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Ciszyński M, Dominiak S, Dominiak M, Gedrange T, Hadzik J. Allogenic Bone Graft in Dentistry: A Review of Current Trends and Developments. Int J Mol Sci 2023; 24:16598. [PMID: 38068918 PMCID: PMC10706024 DOI: 10.3390/ijms242316598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
In an effort to prepare non-autologous bone graft or biomaterial that would possess characteristics comparable to autologous bone, many different allogenic bone derivatives have been created. Although different existing processing methods aim to achieve the very same results, the specific parameters applied during different stages material preparation can result in significant differences in the material's mechanical and biological properties The properties, including osteoconductive, osteoinductive, and even osteogenic potential, can differ vastly depending on particular preparation and storage techniques used. Osteogenic properties, which have long been thought to be characteristic to autogenic bone grafts only, now seem to also be achievable in allogenic materials due to the possibility to seed the host's stem cells on a graft before its implantation. In this article, we aim to review the available literature on allogenic bone and its derivatives as well as the influence of different preparation methods on its performance.
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Affiliation(s)
| | | | | | | | - Jakub Hadzik
- Department of Dental Surgery, Faculty of Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
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Autogenous Tooth Bone Grafts for Repair and Regeneration of Maxillofacial Defects: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063690. [PMID: 35329377 PMCID: PMC8955500 DOI: 10.3390/ijerph19063690] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/16/2022]
Abstract
Autogenous tooth graft is an innovative and ingenious technique that employs a stepwise approach and utilizes human teeth as an autogenous source of bone graft. The structure of teeth closely resembles bone, both physically and biochemically, and can be efficiently used for the process as it depicts properties of osteoinduction and osteoconduction. Autogenous tooth bone has characteristics similar to bone grafts in terms of healing potential, physical properties, and clinical outcome. Autogenous tooth graft has shown reasonable promise as a graft material for the regeneration of maxillary and mandibular defects. Autogenous tooth bone graft finds its principal application in sinus and ridge augmentations and for socket preservation before implant placement. Additionally, it can be used successfully for alveolar cleft patients and patients with limited periodontal defects. The overall complication rates reported for autogenous tooth grafts are comparable to other graft sources. However, although long-term results are still underway, it is still recommended as a grafting option for limited defects in the cranio-facial region.
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Cohen DJ, Ferrara L, Stone MB, Schwartz Z, Boyan BD. Cell and Tissue Response to Polyethylene Terephthalate Mesh Containing Bone Allograft in Vitro and in Vivo. Int J Spine Surg 2020; 14:S121-S132. [PMID: 33122180 PMCID: PMC7735465 DOI: 10.14444/7135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Extended polyethylene terephthalate mesh (PET, Dacron) can provide containment of compressed particulate allograft and autograft. This study assessed if PET mesh would interfere with osteoprogenitor cell migration from vertebral plates through particulate graft, and its effect on osteoblast differentiation or the quality of bone forming within fusing vertebra during vertebral interbody fusion. METHODS The impact of PET mesh on the biological response of normal human osteoblasts (NHOst cells) and bone marrow stromal cells (MSCs) to particulate bone graft was examined in vitro. Cells were cultured on rat bone particles +/- mesh; proliferation and osteoblast differentiation were assessed. The interface between the vertebral endplate, PET mesh, and newly formed bone within consolidated allograft contained by mesh was examined in a sheep model via microradiographs, histology, and mechanical testing. RESULTS Growth on bone particles stimulated proliferation and early differentiation of NHOst cells and MSCs, but delayed terminal differentiation. This was not negatively impacted by mesh. New bone formation in vivo was not prevented by use of a PET mesh graft containment device. Fusion was improved in sites containing allograft/demineralized bone matrix (DBM) versus autograft and was further enhanced when stabilized using pedicle screws. Only sites treated with allograft/DBM+screws exhibited greater percent bone ingrowth versus discectomy or autograft. These results were mirrored biomechanically. CONCLUSIONS PET mesh does not negatively impact cell attachment to particulate bone graft, proliferation, or initial osteoblast differentiation. The results demonstrated that bone growth occurs from vertebral endplates into graft material within the PET mesh. This was enhanced by stabilization with pedicle screws leading to greater bone ingrowth and biomechanical stability across the fusion site. CLINICAL RELEVANCE The use of extended PET mesh allows containment of bone graft material during vertebral interbody fusion without inhibiting migration of osteoprogenitor cells from vertebral end plates in order to achieve fusion. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- D Joshua Cohen
