1
|
Boroojeni HSH, Mohaghegh S, Khojasteh A. Application of CAD-CAM Technologies for Maxillofacial Bone Regeneration: A Narrative Review of the Clinical Studies. Curr Stem Cell Res Ther 2024; 19:461-472. [PMID: 36372914 DOI: 10.2174/1574888x18666221111154057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/24/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022]
Abstract
The application of regenerative methods in treating maxillofacial defects can be categorized as functional bone regeneration in which scaffolds without protection are used and in-situ bone regeneration in which a protected healing space is created to induce bone formation. It has been shown that functional bone regeneration can reduce surgical time and obviate the necessity of autogenous bone grafting. However, studies mainly focused on applying this method to reconstruct minor bone effects, and more investigation concerning the large defects is required. In terms of in situ maxillofacial bone regeneration with the help of CAD-CAM technologies, the present data have suggested feasible mesh rigidity, perseverance of the underlying space, and apt augmentative results with CAD-CAM-based individualized Ti meshes. However, complications, including dehiscence and mesh exposure, coupled with consequent graft loss, infection and impeded regenerative rates have also been reported.
Collapse
Affiliation(s)
- Helia Sadat Haeri Boroojeni
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadra Mohaghegh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
2
|
Mohaghegh S, Sadat Haeri Boroojeni H, Nokhbatolfoghahaei H, Khojasteh A. Application of biodegradable Patient-specific scaffolds for maxillofacial bone regeneration: a scoping review of clinical studies. Br J Oral Maxillofac Surg 2023; 61:587-597. [PMID: 37845099 DOI: 10.1016/j.bjoms.2023.08.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/28/2023] [Accepted: 08/20/2023] [Indexed: 10/18/2023]
Abstract
This study aimed to systematically review clinical studies in which biodegradable patient-specific scaffolds were used for bone regeneration. Studies in which biodegradable scaffolds were fabricated through computer-assisted design and computer-assisted manufacturing (CAD-CAM) procedures were included. Those that applied non-biodegradable materials or used biodegradable materials in a condensable powder or block form were excluded. Among a total of 26 included studies, 11 used customised allogeneic bone blocks, five used polycaprolactone (PCL)-containing scaffolds, four used hydroxyapatite (HA) scaffolds, and four biphasic calcium phosphate (BCP). The majority of the studies applied scaffolds for minor intraoral defects. All the large defects were reconstructed with polymer-containing scaffolds. Results of the included studies showed partial to complete filling of the defect following the application of biodegradable scaffolds. However, limited graft exposure was reported when using PCL, BCP, and HA scaffolds. Tissue engineering can be considered a potential method for the treatment of maxillofacial bone defects. However, more evidence is required, especially for the application of biodegradable scaffolds in large defects.
Collapse
Affiliation(s)
- Sadra Mohaghegh
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
| | - Helia Sadat Haeri Boroojeni
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran
| | - Hanieh Nokhbatolfoghahaei
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran.
| |
Collapse
|
3
|
Cimatti P, Andreoli I, Busacca M, Govoni M, Vivarelli L, Del Piccolo N, Maso A, Stagni C, Pignatti G. An Observational Prospective Clinical Study for the Evaluation of a Collagen-Hydroxyapatite Composite Scaffold in Hip Revision Surgery. J Clin Med 2022; 11:6372. [PMID: 36362601 PMCID: PMC9654158 DOI: 10.3390/jcm11216372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 04/23/2024] Open
Abstract
One of the greatest challenges of hip revision surgery is the need to restore extensive bone loss by creating a stable reconstruction with long-term durability. The present observational, investigator-initiated prospective study was carried out to evaluate the clinical and radiological results of the use of a commercial biomimetic collagen-hydroxyapatite composite biomaterial (RegenOss) applied in hip revision surgery. Thirty-three patients who underwent hip revision were included in this study, and 29 received up to 2 years of follow-up. The acetabulum was reconstructed using an uncemented hemispherical shell both with or without an iliac fixation stem. Functional recovery was assessed according to the Harris Hip Score (HHS) at the pre-hospitalisation check-up, and at 6-, 12-, and 24-month follow-ups. Radiological evaluation consisting of X-ray analyses (6, 12, and 24 month follow-ups) and CT scan exams (within 10 weeks post-surgery and at 12-month follow-up) were performed to evaluate the reduction in bone defect and new bone regeneration. All the patients reported a complete recovery and a considerable improvement in functional outcome assessed by the HHS, which was significantly higher at all the follow-ups than at pre-hospitalisation. Moreover, radiological assessments revealed good scaffold integration. Overall, collected data suggest that RegenOss is a valid and safe alternative to restoring acetabular bone loss in revision hip arthroplasty.
