1
|
Ma YF, Yan XZ. Periodontal Guided Tissue Regeneration Membranes: Limitations and Possible Solutions for the Bottleneck Analysis. TISSUE ENGINEERING. PART B, REVIEWS 2023; 29:532-544. [PMID: 37029900 DOI: 10.1089/ten.teb.2023.0040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
Guided tissue regeneration (GTR) is an important surgical method for periodontal regeneration. By placing barrier membrane on the root surface of the tooth to guide the adhesion and proliferation of periodontal ligament cells, periodontal tissue regeneration can be achieved. This review intends to analyze the current limitations of GTR membranes and to propose possible solutions for developing new ones. Limitations of current GTR membranes include nonabsorbable membranes and absorbable synthetic polymer membranes exhibit weak biocompatibility; when applying to a large defect wound, the natural collagen membrane with fast degradation rate have limited mechanical strength, and the barrier function may not be maintained well. Although the degradation time can be prolonged after cross-linking, it may cause foreign body reaction and affect tissue integration; The clinical operation of current barrier membranes is inconvenient. In addition, most of the barrier membranes lack bioactivity and will not actively promote periodontal tissue regeneration. Possible solutions include using electrospinning (ELS) techniques, nanofiber scaffolds, or developing functional gradient membranes to improve their biocompatibility; adding Mg, Zn, and/or other metal alloys, or using 3D printing technology to improve their mechanical strength; increasing the concentration of nanoparticles or using directional arrangement of membrane fibers to control the fiber diameter and porosity of the membrane, which can improve their barrier function; mixing natural and synthetic polymers as well as other biomaterials with different degradation rates in proportion to change the degradation rate and maintain barrier function; to improve the convenience of clinical operation, barrier membranes that meets personalized adhesion to the wound defect can be manufactured; developing local controlled release drug delivery systems to improve their bioactivity. Impact statement This review provides an up-to-date summary of commonly commercial periodontal guided tissue regeneration membranes, and analyze their limitations in clinical use. Using studies published recently to explore possible solutions from several perspectives and to raise possible strategies in the future. Several strategies have tested in vivo/in vitro, which will guide the way to propel clinical translation, meeting clinical needs.
Collapse
Affiliation(s)
- Yi-Fei Ma
- Department of Periodontology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Stomatological Hospital and Dental School of Tongji University, Shanghai, People's Republic of China
| | - Xiang-Zhen Yan
- Department of Periodontology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Stomatological Hospital and Dental School of Tongji University, Shanghai, People's Republic of China
| |
Collapse
|
2
|
α-Calcium Sulfate Hemihydrate Bioceramic Prepared via Salt Solution Method to Enhance Bone Regenerative Efficiency. J IND ENG CHEM 2022. [DOI: 10.1016/j.jiec.2022.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
3
|
Iviglia G, Kargozar S, Baino F. Biomaterials, Current Strategies, and Novel Nano-Technological Approaches for Periodontal Regeneration. J Funct Biomater 2019; 10:E3. [PMID: 30609698 PMCID: PMC6463184 DOI: 10.3390/jfb10010003] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 12/07/2018] [Accepted: 12/17/2018] [Indexed: 12/14/2022] Open
Abstract
Periodontal diseases involve injuries to the supporting structures of the tooth and, if left untreated, can lead to the loss of the tooth. Regenerative periodontal therapies aim, ideally, at healing all the damaged periodontal tissues and represent a significant clinical and societal challenge for the current ageing population. This review provides a picture of the currently-used biomaterials for periodontal regeneration, including natural and synthetic polymers, bioceramics (e.g., calcium phosphates and bioactive glasses), and composites. Bioactive materials aim at promoting the regeneration of new healthy tissue. Polymers are often used as barrier materials in guided tissue regeneration strategies and are suitable both to exclude epithelial down-growth and to allow periodontal ligament and alveolar bone cells to repopulate the defect. The problems related to the barrier postoperative collapse can be solved by using a combination of polymeric membranes and grafting materials. Advantages and drawbacks associated with the incorporation of growth factors and nanomaterials in periodontal scaffolds are also discussed, along with the development of multifunctional and multilayer implants. Tissue-engineering strategies based on functionally-graded scaffolds are expected to play an ever-increasing role in the management of periodontal defects.