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Lisa Ferrara
- OrthoKinetic Technologies, Southport, North Carolina
| | | | - Zvi Schwartz
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia
- Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Barbara D Boyan
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia
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Ramis JM, Blasco‐Ferrer M, Calvo J, Villa O, Cladera MM, Corbillo C, Gayà A, Monjo M. Improved physical and osteoinductive properties of demineralized bone matrix by gelatin methacryloyl formulation. J Tissue Eng Regen Med 2020; 14:475-485. [DOI: 10.1002/term.3012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/20/2019] [Accepted: 01/05/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Joana M. Ramis
- Group of Cell Therapy and Tissue Engineering, Research Institute on Health Sciences (IUNICS)University of the Balearic Islands Palma Spain
- Health Research Institute of the Balearic Islands (IdISBa) Palma Spain
- Department of Fundamental Biology and Health SciencesUniversity of the Balearic Islands Palma Spain
| | - Marc Blasco‐Ferrer
- Group of Cell Therapy and Tissue Engineering, Research Institute on Health Sciences (IUNICS)University of the Balearic Islands Palma Spain
- Health Research Institute of the Balearic Islands (IdISBa) Palma Spain
| | - Javier Calvo
- Group of Cell Therapy and Tissue Engineering, Research Institute on Health Sciences (IUNICS)University of the Balearic Islands Palma Spain
- Health Research Institute of the Balearic Islands (IdISBa) Palma Spain
- Fundació Banc de Sang i Teixits de les Illes Balears (FBSTIB) Palma Spain
| | - Oscar Villa
- Group of Cell Therapy and Tissue Engineering, Research Institute on Health Sciences (IUNICS)University of the Balearic Islands Palma Spain
- Health Research Institute of the Balearic Islands (IdISBa) Palma Spain
| | - Margalida M. Cladera
- Group of Cell Therapy and Tissue Engineering, Research Institute on Health Sciences (IUNICS)University of the Balearic Islands Palma Spain
- Health Research Institute of the Balearic Islands (IdISBa) Palma Spain
| | - Cristina Corbillo
- Fundació Banc de Sang i Teixits de les Illes Balears (FBSTIB) Palma Spain
| | - Antoni Gayà
- Group of Cell Therapy and Tissue Engineering, Research Institute on Health Sciences (IUNICS)University of the Balearic Islands Palma Spain
- Health Research Institute of the Balearic Islands (IdISBa) Palma Spain
- Fundació Banc de Sang i Teixits de les Illes Balears (FBSTIB) Palma Spain
| | - Marta Monjo
- Group of Cell Therapy and Tissue Engineering, Research Institute on Health Sciences (IUNICS)University of the Balearic Islands Palma Spain
- Health Research Institute of the Balearic Islands (IdISBa) Palma Spain
- Department of Fundamental Biology and Health SciencesUniversity of the Balearic Islands Palma Spain
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Scalable MSC-derived bone tissue modules: In vitro assessment of differentiation, matrix deposition, and compressive load bearing. Acta Biomater 2019; 95:395-407. [PMID: 30654211 DOI: 10.1016/j.actbio.2019.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/23/2018] [Accepted: 01/10/2019] [Indexed: 01/27/2023]
Abstract
Enhancements to the mechanical properties of modular designs for bone tissue engineering could increase their clinical applications. In this study, bone marrow mesenchymal stem cells (MSCs) and hydroxyapatite (HAP) microgranules were encapsulated in polyelectrolyte complex membranes composed of chondroitin 4-sulfate (C4S), carboxymethyl cellulose (CMC) and chitosan. Microcapsules were formed with and without HAP microgranules, and cultured in either osteoinduction medium (Osteo) or expansion medium (Exp) to produce four microcapsule conditions: Osteo, Osteo+HAP, Exp, and Exp+HAP. Microcapsules facilitated alkaline phosphatase secretion and deposition of bone specific proteins (osteocalcin and osteopontin) by encapsulated MSCs over 28 days of osteogenic culture. SEM and micro-CT analysis showed cell-deposited mineral covering the surfaces of the HAP microgranules and interior of the microcapsule membrane. The mineralized microcapsules could be combined and fused into cylindrical constructs (4 × 5 mm, W × H), and uniaxial compression tests confirmed that microcapsule mineralization greatly enhanced the yield stresses of Osteo and Osteo+HAP fused constructs (10.4 ± 4.4 MPa and 6.4 ± 2.8 MPa), compared to only HAP microgranules (Exp+HAP, 0.5 ± 0.3 MPa). The C4S/CMC/Chitosan microcapsules provide a platform allowing pre-mineralization of microcapsules in vitro for later assembly of larger load-bearing constructs, or for use as an injectable bone regeneration strategy. STATEMENT OF SIGNIFICANCE: Clinical translation of bone tissue engineering is limited by the difficulty of generating space filling implants that both resist compressive loading, and simultaneously deliver cells throughout the bone defect. Here, we present the design of a microcapsule system containing both stem cells capable of rebuilding bone tissue, and a mechanically tough bone-like mineral, that imparts compression resistance to the microcapsules. The microcapsules support stem cell differentiation to an osteogenic phenotype, that can mineralize the microcapsule membrane and interior. The mineralized microcapsules can be assembled into larger bone constructs, and have mechanical properties on par with trabecular bone.
