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Song WP, Jin LY, Zhu MD, Wang H, Xia DS. Clinical trials using dental stem cells: 2022 update. World J Stem Cells 2023; 15:31-51. [PMID: 37007456 PMCID: PMC10052340 DOI: 10.4252/wjsc.v15.i3.31] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/20/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023] Open
Abstract
For nearly 20 years, dental stem cells (DSCs) have been successfully isolated from mature/immature teeth and surrounding tissue, including dental pulp of permanent teeth and exfoliated deciduous teeth, periodontal ligaments, dental follicles, and gingival and apical papilla. They have several properties (such as self-renewal, multidirectional differentiation, and immunomodulation) and exhibit enormous potential for clinical applications. To date, many clinical articles and clinical trials using DSCs have reported the treatment of pulpitis, periapical lesions, periodontitis, cleft lip and palate, acute ischemic stroke, and so on, and DSC-based therapies obtained satisfactory effects in most clinical trials. In these studies, no adverse events were reported, which suggested the safety of DSC-based therapy. In this review, we outline the characteristics of DSCs and summarize clinical trials and their safety as DSC-based therapies. Meanwhile, we also present the current limitations and perspectives of DSC-based therapy (such as harvesting DSCs from inflamed tissue, applying DSC-conditioned medium/DSC-derived extracellular vesicles, and expanding-free strategies) to provide a theoretical basis for their clinical applications.
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Affiliation(s)
- Wen-Peng Song
- Department of Stomatology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Lu-Yuan Jin
- Department of General Dentistry and Integrated Emergency Dental Care, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Meng-Di Zhu
- Department of General Dentistry and Integrated Emergency Dental Care, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Hao Wang
- Department of Stomatology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Deng-Sheng Xia
- Department of General Dentistry and Integrated Emergency Dental Care, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
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2
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Jasser RA, AlSubaie A, AlShehri F. Effectiveness of beta-tricalcium phosphate in comparison with other materials in treating periodontal infra-bony defects around natural teeth: a systematic review and meta-analysis. BMC Oral Health 2021; 21:219. [PMID: 33926447 PMCID: PMC8082765 DOI: 10.1186/s12903-021-01570-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 04/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Beta-tricalcium phosphate in regenerative surgery has shown promising results in terms of bone gain and new vital bone formation; however, several studies have contradicted this finding. The aim of this study was to evaluate the effectiveness of beta-tricalcium phosphate compared to other grafting materials in the regeneration of periodontal infra-bony defects. METHODS Electronic database (Cochrane, MEDLINE, PubMed, Embase, Science Citation Index Expanded) and manual searches for related data were performed up until March 2020. The outcomes were pocket depth reduction, clinical attachment level gain, and amount of bone fill. RESULTS Five studies were selected based on the inclusion criteria. Bone regeneration with beta-tricalcium phosphate was observed to be superior to that with debridement alone but showed comparable results to other bone graft materials in terms of pocket depth reduction, clinical attachment level gain, and bone fill. Regenerative procedures for periodontal infra-bony defects that used beta-tricalcium phosphate in combination with other growth factors yielded superior outcomes. The meta-analysis revealed that for cases with two-wall defects, the use of beta-tricalcium phosphate yielded statistically significant differences in pocket depth reduction and clinical attachment level gain, but not in bone fill. CONCLUSIONS Beta-tricalcium phosphate appears to be a promising material for use in periodontal infra-bony defect regeneration around natural teeth. However, randomized clinical trials with larger sample sizes and more controlled study designs are needed to support these findings.
