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Heinig O, Feicht E, Mahamid A, Liberson R, Picard C, Liberson A. Treatment of a compound calcaneus fracture Sanders IV with an external circular fixator and calcaneal osteotomy. Trauma Case Rep 2023; 46:100850. [PMID: 37333494 PMCID: PMC10272509 DOI: 10.1016/j.tcr.2023.100850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 06/20/2023] Open
Abstract
Compound Gustilo-type III intra-articular calcaneus fractures are challenging to treat. Anatomical reduction of the subtalar joint increases the chances of a better functional outcome and is traditionally achieved by an open reduction and plating. Conversely, ORIF is associated with a high risk of infection and even amputation. In our case study, we present the treatment of a Gustilo-type III intra-articular calcaneus fracture with a circular external fixator and a temporary antibiotic cement spacer for fracture reduction and stabilization. Active bio-glass was implanted to fill bone loss and to prevent infection. A closing-wedge calcaneal tuberosity osteotomy was used to facilitate wound closure. We paid special attention to reducing the posterior facet. The patient returned to work and full ambulation five months post-injury.
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Affiliation(s)
- Ofer Heinig
- Foot & Ankle Unite, Laniado University Hospital, Adelson Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Elia Feicht
- Foot & Ankle Unite, Laniado University Hospital, Adelson Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Assil Mahamid
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Roman Liberson
- Foot & Ankle Unite, Laniado University Hospital, Adelson Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Claude Picard
- Foot & Ankle Unite, Laniado University Hospital, Adelson Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Aharon Liberson
- Foot & Ankle Unite, Laniado University Hospital, Adelson Faculty of Health Sciences, Ariel University, Ariel, Israel
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Qiu L, Lu Y, Dong H, Zhang H, Zhang M, Deng Q, Song J. Enhanced effect of a novel bioactive glass-ceramic for dental application. Clin Oral Investig 2023; 27:2027-2040. [PMID: 36933046 DOI: 10.1007/s00784-023-04946-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 03/06/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVES Dental caries is the most common chronic disease in humans, caused by the acid produced by the microflora in the mouth that dissolves the enamel minerals. Bioactive glass (BAG) has been used in various clinical applications due to its unique bioactive properties, such as bone graft substitutes and dental restorative composites. In this study, we introduce a novel bioactive glass-ceramic (NBGC) prepared through a sol-gel process under a water-free condition. MATERIALS AND METHODS The anti-demineralization and remineralization effects of NBGC were evaluated by comparing the measurements of bovine enamel surface morphology, surface roughness, surface micro-hardness, enamel elements, and mineral content before and after related treatments with a commercial BAG. The antibacterial effect was characterized by minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). RESULTS Results showed that NBGC had greater acid resistance and remineralization potential compared to commercial BAG. The fast formation of a hydroxy carbonate apatite (HCA) layer suggests efficient bioactivity. CLINICAL RELEVANCE In addition to its antibacterial properties, NBGC shows promise as an ingredient in oral care products that can prevent demineralization and restore enamel.
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Affiliation(s)
- Lin Qiu
- Dencare (Chongqing) Oral Care Co., Ltd, Chongqing, China.
- College of Stomatology, Chongqing Medical University, Chongqing, China.
| | - Yu Lu
- Dencare (Chongqing) Oral Care Co., Ltd, Chongqing, China
| | - Haide Dong
- Dencare (Chongqing) Oral Care Co., Ltd, Chongqing, China
| | - Huan Zhang
- Dencare (Chongqing) Oral Care Co., Ltd, Chongqing, China
| | - Min Zhang
- Dencare (Chongqing) Oral Care Co., Ltd, Chongqing, China
| | - Quanfu Deng
- Dencare (Chongqing) Oral Care Co., Ltd, Chongqing, China.
| | - Jinlin Song
- College of Stomatology, Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Jafari N, Habashi MS, Hashemi A, Shirazi R, Tanideh N, Tamadon A. Application of bioactive glasses in various dental fields. Biomater Res 2022; 26:31. [PMID: 35794665 PMCID: PMC9258189 DOI: 10.1186/s40824-022-00274-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/09/2022] [Indexed: 12/16/2022] Open
Abstract
AbstractBioactive glasses are a group of bioceramic materials that have extensive clinical applications. Their properties such as high biocompatibility, antimicrobial features, and bioactivity in the internal environment of the body have made them useful biomaterials in various fields of medicine and dentistry. There is a great variation in the main composition of these glasses and some of them whose medical usage has been approved by the US Food and Drug Administration (FDA) are called Bioglass. Bioactive glasses have appropriate biocompatibility with the body and they are similar to bone hydroxyapatite in terms of calcium and phosphate contents. Bioactive glasses are applied in different branches of dentistry like periodontics, orthodontics, endodontics, oral and maxillofacial surgery, esthetic and restorative dentistry. Also, some dental and oral care products have bioactive glasses in their compositions. Bioactive glasses have been used as dental implants in the human body in order to repair and replace damaged bones. Other applications of bioactive glasses in dentistry include their usage in periodontal disease, root canal treatments, maxillofacial surgeries, dental restorations, air abrasions, dental adhesives, enamel remineralization, and dentin hypersensitivity. Since the use of bioactive glasses in dentistry is widespread, there is a need to find methods and extensive resources to supply the required bioactive glasses. Various techniques have been identified for the production of bioactive glasses, and marine sponges have recently been considered as a rich source of it. Marine sponges are widely available and many species have been identified around the world, including the Persian Gulf. Marine sponges, as the simplest group of animals, produce different bioactive compounds that are used in a wide range of medical sciences. Numerous studies have shown the anti-tumor, anti-viral, anti-inflammatory, and antibiotic effects of these compounds. Furthermore, some species of marine sponges due to the mineral contents of their structural skeletons, which are made of biosilica, have been used for extracting bioactive glasses.