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Cheng A, Schwartz Z, Kahn A, Li X, Shao Z, Sun M, Ao Y, Boyan BD, Chen H. Advances in Porous Scaffold Design for Bone and Cartilage Tissue Engineering and Regeneration. TISSUE ENGINEERING. PART B, REVIEWS 2019; 25:14-29. [PMID: 30079807 PMCID: PMC6388715 DOI: 10.1089/ten.teb.2018.0119] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 08/01/2018] [Indexed: 12/11/2022]
Abstract
IMPACT STATEMENT Challenges in musculoskeletal tissue regeneration affect millions of patients globally. Scaffolds for tissue engineering bone and cartilage provide promising solutions that increase healing and decrease need for complicated surgical procedures. Porous scaffolds have emerged as an attractive alternative to traditional scaffolds. However, the success of advanced materials, use of biological factors, and manufacturing techniques can vary depending on use case. This review provides perspective on porous scaffold manufacturing, characterization and application, and can be used to inform future scaffold design.
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Affiliation(s)
- Alice Cheng
- Department of Biomedical Engineering, Peking University, Beijing, China
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
| | - Zvi Schwartz
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia
- Department of Periodontology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Adrian Kahn
- Department of Oral and Maxillofacial Surgery, University of Tel Aviv, Tel Aviv, Israel
| | - Xiyu Li
- Department of Biomedical Engineering, Peking University, Beijing, China
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
| | - Zhenxing Shao
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Muyang Sun
- Department of Biomedical Engineering, Peking University, Beijing, China
| | - Yingfang Ao
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Barbara D. Boyan
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Haifeng Chen
- Department of Biomedical Engineering, Peking University, Beijing, China
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Bone substitute made from a Brazilian oyster shell functions as a fast stimulator for bone-forming cells in an animal model. PLoS One 2018; 13:e0198697. [PMID: 29870546 PMCID: PMC5988300 DOI: 10.1371/journal.pone.0198697] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/23/2018] [Indexed: 11/19/2022] Open
Abstract
Despite their demonstrated biocompatibility and osteogenic properties, oyster shells have been reported as a potential alternative to other commonly used materials for bone substitution. This study evaluated whether an experimental bone substitute (EBS) made from a typical oyster shell of Northeastern Brazil (Crassostrea rhizophora) has effects on bone development using an animal model. Oysters were collected from a biologically assisted vivarium, and their inner layer was used for preparing an EBS. Chemical and surface characterization of EBS was performed using Individually Coupled Plasma Optical Emission Spectrometry (ICP-OES) and Scanning Electron Microscope (SEM), respectively. Seventy-two rats were randomly assigned to groups according to the treatment of bone defects created in the submandibular area: Negative Control (-C), Positive Control (+C; Bio-Oss®) and EBS. Euthanasia occurred at 7, 21, 42 and 56 days postoperatively. The bone pieces were stained with hematoxylin and eosin (H&E). The formation of bone tissue was evaluated histologically and histomorphometrically. Data were analyzed through the Kruskal-Wallis test and ANOVA considering a significant level of 5%. The main element found in EBS was calcium (71.68%), and it presented heterogeneity in the particle size and a porosity aspect at SEM analysis. Histological results revealed the absence of inflammatory cells in all groups, being that EBS presented the most accelerated process of bone formation with a statistically significant difference between this group and the +C and -C groups in the 21-day time-point (p < 0.05). After 21 days, the bone formation process was similar between all groups (p > 0.05), showing an immature lamellar bone pattern after 56 days of experimentation (p > 0.05). Within the limitations of this study, it was possible to conclude that EBS presented good biocompatibility and promoted fast stimulation for bone-forming cells in an animal model.
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Shi M, Yang R, Li Q, Lv K, Miron RJ, Sun J, Li M, Zhang Y. Inorganic Self-Assembled Bioactive Artificial Proto-Osteocells Inducing Bone Regeneration. ACS APPLIED MATERIALS & INTERFACES 2018; 10:10718-10728. [PMID: 29528210 DOI: 10.1021/acsami.8b00385] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Since the discovery of osteoinduction in the early 20th century, innovative biomaterials with osteoinductive potential have emerged as candidates for bone repair. Recently, artificial protocell models have demonstrated great potential for tissue regeneration. Herein, we developed artificial bioactive proto-osteocells by self-assembly of biodegradable biphasic-phosphate particles in the form of aqueous bone morphogenetic protein 2 (BMP2)-containing Pickering emulsions in corn oil to fulfill the release of BMP2 with controlled and local efficacy. These artificial proto-osteocells have the advantage of (1) being directly injected into the target location to avert reported side effects of BMP2, minimizing surgical complications, (2) exhibiting the capability of osteoinduction as shown in both in vitro and in vivo models, and (3) demonstrating calcific deposition locally by utilizing the biodegradable calcium phosphate shell. The efficiency of BMP2 within the artificial proto-osteocells showed 25 times greater bone-inducing potential when compared to the control. This study demonstrates for the first time a new strategy toward utilizing material-based artificial proto-osteocells to tackle medical issues in bone tissue repair and regeneration.