Collapse
Affiliation(s)
| | - Saeid Kargozar
- Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad 917794-8564, Iran.
| | - Francesco Baino
- Institute of Materials Physics and Engineering, Department of Applied Science and Technology, Politecnico di Torino, 10129 Torino, Italy.
| |
Collapse
|
4
|
Elgali I, Omar O, Dahlin C, Thomsen P. Guided bone regeneration: materials and biological mechanisms revisited. Eur J Oral Sci 2017; 125:315-337. [PMID: 28833567 PMCID: PMC5601292 DOI: 10.1111/eos.12364] [Citation(s) in RCA: 418] [Impact Index Per Article: 59.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Guided bone regeneration (GBR) is commonly used in combination with the installment of titanium implants. The application of a membrane to exclude non‐osteogenic tissues from interfering with bone regeneration is a key principle of GBR. Membrane materials possess a number of properties which are amenable to modification. A large number of membranes have been introduced for experimental and clinical verification. This prompts the need for an update on membrane properties and the biological outcomes, as well as a critical assessment of the biological mechanisms governing bone regeneration in defects covered by membranes. The relevant literature for this narrative review was assessed after a MEDLINE/PubMed database search. Experimental data suggest that different modifications of the physicochemical and mechanical properties of membranes may promote bone regeneration. Nevertheless, the precise role of membrane porosities for the barrier function of GBR membranes still awaits elucidation. Novel experimental findings also suggest an active role of the membrane compartment per se in promoting the regenerative processes in the underlying defect during GBR, instead of being purely a passive barrier. The optimization of membrane materials by systematically addressing both the barrier and the bioactive properties is an important strategy in this field of research.
Collapse
Affiliation(s)
- Ibrahim Elgali
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
| | - Omar Omar
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden.,Department of Oral Maxillofacial Surgery/ENT, NU-Hospital organisation, Trollhättan, Sweden
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
5
|
Avila-Ortiz G, De Buitrago JG, Reddy MS. Periodontal regeneration - furcation defects: a systematic review from the AAP Regeneration Workshop. J Periodontol 2016; 86:S108-30. [PMID: 25644295 DOI: 10.1902/jop.2015.130677] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this review is to present the available evidence regarding the effectiveness of different regenerative approaches for the treatment of furcation defects in specific clinical scenarios compared with conventional surgical therapy to provide clinical guidelines for the therapeutic management of furcation defects and to identify priorities for future research that may advance the understanding of periodontal regenerative medicine. METHODS A comprehensive search based on predetermined eligibility criteria was conducted to identify human original studies and systematic reviews on the topic of periodontal regeneration of furcation defects. Two reviewers independently screened the title and abstract of the entries yielded from the initial search. Subsequently, both reviewers read the full-text version of potentially eligible studies, made a final article selection, and extracted the data of the selected studies considering specific clinical scenarios. The clinical scenarios contemplated in this review included the following: 1) facial and interproximal Class I defects in maxillary molars; 2) facial and lingual Class I defects in mandibular molars; 3) facial and interproximal Class II furcation defects in maxillary molars; 4) facial and lingual Class II furcation defects in mandibular molars; 5) Class III furcation defects in maxillary molars; 6) Class III furcation defects in mandibular molars; and 7) Class I, II, or III furcation defects in maxillary premolars. Endpoints of interest included different clinical, radiographic, microbiologic, histologic, and patient-reported outcomes. RESULTS The initial search yielded a total of 1,500 entries. The final selection consisted of 150 articles, of which six were systematic reviews, 109 were clinical trials, 27 were case series, and eight were case reports. A summary of the main findings of previously published systematic reviews and the available evidence relative to the indication of regenerative approaches for the treatment of furcation defects compared with conventional surgical therapy are presented. Given the marked methodologic heterogeneity and the wide variety of materials and techniques applied in the selected clinical trials, the conduction of a meta-analysis was not viable. CONCLUSIONS On the basis of the reviewed evidence, the following conclusions can be drawn. 1) Periodontal regeneration has been demonstrated histologically and clinically for the treatment of maxillary facial or interproximal and mandibular facial or lingual Class II furcation defects. 2) Although periodontal regeneration has been demonstrated histologically for the treatment of mandibular Class III defects, the evidence is limited to one case report. 3) Evidence supporting regenerative therapy in maxillary Class III furcation defects in maxillary molars is limited to clinical case reports. 4) In Class I furcation defects, regenerative therapy may be beneficial in certain clinical scenarios, although most Class I furcation defects may be successfully treated with non-regenerative therapy. 5) Future research efforts should be primarily directed toward the conduction of clinical trials to test novel regenerative approaches that place emphasis primarily on patient-reported outcomes and also on histologic demonstration of periodontal regeneration. Investigators should also focus on understanding the influence that local, systemic, and technical factors may have on the outcomes of regenerative therapy in furcation defects.
