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Al Madhoun A, Meshal K, Carrió N, Ferrés-Amat E, Ferrés-Amat E, Barajas M, Jiménez-Escobar AL, Al-Madhoun AS, Saber A, Abou Alsamen Y, Marti C, Atari M. Randomized Clinical Trial: Bone Bioactive Liquid Improves Implant Stability and Osseointegration. J Funct Biomater 2024; 15:293. [PMID: 39452591 PMCID: PMC11508358 DOI: 10.3390/jfb15100293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 09/26/2024] [Accepted: 09/27/2024] [Indexed: 10/26/2024] Open
Abstract
Implant stability can be compromised by factors such as inadequate bone quality and infection, leading to potential implant failure. Ensuring implant stability and longevity is crucial for patient satisfaction and quality of life. In this multicenter, randomized, double-blind clinical trial, we assessed the impact of a bone bioactive liquid (BBL) on the Galaxy TS implant's performance, stability, and osseointegration. We evaluated the impact stability, osseointegration, and pain levels using initial stability quotient (ISQ) measurements, CBCT scans, and pain assessment post-surgery. Surface analysis was performed using scanning electron microscopy (SEM) and atomic force microscopy (AFM). In vitro studies examined the BBL's effects on dental pulp pluripotent stem cells' (DPPSCs') osteogenesis and inflammation modulation in human macrophages. All implants successfully osseointegrated, as demonstrated by the results of our clinical and histological studies. The BBL-treated implants showed significantly lower pain scores by day 7 (p < 0.00001) and improved stability by day 30 (ISQ > 62.00 ± 0.59, p < 8 × 10-7). By day 60, CBCT scans revealed an increased bone area ratio in BBL-treated implants. AFM images demonstrated the BBL's softening and wettability effect on implant surfaces. Furthermore, the BBL promoted DPPSCs' osteogenesis and modulated inflammatory markers in human primary macrophages. This study presents compelling clinical and biological evidence that BBL treatment improves Galaxy TS implant stability, reduces pain, and enhances bone formation, possibly through surface tension modulation and immunomodulatory effects. This advancement holds promise for enhancing patient outcomes and implant longevity.
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Affiliation(s)
- Ashraf Al Madhoun
- Department of Animal and Imaging Core Facilities, Dasman Diabetes Institute, Dasman 15462, Kuwait;
| | - Khaled Meshal
- Biointelligent Technology Systems SL, C/Diputaccion 316, 3D, 08009 Barcelona, Spain; (K.M.); (E.F.-A.); (M.B.); (A.S.A.-M.); (A.S.); (Y.A.A.); (C.M.)
| | - Neus Carrió
- Periodontology Department, Universitat Internacional de Catalunya (UIC), C/Josep Trueta s/n, 08195 Barcelona, Spain;
| | - Eduard Ferrés-Amat
- Biointelligent Technology Systems SL, C/Diputaccion 316, 3D, 08009 Barcelona, Spain; (K.M.); (E.F.-A.); (M.B.); (A.S.A.-M.); (A.S.); (Y.A.A.); (C.M.)
- Oral and Maxillofacial Surgery Department, Universitat Internacional de Catalunya (UIC), St Josep Trueta s/n, 08195 Barcelona, Spain
| | - Elvira Ferrés-Amat
- Oral and Maxillofacial Surgery and Pediatric Dentistry Department, Universitat Internacional de Catalunya (UIC), St Josep Trueta s/n, 08195 Barcelona, Spain;
| | - Miguel Barajas
- Biointelligent Technology Systems SL, C/Diputaccion 316, 3D, 08009 Barcelona, Spain; (K.M.); (E.F.-A.); (M.B.); (A.S.A.-M.); (A.S.); (Y.A.A.); (C.M.)
- Biochemistry and Molecular Biology Department, Universidad Pública de Navarra, 31006 Pamplona, Spain
| | | | - Areej Said Al-Madhoun
- Biointelligent Technology Systems SL, C/Diputaccion 316, 3D, 08009 Barcelona, Spain; (K.M.); (E.F.-A.); (M.B.); (A.S.A.-M.); (A.S.); (Y.A.A.); (C.M.)
| | - Alaa Saber
- Biointelligent Technology Systems SL, C/Diputaccion 316, 3D, 08009 Barcelona, Spain; (K.M.); (E.F.-A.); (M.B.); (A.S.A.-M.); (A.S.); (Y.A.A.); (C.M.)
| | - Yazan Abou Alsamen
- Biointelligent Technology Systems SL, C/Diputaccion 316, 3D, 08009 Barcelona, Spain; (K.M.); (E.F.-A.); (M.B.); (A.S.A.-M.); (A.S.); (Y.A.A.); (C.M.)
| | - Carles Marti
- Biointelligent Technology Systems SL, C/Diputaccion 316, 3D, 08009 Barcelona, Spain; (K.M.); (E.F.-A.); (M.B.); (A.S.A.-M.); (A.S.); (Y.A.A.); (C.M.)
- Oral and Maxillofacial Surgery Department, Hospital Clinic de Barcelona, 08036 Barcelona, Spain
| | - Maher Atari
- Biointelligent Technology Systems SL, C/Diputaccion 316, 3D, 08009 Barcelona, Spain; (K.M.); (E.F.-A.); (M.B.); (A.S.A.-M.); (A.S.); (Y.A.A.); (C.M.)
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Comparison of 0.12% Chlorhexidine and a New Bone Bioactive Liquid, BBL, in Mouthwash for Oral Wound Healing: A Randomized, Double Blind Clinical Human Trial. J Pers Med 2022; 12:jpm12101725. [PMID: 36294864 PMCID: PMC9605239 DOI: 10.3390/jpm12101725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
Following surgery, healing within the oral cavity occurs in a hostile environment, and proper oral care and hygiene are required to accelerate recovery. The aim of the current study is to investigate and compare the bioreactivity characteristics of mouthwashes based on either chlorhexidine (CHX) or a novel bone bioactive liquid (BBL) in terms of oral healing within seven days application post-surgery. A randomized, double blind clinical trial was conducted in 81 patients, wherein the mouthwashes were applied twice a day for a period of 7 days. The visual analog scale (VAS) protocol was applied to determine pain index scores. Early wound healing index (EHI) score was determined for evaluating oral cavity healing progress. No adverse effects were observed using the mouthwashes, but CHX application resulted in stained teeth. Applications of both CHX and BBL were sufficient to reduce pain over a period of 7 days. However, the BBL group demonstrated a statistically significant reduction in VAS scores starting on day 4. The EHI scores were significantly higher in the BBL group compared with the CHX group, independent of tooth location. No differences in either VAS or EHI scores due to gender were observed. Compared with the commercially available CHX mouthwash, application of the BBL mouthwash reduced pain and accelerated oral cavity healing to a greater extent, suggesting it effectively improves the oral cavity microenvironment at the wound site in mediating soft tissue regeneration.
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