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Yadav VS, Gupta V, Chawla A, Tewari N, Yadav R. Successful management of a large mucosal fenestration at 18-months follow-up. J ESTHET RESTOR DENT 2021; 34:445-450. [PMID: 34927335 DOI: 10.1111/jerd.12855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Mucosal fenestrations are infrequent and often challenging to treat depending on the extent of soft and hard tissue destruction. This article presents the successful management of a relatively larger mucosal fenestration associated with complete absence of buccal bone plate in a mandibular incisor secondary to trauma-induced periapical pathosis. CLINICAL CONSIDERATIONS After non-surgical endodontic therapy, surgery was performed for debridement of the osseous defect, root resection/shaping, connective tissue graft (CTG) placement on the affected root surface and platelet rich fibrin (PRF) in periapical osseous defect rather than use of bone graft and/or barrier membrane. Healing was uneventful, however, a small mucosal defect remained at 2 weeks follow-up. After 3 months of primary surgery, a corrective surgery was performed utilizing an "incision-free" approach i.e. tunnel technique with CTG in contrast to the contemporary flap approach. At 18 months follow-up, complete closure of the mucosal defect with a thick gingival biotype, normal sulcus depth, and good esthetic outcome were achieved. No recurrence and any clinical signs of infection or inflammation were observed. CONCLUSIONS Based on the outcomes of present case, an early intervention utilizing the minimally invasive surgical therapy and autologous biomaterials may be considered a viable approach to treat such complex lesions. CLINICAL SIGNIFICANCE Endodontic therapy in combination with PRF and CTG appears to provide successful outcomes in treatment of a large mucosal fenestration with periapical osseous defect.
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Affiliation(s)
- Vikender Singh Yadav
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vandana Gupta
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amrita Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nitesh Tewari
- Division of Pedodontics and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Renu Yadav
- Department of Prosthodontics, Surendera Dental College and Research Institute, Sriganganagar, Rajasthan, India
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Chen JT, Wu IT, Huang RY, Lin YC, Chou YH, Lin T, Kuo PJ, Tu CC, Hou LT, Lai YL, Lu HK, Tsai CC, Yuan K, Chen CJ, Ho CS, Yang YC, Wu AYJ, Huang KC, Chiang CY, Chang PC. Recommendations for treating stage I-III periodontitis in the Taiwanese population: A consensus report from the Taiwan Academy of Periodontology. J Formos Med Assoc 2021; 120:2072-2088. [PMID: 34294496 DOI: 10.1016/j.jfma.2021.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/PURPOSE Based on the fundamental of the S3-level clinical practice guideline (CPG) for treating stage I-III periodontitis developed by the European Federation of Periodontology (EFP), this consensus report aimed to develop treatment recommendations for treating periodontitis in the Taiwanese population. METHODS The report was constructed by experts from the Taiwan Academy of Periodontology. The following topics were reviewed: (a) the prevalence of periodontitis in Asia and current status of treatment in Taiwan; (b) specific anatomical considerations for treating periodontitis in Asians; (d) educational and preventive interventions and supragingival plaque control; (d) subgingival instrumentation and adjunctive treatment; (e) surgical periodontal therapy; and (f) maintenance and supportive periodontal care. Recommendations were made according to the evidences from the EFP CPG, the published literature and clinical studies in Asians, and the expert opinions. RESULTS The treatment recommendations for the Taiwanese population were generally in parallel with the EFP CPG, and extra cautions during treatment and maintenance phases were advised due to the anatomical variations, such as shorter root trunk, higher prevalence of supernumerary distolingual root and lingual bony concavity in mandibular posteriors, and thinner anterior labial plate, of the Asian population. CONCLUSION The EFP CPG could be adopted for treating periodontitis and maintaining periodontal health of the Taiwanese population, and anatomical variations should be cautious when the treatment is delivered.