Collapse
|
6
|
Pandit N, Sharma A, Jain A, Bali D, Malik R, Gugnani S. The use of nanocrystalline and two other forms of calcium sulfate in the treatment of infrabony defects: A clinical and radiographic study. J Indian Soc Periodontol 2015; 19:545-53. [PMID: 26644722 PMCID: PMC4645542 DOI: 10.4103/0972-124x.156875] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Calcium sulphate(CS) is one of the oldest alloplastic graft materials used because of its biocompatibility, handling characteristics, porosity, different rates of dissolution, chemico-physical resemblance to bone mineral, ability to induce release of growth factors and potentially unlimited supply at a modest cost. Aim of the study was to evaluate the efficacy of 3 forms of calcium sulphate i.e. Nanogen (nCS)(+), BoneGen(+) and Dentogen(+) in treatment of infrabony defects and to compare their efficacy as bone grafting substitutes. Materials and Methods: A prospective randomized, double blind controlled study was conducted on 45 sites from 16 subjects having Moderate to Advanced Periodontitis who were divided into 3 groups i.e. Group I (Nanogen), Group II (Dentogen) and Group III (BoneGen) clinical along with radiographic measurements were taken at baseline, 6 and 12 months postoperatively. Results: There was no significant inter-group difference in mean clinical attachment level (CAL) values at different time intervals whereas Intra-group changes in CAL at 6 and 12 months as compared to baseline were significant statistically. In Group I, changes in CAL between 6 and 12 months were found to be statistically significant in comparison with Group II and III. Conclusion: Both Nanogen and BoneGen TR can be considered valuable options in the treatment of infra-bony periodontal defects. The faster degradation of Dentogen may negatively affect its bone regeneration potential.
