineering and Computing, Miami University , Oxford, Ohio
| | - Lucas C Olson
- 1 Department of Biomedical Engineering, Virginia Commonwealth University , Richmond, Virginia
| | - Barbara D Boyan
- 1 Department of Biomedical Engineering, Virginia Commonwealth University , Richmond, Virginia
- 3 Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University , Atlanta, Georgia
| | - Justin M Saul
- 2 Department of Chemical, Paper and Biomedical Engineering, College of Engineering and Computing, Miami University , Oxford, Ohio
| | - Zvi Schwartz
- 1 Department of Biomedical Engineering, Virginia Commonwealth University , Richmond, Virginia
- 4 Department of Periodontics, University of Texas Health Science Center at San Antonio , San Antonio, Texas
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23
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Fujisawa K, Akita K, Fukuda N, Kamada K, Kudoh T, Ohe G, Mano T, Tsuru K, Ishikawa K, Miyamoto Y. Compositional and histological comparison of carbonate apatite fabricated by dissolution-precipitation reaction and Bio-Oss ®. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:121. [PMID: 30032409 DOI: 10.1007/s10856-018-6129-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 07/09/2018] [Indexed: 06/08/2023]
Abstract
Carbonate apatite (CO3Ap) is an inorganic component of bone. This study aimed to compare the composition and tissue response to of CO3Ap (CO3Ap-DP) fabricated by the dissolution-precipitation reaction using calcite as a precursor and Bio-Oss®, which is widely used in orthopedic and dental fields as a synthetic bone substitute. X-ray diffraction and Fourier transform infrared results showed that CO3Ap-DP and Bio-Oss® were both B-type carbonate apatite with low crystallinity. The average sizes of CO3Ap-DP and Bio-Oss® granules were 450 ± 58 and 667 ± 168μ m, respectively, and their carbonate contents were 12.1 ± 0.6 and 5.6 ± 0.1 wt%, respectively. CO3Ap-DP had a larger amount of CO3 than Bio-Oss® but higher crystallinity than Bio-Oss®. When a bone defect made at the femur of rabbits was reconstructed with CO3Ap-DP and Bio-Oss®, CO3Ap-DP granules were partially replaced with bone, whereas Bio-Oss® remained at 8 weeks after implantation. CO3Ap-DP granules elicited a significantly larger amount of new bone formation at the cortical bone portion than Bio-Oss® at 4 weeks after the implantation. The results obtained in the present study demonstrated that CO3Ap-DP and Bio-Oss® showed different behavior even though they were both classified as CO3Ap. The CO3 content in CO3Ap played a more important role than the crystallinity of CO3Ap for replacement to bone and high osteoconductivity.
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Affiliation(s)
- Kenji Fujisawa
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan.
- Department of Oral Health Sciences, Faculty of Health and Welfare, Tokushima Bunri University, Yamashirocho, Tokushima, 770-8514, Japan.
| | - Kazuya Akita
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Naoyuki Fukuda
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Kumiko Kamada
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Takaharu Kudoh
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Go Ohe
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Takamitsu Mano
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
| | - Kanji Tsuru
- Section of Bioengineering, Department of Dental Engineering, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Kunio Ishikawa
- Department of Biomaterials, Faculty of Dental Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Youji Miyamoto
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, 770-8504, Japan
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24
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Arbez B, Kün-Darbois JD, Convert T, Guillaume B, Mercier P, Hubert L, Chappard D. Biomaterial granules used for filling bone defects constitute 3D scaffolds: porosity, microarchitecture and molecular composition analyzed by microCT and Raman microspectroscopy. J Biomed Mater Res B Appl Biomater 2018; 107:415-423. [PMID: 29675998 DOI: 10.1002/jbm.b.34133] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 03/23/2018] [Indexed: 01/14/2023]
Abstract
Biomaterials are used in the granular form to fill small bone defects. Granules can be prepared with a grinder from trabecular bone samples or provided as synthetic biomaterials by industry. Granules occupy the 3D-space and create a macroporosity allowing invasion of vascular and bone cells when the inter-granular pores are larger than 300 µm. We compared the 3D-porosity of granule stacks obtained or prepared with nine biomaterials Osteopure® , Lubboc® , Bio-Oss® , CopiOs® , TCP Dental® , TCP Dental HP® , KeraOs® , and TCH® in comparison with that of human trabecular bone. For each biomaterial, two sizes of granules were analyzed: 250-1000 and 1000-2000 µm. Microcomputed tomography determined porosity and microarchitectural characteristics of granular stacks and Raman microspectroscopy was used to analyze their composition. Stacks of 250-1000 µm granules had a much lower porosity than 1000-2000 µm granules and the maximum frequency of pores was always centered at 200-250 µm. One biomaterial contained substantial amount of cortical bone (Bio-Oss® ). The highest porosity and pore size was obtained with TCP Dental HP. Raman spectroscopy found differences in biomaterials of the same composition. Stacks of granules represent 3D scaffolds resembling trabecular bone with an interconnected porous microarchitecture. Small granules have created pores <300 µm in diameter; this can interfere with vascular colonization. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 107B: 415-423, 2019.
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Affiliation(s)
- Baptiste Arbez
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM - LabCom NextBone, SFR 42-08, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
| | - Jean-Daniel Kün-Darbois
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM - LabCom NextBone, SFR 42-08, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France.,Service de chirurgie maxillo-faciale, CHU d'Angers, 49933, Angers Cedex, France
| | - Thierry Convert
- CFI, Collège Français d'Implantologie, 6 rue de Rome, 75005, Paris, France
| | - Bernard Guillaume
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM - LabCom NextBone, SFR 42-08, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France.,CFI, Collège Français d'Implantologie, 6 rue de Rome, 75005, Paris, France
| | - Philippe Mercier
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM - LabCom NextBone, SFR 42-08, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
| | - Laurent Hubert
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM - LabCom NextBone, SFR 42-08, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France.,Département de chirurgie osseuse, CHU d'Angers, 49933, Angers Cedex, France
| | - Daniel Chappard
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM - LabCom NextBone, SFR 42-08, Université d'Angers, IRIS-IBS Institut de Biologie en Santé, CHU d'Angers, 49933, Angers Cedex, France
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25
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Shi M, Yang R, Li Q, Lv K, Miron RJ, Sun J, Li M, Zhang Y. Inorganic Self-Assembled Bioactive Artificial Proto-Osteocells Inducing Bone Regeneration. ACS APPLIED MATERIALS & INTERFACES 2018; 10:10718-10728. [PMID: 29528210 DOI: 10.1021/acsami.8b00385] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Since the discovery of osteoinduction in the early 20th century, innovative biomaterials with osteoinductive potential have emerged as candidates for bone repair. Recently, artificial protocell models have demonstrated great potential for tissue regeneration. Herein, we developed artificial bioactive proto-osteocells by self-assembly of biodegradable biphasic-phosphate particles in the form of aqueous bone morphogenetic protein 2 (BMP2)-containing Pickering emulsions in corn oil to fulfill the release of BMP2 with controlled and local efficacy. These artificial proto-osteocells have the advantage of (1) being directly injected into the target location to avert reported side effects of BMP2, minimizing surgical complications, (2) exhibiting the capability of osteoinduction as shown in both in vitro and in vivo models, and (3) demonstrating calcific deposition locally by utilizing the biodegradable calcium phosphate shell. The efficiency of BMP2 within the artificial proto-osteocells showed 25 times greater bone-inducing potential when compared to the control. This study demonstrates for the first time a new strategy toward utilizing material-based artificial proto-osteocells to tackle medical issues in bone tissue repair and regeneration.
