1
|
Boller LA, Jones AA, Cochran DL, Guelcher SA. Compression-Resistant Polymer/Ceramic Composite Scaffolds Augmented with rhBMP-2 Promote New Bone Formation in a Nonhuman Primate Mandibular Ridge Augmentation Model. Int J Oral Maxillofac Implants 2020; 35:616-624. [PMID: 32406661 DOI: 10.11607/jomi.7877] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
PURPOSE This study was designed to test the hypothesis that compression-resistant (CR) scaffolds augmented with recombinant human bone morphogenetic protein-2 (rhBMP-2) at clinically relevant doses in a nonhuman primate lateral ridge augmentation model enhances bone formation in a dose-responsive manner without additional protective membranes. MATERIALS AND METHODS Defects (15 mm long × 8 mm wide × 5 mm deep) were created bilaterally in the mandibles of nine hamadryas baboons. The defect sites were implanted with poly(ester urethane) (PEUR)/ceramic CR scaffolds augmented with 0 mg/mL rhBMP-2 (CR control), 0.75 mg/mL rhBMP-2 (CR-L), or 1.5 mg/mL rhBMP-2 (CR-H). The primary outcome of ridge width and secondary outcomes of new bone formation, cellular infiltration, and integration with host bone were evaluated using histology, histomorphometry, and microcomputed tomography (micro-CT) at 16 weeks following implantation. RESULTS New bone formation in the mandible was observed in a dose-responsive manner. CR-H promoted significantly greater new bone formation compared with the CR control group. In all groups, ridge width was maintained without an additional protective membrane. CONCLUSION CR scaffolds augmented with a clinically relevant dose of rhBMP-2 (1.5 mg/mL) promoted significant new bone formation. These results suggest that a CR PEUR/ceramic composite scaffold without a protective membrane may be a potential new rhBMP-2 carrier for clinical use.
Collapse
|
2
|
Gelli R, Ridi F, Baglioni P. The importance of being amorphous: calcium and magnesium phosphates in the human body. Adv Colloid Interface Sci 2019; 269:219-235. [PMID: 31096075 DOI: 10.1016/j.cis.2019.04.011] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 11/25/2022]
Abstract
This article focuses on the relevance of amorphous calcium (and magnesium) phosphates in living organisms. Although crystalline calcium phosphate (CaP)-based materials are known to constitute the major inorganic constituents of human hard tissues, amorphous CaP-based structures, often in combination with magnesium, are frequently employed by Nature to build up components of our body and guarantee their proper functioning. After a brief description of amorphous calcium phosphate (ACP) formation mechanism and structure, this paper is focused on the stabilization strategies that can be used to enhance the lifetime of the poorly stable amorphous phase. The various locations of our body in which ACP (pure or in combination with Mg2+) can be found (i.e. bone, enamel, small intestine, calciprotein particles and casein micelles) are highlighted, showing how the amorphous nature of ACP is often of paramount importance for the achievement of a specific physiological function. The last section is devoted to ACP-based biomaterials, focusing on how these materials differ from their crystalline counterparts in terms of biological response.
Collapse
|
3
|
Donos N, Dereka X, Calciolari E. The use of bioactive factors to enhance bone regeneration: A narrative review. J Clin Periodontol 2019; 46 Suppl 21:124-161. [DOI: 10.1111/jcpe.13048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
| | - Xanthippi Dereka
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
| |
Collapse
|
4
|
Susin C, Lee J, Fiorini T, Freitas RM, Chiu H, Prasad HS, Buxton AN, Wikesjö UME. Sinus augmentation using rh
BMP
‐2/
ACS
in a mini‐pig model: Influence of an adjunctive ceramic bone biomaterial. J Clin Periodontol 2018; 45:1005-1013. [DOI: 10.1111/jcpe.12921] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 02/23/2018] [Accepted: 05/08/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Tiago Fiorini
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Rubens Moreno Freitas
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Hsien‐Chung Chiu
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Hari S. Prasad
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Amanda N. Buxton
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Ulf ME Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| |
Collapse
|
5
|
Thoma DS, Lim HC, Sapata VM, Yoon SR, Jung RE, Jung UW. Recombinant bone morphogenetic protein-2 and platelet-derived growth factor-BB for localized bone regeneration. Histologic and radiographic outcomes of a rabbit study. Clin Oral Implants Res 2017; 28:e236-e243. [DOI: 10.1111/clr.13002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Hyun-Chang Lim
- Department of Periodontology; School of Dentistry; Kyung Hee University; Seoul Korea
| | - Vitor M. Sapata
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Sora R. Yoon
- Department of Periodontology; Yonsei University; College of Dentistry; Seoul Korea
| | - Ronald E. Jung
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ui-Won Jung
- Department of Periodontology; Yonsei University; College of Dentistry; Seoul Korea
| |
Collapse
|
6
|
Lee JS, Jung GU, Pang EK. Effects of block bone substitutes loaded with Escherichia Coli-produced recombinant human bone morphogenetic protein-2 on space maintenance and bone formation in rat calvarial onlay model. Tissue Eng Regen Med 2016; 13:311-321. [PMID: 30603413 PMCID: PMC6170820 DOI: 10.1007/s13770-016-0011-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/05/2016] [Accepted: 04/08/2016] [Indexed: 12/01/2022] Open
Abstract
We aimed to evaluate the effects of onlay-type grafted human freeze-dried corticocancellous bone block (FDBB) and deproteinized bovine bone with collagen (DBBC) loaded with Escherichia coli-produced recombinant human bone morphogenetic protein-2 (ErhBMP-2) on space maintenance and new bone formation in rat calvaria. Collagen sponge (CS), FDBB, or DBBC disks (8×4 mm) with ErhBMP-2 (2.5 μg) were implanted onto the calvaria of male Sprague-Dawley rats, whereas CS with buffer was implanted onto the calvaria as controls (n=20/carrier). Rats were killed at 2 or 8 weeks post-surgery for histologic and histomorphometric analyses; total augmented area, new bone area, and bone density were evaluated. At both time-points, all ErhBMP-2 groups showed significantly higher new bone area and bone density than the control group (p<0.05). ErhBMP-2/FDBB and ErhBMP-2/DBBC groups showed significantly higher total augmented area than ErhBMP-2/CS group (8 weeks), and ErhBMP-2/FDBB group showed significantly higher new bone area and bone density than ErhBMP-2/DBBC group (p<0.05). ErhBMP-2/CS group showed the highest bone density (p<0.05). Combining ErhBMP-2 with FDBB or DBBC could significantly improve onlay graft outcomes, by new bone formation and bone density increase. Moreover, onlay-grafted FDBB and DBBC with ErhBMP-2 could be an alternative to autogenous block onlay bone graft.
