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Motta C, Cavagnetto D, Amoroso F, Baldi I, Mussano F. Bioactive glass for periodontal regeneration: a systematic review. BMC Oral Health 2023; 23:264. [PMID: 37158885 PMCID: PMC10169491 DOI: 10.1186/s12903-023-02898-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 03/20/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND One of the major clinical challenges of this age could be represented by the possibility to obtain a complete regeneration of infrabony defects. Over the past few years, numerous materials and different approaches have been developed to obtain bone and periodontal healing. Among all biomaterials, bioglasses (BG) are one of the most interesting due to their ability to form a highly reactive carbonate hydroxyapatite layer. Our aim was to systematically review the literature on the use and capability of BG for the treatment of periodontal defects and to perform a meta-analysis of their efficacy. METHODS A search of MEDLINE/PubMed, Cochrane Library, Embase and DOSS was conducted in March 2021 to identify randomized controlled trials (RCTs) using BG in the treatment of intrabony and furcation defects. Two reviewers selected the articles included in the study considering the inclusion criteria. The outcomes of interest were periodontal and bone regeneration in terms of decrease of probing depth (PD) and gain of clinical attachment level (CAL). A network meta-analysis (NMA) was fitted, according to the graph theory methodology, using a random effect model. RESULTS Through the digital search, 46 citations were identified. After duplicate removal and screening process, 20 articles were included. All RCTs were retrieved and rated following the Risk of bias 2 scale, revealing several potential sources of bias. The meta-analysis focused on the evaluation at 6 months, with 12 eligible articles for PD and 10 for CAL. As regards the PD at 6 months, AUTOGENOUS CORTICAL BONE, BIOGLASS and PLATELET RICH FIBRIN were more efficacious than open flap debridement alone, with a statistically significant standardized mean difference (SMD) equal to -1.57, -1.06 and - 2.89, respectively. As to CAL at 6 months, the effect of BIOGLASS is reduced and no longer significant (SMD = -0.19, p-value = 0.4) and curiously PLATELET RICH FIBRIN was more efficacious than OFD (SMD =-4.13, p-value < 0.001) in CAL gain, but in indirect evidence. CONCLUSIONS The present review partially supports the clinical efficacy of BG in periodontal regeneration treatments for periodontal purposes. Indeed, the SMD of 0.5 to 1 in PD and CAL obtained with BG compared to OFD alone seem clinically insignificant even if it is statistically significant. Heterogeneity sources related to periodontal surgery are multiple, difficult to assess and likely hamper a quantitative assessment of BG efficacy.
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Affiliation(s)
- Chiara Motta
- Department of Surgical Sciences UNITO, CIR Dental School, via Nizza 230, Turin, 10126, Italy.
| | - Davide Cavagnetto
- Department of Surgical Sciences UNITO, CIR Dental School, via Nizza 230, Turin, 10126, Italy.
- Politecnico di Torino, Corso Duca Degli Abruzzi 24, Torino, 10129, Italy.
| | - Federico Amoroso
- Department of Surgical Sciences UNITO, CIR Dental School, via Nizza 230, Turin, 10126, Italy
- Politecnico di Torino, Corso Duca Degli Abruzzi 24, Torino, 10129, Italy
| | - Ileana Baldi
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, via Loredan 18, Padova, 35131, Italy
| | - Federico Mussano
- Department of Surgical Sciences UNITO, CIR Dental School, via Nizza 230, Turin, 10126, Italy
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Abushahba F, Algahawi A, Areid N, Hupa L, Närhi T. Bioactive Glasses in Periodontal Regeneration
A Systematic Review
. Tissue Eng Part C Methods 2023; 29:183-196. [PMID: 37002888 DOI: 10.1089/ten.tec.2023.0036] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Bioactive glasses (BAGs) are surface-active ceramic materials that can be used in bone regeneration due to their known osteoconductive and osteoinductive properties. This systematic review aimed to study the clinical and radiographic outcomes of using BAGs in periodontal regeneration. The selected studies were collected from PubMed and Web of Science databases, and included clinical studies investigating the use of BAGs on periodontal bone defect augmentation between January 2000 and February 2022. The identified studies were screened using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 115 full-length peer-reviewed articles were identified. After excluding duplicate articles between the databases and applying the inclusion and exclusion criteria, 14 studies were selected. The Cochrane risk of bias tool for randomized trials was used to assess the selected studies. Five studies compared using BAGs with open flap debridement (OFD) without grafting materials. Two of the selected studies were performed to compare the use of BAGs with protein-rich fibrin, one of which also included an additional OFD group. Also, one study evaluated BAG with biphasic calcium phosphate and used a third OFD group. The remaining six studies compared BAG filler with hydroxyapatite, demineralized freeze-dried bone allograft, autogenous cortical bone graft, calcium sulfate β-hemihydrate, enamel matrix derivatives, and guided tissue regeneration. This systematic review showed that using BAG to treat periodontal bone defects has beneficial effects on periodontal tissue regeneration. OSF Registration No.: 10.17605/OSF.IO/Y8UCR.