Collapse
Affiliation(s)
- Pietro Cimatti
- Reconstructive Orthopaedic Surgery and Innovative Techniques—Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Isabella Andreoli
- Reconstructive Orthopaedic Surgery and Innovative Techniques—Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Maurizio Busacca
- Montecatone Institute Rehabilitation Hospital, 40026 Imola, Italy
| | - Marco Govoni
- Reconstructive Orthopaedic Surgery and Innovative Techniques—Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Leonardo Vivarelli
- Reconstructive Orthopaedic Surgery and Innovative Techniques—Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Nicolandrea Del Piccolo
- Reconstructive Orthopaedic Surgery and Innovative Techniques—Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Alessandra Maso
- Laboratory of Microbiology and GMP Quality Control, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Cesare Stagni
- Reconstructive Orthopaedic Surgery and Innovative Techniques—Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Giovanni Pignatti
- Rizzoli Sicilia Department, IRCCS Istituto Ortopedico Rizzoli, 90011 Bagheria, Italy
| |
Collapse
|
4
|
Xing F, Yin HM, Zhe M, Xie JC, Duan X, Xu JZ, Xiang Z, Li ZM. Nanotopographical 3D-Printed Poly(ε-caprolactone) Scaffolds Enhance Proliferation and Osteogenic Differentiation of Urine-Derived Stem Cells for Bone Regeneration. Pharmaceutics 2022; 14:pharmaceutics14071437. [PMID: 35890332 PMCID: PMC9317219 DOI: 10.3390/pharmaceutics14071437] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/02/2022] [Accepted: 07/06/2022] [Indexed: 02/05/2023] Open
Abstract
3D-printing technology can be used to construct personalized bone substitutes with customized shapes, but it cannot regulate the topological morphology of the scaffold surface, which plays a vital role in regulating the biological behaviors of stem cells. In addition, stem cells are able to sense the topographical and mechanical cues of surface of scaffolds by mechanosensing and mechanotransduction. In our study, we fabricated a 3D-printed poly(ε-caprolactone) (PCL) scaffold with a nanotopographical surface and loaded it with urine-derived stem cells (USCs) for application of bone regeneration. The topological 3D-printed PCL scaffolds (TPS) fabricated by surface epiphytic crystallization, possessed uniformly patterned nanoridges, of which the element composition and functional groups of nanoridges were the same as PCL. Compared with bare 3D-printed PCL scaffolds (BPS), TPS have a higher ability for protein adsorption and mineralization in vitro. The proliferation, cell length, and osteogenic gene expression of USCs on the surface of TPS were significantly higher than that of BPS. In addition, the TPS loaded with USCs exhibited a good ability for bone regeneration in cranial bone defects. Our study demonstrated that nanotopographical 3D-printed scaffolds loaded with USCs are a safe and effective therapeutic strategy for bone regeneration.
Collapse
Affiliation(s)
- Fei Xing
- Orthopedic Research Institute, Department of Orthopedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, China; (F.X.); (Z.X.)
| | - Hua-Mo Yin
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China; (H.-M.Y.); (Z.-M.L.)
| | - Man Zhe
- Animal Experiment Center, West China Hospital, Sichuan University, Chengdu 610041, China;
| | - Ji-Chang Xie
- Laboratoire Roberval, FRE UTC-CNRS 2012, Sorbonne Universités, Université de Technologie de Compiègne, Centre de Recherche Royallieu, CS60319, CEDEX, 60203 Compiègne, France;
| | - Xin Duan
- Orthopedic Research Institute, Department of Orthopedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, China; (F.X.); (Z.X.)
- Correspondence: (X.D.); (J.-Z.X.)
| | - Jia-Zhuang Xu
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China; (H.-M.Y.); (Z.-M.L.)
