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Theodoro LH, Campista CCC, Bury LL, de Souza RGB, Muniz YS, Longo M, Mulinari-Santos G, Ervolino E, Levin L, Garcia VG. Comparison of different bone substitutes in the repair of rat calvaria critical size defects: questioning the need for alveolar ridge presentation. Quintessence Int 2024; 55:328-334. [PMID: 38329717 DOI: 10.3290/j.qi.b4955867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of biomaterials in bone healing of critical bone defects created by piezoelectric surgery in rat calvaria. METHOD AND MATERIALS Histomorphologic analysis was performed to assess bone regeneration and tissue response. Fifty animals were randomized into five groups with one of the following treatments: Control group (n = 10), spontaneous blood clot formation with no bone fill; BO group (Bio-Oss, Geistlich Pharma; n = 10), defects were filled with bovine medullary bone substitute; BF group (Bonefill, Bionnovation; n = 10), defects were filled with bovine cortical bone substitute; hydroxyapatite group (n = 10), defects were filled with hydroxyapatite; calcium sulfate group (n = 10), defects were filled with calcium sulfate. Five animals from each group were euthanized at 30 and 45 days. The histomorphometry calculated the percentage of the new bone formation in the bone defect. RESULTS All data obtained were evaluated statistically considering P < .05 as statistically significant. The results demonstrated the potential of all biomaterials for enhancing bone regeneration. The findings showed no statistical differences between all the biomaterials at 30 and 45 days including the control group without bone grafting. CONCLUSION In conclusion, the tested biomaterials presented an estimated capacity of osteoconduction, statistically nonsignificant between them. In addition, the selection of biomaterial should consider the specific clinical aspect, resorption rates, size of the particle, and desired bone healing responses. It is important to emphasize that in some cases, using no bone filler might provide comparable results with reduced cost and possible complications questioning the very frequent use of ridge presentation procedures.
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Lebedev VN, Kharovskaya MI, Lazoryak BI, Solovieva AO, Fadeeva IV, Amirov AA, Koliushenkov MA, Orudzhev FF, Baryshnikova OV, Yankova VG, Rau JV, Deyneko DV. Strontium and Copper Co-Doped Multifunctional Calcium Phosphates: Biomimetic and Antibacterial Materials for Bone Implants. Biomimetics (Basel) 2024; 9:252. [PMID: 38667262 PMCID: PMC11048597 DOI: 10.3390/biomimetics9040252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
β-tricalcium phosphate (β-TCP) is a promising material in regenerative traumatology for the creation of bone implants. Previously, it was established that doping the structure with certain cations can reduce the growth of bacterial activity. Recently, much attention has been paid to co-doped β-TCP, that is explained by their ability, on the one hand, to reduce cytotoxicity for cells of the human organism, on the other hand, to achieve a successful antibacterial effect. Sr, Cu-co-doped solid solutions of the composition Ca9.5-xSrxCu(PO4)7 was obtained by the method of solid-phase reactions. The Rietveld method of structural refinement revealed the presence of Sr2+ ions in four crystal sites: M1, M2, M3, and M4. The M5 site is completely occupied by Cu2+. Isomorphic substitution of Ca2+ → (Sr2+and Cu2+) expands the concentration limits of the existence of the solid solution with the β-TCP structure. No additional phases were formed up to x = 4.5 in Ca9.5-xSrxCu(PO4)7. Biocompatibility tests were performed on cell lines of human bone marrow mesenchymal stromal cells (hMSC), human fibroblasts (MRC-5) and osteoblasts (U-2OS). It was demonstrated that cytotoxicity exhibited a concentration dependence, along with an increase in osteogenesis and cell proliferation. Ca9.5-xSrxCu(PO4)7 powders showed significant inhibitory activity against pathogenic strains Escherichia coli and Staphylococcus aureus. Piezoelectric properties of Ca9.5-xSrxCu(PO4)7 were investigated. Possible ways to achieve high piezoelectric response are discussed. The combination of bioactive properties of Ca9.5-xSrxCu(PO4)7 renders them multifunctional materials suitable for bone substitutes.
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Affiliation(s)
- Vladimir N. Lebedev
- Chemistry Department, Lomonosov Moscow State University, Leninskie Gory 1, 119991 Moscow, Russia; (V.N.L.); (M.I.K.); (B.I.L.); (O.V.B.)
| | - Mariya I. Kharovskaya
- Chemistry Department, Lomonosov Moscow State University, Leninskie Gory 1, 119991 Moscow, Russia; (V.N.L.); (M.I.K.); (B.I.L.); (O.V.B.)
| | - Bogdan I. Lazoryak
- Chemistry Department, Lomonosov Moscow State University, Leninskie Gory 1, 119991 Moscow, Russia; (V.N.L.); (M.I.K.); (B.I.L.); (O.V.B.)
| | - Anastasiya O. Solovieva
- Laboratory of Pharmacology Active Compounds, Research Institute of Clinical and Experimental Lymphology–Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences (RICEL–Branch of IC&G SB RAS), 630060 Novosibirsk, Russia;
| | - Inna V. Fadeeva
- A.A. Baikov Institute of Metallurgy and Material Science RAS, Leninskie, 49, 119334 Moscow, Russia;
| | - Abdulkarim A. Amirov
- Amirkhanov Institute of Physics, Dagestan Scientific Center of Russian Academy of Sciences, 367003 Makhachkala, Russia;
| | - Maksim A. Koliushenkov
- Physics Department, Lomonosov Moscow State University, Leninskie Gori 1, 119991 Moscow, Russia;
| | - Farid F. Orudzhev
- Geothermal and Renewal Energy Institute of the High Temperature Joint Institute of the Russian Academy of Sciences, 367015 Makhachkala, Russia;
| | - Oksana V. Baryshnikova
- Chemistry Department, Lomonosov Moscow State University, Leninskie Gory 1, 119991 Moscow, Russia; (V.N.L.); (M.I.K.); (B.I.L.); (O.V.B.)
| | - Viktoriya G. Yankova
- Institute of Pharmacy, Department of Analytical, Physical and Colloid Chemistry, I.M. Sechenov First Moscow State Medical University, Trubetskaya 8, Building 2, 119048 Moscow, Russia; (V.G.Y.); (J.V.R.)
| | - Julietta V. Rau
- Institute of Pharmacy, Department of Analytical, Physical and Colloid Chemistry, I.M. Sechenov First Moscow State Medical University, Trubetskaya 8, Building 2, 119048 Moscow, Russia; (V.G.Y.); (J.V.R.)
- Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche, ISM-CNR, Via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - Dina V. Deyneko
- Chemistry Department, Lomonosov Moscow State University, Leninskie Gory 1, 119991 Moscow, Russia; (V.N.L.); (M.I.K.); (B.I.L.); (O.V.B.)
- Laboratory of Arctic Mineralogy and Material Sciences, Kola Science Centre RAS, 14 Fersman Str., 184209 Apatity, Russia
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Aludden H, Starch-Jensen T, Dahlin C, Sdik J, Cederlund A, Mordenfeld A. Histological and radiological outcome after horizontal guided bone regeneration with bovine bone mineral alone or in combination with bone in edentulous atrophic maxilla: A randomized controlled trial. Clin Oral Implants Res 2024; 35:396-406. [PMID: 38291545 DOI: 10.1111/clr.14235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/30/2023] [Accepted: 12/16/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVE To assess the radiological and histological outcome after horizontal guided bone regeneration (GBR) with deproteinized bovine bone mineral (DBBM) alone or in combination with particulate autogenous bone (PAB). MATERIALS AND METHODS Eighteen edentulous patients with an alveolar ridge of ≤4 mm were included in this split-mouth randomized controlled trial. Horizontal GBR with a graft composition of 100% DBBM (100:0) on one side and 90% DBBM and 10% PAB (90:10) on the other side were conducted in all patients. Cone beam computed tomography (CBCT) was obtained preoperatively, immediately postoperative, and after 10 months of healing. Width and volumetric changes in the alveolar process were measured on CBCT. Implants were placed after 10 months of graft healing where biopsies were obtained for histomorphometrical evaluation. RESULTS The gained widths were 4.9 (±2.4) mm (100:0) and 4.5 (±2.0) mm (90:10) at 3 mm from the top of the crest, and 5.6 (±1.3) mm (100:0) and 4.6 (±2.1) mm (90:10) at 6 mm from the top of the crest. The mean volumetric reductions were 32.8% (±23.8) (100:0) and 38.2% (±23.2) (90:10). Histomorphometry revealed that mean percentages of bone were 50.8% (±10.7) (100:0) and 46.4% (±11.3) (90:10), DBBM were 31.6% (±12.6) (100:0) and 35.4% (±14.8) (90:10), and non-mineralized tissue were 17.6% (±11.7; 100:0) and 18.2% (±18.2) (90:10). No significant differences were evident between in any evaluated parameters. CONCLUSIONS There were no additional effects of adding PAB to DBBM regarding bone formation, width changes, or volumetric changes after 10 months of graft healing.
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Affiliation(s)
- Hanna Aludden
- Department of Biomaterials, BIOMATCELL VINN Excellence Center, Institute for Surgical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral and Maxillofacial Surgery, NU-Hospital, Organization Trollhättan, Trollhättan, Sweden
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Christer Dahlin
- Department of Biomaterials, BIOMATCELL VINN Excellence Center, Institute for Surgical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral and Maxillofacial Surgery, NU-Hospital, Organization Trollhättan, Trollhättan, Sweden
| | | | - Andreas Cederlund
- Department of Oral Radiology, Eastman Institute, Stockholm County Council, Region Stockholm, Stockholm, Sweden
| | - Arne Mordenfeld
- Plastic and Oral & Maxillofacial Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Reschke P, Koch V, Mahmoudi S, Booz C, Yel I, Gotta J, Stahl A, Reschke R, Scholtz JE, Martin SS, Gruber-Rouh T, Eichler K, Vogl TJ, Gruenewald LD. Predictive Value of Dual-Energy CT-Derived Metrics for the Use of Bone Substitutes in Distal Radius Fracture Surgery. Diagnostics (Basel) 2024; 14:697. [PMID: 38611610 PMCID: PMC11011262 DOI: 10.3390/diagnostics14070697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: Low bone mineral density (BMD) is a significant risk factor for complicated surgery and leads to the increased use of bone substitutes in patients with distal radius fractures (DRFs). No accepted model has yet been established to predict the use of bone substitutes to facilitate preoperative planning. (2) Methods: Unenhanced dual-energy CT (DECT) images of DRFs were retrospectively acquired between March 2016 and September 2020 using the internal PACS system. Available follow-up imaging and medical health records were reviewed to determine the use of bone substitutes. DECT-based BMD, trabecular Hounsfield units (HU), cortical HU, and cortical thickness ratio were measured in non-fractured segments of the distal radius. Diagnostic accuracy parameters were calculated for all metrics using receiver-operating characteristic (ROC) curves and associations of all metrics with the use of bone substitutes were evaluated using logistic regression models. (3) The final study population comprised 262 patients (median age 55 years [IQR 43-67 years]; 159 females, 103 males). According to logistic regression analysis, DECT-based BMD was the only metric significantly associated with the use of bone substitutes (odds ratio 0.96, p = 0.003). However, no significant associations were found for cortical HU (p = 0.06), trabecular HU (p = 0.33), or cortical thickness ratio (p = 0.21). ROC-curve analysis revealed that a combined model of all four metrics had the highest diagnostic accuracy with an area under the curve (AUC) of 0.76. (4) Conclusions: DECT-based BMD measurements performed better than HU-based measurements and cortical thickness ratio. The diagnostic performance of all four metrics combined was superior to that of the individual parameters.