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Affiliation(s)
- Reham Al Jasser
- Associate Professor,Department of Periodontics and Community Dentistry, Dental College, King Saud University, PO Box 60169, Riyadh, 11545, Saudi Arabia.
| | | | - Fayez AlShehri
- Saudi Board Resident, Ministry of Health, Riyadh, Saudi Arabia
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3
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Chen CC, Lee SY, Teng NC, Hu HT, Huang PC, Yang JC. In Vitro and In Vivo Studies of Hydrophilic Electrospun PLA95/β-TCP Membranes for Guided Tissue Regeneration (GTR) Applications. NANOMATERIALS 2019; 9:nano9040599. [PMID: 30979018 PMCID: PMC6523545 DOI: 10.3390/nano9040599] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 11/28/2022]
Abstract
The guided tissue regeneration (GTR) membrane is a barrier intended to maintain a space for alveolar bone and periodontal ligament tissue regeneration but prevent the migration of fast-growing soft tissue into the defect sites. This study evaluated the physical properties, in vivo animal study, and clinical efficacy of hydrophilic PLA95/β-TCP GTR membranes prepared by electrospinning (ES). The morphology and cytotoxicity of ES PLA95/β-TCP membranes were evaluated by SEM and 3-(4,5-cimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) respectively. The cementum and bone height were measured by an animal study at 8 and 16 weeks after surgery. Fifteen periodontal patients were selected for the clinical trial by using a commercial product and the ES PLA95/β-TCP membrane. Radiographs and various indexes were measured six months before and after surgery. The average fiber diameter for this ES PLA95/β-TCP membrane was 2.37 ± 0.86 µm. The MTT result for the ES PLA95/β-TCP membrane showed negative for cytotoxicity. The significant differences in the cementum and bone height were observed between empty control and the ES PLA95/β-TCP membrane in the animal model (p < 0.05). Clinical trial results showed clinical attachment level (CAL) of both control and ES PLA95/β-TCP groups, with a significant difference from the pre-surgery results after six months. This study demonstrated that the ES PLA95/β-TCP membrane can be used as an alternative GTR membrane for clinical applications.
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Affiliation(s)
- Chien-Chung Chen
- Graduate Institute of Biomedical Materials & Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan.
- Ph.D. Program in Biotechnology Research and Development, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan.
| | - Sheng-Yang Lee
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
- Department of Dentistry, Wan-Fang Medical Center, Taipei Medical University, Taipei 116, Taiwan.
| | - Nai-Chia Teng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Hsin-Tai Hu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Pei-Chi Huang
- Department of Dentistry, Wan-Fang Medical Center, Taipei Medical University, Taipei 116, Taiwan.
| | - Jen-Chang Yang
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan.
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan.
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4
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Struillou X, Fruchet A, Rakic M, Badran Z, Rethore G, Sourice S, Fellah BH, LE Guehennec L, Gauthier O, Weiss P, Soueidan A. Evaluation of a hydrogel membrane on bone regeneration in furcation periodontal defects in dogs. Dent Mater J 2018; 37:825-834. [PMID: 29925730 DOI: 10.4012/dmj.2017-238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the study was to evaluate bone regeneration using a canine model with surgically created periodontal defects filled for 12 weeks using a stratified biomaterial consisting in a biphasic calcium phosphate (BCP) covered with a crosslinking hydrogel acting as polymer membrane of silated hydroxypropyl methylcellulose (Si-HPMC) as the tested new concept. Bilateral, critical-sized, defects were surgically created at the mandibular premolar teeth of six adult beagle dogs. The defects were randomly allocated and: (i) left empty for spontaneous healing or filled with: (ii) BCP and a collagen membrane; (iii) BCP and hydrogel Si-HPMC membrane. At 12 weeks, the experimental conditions resulted in significantly enhanced bone regeneration in the test BCP/Si-HPMC group. Within the limits of this study, we suggest that the hydrogel Si-HPMC may act as an occlusive barrier to protect bone area from soft connective tissue invasion and then effectively contribute to enhance bone regeneration.