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Affiliation(s)
- Faleh Abushahba
- University of Turku, 8058, Department of Prosthetic Dentistry and Stomatognathic Physiology, Turku, Varsinais-Suomi, Finland,
| | - Ahmed Algahawi
- University of Turku, 8058, Department of Periodontology, Turku, Varsinais-Suomi, Finland,
| | - Nagat Areid
- University of Turku, 8058, Department of Prosthetic Dentistry and Stomatognathic Physiology Institute of Dentistry, University of Turku, Turku, Finland,
| | - Leena Hupa
- Åbo Akademi University, Johan Gadolin Process Chemistry Centre, Turku, Finland,
| | - Timo Närhi
- University of Turku Faculty of Medicine, 60654, Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, Turku, Finland,
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Comparative study of volumetric changes and trabecular microarchitecture in human maxillary sinus bone augmentation with bioactive glass and autogenous bone graft: a prospective and randomized assessment. Int J Oral Maxillofac Surg 2017; 47:665-671. [PMID: 29246424 DOI: 10.1016/j.ijom.2017.11.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/05/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022]
Abstract
The aim of this study was to compare the volumetric changes and the new bone microarchitecture in human maxillary sinuses augmented with bioactive glass (Biogran) alone, bioactive glass combined with autogenous bone graft (1:1), or autogenous bone graft alone. Twelve maxillary sinuses were grafted with bioactive glass (group 1), nine with bioactive glass mixed with autogenous bone graft 1:1 (group 2), and 12 with autogenous bone graft (group 3). Patients underwent cone beam computed tomography 15days after the procedure to determine the initial volume of the graft (T1) and again 6 months later (T2). Biopsies were obtained at the time of dental implant placement and were subjected to micro-computed tomography. The volumetric change was 44.2% in group 1, 37.9% in group 2, and 45.7% in group 3 (P>0.05). The trabecular microarchitecture results showed that the materials used in groups 1 and 2 were good bone substitutes. However, the addition of 50% bioactive glass to autogenous bone graft improved the microarchitecture of the graft. Furthermore, the results for volumetric changes indicated that bioactive glass, its association with autogenous bone graft in a 1:1 ratio, and autogenous bone graft alone have similar resorption.