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Affiliation(s)
- Miusi Shi
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology , Wuhan University , Wuhan 430079 , P. R. China
| | - Ruiwen Yang
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Qin Li
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Kangle Lv
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Richard J Miron
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology , Wuhan University , Wuhan 430079 , P. R. China
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Jie Sun
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Mei Li
- Key Laboratory of Catalysis and Materials Science of the State Ethnic Affairs Commission and Ministry of Education, College of Chemistry and Materials Sciences, College of Resources and Environmental Science , South-Central University for Nationalities , Wuhan 430074 , P. R. China
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology , Wuhan University , Wuhan 430079 , P. R. China
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Fujioka-Kobayashi M, Abd El Raouf M, Saulacic N, Kobayashi E, Zhang Y, Schaller B, Miron RJ. Superior bone-inducing potential of rhBMP9 compared to rhBMP2. J Biomed Mater Res A 2018; 106:1561-1574. [PMID: 29396910 DOI: 10.1002/jbm.a.36359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 12/31/2022]
Abstract
Recombinant human bone morphogenic protein (rhBMP) 9 has recently been reported to have more osteopromotive potential in vitro when compared to rhBMP2. The aim of the present study was to investigate the bone-inducing potential of rhBMP2 and rhBMP9. We compared rhBMP2, rhBMP7, and rhBMP9 at five different concentrations and showed convincingly that rhBMP9 possesses much greater potential for osteoblast differentiation even at 20 times lower concentrations in vitro. We further show that Noggin, an inhibitor for rhBMP2-induced osteogenesis, did not alter rhBMP9-induced osteogenesis. Thereafter, we show for the first time that rhBMP9 loaded onto atelo-collagen membranes is osteoinductive and has greater potential to form ectopic bone formation when compared to rhBMP2 even at four times lower doses. Similarly new bone formation of rhBMP2 and 9 when loaded on deproteinized bovine bone mineral (DBBM) was investigated in a rabbit calvarial defect. At 8 weeks, both rhBMP2 and rhBMP9 induced significantly higher new bone formation when compared to DBBM alone samples. Interestingly, once again four times lower dose of rhBMP9 group induced comparable or even greater levels of new bone height and new bone area when compared to the rhBMP2 group. The present study revealed that (1) rhBMP9 is capable of inducing ectopic new bone formation in vivo and (2) up to four times lower doses of rhBMP9 may be utilized to regenerate same-size bone defects when compared to rhBMP2. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1561-1574, 2018.
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Affiliation(s)
- Masako Fujioka-Kobayashi
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mustafa Abd El Raouf
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Eizaburo Kobayashi
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
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Miron RJ, Sculean A, Shuang Y, Bosshardt DD, Gruber R, Buser D, Chandad F, Zhang Y. Osteoinductive potential of a novel biphasic calcium phosphate bone graft in comparison with autographs, xenografts, and DFDBA. Clin Oral Implants Res 2016; 27:668-75. [PMID: 26227281 DOI: 10.1111/clr.12647] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Since the original description of osteoinduction in the early 20th century, the study and development of innovative biomaterials has emerged. Recently, novel synthetic bone grafts have been reported with potential to form ectopic bone in vivo. However, their full characterization in comparison with other leading bone grafts has not been investigated. The aim of this study was to determine the osteoinductive potential of bone grafts by comparing autogenous bone grafts, demineralized freeze-dried bone allografts (DFDBA), a commonly utilized natural bone mineral (NBM) from bovine origin (Bio-Oss), and a newly developed biphasic calcium phosphate (BCP). MATERIALS AND METHODS Grafts were compared in vitro for their ability to stimulate bone marrow stromal cell (BMSC) migration, proliferation, and differentiation as assessed by quantitative real-time PCR for genes coding for bone markers including Runx2, collagen I, and osteocalcin. Furthermore, bone grafts were implanted in the calf muscle of 12 beagle dogs to determine their potential to form ectopic bone in vivo. RESULTS The in vitro results demonstrate that both autografts and DFDBA show potential for cell recruitment, whereas only autografts and BCP demonstrated the ability to differentiate BMSCs toward the osteoblast lineage. The in vivo ectopic bone model demonstrated that while NBM particles were not osteoinductive and autogenous bone grafts were resorbed quickly in vivo, ectopic bone formation was reported in DFDBA and in synthetic BCP grafts. CONCLUSION The modifications in nanotopography and chemical composition of the newly developed BCP bone grafts significantly promoted ectopic bone formation confirming their osteoinductive potential. In conclusion, the results from this study provide evidence that synthetic bone grafts not only serve as a three-dimensional scaffold but are also able to promote osteoinduction.