Collapse
Affiliation(s)
- Jae-Sook Lee
- Department of Periodontology, School of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 09785 Korea
| | - Gyu-Un Jung
- Department of Periodontology, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| | - Eun-Kyoung Pang
- Department of Periodontology, School of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 09785 Korea
- Department of Periodontology, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| |
Collapse
|
7
|
Abstract
Forty years ago Marshal R. Urist discovered a substance in bone matrix that had inductive properties for the development of bone and cartilage, until date, at least 20 bone morphogenetic proteins (BMPs) have been identified, some of which have been shown in vitro to stimulate the process of stem cell differentiation into osteoblasts in human and animal models. The purpose of this paper is to give a brief overview of BMPs and to review critically the clinical data currently available on the use of BMPs in various periodontal applications. The literature on BMPs was reviewed. A comprehensive search was designed. The articles were independently screened for eligibility. Articles with authentic controls and proper randomization and pertaining specifically to their role in periodontal applications were included. The available literature was analyzed and compiled. The analysis indicates BMPs to be a promising, as well as an effective novel approach to reconstruct and engineer the periodontal apparatus. Here, we represent several articles, as well as recent texts that make up a special and an in-depth review on the subject. On the basis of the data provided in the studies that were reviewed BMPs provide revolutionary therapies in periodontal practice.
Collapse
Affiliation(s)
- Supreet Kaur
- Department of Periodontics, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, Punjab, India
| | - Vishakha Grover
- Department of Periodontics, National Dental College and Hospital, Dera Bassi, Punjab, India
| | - Harkiran Kaur
- Department of Periodontics, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, Punjab, India
| | - Ranjan Malhotra
- Department of Periodontics, National Dental College and Hospital, Dera Bassi, Punjab, India
| |
Collapse
|
8
|
Curry AS, Pensa NW, Barlow AM, Bellis SL. Taking cues from the extracellular matrix to design bone-mimetic regenerative scaffolds. Matrix Biol 2016; 52-54:397-412. [PMID: 26940231 DOI: 10.1016/j.matbio.2016.02.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 02/25/2016] [Accepted: 02/25/2016] [Indexed: 12/30/2022]
Abstract
There is an ongoing need for effective materials that can replace autologous bone grafts in the clinical treatment of bone injuries and deficiencies. In recent years, research efforts have shifted away from a focus on inert biomaterials to favor scaffolds that mimic the biochemistry and structure of the native bone extracellular matrix (ECM). The expectation is that such scaffolds will integrate with host tissue and actively promote osseous healing. To further enhance the osteoinductivity of bone graft substitutes, ECM-mimetic scaffolds are being engineered with a range of growth factors (GFs). The technologies used to generate GF-modified scaffolds are often inspired by natural processes that regulate the association between endogenous ECMs and GFs. The purpose of this review is to summarize research centered on the development of regenerative scaffolds that replicate the fundamental collagen-hydroxyapatite structure of native bone ECM, and the functionalization of these scaffolds with GFs that stimulate critical events in osteogenesis.
Collapse
Affiliation(s)
- Andrew S Curry
- Department of Biomedical Engineering, University of Alabama at Birmingham, 1918 University Boulevard, Birmingham, AL 35294, United States
| | - Nicholas W Pensa
- Department of Biomedical Engineering, University of Alabama at Birmingham, 1918 University Boulevard, Birmingham, AL 35294, United States
| | - Abby M Barlow
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, 1918 University Boulevard, Birmingham, AL 35294, United States
| | - Susan L Bellis
- Department of Biomedical Engineering, University of Alabama at Birmingham, 1918 University Boulevard, Birmingham, AL 35294, United States; Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, 1918 University Boulevard, Birmingham, AL 35294, United States.
| |
Collapse
|
9
|
Park JH, Jung YE, Kim MJ, Hwang SJ. Periimplant bone regeneration in hydroxyapatite block grafts with mesenchymal stem cells and bone morphogenetic protein-2. Tissue Eng Regen Med 2016; 13:437-445. [PMID: 30603425 DOI: 10.1007/s13770-015-0049-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 07/12/2015] [Accepted: 07/14/2015] [Indexed: 11/25/2022] Open
Abstract
Hydroxyapatite (HA) blocks as an alternative material for autogenous onlay bone grafts are regarded as an insufficient substitute for osseointegration of dental implant. In this study, we evaluated the effects of dog mesenchymal stromal cells (dMSCs) with or without bone morphogenetic protein-2 (BMP) on new peri-implant bone formation after HA block graft. In four mandibular bone defects (8×8×6 mm each) in five beagle dogs, dental implants were placed with HA block loaded with autogenous dMSCs with or without BMP-2. Animals were sacrificed at eight weeks, and bone healing was evaluated among four groups consisting of 1) HA alone as a control, 2) HA+dMSCs, 3) HA+BMP-2, and 4) HA+dMSCs+BMP-2. According to histomorphometric evaluation, the MSC+BMP-2 group and the BMP-2 group showed significantly higher bone-implant-contact (BIC) length than the MSC group, while there was no significant difference in new bone formation among the groups. According to micro-CT analysis, bone volume and bone mineral density were significantly higher in the MSC+BMP-2 group compared with the control group (p<0.01 and p<0.05, respectively). BIC was significantly higher in the MSC+BMP-2 group than both the control and MSC groups (p<0.01 and p<0.05, respectively). In conclusion, our results showed that bone regeneration at peri-implant bone defects grafted with HA blocks was significantly increased by dual delivery of MSCs and BMP-2. Conversely, HA blocks with MSC or BMP-2 alone did not allow for efficient peri-implant bone regeneration.