Collapse
Affiliation(s)
- Nymphea Pandit
- Department of Periodontology and Oral Implantology, DAV (C) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Aditi Sharma
- Department of Periodontology and Oral Implantology, DAV (C) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Ashish Jain
- Department of Periodontology and Oral Implantology, H.S Judge Institute of Dental Sciences, Chandigarh, India
| | - Deepika Bali
- Department of Periodontology and Oral Implantology, DAV (C) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Rajvir Malik
- Department of Periodontology and Oral Implantology, DAV (C) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Shalini Gugnani
- Department of Periodontology and Oral Implantology, DAV (C) Dental College and Hospital, Yamunanagar, Haryana, India
| |
Collapse
|
7
|
Graziani F, Gennai S, Karapetsa D, Rosini S, Filice N, Gabriele M, Tonetti M. Clinical performance of access flap in the treatment of class II furcation defects. A systematic review and meta-analysis of randomized clinical trials. J Clin Periodontol 2015; 42:169-81. [DOI: 10.1111/jcpe.12327] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Filippo Graziani
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | - Stefano Gennai
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | - Dimitra Karapetsa
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | - Stefano Rosini
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | - Natalia Filice
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | - Mario Gabriele
- Department of surgery; Unit of Dentistry and Oral Surgery; University of Pisa; Pisa Italy
| | | |
Collapse
|
8
|
Shue L, Yufeng Z, Mony U. Biomaterials for periodontal regeneration: a review of ceramics and polymers. BIOMATTER 2014; 2:271-7. [PMID: 23507891 PMCID: PMC3568111 DOI: 10.4161/biom.22948] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Periodontal disease is characterized by the destruction of periodontal tissues. Various methods of regenerative periodontal therapy, including the use of barrier membranes, bone replacement grafts, growth factors and the combination of these procedures have been investigated. The development of biomaterials for tissue engineering has considerably improved the available treatment options above. They fall into two broad classes: ceramics and polymers. The available ceramic-based materials include calcium phosphate (eg, tricalcium phosphate and hydroxyapatite), calcium sulfate and bioactive glass. The bioactive glass bonds to the bone with the formation of a layer of carbonated hydroxyapatite in situ. The natural polymers include modified polysaccharides (eg, chitosan,) and polypeptides (collagen and gelatin). Synthetic polymers [eg, poly(glycolic acid), poly(L-lactic acid)] provide a platform for exhibiting the biomechanical properties of scaffolds in tissue engineering. The materials usually work as osteogenic, osteoconductive and osteoinductive scaffolds. Polymers are more widely used as a barrier material in guided tissue regeneration (GTR). They are shown to exclude epithelial downgrowth and allow periodontal ligament and alveolar bone cells to repopulate the defect. An attempt to overcome the problems related to a collapse of the barrier membrane in GTR or epithelial downgrowth is the use of a combination of barrier membranes and grafting materials. This article reviews various biomaterials including scaffolds and membranes used for periodontal treatment and their impacts on the experimental or clinical management of periodontal defect.
Collapse
Affiliation(s)
- Li Shue
- 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, PR China
| | | | | |
Collapse
|
9
|
Chen TH, Tu YK, Yen CC, Lu HK. A systematic review and meta-analysis of guided tissue regeneration/osseous grafting for the treatment of Class II furcation defects. J Dent Sci 2013. [DOI: 10.1016/j.jds.2013.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
10
|
Khanna D, Malhotra S, Naidu DV. Treatment of grade II furcation involvement using resorbable guided tissue regeneration membrane: A six-month study. J Indian Soc Periodontol 2013; 16:404-10. [PMID: 23162337 PMCID: PMC3498712 DOI: 10.4103/0972-124x.100920] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Accepted: 04/11/2012] [Indexed: 11/24/2022] Open
Abstract
Aims: The present study was undertaken to evaluate the effectiveness of the combination of hydroxyapatite and β-tricalcium phosphate bone alloplast with bioresorbable guided tissue regeneration membrane for the treatment of mandibular grade II furcation defects. Settings and Design: A total of eight patients, four females and four males, in the age group of 18 to 65 years, with bilateral buccal grade II furcation defects in the mandibular molars, participated in the study. Materials and Methods: The following clinical measurements were recorded at baseline as well as three and six months post surgery: The Turesky-Gilmore-Glickman modification of the Quigley Hein plaque index, the Loe and Silness gingival index, Relative Clinical Attachment Level Vertical Probing Depth in the mid-furcation area, and Horizontal Probing Depth in the mid-furcation area. Statistical analysis: Pairwise comparisons within the groups were done by applying the independent student t test. Comparisons were also drawn between the test and the control groups by applying the independent student t test. Results: The mean gain in the relative clinical attachment levels in the test and control groups, at the end of six months, were 2.50 and 1.63 mm, respectively. The mean change in the horizontal probing depth values at the end of six months in the test and control groups were 2.88 and 1.63 mm, respectively. The mean reduction in the vertical probing depth values in the test and control groups were 1.50 and 1.38 mm, respectively. Conclusions: The resorbable GTR membrane with bone material was more effective than open debridement alone, in the treatment of furcation defects.