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Affiliation(s)
- Philipp Reschke
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Vitali Koch
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Scherwin Mahmoudi
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Christian Booz
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Ibrahim Yel
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Jennifer Gotta
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Adrian Stahl
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Robin Reschke
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, 20537 Hamburg, Germany
| | - Jan-Erik Scholtz
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Simon S. Martin
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Tatjana Gruber-Rouh
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Katrin Eichler
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Thomas J. Vogl
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
| | - Leon D. Gruenewald
- Department of Diagnostic and Interventional Radiology, Clinic for Radiology and Nuclear Medicine, Hospital of the Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; (P.R.); (V.K.); (I.Y.); (J.G.); (A.S.); (L.D.G.)
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Lee SY, Choi SH, Lee DW. Vertical Ridge Augmentation with Customized Titanium Mesh Using a 3D-Printing Model: A Prospective Study in Humans. Int J Oral Maxillofac Implants 2024; 39:153-163. [PMID: 38416009 DOI: 10.11607/jomi.10184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
PURPOSE To evaluate the usefulness of ridge augmentation using a customized titanium mesh (CTM) that was preformed by trimming and bending the commercial titanium mesh on a virtually reconstructed 3D acrylic resin model using clinical, radiologic, histologic, and histomorphometric analyses. MATERIALS AND METHODS This study was designed prospectively for patients who required vertical ridge augmentation using a staged approach before implant surgery. After installation of the CTM, grafting was performed using deproteinized porcine bone mineral covered with an absorbable membrane. Computed tomography was performed preoperatively and 6 months after simultaneous/staged guided bone regeneration to measure planned, reconstructed, and lacking bone volume, and the reconstruction rate was calculated based on these values. Clinical complications were also recorded, particularly the mesh exposure rate. At re-entry, the bone core was obtained using a trephine bur, and histologic and histomorphometric analyses were performed. RESULTS A total of 10 sites in eight patients were used for the study analysis. The mean planned bone volume was 1.15 cm3 (range: 0.78 to 1.56 cm3), mean lacking bone volume was 0.13 cm3 (range: 0 to 0.59 cm3), and mean reconstructed bone volume was 1.02 cm3 (range: 0.56 to 1.43 cm3). The exposure rate was 30% (3 out of 10 sites). The reconstruction rate was over 80%, except for one case that showed suppuration. From histomorphometric analysis, 27.52% ± 16.87% of new bone, 7.62% ± 5.19% of residual graft, and 64.86% ± 23.76% of connective tissue were observed. The core biopsy samples demonstrated different pseudoperiosteum layer appearances based on the healing stage of the augmented sites. In the premature bone, the inner osteogenic layer consisted of multiple layers of osteoblast cells with adjacent large blood vessels. However, in the mature augmented site, there was no specific inner osteogenic layer, and the outer fibrous layer was dominant. CONCLUSIONS The fabrication of CTM based on the application of the 3D-printing technique makes vertical ridge augmentation easier and can reduce complications and achieve target bone acquisition. In addition, it is expected that quantitative analysis of the pseudoperiosteum layer will be facilitated using the CTM.
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Dewilde F, Hindryckx M, Younes F, De Bruyckere T, Cosyn J. Lateral bone augmentation with a composite graft covered with a stretched and pinned collagen membrane: A retrospective case series using cone-beam computed tomography. Clin Implant Dent Relat Res 2024. [PMID: 38391277 DOI: 10.1111/cid.13313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/27/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024]
Abstract
AIMS (1) To assess the effectiveness of the Sausage Technique™ when applied for lateral bone augmentation by multiple experienced clinicians; (2) To identify risk indicators for a poor outcome and to assess the need for adjunctive surgery. MATERIALS AND METHODS All patients who had been treated with the Sausage Technique™ for lateral bone augmentation by three experienced surgeons between January 2019 and December 2021 were included in a retrospective case series. The Sausage Technique™ technique includes the use of autogenous bone chips and deproteinized bovine bone mineral (1:1 ratio), covered with a stretched and pinned collagen membrane. The increase in alveolar width between the pre-operative situation and 9 months was assessed at different levels on superimposed cone-beam CT scans. RESULTS Twenty-five augmentations performed in 25 patients (17 males, 8 females, mean age 51 years) were available for evaluation. Mean alveolar width increased from 4.35 to 7.43 mm at 3 mm below the crest. The mean increase of 3.08 mm (95% CI 2.10-4.06; p < 0.001) was significant. The outcome of non-containing single implant sites was significantly worse than the outcome of other sites (MD 2.67 mm; p = 0.008). The need for regrafting was 4% and the need for soft tissue augmentation was 48%. Twenty percent of the patients needed soft tissue augmentation due to a lack of keratinized mucosa width, and 32% due to a lack of buccal convexity. The former was mainly needed at multiple implant sites, whereas the latter was mainly required at single implant sites. All implant survived and remained healthy until the final follow-up. CONCLUSION The Sausage Technique™ is an effective bone augmentation technique. Non-containing single implant sites were associated with a poor outcome and adjunctive soft tissue augmentation was needed in about half of the patients.
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Affiliation(s)
- Florence Dewilde
- Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Matthijs Hindryckx
- Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Faris Younes
- Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Thomas De Bruyckere
- Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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Yamaki D, Fukuba S, Okada M, Takeuchi S, Hoshi S, Matsuura T, Iwata T. Octacalcium phosphate collagen composite for periodontal regeneration in a canine one-wall intrabony defect. J Periodontal Res 2024. [PMID: 38356157 DOI: 10.1111/jre.13245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE This study aimed to evaluate the regenerative capacities of octacalcium phosphate collagen composite (OCP/Col) in one-wall intrabony defects in dogs. The background data discuss the present state of the field: No study has assessed the efficacy of OCP/Col for periodontal regeneration therapy despite the fact that OCP/Col has proved to be efficient for bone regeneration. METHODS In six beagle dogs, the mandibular left third premolars were extracted 12 weeks before the experimental surgery. Standardized bone defects (5 mm in height and 4 mm in width) were simulated on the distal surface of the second premolars and mesially on the fourth premolars. The defect was filled with either OCP/Col (experimental group) or left empty (control group). Histological and histomorphometric characteristics were compared 8 weeks after surgery. RESULTS No infectious or ankylotic complications were detected at any of the tested sites. The experimental group exhibited a significantly greater volume, height, and area of newly formed bone than the control group. The former also showed a greater height of the newly formed cementum than the latter, although the results were not statistically significant. The newly formed periodontal ligaments were inserted into newly formed bone and cementum in the experimental group. CONCLUSION OCP/Col demonstrated high efficacy for bone and periodontal tissue regeneration that can be successfully applied for one-wall intrabony defects.
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Affiliation(s)
- Daichi Yamaki
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Fukuba
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Munehiro Okada
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Shu Hoshi
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
- Private Practice, Niigata, Japan
| | - Takanori Matsuura
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, California, Los Angeles, USA
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
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Cabrera JP, Agarwal N, Mesregah MK, Rodrigues-Pinto R, Wu Y, Martin C, Buser Z, Wang JC, Meisel HJ. Analysis of Complications in Multilevel Anterior Cervical Discectomy and Fusion Using Osteobiologics Other than Bone Morphogenetic Protein: A Systematic Review. Global Spine J 2024; 14:86S-93S. [PMID: 38421321 PMCID: PMC10913906 DOI: 10.1177/21925682231168083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
STUDY DESIGN Systematic review. OBJECTIVES The aim of this study is to analyze the complications related to multilevel anterior cervical discectomy and fusion (ACDF) using osteobiologics other than bone morphogenetic protein (BMP). METHODS A systematic review of the literature was conducted using PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases. The search to identify studies reporting complications in multilevel ACDF surgery using osteobiologics other than bone morphogenetic protein was performed in August 2020. The study was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). RESULTS A total of 584 articles were found after searching the databases and removing duplicates. Next, screening was performed in a double reviewer process, and 153 eligible articles-with 4 retrospective studies-in full-text were selected; these met all inclusion criteria. A total of 197 patients received 3-level ACDF, while 72 patients received 4-level ACDF. Osteobiologics were used in all selected articles, allograft was used in 4 studies, autologous bone graft was utilized in 3 articles, and hydroxyapatite was used in 1 article. The main complications reported were dysphagia, adjacent segment disease, and pseudarthrosis. CONCLUSIONS Given the limited evidence, no conclusions on complications in multilevel ACDF using osteobiologics other than BMP could be made. However, descriptively, the most common complications found were dysphagia, adjacent segment disease, and pseudoarthrosis. Further prospective studies separately analyzing complications in multilevel ACDF by osteobiologics and a number of treated levels are needed.