Collapse
Affiliation(s)
- Jee-Hyun Park
- 1Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
| | - Young-Eun Jung
- 1Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
| | - Myung-Jin Kim
- 1Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
- 3Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080 Korea
| | - Soon Jung Hwang
- 1Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
- 2Dental Research Institute, BK 21 Plus, Seoul National University, Seoul, Korea
- 3Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080 Korea
| |
Collapse
|
10
|
Hong JY, Kim MS, Lim HC, Lee JS, Choi SH, Jung UW. A high concentration of recombinant human bone morphogenetic protein-2 induces low-efficacy bone regeneration in sinus augmentation: a histomorphometric analysis in rabbits. Clin Oral Implants Res 2015; 27:e199-e205. [PMID: 25899917 DOI: 10.1111/clr.12603] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of the study was to elucidate the efficacy of bone regeneration at the early stage of healing in rabbit sinuses grafted with a biphasic calcium phosphate (BCP) carrier soaked in a high concentration of recombinant human bone morphogenetic protein-2 (rhBMP-2). MATERIALS AND METHODS Both maxillary sinuses of eight male rabbits were used. The sinus on one side (assigned randomly) was grafted with BCP loaded with rhBMP-2 (1.5 mg/ml; test group) using a soaking method, while the other was grafted with saline-soaked BCP (control group). After a 2-week healing period, the sinuses were analyzed by micro-computed tomography and histomorphometry. RESULTS The total augmented area and soft tissue space were significantly larger in the test group than in the control group, whereas the opposite was true for the area of residual material and newly formed bone. Most of the new bone in the test group was localized to the Schneiderian membrane (SM), while very little bone formation was observed in the window and center regions of the sinus. New bone was distributed evenly in the control group sinuses. CONCLUSION Within the limitations of this study, it appeared that application of a high concentration of rhBMP-2 soaked onto a BCP carrier inhibited bone regeneration from the pristine bone and increased soft tissue swelling and inflammatory response at the early healing stage of sinus augmentation, although osteoinductive potential was found along the SM.
Collapse
Affiliation(s)
- Ji-Youn Hong
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Min-Soo Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Hyun-Chang Lim
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| |
Collapse
|
11
|
Bone Regeneration Using Bone Morphogenetic Proteins and Various Biomaterial Carriers. MATERIALS 2015; 8:1778-1816. [PMID: 28788032 PMCID: PMC5507058 DOI: 10.3390/ma8041778] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/24/2015] [Accepted: 03/27/2015] [Indexed: 01/28/2023]
Abstract
Trauma and disease frequently result in fractures or critical sized bone defects and their management at times necessitates bone grafting. The process of bone healing or regeneration involves intricate network of molecules including bone morphogenetic proteins (BMPs). BMPs belong to a larger superfamily of proteins and are very promising and intensively studied for in the enhancement of bone healing. More than 20 types of BMPs have been identified but only a subset of BMPs can induce de novo bone formation. Many research groups have shown that BMPs can induce differentiation of mesenchymal stem cells and stem cells into osteogenic cells which are capable of producing bone. This review introduces BMPs and discusses current advances in preclinical and clinical application of utilizing various biomaterial carriers for local delivery of BMPs to enhance bone regeneration.
Collapse
|
12
|
Pilipchuk SP, Plonka AB, Monje A, Taut AD, Lanis A, Kang B, Giannobile WV. Tissue engineering for bone regeneration and osseointegration in the oral cavity. Dent Mater 2015; 31:317-38. [PMID: 25701146 DOI: 10.1016/j.dental.2015.01.006] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 12/19/2014] [Accepted: 01/11/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The focus of this review is to summarize recent advances on regenerative technologies (scaffolding matrices, cell/gene therapy and biologic drug delivery) to promote reconstruction of tooth and dental implant-associated bone defects. METHODS An overview of scaffolds developed for application in bone regeneration is presented with an emphasis on identifying the primary criteria required for optimized scaffold design for the purpose of regenerating physiologically functional osseous tissues. Growth factors and other biologics with clinical potential for osteogenesis are examined, with a comprehensive assessment of pre-clinical and clinical studies. Potential novel improvements to current matrix-based delivery platforms for increased control of growth factor spatiotemporal release kinetics are highlighting including recent advancements in stem cell and gene therapy. RESULTS An analysis of existing scaffold materials, their strategic design for tissue regeneration, and use of growth factors for improved bone formation in oral regenerative therapies results in the identification of current limitations and required improvements to continue moving the field of bone tissue engineering forward into the clinical arena. SIGNIFICANCE Development of optimized scaffolding matrices for the predictable regeneration of structurally and physiologically functional osseous tissues is still an elusive goal. The introduction of growth factor biologics and cells has the potential to improve the biomimetic properties and regenerative potential of scaffold-based delivery platforms for next-generation patient-specific treatments with greater clinical outcome predictability.