Collapse
Affiliation(s)
- Deepti Khanna
- Department of Periodontology and Oral Implantology, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | | | | |
Collapse
|
11
|
Qian X, Yuan F, Zhimin Z, Anchun M. Dynamic perfusion bioreactor system for 3D culture of rat bone marrow mesenchymal stem cells on nanohydroxyapatite/polyamide 66 scaffoldin vitro. J Biomed Mater Res B Appl Biomater 2013; 101:893-901. [DOI: 10.1002/jbm.b.32894] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 12/04/2012] [Accepted: 12/11/2012] [Indexed: 11/11/2022]
|
12
|
Mehrabanian M, Nasr-Esfahani M. HA/nylon 6,6 porous scaffolds fabricated by salt-leaching/solvent casting technique: effect of nano-sized filler content on scaffold properties. Int J Nanomedicine 2011; 6:1651-9. [PMID: 21904455 PMCID: PMC3160951 DOI: 10.2147/ijn.s21203] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Nanohydroxyapatite (n-HA)/nylon 6,6 composite scaffolds were produced by means of the salt-leaching/solvent casting technique. NaCl with a distinct range size was used with the aim of optimizing the pore network. Composite powders with different n-HA contents (40%, 60%) for scaffold fabrication were synthesized and tested. The composite scaffolds thus obtained were characterized for their microstructure, mechanical stability and strength, and bioactivity. The microstructure of the composite scaffolds possessed a well-developed interconnected porosity with approximate optimal pore size ranging from 200 to 500 μm, ideal for bone regeneration and vascularization. The mechanical properties of the composite scaffolds were evaluated by compressive strength and modulus tests, and the results confirmed their similarity to cortical bone. To characterize bioactivity, the composite scaffolds were immersed in simulated body fluid for different lengths of time and results monitored by scanning electron microscopy and energy dispersive X-ray microanalysis to determine formation of an apatite layer on the scaffold surface.
Collapse
Affiliation(s)
- Mehran Mehrabanian
- Member of Young Researchers Club, Najafabad Branch, Islamic Azad University, Isfahan, Iran
| | | |
Collapse
|
13
|
Clinical and Histologic Outcomes of Calcium Sulfate in the Treatment of Postextraction Sockets. J Craniofac Surg 2011; 22:494-8. [DOI: 10.1097/scs.0b013e318208bb21] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
14
|
Kinaia BM, Steiger J, Neely AL, Shah M, Bhola M. Treatment of Class II Molar Furcation Involvement: Meta-Analyses of Reentry Results. J Periodontol 2011; 82:413-28. [DOI: 10.1902/jop.2010.100306] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
15
|
Xu Q, Lu H, Zhang J, Lu G, Deng Z, Mo A. Tissue engineering scaffold material of porous nanohydroxyapatite/polyamide 66. Int J Nanomedicine 2010; 5:331-5. [PMID: 20517477 PMCID: PMC2875726 DOI: 10.2147/ijn.s9869] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The aim of the study was to investigate a porous nanohydroxyapatite/polyamide 66 (n-HA/PA66) scaffold material that was implanted into muscle and tibiae of 16 New Zealand white rabbits to evaluate the biocompatibility and osteogenesis and osteoinductivity of the materials in vivo. The samples were harvested at 2, 4, 12 and 26 weeks respectively, and subjected to histological analysis. At 2 weeks, the experiment showed that osteogenesis was detected in porous n-HA/PA66 composite and the density of new bone formation was similar to the surrounding host bone at 12 weeks. The study indicated that three-dimensional pore structures could facilitate cell adhesion, differentiation and proliferation, and help with fibrovascular and nerve colonization. In conclusion, porous n-HA/PA66 scaffold material could be a good candidate as a bone substitute material used in clinics due to its excellent histocompatibility, osteoconductivity and osteoinductivity.