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Affiliation(s)
- Jung-Tsu Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Ting Wu
- Department of Dentistry, China Medical University Hospital, Taichung, Taiwan
| | - Ren-Yeong Huang
- School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Chun Lin
- Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Hsiang Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Taichen Lin
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Po-Jan Kuo
- School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Che-Chang Tu
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Lein-Tuan Hou
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Lin Lai
- Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsein-Kun Lu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Cheng Tsai
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Kuo Yuan
- Institute of Oral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Jung Chen
- Department of Dentistry, Chi-Mei Medical Center, Tainan, Taiwan
| | | | - Yueh-Chao Yang
- Department of Dentistry, Cathay General Hospital, Taipei, Taiwan
| | - Aaron Yu-Jen Wu
- Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | | | - Cheng-Yang Chiang
- School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Po-Chun Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
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Bioactive Glass Applications: A Literature Review of Human Clinical Trials. MATERIALS 2021; 14:ma14185440. [PMID: 34576662 PMCID: PMC8470635 DOI: 10.3390/ma14185440] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 12/11/2022]
Abstract
The use of bioactive glasses in dentistry, reconstructive surgery, and in the treatment of infections can be considered broadly beneficial based on the emerging literature about the potential bioactivity and biocompatibility of these materials, particularly with reference to Bioglass® 45S5, BonAlive® and 19-93B3 bioactive glasses. Several investigations have been performed (i) to obtain bioactive glasses in different forms, such as bulk materials, powders, composites, and porous scaffolds and (ii) to investigate their possible applications in the biomedical field. Although in vivo studies in animals provide us with an initial insight into the biological performance of these systems and represent an unavoidable phase to be performed before clinical trials, only clinical studies can demonstrate the behavior of these materials in the complex physiological human environment. This paper aims to carefully review the main published investigations dealing with clinical trials in order to better understand the performance of bioactive glasses, evaluate challenges, and provide an essential source of information for the tailoring of their design in future applications. Finally, the paper highlights the need for further research and for specific studies intended to assess the effect of some specific dissolution products from bioactive glasses, focusing on their osteogenic and angiogenic potential.
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7
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Autogenous Bone and Bioactive Glass around Implants Placed Simultaneously with Ridge Splitting for the Treatment of Horizontal Bony Defects: A Randomised Clinical Trial. Int J Dent 2021; 2021:2457328. [PMID: 34367287 PMCID: PMC8337152 DOI: 10.1155/2021/2457328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To compare using autogenous bone with or without bioactive glass in ridge splitting of horizontal bone defects combined with simultaneous implant placement. Materials and Methods In control group, bone expansion was performed and autogenous bone was used to augment the intercortical bone defect. In study group, autogenous bone was mixed with bioactive glass (1 : 1 in volume). In both groups, the implants were inserted simultaneously with ridge splitting. Six months following implant insertion, bone width and height were evaluated. Statistical analysis utilizing paired Student's t-test was used for comparing results within the same group, whereas independent samples t-test was used for intergroup variables comparison. Results The mean bone width and labial and mesiodistal crestal bone height values were increased significantly in both groups from baseline to 6 months postoperatively. Comparing the two groups showed nonstatistical significant difference regarding the labial crestal bone loss, while the ridge width gain values were significantly higher in the study group than in the control group. The mesiodistal bone loss was significantly higher in control group than in study group. Conclusion Autogenous bone was mixed with bioactive glass (1 : 1 in volume) to fill intercortical defect created after ridge splitting to decrease peri-implant bone resorption associated with autogenous bone alone. This trial is registered with clinical trial registration: NCT04814160.
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8
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Deraine A, Rebelo Calejo MT, Agniel R, Kellomäki M, Pauthe E, Boissière M, Massera J. Polymer-Based Honeycomb Films on Bioactive Glass: Toward a Biphasic Material for Bone Tissue Engineering Applications. ACS APPLIED MATERIALS & INTERFACES 2021; 13:29984-29995. [PMID: 34129320 PMCID: PMC8289249 DOI: 10.1021/acsami.1c03759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The development of innovative materials for bone tissue engineering to promote bone regeneration while avoiding fibrous tissue infiltration is of paramount importance. Here, we combined the known osteopromotive properties of bioactive glasses (BaGs) with the biodegradability, biocompatibility, and ease to shape/handle of poly-l-co-d,l-lactic acid (PLDLA) into a single biphasic material. The aim of this work was to unravel the role of the surface chemistry and topography of BaG surfaces on the stability of a PLDLA honeycomb membrane, in dry and wet conditions. The PLDLA honeycomb membrane was deposited using the breath figure method (BFM) on the surface of untreated BaG discs (S53P4 and 13-93B20), silanized with 3-aminopropyltriethoxysilane (APTES) or conditioned (immersed for 24 h in TRIS buffer solution). The PLDLA membranes deposited onto the BaG discs, regardless of their composition or surface treatments, exhibited a honeycomb-like structure with pore diameter ranging from 1 to 5 μm. The presence of positively charged amine groups (APTES grafting) or the precipitation of a CaP layer (conditioned) significantly improved the membrane resistance to shear as well as its stability upon immersion in the TRIS buffer solution. The obtained results demonstrated that the careful control of the substrate surface chemistry enabled the deposition of a stable honeycomb membrane at their surface. This constitutes a first step toward the development of new biphasic materials enabling osteostimulation (BaG) while preventing migration of fibrous tissue inside the bone defect (honeycomb polymer membrane).