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Affiliation(s)
- Richard J Miron
- Faculté de Medecine Dentaire, Pavillon de Médecine Dentaire, Université Laval, Québec City, QC, Canada
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Yang Shuang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Dieter D Bosshardt
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Reinhard Gruber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Fatiha Chandad
- Faculté de Medecine Dentaire, Pavillon de Médecine Dentaire, Université Laval, Québec City, QC, Canada
| | - Yufeng Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Cantín M, Olate S, Fuentes R, Vásquez B. Alveolar Ridge Conservation by Early Bone Formation After Tooth Extraction in Rabbits. A Histomorphological Study. INT J MORPHOL 2015; 33:369-374. [PMID: 27840551 DOI: 10.4067/s0717-95022015000100058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Alveolar ridge volume loss is an irreversible process. To prevent this physiological event, which typically result in significant local anatomical changes in both the horizontal and the vertical dimension, some strategies are indicated to minimize the loss of ridge volume that typically follows tooth extraction. The purpose of this study was to evaluate if three different bone grafts could promote new bone formation in the alveolar socket following tooth extraction for the alveolar ridge conservation. First mandibular molars of male adults rabbits were extracted and the extraction sockets were randomly treated with three different bone grafts, one xenograft and two alloplastic grafts, and a group that received no treatment (blood clot). The extraction sockets of selected rabbits from each group were evaluated at 4, 6, or 8-week post-extraction. The results indicated that the extraction sockets treated with alloplastic graft (biphasic calcium phosphate) exhibited lamellar bone formation (6.5%) as early as four weeks after the extraction was performed. Moreover, the degree of new bone formation was significantly higher (P<0.05) in the extraction sockets treated with biphasic calcium phosphate at 8-week post-extraction than that in the other study groups. In this study, we demonstrated that the proposed animal model is useful to evaluate the bone formation after tooth extraction and the alveolar ridge conservation is feasible. The new bone formation and alveolar ridge preservation with bone graft after extraction of molar teeth, could result in the maintenance of sufficient bone volume to place an implant in an ideal restorative position without the need for ancillary implant site development procedures.
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Affiliation(s)
- Mario Cantín
- Departamento de Odontología Integral, Facultad de Odontología Universidad de La Frontera, Temuco, Chile; Programa de Doctorado en Ciencias Morfológica, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Sergio Olate
- Departamento de Odontología Integral, Facultad de Odontología Universidad de La Frontera, Temuco, Chile; Centro de Investigación en Ciencias Biomédicas, Universidad Autónoma de Chile, Temuco, Chile
| | - Ramón Fuentes
- Departamento de Odontología Integral, Facultad de Odontología Universidad de La Frontera, Temuco, Chile
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Kim JM, Kim MH, Kang SS, Kim G, Choi SH. Comparable bone healing capacity of different bone graft matrices in a rabbit segmental defect model. J Vet Sci 2014; 15:289-95. [PMID: 24675830 PMCID: PMC4087232 DOI: 10.4142/jvs.2014.15.2.289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 02/21/2014] [Indexed: 12/03/2022] Open
Abstract
We compared the bone healing capacity of three different demineralized bone matrix (DBM) products applied using different carrier molecules (hyaluronic acid [HA] vs. carboxymethylcellulose [CMC]) or bone compositions (cortical bone vs. cortical bone and cancellous bone) in a rabbit segmental defect model. Overall, 15-mm segmental defects in the left and right radiuses were created in 36 New Zealand White rabbits and filled with HA-based demineralized cortical bone matrix (DBX), CMC-based demineralized cortical bone matrix (DB) or CMC-based demineralized cortical bone with cancellous bone (NDDB), and the wound area was evaluated at 4, 8, and 12 weeks post-implantation. DBX showed significantly lower radiopacity, bone volume fraction, and bone mineral density than DB and NDDB before implantation. However, bone healing score, bone volume fraction, bone mineral density, and residual bone area at 4, 8, and 12 weeks post-implantation revealed no significant differences in bone healing capacity. Overall, three DBM products with different carrier molecules or bone compositions showed similar bone healing capacity.