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Affiliation(s)
- Xavier Struillou
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
| | - Aurélien Fruchet
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
| | - Mia Rakic
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Institute for Biological Research "Sinisa Stankovic", University of Belgrade
| | - Zahi Badran
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Faculty of Dentistry, Mcgill University
| | - Gildas Rethore
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
| | - Sophie Sourice
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes
| | | | - Laurent LE Guehennec
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
| | - Olivier Gauthier
- ONIRIS, College of Veterinary Medicine, Department of Small Animal Surgery
| | - Pierre Weiss
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
| | - Assem Soueidan
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
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Nunes FAS, Pignaton TB, Novaes AB, Taba M, Messora MR, Palioto DB, Spin-Neto R, de Souza SLS. Evaluation of a bone substitute covered with a collagen membrane for ridge preservation after tooth extraction. Clinical and tomographic randomized controlled study in humans. Clin Oral Implants Res 2018; 29:424-433. [DOI: 10.1111/clr.13140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Felipe Anderson Sousa Nunes
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Túlio B. Pignaton
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Arthur B. Novaes
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Mário Taba
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Michel R. Messora
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Daniela B. Palioto
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
| | - Rubens Spin-Neto
- Oral Radiology; Department of Dentistry and Oral Health; Aarhus University; Aarhus Denmark
| | - Sérgio Luís Scombatti de Souza
- Departament of Oral & Maxillofacial Surgery and Periodontology; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto São Paulo Brazil
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Dutta SR, Passi D, Singh P, Bhuibhar A. Ceramic and non-ceramic hydroxyapatite as a bone graft material: a brief review. Ir J Med Sci 2014; 184:101-6. [PMID: 25428698 DOI: 10.1007/s11845-014-1199-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 09/02/2014] [Indexed: 11/25/2022]
Abstract
Treatment of dental, craniofacial and orthopedic defects with bone graft substitutes has shown promising result achieving almost complete bone regeneration depending on product resorption similar to human bone's physicochemical and crystallographic characteristics. Among these, non-ceramic and ceramic hydroxyapatite being the main inorganic salt of bone is the most studied calcium phosphate material in clinical practices ever since 1970s and non-ceramic since 1985. Its "chemical similarity" with the mineralized phase of biologic bone makes it unique. Hydroxyapatite as an excellent carrier of osteoinductive growth factors and osteogenic cell populations is also useful as drug delivery vehicle regardless of its density. Porous ceramic and non-ceramic hydroxyapatite is osteoconductive, biocompatible and very inert. The need for bone graft material keeps on increasing with increased age of the population and the increased conditions of trauma. Recent advances in genetic engineering and doping techniques have made it possible to use non-ceramic hydroxyapatite in larger non-ceramic crystals and cluster forms as a successful bone graft substitute to treat various types of bone defects. In this paper we have mentioned some recently studied properties of hydroxyapatite and its various uses through a brief review of the literatures available to date.
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Affiliation(s)
- S R Dutta
- Department of Oral and Maxillofacial Surgery, M. B. Kedia Dental College, Tribhuvan University, Chhapkaiya, Birgunj, Nepal,
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Bansal R, Patil S, Chaubey KK, Thakur RK, Goyel P. Clinical evaluation of hydroxyapatite and β-tricalcium phosphate composite graft in the treatment of intrabony periodontal defect: A clinico-radiographic study. J Indian Soc Periodontol 2014; 18:610-7. [PMID: 25425823 PMCID: PMC4239751 DOI: 10.4103/0972-124x.142455] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 02/10/2014] [Indexed: 11/12/2022] Open
Abstract
Background and Objective: Hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) grafts have shown to be effective in promoting the clinical signs of periodontal regeneration in intrabony defects. The aim of our study was to clinically and radiographically evaluate the efficacy of HA and β-TCP composite bone graft material in the treatment of intrabony three-wall defect. Materials and Methods: Twenty patients participated in this study. Interproximal bony defects were surgically treated with a combination of HA–βTCP (biphasic calcium phosphate). Changes in clinical parameters such as gingival status, probing pocket depth, clinical attachment, and radiographic estimation of the amount of bone fill were evaluated after 6 months postoperatively. Statistical Analysis Used: Student's “t” test. Results: This treatment modality resulted in significant pocket depth reduction and clinical attachment gain which were observed to be 2.938 mm (47.04%) and 3.188 mm (29.09%), respectively. The defect fill as seen radiographically was 3.204 mm (63.195%). All the differences were highly significant and in favor of postoperative group. Conclusion: The results of this study suggest that HA–βTCP (biphasic calcium phosphate) provides an added regenerative effect in promoting the clinical resolution of intrabony three-wall defects in patients with periodontitis.