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Affiliation(s)
- Juan P Cabrera
- Department of Neurosurgery, Hospital Clínico Regional de Concepción, Concepción, Chile
- Faculty of Medicine, University of Concepción, Concepción, Chile
| | - Neha Agarwal
- Department of Neurosurgery, BG Klinikum Bergmannstrost Halle, Halle, Germany
| | - Mohamed Kamal Mesregah
- Department of Orthopaedic Surgery, Menoufia University Faculty of Medicine, Shebin El-Kom, Menoufia, Egypt
| | - Ricardo Rodrigues-Pinto
- Spinal Unit (UVM). Department of Orthopaedics, Centro Hospitalar Universitário de Santo António; ICBAS - School of Medical and Biomedical Sciences; Hospital CUF Trindade, Porto, Portugal
| | - Yabin Wu
- Research Department, AO Spine, AO Foundation, Davos, Switzerland
| | - Christopher Martin
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Zorica Buser
- Gerling Institute, Brooklyn, NY, USA
- Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Jeffrey C Wang
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hans Jörg Meisel
- Department of Neurosurgery, BG Klinikum Bergmannstrost Halle, Halle, Germany
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Sokolowski A, Theisen K, Arefnia B, Payer M, Lorenzoni M, Sokolowski A. A randomized clinical trial of phycogenic materials for sinus grafting with hydroxyapatite versus biphasic calcium phosphate: 2 years clinical outcomes. Clin Oral Implants Res 2024; 35:155-166. [PMID: 37987199 DOI: 10.1111/clr.14209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 08/31/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES To assess in a prospective randomized trial two phycogenic bone substitutes-biphasic calcium phosphate (BCP) versus almost pure hydroxyapatite (HA)-for their volume stability and clinical implications after sinus floor elevation (SFE). MATERIALS AND METHODS Twenty patients requiring lateral-window SFE 6 months prior to implant surgery were randomized to a BCP or HA group. As primary outcome, the grafts were analyzed for volume stability, using four cone-beam computed tomography scans obtained immediately/6/12/24 months after SFE. Secondary outcomes were implant survivval, success, periotest values, oral-health-related quality of life (OHIP-G14), and pain (VAS). RESULTS Kolmogorov-Smirnov goodness-of-fit test revealed normal distribution of samples (p = .200). At 6/12/24 months, the augmented volumes decreased to 96/92/90% (HA) or 99/96/96% (BCP). Volume changes were significantly a factor of time (p < .001; generalized linear model with repeated measures) and reached significantly lower values in HA group (p = .018). Significant intergroup difference in volume losses was notable at 24 months (p = .021; t-test for independent samples). Periotest values decreased from -3/-4.1 (HA/BCP) after implant placement to -6.3/-4.5 (HA/BCP) after 6 months. OHIP scores diverged at 2 months (HA: 9.5; BCP: 5.2) and largely resolved by 24 months (HA: 1.3; BCP: 1.9). VAS scores were comparable, 2.2 at 1 week after SFE being their highest mean level. CONCLUSIONS After 2 years, both groups experienced no biological or technical complications, demonstrating a consistent healing trajectory without notable symptoms. Although no significant differences were observed in implant stability and survival, BCP demonstrated higher volume stability than HA.
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Affiliation(s)
- Alwin Sokolowski
- Division of Restorative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Kerstin Theisen
- Division of Restorative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Behrouz Arefnia
- Division of Restorative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Martin Lorenzoni
- Division of Restorative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Armin Sokolowski
- Division of Restorative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
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Abstract
This umbrella review aims to evaluate systematic/meta-analysis studies containing clinical evidence on tooth grafts as bone substitutes in the oral and maxillofacial regions. Using language restrictions and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an electronic database search of PubMed, MEDLINE, Embase, Cochrane library, and Google Scholar was conducted, featuring published studies up until August 2022. All systematic/meta-analysis review articles relating to tooth graft materials were matched against the inclusion criteria. Two qualified researchers independently assessed the studies' inclusion or exclusion criteria and risk of bias, and a third investigator assisted in resolving ambiguities. A total of 81 systematic/meta-analysis studies, comprising 21 animal-controlled trials, 23 randomized controlled human trials, 23 prospective studies, and 14 retrospective studies, were selected for this study. A small risk of bias was observed in systematic studies/meta-analyses. In addition, the clinical evidence from the analysis of these studies revealed a low incidence of side effects. According to the current review, two systematic reviews indicated that autogenous bone grafting of prepared teeth might be as effective as other bone grafting materials. Four studies also mentioned autologous grafts as potential alternatives to autologous grafts, autogenous demineralized dentin (ADDM), engineered grafts, root blocks, and dental matrix. On the other hand, three systematic studies stated that more long-term research is needed to confirm their findings. Finally, given the importance of standardization and homogeneity of studies for clinical cases, it is advised to be used cautiously due to the risks of transplant rejection.
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Affiliation(s)
- Sara Hashemi
- Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Amirhossein Fathi
- Dental Prosthodontics Department, Dental Materials Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ramin Atash
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
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Calvert ND, Proulx S, Rodriguez-Navarro A, Ahmed T, Lehoux EA, Hincke MT, Catelas I. Development of hydrogel-based composite scaffolds containing eggshell particles for bone regeneration applications. J Biomed Mater Res B Appl Biomater 2024; 112:e35296. [PMID: 37702399 DOI: 10.1002/jbm.b.35296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/23/2023] [Accepted: 06/10/2023] [Indexed: 09/14/2023]
Abstract
This study describes the development and characterization of novel composite scaffolds, made of an alginate-chitosan hydrogel matrix containing eggshell (ES) particles, for bone tissue engineering applications. Scaffolds with ES particles, either untreated or treated with phosphoric acid to create a nanotextured particle surface, were compared to scaffolds without particles. Results indicate that the nanotexturing process exposed occluded ES proteins orthologous to those in human bone extracellular matrix. Scaffolds with ES or nanotextured ES (NTES) particles had a higher porosity (81 ± 4% and 89 ± 5%, respectively) than scaffolds without particles (59 ± 5%) (p = .002 and p < .001, respectively). Scaffolds with NTES particles had a larger median pore size (113 μm [interquartile range [IQ]: 88-140 μm]) than scaffolds with ES particles (94 μm [IQ: 75-112 μm]) and scaffolds without particles (99 μm [IQ: 74-135 μm]) (p < .001 and p = .011, respectively). The compressive modulus of the scaffolds with ES or NTES particles remained low (3.69 ± 0.70 and 3.14 ± 0.62 kPa, respectively), but these scaffolds were more resistant to deformation following maximum compression than those without particles. Finally, scaffolds with ES or NTES particles allowed better retention of human mesenchymal stem cells during seeding (53 ± 12% and 57 ± 8%, respectively, vs. 17 ± 5% for scaffolds without particles; p < .001 in both cases), as well as higher cell viability up to 21 days of culture (67 ± 17% and 61 ± 11%, respectively, vs. 15 ± 7% for scaffolds without particles; p < .001 in both cases). In addition, alkaline phosphatase (ALP) activity increased up to 558 ± 164% on day 21 in the scaffolds with ES particles, and up to 567 ± 217% on day 14 in the scaffolds with NTES particles (p = .006 and p = .002, respectively, relative to day 0). Overall, this study shows that the physicochemical properties of the alginate-chitosan hydrogel scaffolds with ES or NTES particles are similar to those of cancellous bone. In addition, scaffolds with particles supported early osteogenic differentiation and therefore represent a promising new bone substitute, especially for non-load bearing applications.
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Affiliation(s)
- Nicholas D Calvert
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Scott Proulx
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Tamer Ahmed
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Eric A Lehoux
- Department of Mechanical Engineering, Faculty of Engineering, University of Ottawa, Ottawa, Ontario, Canada
| | - Maxwell T Hincke
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Isabelle Catelas
- Department of Mechanical Engineering, Faculty of Engineering, University of Ottawa, Ottawa, Ontario, Canada
- Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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12
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Rosano G, Testori T, Torrisi P, Invernizzi M, Vercellini N, Del Fabbro M. Immediate placement and loading of implants with laser-microgrooved collar in combination with an anorganic porcine bone mineral matrix in the esthetic zone. Twelve-month results of a prospective multicenter cohort study. Clin Implant Dent Relat Res 2023; 25:1164-1177. [PMID: 37592396 DOI: 10.1111/cid.13261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/20/2023] [Accepted: 07/29/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Many techniques have been proposed to address post-extraction ridge resorption, which often represents a concern, especially in the esthetic region. PURPOSE The purpose of the present, prospective, multicenter, single cohort study was to investigate, up to 1 year of function, the effectiveness of a protocol for alveolar ridge preservation involving implants with laser-microgrooved surface immediately placed in fresh extraction sockets. MATERIALS AND METHODS Twenty eight patients candidate to tooth extraction in the esthetic zone (site 15-25 and 35-45) were treated by immediate placement of a single laser-microgrooved implants with the adjunct of a highly porous anorganic porcine bone mineral matrix and a collagen wound dressing. Peri-implant marginal bone level (MBL) was evaluated at time of loading, 3 and 12 months after loading. Gingival index, plaque index, probing depth, and bleeding on probing were measured at 3, 6, and 12 months after loading. Dimensional changes at implant sites were digitally evaluated using the best-fit superimposition of pre-and post-socket preservation models. Implant aesthetic score (IAS) as well as patients' post-operative quality of life were also evaluated at 12 months. Comparisons between data relative to thick and thin gingival phenotypes were made using Student's t-test or Mann-Whitney test, as appropriate. The significance level was set at p = 0.05. RESULTS No patient dropped out, and 28 implants were evaluated at 12 months post-loading. The overall MBL was found to be 0.92 ± 1.11 mm. Volumetric analysis of superimposed models showed an alveolar bone tissue displacement at the buccal aspect of -0.57 ± 0.52 mm in thin phenotypes and -0.46 ± 0.31 mm in thick phenotypes (p = 0.58, unpaired Student's t-test). No signs of soft tissue recession or esthetically unpleasant buccal gingiva were reported. CONCLUSIONS The clinical protocol herein employed showed benefits in maintaining marginal bone levels and soft tissue contour around post-extraction implants in the esthetic zone.
