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Bighetti ACC, Cestari TM, Paini S, Pomini KT, Buchaim DV, Ortiz RC, Júnior RSF, Barraviera B, Bullen IRFR, Garlet GP, Buchaim RL, de Assis GF. Efficacy and safety of a new heterologous fibrin biopolymer on socket bone healing after tooth extraction: An experimental pre-clinical study. J Clin Periodontol 2024. [PMID: 38685818 DOI: 10.1111/jcpe.13992] [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: 11/03/2023] [Revised: 03/13/2024] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
AIM To assess the efficacy of heterologous fibrin biopolymer (HFB) in promoting alveolar bone healing after tooth extraction in rats. MATERIALS AND METHODS The upper right incisors of 48 Wistar rats were extracted. Toothless sockets were filled with HFB (HFBG, n = 24) or blood clot (BCG, n = 24). The tooth extraction sites were subjected to micro-computed tomography (micro-CT), histological, histomorphometric and immunohistochemical (for Runt-related transcription factor 2/Runx2 and tartrate-resistant acid phosphatase/TRAP) analyses on days 0, 7, 14 and 42 after extraction. RESULTS Socket volume remained similar between days 0 and 14 (69 ± 5.4 mm3), except in the BCG on day 14, when it was 10% lower (p = .043). Although the number of Runx2+ osteoblasts was high and similar in both groups (34 × 102 cells/mm2), the HFBG showed lower inflammatory process and osteoclast activity than BCG at 7 days. On day 14, the number of Runx2+ osteoblasts remained high and similar to the previous period in both groups. However, osteoclast activity increased. This increase was 55% lower in the HFBG than BCG. In the BCG, the presence of an inflammatory process and larger and numerous osteoclasts on day 14 led to resorption of the alveolar bone ridge and newly formed bone. On day 42, numbers of Runx2+ osteoblast and TRAP+ osteoclasts decreased dramatically in both groups. Although the BCG exhibited a more mature cortical bone formation, it exhibited a higher socket reduction (28.3 ± 6.67%) and smaller bone volume (37 ± 5.8 mm3) compared with HFBG (socket reduction of 14.8 ± 7.14% and total bone volume of 46 ± 5.4 mm3). CONCLUSIONS HFB effectively suppresses osteoclast activity and reduces alveolar bone resorption compared with blood clot, thus preventing three-dimensional bone loss, particularly during the early healing period. HFB emerges as a promising biopharmaceutical material for enhancing healing processes after tooth extraction.
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Affiliation(s)
| | - Tania Mary Cestari
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Suelen Paini
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Karina T Pomini
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marilia, Brazil
| | - Daniela Vieira Buchaim
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marilia, Brazil
- Teaching and Research Coordination of the Medical School, University Center of Adamantina (UNI-FAI), Adamantina, Brazil
| | - Rafael Carneiro Ortiz
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rui Seabra Ferreira Júnior
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ Estadual Paulista, UNESP), Botucatu, São Paulo, Brazil
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu, São Paulo, Brazil
| | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ Estadual Paulista, UNESP), Botucatu, São Paulo, Brazil
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu, São Paulo, Brazil
| | - Izabel R F R Bullen
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gustavo Pompermaier Garlet
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rogério Leone Buchaim
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of São Paulo (FMVZ/USP), São Paulo, Brazil
| | - Gerson F de Assis
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
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Erdem NF, Abdioğlu G, Ekinci SA, Şişman AÇ. Radiological Evaluation and Biomechanical Stability of Implants Simultaneously Placed at the Sites with Sole Advanced Platelet-Rich Fibrin (A-PRF) Grafted Sinus Floor. J Maxillofac Oral Surg 2023; 22:1083-1090. [PMID: 38105860 PMCID: PMC10719193 DOI: 10.1007/s12663-022-01785-4] [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: 06/30/2021] [Accepted: 09/05/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction In this retrospective study stabilities of 24 implants simultaneously placed at posterior maxillae with sinuses grafted by advanced platelet rich fibrin (A-PRF) and newly formed bone around them were evaluated. Patient and Methods Fourteen augmented maxillary sinuses of 11 patients with a mean residual alveolar bone height of 4.55 mm were involved in this study. Maxillary sinus lifting via lateral window approach and implant site osteotomy were performed, and prepared A-PRF clots were used as sole graft material. Each of the implants was immediately placed with a good primary stability. Postoperative sixth month tomography images were compared with preoperative ones in order to calculate the gained bone height and implant stability quotient (ISQ) values were recorded. Results The new vertical mean bone height of 24 implant sites was 12.21 mm with an implant survival rate of 100%. ISQ values of the implants were ranging from 62 to 75 with a mean value of 68. Statistically the diameter of implant did not have any effect on new bone formation and the ISQ values, however the length of them did. Conclusion A-PRF as a graft material for sinus lifting with simultaneous implant placement is a reliable technique with its low cost and lack of immunogenic reaction risk.