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Affiliation(s)
- A. Deraine
- ERRMECe,
Equipe de Recherche sur les Relations Matrice Extracellulaire-Cellules
(EA1391), Université de Cergy-Pontoise, Maison Internationale
de la Recherche (MIR), Rue Descartes, 95001 Neuville sur Oise, Cedex, France
- Laboratory
of Biomaterials and Tissue Engineering, Faculty of Medicine and Health
Technology, Tampere University, Korkeakoulunkatu 3, 33720 Tampere, Finland
| | - M. T. Rebelo Calejo
- Laboratory
of Biomaterials and Tissue Engineering, Faculty of Medicine and Health
Technology, Tampere University, Korkeakoulunkatu 3, 33720 Tampere, Finland
| | - R. Agniel
- ERRMECe,
Equipe de Recherche sur les Relations Matrice Extracellulaire-Cellules
(EA1391), Université de Cergy-Pontoise, Maison Internationale
de la Recherche (MIR), Rue Descartes, 95001 Neuville sur Oise, Cedex, France
| | - M. Kellomäki
- Laboratory
of Biomaterials and Tissue Engineering, Faculty of Medicine and Health
Technology, Tampere University, Korkeakoulunkatu 3, 33720 Tampere, Finland
| | - E. Pauthe
- ERRMECe,
Equipe de Recherche sur les Relations Matrice Extracellulaire-Cellules
(EA1391), Université de Cergy-Pontoise, Maison Internationale
de la Recherche (MIR), Rue Descartes, 95001 Neuville sur Oise, Cedex, France
| | - M. Boissière
- ERRMECe,
Equipe de Recherche sur les Relations Matrice Extracellulaire-Cellules
(EA1391), Université de Cergy-Pontoise, Maison Internationale
de la Recherche (MIR), Rue Descartes, 95001 Neuville sur Oise, Cedex, France
| | - J. Massera
- Laboratory
of Biomaterials and Tissue Engineering, Faculty of Medicine and Health
Technology, Tampere University, Korkeakoulunkatu 3, 33720 Tampere, Finland
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9
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Jones JR, Gibson IR. Ceramics, Glasses, and Glass-Ceramics. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00022-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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11
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Issa DR, Abdel-Ghaffar KA, Al-Shahat MA, Hassan AAA, Iacono VJ, Gamal AY. Guided tissue regeneration of intrabony defects with perforated barrier membranes, simvastatin, and EDTA root surface modification: A clinical and biochemical study. J Periodontal Res 2019; 55:85-95. [PMID: 31448832 DOI: 10.1111/jre.12692] [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: 11/17/2018] [Revised: 07/08/2019] [Accepted: 07/28/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Perforated barrier membranes (PBM) were suggested to enhance periodontal regeneration by allowing positive charity of wanted elements from the gingival tissue side. The present study was designed to evaluate clinically and biochemically the use of PBM combined with simvastatin (SMV) gel with and without an associated EDTA gel root surface etching as a suggested option that could improve SMV availability and clinical outcomes of PBM. METHODS Forty patients having moderate-to-severe chronic periodontitis with 40 intrabony defects were randomly divided into four treatment groups (10 sites each). Patients in group 1 received 1.2% SMV gel and covering the defect with occlusive membrane (OM). Patients in group 2 received 1.2% SMV gel and covering the defect with PBM. Group 3 received 24% EDTA root surface etching, 1.2% SMV gel, and defect coverage with OM (eOM). Patients in group 4 were treated as in group 3 but the defect was covered with PBM (ePBM). Clinical parameters were recorded at baseline before surgical procedures and were reassessed at 6 and 9 months after therapy. The mean concentration of SMV in gingival crevicular fluid (GCF) was estimated by reverse-phase high-performance liquid chromatography at days 1, 7, 14, 21, and 30. RESULTS At 6- and 9-month observation periods, groups 3 and 4 showed a statistically significant improvement in PD reduction and CAL gain compared with groups 1 and 2. Group 4 showed a statistically significant more defect fill compared with groups 1, 2, and 3 (P ≤ .05). Group 2 showed statistically significant higher defect fill compared with group 1 and group 3 (P < .05). Bone density was significantly increased with no significant difference between the four groups at 6- and 9-month observation periods. SMV-GCF concentration in group 4 showed the highest mean concentration with no significant difference than that of group 3. CONCLUSION The use of perforated barrier membranes in association with SMV enhances the clinical hard tissue parameters compared with occlusive ones in treating intrabony periodontal defects. Moreover, EDTA root surface treatment could enhance SMV availability in the defect area.
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Affiliation(s)
- Dalia Rasheed Issa
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Kafrelsheikh University, Kafr El Sheikh, Egypt
| | - Khaled A Abdel-Ghaffar
- Department of Periodontology, Faculty of Dental Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed A Al-Shahat
- Department of Periodontology, Faculty of Dental Medicine, Delta University for science and technology, Cairo, Egypt
| | - Ahmed Abdel Aziz Hassan
- Department of Periodontology, Faculty of Dental Medicine, Ain Shams University, Cairo, Egypt
| | - Vincent J Iacono
- School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ahmed Y Gamal
- Department of Periodontology, Faculty of Oral and Dental Medicine, Nahda University, Benisweif, Egypt
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12
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Iviglia G, Kargozar S, Baino F. Biomaterials, Current Strategies, and Novel Nano-Technological Approaches for Periodontal Regeneration. J Funct Biomater 2019; 10:E3. [PMID: 30609698 PMCID: PMC6463184 DOI: 10.3390/jfb10010003] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 12/07/2018] [Accepted: 12/17/2018] [Indexed: 12/14/2022] Open
Abstract
Periodontal diseases involve injuries to the supporting structures of the tooth and, if left untreated, can lead to the loss of the tooth. Regenerative periodontal therapies aim, ideally, at healing all the damaged periodontal tissues and represent a significant clinical and societal challenge for the current ageing population. This review provides a picture of the currently-used biomaterials for periodontal regeneration, including natural and synthetic polymers, bioceramics (e.g., calcium phosphates and bioactive glasses), and composites. Bioactive materials aim at promoting the regeneration of new healthy tissue. Polymers are often used as barrier materials in guided tissue regeneration strategies and are suitable both to exclude epithelial down-growth and to allow periodontal ligament and alveolar bone cells to repopulate the defect. The problems related to the barrier postoperative collapse can be solved by using a combination of polymeric membranes and grafting materials. Advantages and drawbacks associated with the incorporation of growth factors and nanomaterials in periodontal scaffolds are also discussed, along with the development of multifunctional and multilayer implants. Tissue-engineering strategies based on functionally-graded scaffolds are expected to play an ever-increasing role in the management of periodontal defects.