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Affiliation(s)
- Rajat Bansal
- Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Sudhir Patil
- Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Krishna Kumar Chaubey
- Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Rajesh Kumar Thakur
- Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Purnita Goyel
- Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
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8
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Fishero BA, Kohli N, Das A, Christophel JJ, Cui Q. Current concepts of bone tissue engineering for craniofacial bone defect repair. Craniomaxillofac Trauma Reconstr 2014; 8:23-30. [PMID: 25709750 DOI: 10.1055/s-0034-1393724] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 02/28/2014] [Indexed: 12/17/2022] Open
Abstract
Craniofacial fractures and bony defects are common causes of morbidity and contribute to increasing health care costs. Successful regeneration of bone requires the concomitant processes of osteogenesis and neovascularization. Current methods of repair and reconstruction include rigid fixation, grafting, and free tissue transfer. However, these methods carry innate complications, including plate extrusion, nonunion, graft/flap failure, and donor site morbidity. Recent research efforts have focused on using stem cells and synthetic scaffolds to heal critical-sized bone defects similar to those sustained from traumatic injury or ablative oncologic surgery. Growth factors can be used to augment both osteogenesis and neovascularization across these defects. Many different growth factor delivery techniques and scaffold compositions have been explored yet none have emerged as the universally accepted standard. In this review, we will discuss the recent literature regarding the use of stem cells, growth factors, and synthetic scaffolds as alternative methods of craniofacial fracture repair.
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Affiliation(s)
- Brian Alan Fishero
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Nikita Kohli
- Department of Otolaryngology-Head and Neck Surgery, SUNY Downstate Medical Center, Brooklyn, New York
| | - Anusuya Das
- Orthopaedic Surgery Research Center, University of Virginia, Charlottesville, Virginia
| | - John Jared Christophel
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Quanjun Cui
- Department of Orthopaedic Surgery, School of Medicine, University of Virginia, Charlottesville, Virginia
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Yip I, Ma L, Mattheos N, Dard M, Lang NP. Defect healing with various bone substitutes. Clin Oral Implants Res 2014; 26:606-14. [DOI: 10.1111/clr.12395] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Ian Yip
- Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - Li Ma
- Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - Nikos Mattheos
- Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Hong Kong
| | - Michel Dard
- Department of Periodontology and Implant Dentistry; College of Dentistry; New York University; New York NY USA
| | - Niklaus P. Lang
- Oral Rehabilitation; Faculty of Dentistry; The University of Hong Kong; Hong Kong
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Zafiropoulos GGK, Deli G, Vittorini G, Hoffmann O. Implant Placement and Immediate Loading With Fixed Restorations in Augmented Sockets. Five-Year Results. A Case Report. J ORAL IMPLANTOL 2013; 39:372-9. [DOI: 10.1563/aaid-joi-d-10-00013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In this report, a case is presented in which a patient received eight implants 10 months after tooth extraction and socket preservation. The implants were placed in both arches (maxilla = 4, mandible = 4) and immediately loaded using fixed partial restorations; they remained functional over 5 years. No changes in bleeding on probing or plaque index were observed; however, a 1.5-mm probing attachment level loss was observed during the first 3 years (mean: 0.25 mm/year) with no subsequent changes.