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Affiliation(s)
- Gabriele Rosano
- Academy of Craniofacial Anatomy (ACA), Como, Italy
- Lake Como Institute, Academy of Osseointegration (AO) Approved Training Center, Como, Italy
| | - Tiziano Testori
- Department of Implantology and Oral Rehabilitation, Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, Michigan, USA
- Department of Oral Medicine, Infection and Immunity, Harvard University, School of Dental Medicine, Cambridge, Massachusetts, USA
| | - Paolo Torrisi
- Department of General Surgery and Surgical Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
- Private Practice, Catania, Italy
| | - Matteo Invernizzi
- Academy of Craniofacial Anatomy (ACA), Como, Italy
- Lake Como Institute, Academy of Osseointegration (AO) Approved Training Center, Como, Italy
| | - Nicolò Vercellini
- Lake Como Institute, Academy of Osseointegration (AO) Approved Training Center, Como, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Starch-Jensen T, Schou S, Terheyden H, Bruun NH, Aludden H. Bone regeneration after maxillary sinus floor augmentation with different ratios of autogenous bone and deproteinized bovine bone mineral an in vivo experimental study. Clin Oral Implants Res 2023; 34:1406-1416. [PMID: 37766500 DOI: 10.1111/clr.14186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 08/01/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVE Test the hypothesis of no difference in bone regeneration after maxillary sinus floor augmentation (MSFA) with different ratios of iliac or mandibular autogenous bone (AB) graft and deproteinized bovine bone mineral (DBBM). MATERIALS AND METHODS Forty minipigs were randomly allocated to bilateral MSFA using: (A) 100% AB, (B) 75% AB and 25% DBBM, (C) 50% AB and 50% DBBM, (D) 25% AB and 75% DBBM, or (E) 100% DBBM. The animals were euthanized 12 weeks after surgery. Percentage of bone, non-mineralized tissue, and residual DBBM were estimated by histomorphometric analysis in a randomly selected region of interest and summarized as mean percentage with 95% confidence interval (CI). RESULTS Mean percentage of bone following MSFA with iliac or mandibular AB graft was: (A) 55.5% and 64.2%, (B) 60.3% and 61.6%, (C) 54.4% and 52.1%, (D) 51.8% and 53.1%, and (E) 47.6%, respectively. There was a significant trend toward a higher percentage of bone, with a higher ratio of AB within the graft (p < .01), regardless of the origin of AB graft (iliac or mandible). CONCLUSIONS The hypothesis was rejected since percentage of bone was significantly increased with larger proportions of AB within the graft. Consequently, AB or a mixture of AB and diminutive quantities of DBBM seem to be the preferred graft for MSFA based solely on histomorphometric assessment. However, it should be emphasized that newly formed bone and residual AB graft particles could not be distinguished by the applied histologic procedure.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Søren Schou
- Private Practice in Oral Surgery, Specialtandlaegerne Seedorffs Straede, Aarhus, Denmark
| | - Hendrik Terheyden
- Department of Oral and Maxillofacial Surgery, Red Cross Hospital, Kassel, Germany
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Hanna Aludden
- Department of Oral and Maxillofacial Surgery, NU-Hospital Organization, Trollhättan, Sweden
- Department of Biomaterials, Institute for Surgical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Alrmali A, Saleh MHA, Mazzocco J, Zimmer JM, Testori T, Wang H. Auto-dentin platelet-rich fibrin matrix is an alternative biomaterial for different augmentation procedures: A retrospective case series report. Clin Exp Dent Res 2023; 9:993-1004. [PMID: 37933487 PMCID: PMC10728516 DOI: 10.1002/cre2.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/08/2023] [Accepted: 10/13/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Autologous dentin grafts derived from extracted teeth have shown promise as bone graft materials for promoting bone regeneration. This retrospective case series aimed to evaluate clinical, radiographic, and histologic outcomes of using autologous dentin matrices in various bone regeneration procedures. MATERIALS AND METHODS This case series included 26 eligible patients and encompassed 4 socket preservation cases, 5 cases of guided tissue regeneration, 5 cases of guided bone regeneration (GBR), 10 cases of sinus augmentation procedures, 2 immediate placement implants, and 2 socket shields. Dentin grafts were prepared from extracted teeth, cleaned, and processed. These grafts were combined with platelet-rich fibrin (PRF) to create adhesive dentin matrices, then covered with collagen membranes for simultaneous guided bone augmentation cases. Cone beam computed tomography (CBCT) scans were conducted before surgery and 4 months postoperatively to assess ridge dimensions. Histologic evaluation was performed through bone core biopsies for socket preservation cases at the 4-month mark. RESULTS A total of 42 implants were placed in 26 patients, with an average follow-up of 32 months. Notably, two implant failures occurred following lateral maxillary sinus augmentation. CBCT scans at the 4-month interval revealed bone coverage over implant platforms in the majority of cases. Histologic analysis from two cases of socket preservation demonstrated dentin granules enveloped by newly formed bone undergoing continuous remodeling. The quantitative histomorphometric assessment revealed a bone area of 42.8 ± 3.56%, a remaining graft area of 19.05 ± 4.58%, and a viable bone of 38.15 ± 7.84%. CONCLUSIONS The utilization of autologous dentin particles mixed with PRF proved effective as an alternative to conventional bone graft materials in GBR and maxillary sinus augmentation procedures. Larger controlled clinical trials are recommended to further substantiate these findings.
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Affiliation(s)
- Abdusalam Alrmali
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
- Department of Oral Medicine, Oral Pathology, Oral and Maxillofacial SurgeryUniversity of Tripoli School of DentistryTripoliLibya
| | - Muhammad H. A. Saleh
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - John Mazzocco
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Jacob M. Zimmer
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Tiziano Testori
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
- Section of Implant Dentistry and Oral RehabilitationIRCCS Orthopedic Institute Galeazzi, Dental ClinicMilanItaly
| | - Hom‐Lay Wang
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
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Frigério PB, Quirino LC, Gabrielli MAC, Carvalho PHDA, Garcia Júnior IR, Pereira-Filho VA. Evaluation of Bone Repair Using a New Biphasic Synthetic Bioceramic (Plenum ® Oss hp) in Critical Calvaria Defect in Rats. Biology (Basel) 2023; 12:1417. [PMID: 37998016 PMCID: PMC10668970 DOI: 10.3390/biology12111417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023]
Abstract
(1) Background: Biphasic bioceramics are synthetic bone substitutes that provide greater safety and better predictability in guided bone regeneration. This study aimed to evaluate the bone repair process using a new biphasic bioceramic of synthetic origin (Plenum® Osshp-70HA: 30β-TCP) in critical calvarial defects. (2) Methods: seventy-four defects were created in rat calvaria and divided into two groups-Plenum® Osshp (PO), right side, and Straumann® BoneCeramic™ (BC), left side. Euthanasia was performed at 7, 15, 30, and 60 days after surgery. (3) Results: Lower gene expression was observed for runt-related transcription factor 2 (RUNX2) and vascular endothelial growth factor (VEGF) and higher expression for Integrin Binding Sialoprotein (IBSP). The results correlated with moderate immunolabeling for osteocalcin (OCN) and slight immunolabeling for osteopontin (OPN) in the PO group. Histometry showed a greater amount of biomaterial remaining in the PO group at 60 days. The microtomographic analysis showed a lower density of bone connectivity and a greater thickness of the trabeculae for the remnants of the PO group. (4) Conclusions: the Plenum® Osshp showed no differences compared to BoneCeramic™ and is therefore considered an effective option as a synthetic bone substitute in bone regeneration.
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Affiliation(s)
- Paula Buzo Frigério
- Department of Diagnosis and Surgery, Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo 16015-050, Brazil;
| | - Lilian Caldas Quirino
- Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo 14801-903, Brazil; (L.C.Q.); (M.A.C.G.); (P.H.d.A.C.); (V.A.P.-F.)
| | - Marisa Aparecida Cabrini Gabrielli
- Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo 14801-903, Brazil; (L.C.Q.); (M.A.C.G.); (P.H.d.A.C.); (V.A.P.-F.)
| | - Pedro Henrique de Azambuja Carvalho
- Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo 14801-903, Brazil; (L.C.Q.); (M.A.C.G.); (P.H.d.A.C.); (V.A.P.-F.)
| | - Idelmo Rangel Garcia Júnior
- Department of Diagnosis and Surgery, Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo 16015-050, Brazil;
| | - Valfrido Antonio Pereira-Filho
- Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo 14801-903, Brazil; (L.C.Q.); (M.A.C.G.); (P.H.d.A.C.); (V.A.P.-F.)
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Krennmair S, Postl L, Schwarze UY, Malek M, Stimmelmayr M, Krennmair G. Clinical, radiographic, and histological/histomorphometric analysis of maxillary sinus grafting with deproteinized porcine or bovine bone mineral: A randomized clinical trial. Clin Oral Implants Res 2023; 34:1230-1247. [PMID: 37610063 DOI: 10.1111/clr.14164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE The present study aimed to compare histomorphometrically evaluated new bone formation, radiographically measured graft stability, and clinical implant outcome between maxillary sinus grafting with either deproteinized porcine bone mineral (DPBM) or deproteinized bovine bone mineral (DBBM). MATERIALS AND METHODS Thirty maxillary sinuses were initially included and randomly assigned to the test group (TG; DPBM, n = 15) or control group (CG; DBBM, n = 15). After a healing period (6 months), axially retrieved bone biopsies of the molar region were used for histological/histomorphometric analysis of new bone formations. Additionally, radiographically measured graft stability and clinical implant outcome were assessed. RESULTS Twenty-three sinus sites with 10 sinuses of the TG and 13 of the CG were ultimately available for data and statistical analysis. In the TG, a slightly, but yet significantly (p = .040) higher proportion of new bone formation (TG: 27.7 ± 5.6% vs. CG: 22.9 ± 5.1%) and a lesser (p = .019) amount of connective (non-mineralized) tissue (TG: 47.5 ± 9.5% vs. CG: 56.1 ± 9.5%) was found than in the CG. However, both xenografts showed comparable (n.s.) residual bone graft (TG: 23.7 ± 7.2% vs. CG: 21.1 ± 9.85.6%), bone-to-graft contacts (TG: 26.2 ± 9.8% vs. CG: 30.8 ± 13.8%), similar graft height reduction over time (TG: 12.9 ± 6.7% CG: 12.4 ± 5.8%) and implant survival/success rate (100%). At the 3-year post-loading evaluation, the peri-implant marginal bone loss (TG: 0.52 ± 0.19 mm; CG: 0.48 ± 0.15 mm) and the peri-implant health conditions (TG: 87.5%/CG: 81.2%) did not differ between implants inserted in both xenografts used. CONCLUSIONS The use of DPBM or DBBM for maxillary sinus augmentation is associated with comparable bone formation providing stable graft dimension combined with healthy peri-implant conditions.
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Affiliation(s)
- Stefan Krennmair
- Department of Oral and Maxillofacial Surgery, Keplerklinikum Linz, Johannes Kepler University (JKU) Linz, Linz, Austria
- NumBiolab Research Associate, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Lukas Postl
- Department of Oral and Maxillofacial Surgery, Keplerklinikum Linz, Johannes Kepler University (JKU) Linz, Linz, Austria
- NumBiolab Research Associate, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Uwe Yacine Schwarze
- Division of Oral Surgery and Orthodontics and Musculo-Skeletal Research Unit for Biomaterials, Medical University Graz, Graz, Austria
| | - Michael Malek
- Department of Oral and Maxillofacial Surgery, Keplerklinikum Linz, Johannes Kepler University (JKU) Linz, Linz, Austria
| | - Michael Stimmelmayr
- Department of Prosthodontics, Ludwig-Maximilian University (LMU), Munich, Germany
| | - Gerald Krennmair
- Department of Prosthodontics, Dental School, Sigmund Freud Medical University of Vienna, Vienna, Austria
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Pawelke J, Vinayahalingam V, Heiss C, Budak M, El Khassawna T, Knapp G. Comparison of Nanocrystalline Hydroxyapatite Bone Graft with Empty Defects in Long Bone Fractures: A Retrospective Case-Control Study. Med Sci Monit 2023; 29:e941112. [PMID: 37872747 PMCID: PMC10612429 DOI: 10.12659/msm.941112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/16/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND The regeneration of bone defects is indicated to restore lost tissue mass and functionality. Ostim®, an absorbable nanocrystalline hydroxyapatite (NCHA) paste, is indicated to enhance bone regeneration in bone defects due to trauma or surgery. This retrospective study of 110 patients with long-bone fracture defects presenting at a single trauma center between 2010 and 2012 aimed to compare outcomes with and without the use of Ostim® absorbable nanocrystalline hydroxyapatite paste. MATERIAL AND METHODS The study encompassed fractures in 110 patients - 55 patients received any defect augmentation (ED) and 55 patients were treated with NCHA augmentation. Fractures were located at the distal radius (66.4%, n=73), proximal humerus (5.5%, n=6), and proximal tibia (28.2%, n=31). Evaluating the clinical follow-up, the study encompassed post-surgery complications (eg, non-unions, infection). Bone healing was evaluated by conventional radiographs. RESULTS Postoperative complications occurred in 45.5% of patients regardless of the treatment (P=1.0). The non-union rate in both groups was 5.5% (n=8, P=1.0), and the risk for infection was lower in the NCHA group (3.6%, ED: n=3, NCHA: n=1, p=0.62). Patients suffered open fractures were treated in the NCHA group (100%, n=7, P=0.003). Radiological assessment demonstrated comparable healing of the fracture border, fracture gap, and articular surface (P>0.05). CONCLUSIONS The findings from this retrospective study support previous studies that have shown Ostim® absorbable nanocrystalline hydroxyapatite paste enhances outcomes and reduces the risk of complications when used to repair bone defects in long-bone fractures in trauma patients. NCHA paste augmentation is suitable for use in traumatic long-bone fractures.