- Correspondence: (X.D.); (J.-Z.X.)
| | - Zhou Xiang
- Orthopedic Research Institute, Department of Orthopedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, China; (F.X.); (Z.X.)
| | - Zhong-Ming Li
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China; (H.-M.Y.); (Z.-M.L.)
| |
Collapse
|
5
|
Gu Y, Yan C, Yan Z, Wang X, Yue L, Li L. Evaluation of the clinical efficacy and safety of modified alveolar cleft bone graft with cone-beam CT digital imaging in children. Transl Pediatr 2022; 11:1140-1148. [PMID: 35958001 PMCID: PMC9360813 DOI: 10.21037/tp-22-214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/13/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cone-beam computed tomography (CBCT) is used to observe the bone density and bone height in children with modified alveolar bone graft (ABG) at different times after operation. In this study, the changes of labial-palatal bone mass in the stable period of bone union and in the bone graft area were investigated to provide reference for subsequent treatment. METHODS A total of 140 pediatric patients with unilateral complete alveolar cleft were selected and routinely underwent iliac bone grafting. The original data obtained by ProMax 3D (Planmeca) examination were stored in DICOM format at 3 and 6 months postoperatively, and the images were reconstructed by Simplant software (Dentsply Sirona). The bone density of the healthy side was measured at 3 months and 6 months, and the results were expressed as Hounsfield units (HU). The labial and palatal bone height at the bone graft site at 3 and 6 months postoperatively was classified according to the modified Bergland classification method, and was compared with panoramic film classification. RESULTS Mean bone density at 3 months after surgery (385.4800±78.39770 HU) was not significantly different from that at 6 months (356.1875±73.67164 HU; P>0.05). There were significant differences between the classification of lip and palatal bone height 3 months after operation and that of the classification of panorama film in the same month (P<0.05); between the classification of lip and palatal bone height 6 months after surgery compared with that of panorama film of the same month (P<0.05); and between the classification of bone height degree in labial, palatal, and panoramic slices at 3 months after operation and that at 6 months after operation (P<0.05). CONCLUSIONS The labial and palatal classification is different, and the bone height classification 6 months after surgery is lower than that 3 months after surgery, indicating the persistence of bone resorption. CBCT can objectively evaluate the bone quality in the bone graft area, which has clinical application value for surgical evaluation value and posttreatment guidance.
Collapse
Affiliation(s)
- Yueguang Gu
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Chaoting Yan
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Zhongyi Yan
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Xiaochen Wang
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Li Yue
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Lei Li
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| |
Collapse
|
6
|
Vivarelli L, Govoni M, Attala D, Zoccali C, Biagini R, Dallari D. Custom Massive Allograft in a Case of Pelvic Bone Tumour: Simulation of Processing with Computerised Numerical Control vs. Robotic Machining. J Clin Med 2022; 11:jcm11102781. [PMID: 35628908 PMCID: PMC9143408 DOI: 10.3390/jcm11102781] [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: 02/28/2022] [Revised: 05/04/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023] Open
Abstract
The use of massive bone allografts after the resection of bone tumours is still a challenging process. However, to overcome some issues related to the processing procedures and guarantee the best three-dimensional matching between donor and recipient, some tissue banks have developed a virtual tissue database based on the scanning of the available allografts for using their 3D shape during virtual surgical planning (VSP) procedures. To promote the use of future VSP bone-shaping protocols useful for machining applications within a cleanroom environment, in our work, we simulate a massive bone allograft machining with two different machines: a four-axes (computer numerical control, CNC) vs. a five-axes (robot) milling machine. The allograft design was based on a real case of allograft reconstruction after pelvic tumour resection and obtained with 3D Slicer and Rhinoceros software. Machining simulations were performed with RhinoCAM and graphically and mathematically analysed with CloudCompare and R, respectively. In this case, the geometrical differences of the allograft design are not clinically relevant; however, the mathematical analysis showed that the robot performed better than the four-axes machine. The proof-of-concept presented here paves the way towards massive bone allograft cleanroom machining. Nevertheless, further studies, such as the simulation of different types of allografts and real machining on massive bone allografts, are needed.