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Affiliation(s)
- Miusi Shi
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology , Wuhan University , Wuhan 430079 , P. R. China
| | - Ruiwen Yang
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Qin Li
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Kangle Lv
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Richard J Miron
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology , Wuhan University , Wuhan 430079 , P. R. China
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Jie Sun
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Mei Li
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology , Wuhan University , Wuhan 430079 , P. R. China
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26
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Fujioka-Kobayashi M, Abd El Raouf M, Saulacic N, Kobayashi E, Zhang Y, Schaller B, Miron RJ. Superior bone-inducing potential of rhBMP9 compared to rhBMP2. J Biomed Mater Res A 2018; 106:1561-1574. [PMID: 29396910 DOI: 10.1002/jbm.a.36359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 12/31/2022]
Abstract
Recombinant human bone morphogenic protein (rhBMP) 9 has recently been reported to have more osteopromotive potential in vitro when compared to rhBMP2. The aim of the present study was to investigate the bone-inducing potential of rhBMP2 and rhBMP9. We compared rhBMP2, rhBMP7, and rhBMP9 at five different concentrations and showed convincingly that rhBMP9 possesses much greater potential for osteoblast differentiation even at 20 times lower concentrations in vitro. We further show that Noggin, an inhibitor for rhBMP2-induced osteogenesis, did not alter rhBMP9-induced osteogenesis. Thereafter, we show for the first time that rhBMP9 loaded onto atelo-collagen membranes is osteoinductive and has greater potential to form ectopic bone formation when compared to rhBMP2 even at four times lower doses. Similarly new bone formation of rhBMP2 and 9 when loaded on deproteinized bovine bone mineral (DBBM) was investigated in a rabbit calvarial defect. At 8 weeks, both rhBMP2 and rhBMP9 induced significantly higher new bone formation when compared to DBBM alone samples. Interestingly, once again four times lower dose of rhBMP9 group induced comparable or even greater levels of new bone height and new bone area when compared to the rhBMP2 group. The present study revealed that (1) rhBMP9 is capable of inducing ectopic new bone formation in vivo and (2) up to four times lower doses of rhBMP9 may be utilized to regenerate same-size bone defects when compared to rhBMP2. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1561-1574, 2018.
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Affiliation(s)
- Masako Fujioka-Kobayashi
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mustafa Abd El Raouf
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Eizaburo Kobayashi
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
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27
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Shi M, Wang C, Wang Y, Tang C, Miron RJ, Zhang Y. Deproteinized bovine bone matrix induces osteoblast differentiation via macrophage polarization. J Biomed Mater Res A 2018; 106:1236-1246. [PMID: 29280261 DOI: 10.1002/jbm.a.36321] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 12/17/2022]
Abstract
Bone grafts are widely used in bone regeneration to increase the speed and quality of new bone formation. While they are routinely characterized based on their biocompatible and bioactive properties, they also exert a profound impact on host immune responses, which in turn can display a significant effect on the healing and repair process. In this study, we investigated the role of macrophage behavior on deproteinized bovine bone matrix (DBBM, BioOss) to investigate their impact on creating either a pro- or anti-inflammatory microenvironment for tissue integration. RT-PCR and immunofluorescence staining results demonstrated the ability for RAW 264.7 cells to polarize toward M2 wound-healing macrophages in response to DBBM and positive control (IL-4). Interestingly, significantly higher expression of interleukin-10 and higher number of multinucleated giant cells (MNGCs) was observed in the DBBM group. Thereafter, conditioned media (CM) from macrophages cultured with DBBM seeded with MC3T3-E1 cells demonstrated a marked increase in osteoblast differentiation. Noteworthy, this effect was reversed by blocking IL10 with addition of IL10 antibody to CM from the DBBM macrophages. Furthermore, the use of dendritic cell specific transmembrane protein (DC-STAMP)-knockout to inhibit MNGC formation in the DBBM group resulted in a significant reduction in osteoblast differentiation, indication a pivotal role for MNGCs in biomaterials-induced osteogenesis. The results from this study indicate convincingly that the immune response of macrophages towards DBBM has a potent effect on osteoblast differentiation. Furthermore, DBBM promoted macrophage fusion and polarization towards an M2 wound-healing phenotype, further created a microenvironment favoring biomaterial-induced osteogenesis. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1236-1246, 2018.
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Affiliation(s)
- Miusi Shi
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, 430079, People's Republic of China.,Department of Dental Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, 430079, People's Republic of China
| | - Can Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, 430079, People's Republic of China
| | - Yulan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, 430079, People's Republic of China
| | - Cuizhu Tang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, 430079, People's Republic of China
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, 430079, People's Republic of China.,Department of Dental Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, 430079, People's Republic of China
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28
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Smith MM, Duncan WJ, Coates DE. Attributes of Bio-Oss ® and Moa-Bone ® graft materials in a pilot study using the sheep maxillary sinus model. J Periodontal Res 2017; 53:80-90. [PMID: 28868669 DOI: 10.1111/jre.12490] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVE The aim of this pilot study was to characterize surface morphology and to evaluate resorption and osseous healing of two deproteinated bovine bone graft materials after sinus grafting in a large animal model. MATERIAL AND METHODS Surfaces of a novel particulate bovine bone graft, Moa-Bone® were compared with Bio-Oss® using scanning electron microscopy. Six sheep then had maxillary sinus grafting bilaterally, covered with BioGide® . Grafted maxillae were harvested after 4, 6 and 12 weeks. Healing was described for half of each site using resin-embedded ground sections. For the other half, paraffin-embedded sections were examined using tartrate resistant acid phosphatase staining for osteoclast activity, runt-related transcription factor2 immunohistochemistry for pre-osteoblasts and osteoblasts and proliferating cell nuclear antigen for proliferative cells. RESULTS Moa-Bone® had a smoother, more porous fibrous structure with minimal globular particles compared with Bio-Oss® . After 4 weeks, woven bone formed on both grafts and the Moa-Bone® particles also showed signs of resorption. After 12 weeks, Moa-Bone® continued to be resorbed, however Bio-Oss® did not; both grafts were surrounded by maturing lamellar bone. Moa-Bone® was associated with earlier evidence of runt-related transcription factor 2-positive cells. Moa-Bone® but not Bio-Oss® was associated with strong tartrate resistant acid phosphatase-positive osteoclasts on the graft surface within resorption lacunae at both 4 and 6 weeks post-grafting. CONCLUSION Both materials supported osseous healing and maturation without inflammation. Moa-Bone® showed marked osteoclast activity after 4 and 6 weeks and demonstrated positive attributes for grafting, if complete remodeling of the graft within the site is desired. Further optimization of Moa-Bone® for maxillofacial applications is warranted.