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Pereira RDS, Menezes JD, Bonardi JP, Griza GL, Okamoto R, Hochuli-Vieira E. Histomorphometric and immunohistochemical assessment of RUNX2 and VEGF of Biogran™ and autogenous bone graft in human maxillary sinus bone augmentation: A prospective and randomized study. Clin Implant Dent Relat Res 2017; 19:867-875. [PMID: 28608398 DOI: 10.1111/cid.12507] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Few studies have been conducted to assess new bone formation using Biogran, a bioactive glass, in maxillary sinus bone augmentation through a prospective and randomized evaluation. Moreover, there are no studies that evaluate cellular behavior by immunohistochemical assessment for osteoblastic and vascular activity during bone repair. PURPOSE The aim of this study is to compare new bone formation and cellular behavior with Biogran alone, a 1:1 combination of Biogran and autogenous bone graft, and autogenous bone graft alone in human maxillary sinuses. MATERIALS AND METHODS Ten maxillary sinuses were grafted with Biogran (Group 1), 10 grafted with Biogran added to autogenous bone graft in a 1:1 ratio (Group 2), and 10 grafted with autogenous bone graft alone (Group 3). After 6 months of bone healing, samples were obtained concurrent to the dental implants' placement to be evaluated by histomorphometric and immunohistochemical assessment for RUNX2 and vascular endothelial growth factor (VEGF). RESULTS The amount of new bone formation in Group 1 was 42.0 ± 7.3% in the pristine bone region, 40.7 ± 14.0% in the intermediate region, and 45.6 ± 13.5% in apical region. In Group 2, for pristine bone, intermediate, and apical regions, new bone formation was 36.6 ± 12.9%, 33.2 ± 13.3%, and 45.8 ± 13.9%, respectively. Group 3 showed new bone formation of 37.3 ± 11.6%, 35.3 ± 14.7%, and 39.9 ± 15.8% in pristine bone, intermediate, and apical regions, respectively. The immunolabeling for RUNX2 showed low cellular activity in osteoblasts for all groups, and the VEGF assessment demonstrated moderate cellular activity in Groups 1 and 2; however, Group 3 presented with low activity in the pristine bone region, followed by moderate activity in the intermediate and apical region. CONCLUSION This study demonstrates that Biogran and its combination with autogenous bone graft 1:1 are good bone substitutes due to their similarity to autogenous bone graft.
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Affiliation(s)
| | - Juliana Dreyer Menezes
- Universidade Estadual Paulista - UNESP, Surgery and Integrated Clinic Department, São Paulo, Brazil
| | - João Paulo Bonardi
- Universidade Estadual Paulista - UNESP, Surgery and Integrated Clinic Department, São Paulo, Brazil
| | - Geraldo Luiz Griza
- Universidade Estadual Paulista - UNESP, Surgery and Integrated Clinic Department, São Paulo, Brazil
| | - Roberta Okamoto
- Universidade Estadual Paulista - UNESP, Surgery and Integrated Clinic Department, São Paulo, Brazil
| | - Eduardo Hochuli-Vieira
- Universidade Estadual Paulista - UNESP, Surgery and Integrated Clinic Department, São Paulo, Brazil
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Lee MJ, Kim BO, Yu SJ. Clinical evaluation of a biphasic calcium phosphate grafting material in the treatment of human periodontal intrabony defects. J Periodontal Implant Sci 2012; 42:127-35. [PMID: 22977742 PMCID: PMC3439524 DOI: 10.5051/jpis.2012.42.4.127] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 08/03/2012] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of this study was to compare the clinical outcome of open flap debridement (OFD) with a biphasic calcium phosphate (BCP) graft to that of OFD without BCP graft for the treatment of intrabony periodontal defects (IBDs). Methods The study included 25 subjects that had at least one intrabony defect of 2- or 3-wall morphology and an intrabony component≥4 mm as detected radiographically. Subjects were randomly assigned to treatment with (BCP group, n=14) or without BCP (OFD group, n=11). Clinical parameters were recorded at baseline and 6 months after surgery and included the plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), and gingival recession (REC). A stringent plaque control regimen was enforced for all of the patients during the 6-month observation period. Results In all of the treatment groups, significant PD reductions and CAL gains occurred during the study period (P<0.01). At 6 months, patients in the BCP group exhibited a mean PD reduction of 3.7±1.2 mm and a mean CAL gain of 3.0±1.1 mm compared to the baseline. Corresponding values for the patients treated with OFD were 2.5±0.8 mm and 1.4±1.0 mm, respectively. Compared to OFD group, the additional CAL gain was significantly greater in the patients in BCP group (P=0.028). The additional PD reduction was significant for the BCP group (P=0.048). The REC showed a significant increase in both groups, and the amount of recession was significantly smaller in the BCP group than OFD group (P=0.023). In radiographic evaluation, the height of the bone fill in the BCP group was significantly greater than OFD group. Conclusions The clinical benefits of BCP found in this study indicate that BCP may be an appropriate alternative to conventional graft materials.