Collapse
Affiliation(s)
- Sophia P Pilipchuk
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, 1101 Beal Avenue, Ann Arbor, MI 48109, USA.
| | - Alexandra B Plonka
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA.
| | - Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA.
| | - Andrei D Taut
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA.
| | - Alejandro Lanis
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA.
| | - Benjamin Kang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA.
| | - William V Giannobile
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, 1011 N. University Avenue, Ann Arbor, MI 48109, USA; Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, 1101 Beal Avenue, Ann Arbor, MI 48109, USA.
| |
Collapse
|
13
|
Lee EU, Lim HC, Hong JY, Lee JS, Jung UW, Choi SH. Bone regenerative efficacy of biphasic calcium phosphate collagen composite as a carrier of rhBMP-2. Clin Oral Implants Res 2015; 27:e91-e99. [PMID: 25675839 DOI: 10.1111/clr.12568] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This study compared the bone regenerative effects of a recombinant human bone morphogenetic protein 2 (rhBMP-2)-loaded collagen-based biphasic calcium phosphate composite (BCPC) and rhBMP-2-loaded biphasic calcium phosphate (BCP). MATERIAL AND METHODS The in vitro release profiles of rhBMP-2-loaded BCP and BCPC were measured. The animal surgery was performed on ten rabbits. Four 8-mm-diameter circular calvarial defects were made and filled with BCP, BCPC, rhBMP-2-loaded BCP (BMP + BCP) and rhBMP-2-loaded BCPC (BMP + BCPC). The animals were euthanized either 2 or 8 weeks after surgery. RESULTS The initial burst release of rhBMP-2 was greater for BCP than for BCPC, and both presented a slow release pattern thereafter. In rabbit calvarial defects, the space maintaining capability and graft resorption of all experimental groups did not show statistical differences at 2 and 8 weeks. New bone formation in the rhBMP-2-loaded groups was greater than in the non-loaded groups at both weeks, but the amount of new bone was comparable between both rhBMP-2-loaded groups at both weeks. There was a distinct histologic difference between the BMP + BCP and BMP + BCPC groups at 2 weeks; the new bone formation occurred more in the intergranular spaces and the BCP-to-bone contact was greater in the BMP + BCPC group, but these differences were no longer discernible at 8 weeks. CONCLUSIONS BCP- and BCPC-loaded rhBMP-2 significantly improved bone regeneration and BCPC led to a dense network of new bone and bone particles during the early healing period. BCPC can therefore be considered as a promising candidate for carrying rhBMP-2.
Collapse
Affiliation(s)
- Eun-Ung Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ji-Youn Hong
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea.
| |
Collapse
|
14
|
Casap N, Laviv A, Debecco M, Alterman M, Laster Z, Jensen OT. Imperforate Titanium Shell Enclosing Recombinant Human Bone Morphogenetic Protein-2–Induced Bone Formation for High-Profile Dental Implants in Rabbit Tibia. J Oral Maxillofac Surg 2015; 73:245-52. [DOI: 10.1016/j.joms.2014.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 10/06/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
|
15
|
Yun PY, Kim YK, Jeong KI, Park JC, Choi YJ. Influence of bone morphogenetic protein and proportion of hydroxyapatite on new bone formation in biphasic calcium phosphate graft: Two pilot studies in animal bony defect model. J Craniomaxillofac Surg 2014; 42:1909-17. [DOI: 10.1016/j.jcms.2014.07.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 07/26/2014] [Accepted: 07/28/2014] [Indexed: 11/30/2022] Open
|
16
|
Choi Y, Lee JS, Kim YJ, Kim MS, Choi SH, Cho KS, Jung UW. Recombinant human bone morphogenetic protein-2 stimulates the osteogenic potential of the Schneiderian membrane: a histometric analysis in rabbits. Tissue Eng Part A 2013; 19:1994-2004. [PMID: 23544996 DOI: 10.1089/ten.tea.2012.0724] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study evaluated the osteoinductive effect of the recombinant human bone morphogenetic protein-2 (rhBMP-2)-coated biphasic calcium phosphate (BCP) carrier system on the grafted sinus area, including surrounding tissues and the Schneiderian membrane. A total of 18 male rabbits were used in this study; two for in vitro and 16 for in vivo experiments. Schneiderian membranes taken from two animals were cultured with or without rhBMP-2, and quantitative reverse transcriptase-polymerase chain reaction analysis was performed. Both maxillary sinuses in each of the 16 animals were used to compare the in vivo effects of rhBMP-2-coated BCP (experimental group) and BCP alone (control group). In each animal, rhBMP-2-coated BCP was grafted into one of the maxillary sinuses, and the same amount of BCP alone was grafted into the contralateral site in random order. Radiologic and histometric analyses were performed at 2 and 8 weeks after surgery. After 2 days of culturing with or without rhBMP-2, a significant increase in the expression of early osteoblasts (RUNX2, type I collagen, alkaline phosphatase, and osteopontin) could be observed. Different histologic healing patterns were observed in experimental and control sites: newly formed bone lining the reflected sinus membrane without bone formation was observed at the central areas of experimental sites (window=0.06%; center=0%; membrane=20.86% of new bone), whereas evenly distributed new bone formation was observed at the control sites (window=7.27%; center=7.41%; membrane=15.58% of new bone).The augmented volume was well maintained at both the experimental and control sites during the experimental period, but at 2 weeks, the augmented volume was greater at the experimental sites than at the control sites (232.62 and 195.29 mm(3), respectively; p<0.001). These results suggest that good space maintenance in sinus augmentation is achieved with BCP, while the osteoinductive potential of the sinus membrane is activated at the early stage of healing with rhBMP-2.
Collapse
Affiliation(s)
- Youna Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | | | | | | | | | | | | |
Collapse
|
17
|
Simon D, Manuel S, Varma H. Novel nanoporous bioceramic spheres for drug delivery application: a preliminary in vitro investigation. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:e7-14. [DOI: 10.1016/j.oooo.2011.10.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 10/16/2011] [Accepted: 10/31/2011] [Indexed: 11/29/2022]
|
18
|
Khojasteh A, Behnia H, Naghdi N, Esmaeelinejad M, Alikhassy Z, Stevens M. Effects of different growth factors and carriers on bone regeneration: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 116:e405-23. [PMID: 22901644 DOI: 10.1016/j.oooo.2012.01.044] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 08/26/2011] [Accepted: 01/10/2012] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The application and subsequent investigations in the use of varied osteogenic growth factors in bone regeneration procedures have grown dramatically over the past several years. Owing to this rapid gain in popularity and documentation, a review was undertaken to evaluate the in vivo effects of growth factors on bone regeneration. STUDY DESIGN Using related key words, electronic databases (Medline, Embase, and Cochrane) were searched for articles published from 1999 to April 2010 to find growth factor application in bone regeneration in human or animal models. RESULTS A total of 63 articles were matched with the inclusion criteria of this study. Bone morphogenetic protein 2 (BMP-2) was the most studied growth factor. Carriers for the delivery, experimental sites, and methods of evaluation were different, and therefore articles did not come to a general agreement. CONCLUSIONS Within the limitations of this review, BMP-2 may be an appropriate growth factor for osteogenesis.