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Affiliation(s)
- M M Smith
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - W J Duncan
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - D E Coates
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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29
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Mansour A, Mezour MA, Badran Z, Tamimi F. * Extracellular Matrices for Bone Regeneration: A Literature Review. Tissue Eng Part A 2017; 23:1436-1451. [PMID: 28562183 DOI: 10.1089/ten.tea.2017.0026] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The gold standard material for bone regeneration is still autologous bone, a mesenchymal tissue that consists mainly of extracellular matrix (ECM) (90% v/v) and little cellular content (10% v/v). However, the fact that decellularized allogenic bone grafts often present a clinical performance comparable to autologous bone grafts demonstrates the crucial role of ECM in bone regeneration. For long, the mechanism by which bone allografts function was not clear, but recent research has unveiled many unique characteristics of ECM that seem to play a key role in tissue regeneration. This is further confirmed by the fact that synthetic biomaterials with composition and properties resembling bone ECM present excellent bone regeneration properties. In this context, ECM molecules such as glycosaminoglycans (GAGs) and self-assembly peptides (SAPs) can improve the performance of bone regeneration biomaterials. Moreover, decellularized ECM derived either from native tissues such as bone, cartilage, skin, and tooth germs or from cells such as osteoblasts, chondrocytes, and stem cells has shown promising results in bone regeneration applications. Understanding the role of ECM in bone regeneration is crucial for the development of the next generation of biomaterials for bone tissue engineering. In this sense, this review addresses the state-of-the-art on this subject matter.
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Affiliation(s)
- Alaa Mansour
- 1 Faculty of Dentistry, McGill University , Montreal, Canada
| | | | - Zahi Badran
- 1 Faculty of Dentistry, McGill University , Montreal, Canada .,2 Department of Periodontology (CHU/UIC 11, INSERM UMR 1229-RMeS), Faculty of Dental Surgery, University of Nantes , Nantes, France
| | - Faleh Tamimi
- 1 Faculty of Dentistry, McGill University , Montreal, Canada
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30
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SEM-EDX Study of the Degradation Process of Two Xenograft Materials Used in Sinus Lift Procedures. MATERIALS 2017; 10:ma10050542. [PMID: 28772900 PMCID: PMC5459008 DOI: 10.3390/ma10050542] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 03/24/2017] [Accepted: 05/11/2017] [Indexed: 12/13/2022]
Abstract
Some studies have demonstrated that in vivo degradation processes are influenced by the material’s physico-chemical properties. The present study compares two hydroxyapatites manufactured on an industrial scale, deproteinized at low and high temperatures, and how physico-chemical properties can influence the mineral degradation process of material performance in bone biopsies retrieved six months after maxillary sinus augmentation. Residual biomaterial particles were examined by field scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) to determine the composition and degree of degradation of the bone graft substitute material. According to the EDX analysis, the Ca/P ratio significantly lowered in the residual biomaterial (1.08 ± 0.32) compared to the initial composition (2.22 ± 0.08) for the low-temperature sintered group, which also presented high porosity, low crystallinity, low density, a large surface area, poor stability, and a high resorption rate compared to the high-temperature sintered material. This demonstrates that variations in the physico-chemical properties of bone substitute material clearly influence the degradation process. Further studies are needed to determine whether the resorption of deproteinized bone particles proceeds slowly enough to allow sufficient time for bone maturation to occur.
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Maxillary Sinus Augmentation with Decellularized Bovine Compact Particles: A Radiological, Clinical, and Histologic Report of 4 Cases. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2594670. [PMID: 28349056 PMCID: PMC5352871 DOI: 10.1155/2017/2594670] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/13/2017] [Indexed: 11/23/2022]
Abstract
Background. One of the most problematic regions for endosseous implants is the posterior maxilla, not only having poor bone density, but also lacking adequate vertical height as a result of sinus pneumatization. The purpose of the present study was a radiologic, histological, and histomorphometrical evaluation, in humans, of specimens retrieved from sinuses augmented with decellularized bovine compact particles, after a healing period of 6 months. Methods. Four patients, with atrophic resorbed maxillas, underwent a sinus lift augmentation with decellularized bovine compact bone from bovine femur. The size of the particles used was 0.25–1 mm. A total of four grafts and 5 biopsies were retrieved and processed to obtain thin ground sections with the Precise 1 Automated System. Results. The mean volume after graft elevation calculated for each of the 4 patients was 2106 mm3 in the immediate postoperative period (5–7 days), ranging from 1408.8 to 2946.4 mm3. In the late postoperative period (6 months) it was 2053 mm3, ranging from 1339.9 to 2808.9 mm3. Histomorphometry showed that newly formed bone was 36 ± 1.6% and marrow spaces were 34 ± 1.6%, while the residual graft material was 35 ± 1.4%. Conclusion. In conclusion, based on the outcome of the present study, Re-Bone® can be used with success in sinus augmentation procedures and 6 months are considered an adequate time for maturation before implant placement.
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BMP2-coprecipitated calcium phosphate granules enhance osteoinductivity of deproteinized bovine bone, and bone formation during critical-sized bone defect healing. Sci Rep 2017; 7:41800. [PMID: 28139726 PMCID: PMC5282552 DOI: 10.1038/srep41800] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 12/28/2016] [Indexed: 11/08/2022] Open
Abstract
Most materials used clinically for filling critical-sized bone defects (CSBD), such as deproteinized bovine bone (DBB), lack osteoinductivity so that their therapeutic effects are far from satisfactory. The effect of bone morphogenic protein 2 (BMP2)-coprecipitated biomimetic calcium phosphate granules (BMP2-cop.BioCaP) on osteoinduction of DBB graft(s) during CSBD healing is still unknown. We investigated whether BMP2-cop.BioCaP affects the osteoinductivity of DBB, bone formation, and foreign body reaction during CSBD healing. DBB + BMP2-cop.BioCaP, DBB, DBB + BMP2, DBB + BioCaP, and autologous bone grafts were implanted in the CSBD of sheep. Bone formation, DBB/BioCaP degradability, foreign body reaction, and osteoinductivity of DBB were analyzed histologically and histomorphometrically at week 4 and 8. Combination of BMP2-cop.BioCaP and DBB healed CSBD as effectively as autologous bone grafts. About 95% of the BMP2-cop.BioCaP had been degraded and replaced by new bone at week 8 in the DBB + BMP2-cop.BioCaP-group. Foreign body reaction was reduced in the DBB + BMP2-cop.BioCaP-group compared to the other groups. The independent use of the BMP2-cop.BioCaP did not achieve a satisfactory bone repair. In conclusion, the BMP2-cop.BioCaP showed good degradability and biocompatibility, and enhanced osteoinductivity of DBB during CSBD healing in sheep, suggesting BMP2-cop.BioCaP as a potential osteoinducer to enhance the therapeutic effects of the graft materials in clinic.