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Affiliation(s)
| | - Saeid Kargozar
- Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad 917794-8564, Iran.
| | - Francesco Baino
- Institute of Materials Physics and Engineering, Department of Applied Science and Technology, Politecnico di Torino, 10129 Torino, Italy.
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Jazayeri HE, Tahriri M, Razavi M, Khoshroo K, Fahimipour F, Dashtimoghadam E, Almeida L, Tayebi L. A current overview of materials and strategies for potential use in maxillofacial tissue regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 70:913-929. [DOI: 10.1016/j.msec.2016.08.055] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/01/2016] [Accepted: 08/22/2016] [Indexed: 02/06/2023]
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14
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Echazú MIA, Tuttolomondo MV, Foglia ML, Mebert AM, Alvarez GS, Desimone MF. Advances in collagen, chitosan and silica biomaterials for oral tissue regeneration: from basics to clinical trials. J Mater Chem B 2016; 4:6913-6929. [DOI: 10.1039/c6tb02108e] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Different materials have distinct surface and bulk characteristics; each of them potentially useful for the treatment of a particular wound or disease.
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Affiliation(s)
- Maria Inés Alvarez Echazú
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
| | - Maria Victoria Tuttolomondo
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
| | - Maria Lucia Foglia
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
| | - Andrea Mathilde Mebert
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
| | - Gisela Solange Alvarez
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
| | - Martin Federico Desimone
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
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15
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LEE JH, SEO SJ, KIM HW. Bioactive glass-based nanocomposites for personalized dental tissue regeneration. Dent Mater J 2016; 35:710-720. [DOI: 10.4012/dmj.2015-428] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jung-Hwan LEE
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University
| | - Seog-Jin SEO
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University
- Department of Nanobiomedical Science, Dankook University
| | - Hae-Won KIM
- Institute of Tissue Regeneration Engineering (ITREN), Dankook University
- Department of Nanobiomedical Science, Dankook University
- BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University
- Department of Biomaterials Science, College of Dentistry, Dankook University
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16
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Jones JR. Reprint of: Review of bioactive glass: From Hench to hybrids. Acta Biomater 2015; 23 Suppl:S53-82. [PMID: 26235346 DOI: 10.1016/j.actbio.2015.07.019] [Citation(s) in RCA: 243] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 08/10/2012] [Accepted: 08/14/2012] [Indexed: 02/07/2023]
Abstract
Bioactive glasses are reported to be able to stimulate more bone regeneration than other bioactive ceramics but they lag behind other bioactive ceramics in terms of commercial success. Bioactive glass has not yet reached its potential but research activity is growing. This paper reviews the current state of the art, starting with current products and moving onto recent developments. Larry Hench's 45S5 Bioglass® was the first artificial material that was found to form a chemical bond with bone, launching the field of bioactive ceramics. In vivo studies have shown that bioactive glasses bond with bone more rapidly than other bioceramics, and in vitro studies indicate that their osteogenic properties are due to their dissolution products stimulating osteoprogenitor cells at the genetic level. However, calcium phosphates such as tricalcium phosphate and synthetic hydroxyapatite are more widely used in the clinic. Some of the reasons are commercial, but others are due to the scientific limitations of the original Bioglass 45S5. An example is that it is difficult to produce porous bioactive glass templates (scaffolds) for bone regeneration from Bioglass 45S5 because it crystallizes during sintering. Recently, this has been overcome by understanding how the glass composition can be tailored to prevent crystallization. The sintering problems can also be avoided by synthesizing sol-gel glass, where the silica network is assembled at room temperature. Process developments in foaming, solid freeform fabrication and nanofibre spinning have now allowed the production of porous bioactive glass scaffolds from both melt- and sol-gel-derived glasses. An ideal scaffold for bone regeneration would share load with bone. Bioceramics cannot do this when the bone defect is subjected to cyclic loads, as they are brittle. To overcome this, bioactive glass polymer hybrids are being synthesized that have the potential to be tough, with congruent degradation of the bioactive inorganic and the polymer components. Key to this is creating nanoscale interpenetrating networks, the organic and inorganic components of which have covalent coupling between them, which involves careful control of the chemistry of the sol-gel process. Bioactive nanoparticles can also now be synthesized and their fate tracked as they are internalized in cells. This paper reviews the main developments in the field of bioactive glass and its variants, covering the importance of control of hierarchical structure, synthesis, processing and cellular response in the quest for new regenerative synthetic bone grafts. The paper takes the reader from Hench's Bioglass 45S5 to new hybrid materials that have tailorable mechanical properties and degradation rates.