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Affiliation(s)
- Jonas Pawelke
- Department of Experimental Trauma Surgery, Faculty of Medicine, Justus Liebig University, Giessen, Germany
| | - Vithusha Vinayahalingam
- Department of Experimental Trauma Surgery, Faculty of Medicine, Justus Liebig University, Giessen, Germany
| | - Christian Heiss
- Department of Experimental Trauma Surgery, Faculty of Medicine, Justus Liebig University, Giessen, Germany
- Department of Trauma, Hand and Reconstructive Surgery, Faculty of Medicine, Justus Liebig University, Giessen, Germany
| | - Matthäus Budak
- Department of Trauma, Hand and Reconstructive Surgery, Faculty of Medicine, Justus Liebig University, Giessen, Germany
| | - Thaqif El Khassawna
- Department of Experimental Trauma Surgery, Faculty of Medicine, Justus Liebig University, Giessen, Germany
| | - Gero Knapp
- Department of Trauma, Hand and Reconstructive Surgery, Faculty of Medicine, Justus Liebig University, Giessen, Germany
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Mahardawi B, Kyaw TT, Mattheos N, Pimkhaokham A. The clinical efficacy of autogenous dentin blocks prepared chairside for alveolar ridge augmentation: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34:1025-1037. [PMID: 37461220 DOI: 10.1111/clr.14131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/06/2023] [Accepted: 07/06/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES This systematic review aimed to evaluate the current evidence on the effectiveness of autogenous dentin block graft prepared chairside for alveolar ridge augmentation and compare its clinical outcomes to the main available grafting materials and techniques. MATERIALS AND METHODS Three databases were screened, including prospective clinical studies, utilizing autogenous dentin blocks for ridge augmentation, with at least 3 months of postoperative follow-up. RESULTS Eight articles were included, and four of them were meta-analyzed. Dentin blocks demonstrated similar vertical bone gain and significantly higher width gain, compared to bone blocks (WMD = 0.03, 95% CI -0.51 to 0.57, p = .92 and WMD = 1.34, 95% CI 0.57 to 2.12, p = .0007, respectively). Vertical and horizontal resorption were similar between the two groups (WMD = -0.36, 95% CI -0.91 to 0.18, p = .19, and WMD = -0.47, 95% CI -1.05 to 0.11, p = .11, respectively). Dentin blocks showed more incidences of postoperative complications, however, with no statistical significance (RR = 4.30, 95% CI 0.97 to 18.96, p = .054). The need for additional augmentation upon implant placement was also similar between both grafts (RR = 0.95, 95% CI 0.39 to 2.28, p = .90). Recorded incidences of graft exposure were low (2.27%), and no study stated surgical site infection. CONCLUSION Within its limitations, this study indicates that the autogenous dentin blocks prepared chairside could be a possible alternative to the other established bone augmentation techniques for staged ridge augmentation. Nevertheless, future studies are needed to confirm its efficacy and implant success/survival in sites grafted with this material.
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Affiliation(s)
- Basel Mahardawi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Thiha Tin Kyaw
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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19
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Pawelke J, Vinayahalingam V, Heiss C, Khassawna TE, Knapp G. Retrospective Analysis of Bone Substitute Material for Traumatic Long Bone Fractures: Sex-Specific Outcomes. Int J Mol Sci 2023; 24:14232. [PMID: 37762534 PMCID: PMC10532127 DOI: 10.3390/ijms241814232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Male patients often experience increased bone and muscle loss after traumatic fractures. This study aims to compare the treatment outcomes of male and female patients with large bone defects. A total of 345 trauma patients underwent surgery, with participants divided into two groups: one receiving bone substitute material (BSM) for augmented defects (n = 192) and the other without augmentation (empty defects = ED, n = 153). Outcome parameters were assessed among female (n = 184) and male (n = 161) patients. Descriptive statistics revealed no significant differences between male and female patients. Approximately one-half of the fractures resulted from high-energy trauma (n = 187). The BSM group experienced fewer complications (p = 0.004), including pseudarthrosis (BSM: n = 1, ED: n = 7; p = 0.02). Among female patients over 65, the incidence of pseudarthrosis was lower in the BSM group (p = 0.01), while younger females showed no significant differences (p = 0.4). Radiologically, we observed premature bone healing with subsequent harmonization. Post hoc power analysis demonstrated a power of 0.99. Augmenting bone defects, especially with bone substitute material, may reduce complications, including pseudarthrosis, in female patients. Additionally, this material accelerates bone healing. Further prospective studies are necessary for confirmation.
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Affiliation(s)
- Jonas Pawelke
- Experimental Trauma Surgery, Faculty of Medicine, Justus Liebig University, 35392 Giessen, Germany; (J.P.); (V.V.); (C.H.); (T.E.K.)
| | - Vithusha Vinayahalingam
- Experimental Trauma Surgery, Faculty of Medicine, Justus Liebig University, 35392 Giessen, Germany; (J.P.); (V.V.); (C.H.); (T.E.K.)
| | - Christian Heiss
- Experimental Trauma Surgery, Faculty of Medicine, Justus Liebig University, 35392 Giessen, Germany; (J.P.); (V.V.); (C.H.); (T.E.K.)
- Department of Trauma, Hand and Reconstructive Surgery, Faculty of Medicine, Justus Liebig University, Rudolf-Buchheim-Straße 8, 35392 Giessen, Germany
| | - Thaqif El Khassawna
- Experimental Trauma Surgery, Faculty of Medicine, Justus Liebig University, 35392 Giessen, Germany; (J.P.); (V.V.); (C.H.); (T.E.K.)
| | - Gero Knapp
- Department of Trauma, Hand and Reconstructive Surgery, Faculty of Medicine, Justus Liebig University, Rudolf-Buchheim-Straße 8, 35392 Giessen, Germany
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20
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Calvo-Guirado JL, Cabo-Pastor MB, Martínez-Martínez F, Garcés-Villalá MÁ, de Carlos-Villafranca F, García-Carrillo N, Fernández-Domínguez M. The Use of Human Sterilized Crushed Tooth Particles Compared with BTCP Biomaterial and Empty Defects in Bone Formation inside Critical Rabbit Calvaria Sites. Bioengineering (Basel) 2023; 10:638. [PMID: 37370569 DOI: 10.3390/bioengineering10060638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/12/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
This study aimed to assess the bone regeneration of critical-size defects in rabbit calvaria filled with freshly crushed extracted teeth, comparing them with BTCP biomaterial and empty sites. Materials and methods: Twenty-one female New Zealand rabbits were used in this study. Two critical-size defects 6 mm in size were created in the skull bone, each with a 3 mm separation between them. Three experimental groups were evaluated: Group A (human sterilized crushed teeth granules alone), Group B (Bioner Bone, Bioner Sitemas Implantológicos), and Group C (unfilled defects). The animals were sacrificed at 4 and 8 weeks. Evaluation of the samples involved histological and histomorphometric analyses with radiographic evaluation. The histological evaluation showed a higher volume reduction in Group A compared with Group B (p < 0.05) and Control. Group A showed the highest values for cortical closure and bone formation around the particles, followed by Group B and Group C (p < 0.05). Within the limitations of this animal study, we can conclude that the use of human tooth particles leads to increased bone formation and reduced connective tissue in critical-size defects in rabbit calvaria when compared to BTCP biomaterial. The calvarial model is a robust base for the evaluation of different biomaterials.
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Affiliation(s)
| | | | - Francisco Martínez-Martínez
- Department of Orthopaedic Surgery and Traumatology, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain
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21
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Christensen JG, Grønlund GP, Georgi SR, Starch-Jensen T, Bruun NH, Jensen SS. Horizontal Alveolar Ridge Augmentation with Xenogenic Block Grafts Compared with Autogenous Bone Block Grafts for Implant-retained Rehabilitation: a Systematic Review and Meta-Analysis. J Oral Maxillofac Res 2023; 14:e1. [PMID: 37521322 PMCID: PMC10382196 DOI: 10.5037/jomr.2023.14201] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 06/29/2023] [Indexed: 08/01/2023]
Abstract
Objectives The objective of the present systematic review and meta-analysis was to test the 0-hypothesis of no difference in implant treatment outcome after horizontal alveolar ridge augmentation with xenogenic block compared with autogenous bone block. Material and Methods A literature search was conducted using PubMed, Embase and Cochrane Library databases in combination with a hand-search of relevant journals until 25th of January 2022. Comparative and non-comparative studies evaluating horizontal alveolar ridge augmentations with xenogenic blocks were included. Quality and risk of bias were evaluated by Cochrane Collaboration's revised tool and Newcastle-Ottawa scale. Results Meta-analysis revealed no statistically significant difference in implant survival rate after more than 6 months of functional implant loading (P = 0.71), no difference in alveolar ridge width (P = 0.07) or gain of alveolar ridge width at re-entry (P = 0.13). Non-comparative studies revealed moderate to high short-term implant survival rate and gain in alveolar ridge width, however, complications including dehiscences, graft exposure and graft failure were observed in several studies. Conclusions No significant difference could be identified in short-term implant treatment outcome following horizontal alveolar ridge augmentation using xenogenic block compared with autogenous bone block with the limited data available. A high incidence of healing complications and implant failures necessitates further investigation, as well as long-term results on implant survival rate.
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Affiliation(s)
- Jeppe Gronemann Christensen
- Research Area Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, CopenhagenDenmark.
- All authors contributed equally to the present study.
| | - Gustav Pors Grønlund
- Research Area Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, CopenhagenDenmark.
- All authors contributed equally to the present study.
| | - Signe Risom Georgi
- Research Area Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, CopenhagenDenmark.
- All authors contributed equally to the present study.