Collapse
Affiliation(s)
- Arash Khojasteh
- Assistant Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Head, Division of Basic Sciences, Dental Research Center, Tehran, Iran.
| | | | | | | | | | | |
Collapse
|
19
|
Kim JW, Jung IH, Jeong IH, Lee KI, Jung UW, Kim CS, Choi SH, Cho KS, Yun JH. Volumetric bone regenerative efficacy of biphasic calcium phosphate-collagen composite block loaded with rhBMP-2 in vertical bone augmentation model of a rabbit calvarium. J Biomed Mater Res A 2012; 100:3304-13. [PMID: 22733619 DOI: 10.1002/jbm.a.34278] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 03/18/2012] [Accepted: 05/15/2012] [Indexed: 11/07/2022]
Abstract
Block-type biphasic calcium phosphate (BCP) carriers are more effective at delivering recombinant human bone morphogenetic protein-2 (rhBMP-2) in various clinical situations than are particle-type carriers, due to their potential for highly successful three-dimensional bone regeneration. The aim of this study was to confirm the bone-regenerative capabilities of three-dimensional BCP blocks with a low hydroxyapatite/β-tricalcium phosphate ratio (20/80) combined with collagen (10% wt) as an rhBMP-2 delivery system in a craniofacial vertical bone augmentation model. BCP blocks and BCP-collagen blocks (with average macropore sizes of 296 and 390 μm, respectively) with or without rhBMP-2 were fixed with osteosynthesis screws to the calvarial surface of rabbits. After 8 weeks, histologic and histomorphometric analyses were performed to evaluate the resulting new bone area, augmented area, bone density, and degree of integration. The area of new bone was significantly greater in specimens containing rhBMP-2 than in the control group (p < 0.05). Moreover, the area fractions of newly formed bone within the augmented area and a degree of integration between the regenerative bone and the calvarium were both significantly greater in the BCP-collagen/rhBMP-2 group than in the BCP/rhBMP-2 group (p < 0.05), whereas the two carrier systems exhibited similar rhBMP-2 release profiles, with sustained and linear release. The BCP and BCP/rhBMP-2 blocks exhibited excellent structural integrity, with large fragments of residual ceramic. In conclusion, the BCP-collagen composite block exhibited enhanced osteoinductive potential and could be a good candidate as a carrier of rhBMP-2 due to its characteristics of favorable volumetric stability, ease of handling, and excellent remodeling properties.
Collapse
Affiliation(s)
- Jin-Woo Kim
- Department of Periodontology, College of Dentistry, Yonsei University, Research Institute for Periodontal Regeneration, Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Polo CI, Lima JLO, De Lucca L, Piacezzi CB, Naclério-Homem MDG, Arana-Chavez VE, Sendyk WR. Effect of recombinant human bone morphogenetic protein 2 associated with a variety of bone substitutes on vertical guided bone regeneration in rabbit calvarium. J Periodontol 2012; 84:360-70. [PMID: 22524330 DOI: 10.1902/jop.2012.110674] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND A major challenge for dental implantology is to consistently obtain appropriate bone augmentation before implant placement. The aim of this study is to evaluate the effect of recombinant human bone morphogenetic protein 2 (rhBMP-2) associated with bone substitute materials beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), and bovine bone mineral on vertical guided bone regeneration (GBR) in rabbit calvarium. METHODS Four titanium cylinders were fixed to the calvarium of 22 rabbits. In group 1 (n = 10), three cylinders were randomly filled with one of the test materials, and one cylinder was filled with a blood clot (CL). In group 2 (n = 12), the cylinders were randomly assigned to the same materials and CL but with the addition of rhBMP-2. Bone labels were injected over the course of 13 weeks, and euthanasia was performed 14 weeks after surgery in both groups. RESULTS The mean volume and area of tissue growth was greater in group 2 (with rhBMP-2) than in group 1 (without rhBMP-2), irrespective of the material used (P <0.001). The mean volume of tissue growth in the CL cylinder was smaller than that observed with all other materials (P <0.001) in both groups. The mean area of regenerated bone in the CL cylinder was smaller than that observed in the β-TCP cylinder (P = 0.028). The histologic study revealed more lamellar bone in the rhBMP-2 group, with a greater level of biodegradation of all the bone substitute materials tested. CONCLUSION The use of rhBMP-2/absorbable collagen sponge (ACS) combined with all of the bone substitute materials tested resulted in a greater amount of bone formation than that produced with the bone substitute materials alone or rhBMP-2/(ACS) and CL using the rabbit calvarium GBR model.
