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Shanbhag S, Kampleitner C, Sanz-Esporrin J, Lie SA, Gruber R, Mustafa K, Sanz M. Regeneration of alveolar bone defects in the experimental pig model: A systematic review and meta-analysis. Clin Oral Implants Res 2024; 35:467-486. [PMID: 38450852 DOI: 10.1111/clr.14253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Pigs are emerging as a preferred experimental in vivo model for bone regeneration. The study objective was to answer the focused PEO question: in the pig model (P), what is the capacity of experimental alveolar bone defects (E) for spontaneous regeneration in terms of new bone formation (O)? METHODS Following PRISMA guidelines, electronic databases were searched for studies reporting experimental bone defects or extraction socket healing in the maxillae or mandibles of pigs. The main inclusion criteria were the presence of a control group of untreated defects/sockets and the assessment of regeneration via 3D tomography [radiographic defect fill (RDF)] or 2D histomorphometry [new bone formation (NBF)]. Random effects meta-analyses were performed for the outcomes RDF and NBF. RESULTS Overall, 45 studies were included reporting on alveolar bone defects or extraction sockets, most frequently in the mandibles of minipigs. Based on morphology, defects were broadly classified as 'box-defects' (BD) or 'cylinder-defects' (CD) with a wide range of healing times (10 days to 52 weeks). Meta-analyses revealed pooled estimates (with 95% confidence intervals) of 50% RDF (36.87%-63.15%) and 43.74% NBF (30.47%-57%) in BD, and 44% RDF (16.48%-71.61%) and 39.67% NBF (31.53%-47.81%) in CD, which were similar to estimates of socket-healing [48.74% RDF (40.35%-57.13%) and 38.73% NBF (28.57%-48.89%)]. Heterogeneity in the meta-analysis was high (I2 > 90%). CONCLUSION A substantial body of literature revealed a high capacity for spontaneous regeneration in experimental alveolar bone defects of (mini)pigs, which should be considered in future studies of bone regeneration in this animal model.
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Affiliation(s)
- Siddharth Shanbhag
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Carina Kampleitner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, The Research Center in Cooperation with AUVA, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Javier Sanz-Esporrin
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Stein-Atle Lie
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Reinhard Gruber
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Kamal Mustafa
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Mariano Sanz
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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Parsaee F, Alizadeh A, Rezaee M, Alavi O, Alipour H. Evaluation of the osteoconductive properties of scaffold containing platete-enriched-fibrin (PRF) with three calcium phosphate (TCP) in the alveolar socket repair after tooth extraction: An animal study. J Biomater Appl 2023; 37:1789-1800. [PMID: 37122094 DOI: 10.1177/08853282231170346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Bone regeneration can be accomplished through osteogenesis, osteoinduction, and osteoconduction mechanisms. This study aimed to investigate the properties of the PRF scaffold with tricalcium phosphate nanoparticles in socket preservation in an animal model. Fabrication of PRF performed. In this experimental study, 18 rats were divided into three negative control, PRF, and PRF/TCP groups. The mechanical and chemical tests including swelling rate, degradation time, and MTT tests were applied to the scaffolds. In each animal, the first maxillary right molar was extracted, and extraction sites of test groups were filled with a resorbable biocompatible biomaterial in situ hardening bone substitute. After 2 and 4 weeks all animals were sacrificed and examined histopathologically and with qRT-PCR. Histological results showed TCP in combination with PRF accelerates bone regeneration with the highest amount of lamellar bone and collagen formation compared to the control and PRF alone. Mechanical and chemical tests on the scaffolds showed the addition of TCP to the PRF scaffold decreases the swelling rate and increases the degradation time. qRT-PCR showed expression of osteogenic genes increased significantly (p < 0.05) in PRF/TCP and PRF, respectively. In conclusion, the gelatin hydrogel containing PRF/TCP scaffold led to more bone formation after tooth extraction. Therefore, the injectable PRF\TCP hydrogel is a promising candidate for bone repair and regeneration.