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
| | - Simon Storgård Jensen
- Research Area Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, CopenhagenDenmark.
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark.
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22
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Lin X, Wu Y, Huang H, Peng R, Huang F, Hong L, Chen W. Antibiotic-loaded bone substitutes therapy in the management of the moderate to severe diabetic foot infection: A meta-analysis. Wound Repair Regen 2023; 31:205-226. [PMID: 36519343 DOI: 10.1111/wrr.13061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 09/16/2022] [Accepted: 10/13/2022] [Indexed: 12/23/2022]
Abstract
In recent years, local antibiotic-loaded bone substitutes (ALBS) have been used increasingly in the treatment of diabetic foot infection (DFI). The meta-analysis aimed to analyse the efficacy of ALBS on patients with moderate to severe DFI (with or without osteomyelitis). With an appropriate search strategy, 7 studies were selected for analysis (2 RCTs and 5 cohort studies). The result showed that the application of ALBS effectively reduced the length of hospital stay (WMD -5.55; 95% CI: -9.85 to -1.26; P = 0.01), the recurrence rates (RR 0.33; 95% CI: 0.15 to 0.69; P = 0.003) and the mortality rates (RR 0.22; 95% CI: 0.06 to 0.82; P = 0.02). Compared to the control groups, however, there was no difference in healing rates (RR 1.06; 95% CI: 0.96 to 1.18; P = 0.26), healing time (WMD -1.44; 95% CI: -3.37 to -0.49; P = 0.14), the number of debridement (WMD -1.98; 95% CI: -4.08 to 0.12; P = 0.06) and major amputation rates (RR 0.76; 95% CI: 0.35 to 1.61; P = 0.47). The ALBS appears to have some beneficial effects as an adjunct to standard surgery in the treatment of DFI with or without osteomyelitis, as it reduces recurrence rates, mortality rates, and length of hospital stay, but there was no statistically significant difference in enhancing wound healing.
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Affiliation(s)
- Xinyi Lin
- Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong Province, China.,Shantou University Medical College, Shantou, Guangdong Province, China
| | - Yan Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Hong Huang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Ruihan Peng
- Shantou University Medical College, Shantou, Guangdong Province, China
| | - FuHua Huang
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Lvrong Hong
- Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong Province, China
| | - WenZhuan Chen
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
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23
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Romagnoli M, Casali M, Zaffagnini M, Cucurnia I, Raggi F, Reale D, Grassi A, Zaffagnini S. Tricalcium Phosphate as a Bone Substitute to Treat Massive Acetabular Bone Defects in Hip Revision Surgery: A Systematic Review and Initial Clinical Experience with 11 Cases. J Clin Med 2023; 12:jcm12051820. [PMID: 36902607 PMCID: PMC10003370 DOI: 10.3390/jcm12051820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/28/2023] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
The use of tricalcium phosphate (TCP) as a bone substitute is gaining increasing interest to treat severe acetabular bone defects in revision total hip arthroplasty (rTHA). The aim of this study was to investigate the evidence regarding the efficacy of this material. A systematic review of the literature was performed according to the PRISMA and Cochrane guidelines. The study quality was assessed using the modified Coleman Methodology Score (mCMS) for all studies. A total of eight clinical studies (230 patients) were identified: six on TCP used as biphasic ceramics composed of TCP and hydroxyapatite (HA), and two as pure-phase ceramics consisting of TCP. The literature analysis showed eight retrospective case series, of which only two were comparative studies. The mCMS showed an overall poor methodology (mean score 39.5). While the number of studies and their methodology are still limited, the available evidence suggests safety and overall promising results. A total of 11 cases that underwent rTHA with a pure-phase ceramic presented satisfactory clinical and radiological outcomes at initial short-term follow-up. Further studies at long-term follow-up, involving a larger number of patients, are needed before drawing more definitive conclusions on the potential of TCP for the treatment of patients who undergo rTHA.
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Affiliation(s)
- Matteo Romagnoli
- Ortopedia e Traumatologia Rizzoli Argenta, 44011 Argenta, FE, Italy
| | - Marco Casali
- Ortopedia e Traumatologia Rizzoli Argenta, 44011 Argenta, FE, Italy
- Correspondence:
| | - Marco Zaffagnini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, BO, Italy
| | - Ilaria Cucurnia
- Ortopedia e Traumatologia Rizzoli Argenta, 44011 Argenta, FE, Italy
| | - Federico Raggi
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, BO, Italy
| | - Davide Reale
- Ortopedia e Traumatologia Rizzoli Argenta, 44011 Argenta, FE, Italy
| | - Alberto Grassi
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, BO, Italy
| | - Stefano Zaffagnini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, BO, Italy
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24
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de Souza Balbinot G, Leitune VCB, da Cunha Bahlis EA, Ponzoni D, Visioli F, Collares FM. Niobium-containing bioactive glasses modulate alkaline phosphatase activity during bone repair. J Biomed Mater Res B Appl Biomater 2023; 111:1224-1231. [PMID: 36773168 DOI: 10.1002/jbm.b.35227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/12/2023]
Abstract
This study aimed to evaluate the pre-clinical behavior of niobium-containing bioactive glasses (BAGNb) by their ability to promote bone repair and regulate alkaline phosphatase (ALP) levels in an animal model. BAGNbs were produced as powders and as scaffolds and surgically implanted in the femur of male rats (Wistar lineage n = 10). Glasses without Nb (BAG) were produced and implanted as well. The Autogenous Bone (AB) was used as a control. After 15, 30, and 60 days of surgical implantation, blood serum samples were collected to quantify ALP activity, and femurs were removed to assess bone repair. Bone samples were histologically processed and stained with H&E to quantify the % new bone into defects. No postoperative complications were identified. Early-stage repair (15 days) resulted in increased ALP activity for all groups, with increased values for powdered BAGNb. The maturation of the new bone led to a reduction in serum ALP levels. Histological sections showed the formation of immature bone tissue and vascularization with the progression of bone deposition to mature and functional tissue over time. BAG powder showed less new bone formation in 15 days, while the analysis at 30 and 60 days showed no difference between groups (p > .05). Niobium-containing bioactive glasses safely and successfully induced bone repair in vivo. The modulation of ALP activity may be a pathway to describe the ability of niobium-containing materials to contribute to new bone formation.
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Affiliation(s)
- Gabriela de Souza Balbinot
- Department of Dental Materials, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Deise Ponzoni
- Oral and Maxillofacial Surgery Unit, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernanda Visioli
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fabrício Mezzomo Collares
- Department of Dental Materials, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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25
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Khijmatgar S, Del Fabbro M, Tumedei M, Testori T, Cenzato N, Tartaglia GM. Residual Bone Height and New Bone Formation after Maxillary Sinus Augmentation Procedure Using Biomaterials: A Network Meta-Analysis of Clinical Trials. Materials (Basel) 2023; 16:1376. [PMID: 36837005 PMCID: PMC9962504 DOI: 10.3390/ma16041376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/26/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Different factors may affect new bone formation following maxillary sinus floor augmentation for the rehabilitation of posterior edentulous maxilla. The purpose of this study was to determine the influence of residual bone height (RBH) on new bone formation after lateral sinus augmentation utilizing different biomaterials, through a network meta-analysis (NMA). METHODS PUBMED, Scopus, and Web of Science electronic databases were searched until 31 December 2022 to obtain relevant articles. A hand search was also conducted. Randomised controlled studies on maxillary sinus augmentation comparing different grafting materials in patients with atrophic posterior maxilla, in need of prosthetic rehabilitation, were included. The risk of bias was assessed following the guidelines of the Cochrane Collaboration. The primary outcome was new bone formation (NBF), assessed histomorphometrically. The statistical analysis was performed by splitting the data according to RBH (<4 mm and ≥4 mm). RESULTS A total of 67 studies were eligible for conducting NMA. Overall, in the included studies, 1955 patients were treated and 2405 sinus augmentation procedures were performed. The biomaterials used were grouped into: autogenous bone (Auto), xenografts (XG), allografts (AG), alloplasts (AP), bioactive agents (Bio), hyaluronic acid (HA), and combinations of these. An inconsistency factor (IF) seen in the entire loop of the XG, AP, and Bio+AP was found to be statistically significant. The highest-ranked biomaterials for the <4 mm RBH outcome were XG+AG, XG+AP, and Auto. Similarly, the surface under the cumulative ranking curve (SUCRA) of biomaterials for ≥4 mm RBH was Auto, Bio+XG, and XG+Auto. CONCLUSION There is no grafting biomaterial that is consistently performing better than others. The performance of the materials in terms of NBF may depend on the RBH. While choosing a biomaterial, practitioners should consider both patient-specific aspects and sinus clinical characteristics.
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Affiliation(s)
- Shahnavaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Department of Oral Biology and Genomic Studies, AB Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore 575018, Karnataka, India
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Margherita Tumedei
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Tiziano Testori
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Department of Implantology and Oral Rehabilitation, Dental Clinic, IRCCS Ospedale Galeazzi-Sant’Ambrogio, 20157 Milan, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Niccolò Cenzato
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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26
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Thieu MKL, Stoetzel S, Rahmati M, El Khassawna T, Verket A, Sanz-Esporrin J, Sanz M, Ellingsen JE, Haugen HJ. Immunohistochemical comparison of lateral bone augmentation using a synthetic TiO 2 block or a xenogeneic graft in chronic alveolar defects. Clin Implant Dent Relat Res 2023; 25:57-67. [PMID: 36222116 PMCID: PMC10092822 DOI: 10.1111/cid.13143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/28/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate osteogenic markers and alveolar ridge profile changes in guided bone regeneration (GBR) of chronic noncontained bone defects using a nonresorbable TiO2 block. MATERIALS AND METHODS Three buccal bone defects were created in each hemimandible of eight beagle dogs and allowed to heal for 8 weeks before GBR. Treatment was assigned by block randomization: TiO2 block: TiO2 -scaffold and a collagen membrane, DBBM particulates: Deproteinized bovine bone mineral (DBBM) and a collagen membrane, Empty control: Only collagen membrane. Bone regeneration was assessed on two different healing timepoints: early (4 weeks) and late healing (12 weeks) using several immunohistochemistry markers including alpha-smooth muscle actin (α-SMA), osteopontin, osteocalcin, tartrate-resistant acid phosphatase, and collagen type I. Histomorphometry was performed on Movat Pentachrome-stained and Von Kossa/Van Gieson-stained sections. Stereolithographic (STL) models were used to compare alveolar profile changes. RESULTS The percentage of α-SMA and osteopontin increased in TiO2 group after 12 weeks of healing at the bone-scaffold interface, while collagen type I increased in the empty control group. In the defect area, α-SMA decreased in the empty control group, while collagen type I increased in the DBBM group. All groups maintained alveolar profile from 4 to 12 weeks, but TiO2 group demonstrated the widest soft tissue contour profile. CONCLUSIONS The present findings suggested contact osteogenesis when GBR is performed with a TiO2 block or DBBM particulates. The increase in osteopontin indicated a potential for bone formation beyond 12 weeks. The alveolar profile data indicated a sustained lateral increase in lateral bone augmentation using a TiO2 block and a collagen membrane, as compared with DBBM and a collagen membrane or a collagen membrane alone.