Collapse
Affiliation(s)
- Leonardo Vivarelli
- Reconstructive Orthopaedic Surgery and Innovative Techniques—Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
- Correspondence: (L.V.); (M.G.)
| | - Marco Govoni
- Reconstructive Orthopaedic Surgery and Innovative Techniques—Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
- Correspondence: (L.V.); (M.G.)
| | - Dario Attala
- Department of Oncological Orthopaedics—Musculoskeletal Tissue Bank, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Carmine Zoccali
- Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Roberto Biagini
- Department of Oncological Orthopaedics, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Dante Dallari
- Reconstructive Orthopaedic Surgery and Innovative Techniques—Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
| |
Collapse
|
7
|
Kim Y, Lee EJ, Kotula AP, Takagi S, Chow L, Alimperti S. Engineering 3D Printed Scaffolds with Tunable Hydroxyapatite. J Funct Biomater 2022; 13:34. [PMID: 35466216 PMCID: PMC9036238 DOI: 10.3390/jfb13020034] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
Orthopedic and craniofacial surgical procedures require the reconstruction of bone defects caused by trauma, diseases, and tumor resection. Successful bone restoration entails the development and use of bone grafts with structural, functional, and biological features similar to native tissues. Herein, we developed three-dimensional (3D) printed fine-tuned hydroxyapatite (HA) biomimetic bone structures, which can be applied as grafts, by using calcium phosphate cement (CPC) bioink, which is composed of tetracalcium phosphate (TTCP), dicalcium phosphate anhydrous (DCPA), and a liquid [Polyvinyl butyral (PVB) dissolved in ethanol (EtOH)]. The ink was ejected through a high-resolution syringe nozzle (210 µm) at room temperature into three different concentrations (0.01, 0.1, and 0.5) mol/L of the aqueous sodium phosphate dibasic (Na2HPO4) bath that serves as a hardening accelerator for HA formation. Raman spectrometer, X-ray diffraction (XRD), and scanning electron microscopy (SEM) demonstrated the real-time HA formation in (0.01, 0.1, and 0.5) mol/L Na2HPO4 baths. Under those conditions, HA was formed at different amounts, which tuned the scaffolds' mechanical properties, porosity, and osteoclast activity. Overall, this method may pave the way to engineer 3D bone scaffolds with controlled HA composition and pre-defined properties, which will enhance graft-host integration in various anatomic locations.
Collapse
Affiliation(s)
- Yoontae Kim
- American Dental Association Science & Research Institute, Gaithersburg, MD 20899, USA; (Y.K.); (E.-J.L.); (S.T.); (L.C.)
| | - Eun-Jin Lee
- American Dental Association Science & Research Institute, Gaithersburg, MD 20899, USA; (Y.K.); (E.-J.L.); (S.T.); (L.C.)
| | - Anthony P. Kotula
- Materials Science and Engineering Division, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA;
| | - Shozo Takagi
- American Dental Association Science & Research Institute, Gaithersburg, MD 20899, USA; (Y.K.); (E.-J.L.); (S.T.); (L.C.)
| | - Laurence Chow
- American Dental Association Science & Research Institute, Gaithersburg, MD 20899, USA; (Y.K.); (E.-J.L.); (S.T.); (L.C.)
| | - Stella Alimperti
- American Dental Association Science & Research Institute, Gaithersburg, MD 20899, USA; (Y.K.); (E.-J.L.); (S.T.); (L.C.)
| |
Collapse
|
8
|
Bioengineered Living Bone Grafts-A Concise Review on Bioreactors and Production Techniques In Vitro. Int J Mol Sci 2022; 23:ijms23031765. [PMID: 35163687 PMCID: PMC8836415 DOI: 10.3390/ijms23031765] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/29/2022] [Accepted: 01/30/2022] [Indexed: 12/26/2022] Open
Abstract
It has been observed that bone fractures carry a risk of high mortality and morbidity. The deployment of a proper bone healing method is essential to achieve the desired success. Over the years, bone tissue engineering (BTE) has appeared to be a very promising approach aimed at restoring bone defects. The main role of the BTE is to apply new, efficient, and functional bone regeneration therapy via a combination of bone scaffolds with cells and/or healing promotive factors (e.g., growth factors and bioactive agents). The modern approach involves also the production of living bone grafts in vitro by long-term culture of cell-seeded biomaterials, often with the use of bioreactors. This review presents the most recent findings concerning biomaterials, cells, and techniques used for the production of living bone grafts under in vitro conditions. Particular attention has been given to features of known bioreactor systems currently used in BTE: perfusion bioreactors, rotating bioreactors, and spinner flask bioreactors. Although bioreactor systems are still characterized by some limitations, they are excellent platforms to form bioengineered living bone grafts in vitro for bone fracture regeneration. Moreover, the review article also describes the types of biomaterials and sources of cells that can be used in BTE as well as the role of three-dimensional bioprinting and pulsed electromagnetic fields in both bone healing and BTE.