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Miron RJ, Sculean A, Shuang Y, Bosshardt DD, Gruber R, Buser D, Chandad F, Zhang Y. Osteoinductive potential of a novel biphasic calcium phosphate bone graft in comparison with autographs, xenografts, and DFDBA. Clin Oral Implants Res 2016; 27:668-75. [PMID: 26227281 DOI: 10.1111/clr.12647] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Since the original description of osteoinduction in the early 20th century, the study and development of innovative biomaterials has emerged. Recently, novel synthetic bone grafts have been reported with potential to form ectopic bone in vivo. However, their full characterization in comparison with other leading bone grafts has not been investigated. The aim of this study was to determine the osteoinductive potential of bone grafts by comparing autogenous bone grafts, demineralized freeze-dried bone allografts (DFDBA), a commonly utilized natural bone mineral (NBM) from bovine origin (Bio-Oss), and a newly developed biphasic calcium phosphate (BCP). MATERIALS AND METHODS Grafts were compared in vitro for their ability to stimulate bone marrow stromal cell (BMSC) migration, proliferation, and differentiation as assessed by quantitative real-time PCR for genes coding for bone markers including Runx2, collagen I, and osteocalcin. Furthermore, bone grafts were implanted in the calf muscle of 12 beagle dogs to determine their potential to form ectopic bone in vivo. RESULTS The in vitro results demonstrate that both autografts and DFDBA show potential for cell recruitment, whereas only autografts and BCP demonstrated the ability to differentiate BMSCs toward the osteoblast lineage. The in vivo ectopic bone model demonstrated that while NBM particles were not osteoinductive and autogenous bone grafts were resorbed quickly in vivo, ectopic bone formation was reported in DFDBA and in synthetic BCP grafts. CONCLUSION The modifications in nanotopography and chemical composition of the newly developed BCP bone grafts significantly promoted ectopic bone formation confirming their osteoinductive potential. In conclusion, the results from this study provide evidence that synthetic bone grafts not only serve as a three-dimensional scaffold but are also able to promote osteoinduction.
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Affiliation(s)
- Richard J Miron
- Faculté de Medecine Dentaire, Pavillon de Médecine Dentaire, Université Laval, Québec City, QC, Canada
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Yang Shuang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Dieter D Bosshardt
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Reinhard Gruber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Fatiha Chandad
- Faculté de Medecine Dentaire, Pavillon de Médecine Dentaire, Université Laval, Québec City, QC, Canada
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Scolozzi P, Perez A, Verdeja R, Courvoisier DS, Lombardi T. Association between maxillary sinus fungus ball and sinus bone grafting with deproteinized bovine bone substitutes: a case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:e143-7. [PMID: 26972422 DOI: 10.1016/j.oooo.2016.01.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/20/2015] [Accepted: 01/28/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the association between sinus bone graft and the development of fungus ball (FB) of the maxillary sinus. STUDY DESIGN The charts of all patients seen for surgical treatment of maxillary sinus FB following sinus bone grafting between 2006 and 2014 were reviewed. The charts of 49 participants were selected from our internal registry for comparison as controls. The association between FB and age, gender, smoking habits, associated co-morbidities, and bone grafting material was evaluated. FB of the maxillary sinus was estimated by using an odds ratio with a Yates' correction. P values were computed using Fisher's exact test, and the statistical significance was set at a P value < .05. RESULTS All 13 cases (100%) with FB of the maxillary sinus had received anorganic bovine bone as the bone substitute (P = .0001). There were significantly more women in the case group than in the control group (84.6% in the cases vs 40.8% in the controls; P = .01). CONCLUSIONS This study demonstrated a significant association between a specific deproteinized bovine bone substitute use as sinus bone graft material and subsequent development of FB of the maxillary sinus.
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Affiliation(s)
- Paolo Scolozzi
- Head, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland.
| | - Alexandre Perez
- Resident, Division of Oral and Maxillofacial Surgery, Unit of Oral Surgery and Implantology, Department of Surgery, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Raul Verdeja
- Maxillofacial Surgeon, Private Practice, Fribourg, Switzerland
| | - Delphine S Courvoisier
- Biostatistician, CRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Tommaso Lombardi
- Head, Division of Oral and Maxillofacial Surgery, Unit of Oral and Maxillofacial Medicine and Pathology, Department of Surgery, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
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Miron RJ, Zhang Q, Sculean A, Buser D, Pippenger BE, Dard M, Shirakata Y, Chandad F, Zhang Y. Osteoinductive potential of 4 commonly employed bone grafts. Clin Oral Investig 2016; 20:2259-2265. [PMID: 26814714 DOI: 10.1007/s00784-016-1724-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/12/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Guided bone regeneration (GBR) aims to predictably restore missing bone that has been lost due to trauma, periodontal disease or a variety of systemic conditions. Critical to this procedure is the ability of a bone grafting material to predictably serve as a 3-dimensional scaffold capable of inducing cell and bone tissue in-growth at the material surface. Although all bone grafts are osteoconductive to bone-forming osteoblasts, only a small number of commercially available bone grafts with FDA approval are osteoinductive including demineralized freeze-dried bone allographs (DFDBA) and scaffolds containing bone morphogenetic proteins (BMPs). Recently, a class of synthetic bone grafts fabricated from biphasic calcium phosphate (BCP) sintered at a low temperature have been shown to form ectopic bone formation in non-skeletal sites without the use of growth factors. Therefore, the present study aimed to compare the osteoinductive potential of this group of synthetic BCP alloplasts with autografts, allografts and xenografts. MATERIALS AND METHODS In the present study, 4 types of bone grafting materials including autogenous bone harvested with a bone mill, DFDBA (LifeNet, USA), a xenograft derived from bovine bone mineral (NBM, BioOss, Geistlich, Switzerland) and a novel synthetic biphasic calcium phosphate (BCP, Straumman, Switzerland) were implanted into intramuscular pouches of 24 rats and analysed histologically for their ability to form ectopic bone formation around grafting particles. A semi-quantitative osteoinductive score was used to quantify the osteoinductive ability of each bone graft. RESULTS The results from the present study reveal that (1) autogenous bone resorbed rapidly in vivo, (2) the xenograft showed no potential to form ectopic bone formation and (3) both DFDBA and BCP were able to stimulate ectopic bone formation. CONCLUSION These studies demonstrate that these newly developed synthetic bone grafts have potential for inducing ectopic bone formation similar to DFDBA. Future clinical testing is necessary to reveal their bone-inducing properties in clinical scenarios including GBR procedures and in combination with implant dentistry. CLINICAL RELEVANCE Novel BCP scaffolds are able to induce ectopic bone formation without the use of osteoinductive growth factors such as BMP2 and thus demonstrate a large clinical possibility to further enhance bone formation for a variety of clinical procedures.