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Affiliation(s)
- Minh Khai Le Thieu
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.,Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Sabine Stoetzel
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Maryam Rahmati
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Thaqif El Khassawna
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Anders Verket
- Department of Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig University Giessen, Giessen, Germany
| | | | - Mariano Sanz
- Periodontology, University Complutense of Madrid, Madrid, Spain
| | - Jan Eirik Ellingsen
- Department of Prosthetics and Oral Function, University of Oslo, Oslo, Norway
| | - Håvard Jostein Haugen
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
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27
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Francisco I, Basílio Â, Ribeiro MP, Nunes C, Travassos R, Marques F, Pereira F, Paula AB, Carrilho E, Marto CM, Vale F. Three-Dimensional Impression of Biomaterials for Alveolar Graft: Scoping Review. J Funct Biomater 2023; 14. [PMID: 36826875 DOI: 10.3390/jfb14020076] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
Craniofacial bone defects are one of the biggest clinical challenges in regenerative medicine, with secondary autologous bone grafting being the gold-standard technique. The development of new three-dimensional matrices intends to overcome the disadvantages of the gold-standard method. The aim of this paper is to put forth an in-depth review regarding the clinical efficiency of available 3D printed biomaterials for the correction of alveolar bone defects. A survey was carried out using the following databases: PubMed via Medline, Cochrane Library, Scopus, Web of Science, EMBASE, and gray literature. The inclusion criteria applied were the following: in vitro, in vivo, ex vivo, and clinical studies; and studies that assessed bone regeneration resorting to 3D printed biomaterials. The risk of bias of the in vitro and in vivo studies was performed using the guidelines for the reporting of pre-clinical studies on dental materials by Faggion Jr and the SYRCLE risk of bias tool, respectively. In total, 92 publications were included in the final sample. The most reported three-dimensional biomaterials were the PCL matrix, β-TCP matrix, and hydroxyapatite matrix. These biomaterials can be combined with different polymers and bioactive molecules such as rBMP-2. Most of the included studies had a high risk of bias. Despite the advances in the research on new three-dimensionally printed biomaterials in bone regeneration, the existing results are not sufficient to justify the application of these biomaterials in routine clinical practice.
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Bonardi JP, Pereira RDS, Mourão CF, Coelho Mendes B, Lowenstein A, Montemezzi P, Giubilato F, Okamoto R, Hochuli-Vieira E. Clinical Assessment of Biphasic Calcium Phosphate in Granules and Paste Forms in Human Maxillary Sinus Bone Augmentation: A Randomized, Split-Mouth Clinical Trial. Materials (Basel) 2023; 16:1059. [PMID: 36770066 PMCID: PMC9918988 DOI: 10.3390/ma16031059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/19/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
The aim of the present study is to compare the biphasic calcium phosphate (BCP) using two different forms-(1) granules and (2) paste-in human maxillary sinus bone reconstruction as a split-mouth study using histomorphometric and immunolabeling for osteocalcin. Ten patients with bilateral maxillary posterior partial edentulism were selected in order to reconstruct bone height. They were divided into two groups: BCPG and BCP-P. After six months of bone healing, biopsies were harvested to assess the new bone formation and immunostaining for osteocalcin. The BCP g group had the following results: mean of bone formation in pristine bone 49.4 ± 21.6%, intermediate 49.4 ± 16.2%, and apical 55.3 ± 21.4%. The group BCP-P had a mean of 41.9 ± 17.3% in the pristine bone region, 37.5 ± 7.8% for intermediate, and 39.0 ± 13.5% for apical. The osteocalcin immunolabeling was high for both groups, demonstrating bone calcification. Thus, the two biomaterials present suitable results for the placement of dental implants.
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Affiliation(s)
- João Paulo Bonardi
- Department of Oral & Maxillofacial Surgery, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil
| | - Rodrigo dos Santos Pereira
- Department of Oral & Maxillofacial Surgery, University of Grande Rio-UNIGRANRIO, Rio de Janeiro 25071-202, Brazil
| | - Carlos F. Mourão
- Department of Periodontology, Division of Dental Research Administration, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Bruno Coelho Mendes
- Department of Oral & Maxillofacial Surgery, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil
| | - Adam Lowenstein
- Department of Periodontology, Division of Dental Research Administration, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | | | - Flavio Giubilato
- Department of Human Anatomy, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil
| | - Roberta Okamoto
- Department of Human Anatomy, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil
| | - Eduardo Hochuli-Vieira
- Department of Diagnostic and Surgery, Araraquara School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil
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Arpornmaeklong P, Jaiman N, Apinyauppatham K, Fuongfuchat A, Boonyuen S. Effects of Calcium Carbonate Microcapsules and Nanohydroxyapatite on Properties of Thermosensitive Chitosan/Collagen Hydrogels. Polymers (Basel) 2023; 15. [PMID: 36679297 DOI: 10.3390/polym15020416] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/14/2023] Open
Abstract
Thermosensitive chitosan/collagen hydrogels are osteoconductive and injectable materials. In this study, we aimed to improve these properties by adjusting the ratio of nanohydroxyapatite particles to calcium carbonate microcapsules in a β-glycerophosphate-crosslinked chitosan/collagen hydrogel. Two hydrogel systems with 2% and 5% nanohydroxyapatite particles were studied, each of which had varying microcapsule content (i.e., 0%, 1%, 2%, and 5%). Quercetin-incorporated calcium carbonate microcapsules were prepared. Calcium carbonate microcapsules and nanohydroxyapatite particles were then added to the hydrogel according to the composition of the studied system. The properties of the hydrogels, including cytotoxicity and biocompatibility, were investigated in mice. The calcium carbonate microcapsules were 2-6 µm in size, spherical, with rough and nanoporous surfaces, and thus exhibited a burst release of impregnated quercetin. The 5% nanohydroxyapatite system is a solid particulate gel that supports homogeneous distribution of microcapsules in the three-dimensional matrix of the hydrogels. Calcium carbonate microcapsules increased the mechanical and physical strength, viscoelasticity, and physical stability of the nanohydroxyapatite hydrogels while decreasing their porosity, swelling, and degradation rates. The calcium carbonate microcapsules-nanohydroxyapatite hydrogels were noncytotoxic and biocompatible. The properties of the hydrogel can be tailored by adjusting the ratio of calcium carbonate microcapsules to the nanohydroxyapatite particles. The 1% calcium carbonate microcapsules containing 5% nanohydroxyapatite particle-chitosan/collagen hydrogel exhibited mechanical and physical strength, permeability, and prolonged release profiles of quercetin, which were superior to those of the other studied systems and were optimal for promoting bone regeneration and delivering natural flavonoids.
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Pomini KT, Buchaim DV, Bighetti ACC, Hamzé AL, Reis CHB, Duarte MAH, Alcalde MP, Barraviera B, Júnior RSF, de Souza AT, da Silva Santos PS, Pilon JPG, de Marchi MÂ, Nogueira DMB, de Souza Bueno CR, Soares WC, Buchaim RL. Tissue Bioengineering with Fibrin Scaffolds and Deproteinized Bone Matrix Associated or Not with the Transoperative Laser Photobiomodulation Protocol. Molecules 2023; 28. [PMID: 36615601 DOI: 10.3390/molecules28010407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/17/2022] [Accepted: 11/28/2022] [Indexed: 01/06/2023]
Abstract
Extending the range of use of the heterologous fibrin biopolymer, this pre-clinical study showed a new proportionality of its components directed to the formation of scaffold with a lower density of the resulting mesh to facilitate the infiltration of bone cells, and combined with therapy by laser photobiomodulation, in order to accelerate the repair process and decrease the morphofunctional recovery time. Thus, a transoperative protocol of laser photobiomodulation (L) was evaluated in critical bone defects filled with deproteinized bovine bone particles (P) associated with heterologous fibrin biopolymer (HF). The groups were: BCL (blood clot + laser); HF; HFL; PHF (P+HF); PHFL (P+HF+L). Microtomographically, bone volume (BV) at 14 days, was higher in the PHF and PHFL groups (10.45 ± 3.31 mm3 and 9.94 ± 1.51 mm3), significantly increasing in the BCL, HFL and PHFL groups. Histologically, in all experimental groups, the defects were not reestablished either in the external cortical bone or in the epidural, occurring only in partial bone repair. At 42 days, the bone area (BA) increased in all groups, being significantly higher in the laser-treated groups. The quantification of bone collagen fibers showed that the percentage of collagen fibers in the bone tissue was similar between the groups for each experimental period, but significantly higher at 42 days (35.71 ± 6.89%) compared to 14 days (18.94 ± 6.86%). It can be concluded that the results of the present study denote potential effects of laser radiation capable of inducing functional bone regeneration, through the synergistic combination of biomaterials and the new ratio of heterologous fibrin biopolymer components (1:1:1) was able to make the resulting fibrin mesh less dense and susceptible to cellular permeability. Thus, the best fibrinogen concentration should be evaluated to find the ideal heterologous fibrin scaffold.
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Esfahanian V, Ejeian F, Mohebinia H, Zojaji Nejad ZS, Yazdchi M, Ebrahimi Dastgerdi M, Ebrahimi Dastgerdi M, Nasr-Esfahani MH. Cellular Behaviors of Periodontal Ligament Stem Cells in the Presence of Bone Grafting Biomaterials, In-Vitro Study. Life (Basel) 2022; 13:life13010089. [PMID: 36676038 PMCID: PMC9862872 DOI: 10.3390/life13010089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
Periodontal regeneration through the employment of bone substitutes has become a feasible strategy in animal and clinical studies. In this regard, we aimed to compare the periodontal ligament stem cell behavior in the vicinity of various bone grafting substitutes. Three types of popular bone substitutes, including allografts (Regen), xenografts (Cerabone), and alloplasts (Osteon) were studied in this experimental survey. The cellular attachment was assessed after four hours using the MTS assay and SEM imaging. In addition, cellular proliferation was investigated after 1, 3, 5, and 7 days through MTS assay. Osteogenesis was studied after 21 days of cell culture in a differentiation medium (DM+) and a normal medium (DM-), by employing real-time PCR and alizarin red staining. The highest cellular attachment was seen in the xenograft group with a significant difference in comparison to the other grafting materials. Despite the relatively low primary attachment of cells to allografts, the allograft group showed the highest total proliferation rate, while the lowest proliferation capacity was found in the alloplast group. Osteogenesis fount to be accelerated mostly by xenografts in both mediums (DM+ and DM-) after 3 weeks, while alloplasts showed the lowest osteogenesis. This study revealed that the type of bone substitutes used in regenerative treatments can affect cellular behavior and as a whole allografts and xenografts showed better results.