Collapse
|
9
|
Boccaccio A. Design of Materials for Bone Tissue Scaffolds. MATERIALS 2021; 14:ma14205985. [PMID: 34683577 PMCID: PMC8541387 DOI: 10.3390/ma14205985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/06/2021] [Indexed: 12/12/2022]
Abstract
The strong impulse recently experienced by the manufacturing technologies as well as the development of innovative biocompatible materials has allowed the fabrication of high-performing scaffolds for bone tissue engineering. The design process of materials for bone tissue scaffolds represents, nowadays, an issue of crucial importance and the object of study of many researchers throughout the world. A number of studies have been conducted, aimed at identifying the optimal material, geometry, and surface that the scaffold must possess to stimulate the formation of the largest amounts of bone in the shortest time possible. This book presents a collection of 10 research articles and 2 review papers describing numerical and experimental design techniques definitively aimed at improving the scaffold performance, shortening the healing time, and increasing the success rate of the scaffold implantation process.
Collapse
Affiliation(s)
- Antonio Boccaccio
- Dipartimento di Meccanica, Matematica e Management, Politecnico di Bari, 70125 Bari, Italy
| |
Collapse
|
10
|
Vaid T, Kumar S, Mehta R, Shah S, Joshi S, Bhakkand S, Hirani T. Clinical and radiographic evaluation of demineralized freeze-dried bone allograft with concentrated growth factor versus concentrated growth factor alone in the treatment of intrabony defects. Med Pharm Rep 2021; 94:220-228. [PMID: 34013194 PMCID: PMC8118214 DOI: 10.15386/mpr-1718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/15/2020] [Accepted: 08/04/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Periodontal disease is one of the major causes of alveolar bone loss. There are various ways of regenerating the lost bone, i.e. guided tissue regeneration, bone grafts, and growth factors. In this purview, it becomes immensely important for a clinician to decide the best modality of treatment. In this study, we compared the effect of demineralized freeze-dried bone allograft (DFDBA) in combination with concentrated growth factors (CGF) verses CGF alone. METHODS This double-blind, split-mouth study was conducted on ten patients with two comparable bilateral intrabony defects. Each pair of defects was randomly treated by DFDBA + CGF or CGF alone. Clinical parameters such as plaque index (PI), modified gingival index (MGI), pocket probing depth (PPD), and relative attachment level (RAL) were recorded at baseline, three months, and six months. In addition, radiograph with grids was also taken at baseline and six months. The paired t-test was used to compare the pre- and post-treatment values and the unpaired t-test was used to compare the test and control group. RESULTS The PI score decreased significantly from baseline to six months. Similarly, the mean MGI score decreased significantly from baseline to six months. The intragroup comparison showed that there was a significant reduction in PPD in both the test and control group. However, the intergroup comparison showed that the reduced pocket depth was not significant. The intragroup radiographic comparison showed that there was the significant formation of bone in both the test and control group but inter-group showed that the formation of bone among both the group were non-significant. CONCLUSION Radiographic and clinical outcomes of this study concluded that post six months, both groups demonstrated significant improvement in clinical and radiographic parameters. However, the addition of DFDBA to CGFs did not give any additional benefits.
Collapse
Affiliation(s)
- Tithi Vaid
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Santosh Kumar
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Rupal Mehta
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Sujay Shah
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Surabhi Joshi
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Susmita Bhakkand
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Tanvi Hirani
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| |
Collapse
|
11
|
da Silva Brum I, Frigo L, Lana Devita R, da Silva Pires JL, Hugo Vieira de Oliveira V, Rosa Nascimento AL, de Carvalho JJ. Histomorphometric, Immunohistochemical, Ultrastructural Characterization of a Nano-Hydroxyapatite/Beta-Tricalcium Phosphate Composite and a Bone Xenograft in Sub-Critical Size Bone Defect in Rat Calvaria. MATERIALS 2020; 13:ma13204598. [PMID: 33076561 PMCID: PMC7602735 DOI: 10.3390/ma13204598] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
Nowadays, we can observe a worldwide trend towards the development of synthetic biomaterials. Several studies have been conducted to better understand the cellular mechanisms involved in the processes of inflammation and bone healing related to living tissues. The aim of this study was to evaluate tissue behaviors of two different types of biomaterials: synthetic nano-hydroxyapatite/beta-tricalcium phosphate composite and bone xenograft in sub-critical bone defects in rat calvaria. Twenty-four rats underwent experimental surgery in which two 3 mm defects in each cavity were tested. Rats were divided into two groups: Group 1 used xenogen hydroxyapatite (Bio Oss™); Group 2 used synthetic nano-hydroxyapatite/beta-tricalcium phosphate (Blue Bone™). Sixty days after surgery, calvaria bone defects were filled with biomaterial, animals were euthanized, and tissues were stained with Masson’s trichrome and periodic acid–Schiff (PAS) techniques, immune-labeled with anti-TNF-α and anti-MMP-9, and electron microscopy analyses were also performed. Histomorphometric analysis indicated a greater presence of protein matrix in Group 2, in addition to higher levels of TNF-α and MMP-9. Ultrastructural analysis showed that biomaterial fibroblasts were associated with the tissue regeneration stage. Paired statistical data indicated that Blue Bone™ can improve bone formation/remodeling when compared to biomaterials of xenogenous origin.