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Affiliation(s)
- Richard J Miron
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, People's Republic of China. .,Faculté de Medecine Dentaire, Pavillon de Médecine Dentaire, Université de Laval, 2420 rue de la Terrasse, Québec, G1V 0A6, Canada. .,Department of Periodontology, University of Bern, School of Dental Medicine, Bern, Switzerland. .,Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Qiao Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, People's Republic of China
| | - Anton Sculean
- Department of Periodontology, University of Bern, School of Dental Medicine, Bern, Switzerland
| | - Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Michel Dard
- Department of Periodontology and Implant Dentistry, New York University, New York, NY, USA
| | - Yoshinori Shirakata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Fatiha Chandad
- Faculté de Medecine Dentaire, Pavillon de Médecine Dentaire, Université de Laval, 2420 rue de la Terrasse, Québec, G1V 0A6, Canada
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, People's Republic of China.
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Aly LAA, Hammouda N. Secondary closure of alveolar cleft with resorbable collagen membrane and a combination of intraoral autogenous bone graft and deproteinized anorganic bovine bone. Ann Maxillofac Surg 2016; 6:165-171. [PMID: 28299252 PMCID: PMC5343622 DOI: 10.4103/2231-0746.200351] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTS Secondary alveolar bone grafting is a method that enables an excellent oral rehabilitation of the patients having alveolar cleft. The aim of this work is to report the closure of the alveolar cleft with the use of harvested autogenous bone graft combined with deproteinized anorganic bovine bone (Bio-Oss) under local anesthesia. SETTINGS AND SAMPLE POPULATION Nine patients with age range, 8-11 years were consulted for their unilateral alveolar cleft. MATERIALS AND METHODS A combination of symphyseal bone and deproteinized bovine bone mineral (DBBM) was placed into the alveolar cleft defect. Clinical and radiographical assessments were performed at 1, 3, and 6 months postoperatively. RESULTS The healing period was uneventful in all cases, and no complications, such as membrane exposure, infection, or harvest site morbidity, were observed. All treated defect sites exhibited excellent bone formation, with an average of 5.45 mm (range, 2-9 mm; standard deviation 1.93 mm) of augmentation achieved overall. CONCLUSION The treatment of vertically deficient alveolar ridges with guided bone regeneration using a mixture of autogenous bone and DBBM and resorbable collagen membrane can be considered successful, using this technique in an out-patient office setting.
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Affiliation(s)
- Lobna Abdel Aziz Aly
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Future University, Cairo, Egypt
| | - Nelly Hammouda
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Liu N, Wang Z. Sequential delivery of BMP-7 and IGF-I to enhance the osteoinductive property of deproteinized bovine bone. RSC Adv 2016. [DOI: 10.1039/c6ra04336d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Calcium phosphate coated deproteinized bovine bone with sequential delivery of BMP-7 and IGF-I has osteoinductive property to promote bone regeneration.
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Affiliation(s)
- Ning Liu
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration
- Department of Oral Implant
- School of Stomatology
- Tongji University
- Shanghai
| | - Zuolin Wang
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration
- Department of Oral Implant
- School of Stomatology
- Tongji University
- Shanghai
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Zhang Y, Yang S, Zhou W, Fu H, Qian L, Miron RJ. Addition of a Synthetically Fabricated Osteoinductive Biphasic Calcium Phosphate Bone Graft to BMP2 Improves New Bone Formation. Clin Implant Dent Relat Res 2015; 18:1238-1247. [PMID: 26510170 DOI: 10.1111/cid.12384] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bone morphogenetic protein-2 (BMP2) has been successfully utilized in dentistry to promote new bone formation because of its osteoinductive ability to recruit mesenchymal progenitor cells and induce their differentiation to bone-forming osteoblasts. Recently, novel biphasic calcium phosphate scaffolds have been developed with similar osteoinductive properties capable of forming ectopic bone formation. PURPOSE The aim of the present study was to assess whether the combination of BMP2 with this novel Biphasic Calcium Phosphate (BCP) scaffold may additionally promote new bone regeneration. MATERIALS AND METHODS Cylindrical bone defects measuring 2.5 mm were created bilaterally in the femurs of 18 Wistar rats. After 4 weeks, the following six groups were assessed for new bone formation by micro-computed tomography (CT) as well as histological assessment: 1) collagen scaffolds + 20 μg of BMP2; 2) collagen scaffolds + 50 μg of BMP2; 3) collagen scaffolds + 100 μg of BMP2; 4) BCP scaffolds + 20 μg of BMP2; 5) BCP scaffolds + 50 μg of BMP2; and 6) BCP scaffolds + 100 μg of BMP2. Furthermore, tartrate-resistant acid phosphatase (TRAP) staining was utilized to assess osteoclast activity and osteoclast number. The release kinetics of BMP2 from both BCP and collagen scaffolds was investigated over a 14-day period. RESULTS The results from present study demonstrate that BMP2 is able to promote new bone formation in a concentration dependant manner when loaded with either a collagen scaffolds or BCP scaffolds. Micro-CT analysis demonstrated significantly higher levels of new bone formation in groups containing BCP + BMP2 when compared with collagen scaffolds + BMP2. BMP2 had little effect on osteoclast activity; however, less TRAP staining and osteoclast number was observed in the defects receiving collagen scaffolds when compared with BCP scaffolds. The release of BMP2 over time was rapidly released after 1 day on BCP scaffolds whereas a gradually release over time was observed for collagen scaffolds up to 14 days. CONCLUSION The osteoinductive properties of BMP2 may further be enhanced by its combination with a novel synthetically fabricated osteoinductive BCP scaffold. Future clinical testing is required to further assess these preliminary findings.