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Affiliation(s)
- Min-Jae Lee
- Department of Periodontology, Chosun University School of Dentistry, Gwangju, Korea
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Gamal AY. Enhanced β-Tricalcium Phosphate Blended Clot Adhesion to EDTA Biomodulated Periodontally Affected Root Surfaces: In Vivo Scanning Electron Microscopy Evaluation. J Periodontol 2011; 82:1587-95. [DOI: 10.1902/jop.2011.110023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sohrabi K, Saraiya V, Laage TA, Harris M, Blieden M, Karimbux N. An evaluation of bioactive glass in the treatment of periodontal defects: a meta-analysis of randomized controlled clinical trials. J Periodontol 2011; 83:453-64. [PMID: 21861641 DOI: 10.1902/jop.2011.110347] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The regenerative surgical treatment of intrabony defects caused by periodontal disease has been examined in several systematic reviews and meta-analyses. The use of bioactive glass (BG) as a graft material to treat intrabony defects has been reported, but all data have not been synthesized and compiled. Our objective was to systematically review the literature on the use of BG for the treatment of intrabony defects and to perform a meta-analysis of its efficacy. METHODS A search of PubMed, EMBASE, and Cochrane Database of Systematic Reviews, as well as a manual search of recently published periodontology journals, were conducted to identify randomized controlled trials of the use of BG in the treatment of intrabony and furcation defects. Criteria included publication in English, follow-up duration of ≥6 months, baseline and follow-up measures of probing depth (PD) and clinical attachment levels (CAL) with 95% confidence intervals (CIs), and an appropriate control arm. Twenty-five citations were identified, 15 of which were included in the final analysis. Data, including study methods and results, as well as CONSORT (Consolidated Standards of Reporting Trials) criteria, were extracted from eligible studies and cross-checked by at least two reviewers. RESULTS Meta-analyses of eligible studies were performed to ascertain summary effects for changes in PD and CAL among experimental and control groups, using the mean change plus standard deviation for each study. Pooled analyses showed that BG was superior to control for both measures: the mean (95% CIs) difference from baseline to follow-up between BG and controls was 0.52 mm (0.27, 0.78, P <0.0001) in reduction for PD and 0.60 mm (0.18, 1.01, P = 0.005) in gain for CAL. Analyses of CAL revealed heterogeneity across studies (I(2) = 60.5%), although studies reporting PD measures were homogeneous (I(2) = 0.00%). CAL heterogeneity appeared secondary to active controls versus open flap debridement (OFD) alone and to defect-type modifying BG treatment success. Per subgroup analyses, the benefit of BG over control treatment was highly significant only in studies comparing BG to OFD (P <0.0001), with mean difference change in CAL being 1.18 mm (95% CI = 0.74, 1.62 mm) between the BG and OFD group. CONCLUSION Treatment of intrabony defects with BG imparts a significant improvement in both PD and CAL compared to both active controls and OFD.
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Affiliation(s)
- Keyvan Sohrabi
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA
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Bashutski JD, Eber RM, Kinney JS, Benavides E, Maitra S, Braun TM, Giannobile WV, McCauley LK. The impact of vitamin D status on periodontal surgery outcomes. J Dent Res 2011; 90:1007-12. [PMID: 21555774 DOI: 10.1177/0022034511407771] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Vitamin D regulates calcium and immune function. While vitamin D deficiency has been associated with periodontitis, little information exists regarding its effect on wound healing and periodontal surgery outcomes. This longitudinal clinical trial assessed outcomes of periodontal surgery and teriparatide administration in vitamin-D-sufficient and -insufficient individuals. Forty individuals with severe chronic periodontitis received periodontal surgery, daily calcium and vitamin D supplements, and self-administered teriparatide or placebo for 6 wks to correspond with osseous healing time. Serum 25(OH)D was evaluated at baseline, 6 wks, and 6 mos post-surgery. Clinical and radiographic outcomes were evaluated over 1 yr. Placebo patients with baseline vitamin D deficiency [serum 25(OH)D, 16-19 ng/mL] had significantly less clinical attachment loss (CAL) gain (-0.43 mm vs. 0.92 mm, p < 0.01) and probing depth (PPD) reduction (0.43 mm vs. 1.83 mm, p < 0.01) than vitamin-D-sufficient individuals. Vitamin D levels had no significant impact on CAL and PPD improvements in teriparatide patients at 1 yr, but infrabony defect resolution was greater in teriparatide-treated vitamin-D-sufficient vs. -deficient individuals (2.05 mm vs. 0.87 mm, p = 0.03). Vitamin D deficiency at the time of periodontal surgery negatively affects treatment outcomes for up to 1 yr. Analysis of these data suggests that vitamin D status may be critical for post-surgical healing. (ClinicalTrials.gov number, CT00277706).