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Affiliation(s)
- Jong Min Kim
- Xenotransplantation Research Center, Biomedical Research Institute, Seoul National University Hospital, Seoul 153-832, Korea
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Chang HH, Wang YL, Chiang YC, Chen YL, Chuang YH, Tsai SJ, Heish KH, Lin FH, Lin CP. A novel chitosan-γPGA polyelectrolyte complex hydrogel promotes early new bone formation in the alveolar socket following tooth extraction. PLoS One 2014; 9:e92362. [PMID: 24658174 PMCID: PMC3962413 DOI: 10.1371/journal.pone.0092362] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 02/20/2014] [Indexed: 11/18/2022] Open
Abstract
A novel chitosan-γPGA polyelectrolyte complex hydrogel (C-PGA) has been developed and proven to be an effective dressing for wound healing. The purpose of this study was to evaluate if C-PGA could promote new bone formation in the alveolar socket following tooth extraction. An animal model was proposed using radiography and histomorphology simultaneously to analyze the symmetrical sections of Wistar rats. The upper incisors of Wistar rats were extracted and the extraction sockets were randomly treated with gelatin sponge, neat chitosan, C-PGA, or received no treatment. The extraction sockets of selected rats from each group were evaluated at 1, 2, 4, or 6 wk post-extraction. The results of radiography and histopathology indicated that the extraction sockets treated with C-PGA exhibited lamellar bone formation (6.5%) as early as 2 wk after the extraction was performed. Moreover, the degree of new bone formation was significantly higher (P < 0.05) in the extraction sockets treated with C-PGA at 6 wk post-extraction than that in the other study groups. In this study, we demonstrated that the proposed animal model involving symmetrical sections and simultaneous radiography and histomorphology evaluation is feasible. We also conclude that the novel C-PGA has great potential for new bone formation in the alveolar socket following tooth extraction.
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Affiliation(s)
- Hao-Hueng Chang
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yin-Lin Wang
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Chih Chiang
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Liang Chen
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Horng Chuang
- School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Shang-Jye Tsai
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, Cardinal Tien Hospital Yonghe Branch, New Taipei, Taiwan
| | - Kuo-Huang Heish
- Department of Chemical Engineering, National Taiwan University, Taipei, Taiwan
| | - Feng-Huei Lin
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Chun-Pin Lin
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail:
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Wildburger A, Payer M, Jakse N, Strunk D, Etchard-Liechtenstein N, Sauerbier S. Impact of autogenous concentrated bone marrow aspirate on bone regeneration after sinus floor augmentation with a bovine bone substitute--a split-mouth pilot study. Clin Oral Implants Res 2013; 25:1175-81. [PMID: 23875876 DOI: 10.1111/clr.12228] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2013] [Indexed: 12/22/2022]
Abstract
PURPOSE Mesenchymal stem cells (MSC) with biomaterials have osteoinductive potential. The aim of this study was to evaluate early bone formation in xenogenic sinus grafts in a direct comparison with and without MSCs after 3 and 6 months. Literature on bone formation in pure xenogenic graft materials after 3 months in a human model is still lacking. MATERIALS AND METHODS In a split-mouth design, seven patients with a bilateral highly atrophic posterior maxilla were included. The test side was grafted with MSCs from concentrated bone marrow aspirate admixed to the bone graft material. On the control side, pure bovine bone material was applied. Biopsies were taken navigated after 3 and 6 months. RESULTS After 3 months, new bone formation in the control group was 11.8% (SD 6.2%) and in the test group 7.4% (SD 4.1%). After 6 months, the control group showed 13.9% (SD 8.5%) of new bone and the test group 13.5% NB (SD 5.4%). The fraction of bovine bone material after 3 months was 42.6% (SD 3.5%) in the test group and 34.9% (SD 11.8%) in the control group. After 6 months, the biomaterial content was comparable at both sides (test 36.2%, SD 7.8%; control 39.5%, SD 9.3%). CONCLUSIONS There was no significant difference in new bone formation between the test and control group with n = 7. The results may be dominated by the high mineral content of the biomaterial but could nevertheless be valuable for meta-analysis in the future.