Collapse
Affiliation(s)
- Cristiane Ibanhes Polo
- Department of Oral and Maxillofacial Surgery and Traumatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
| | | | | | | | | | | | | |
Collapse
|
21
|
Wehrhan F, Amann K, Molenberg A, Lutz R, Neukam FW, Schlegel KA. PEG matrix enables cell-mediated local BMP-2 gene delivery and increased bone formation in a porcine critical size defect model of craniofacial bone regeneration. Clin Oral Implants Res 2011; 23:805-13. [PMID: 22151397 DOI: 10.1111/j.1600-0501.2011.02223.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2011] [Indexed: 01/19/2023]
Abstract
PURPOSE This study addressed the suitability of a polyethylene glycol (PEG) matrix as scaffold for cell-mediated local BMP-2 gene transfer in a calvarial critical size defect (CSD) model. MATERIALS AND METHODS PEG matrix (degradation time 10 days) and PEG membrane (degradation time 120 days) were used in the pig calvarial model. Cylindrical (1 × 1 cm) CSD (9 per animal; 20 animals) were filled with: (i) HA/TCP, covered by PEG membrane (group 1); (ii) HA/TCP, mixed with PEG matrix (group 2); and (iii) HA/TCP mixed with BMP-2 transfected osteoblasts and PEG matrix (group 3). BMP-2/4 gene transfer: liposomal in vitro transfection of BMP-2/V5-tag fusion-protein. Quantitative histomorphometry (toluidine blue staining) after 2, 4 and 12 weeks assessed bone formation. Semiquantitative immunohistochemistry estimated the expression of BMP-2 and V5-tag. RESULTS Group 3 showed significantly higher new bone formation than groups 1, 2 at 4 (P < 0.05) and 12 (P < 0.02) weeks. BMP-2-V5-tag was detected for 4 weeks. BMP-2 expression in group 3 was higher compared to all other groups after 2 and 4 (P < 0.02) weeks. CONCLUSIONS The PEG matrix serves as scaffold for cell-mediated BMP-2 gene delivery in guided bone regeneration facilitating cell survival and protein synthesis for at least 4 weeks. Local BMP-2 gene delivery by PEG matrix-embedded cells leads to increased bone formation during critical size defect regeneration.
Collapse
Affiliation(s)
- Falk Wehrhan
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
| | | | | | | | | | | |
Collapse
|
22
|
Freilich M, Wen B, Shafer D, Schleier P, Dard M, Pendrys D, Ortiz D, Kuhn L. Implant-guided vertical bone growth in the mini-pig. Clin Oral Implants Res 2011; 23:751-757. [DOI: 10.1111/j.1600-0501.2011.02199.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
23
|
Wen B, Karl M, Pendrys D, Shafer D, Freilich M, Kuhn L. An evaluation of BMP-2 delivery from scaffolds with miniaturized dental implants in a novel rat mandible model. J Biomed Mater Res B Appl Biomater 2011; 97:315-26. [DOI: 10.1002/jbm.b.31817] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Revised: 11/14/2010] [Accepted: 12/10/2010] [Indexed: 11/11/2022]
|
24
|
Kim JW, Choi KH, Yun JH, Jung UW, Kim CS, Choi SH, Cho KS. Bone formation of block and particulated biphasic calcium phosphate lyophilized with Escherichia coli-derived recombinant human bone morphogenetic protein 2 in rat calvarial defects. ACTA ACUST UNITED AC 2011; 112:298-306. [PMID: 21292513 DOI: 10.1016/j.tripleo.2010.10.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 10/14/2010] [Indexed: 11/28/2022]
Abstract
The objective of this study was to evaluate bone formation in rat calvarial defects after surgical implantation of block or particulated biphasic calcium phosphate (BCP) lyophilized with Escherichia coli-derived recombinant human bone morphogenetic protein 2 (ErhBMP-2). Critical-size calvarial osteotomy defects were created in 5 groups of Sprague-Dawley rats. Each group received one of the following: 1) sham surgery control; 2) biphasic calcium phosphate particles (CPP); 3) biphasic calcium phosphate block (CPB); 4) ErhBMP-2-coated CPP; or 5) ErhBMP-2-coated CPB. ErhBMP was coated on BCP by a stepwise lyophilizing protocol. The new bone formation was significantly greater in ErhBMP-2-treated groups compared with the untreated group. In particular, the ErhBMP-2/CPB group showed stability of augmented areas during the period of healing, due to relevant space-providing capacity. Thus, it can be concluded that CPP and CPB lyophilized with ErhBMP-2 enhance the formation of new bone, and CPB appears to be a suitable carrier for ErhBMP-2 in which a 3-dimensional structural integrity is an important consideration factor.
Collapse
Affiliation(s)
- Jin-Woo Kim
- Research Institute for Periodontal Regeneration, Department of Periodontology, College of Dentistry, Yonsei University, Seodaemun-gu, Seoul, South Korea
| | | | | | | | | | | | | |
Collapse
|
25
|
Combes C, Rey C. Amorphous calcium phosphates: synthesis, properties and uses in biomaterials. Acta Biomater 2010; 6:3362-78. [PMID: 20167295 DOI: 10.1016/j.actbio.2010.02.017] [Citation(s) in RCA: 340] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 02/07/2010] [Accepted: 02/10/2010] [Indexed: 10/19/2022]
Abstract
This review paper on amorphous calcium phosphates (ACPs) provides an update on several aspects of these compounds which have led to many studies and some controversy since the 1970s, particularly because of the lack of irrefutable proof of the occurrence of an ACP phase in mineralised tissues of vertebrates. The various synthesis routes of ACPs with different compositions are reported and the techniques used to characterise this phase are reviewed. We focus on the various physico-chemical properties of ACPs, especially the reactivity in aqueous media, which have been exploited to prepare bioactive bone substitutes, particularly in the form of coatings and cements for orthopaedic applications and composites for dental applications.
Collapse
|
26
|
Recombinant human bone morphogenetic protein-2 (rhBMP-2) in the treatment of mandibular sequelae after tumor resection. Oral Maxillofac Surg 2010; 15:169-74. [PMID: 20571845 DOI: 10.1007/s10006-010-0236-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Accepted: 06/01/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Ameloblastoma is a locally aggressive tumor most often found in posterior body and angle of the mandible. Although ameloblastoma has histological characteristics of benignity, they have a high percentage of local recurrence and possible malignant development if treated improperly. CASE REPORT This report presents a treatment of unusual mandibular sequelae after tumor resection using recombinant human bone morphogenetic protein-2 (rhBMP-2) associated with hydroxyapatite (HA) and calcium triphosphate (TCP). DISCUSSION Seven months after surgery, the patient was asymptomatic, with stable occlusion and class I, without signs of infection or rejection, and bone repair with rigidity compatible to an immature bone structure was observed. Reconstruction of large mandibular bone defect with a combination of rhBMP-2 and HA/TCP achieving a satisfactory result with less invasive and minimum morbidity has been demonstrated.