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Affiliation(s)
- J D Bashutski
- Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, School of Dentistry, University of Michigan, 1011 N. University Ave., Room 3349, Ann Arbor, MI 48109, USA.
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Bashutski JD, Eber RM, Kinney JS, Benavides E, Maitra S, Braun TM, Giannobile WV, McCauley LK. Teriparatide and osseous regeneration in the oral cavity. N Engl J Med 2010; 363:2396-405. [PMID: 20950166 PMCID: PMC5695223 DOI: 10.1056/nejmoa1005361] [Citation(s) in RCA: 177] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Intermittent administration of teriparatide, a drug composed of the first 34 amino acids of parathyroid hormone, has anabolic effects on bone. Although teriparatide has been evaluated for the treatment of osteoporosis and for the healing of fractures, clinical trials evaluating it for the treatment of osseous conditions of the oral cavity in humans are lacking. METHODS A total of 40 patients with severe, chronic periodontitis underwent periodontal surgery and received daily injections of teriparatide (20 μg) or placebo, along with oral calcium (1000 mg) and vitamin D (800 IU) supplementation, for 6 weeks. The patients were followed for 1 year. The primary outcome was a radiographic linear measurement of alveolar bone level. Secondary outcomes included clinical variables, bone turnover markers in serum and oral fluid, systemic bone mineral density, and quality of life. RESULTS Radiographic linear resolution of osseous defects was significantly greater after teriparatide therapy than after placebo beginning at 6 months, with a mean linear gain in bone at 1 year of 29% as compared with 3% (P<0.001). Clinical improvement was greater in patients taking teriparatide than in those taking placebo, with a reduction in periodontal probing depth of 33% versus 20% (2.42 mm vs. 1.32 mm) and a gain in clinical attachment level of 22% versus 7% (1.58 mm vs. 0.42 mm) in target lesions at 1 year (P = 0.02 for both comparisons). No serious adverse events were reported; however, the number of patients in the study was small. No significant differences were noted with respect to the other variables that were assessed. CONCLUSIONS Teriparatide, as compared with placebo, was associated with improved clinical outcomes, greater resolution of alveolar bone defects, and accelerated osseous wound healing in the oral cavity. Teriparatide may offer therapeutic potential for localized bone defects in the jaw. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT00277706 .).
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Affiliation(s)
- Jill D Bashutski
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
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Stein JM, Fickl S, Yekta SS, Hoischen U, Ocklenburg C, Smeets R. Clinical Evaluation of a Biphasic Calcium Composite Grafting Material in the Treatment of Human Periodontal Intrabony Defects: A 12-Month Randomized Controlled Clinical Trial. J Periodontol 2009; 80:1774-82. [DOI: 10.1902/jop.2009.090229] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Neamat A, Gawish A, Gamal-Eldeen AM. beta-Tricalcium phosphate promotes cell proliferation, osteogenesis and bone regeneration in intrabony defects in dogs. Arch Oral Biol 2009; 54:1083-90. [PMID: 19828137 DOI: 10.1016/j.archoralbio.2009.09.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2009] [Revised: 09/01/2009] [Accepted: 09/10/2009] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study investigates the effect of the new synthetic bone grafting material, high pure-phase beta-tricalcium phosphate (Cerasorb(1) M, granule size 500-1000microm), on the osteogenesis process and proliferation marker in bone marrow stromal cells (BMSCs) and its regenerative effect in the periodontal intrabony defects in dogs. DESIGN The effect of Cerasorb(1) M (20 and 40mgml(-1) for 1 and 2 weeks) on the proliferation rate of BMSCs was assessed by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay on the proliferating cell nuclear antigen (PCNA) by immunoblotting and on alkaline phosphatase level by colourimetric assay. The regenerative effect of Cerasorb(1) M in the periodontal intrabony defects in dogs was investigated by histological and immunohistochemical analysis after 3 and 6 months of grafting. RESULTS Incubation of BMSCs with Cerasorb(1) M for 2 weeks led to significant increase in cell proliferation rate, which was associated with increased PCNA. Cerasorb(1) M significantly increased the production of alkaline phosphatase as a marker for the osteogenic stromal lineage and for differentiation and bone formation in BMSCs after 2 weeks. In the histological features and immunohistochemical analysis of PCNA of the intrabony defects in dogs augmented with Cerasorb(1) M, osteoid tissue with a plate-like structure and cellular mesenchymal proliferation besides osteoid islands joined by bridges were observed after 3 months. Six months after the implantation, the Cerasorb(1) M granules were replaced by abundant new plate-like bone besides PCNA-enriched, small, oval-shaped mononuclear cells and multinucleated-giant cells that were attached to newly formed bones. No remains of the Cerasorb(1) M granules could be seen after 3 and 6 months with the newly formed plate-like bones and no histological sign of inflammatory reaction or formation of foreign-body granulomas. CONCLUSION Cerasorb(1) M may induce cell proliferation via induction of PCNA that may induce early osteogenesis and bone formation. Cerasorb(1) M regenerated the bone completely in intrabony defects and that this regeneration was highly associated with PCNA expression in different cell lineage.