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Affiliation(s)
- Necip Fazıl Erdem
- Department of Oral and Maxillofacial Surgery, Marmara University, School of Dentistry, No: 9/3, 34854 Başıbüyük, Maltepe, Istanbul Turkey
| | - Gürkan Abdioğlu
- Department of Oral and Maxillofacial Surgery, Marmara University, School of Dentistry, No: 9/3, 34854 Başıbüyük, Maltepe, Istanbul Turkey
| | - Senem Aşkın Ekinci
- Department of Oral and Maxillofacial Surgery, Marmara University, School of Dentistry, No: 9/3, 34854 Başıbüyük, Maltepe, Istanbul Turkey
| | - Alanur Çiftçi Şişman
- Department of Oral and Maxillofacial Surgery, Sağlık Bilimleri University, School of Dentistry, Selimiye Mah. Tıbbiye Cad. No: 38, 34668 Üsküdar, Istanbul Turkey
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Naeimi Darestani M, Asl Roosta H, Mosaddad SA, Yaghoubee S. The effect of leukocyte- and platelet-rich fibrin on the bone loss and primary stability of implants placed in posterior maxilla: a randomized clinical trial. Int J Implant Dent 2023; 9:23. [PMID: 37555894 PMCID: PMC10412516 DOI: 10.1186/s40729-023-00487-x] [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: 05/02/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023] Open
Abstract
PURPOSE In this study, we investigated the effects of leukocyte- and platelet-rich fibrin (L-PRF) on implant stability and alterations in the marginal bone surrounding posterior maxillary implants. METHODS This randomized clinical trial was conducted to compare the variable of L-PRF placement around maxillary implants. Resonance frequency analysis (RFA) was used to evaluate the implant stability immediately after surgery and at 1, 2, 4, 6, 8, and 12 weeks after surgery (t0 to t6, respectively). In addition, the amount of marginal bone changes around the implant at t6 was compared with the baseline using periapical radiography. RESULTS The RFA outcomes were statistically significant within each group (P < 0.001, Eta2 = 0.322); however, in none of the follow-ups and immediately after the surgery, there was a significant difference between the two groups in terms of the implant stability quotient (ISQ) scores (P > 0.05). At t0, the test and control groups' respective mean levels of marginal bone loss around the implants were 0.4836 mm and 0.7343 mm, significantly different from the corresponding values at t6. On the other hand, marginal bone loss around the implant was not significantly different between the two groups in t0 and t6 (P = 0.532). CONCLUSIONS L-PRF did not improve the RFA outcomes of implants three months after implant placement, and changes in the ISQ values over time were the same in both groups. In addition, L-PRF had no superior effect on the marginal bone loss around the implants. TRIAL REGISTRATION NUMBER The research was registered in the Iranian Registry of Clinical Trials on 22 December 2020 (No: IRCT20200624047906N1), available at http://www.irct.ir.
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Affiliation(s)
| | - Hoori Asl Roosta
- Periodontics Department, Dental Faculty, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Siamak Yaghoubee
- Periodontics Department, Dental Faculty, Tehran University of Medical Sciences, Tehran, Iran.