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Affiliation(s)
- Fatemeh Parsaee
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aliakbar Alizadeh
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Rezaee
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Alavi
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamed Alipour
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Yazdanian M, Alam M, Abbasi K, Rahbar M, Farjood A, Tahmasebi E, Tebyaniyan H, Ranjbar R, Hesam Arefi A. Synthetic materials in craniofacial regenerative medicine: A comprehensive overview. Front Bioeng Biotechnol 2022; 10:987195. [PMID: 36440445 PMCID: PMC9681815 DOI: 10.3389/fbioe.2022.987195] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/26/2022] [Indexed: 07/25/2023] Open
Abstract
The state-of-the-art approach to regenerating different tissues and organs is tissue engineering which includes the three parts of stem cells (SCs), scaffolds, and growth factors. Cellular behaviors such as propagation, differentiation, and assembling the extracellular matrix (ECM) are influenced by the cell's microenvironment. Imitating the cell's natural environment, such as scaffolds, is vital to create appropriate tissue. Craniofacial tissue engineering refers to regenerating tissues found in the brain and the face parts such as bone, muscle, and artery. More biocompatible and biodegradable scaffolds are more commensurate with tissue remodeling and more appropriate for cell culture, signaling, and adhesion. Synthetic materials play significant roles and have become more prevalent in medical applications. They have also been used in different forms for producing a microenvironment as ECM for cells. Synthetic scaffolds may be comprised of polymers, bioceramics, or hybrids of natural/synthetic materials. Synthetic scaffolds have produced ECM-like materials that can properly mimic and regulate the tissue microenvironment's physical, mechanical, chemical, and biological properties, manage adherence of biomolecules and adjust the material's degradability. The present review article is focused on synthetic materials used in craniofacial tissue engineering in recent decades.
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Affiliation(s)
- Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Rahbar
- Department of Restorative Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Amin Farjood
- Orthodontic Department, Dental School, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran
| | - Reza Ranjbar
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Arian Hesam Arefi
- Dental Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Varghese J, Rajagopal A, Shanmugasundaram S. Role of Biomaterials Used for Periodontal Tissue Regeneration—A Concise Evidence-Based Review. Polymers (Basel) 2022; 14:polym14153038. [PMID: 35956553 PMCID: PMC9370319 DOI: 10.3390/polym14153038] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/04/2022] [Accepted: 07/06/2022] [Indexed: 12/14/2022] Open
Abstract
Periodontal infections are noncommunicable chronic inflammatory diseases of multifactorial origin that can induce destruction of both soft and hard tissues of the periodontium. The standard remedial modalities for periodontal regeneration include nonsurgical followed by surgical therapy with the adjunctive use of various biomaterials to achieve restoration of the lost tissues. Lately, there has been substantial development in the field of biomaterial, which includes the sole or combined use of osseous grafts, barrier membranes, growth factors and autogenic substitutes to achieve tissue and bone regeneration. Of these, bone replacement grafts have been widely explored for their osteogenic potential with varied outcomes. Osseous grafts are derived from either human, bovine or synthetic sources. Though the biologic response from autogenic biomaterials may be better, the use of bone replacement synthetic substitutes could be practical for clinical practice. This comprehensive review focuses initially on bone graft replacement substitutes, namely ceramic-based (calcium phosphate derivatives, bioactive glass) and autologous platelet concentrates, which assist in alveolar bone regeneration. Further literature compilations emphasize the innovations of biomaterials used as bone substitutes, barrier membranes and complex scaffold fabrication techniques that can mimic the histologically vital tissues required for the regeneration of periodontal apparatus.
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Labussiere M, Badran Z, Rethore G, Verner C, Soueidan A, Struillou X. Combination of bone substitutes and vectors in periodontology and implantology: A systematic review. Dent Mater J 2021; 40:839-852. [PMID: 34121025 DOI: 10.4012/dmj.2020-361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
The aim of the systematic review was to analyze the use of combination of bone substitutes and vectors in periodontology and implantology among animals models and humans. Electronic databases were searched, and additional hand search was performed. The research strategy was achieved according to the PRISMA guidelines. The including criteria were: combination of bone substitutes and vectors, in vivo studies, a precise number of specimens, histological and radiographic analysis, written in English. The risk of bias was evaluated for individual studies. Thirty-two articles were selected and investigated in this systematic review. The results do not show a superiority of the use of composite biomaterial in comparison with simple biomaterial but suggest the efficacity of their utilization as a carrier of bioactive agents. Future studies need to identify the suitable association of bone substitutes and vectors and explore interest in their use such as the support of growth factors.