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Affiliation(s)
- Amany Neamat
- Department of Surgery and Oral Medicine Researches, National Research Center, Cairo, Egypt
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Leknes KN, Andersen KM, Bøe OE, Skavland RJ, Albandar JM. Enamel Matrix Derivative Versus Bioactive Ceramic Filler in the Treatment of Intrabony Defects: 12-Month Results. J Periodontol 2009; 80:219-27. [DOI: 10.1902/jop.2009.080236] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Effect of soft laser and bioactive glass on bone regeneration in the treatment of bone defects (an experimental study). Lasers Med Sci 2008; 24:527-33. [DOI: 10.1007/s10103-008-0590-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Accepted: 05/15/2008] [Indexed: 10/21/2022]
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Effect of soft laser and bioactive glass on bone regeneration in the treatment of infra-bony defects (a clinical study). Lasers Med Sci 2008; 24:387-95. [DOI: 10.1007/s10103-008-0576-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Accepted: 05/15/2008] [Indexed: 11/25/2022]
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Shirakata Y, Setoguchi T, Machigashira M, Matsuyama T, Furuichi Y, Hasegawa K, Yoshimoto T, Izumi Y. Comparison of injectable calcium phosphate bone cement grafting and open flap debridement in periodontal intrabony defects: a randomized clinical trial. J Periodontol 2008; 79:25-32. [PMID: 18166089 DOI: 10.1902/jop.2008.070141] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Regeneration of lost periodontium is the ultimate goal of periodontal therapy. Bone grafts, guided tissue regeneration, and application of growth factors are used for periodontal regeneration. This study aimed to evaluate the clinical efficacy of a new, injectable calcium phosphate bone cement (CPC) in human periodontal intrabony defects. METHODS Thirty subjects (mean age, 53.4 +/- 9.1 years) with periodontitis and narrow intrabony defects were enrolled in the study. Subjects were classified randomly into the CPC graft group (N = 15) or the open flap debridement (OFD) alone group (N = 15). Clinical measurements were performed at baseline and at 3, 6, 9, and 12 months; radiographs were taken at baseline, 2 weeks, and 6 and 12 months after surgery. The Student t test was used for statistical analysis. RESULTS In the CPC group, six cases showed exposure or loss of the CPC within 12 months, whereas the remaining nine cases (CPC-R group) showed no adverse reaction, including infection or suppuration. Overall, CPC-R and OFD treatment groups exhibited a significant reduction in probing depth and a significant gain in clinical attachment level at 3, 6, 9, and 12 months compared to baseline values. However, there were no significant differences in any of the clinical parameters between the groups. In the CPC-R group, radiographic bone level gain appeared to be greater than in the OFD group. CONCLUSIONS The present study failed to demonstrate any superior clinical outcomes for the CPC group compared to the OFD group; however, radiographs revealed more favorable results in the CPC-R group. The filling volume and stiffness of CPC may compromise the clinical outcomes for periodontal intrabony defects.
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Affiliation(s)
- Yoshinori Shirakata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
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