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Affiliation(s)
- Yufeng Zhang
- Department of Oral Implantology, School of Stomatology, Wuhan University, Wuhan, China
| | - Shuang Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Zhou
- Hangzhou Jiuyuan Gene Engineering Co, Hangzhou, China
| | - Hang Fu
- Hangzhou Jiuyuan Gene Engineering Co, Hangzhou, China
| | - Li Qian
- Hangzhou Jiuyuan Gene Engineering Co, Hangzhou, China
| | - Richard J Miron
- Department of Periodontology, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Measure bone volume and density changes of sites grafted with bone allografts and a titanium mesh on cone-beam computed tomography: a technique. IMPLANT DENT 2015; 24:362-6. [PMID: 25946661 DOI: 10.1097/id.0000000000000243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to introduce a novel method to evaluate volumetric and density changes of the augmented sites. MATERIALS AND METHODS A ridge augmentation procedure, using particulate bone allografts and a titanium mesh, was performed on the posterior edentulous mandible of 3 participants. Cone-beam computed tomography was taken preoperatively (1st scan), immediately (2nd scan), and 5 months (3rd scan) after the surgery. The grafted area was segmented on the 2nd and 3rd scans, using the 1st scan as the reference. The volume of the grafted area and the newly formed bone-graft complex that is defined by a preselected threshold was then determined. The bone mineral density (BMD) of the grafted area was determined by comparing gray-scale histograms of the grafted area for the 2nd and 3rd scans using the cortical bone adjacent to the grafted area as the reference. RESULTS The mean volumetric shrinkage was 13.5%. The BMD increase was 4.65%. The mean error in determining cortical bone density between the scans was 1.69%. CONCLUSIONS A novel technique to measure bone volume and density changes after bone augmentation was described. The low measurement/scanning error suggested that this technique is reliable and reproducible.
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Miron RJ, Bosshardt DD, Buser D, Zhang Y, Tugulu S, Gemperli A, Dard M, Caluseru OM, Chandad F, Sculean A. Comparison of the Capacity of Enamel Matrix Derivative Gel and Enamel Matrix Derivative in Liquid Formulation to Adsorb to Bone Grafting Materials. J Periodontol 2015; 86:578-87. [DOI: 10.1902/jop.2015.140538] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Effect of bone graft density on in vitro cell behavior with enamel matrix derivative. Clin Oral Investig 2014; 19:1643-51. [PMID: 25518814 DOI: 10.1007/s00784-014-1388-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 12/08/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Bone replacement grafting materials play an important role in regenerative dentistry. Despite a large array of tested bone-grafting materials, little information is available comparing the effects of bone graft density on in vitro cell behavior. Therefore, the aim of the present study is to compare the effects of cells seeded on bone grafts at low and high density in vitro for osteoblast adhesion, proliferation, and differentiation. MATERIALS AND METHODS The response of osteoblasts to the presence of a growth factor (enamel matrix derivative, (EMD)) in combination with low (8 mg per well) or high (100 mg per well) bone grafts (BG; natural bone mineral, Bio-Oss®) density, was studied and compared for osteoblast cell adhesion, proliferation, and differentiation as assessed by real-time PCR. Standard tissue culture plastic was used as a control with and without EMD. RESULTS The present study demonstrates that in vitro testing of bone-grafting materials is largely influenced by bone graft seeding density. Osteoblast adhesion was up to 50 % lower when cells were seeded on high-density BG when compared to low-density BG and control tissue culture plastic. Furthermore, proliferation was affected in a similar manner whereby cell proliferation on high-density BG (100 mg/well) was significantly increased when compared to that on low-density BG (8 mg/well). In contrast, cell differentiation was significantly increased on high-density BG as assessed by real-time PCR for markers collagen 1 (Col 1), alkaline phosphatase (ALP), and osteocalcin (OC) as well as alizarin red staining. The effects of EMD on osteoblast adhesion, proliferation, and differentiation further demonstrated that the bone graft seeding density largely controls in vitro results. EMD significantly increased cell attachment only on high-density BG, whereas EMD was able to further stimulate cell proliferation and differentiation of osteoblasts on control culture plastic and low-density BG when compared to high-density BG. CONCLUSION The results from the present study demonstrate that the in vitro conditions largely influence cell behavior of osteoblasts seeded on bone grafts and in vitro testing. CLINICAL RELEVANCE These results also illustrate the necessity for careful selection of bone graft seeding density to optimize in vitro testing and provide the clinician with a more accurate description of the osteopromotive potential of bone grafts.
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Turri A, Dahlin C. Comparative maxillary bone-defect healing by calcium-sulphate or deproteinized bovine bone particles and extra cellular matrix membranes in a guided bone regeneration setting: an experimental study in rabbits. Clin Oral Implants Res 2014; 26:501-6. [PMID: 24954120 DOI: 10.1111/clr.12425] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to histologically compare the dynamics of bone healing response between calcium sulphate (CaS) and deproteinized bovine bone mineral (DBBM) particles in guided bone regeneration utilizing an extracellular matrix membrane (ECM) as barrier. MATERIALS AND METHODS Eighteen rabbits were used in thisstudy. 5 × 5 mm defects were created in the edentulous space between the incisors and molars in the maxilla. The CaS and DBBM particles were placed in the defects, with or without the placement of a membrane by means of random selection. Healing was evaluated at 2, 4 and 8 weeks by histology. RESULTS A total resorption of the CaS material was seen already at 2 weeks. Only minor resorption could be seen of the DBBM particles. The CaS group showed significantly more bone regeneration at all three healing periods compared to the DBBM group. The addition of an ECM membrane demonstrated significant additional effect on bone regeneration. The CaS group showed significant increased amounts of blood vessels compared to the DBBM group. CONCLUSIONS Thisstudy showed that CaS in combination with an ECM membrane provided synergistic effects on bone regeneration, seemingly due to stimulating angiogenesis in the early healing process.
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Affiliation(s)
- Alberto Turri
- Department of Biomaterials, BIOMATCELL VINN Excellence Center, Institute for Surgical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Brånemark Clinic, Institute of Odontology, Public Dental Health Care, Gothenburg, Sweden
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Elgali I, Igawa K, Palmquist A, Lennerås M, Xia W, Choi S, Chung UI, Omar O, Thomsen P. Molecular and structural patterns of bone regeneration in surgically created defects containing bone substitutes. Biomaterials 2014; 35:3229-42. [DOI: 10.1016/j.biomaterials.2013.12.084] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 12/22/2013] [Indexed: 12/31/2022]
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Raposo-Amaral CE, Bueno DF, Almeida AB, Jorgetti V, Costa CC, Gouveia CH, Vulcano LC, Fanganiello RD, Passos-Bueno MR, Alonso N. Is bone transplantation the gold standard for repair of alveolar bone defects? J Tissue Eng 2014; 5:2041731413519352. [PMID: 24551445 PMCID: PMC3924878 DOI: 10.1177/2041731413519352] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
New strategies to fulfill craniofacial bone defects have gained attention in recent years due to the morbidity of autologous bone graft harvesting. We aimed to evaluate the in vivo efficacy of bone tissue engineering strategy using mesenchymal stem cells associated with two matrices (bovine bone mineral and α-tricalcium phosphate), compared to an autologous bone transfer. A total of 28 adult, male, non-immunosuppressed Wistar rats underwent a critical-sized osseous defect of 5 mm diameter in the alveolar region. Animals were divided into five groups. Group 1 (n = 7) defects were repaired with autogenous bone grafts; Group 2 (n = 5) defects were repaired with bovine bone mineral free of cells; Group 3 (n = 5) defects were repaired with bovine bone mineral loaded with mesenchymal stem cells; Group 4 (n = 5) defects were repaired with α-tricalcium phosphate free of cells; and Group 5 (n = 6) defects were repaired with α-tricalcium phosphate loaded with mesenchymal stem cells. Groups 2-5 were compared to Group 1, the reference group. Healing response was evaluated by histomorphometry and computerized tomography. Histomorphometrically, Group 1 showed 60.27% ± 16.13% of bone in the defect. Groups 2 and 3 showed 23.02% ± 8.6% (p = 0.01) and 38.35% ± 19.59% (p = 0.06) of bone in the defect, respectively. Groups 4 and 5 showed 51.48% ± 11.7% (p = 0.30) and 61.80% ± 2.14% (p = 0.88) of bone in the defect, respectively. Animals whose bone defects were repaired with α-tricalcium phosphate and mesenchymal stem cells presented the highest bone volume filling the defects; both were not statistically different from autogenous bone.