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Affiliation(s)
- Marion Labussiere
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes
| | - Zahi Badran
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes
| | - Gildas Rethore
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes
| | - Christian Verner
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes
| | - Assem Soueidan
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes
| | - Xavier Struillou
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes
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Titsinides S, Karatzas T, Perrea D, Eleftheriadis E, Podaropoulos L, Kalyvas D, Katopodis C, Agrogiannis G. Osseous Healing in Surgically Prepared Bone Defects Using Different Grafting Materials: An Experimental Study in Pigs. Dent J (Basel) 2020; 8:dj8010007. [PMID: 31936576 PMCID: PMC7175133 DOI: 10.3390/dj8010007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 12/21/2019] [Accepted: 01/06/2020] [Indexed: 11/29/2022] Open
Abstract
Regeneration of large jaw bone defects still remains a clinical challenge. To avoid incomplete bone repair, bone grafts have been advocated to support the healing process. This study comparatively evaluated new bone formation among a synthetic graft substitute, a human bone derivative, and a bovine xenograft. Materials were placed in 3 out of the 4 bone cavities, while 1 deficit was left empty, serving as a control, in mono-cortical defects, surgically prepared in the porcine calvaria bone. Animals were randomized in 2 groups and euthanized at 8 and 12 weeks. Harvested tissue specimens were qualitatively evaluated by histology. New bone formation was quantitatively measured by histomorphometry. Maximum new bone formation was noticed in defects grafted with beta-tricalcium phosphate b-TCP compared to the other bone substitutes, at 8 and 12 weeks post-surgery. Bovine and human allograft induced less new bone formation compared to empty bone cavity. Histologic analysis revealed that b-TCP was absorbed and substituted significantly, while bovine and human allograft was maintained almost intact in close proximity with new bone. Based on our findings, higher new bone formation was detected in defects filled with b-TCP when compared to bovine and human graft substitutes.
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Affiliation(s)
- Savvas Titsinides
- Dental School, University of Athens, 2 Thivon Street, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-69-4817-2729
| | - Theodore Karatzas
- Laboratory of Experimental Surgery and Surgical Research “N. S. Christeas”, Medical School, University of Athens, 75 M. Assias Street, 11527 Athens, Greece; (T.K.); (D.P.)
| | - Despoina Perrea
- Laboratory of Experimental Surgery and Surgical Research “N. S. Christeas”, Medical School, University of Athens, 75 M. Assias Street, 11527 Athens, Greece; (T.K.); (D.P.)
| | - Efstathios Eleftheriadis
- Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, 2 Thivon Street, 11527 Athens, Greece; (E.E.); (L.P.); (D.K.)
| | - Leonidas Podaropoulos
- Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, 2 Thivon Street, 11527 Athens, Greece; (E.E.); (L.P.); (D.K.)
| | - Demos Kalyvas
- Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, 2 Thivon Street, 11527 Athens, Greece; (E.E.); (L.P.); (D.K.)
| | | | - George Agrogiannis
- 1st Department of Pathology, Medical School, University of Athens, 75 M. Assias Street, 11527 Athens, Greece;
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Okada M, Matsuura T, Akizuki T, Hoshi S, Shujaa Addin A, Fukuba S, Izumi Y. Ridge preservation of extraction sockets with buccal bone deficiency using poly lactide‐co‐glycolide coated β‐tricalcium phosphate bone grafts: An experimental study in dogs. J Periodontol 2019; 90:1014-1022. [DOI: 10.1002/jper.18-0574] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/15/2019] [Accepted: 02/16/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Munehiro Okada
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Bunkyo‐ku Tokyo Japan
| | - Takanori Matsuura
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Bunkyo‐ku Tokyo Japan
- PeriodonticsDental HospitalTokyo Medical and Dental University Bunkyo‐ku Tokyo Japan
| | - Tatsuya Akizuki
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Bunkyo‐ku Tokyo Japan
- PeriodonticsDental HospitalTokyo Medical and Dental University Bunkyo‐ku Tokyo Japan
| | - Shu Hoshi
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Bunkyo‐ku Tokyo Japan
| | - Ammar Shujaa Addin
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Bunkyo‐ku Tokyo Japan
| | - Shunsuke Fukuba
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Bunkyo‐ku Tokyo Japan
| | - Yuichi Izumi
- Department of PeriodontologyGraduate School of Medical and Dental SciencesTokyo Medical and Dental University Bunkyo‐ku Tokyo Japan
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