Collapse
|
27
|
Chen FM, Jin Y. Periodontal tissue engineering and regeneration: current approaches and expanding opportunities. TISSUE ENGINEERING PART B-REVIEWS 2010; 16:219-55. [PMID: 19860551 DOI: 10.1089/ten.teb.2009.0562] [Citation(s) in RCA: 212] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The management of periodontal tissue defects that result from periodontitis represents a medical and socioeconomic challenge. Concerted efforts have been and still are being made to accelerate and augment periodontal tissue and bone regeneration, including a range of regenerative surgical procedures, the development of a variety of grafting materials, and the use of recombinant growth factors. More recently, tissue-engineering strategies, including new cell- and/or matrix-based dimensions, are also being developed, analyzed, and employed for periodontal regenerative therapies. Tissue engineering in periodontology applies the principles of engineering and life sciences toward the development of biological techniques that can restore lost alveolar bone, periodontal ligament, and root cementum. It is based on an understanding of the role of periodontal formation and aims to grow new functional tissues rather than to build new replacements of periodontium. Although tissue engineering has merged to create more opportunities for predictable and optimal periodontal tissue regeneration, the technique and design for preclinical and clinical studies remain in their early stages. To date, the reconstruction of small- to moderate-sized periodontal bone defects using engineered cell-scaffold constructs is technically feasible, and some of the currently developed concepts may represent alternatives for certain ideal clinical scenarios. However, the predictable reconstruction of the normal structure and functionality of a tooth-supporting apparatus remains challenging. This review summarizes current regenerative procedures for periodontal healing and regeneration and explores their progress and difficulties in clinical practice, with particular emphasis placed upon current challenges and future possibilities associated with tissue-engineering strategies in periodontal regenerative medicine.
Collapse
Affiliation(s)
- Fa-Ming Chen
- Department of Periodontology and Oral Medicine, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, P.R. China
| | | |
Collapse
|
28
|
Sohier J, Daculsi G, Sourice S, de Groot K, Layrolle P. Porous beta tricalcium phosphate scaffolds used as a BMP-2 delivery system for bone tissue engineering. J Biomed Mater Res A 2010; 92:1105-14. [PMID: 19301273 DOI: 10.1002/jbm.a.32467] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Macroporous beta tricalcium phosphate (beta-TCP) scaffolds were evaluated as potential carriers and delivery systems for bone morphogenetic protein-2 (BMP-2). Chemical etching was performed to increase the available surface and thus the protein loading. X-ray diffraction and infrared spectrocopy analyses confirmed the preparation of pure beta-TCP scaffolds. Scanning electron microscopy revealed interconnected porosity (64%) and a microporous surface after chemical etching. Scaffolds loaded with 30 and 15 microg of BMP-2 were implanted respectively into the back muscles and into femoral defects (condyle and diaphysis) of rabbits for 4 weeks. Histological observations confirmed the activity of the BMP-2 released from the scaffolds. Intramuscularly, bone was formed within the BMP-2-loaded scaffold pores. In the bone defects, the effect of released BMP-2 was similarly noticeable, as evaluated by histomorphometry. The incorporation of BMP-2 resulted in an amount of newly formed bone that was 1.3 times higher than with unloaded scaffolds. The implant site, however, did not have an effect on bone formation as no statistical differences were measured between cortical (diaphysis) and trabecular (condyle) defects. These results indicate the suitability of chemically etched beta-TCP scaffolds as BMP-2 carriers, in the context of bone regeneration.
Collapse
Affiliation(s)
- Jérôme Sohier
- Inserm, U791, Laboratory for Osteo-Articular and Dental Tissue Engineering, Faculty of Dental Surgery, University of Nantes, Nantes, France
| | | | | | | | | |
Collapse
|
29
|
The effect of growth factors for bone augmentation to enable dental implant placement: A systematic review. JAPANESE DENTAL SCIENCE REVIEW 2010. [DOI: 10.1016/j.jdsr.2009.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
30
|
Jung RE, Thoma DS, Hammerle CHF. Assessment of the potential of growth factors for localized alveolar ridge augmentation: a systematic review. J Clin Periodontol 2009; 35:255-81. [PMID: 18724854 DOI: 10.1111/j.1600-051x.2008.01270.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To systematically assess the literature regarding the clinical, histological, and radiographic outcome of bone morphogenetic proteins (BMP-2, BMP-7), growth/differentiation factor-5 (GDF-5), platelet-derived growth factor (PDGF), and parathyroid hormone (PTH) for localized alveolar ridge augmentation. MATERIAL AND METHODS Five separate Medline searches were performed in duplicate for human and animal studies, respectively. The primary outcome of the included studies was bone regeneration of localized alveolar ridge defects or craniofacial defects. RESULTS In six human studies, BMP-2 affected local bone augmentation with increasing volume for higher doses. A majority (43 of 45) of animal studies using BMP-2 showed a positive effect in favour of the growth factor (GF). In six of eight studies, a positive effect was associated with the use of BMP-7. Only one animal study was included for GDF-5 revealing statistically significantly higher bone volume. Regarding PDGF, statistically significantly higher bone volume was observed in five of 10 included studies. Four animal studies using PTH revealed statistically significantly more bone regeneration compared with controls. CONCLUSIONS Differing levels and quantity of evidence were noted to be available for the GFs evaluated, revealing that BMP-2, BMP-7, GDF-5, PDGF, and PTH may stimulate local bone augmentation to various degrees. Human data for the potential of rhBMP-2 are supportive.