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Affiliation(s)
- Angelika Wildburger
- Department of Oral Surgery and Radiology, Medical University of Graz, Graz, Austria
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An overview on bone protein extract as the new generation of demineralized bone matrix. SCIENCE CHINA-LIFE SCIENCES 2012; 55:1045-56. [DOI: 10.1007/s11427-012-4415-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 11/15/2012] [Indexed: 01/24/2023]
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Schwartz Z, Hyzy SL, Moore MA, Hunter SA, Ronholdt CJ, Sunwoo M, Boyan BD. Osteoinductivity of demineralized bone matrix is independent of donor bisphosphonate use. J Bone Joint Surg Am 2011; 93:2278-86. [PMID: 22258774 PMCID: PMC3234347 DOI: 10.2106/jbjs.j.01469] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Demineralized bone matrix is commonly used as a bone graft substitute, either alone or to supplement an osteoconductive material, because of its osteoinductive properties. The aging of the population has led to an increase in the number of prospective donors of demineralized bone matrix who have taken bisphosphonates to prevent osteoclast-mediated bone resorption. The aim of this study was to determine whether oral bisphosphonate usage affects the osteoinductivity of demineralized bone matrix from donors. METHODS Sex-matched and age-matched pairs of samples were provided by four tissue banks (three or four pairs per bank). Demineralized bone matrix donors without bisphosphonate treatment had a mean age (and standard deviation) of 69.1 ± 2.5 years, and donors with bisphosphonate treatment had a mean age of 68.9 ± 2.0 years. Each pair included one donor known to have taken bisphosphonates and one who had not taken bisphosphonates. Demineralized bone matrix previously confirmed as osteoinductive was the positive control, and heat-inactivated demineralized bone matrix was the negative control. Demineralized bone matrix incubated with 1 mL of phosphate-buffered saline solution containing 0, 0.002, 2.0, or 2000 ng/mL of alendronate was also tested. Gelatin capsules containing 15 mg of demineralized bone matrix were implanted bilaterally in the gastrocnemius muscle of male nude mice (eight implants per group). The mice were killed thirty-five days after implantation, and hind limbs were recovered and processed for histological analysis. Osteoinductivity was measured with use of a qualitative score and by histomorphometry. RESULTS Nine of fifteen samples from donors who had had bisphosphonate treatment and ten of fifteen samples from patients who had not had bisphosphonate treatment were osteoinductive. Qualitative mean scores were comparable (1.7 ± 0.4 for those without bisphosphonates and 1.9 ± 0.7 for those with bisphosphonates). Osteoinductive demineralized bone matrix samples produced ossicles of comparable size, regardless of bisphosphonate usage. Histomorphometric measurements of the area of new bone formation and residual demineralized bone matrix were also comparable. The addition of alendronate to control demineralized bone matrix did not affect its osteoinductivity. CONCLUSIONS Demineralized bone matrix samples from donors treated with bisphosphonates and donors not treated with bisphosphonates have the same ability to induce bone formation. However, it is not known if the quality of the new bone is affected, with subsequent consequences affecting bone remodeling.
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Affiliation(s)
- Zvi Schwartz
- Department of Biomedical Engineering, Georgia Institute of Technology, 315 Ferst Drive N.W., Atlanta, GA 30332-0363. E-mail address for B.D. Boyan:
| | - Sharon L. Hyzy
- Department of Biomedical Engineering, Georgia Institute of Technology, 315 Ferst Drive N.W., Atlanta, GA 30332-0363. E-mail address for B.D. Boyan:
| | - Mark A. Moore
- LifeNet Health, Bio-Implants Division, 1864 Concert Drive, Virginia Beach, VA 23453. E-mail address:
| | - Shawn A. Hunter
- Community Tissue Services, Center for Tissue Innovation and Research, 2900 College Drive, Kettering, OH 45420. E-mail address:
| | - Chad J. Ronholdt
- LABS Inc., 6933-B South Revere Parkway, Centennial, CO 80112. E-mail address:
| | - MoonHae Sunwoo
- Musculoskeletal Transplant Foundation, 125 May Street, Edison, NJ 08837. E-mail address:
| | - Barbara D. Boyan
- Department of Biomedical Engineering, Georgia Institute of Technology, 315 Ferst Drive N.W., Atlanta, GA 30332-0363. E-mail address for B.D. Boyan:
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Irinakis T. Efficacy of injectable demineralized bone matrix as graft material during sinus elevation surgery with simultaneous implant placement in the posterior maxilla: clinical evaluation of 49 sinuses. J Oral Maxillofac Surg 2010; 69:134-41. [PMID: 21050634 DOI: 10.1016/j.joms.2010.07.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 06/02/2010] [Accepted: 07/03/2010] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of the present retrospective investigation was to evaluate the survivability and success of single implants placed simultaneously during direct sinus lifts with allograft forms of bone and to investigate the effect demineralized bone matrix paste has on time management and membrane integrity during these procedures. MATERIALS AND METHODS The charts of 49 consecutively treated nonsmoking patients who had met the inclusion criteria were examined. All the patients had undergone unilateral direct sinus augmentation using the lateral window technique, during which only 1 implant (minimum 10 mm in length) was placed in the premolar or molar maxillary region. All implants were submerged using a 2-stage technique and with at least 3 mm of residual sinus floor bone height. The control group of 27 patients had received particulate allograft bone as the graft material, and the 22 test patients had received allograft bone in a paste form (DynaBlast). No implants were loaded before a minimum of 6 months from the date of fixture placement. All implant-supported single crowns in the present study had been functioning for at least 12 months. All patients were seen immediately after placement of the final crown and were requested to return to the surgeon's practice for 1 annual radiographic follow-up examination. The range of follow-up for these patients was 12 to 24 months based entirely on patient compliance. This interval constituted the loading time. The patients were not seen by the specialist in between the "final crown" appointment (original radiograph) and the "annual" follow-up evaluation (final radiograph). No patients experienced complications that required surgical re-entry. The average loading time for the control group was 13.62 months and was 18.77 months for the test group. The survivability and success of the implants were studied, along with the operative time, between the 2 groups. Statistical analysis was performed for various comparisons in the present study. RESULTS None of the fixtures placed in these patients failed. The success and survivability criteria as stated were met for all 49 implants, regardless of the allograft formulation used. The average operative time in the control group was 70.11 minutes and was 62.36 minutes in the test group. This difference was statistically significant (P < .05). CONCLUSIONS Using an injectable formulation of allograft material during simultaneous direct sinus lift and implant placement seems to be an acceptable alternative to particulate forms of allograft bone. In addition, when using the injectable graft evaluated in our study, a statistically significant 11% decrease in the operative time resulted.