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Patel B, Joshi S, Nagrani T, Girdhar GA, Patel H, Sinha S, Haque M, Kumar S, Haq MA. Clinical and Radiographic Evaluation of Autologous Platelet-Rich Fibrin With or Without Demineralized Bone Matrix in the Treatment of Grade II Furcation Defects. Cureus 2023; 15:e44394. [PMID: 37654905 PMCID: PMC10468150 DOI: 10.7759/cureus.44394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction This study aims to differentiate the employment of demineralized bone matrix (DMBM; Osseograft, Advanced Biotech Products (P) Ltd, Chennai, India) and platelet-rich fibrin (PRF) alone to a composite graft consisting of both materials in the surgical actions toward the anomalies of the human periodontal furcation imperfection. Methods In a split-mouth study, 30 patients with mandibular molars affected by the furcation were allocated without conscious choice to test (PRF + DMBM, n = 30) or control (PRF, n = 30) categories. At the starting point, three months after surgery, and six months later, the following modifiable factors were evaluated: probing pocket depth (PPD), full-mouth plaque scores, full-mouth gingival scores, radiographic defect depth, relative vertical clinical attachment level (RVCAL), and relative horizontal clinical attachment level (RHCAL). Results Results at three and six months demonstrated substantial differences between baseline values for both treatment methods in clinical and X-ray imaging appraisal. Nonetheless, the PRF/DMBM group manifests statistically significantly soaring changes observed in comparison to the PRF group. Overall, the probing depth (PD) in the test site was significantly lower than that in the control site, showing a reduction of 68% (95% CI=41%, 95%, p<0.001). Conclusion Clinical indications significantly improved with PRF and DMBM combined instead of PRF alone. On radiographs, the test group also showed higher bone fill.
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Affiliation(s)
- Bhavin Patel
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Surabhi Joshi
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Tanya Nagrani
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Gaurav A Girdhar
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Heli Patel
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Susmita Sinha
- Physiology, Khulna City Medical College Hospital, Khulna, BGD
| | - Mainul Haque
- Karnavati Scientific Research Center, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
- Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
| | - Santosh Kumar
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Md Ahsanul Haq
- Biostatistics, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB), Dhaka, BGD
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Dadpe AM, Shah DY, Natanasabapathy V, Sureshbabu NM, Hindlekar AN, Modi K. Regenerative Endodontic Procedures in Teeth with Root Resorption: A Systematic Review. Eur Endod J 2023; 8:170-186. [PMID: 37257034 PMCID: PMC10244915 DOI: 10.14744/eej.2023.77486] [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: 11/16/2022] [Revised: 02/21/2023] [Accepted: 03/14/2023] [Indexed: 04/09/2023] Open
Abstract
The purpose of this systematic review was to critically evaluate the available clinical literature on the use of regenerative endodontic therapy (RET) for the treatment of root resorption. All case reports, case series and clinical studies documenting the management of root resorption in mature or immature permanent teeth using RET were included. Review articles, animal studies, and RET in teeth showing developmental anomalies were excluded. A literature search was conducted in electronic databases MEDLINE, Scopus, Cochrane, and Google Scholar from 2001 to January 2022. The JBI Critical Appraisal Checklist Quality was used to appraise the included case reports and case series. The Methodological item for non-randomised studies (MINORS) tool was used to appraise the clinical study critically. After applying the inclusion and exclusion criteria, the search resulted in 14 studies (12 case reports, 1 case series, and 1 clinical study) accounting for root resorption in 34 teeth from 29 patients treated with RET. Despite the wide variation in RET protocols, the arrest of root resorption and resolution of symptoms was seen in all teeth except one (failure after 27 months). The clinical study's cone beam computed tomography (CBCT) imaging evalu- ation documented a significant volumetric decrease in resorptive and periapical lesions after RET. The clinical study was deemed as good quality using the MINORS scale. The JBI critical appraisal tool showed that the case series was of poor quality; 11 of the case reports were of good quality, while 1 case report was of fair quality. This systematic review revealed a low-to-moderate level of evidence for the use of RET in resorption cases. However, further well-designed, long-term clinical studies are required to recommend it as an alternative treatment option for root resorption management. Funding: None. The systematic review was registered in PROSPERO (CRD42021274569). (EEJ-2022-11-136).