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Affiliation(s)
| | - Giorgio Deli
- Division of Periodontology, A. Gemelli Hospital, Catholic University, Rome, Italy
| | - Gianluca Vittorini
- Division of Periodontology, A. Gemelli Hospital, Catholic University, Rome, Italy
| | - Oliver Hoffmann
- Department of Periodontics, University of Loma Linda, Loma Linda, Calif
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11
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De Leonardis D, Paolantonio M. Enamel Matrix Derivative, Alone or Associated With a Synthetic Bone Substitute, in the Treatment of 1- to 2-Wall Periodontal Defects. J Periodontol 2013; 84:444-55. [DOI: 10.1902/jop.2012.110656] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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Tour G, Wendel M, Tcacencu I. Human fibroblast-derived extracellular matrix constructs for bone tissue engineering applications. J Biomed Mater Res A 2013; 101:2826-37. [DOI: 10.1002/jbm.a.34600] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 01/08/2013] [Accepted: 01/14/2013] [Indexed: 01/10/2023]
Affiliation(s)
- Gregory Tour
- Department of Dental Medicine; Karolinska Institutet; 14104 Huddinge; Sweden
| | - Mikael Wendel
- Department of Dental Medicine; Karolinska Institutet; 14104 Huddinge; Sweden
| | - Ion Tcacencu
- Department of Dental Medicine; Karolinska Institutet; 14104 Huddinge; Sweden
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Peres MFS, Ribeiro ÉDP, Casarin RCV, Ruiz KGS, Junior FHN, Sallum EA, Casati MZ. Hydroxyapatite/β-tricalcium phosphate and enamel matrix derivative for treatment of proximal class II furcation defects: a randomized clinical trial. J Clin Periodontol 2013; 40:252-9. [DOI: 10.1111/jcpe.12054] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 10/20/2012] [Accepted: 11/30/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Maria F. S. Peres
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Érica D. P. Ribeiro
- Department of Periodontics; Bahian Foundation for Development of Science; Bahia Brazil
| | | | - Karina G. S. Ruiz
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Francisco H. N. Junior
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Enilson A. Sallum
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
| | - Márcio Z. Casati
- Department of Prosthodontics and Periodontics; Piracicaba Dental School; UNICAMP; São Paulo Brazil
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14
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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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15
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Patel K, Mardas N, Donos N. Radiographic and clinical outcomes of implants placed in ridge preserved sites: a 12-month post-loading follow-up. Clin Oral Implants Res 2012; 24:599-605. [PMID: 22672611 DOI: 10.1111/j.1600-0501.2012.02500.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this clinical study was to evaluate the interproximal radiographic bone levels and the survival/success rate of dental implants placed in alveolar ridges previously preserved with a synthetic bone substitute or a bovine xenograft. MATERIAL AND METHODS Alveolar ridge preservation was performed in 27 patients who were randomly assigned in two groups. In the test group (n = 14), the extraction socket was treated with a synthetic bone graft Straumann Bone Ceramic; SBC and a collagen barrier, whereas in the control group (n = 13) a deproteinized bovine bone mineral (DBBM) and the same collagen barrier were used. After 8 months of healing, titanium dental implants with a hydrophilic surface were placed in the preserved ridges. During surgery, 9/13 implants in the SBC group and 8/12 implants in the DBBM group presented with either dehiscence or fenestration defects and required additional bone augmentation. The implants were loaded at 4 months following placement and were followed up for 1 year post-loading. Interproximal radiographic bone levels were evaluated in standardized periapical radiographs at loading and 1 year post-loading. Probing pocket depth, gingival recession and bleeding upon probing were recorded at implants and neighbouring teeth. The success rate of the implants was evaluated according to criteria set by Albrektsson et al. (1986). RESULTS The survival rate of the implants in both groups was 100% at 1-year post-loading. No statistically significant differences in any of the clinical and radiographic measurements were detected between the two groups (P < 0.05). The success rate of the implants was 84.6% (11/13) in the SBC group and 83.3% (10/12) in the DBBM group. CONCLUSION Equivalent success and survival rates (as well as similar radiographic changes) of dental implants placed in alveolar ridges previously preserved with SBC or DBBM should be anticipated.
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Affiliation(s)
- K Patel
- Restorative Dentistry, UCLH Eastman Dental Hospital, London, UK
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Yadav VS, Narula SC, Sharma RK, Tewari S, Yadav R. Clinical evaluation of guided tissue regeneration combined with autogenous bone or autogenous bone mixed with bioactive glass in intrabony defects. J Oral Sci 2012; 53:481-8. [PMID: 22167034 DOI: 10.2334/josnusd.53.481] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Conflicting data exist on the combined use of grafting materials and barrier membranes in comparison to guided tissue regeneration (GTR) with membrane alone. The aim of the present study was to compare the clinical outcomes of GTR with collagen membrane (CM) alone (control group) or CM combined with autogenous bone graft (test group 1) or autogenous bone mixed with bioactive glass (test group 2) in intrabony defects. A total of 32 intraosseous defects in 22 subjects were treated randomly. After 6 months, significant probing depth reduction, clinical attachment level gain (CAL) and defect resolution were observed in all groups with significantly greater improvements in the test groups. There was no significant difference between the two test groups in any parameter. Results of the present study suggest that autogenous bone can be mixed with bioactive glass if the amount of the harvested bone is not sufficient.