Collapse
Affiliation(s)
- Igor da Silva Brum
- Implantology Department, State University of Rio de Janeiro, Rio de Janeiro 20550-900, Brazil;
- Correspondence: ; Tel.: +55-21-988-244-976
| | - Lucio Frigo
- Periodontology Department, Universidade Guarulhos, Guarulhos 07023-070, São Paulo, Brazil;
| | - Renan Lana Devita
- Orthodontics Department, State University Barcelona, 08193 Barcelona, Spain;
| | | | - Victor Hugo Vieira de Oliveira
- Biology Department, State University of Rio de Janeiro, Rio de Janeiro 20550-900, Brazil; (V.H.V.d.O.); (A.L.R.N.); (J.J.d.C.)
| | - Ana Lucia Rosa Nascimento
- Biology Department, State University of Rio de Janeiro, Rio de Janeiro 20550-900, Brazil; (V.H.V.d.O.); (A.L.R.N.); (J.J.d.C.)
| | - Jorge José de Carvalho
- Biology Department, State University of Rio de Janeiro, Rio de Janeiro 20550-900, Brazil; (V.H.V.d.O.); (A.L.R.N.); (J.J.d.C.)
| |
Collapse
|
12
|
Lee UL, Lim JY, Park SN, Choi BH, Kang H, Choi WC. A Clinical Trial to Evaluate the Efficacy and Safety of 3D Printed Bioceramic Implants for the Reconstruction of Zygomatic Bone Defects. MATERIALS 2020; 13:ma13204515. [PMID: 33053855 PMCID: PMC7601564 DOI: 10.3390/ma13204515] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to evaluate the clinical efficacy and safety of patient-specific additive-manufactured CaOSiO2-P2O5-B2O3 glass-ceramic (BGS-7) implants for reconstructing zygomatic bone defects at a 6-month follow-up. A prospective, single-arm, single-center, clinical trial was performed on patients with obvious zygoma defects who needed and wanted reconstruction. The primary outcome variable was a bone fusion between the implant and the bone evaluated by computed tomography (CT) at 6 months post surgery. Secondary outcomes, including implant immobilization, satisfaction assessment, osteolysis, subsidence of the BGS-7 implant, and safety, were assessed. A total of eight patients were enrolled in the study. Two patients underwent simultaneous reconstruction of the left and right malar defects using a BGS-7 3D printed implant. Cone beam CT analysis showed that bone fusion at 6 months after surgery was 100%. We observed that the average fusion rate was 76.97%. Osteolysis around 3D printed BGS-7 implants was not observed. The mean distance displacement of all 10 implants was 0.4149 mm. Our study showed no adverse event in any of the cases. The visual analog scale score for satisfaction was 9. All patients who enrolled in this trial were aesthetically and functionally satisfied with the surgical results. In conclusion, this study demonstrates the safety and promising value of patient-specific 3D printed BGS-7 implants as a novel facial bone reconstruction method.