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Affiliation(s)
- Ashwini Manish Dadpe
- Department of Conservative Dentistry and Endodontics, Sinhgad Dental College & Hospital, Pune, India
| | - Dipali Yogesh Shah
- Department of Conservative Dentistry and Endodontics, Sinhgad Dental College & Hospital, Pune, India
| | - Velmurugan Natanasabapathy
- Department of Conservative Dentistry and Endodontics, MeenakshiAmmal Dental College and Hospital, Chennai, India
| | | | - Ajit Narayan Hindlekar
- Department of Conservative Dentistry and Endodontics, Dr. D. Y. Patil Dental College & Hospital, Pune, India
| | - Kajal Modi
- Department of Conservative Dentistry and Endodontics, MeenakshiAmmal Dental College and Hospital, Chennai, India
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Guo X, Lu H, Liu C, Zhang Y, Bi L. Effects of Super-Activated Platelet Lysate on Early Healing of Tooth Extraction Sockets in Rats. Drug Des Devel Ther 2022; 16:2213-2227. [PMID: 35860524 PMCID: PMC9289175 DOI: 10.2147/dddt.s363766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/30/2022] [Indexed: 12/28/2022] Open
Abstract
Purpose To evaluate the effect of super-activated platelet lysate (sPL) on wound healing of tooth extraction sockets in rats. Methods Rat models of the tooth extraction socket were established. Thirty-six rats were divided into control and sPL groups and sacrificed on days 7, 14, and 28 after tooth extraction. Bone formation in tooth extraction sockets were observed by microscopic computed tomography (micro-CT) and hematoxylin and eosin (HE) staining; osteoprotegerin (OPG), receptor activator of nuclear factor kappa-Β ligand (RANKL), interleukin 6(IL-6), and tumor necrosis factor-alpha (TNF-α) proteins were detected by immunohistochemistry; and chemokine and osteogenic gene expressions were detected by polymerase chain reaction (PCR). Results sPL accelerated soft tissue wound healing in the extraction socket of rats. Micro-CT showed that the amount of bone formation and bone volume fraction were higher in the sPL group than the control 14 days after extraction. HE staining showed promotion of the formation of bony trabeculae by sPL in the apical third of the extraction socket 7 days after extraction and more mature and organized bony trabeculae in the sPL group than the control 14 days after extraction; mature bony trabeculae filling most of the fossa with lesser bone porosity in the socket in the sPL group than the control 28 days after extraction. Immunohistochemistry showed that sPL induced OPG expressions 7 and 14 days after tooth extraction but did not affect the RANKL expression while transiently promoting the IL-6 expression 7 days after extraction. PCR showed that sPL promoted chemokine expressions 7 and 14 days after extraction. The expressions of osteogenesis-related factors were higher in the sPL group than the control 7 and 28 days after extraction, while the opposite trend was observed 14 days after extraction. Conclusion sPL has a transient pro-inflammatory effect and promotes soft tissue healing and bone formation during early wound healing of extraction sockets in rats.
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Affiliation(s)
- Xiaorui Guo
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, 150001, People's Republic of China.,State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Huiying Lu
- National and Local Joint Stem Cell Research & Engineering Center for Aging Diseases, Tian Qing Stem Cell Co., Ltd, Harbin, 150028, People's Republic of China
| | - Chunxiang Liu
- National and Local Joint Stem Cell Research & Engineering Center for Aging Diseases, Tian Qing Stem Cell Co., Ltd, Harbin, 150028, People's Republic of China
| | - Yi Zhang
- National and Local Joint Stem Cell Research & Engineering Center for Aging Diseases, Tian Qing Stem Cell Co., Ltd, Harbin, 150028, People's Republic of China
| | - Liangjia Bi
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, 150001, People's Republic of China
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7
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Idulhaq M, Mudigdo A, Utomo P, Wasita B. The Evidence-based Effect of Platelet-rich Fibrin in Osteogenesis: A Systematic Review and Meta-analysis. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
ABSTRACT
Background: Platelet Rich Fibrin (PRF) is a growth factor concentration functioning as an initiator of wound healing and bone regeneration, and it is mainly reported in dentistry rehabilitation and rejuvenation.
Objective: summarize and analyze the evidence based on the effect of PRF on the bone osteogenesis
Methods: A comprehensive search was conducted on the bibliographic databases or Medical Subject Headings in the PubMed. The search was conducted among articles that were published between 2010 and 2021. Required article information was extracted from each article by abstract and full paper availability that focuses on the Platelet-Rich Fibrin (PRF) And Osteogenesis. We recruited studies with the design was employed clinical trials with in vitro and in vivo approaches. The only study that provided osteogenesis outcome proceeded to the quantitative analysis.