Collapse
Affiliation(s)
- Ronald E Jung
- Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zurich, Zurich, Switzerland.
| | | | | |
Collapse
|
31
|
Huang YH, Polimeni G, Qahash M, Wikesjö UME. Bone morphogenetic proteins and osseointegration: current knowledge – future possibilities. Periodontol 2000 2008; 47:206-23. [DOI: 10.1111/j.1600-0757.2007.00240.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
32
|
Reduced morbidity and improved healing with bone morphogenic protein-2 in older patients with alveolar cleft defects. Plast Reconstr Surg 2008; 121:209-217. [PMID: 18176223 DOI: 10.1097/01.prs.0000293870.64781.12] [Citation(s) in RCA: 150] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In older cleft patients, alveolar bone grafting may be associated with poor wound healing, graft exposure, recurrent fistula, and failure of tooth eruption. A new procedure using a resorbable collagen matrix with bone morphogenetic protein (BMP)-2 was compared with traditional iliac crest bone graft to close alveolar defects in older patients. METHODS Skeletally mature patients with an alveolar cleft defect undergoing alveolar cleft repair were divided into either group 1 (BMP-2, experimental) or group 2 (traditional iliac graft, control) (n = 21). Bone healing was assessed with intraoral examination and NewTom scans (three-dimensional, Panorex, periapical films). Donor-site morbidity was determined with pain surveys. Overall cost and length of hospital stay were used to examine economic differences. RESULTS Preoperative and follow-up (1 year) intraoral examinations revealed fewer complications (11 percent versus 50 percent) and better estimated bone graft take in group 1 compared with group 2. Panorex and three-dimensional computed tomographic scans showed enhanced mineralization in group 1 compared with group 2. Volumetric analysis showed group 1 had a larger percentage alveolar defect filled with new bone (95 percent) compared with group 2 (63 percent). Donor-site pain intensity and frequency were significant in group 2 but not group 1. The mean length of stay was greater for group 2 compared with group 1. In addition, the mean overall cost of the procedure was greater in group 2 ($21,800) compared with group 1 ($11,100). CONCLUSIONS For this select group of late-presenting alveolar cleft patients, the BMP-2 procedure resulted in improved bone healing and reduced morbidity compared with traditional iliac bone grafting.
Collapse
|
33
|
Jung RE, Weber FE, Thoma DS, Ehrbar M, Cochran DL, Hämmerle CHF. Bone morphogenetic protein-2 enhances bone formation when delivered by a synthetic matrix containing hydroxyapatite/tricalciumphosphate. Clin Oral Implants Res 2008; 19:188-95. [DOI: 10.1111/j.1600-0501.2007.01431.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
34
|
Bessa PC, Casal M, Reis RL. Bone morphogenetic proteins in tissue engineering: the road from laboratory to clinic, part II (BMP delivery). J Tissue Eng Regen Med 2008; 2:81-96. [DOI: 10.1002/term.74] [Citation(s) in RCA: 417] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
35
|
Bone Morphogenetic Proteins: A Realistic Alternative to Bone Grafting for Alveolar Reconstruction. Oral Maxillofac Surg Clin North Am 2007; 19:535-51, vi-vii. [DOI: 10.1016/j.coms.2007.07.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
36
|
Chen FM, Zhao YM, Zhang R, Jin F, Wu ZF, Jin Y. Novel composite nanoparticles based on glycidyl methacrylate-derivatized dextrans and gelatin as new bone morphogenetic protein carrier. J Biomed Mater Res A 2007. [DOI: 10.1002/jbm.a.31252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
37
|
Wikesjö UME, Susin C, Qahash M, Polimeni G, Leknes KN, Shanaman RH, Prasad HS, Rohrer MD, Hall J. The critical-size supraalveolar peri-implant defect model: characteristics and use. J Clin Periodontol 2006; 33:846-54. [PMID: 16965525 DOI: 10.1111/j.1600-051x.2006.00985.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Novel implant technologies and reconstructive therapies for alveolar augmentation require pre-clinical evaluation to estimate their biologic potential, efficacy, and safety before clinical application. The objective of this report is to present characteristics and use of the critical-size, supraalveolar, peri-implant defect model. METHODS Bilateral extraction of the mandibular premolars was performed in 12 Hound Labrador mongrel dogs following horizontal surgical cut-down of the alveolar ridge approximating 6 mm. Each jaw quadrant received three custom-produced TiUnite, phi 4.0 x 10 mm threaded implants placed into osteotomies prepared into the extraction sites of the third and fourth premolars. The implants exhibited a reference notch 5 mm from the implant platform to facilitate surgical placement leaving 5 mm of the implant in a supraalveolar position, and to serve as a reference point in the radiographic, histologic and histometric analysis. The implants were submerged under the mucoperiosteal flaps for primary intention healing. Fluorescent bone markers were administered at weeks 3 and 4 post-surgery, and pre-euthanasia. The animals were euthanized following an 8-week healing interval when block biopsies were collected for analysis. RESULTS Healing was generally uneventful. The radiographic and histometric evaluations demonstrate the limited osteogenic potential of this defect model. Whereas lingual peri-implant sites exhibited a mean (+/-SE) bone gain of 0.4+/-0.1 mm, resorption of the buccal crestal plate resulted in a mean bone loss of 0.4+/-0.2 mm for an overall osteogenic potential following sham-surgery averaging 0.0+/-0.1 mm. Overall bone density and bone-implant contact in the contiguous resident bone averaged 79.1+/-1.1% and 76.9+/-2.3%, respectively. CONCLUSION The results suggest that the critical-size, supraalveolar, peri-implant defect model appears a rigorous tool in the evaluation of candidate technologies for alveolar reconstruction and osseointegration of endosseous oral implants. Limited innate osteogenic potential allows critical evaluation of osteogenic, osteoconductive, or osteoinductive technologies in a challenging clinical setting.
Collapse
Affiliation(s)
- Ulf M E Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Medical College of Georgia School of Dentistry - Periodontics/Oral Biology & Maxillofacial Pathology, Augusta, GA 30912, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|