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Affiliation(s)
- Vikender S Yadav
- Department of Periodontics and Oral Implantology, Government Dental College, Rohtak, Haryana, India.
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Mardas N, D'Aiuto F, Mezzomo L, Arzoumanidi M, Donos N. Radiographic alveolar bone changes following ridge preservation with two different biomaterials. Clin Oral Implants Res 2011; 22:416-23. [PMID: 21561483 DOI: 10.1111/j.1600-0501.2010.02154.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this randomized controlled trial was to evaluate radiographical bone changes following alveolar ridge preservation with a synthetic bone substitute or a bovine xenograft. METHODS Alveolar ridge preservation was performed in 27 patients randomized in two groups. In the test group (n=14), the extraction socket was treated with Straumann bone ceramic(®) (SBC) and a collagen barrier membrane (Bio-Gide(®)), whereas in the control group (n=13) with deproteinized bovine bone mineral and the same barrier. Standardized periapical X-rays were taken at 4 time points, BL: after tooth extraction, GR: immediately after socket grafting, 4M: 16 weeks, 8M: 32 weeks post-operatively. The levels of the alveolar bone crest at the mesial (Mh), and distal (Dh) and central aspects of the socket were measured at all time points. All the radiographs obtained were subtracted from the follow-up images. The gain, loss and unchanged areas in terms of grey values were tested for significant difference between the two groups. RESULTS In the test group, the Mh and Dh showed a mean difference (± standard deviation) of 0.9 ± 1.2 and 0.7 ± 1.8 mm, respectively, among BL-8M. In the control group, the Mh and Dh showed a mean difference of 0.4 ± 1.3 and 0.7 ± 1.3 mm, respectively (P>0.05). Both treatments presented similar gain in grey values between BL-GR, BL-4M and BL-8M. The SBC presented less loss in grey values between BL-4M and BL-8M (P<0.05). Radiographic assessment underestimated the intrasurgical measurements (mesial and distal) of an average 0.3 mm (95% CI, 0.02-0.6). CONCLUSION Both types of bone grafts presented similar radiographic alveolar bone changes when used for alveolar ridge preservation.
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Affiliation(s)
- Nikos Mardas
- Periodontology Unit, Eastman Dental Institute, University College London, London, UK.
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Schneider D, Weber FE, Hämmerle CHF, Feloutzis A, Jung RE. Bone regeneration using a synthetic matrix containing enamel matrix derivate. Clin Oral Implants Res 2011; 22:214-22. [PMID: 21223377 DOI: 10.1111/j.1600-0501.2010.01985.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of the present study was to test whether the delivery of enamel matrix derivate (EMD) via synthetic polyethylene glycol (PEG)-based hydrogels with and without RGD sequences enhances bone formation in vivo. MATERIAL AND METHODS In each of 10 rabbits, four titanium cylinders were placed on the external cortical bones of their calvaria. The following four treatment modalities were randomly allocated: One of the four cylinders was left empty (control), the other three were filled with a combination of PEG matrix with hydroxyapatite/tricalciumphosphate (HA/TCP) granules and EMD in a concentration of 100 μg/ml (test 1) or 500 μg/ml (test 2) or 500 μg/ml and RGD peptide (test 3). After 8 weeks, the animals were sacrificed and ground sections were obtained for histological analysis. For statistical analysis, the Kruskal-Wallis test was applied (P<0.05). RESULTS The histomorphometric analysis revealed a statistically larger area fraction of newly formed bone in the EMD 500/RGD group (54.8±14.5%) compared with the control group (28.7±10.3%) and the EMD 500 group (31.2±14.1%) and non-significantly higher area fraction compared with the EMD 100 group (38.2±10.4%). The percentage of mineralized bone showed no statistically significant differences among the four groups. The mean percentage of mineralized bone was 13.6±3.3% in the control group, 14.2±5.8% in the EMD 100 group, 11.69±5.9% in the EMD 500 group and 15.66±5.2% in the EMD 500/RGD group. No statistically significant difference regarding the bone-to-graft contact between the EMD 100 group (23±15.7%), the EMD 500 group (22.2±14.6%) and the EMD 500/RGD group (21.6±8.8%) was observed. CONCLUSIONS The combination of a PEG matrix containing EMD with HA/TCP granules had no effect on the formation of mineralized bone tissue in rabbit calvaria. The addition of RGD peptide to the PEG/EMD 500 combination increased the area fraction of newly formed bone compared with the other treatment groups. Further studies are indicated to study a possible synergistic effect of EMD and RGD.