Collapse
Affiliation(s)
- Ui-Lyong Lee
- Department of Oral and Maxillofacial Surgery, Chung-Ang University Hospital, Soeul 06973, Korea
- Chung-Ang 3D Craniofacial Research Society, Chun-Ang University, Seoul 06974, Korea
- Correspondence: (U.-L.L.); (W.-C.C.)
| | - Jun-Young Lim
- CGbio 3D Innovation Center, Seongnam-si 13211, Korea; (J.-Y.L.); (S.-N.P.); (B.-H.C.)
| | - Sung-Nam Park
- CGbio 3D Innovation Center, Seongnam-si 13211, Korea; (J.-Y.L.); (S.-N.P.); (B.-H.C.)
| | - Byoung-Hun Choi
- CGbio 3D Innovation Center, Seongnam-si 13211, Korea; (J.-Y.L.); (S.-N.P.); (B.-H.C.)
| | - Hyun Kang
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul 06974, Korea;
| | - Won-Cheul Choi
- Chung-Ang 3D Craniofacial Research Society, Chun-Ang University, Seoul 06974, Korea
- Department of Orthodontics, Chung-Ang University Hospital, Seoul 06974, Korea
- Correspondence: (U.-L.L.); (W.-C.C.)
| |
Collapse
|
13
|
Cosola S, Marconcini S, Boccuzzi M, Menchini Fabris GB, Covani U, Peñarrocha-Diago M, Peñarrocha-Oltra D. Radiological Outcomes of Bone-Level and Tissue-Level Dental Implants: Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186920. [PMID: 32971869 PMCID: PMC7557536 DOI: 10.3390/ijerph17186920] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/31/2020] [Accepted: 09/09/2020] [Indexed: 12/14/2022]
Abstract
Background: to assess the radiological marginal bone loss between bone-level or tissue-level dental implants through a systematic review of literature until September 2019. Methods: MEDLINE, Embase and other database were searched by two independent authors including only English articles. Results: The search provided 1028 records and, after removing the duplicates through titles and abstracts screening, 45 full-text articles were assessed for eligibility. For qualitative analysis 20 articles were included, 17 articles of them for quantitative analysis counting a total of 1161 patients (mean age 54.4 years) and 2933 implants, 1427 inserted at Tissue-level (TL) and 1506 inserted at Bone-level (BL). The survival rate and the success rate were more than 90%, except for 2 studies with a success rate of 88% and 86.2%. No studies reported any differences between groups in term of success and survival rates. Three studies showed that BL-implants had statistically less marginal bone loss (p < 0.05). Only one study reported statistically less marginal bone loss in TL-implants (p < 0.05). Conclusion: In the most part of the studies, differences between implant types in marginal bone loss were not statistically significant after a variable period of follow-up ranged between 1 and 5 years.
Collapse
Affiliation(s)
- Saverio Cosola
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 13, 46010 Valencia, Spain; (M.P.-D.); (D.P.-O.)
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
- Correspondence:
| | - Simone Marconcini
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
| | - Michela Boccuzzi
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
| | - Giovanni Battista Menchini Fabris
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
- Department of Stomatology, University of Studies Guglielmo Marconi, 44, 00193 Roma, Italy
| | - Ugo Covani
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
| | - Miguel Peñarrocha-Diago
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 13, 46010 Valencia, Spain; (M.P.-D.); (D.P.-O.)
| | - David Peñarrocha-Oltra
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 13, 46010 Valencia, Spain; (M.P.-D.); (D.P.-O.)
| |
Collapse
|
14
|
Computer-Aided Surgical Simulation for Correcting Complex Limb Deformities in Children. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10155181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This work aims to present an in-house low-cost computer-aided simulation (CASS) process that was recently implemented in the preoperative planning of complex osteotomies for limb deformities in children. Five patients admitted to the Unit of Paediatric Orthopaedics and Traumatology from April 2018 to December 2019, for correcting congenital or post-traumatic limb deformities were included in the study. Three-dimensional (3D) digital models were generated from Computed Tomography (CT) scans, using free open-source software, and the surgery was planned and simulated starting from the 3D digital model. 3D printed sterilizable models were fabricated using a low-cost 3D printer, and animations of the operation were generated with the aim to accurately explain the operation to parents. All procedures were successfully planned using our CASS method and the 3D printed models were used during the operation, improving the understanding of the severely abnormal bony anatomy. The surgery was precisely reproduced according to CASS and the deformities were successfully corrected in four cases, while in one case, the intraoperative intentional undersizing of the bone osteotomy produced an incomplete correction of a congenital forearm deformity. Our study describes the application of a safe, effective, user-friendly, and low-cost CASS process in paediatric orthopaedics (PO) surgery. We are convinced that our study will stimulate the widespread adoption of this technological innovation in routine clinical practice for the treatment of rare congenital and post-traumatic limb deformities during childhood.
Collapse
|