Collapse
Affiliation(s)
- Qian Xu
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, PR China
| | | | | | | | | | | |
Collapse
|
16
|
Osteogenesis Mechanism of Chitosan-Coated Calcium Sulfate Pellets on the Restoration of Segmental Bone Defects. J Craniofac Surg 2009; 20:1445-50. [DOI: 10.1097/scs.0b013e3181af1529] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
17
|
Bashutski JD, Wang HL. Periodontal and endodontic regeneration. J Endod 2009; 35:321-8. [PMID: 19249588 DOI: 10.1016/j.joen.2008.11.023] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 11/25/2008] [Accepted: 11/28/2008] [Indexed: 02/05/2023]
Abstract
Guided tissue regeneration (GTR) is effective in halting tissue and bone destruction and promoting new tissue and bone formation. Although the goal of complete and predictable regeneration still remains elusive, many techniques and materials have been developed that show good clinical and histologic outcomes. The most commonly used materials in GTR include bone replacement grafts from numerous sources, nonresorbable and bioabsorbable membranes, and recently growth hormones/cytokines and other host modulating factors. This article reviews the biologic rationale behind current techniques used for tissue/bone regeneration, reviews the most common materials and techniques, and attempts to explain the factors that influence the outcomes of these therapies.
Collapse
Affiliation(s)
- Jill D Bashutski
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA
| | | |
Collapse
|
18
|
Thomas MV, Puleo DA. Calcium sulfate: Properties and clinical applications. J Biomed Mater Res B Appl Biomater 2009; 88:597-610. [DOI: 10.1002/jbm.b.31269] [Citation(s) in RCA: 211] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
19
|
Maeda ST, Bramante CM, Taga R, Garcia RB, de Moraes IG, Bernadineli N. Evaluation of surgical cavities filled with three types of calcium sulfate. J Appl Oral Sci 2007; 15:416-9. [PMID: 19089171 PMCID: PMC4327262 DOI: 10.1590/s1678-77572007000500008] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Revised: 05/31/2007] [Accepted: 07/13/2007] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to evaluate histologically, three types of calcium sulfate - Merck (Brazil), Surgiplaster (Italy) and Capset (USA) - in surgically created defects on rabbit femurs. Twenty male New Zealand rabbits were used. Two surgical bone defects (5 mm diameter x 8 mm depth) were created on each distal epiphysis using a #3 Dentoflex trephine bur. Defects were filled with: group 1 - di-hydrated calcium sulfate (Merck); group 2 - Capset (Lifecore-USA); group 3 - Surgiplaster (Classimport-Italy); group 4 - control (blood clot). The animals were sacrificed 30, 60, 90 and 180 days postoperatively. Semi-serial 6-mm-thick sections were obtained, stained with hematoxylin and eosin and examined under light microscopy. Bone defects treated with calcium sulfate exhibited new bone formation regardless of the product trademark.
Collapse
Affiliation(s)
- Sergio Toshinori Maeda
- DDS, MSc, Department of Endodontics, Metodista Dental School, University Metodista of São Paulo, São Bernardo do Campo-SP, Brazil
| | - Clovis Monteiro Bramante
- DDS, MSc, PhD, Department of Endodontics–Bauru Dental School, University of São Paulo, Bauru-SP, Brazil
| | - Rumio Taga
- DDS, PhD, Department of Biological Sciences, Bauru Dental School, University of São Paulo, Bauru-SP, Brazil
| | - Roberto Brandão Garcia
- DDS, MSc, Department of Endodontics-Bauru Dental School, University of São Paulo, Bauru-SP, Brazil
| | - Ivaldo Gomes de Moraes
- DDS, MSc, Department of Endodontics-Bauru Dental School, University of São Paulo, Bauru-SP, Brazil
| | - Norberti Bernadineli
- DDS, MSc, Department of Endodontics-Bauru Dental School, University of São Paulo, Bauru-SP, Brazil
| |
Collapse
|
20
|