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Affiliation(s)
- David Schneider
- Center for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, Clinic for Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Plattenstrasse 11, Zurich, Switzerland
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Mardas N, Chadha V, Donos N. Alveolar ridge preservation with guided bone regeneration and a synthetic bone substitute or a bovine-derived xenograft: a randomized, controlled clinical trial. Clin Oral Implants Res 2010; 21:688-98. [PMID: 20636724 DOI: 10.1111/j.1600-0501.2010.01918.x] [Citation(s) in RCA: 169] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this randomized, controlled clinical trial was to compare the potential of a synthetic bone substitute or a bovine-derived xenograft combined with a collagen membrane to preserve the alveolar ridge dimensions following tooth extraction. METHODS Twenty-seven patients were randomized into two treatment groups following single tooth extraction in the incisor, canine and premolar area. In the test group, the alveolar socket was grafted with Straumann Bone Ceramic (SBC), while in the control group, Bio-Oss deproteinized bovine bone mineral (DBBM) was applied. In both groups, a collagen barrier was used to cover the grafting material. Complete soft tissue coverage of the barriers was not achieved. After 8 months, during re-entry procedures and before implant placement, the horizontal and vertical dimensions of the residual ridge were re-evaluated and trephine biopsies were performed for histological analysis in all patients. RESULTS Twenty-six patients completed the study. The bucco-lingual dimension of the alveolar ridge decreased by 1.1+/-1 mm in the SBC group and by 2.1+/-1 in the DBBM group (P<0.05). Both materials preserved the mesio-distal bone height of the ridge. No differences in the width of buccal and palatal bone plate were observed between the two groups. The histological analysis showed new bone formation in the apical part of the biopsies, which, in some instances, was in direct contact with both SBC and DBBM particles. The coronal part of the biopsies was occupied by a dense fibrous connective tissue surrounding the SBC and DBBM particles. CONCLUSION Both biomaterials partially preserved the width and the interproximal bone height of the alveolar ridge.
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Affiliation(s)
- Nikos Mardas
- Periodontology Unit, UCL - Eastman Dental Institute, London, UK
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Lindgren C, Hallman M, Sennerby L, Sammons R. Back-scattered electron imaging and elemental analysis of retrieved bone tissue following sinus augmentation with deproteinized bovine bone or biphasic calcium phosphate. Clin Oral Implants Res 2010; 21:924-30. [PMID: 20491837 DOI: 10.1111/j.1600-0501.2010.01933.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To compare resorption of a synthetic biphasic calcium phosphate (BCP) bone-graft substitute with deproteinized bovine bone (DBB) used for human maxillary sinus augmentation. MATERIALS AND METHODS Eleven patients underwent bilateral maxillary sinus floor augmentation with DBB in one side and a BCP (40%beta-tricalcium phosphate (beta-TCP) and 60% hydroxyapatite) in the contralateral side. Simultaneously, with the augmentation on each side a microimplant was placed vertically from the top of the alveolar crest penetrating the residual bone and the grafting material. Eight months after initial surgery the microimplants were retrieved with a surrounding bone core. The composition of residual graft material and surrounding bone was analysed by scanning electron microscopy and energy dispersive X-ray spectroscopy. RESULTS Residual graft material of both types was present as 10-500 mum particles in direct contact with, or completely surrounded by, newly formed bone; smaller particles were also present in non-mineralized tissue. In the case of BCP the bone-graft substitute interface showed evidence of superficial disintegration of particles into individual grains. Median Ca/P ratios (at.%), determined from >200 discreet sites within residual graft particles and adjacent bone, were: DBB: 1.61 (confidence interval [CI] 1.59-1.64); BCP: 1.5 (CI 1.45-1.52); DBB-augmented bone: 1.62 (CI 1.59-1.66); BCP-augmented bone: 1.52 (CI 1.47-1.55); P=0.028 for DBB vs. BCP and DBB- vs. BCP-augmented bone. The reduction in Ca/P ratio for BCP over the healing period is consistent with the dissolution of beta-TCP and reprecipitation on the surface of calcium-deficient hydroxyapatite. CONCLUSION The beta-TCP component of BCP may be gradually substituted by calcium-deficient hydroxyapatite over the healing period. This process and superficial degranulation of BCP particles may influence the progress of resorption and healing.