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Affiliation(s)
- Tassos Irinakis
- Graduate Periodontics Program, Division of Periodontics and Implant Surgery, University of British Columbia, Faculty of Dentistry, Vancouver, BC, Canada.
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Bahar H, Yaffe A, Boskey A, Binderman I. Influence of bone-derived matrices on generation of bone in an ectopic rat model. J Orthop Res 2010; 28:664-70. [PMID: 19918912 DOI: 10.1002/jor.21017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Most bone regeneration experimental models that test bone-derived matrices take place in conjunction with the native bone. Here, we compared the relative effectiveness of bone matrix components on bone-marrow-directed osteogenesis in an ectopic model. Cortical bone cylinders consisted of diaphysis of DA rat femurs. They were either demineralized (DBM), deproteinized (HABM), or nontreated (MBM). Fresh bone marrow was placed into cylinders and implanted at subcutaneous thoracic sites of 2-month-old DA rats. At designated times the cylinders were surgically removed from the animals. Microradiographs of DBM and histology of DBM and MBM cylinders demonstrated progressive increase in mineralized bone volume and its trabecular configuration. Bone filled the inner volume of DBM and MBM cylinders within 4 weeks, while in HABM cylinders mostly granulation tissue developed. In the DBM cylinders cartilage deposited within 10 days, while in the MBM cylinders bone was directly deposited. As early as day 3 after marrow transplantation, marrow cells interacting with DBM increased significantly the genes that express the cartilage and the bone phenotype. In conclusion, organic components of bone are needed for marrow-directed osteogenesis.
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Affiliation(s)
- H Bahar
- Department of Oral Biology, The Maurice and Gabriela Goldschleger, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Mesenchymal Stem Cell–Encapsulated Collagen Microspheres for Bone Tissue Engineering. Tissue Eng Part C Methods 2010; 16:225-35. [DOI: 10.1089/ten.tec.2008.0709] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dereka XE, Markopoulou CE, Mamalis A, Vrotsos IA. Effect of rhBMP-7 combined with two bone grafts on human periodontal ligament cell differentiation. Growth Factors 2009; 27:274-9. [PMID: 19606370 DOI: 10.1080/08977190903112721] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to evaluate the in vitro effect of recombinant human bone morphogenetic protein-7 (rhBMP-7) combined with demineralised freeze-dried bone allograft (DFDBA) and an inorganic bovine material with a synthetic peptide (PepGen P-15) on human periodontal ligament (hPDL) cell differentiation, in a time-dependent manner. hPDL cells were cultured and treated with: (1) 500 ng/ml of rhBMP-7, (2) 10 mg of DFDBA or PepGen P-15 and (3) their combination. Cell differentiation was estimated after 48 and 72 h by measuring alkaline phosphatase (ALPase) activity and osteocalcin (OC) secretion. The presence of rhBMP-7, DFDBA, PepGen P-15, rhBMP-7 + DFDBA and rhBMP-7+ PepGen P-15 promoted a significant increase of ALPase activity after 48 and 72 h. The combination of rhBMP-7 with DFDBA or PepGen P-15 did not lead to significant OC secretion. The results of this study imply that rhBMP-7 stimulates the early osteoblastic differentiation of hPDL cells and that DFDBA and PepGen P-15 could serve as carriers for rhBMP-7.
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Affiliation(s)
- X E Dereka
- Department of Periodontology, School of Dentistry, University of Athens, Athens, Greece.
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