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Affiliation(s)
- Cassio Eduardo Raposo-Amaral
- Departamento de Cirurgia Plástica e Queimaduras, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Daniela Franco Bueno
- Centro de Estudos do Genoma Humano, Instituto de Biociências, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Ana Beatriz Almeida
- Departamento de Cirurgia Plástica e Queimaduras, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Vanda Jorgetti
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Cristiane Cabral Costa
- Centro de Estudos do Genoma Humano, Instituto de Biociências, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Cecília Helena Gouveia
- Centro de Estudos do Genoma Humano, Instituto de Biociências, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Luiz Carlos Vulcano
- Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), São Paulo, Brazil
| | - Roberto D Fanganiello
- Centro de Estudos do Genoma Humano, Instituto de Biociências, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Maria Rita Passos-Bueno
- Centro de Estudos do Genoma Humano, Instituto de Biociências, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Nivaldo Alonso
- Departamento de Cirurgia Plástica e Queimaduras, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, Brazil
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Koerdt S, Siebers J, Bloch W, Ristow O, Kuebler AC, Reuther T. Immunohistochemial study on the expression of von Willebrand factor (vWF) after onlay autogenous iliac grafts for lateral alveolar ridge augmentation. Head Face Med 2013; 9:40. [PMID: 24330606 PMCID: PMC3931527 DOI: 10.1186/1746-160x-9-40] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 12/03/2013] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The main problems of autogenous bone transplants are their unpredictable atrophy and their loss of structure. One key factor lies in the poor revascularization of simple onlay grafts. The the aim of this study was to evaluate the revascularization processes in autogenous bone grafts from the iliac crest to the alveolar ridge. METHODS In a sheep model, autogenous bone grafts were harvested from the iliac crest. A combination of a resorbable collagen membrane (CM) and deproteinized bovine bone material (DBBM) was used to modify the bone graft (experiment 2). This was compared with a simple onlay bone graft (control group, experiment 1). The amount of vessels in bone and connective tissue (CT), and the amount of CT were analyzed. The expression of von Willebrand factor (vWF) was compared between the two experimental groups using immunohistochemical analysis. RESULTS The ratio of the amount of vessels in bone and CT changed over time, and more vessels could be detected in bone at 12-16 weeks of graft healing. The number of vessels were significantly higher in experiment 2 than in experiment 1. More CT was found in experiment 1, whereas the amount of CT in both experiments decreased over time. CONCLUSION This study shows a more intensive and extensive revascularization in experiment 2, as significantly more vessels were detected. The decreased amount of CT in experiment 2 clarifies its clinical superiority.
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Affiliation(s)
- Steffen Koerdt
- Department of Oral and Maxillofacial Plastic Surgery, University of Wuerzburg, Pleicherwall 2, Wuerzburg D-97070, Germany
| | - Joerg Siebers
- Department of Oral and Maxillofacial Plastic Surgery, University of Wuerzburg, Pleicherwall 2, Wuerzburg D-97070, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sport Medicine, German Sport University, Am Sportpark Muengersdorf 6, Cologne D-50933, Germany
| | - Oliver Ristow
- Medicine & Aesthetics, Clinic for Oral, Maxillofacial and Plastical Surgery, Lenbachplatz 2a, Munich D-80333, Germany
| | - Alexander C Kuebler
- Department of Oral and Maxillofacial Plastic Surgery, University of Wuerzburg, Pleicherwall 2, Wuerzburg D-97070, Germany
| | - Tobias Reuther
- Department of Oral and Maxillofacial Plastic Surgery, University of Wuerzburg, Pleicherwall 2, Wuerzburg D-97070, Germany
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DeNicolo PJ, Guyton MK, Cuenin MF, Hokett SD, Sharawy M, Borke J, McPherson JC. Histologic Evaluation of Osseous Regeneration Following Combination Therapy With Platelet-Rich Plasma and Bio-Oss in a Rat Calvarial Critical-Size Defect Model. J ORAL IMPLANTOL 2013; 41:543-9. [PMID: 24003871 DOI: 10.1563/aaid-joi-d-12-00075] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Platelet-rich plasma (PRP) is an autogenous source of growth factors shown to facilitate human bone growth. Bio-Oss, an osteoconductive xenograft, is used clinically to regenerate periodontal defects, restore dental alveolar ridges, and facilitate sinus-lift procedures. The purpose of this study was to analyze whether a combination of PRP and Bio-Oss would enhance bone regeneration better than either material alone. PRP and/or Bio-Oss were administered in an 8-mm critical-size defect (CSD) rat calvarial model of bone defect between 2 polytetrafluoroethylene membranes to prevent soft tissue incursion. Eight weeks after the induction of the CSD, histologic sections were stained with hematoxylin and eosin stain and analyzed via light microscopy. Qualitative analyses revealed new bone regeneration in all 4 groups. The Bio-Oss and PRP plus Bio-Oss groups demonstrated greater areas of closure in the defects than the control or PRP-only groups because of the space-maintaining ability of Bio-Oss. The groups grafted with Bio-Oss showed close contact with new bone growth throughout the defects, suggesting a stronger graft. The use of PRP alone or in combination with Bio-Oss, however, did not appear to enhance osseous regeneration at 8 weeks. Areas grafted with Bio-Oss demonstrated greater space-maintaining capacity than controls, and PRP was an effective vehicle for placement of the Bio-Oss. However, at 8 weeks this study was unable to demonstrate a significant advantage of using PRP plus Bio-Oss over using Bio-Oss alone.