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Fukaya C, Nakayama Y, Murayama Y, Omata S, Ishikawa A, Hosaka Y, Nakagawa T. Improvement of hydrogelation abilities and handling of photocurable gelatin-based crosslinking materials. J Biomed Mater Res B Appl Biomater 2009; 91:329-36. [DOI: 10.1002/jbm.b.31406] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Foster BL, Tompkins KA, Rutherford RB, Zhang H, Chu EY, Fong H, Somerman MJ. Phosphate: known and potential roles during development and regeneration of teeth and supporting structures. BIRTH DEFECTS RESEARCH. PART C, EMBRYO TODAY : REVIEWS 2008; 84:281-314. [PMID: 19067423 PMCID: PMC4526155 DOI: 10.1002/bdrc.20136] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Inorganic phosphate (P(i)) is abundant in cells and tissues as an important component of nucleic acids and phospholipids, a source of high-energy bonds in nucleoside triphosphates, a substrate for kinases and phosphatases, and a regulator of intracellular signaling. The majority of the body's P(i) exists in the mineralized matrix of bones and teeth. Systemic P(i) metabolism is regulated by a cast of hormones, phosphatonins, and other factors via the bone-kidney-intestine axis. Mineralization in bones and teeth is in turn affected by homeostasis of P(i) and inorganic pyrophosphate (PPi), with further regulation of the P(i)/PP(i) ratio by cellular enzymes and transporters. Much has been learned by analyzing the molecular basis for changes in mineralized tissue development in mutant and knock-out mice with altered P(i) metabolism. This review focuses on factors regulating systemic and local P(i) homeostasis and their known and putative effects on the hard tissues of the oral cavity. By understanding the role of P(i) metabolism in the development and maintenance of the oral mineralized tissues, it will be possible to develop improved regenerative approaches.
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Affiliation(s)
- Brian L Foster
- Department of Periodontics, University of Washington School of Dentistry, Seattle, WA 98195, USA
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Crea A, Dassatti L, Hoffmann O, Zafiropoulos GG, Deli G. Treatment of Intrabony Defects Using Guided Tissue Regeneration or Enamel Matrix Derivative: A 3-Year Prospective Randomized Clinical Study. J Periodontol 2008; 79:2281-9. [DOI: 10.1902/jop.2008.080135] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Sculean A, Windisch P, Szendröi-Kiss D, Horváth A, Rosta P, Becker J, Gera I, Schwarz F. Clinical and Histologic Evaluation of an Enamel Matrix Derivative Combined With a Biphasic Calcium Phosphate for the Treatment of Human Intrabony Periodontal Defects. J Periodontol 2008; 79:1991-9. [DOI: 10.1902/jop.2008.080009] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jepsen S, Topoll H, Rengers H, Heinz B, Teich M, Hoffmann T, Al-Machot E, Meyle J, Jervøe-Storm PM. Clinical outcomes after treatment of intra-bony defects with an EMD/synthetic bone graft or EMD alone: a multicentre randomized-controlled clinical trial. J Clin Periodontol 2008; 35:420-8. [DOI: 10.1111/j.1600-051x.2008.01217.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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