Tsao YP, Neiva R, Al-Shammari K, Oh TJ, Wang HL. Effects of a Mineralized Human Cancellous Bone Allograft in Regeneration of Mandibular Class II Furcation Defects. J Periodontol 2006; 77:416-25. [PMID: 16512756 DOI: 10.1902/jop.2006.050109] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND A solvent-preserved, mineralized human cancellous bone allograft (MBA) was recently developed. However, its effect in regenerating furcation defects remains to be determined. Hence, the aim of the study is to evaluate the effects of this newly introduced MBA, with and without a bioabsorbable collagen membrane, for the treatment of mandibular class II furcation defects. METHODS Thirty subjects with Hamp's Class II buccal or lingual furcation defects in lower molars were randomly assigned to open flap debridement (OFD), MBA, or MBA with a bioabsorbable collagen membrane (guided tissue regeneration [GTR]+MBA) groups. Clinical and defect measurements were obtained at the initial visit and at 6-month reentry surgeries. The data were analyzed for intra- and intergroup comparisons and associations of treatment with probability of clinical improvement. RESULTS Out of a total of 30 subjects, 27 individuals completed the study. Vertical bone fill (VBF) was -1.6+/-2.1 mm in OFD, 1.9+/-1.4 mm in MBA, and 0.7+/-0.9 mm in GTR+MBA groups. VBF in MBA and GTR + MBA groups was significantly higher than that in the OFD group (P<0.05). Horizontal bone fill (HBF) was 0.2+/-1.7 mm, 1.1+/-0.9 mm, and 1.1+/-0.9 mm for OFD, MBA, and GTR+MBA groups, respectively. However, HBF, recession, clinical attachment level gain, and probing depth reduction at furcations showed no differences among groups. CONCLUSIONS Results obtained from this study indicate that solvent-preserved, mineralized human cancellous allograft, with or without collagen membrane, can significantly improve bone fill in mandibular Class II furcation defects. In addition, initial vertical defect depth was found to be the only factor that was associated with a higher probability of clinical improvement.
Collapse
Affiliation(s)
- Yi-Pin Tsao
- Department of Periodontics/Prevention/Geriatrics, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA
| | | | | | | | | |
Collapse
|
21
|
Melo LGN, Nagata MJH, Bosco AF, Ribeiro LLG, Leite CM. Bone healing in surgically created defects treated with either bioactive glass particles, a calcium sulfate barrier, or a combination of both materials. A histological and histometric study in rat tibias. Clin Oral Implants Res 2006; 16:683-91. [PMID: 16307575 DOI: 10.1111/j.1600-0501.2005.01090.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to histologically analyze the influence of bioactive glass and/or a calcium sulfate barrier on bone healing in surgically created defects in rat tibias. MATERIAL AND METHODS Sixty-four rats were divided into 4 groups: C (control), CS (calcium sulfate), BG (bioactive glass), and BG/CS (bioactive glass/calcium sulfate). A surgical defect was created in the tibia of each animal. In Group CS, a calcium sulfate barrier was placed to cover the defect. In Group BG the defect was filled with bioactive glass. In Group BG/CS, it was filled with bioactive glass and protected by a barrier of calcium sulfate. Animals were sacrificed at 10 or 30 days post-operative. The formation of new bone in the cortical area of the defect was evaluated histomorphometrically. RESULTS At 10 days post-operative, Group C presented significantly more bone formation than Groups CS, BG, or BG/CS. No statistically significant differences were found between the experimental groups. At 30 days post-operative, Group C demonstrated significantly more bone formation than the experimental groups. Groups CS and BG/CS showed significantly more bone formation than Group BG. No statistically significant differences were found between Group CS and BG/CS. CONCLUSIONS (a) the control groups had significantly more bone formation than the experimental groups; (b) at 10 days post-operative, no significant differences were found between any of the experimental groups; and (c) at 30 days post-operative, the groups with a calcium sulfate barrier had significantly more bone formation than the group that used bioactive glass only.
Collapse
Affiliation(s)
- Luiz G N Melo
- Division of Periodontics, Department of Surgery and Integrated Clinic, Dental School of Araçatuba, University of State of São Paulo Júlio de Mesquita Filho-UNESP, Araçatuba, Brazil
| | | | | | | | | |
Collapse
|