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Affiliation(s)
- Julian R Jones
- Department of Materials, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
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17
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Willenbacher M, Al-Nawas B, Berres M, Kämmerer PW, Schiegnitz E. The Effects of Alveolar Ridge Preservation: A Meta-Analysis. Clin Implant Dent Relat Res 2015; 18:1248-1268. [DOI: 10.1111/cid.12364] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Maximillian Willenbacher
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre of the Johannes Gutenberg-University; Mainz Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre of the Johannes Gutenberg-University; Mainz Germany
| | - Manfred Berres
- Department of Mathematics and Technology; University of Applied Sciences Koblenz, RheinAhrCampus Remagen; Remagen Germany
- Institute of Medical Biometry, Epidemiology, and Informatics; Johannes Gutenberg-University; Mainz Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University of Rostock; Rostock Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre of the Johannes Gutenberg-University; Mainz Germany
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18
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Rai JJ, Kalantharakath T. Biomimetic ceramics for periodontal regeneration in infrabony defects: A systematic review. J Int Soc Prev Community Dent 2014; 4:S78-92. [PMID: 25558455 PMCID: PMC4278107 DOI: 10.4103/2231-0762.146207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Biomimetic materials are widely used in the treatment of osseous defects as an alternative to autogenous bone graft. The aim of this article was to review the literature and compare the quality of published articles on biomimetic ceramic material used for periodontal regeneration in the treatment of infrabony defects and to discuss the future direction of research. The bibliographic databases PubMed, Ebsco, and Google Scholar were searched from January 2000 to March 2014 for randomized control trials in which biomimetic ceramic graft material was compared with open flap debridement or in combination with any other regenerative material. To avoid the variability of the search terms, the thesaurus Mesh was used. The primary outcome variable assessed was clinical attachment level (CAL). The screening of eligible studies, assessment of the methodological quality of the trials, and data extraction were performed by two observers independently. Twenty-six articles were identified and included in this systematic review. The primary outcome was CAL. Out of the 26 studies, 24 showed more than 2 mm of CAL gain. The difference in CAL change between test and control groups varied from 1.2 mm to 5.88 mm with respect to different biomaterials/biomimetic materials, which was clinically and statistically significant. Meta-analysis was not done due to heterogeneity in results between studies. Overall, biomaterials were found to be more effective than open flap debridement in improving the attachment levels in intraosseous defects. Future research should aim at increasing the osteoinductive capacity of these biomimetic graft materials.
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Affiliation(s)
- Jasuma Jagdish Rai
- Department of Periodontics, K. M. Shah Dental College and Hospital, Sumadeep Vidyapeeth, Gujarat, India
| | - Thanveer Kalantharakath
- Department of Public Health Dentistry, K. M. Shah Dental College and Hospital, Sumadeep Vidyapeeth, Gujarat, India
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19
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Yu Z, Geng J, Gao H, Zhao X, Chen J. Evaluations of guided bone regeneration in canine radius segmental defects using autologous periosteum combined with fascia lata under stable external fixation. J Orthop Traumatol 2014; 16:133-40. [PMID: 25308901 PMCID: PMC4441637 DOI: 10.1007/s10195-014-0321-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 09/22/2014] [Indexed: 12/11/2022] Open
Abstract
Background Although bone defect is one of the most common orthopaedic diseases, treatment remains a challenge and an issue of debate. Guided bone regeneration (GBR) is primarily accompanied by barrier membranes; however, optional membranes show some inherent flaws in clinical application. The purpose of this study was to observe the healing velocity and quality of repairing canine radius segmental defect using transferred autologous periosteum combined with fascia lata, which can provide better biological safety than other materials. Materials and methods Twenty adult male beagles weighing 11.45 ± 1.29 kg were used as animal models. The animals were randomly allocated into three groups, a blank control group, a fascia lata control group and a combined fascia lata and periosteum group. Standardised artificial bony defects were prepared at the radius and treated with autologous periosteum combined with fascia lata under stable external fixation. The newly formed bone-growth curve was made according to ultrasound (US) detection, and histopathologic and scanning electronic microscope (SEM) evaluations were also performed. Results Bone union was seen in most individuals from the autologous periosteum combined with fascia lata group, within an average of 14.2 weeks. Histopathologic and SEM examinations both showed the different osteogenesis state between groups. Necropsy confirmed US findings with regard to distance of bone defects and location. Conclusion These findings suggest that autologous periosteum combined with fascia lata is as effective as a GBR membrane, even in long tubular bone defects. With reliable biological safety, the autologous periosteum combined with fascia lata is expected to achieve increasing application in orthopaedic trauma patients. Level of evidence Not applicable, animal study.