Results: Regarding literature search and screening processes, it yielded 24 studies for qualitative assessment and eleven studies for quantitative analysis. Most of the studies performed a combination of PRF with other materials such as Mg ring, BMSCs, Gold nanoparticles, and PDLSCs. It showed that PRF combined with other materials enhanced the osteogenic ability. The assessment of PRF only showed the various result in multiple outcome markers. For the ALP, the mean difference is 1.40 [1.14-1.67] p-value 0.001. It indicates there is a significant effect of PRF application with the increase of ALP. For the RUNX2, there is a significant effect of PRF application with the increase of RUNX2 1.10 [0.93, 1.26]. For OCN, the mean difference of PRF in OCN is 0.77 [0.43, 1.12] p=0.001. It showed a significant effect of PRF application with the increase of OCN. There is also a significant effect of PRF application for TRAP with the declining number of TRAP is -1.59 [-2.96, -0.22] p=0.001.
Conclusion: PRF combined with other materials showed more promising results rather than PRF only. Moreover, in the assessment of PRF only, it was found that PRF has a significant effect in accelerating bone osteogenesis.
Keywords:
PRF, Platelet-Rich Fibrin, Osteogenesis
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Blatt S, Thiem DGE, Kyyak S, Pabst A, Al-Nawas B, Kämmerer PW. Possible Implications for Improved Osteogenesis? The Combination of Platelet-Rich Fibrin With Different Bone Substitute Materials. Front Bioeng Biotechnol 2021; 9:640053. [PMID: 33816452 PMCID: PMC8010662 DOI: 10.3389/fbioe.2021.640053] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/22/2021] [Indexed: 12/27/2022] Open
Abstract
Bone substitute materials (BSM) are widely used in oral regeneration, but sufficient angiogenesis is crucial for osteogenesis. The combination of BSM with autologous thrombocyte concentrations such as platelet-rich fibrin (PRF) may represent a clinical approach to overcome this limitation. This study analyzes the early influence on osteoblast (HOB) in vitro. Here, four different BSM (allogeneic, alloplastic, and two of xenogeneic origin) were combined with PRF. After the incubation with osteoblasts for 24 h, cell viability, migration, and proliferation were assessed. Next, marker of proliferation, migration, and differentiation were evaluated on gene and protein levels in comparison to the native BSM and osteoblast alone. Addition of PRF increased viability for both the xenogeneic BSM (p = 0.0008, p = 0.032, respectively) in comparison to HOB and vs. native BSM (p = 0.008), and led to a tendency for increased cell proliferation and migration for all BSM (each p > 0.05). On gene basis, allogeneic and alloplastic BSM displayed a significantly increased RUNX2 expression (each p = 0.050). Expression of alkaline phosphatase for alloplastic (p = 0.050) and collagen-1 for xenogeneic BSM (p = 0.05) were significantly increased in combination with PRF. In addition, bone morphogenic protein was expressed significantly higher when xenogeneic material was combined with PRF in comparison to HOB alone (each p = 0.05). In summary, the combination of PRF with different BSM increases initial viability and may influence early proliferation and migration potential of osteoblast via RUNX2, alkaline phosphatase, collagen, and BMP2 especially in combination with alloplastic and xenogeneic BSM. Biofunctionalization of BSM using PRF might improve osteogenesis and extend the range of indications.
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Affiliation(s)
- Sebastian Blatt
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.,Platform for Biomaterial Research, BiomaTiCS Group, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Daniel G E Thiem
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Solomiya Kyyak
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andreas Pabst
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Koblenz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
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9
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Oliver JD, Jia S, Halpern LR, Graham EM, Turner EC, Colombo JS, Grainger DW, D'Souza RN. Innovative Molecular and Cellular Therapeutics in Cleft Palate Tissue Engineering. TISSUE ENGINEERING PART B-REVIEWS 2020; 27:215-237. [PMID: 32873216 DOI: 10.1089/ten.teb.2020.0181] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Clefts of the lip and/or palate are the most prevalent orofacial birth defects occurring in about 1:700 live human births worldwide. Early postnatal surgical interventions are extensive and staged to bring about optimal growth and fusion of palatal shelves. Severe cleft defects pose a challenge to correct with surgery alone, resulting in complications and sequelae requiring life-long, multidisciplinary care. Advances made in materials science innovation, including scaffold-based delivery systems for precision tissue engineering, now offer new avenues for stimulating bone formation at the site of surgical correction for palatal clefts. In this study, we review the present scientific literature on key developmental events that can go awry in palate development and the common surgical practices and challenges faced in correcting cleft defects. How key osteoinductive pathways implicated in palatogenesis inform the design and optimization of constructs for cleft palate correction is discussed within the context of translation to humans. Finally, we highlight new osteogenic agents and innovative delivery systems with the potential to be adopted in engineering-based therapeutic approaches for the correction of palatal defects. Impact statement Tissue-engineered scaffolds supplemented with osteogenic growth factors have attractive, largely unexplored possibilities to modulate molecular signaling networks relevant to driving palatogenesis in the context of congenital anomalies (e.g., cleft palate). Constructs that address this need may obviate current use of autologous bone grafts, thereby avoiding donor-site morbidity and other regenerative challenges in patients afflicted with palatal clefts. Combinations of biomaterials and drug delivery of diverse regenerative cues and biologics are currently transforming strategies exploited by engineers, scientists, and clinicians for palatal cleft repair.