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Affiliation(s)
- Philip J DeNicolo
- 1 US Army Dental Activity, Dental and Trauma Research Detachment, Fort Sam Houston, San Antonio, Tex
| | - M Kelly Guyton
- 2 Department of Clinical Investigation, D. D. Eisenhower Army Medical Center, Fort Gordon, Ga
| | | | | | - Mohamed Sharawy
- 5 Department of Oral Biology, Medical College of Georgia, Augusta, Ga
| | - James Borke
- 6 College of Dental Medicine, Western University of Health Sciences, Pomona, Calif
| | - James C McPherson
- 2 Department of Clinical Investigation, D. D. Eisenhower Army Medical Center, Fort Gordon, Ga
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Liu T, Wu G, Wismeijer D, Gu Z, Liu Y. Deproteinized bovine bone functionalized with the slow delivery of BMP-2 for the repair of critical-sized bone defects in sheep. Bone 2013; 56:110-8. [PMID: 23732874 DOI: 10.1016/j.bone.2013.05.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/22/2013] [Accepted: 05/24/2013] [Indexed: 10/26/2022]
Abstract
As an alternative to an autologous bone graft, deproteinized bovine bone (DBB) is widely used in the clinical dentistry. Although DBB provides an osteoconductive scaffold, it is not capable of enhancing bone regeneration because it is not osteoinductive. In order to render DBB osteoinductive, bone morphogenetic protein 2 (BMP-2) has previously been incorporated into a three dimensional reservoir (a biomimetic calcium phosphate coating) on DBB, which effectively promoted the osteogenic response by the slow delivery of BMP-2. The aim of this study was to investigate the therapeutic effectiveness of such coating on the DBB granules in repairing a large cylindrical bone defect (8 mm diameter, 13 mm depth) in sheep. Eight groups were randomly assigned to the bone defects: (i) no graft material; (ii) autologous bone; (iii) DBB only; (iv) DBB mixed with autologous bone; (v) DBB bearing adsorbed BMP-2; (vi) DBB bearing a coating but no BMP-2; (vii) DBB bearing a coating with adsorbed BMP-2; and (viii) DBB bearing a coating-incorporated depot of BMP-2. 4 and 8 weeks after implantation, samples were withdrawn for a histological and a histomorphometric analysis. Histological results confirmed the excellent biocompatibility and osteoconductivity of all the grafts tested. At 4 weeks, DBB mixed with autologous bone or functionalized with coating-incorporated BMP-2 showed more newly-formed bone than the other groups with DBB. At 8 weeks, the volume of newly-formed bone around DBB that bore a coating-incorporated depot of BMP-2 was greatest among the groups with DBB, and was comparable to the autologous bone group. The use of autologous bone and BMP-2 resulted in more bone marrow formation. Multinucleated giant cells were observed in the resorption process around DBB, whereas histomorphometric analysis revealed no significant degradation of DBB. In conclusion, it was shown that incorporating BMP-2 into the calcium phosphate coating of DBB induced strong bone formation around DBB for repairing a critical-sized bone defect.
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Affiliation(s)
- Tie Liu
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Research Institute MOVE, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands.
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Wagner-Ecker M, Voltz P, Egermann M, Richter W. The collagen component of biological bone graft substitutes promotes ectopic bone formation by human mesenchymal stem cells. Acta Biomater 2013; 9:7298-307. [PMID: 23542556 DOI: 10.1016/j.actbio.2013.03.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/06/2013] [Accepted: 03/23/2013] [Indexed: 12/13/2022]
Abstract
Synthetic bone substitutes are attractive materials for repairing a variety of bone defects. They are readily available in unlimited quantities, have a defined composition without batch variability and bear no risk of disease transmission. When combined with mesenchymal stem cells (MSCs), bone healing can be further enhanced due to the osteogenic potential of these cells. However, human MSCs showed considerable donor variability in ectopic bone formation assays on synthetic bone substitutes, which may limit clinical success. This study addresses whether bone formation variability of MSCs is cell-intrinsic or biomaterial-dependent and may be improved using biological bone substitutes with and without collagen. Ectopic bone formation of MSCs from nine donors was tested in immune-deficient mice on biological bone substitutes of bovine and equine origin, containing collagen (bHA-C; eHA-C) or not (bHA; eHA). Synthetic β-TCP was used for comparison. Histology of 8-week explants demonstrated a significant influence of the bone graft substitute (BGS) on donor variability of ectopic bone formation with best results seen for eHA-C (15/17) and β-TCP (16/18). Bone was of human origin in all groups according to species-specific in situ hybridization, but MSCs from one donor formed no bone with any bone substitute. According to histomorphometry, most neo-bone was formed on eHA-C with significant differences to bHA, eHA and β-TCP (p<0.001). Collagen-free biological BGSs were inferior to biological BGSs with collagen (p<0.001), while species-origin was of little influence. In conclusion, BGS composition had a strong influence on ectopic bone formation ability of MSCs, and biological BGSs with a collagen component seem most promising to display the strong osteogenic potential of MSCs.
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50
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Bernhardt A, Dittrich R, Lode A, Despang F, Gelinsky M. Nanocrystalline spherical hydroxyapatite granules for bone repair: in vitro evaluation with osteoblast-like cells and osteoclasts. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2013; 24:1755-1766. [PMID: 23625348 DOI: 10.1007/s10856-013-4933-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 04/18/2013] [Indexed: 06/02/2023]
Abstract
Conventionally sintered hydroxyapatite-based materials for bone repair show poor resorbability due to the loss of nanocrystallinity. The present study describes a method to establish nanocrystalline hydroxyapatite granules. The material was prepared by ionotropic gelation of an alginate sol containing hydroxyapatite (HA) powder. Subsequent thermal elimination of alginate at 650 °C yielded non-sintered, but unexpectedly stable hydroxyapatite granules. By adding stearic acid as an organic filler to the alginate/HA suspension, the granules exhibited macropores after thermal treatment. A third type of material was achieved by additional coating of the granules with silica particles. Microstructure and specific surface area of the different materials were characterized in comparison to the already established granular calcium phosphate material Cerasorb M(®). Cytocompatibility and potential for bone regeneration of the materials was evaluated by in vitro examinations with osteosarcoma cells and osteoclasts. Osteoblast-like SaOS-2 cells proliferated on all examined materials and showed the typical increase of alkaline phosphatase (ALP) activity during cultivation. Expression of bone-related genes coding for ALP, osteonectin, osteopontin, osteocalcin and bone sialoprotein II on the materials was proven by RT-PCR. Human monocytes were seeded onto the different granules and osteoclastogenesis was examined by activity measurement of tartrate-specific acid phosphatase (TRAP). Gene expression analysis after 23 days of cultivation revealed an increased expression of osteoclast-related genes TRAP, vitronectin receptor and cathepsin K, which was on the same level for all examined materials. These results indicate, that the nanocrystalline granular materials are of clinical interest, especially for bone regeneration.
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Affiliation(s)
- A Bernhardt
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty of Technische Universität Dresden and University Hospital Carl Gustav Carus, Fetscher Str. 74, 01307, Dresden, Germany.
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