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Affiliation(s)
- Zhe Yu
- Department of Orthopedic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, People's Republic of China,
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20
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Abou Neel EA, Chrzanowski W, Salih VM, Kim HW, Knowles JC. Tissue engineering in dentistry. J Dent 2014; 42:915-28. [PMID: 24880036 DOI: 10.1016/j.jdent.2014.05.008] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 05/15/2014] [Accepted: 05/17/2014] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES of this review is to inform practitioners with the most updated information on tissue engineering and its potential applications in dentistry. DATA The authors used "PUBMED" to find relevant literature written in English and published from the beginning of tissue engineering until today. A combination of keywords was used as the search terms e.g., "tissue engineering", "approaches", "strategies" "dentistry", "dental stem cells", "dentino-pulp complex", "guided tissue regeneration", "whole tooth", "TMJ", "condyle", "salivary glands", and "oral mucosa". SOURCES Abstracts and full text articles were used to identify causes of craniofacial tissue loss, different approaches for craniofacial reconstructions, how the tissue engineering emerges, different strategies of tissue engineering, biomaterials employed for this purpose, the major attempts to engineer different dental structures, finally challenges and future of tissue engineering in dentistry. STUDY SELECTION Only those articles that dealt with the tissue engineering in dentistry were selected. CONCLUSIONS There have been a recent surge in guided tissue engineering methods to manage periodontal diseases beyond the traditional approaches. However, the predictable reconstruction of the innate organisation and function of whole teeth as well as their periodontal structures remains challenging. Despite some limited progress and minor successes, there remain distinct and important challenges in the development of reproducible and clinically safe approaches for oral tissue repair and regeneration. Clearly, there is a convincing body of evidence which confirms the need for this type of treatment, and public health data worldwide indicates a more than adequate patient resource. The future of these therapies involving more biological approaches and the use of dental tissue stem cells is promising and advancing. Also there may be a significant interest of their application and wider potential to treat disorders beyond the craniofacial region. CLINICAL SIGNIFICANCE Considering the interests of the patients who could possibly be helped by applying stem cell-based therapies should be carefully assessed against current ethical concerns regarding the moral status of the early embryo.
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Affiliation(s)
- Ensanya Ali Abou Neel
- Division of Biomaterials, Operative and Aesthetic Department Biomaterials Division, King Abdulaziz University, Jeddah, Saudi Arabia; Biomaterials Department, Faculty of Dentistry, Tanta University, Tanta, Egypt; UCL Eastman Dental Institute, Biomaterials & Tissue Engineering, 256 Gray's Inn Road, London WC1X 8LD, UK.
| | - Wojciech Chrzanowski
- The University of Sydney, The Faculty of Pharmacy, NSW 2006 Sydney, Australia; Department of Nanobiomedical Science & BK21 Plus NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea
| | - Vehid M Salih
- UCL Eastman Dental Institute, Biomaterials & Tissue Engineering, 256 Gray's Inn Road, London WC1X 8LD, UK; Plymouth University Peninsula School of Medicine & Dentistry, Drake's Circus, Plymouth PL4 8AA, Devon, UK
| | - Hae-Won Kim
- Department of Nanobiomedical Science & BK21 Plus NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea; Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan 330-714, Republic of Korea; Department of Biomaterials Science, College of Dentistry, Dankook, University, Cheonan 330-714, Republic of Korea
| | - Jonathan C Knowles
- UCL Eastman Dental Institute, Biomaterials & Tissue Engineering, 256 Gray's Inn Road, London WC1X 8LD, UK; Department of Nanobiomedical Science & BK21 Plus NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 330-714, Republic of Korea
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21
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Shue L, Yufeng Z, Mony U. Biomaterials for periodontal regeneration: a review of ceramics and polymers. BIOMATTER 2014; 2:271-7. [PMID: 23507891 PMCID: PMC3568111 DOI: 10.4161/biom.22948] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Periodontal disease is characterized by the destruction of periodontal tissues. Various methods of regenerative periodontal therapy, including the use of barrier membranes, bone replacement grafts, growth factors and the combination of these procedures have been investigated. The development of biomaterials for tissue engineering has considerably improved the available treatment options above. They fall into two broad classes: ceramics and polymers. The available ceramic-based materials include calcium phosphate (eg, tricalcium phosphate and hydroxyapatite), calcium sulfate and bioactive glass. The bioactive glass bonds to the bone with the formation of a layer of carbonated hydroxyapatite in situ. The natural polymers include modified polysaccharides (eg, chitosan,) and polypeptides (collagen and gelatin). Synthetic polymers [eg, poly(glycolic acid), poly(L-lactic acid)] provide a platform for exhibiting the biomechanical properties of scaffolds in tissue engineering. The materials usually work as osteogenic, osteoconductive and osteoinductive scaffolds. Polymers are more widely used as a barrier material in guided tissue regeneration (GTR). They are shown to exclude epithelial downgrowth and allow periodontal ligament and alveolar bone cells to repopulate the defect. An attempt to overcome the problems related to a collapse of the barrier membrane in GTR or epithelial downgrowth is the use of a combination of barrier membranes and grafting materials. This article reviews various biomaterials including scaffolds and membranes used for periodontal treatment and their impacts on the experimental or clinical management of periodontal defect.
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Affiliation(s)
- Li Shue
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine, Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
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Abou Neel EA, Bozec L, Knowles JC, Syed O, Mudera V, Day R, Hyun JK. Collagen--emerging collagen based therapies hit the patient. Adv Drug Deliv Rev 2013; 65:429-56. [PMID: 22960357 DOI: 10.1016/j.addr.2012.08.010] [Citation(s) in RCA: 190] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Revised: 08/10/2012] [Accepted: 08/28/2012] [Indexed: 12/11/2022]
Abstract
The choice of biomaterials available for regenerative medicine continues to grow rapidly, with new materials often claiming advantages over the short-comings of those already in existence. Going back to nature, collagen is one of the most abundant proteins in mammals and its role is essential to our way of life. It can therefore be obtained from many sources including porcine, bovine, equine or human and offer a great promise as a biomimetic scaffold for regenerative medicine. Using naturally derived collagen, extracellular matrices (ECMs), as surgical materials have become established practice for a number of years. For clinical use the goal has been to preserve as much of the composition and structure of the ECM as possible without adverse effects to the recipient. This review will therefore cover in-depth both naturally and synthetically produced collagen matrices. Furthermore the production of more sophisticated three dimensional collagen scaffolds that provide cues at nano-, micro- and meso-scale for molecules, cells, proteins and bulk fluids by inducing fibrils alignments, embossing and layered configuration through the application of plastic compression technology will be discussed in details. This review will also shed light on both naturally and synthetically derived collagen products that have been available in the market for several purposes including neural repair, as cosmetic for the treatment of dermatologic defects, haemostatic agents, mucosal wound dressing and guided bone regeneration membrane. There are other several potential applications of collagen still under investigations and they are also covered in this review.