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Affiliation(s)
- Jeremie D Oliver
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Shihai Jia
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Leslie R Halpern
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emily M Graham
- School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Emma C Turner
- University of Western Australia Dental School, Perth, Western Australia
| | - John S Colombo
- University of Las Vegas at Nevada School of Dental Medicine, Las Vegas, Nevada, USA
| | - David W Grainger
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah Health Sciences, Salt Lake City, Utah, USA
| | - Rena N D'Souza
- School of Dentistry, University of Utah Health Sciences, Salt Lake City, Utah, USA.,Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.,School of Medicine, University of Utah Health Sciences, Salt Lake City, Utah, USA
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10
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Paiva KBS, Maas CS, dos Santos PM, Granjeiro JM, Letra A. Extracellular Matrix Composition and Remodeling: Current Perspectives on Secondary Palate Formation, Cleft Lip/Palate, and Palatal Reconstruction. Front Cell Dev Biol 2019; 7:340. [PMID: 31921852 PMCID: PMC6923686 DOI: 10.3389/fcell.2019.00340] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 11/29/2019] [Indexed: 12/13/2022] Open
Abstract
Craniofacial development comprises a complex process in humans in which failures or disturbances frequently lead to congenital anomalies. Cleft lip with/without palate (CL/P) is a common congenital anomaly that occurs due to variations in craniofacial development genes, and may occur as part of a syndrome, or more commonly in isolated forms (non-syndromic). The etiology of CL/P is multifactorial with genes, environmental factors, and their potential interactions contributing to the condition. Rehabilitation of CL/P patients requires a multidisciplinary team to perform the multiple surgical, dental, and psychological interventions required throughout the patient's life. Despite progress, lip/palatal reconstruction is still a major treatment challenge. Genetic mutations and polymorphisms in several genes, including extracellular matrix (ECM) genes, soluble factors, and enzymes responsible for ECM remodeling (e.g., metalloproteinases), have been suggested to play a role in the etiology of CL/P; hence, these may be considered likely targets for the development of new preventive and/or therapeutic strategies. In this context, investigations are being conducted on new therapeutic approaches based on tissue bioengineering, associating stem cells with biomaterials, signaling molecules, and innovative technologies. In this review, we discuss the role of genes involved in ECM composition and remodeling during secondary palate formation and pathogenesis and genetic etiology of CL/P. We also discuss potential therapeutic approaches using bioactive molecules and principles of tissue bioengineering for state-of-the-art CL/P repair and palatal reconstruction.
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Affiliation(s)
- Katiúcia Batista Silva Paiva
- Laboratory of Extracellular Matrix Biology and Cellular Interaction, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Clara Soeiro Maas
- Laboratory of Extracellular Matrix Biology and Cellular Interaction, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Pâmella Monique dos Santos
- Laboratory of Extracellular Matrix Biology and Cellular Interaction, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - José Mauro Granjeiro
- Clinical Research Laboratory in Dentistry, Federal Fluminense University, Niterói, Brazil
- Directory of Life Sciences Applied Metrology, National Institute of Metrology, Quality and Technology, Duque de Caxias, Brazil
| | - Ariadne Letra
- Center for Craniofacial Research, UTHealth School of Dentistry at Houston, Houston, TX, United States
- Pediatric Research Center, UTHealth McGovern Medical School, Houston, TX, United States
- Department of Diagnostic and Biomedical Sciences, UTHealth School of Dentistry at Houston, Houston, TX, United States
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