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24
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Jones JR. Review of bioactive glass: from Hench to hybrids. Acta Biomater 2013; 9:4457-86. [PMID: 22922331 DOI: 10.1016/j.actbio.2012.08.023] [Citation(s) in RCA: 982] [Impact Index Per Article: 89.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 08/10/2012] [Accepted: 08/14/2012] [Indexed: 12/18/2022]
Abstract
Bioactive glasses are reported to be able to stimulate more bone regeneration than other bioactive ceramics but they lag behind other bioactive ceramics in terms of commercial success. Bioactive glass has not yet reached its potential but research activity is growing. This paper reviews the current state of the art, starting with current products and moving onto recent developments. Larry Hench's 45S5 Bioglass® was the first artificial material that was found to form a chemical bond with bone, launching the field of bioactive ceramics. In vivo studies have shown that bioactive glasses bond with bone more rapidly than other bioceramics, and in vitro studies indicate that their osteogenic properties are due to their dissolution products stimulating osteoprogenitor cells at the genetic level. However, calcium phosphates such as tricalcium phosphate and synthetic hydroxyapatite are more widely used in the clinic. Some of the reasons are commercial, but others are due to the scientific limitations of the original Bioglass 45S5. An example is that it is difficult to produce porous bioactive glass templates (scaffolds) for bone regeneration from Bioglass 45S5 because it crystallizes during sintering. Recently, this has been overcome by understanding how the glass composition can be tailored to prevent crystallization. The sintering problems can also be avoided by synthesizing sol-gel glass, where the silica network is assembled at room temperature. Process developments in foaming, solid freeform fabrication and nanofibre spinning have now allowed the production of porous bioactive glass scaffolds from both melt- and sol-gel-derived glasses. An ideal scaffold for bone regeneration would share load with bone. Bioceramics cannot do this when the bone defect is subjected to cyclic loads, as they are brittle. To overcome this, bioactive glass polymer hybrids are being synthesized that have the potential to be tough, with congruent degradation of the bioactive inorganic and the polymer components. Key to this is creating nanoscale interpenetrating networks, the organic and inorganic components of which have covalent coupling between them, which involves careful control of the chemistry of the sol-gel process. Bioactive nanoparticles can also now be synthesized and their fate tracked as they are internalized in cells. This paper reviews the main developments in the field of bioactive glass and its variants, covering the importance of control of hierarchical structure, synthesis, processing and cellular response in the quest for new regenerative synthetic bone grafts. The paper takes the reader from Hench's Bioglass 45S5 to new hybrid materials that have tailorable mechanical properties and degradation rates.
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Affiliation(s)
- Julian R Jones
- Department of Materials, Imperial College London, South Kensington Campus, London, UK.
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25
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Gamal AY, Iacono VJ. Enhancing guided tissue regeneration of periodontal defects by using a novel perforated barrier membrane. J Periodontol 2012; 84:905-13. [PMID: 23003916 DOI: 10.1902/jop.2012.120301] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The present study was designed to determine whether exclusion of the gingival connective tissue (CT) and periosteum with contained stem cells has a positive or negative effect on periodontal regeneration by comparing the use of a novel modified perforated collagen membrane with a traditional cell occlusive barrier membrane. METHODS Twenty non-smoking patients with severe chronic periodontitis were included in the study. Single deep intrabony defects from each of the patients were randomly divided into two groups, as follows: occlusive bovine collagen membranes (OM control group, 10 sites) and modified perforated bovine collagen membranes (MPM test group, 10 sites). Plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), defect base level (DBL), and crestal bone level (CBL) were measured at baseline and were reassessed at 6 and 9 months after therapy to evaluate the quantitative changes in the defect. RESULTS At 6- and 9-month observation periods, the MPM-treated sites showed a statistically significant improvement in PD reduction and CAL gain compared with the OM control group. DBL was significantly reduced with no significant difference between the two groups at 6- and 9-month observation periods. CBL was significantly higher in the MPM group when compared with that of the OM group at both observation periods. The postoperative differences between the two groups were 2 and 1.7 mm at 6 and 9 months, respectively, in favor of the MPM-treated sites. CONCLUSIONS The present study demonstrated enhanced clinical outcomes when using novel MPMs compared to OMs in guided tissue regeneration procedures. These results may be affected by the penetration of gingival CT contained stem cells and periosteal cells and their differentiation into components of the attachment apparatus.
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Affiliation(s)
- Ahmed Y Gamal
- Faculty of Dental Medicine, Department of Periodontology, Al Azhar University, Cairo, Egypt
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