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Affiliation(s)
- Vahid Esfahanian
- Department of Periodontic, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan 8155139998, Iran
| | - Fatemeh Ejeian
- Department of Animal Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan 8159358686, Iran
- Correspondence: (F.E.); (M.E.D.); Tel.: +98-31-95015680 (F.E.); Fax: +98-31-95015687 (F.E.)
| | - Hajar Mohebinia
- Department of Periodontics, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan 8155139998, Iran
| | - Zahra Sadat Zojaji Nejad
- Department of Periodontics, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan 8155139998, Iran
| | - Maryam Yazdchi
- Department of Animal Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan 8159358686, Iran
| | | | - Mehrnoush Ebrahimi Dastgerdi
- Department of Periodontics, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan 8155139998, Iran
- Correspondence: (F.E.); (M.E.D.); Tel.: +98-31-95015680 (F.E.); Fax: +98-31-95015687 (F.E.)
| | - Mohammad Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan 8159358686, Iran
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Shanbhag S, Rana N, Suliman S, Idris SB, Mustafa K, Stavropoulos A. Influence of Bone Substitutes on Mesenchymal Stromal Cells in an Inflammatory Microenvironment. Int J Mol Sci 2022; 24:ijms24010438. [PMID: 36613880 PMCID: PMC9820717 DOI: 10.3390/ijms24010438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
Bone regeneration is driven by mesenchymal stromal cells (MSCs) via their interactions with immune cells, such as macrophages (MPs). Bone substitutes, e.g., bi-calcium phosphates (BCPs), are commonly used to treat bone defects. However, little research has focused on MSC responses to BCPs in the context of inflammation. The objective of this study was to investigate whether BCPs influence MSC responses and MSC-MP interactions, at the gene and protein levels, in an inflammatory microenvironment. In setup A, human bone marrow MSCs combined with two different BCP granules (BCP 60/40 or BCP 20/80) were cultured with or without cytokine stimulation (IL1β + TNFα) to mimic acute inflammation. In setup B, U937 cell-line-derived MPs were introduced via transwell cocultures to setup A. Monolayer MSCs with and without cytokine stimulation served as controls. After 72 h, the expressions of genes related to osteogenesis, healing, inflammation and remodeling were assessed in the MSCs via quantitative polymerase chain reactions. Additionally, MSC-secreted cytokines related to healing, inflammation and chemotaxis were assessed via multiplex immunoassays. Overall, the results indicate that, under both inflammatory and non-inflammatory conditions, the BCP granules significantly regulated the MSC gene expressions towards a pro-healing genotype but had relatively little effect on the MSC secretory profiles. In the presence of the MPs (coculture), the BCPs positively regulated both the gene expression and cytokine secretion of the MSCs. Overall, similar trends in MSC responses were observed with BCP 60/40 and BCP 20/80. In summary, within the limits of in vitro models, these findings suggest that the presence of BCP granules at a surgical site may not necessarily have a detrimental effect on MSC-mediated wound healing, even in the event of inflammation.
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Affiliation(s)
- Siddharth Shanbhag
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, 5009 Bergen, Norway
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Neha Rana
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, 5009 Bergen, Norway
| | - Salwa Suliman
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, 5009 Bergen, Norway
| | | | - Kamal Mustafa
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, 5009 Bergen, Norway
| | - Andreas Stavropoulos
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Department of Periodontology, Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden
- Correspondence: ; Tel.: +46-040-6658066
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Assem NZ, Pazmiño VFC, Caliente EA, Dalben GDS, Soares S, Santiago Júnior JF, de Almeida ALPF, de Almeida ALPF. Bone substitutes vs. autogenous bone graft for regeneration of the anterior maxillary alveolar process with horizontal bone resorption: systematic review. J ORAL IMPLANTOL 2022; 49:102-113. [PMID: 36913696 DOI: 10.1563/aaid-joi-d-22-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 07/26/2022] [Accepted: 08/20/2022] [Indexed: 12/12/2022]
Abstract
The objective of this systematic review was to identify the available scientific evidence on bone substitutes (BS) compared to autogenous bone grafts (ABG) for regeneration of horizontal bone resorption in the anterior maxillary alveolar process, aiming at rehabilitation with endosseous implants. This review was performed according to the PRISMA guidelines (2020) and registered in the database PROSPERO (CRD: 42017070574) . The databases searched were PUBMED/MEDLINE, EMBASE, SCOPUS, SCIENCE DIRECT, WEB OF SCIENCE, and CENTRAL COCHRANE, in the English language. The Australian National Health and Medical Research Council (NHMRC) and Cochrane Risk of Bias Tool were used to assess the study's quality and risk of bias. 544 papers were found. After the selection process, six studies were selected for review. A total of 182 patients were followed for a period of 6 to 48 months. The mean age of patients was 46.46 years, 152 implants were installed in the anterior region. Two studies achieved a reduced graft and implant failure rate, while the remaining four studies had no losses. It may be concluded that both the use of ABG and some BS are viable alternatives for the rehabilitation with implants in individuals with anterior horizontal bone loss. However, additional RCTs are warranted due to the limited number of papers.
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Affiliation(s)
- Naida Zanini Assem
- Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Eliana Aparecida Caliente
- Postgraduate Student at the Department of Dentistry, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Gisele da Silva Dalben
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Simone Soares
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Joel Ferreira Santiago Júnior
- Sacred Heart University - Bauru Assistant Professor Health Sciences 10-50 Irmã Arminda BRAZIL Bauru São Paulo 17011160 551421077112
| | - Ana Lúcia Pompéia Fraga de Almeida
- Associate Professor, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Miyauchi Y, Izutani T, Teranishi Y, Iida T, Nakajima Y, Xavier SP, Baba S. Healing Patterns of Non-Collagenated Bovine and Collagenated Porcine Xenografts Used for Sinus Floor Elevation: A Histological Study in Rabbits. J Funct Biomater 2022; 13:jfb13040276. [PMID: 36547536 PMCID: PMC9787467 DOI: 10.3390/jfb13040276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Objective: To compare healing of collagenated and non-collagenated xenografts used for maxillary sinus floor elevation. Materials and Methods: Two different xenografts were used: deproteinized bovine bone (DBBM group) and collagenated corticocancellous porcine bone (collagenated group). Healing was studied after 2, 4, and 8 weeks. The loss of dimensions of the elevated area and the percentages of new bone, xenograft remnants, osteoclastic zones, vessels, inflammatory infiltrates, and soft tissues were analyzed. Three regions were evaluated: close to the bone walls (bone wall region), subjacent the sinus mucosa (submucosa region), and the center of the elevated area (middle region). The primary variables were the percentage of new bone and xenograft remnants. Results: Between 2 and 8 weeks, the elevated areas showed a reduction of 16.3% and 52.2% in the DBBM and collagenated groups, respectively (p < 0.01 between the two areas after 8 weeks). After 8 weeks, the highest content of new bone was observed in the bone wall region, which was higher in the collagenated group than in the DBBM group (41.6% and 28.6%, respectively; p < 0.01). A similar quantity of new bone was found between the two groups in other regions. A higher percentage of vessels in all regions evaluated (p < 0.01) and soft tissue in the sub-mucosa region (p < 0.05) was found in the collagenated group than in the DBBM group. Conclusions: The present study showed that both xenografts allowed new bone formation. In comparison with the non-collagenated xenograft, the collagenated xenograft underwent higher resorption, resulting in greater shrinkage of the elevated space after sinus lifting and a higher content of new bone in the regions close to the bone walls. Clinical relevance: In this study, the region adjacent to the bone wall showed the highest new bone content. This region resembles the base of the sinus, closest to the sinus floor and walls, and is the most important region from a clinical point of view because it is where the implant will be installed. Residues of the biomaterial remained after 8 weeks of healing. Other reports have shown that these biomaterial residues may interfere with the integration of implants.
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Affiliation(s)
- Yuhei Miyauchi
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Takayuki Izutani
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Yuki Teranishi
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Takahisa Iida
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
| | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
| | - Samuel Porfirio Xavier
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, São Paulo, Brazil
- Correspondence:
| | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka 573-1121, Japan
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Del Barrio RAL, de Souza ER, Al Houch AO, Marão HF. Rehabilitation of Severely Atrophic Mandible: A 3-Year Follow-Up Protocol. J ORAL IMPLANTOL 2022; 48:475-479. [PMID: 34091666 DOI: 10.1563/aaid-joi-d-20-00418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/04/2021] [Accepted: 03/09/2021] [Indexed: 11/22/2022]
Abstract
Severe bone atrophies are considered a challenge in the rehabilitation process. In clinical situations involving excessive vertical bone deficiency in edentulous mandibles, there is a risk of fracture and frequently the need for an approach that involves highly complex procedures. In this context, simultaneous three-dimensional bone reconstruction associated with rigid fixation is a viable alternative to optimize longevity and avoid failures in these cases. This clinical case report presents a technique for reconstruction of severely atrophic mandibles in an elderly female patient to allow the implant-supported prosthesis protocol. The placement of immediate implants was possible by using an intraoral approach for fixation of a titanium plate followed by guided bone regeneration in association with recombinant human bone morphogenetic protein-2, deproteinized bovine bone mineral, and titanium mesh in a 1-stage surgical procedure. There are no reports in the literature of this approach for treating of severely atrophic mandibles. This association of techniques was shown to be predictable after 3 years of follow-up. Therefore, this protocol provides safe supported-implant prosthesis rehabilitation for patients with severely atrophic mandible.
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Affiliation(s)
| | | | - Alia Oka Al Houch
- Department of Implantology, University of Fortaleza, UNIFOR, Fortaleza, CE, Brazil
| | - Heloisa F Marão
- Department of Implantology, University of Santo Amaro, UNISA, São Paulo, SP, Brazil
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Gallo P, Díaz‐Báez D, Perdomo S, Aloise AC, Tattan M, Saleh MHA, Pelegrine AA, Ravidà A, Wang H. Comparative analysis of two biomaterials mixed with autogenous bone graft for vertical ridge augmentation: A histomorphometric study in humans. Clin Implant Dent Relat Res 2022; 24:709-719. [PMID: 35916287 PMCID: PMC9804607 DOI: 10.1111/cid.13124] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The vertical increase of the alveolar ridge dimension using allograft or xenograft mixed with autogenous bone graft and covered by a nonabsorbable high-density polytetrafluoroethylene (d-PTFE) membrane is well documented in the literature. PURPOSE The aim of this study was to assess vital mineralized tissue formation in vertical ridge augmentation (VRA) procedures using autogenous bone chips mixed either with an allograft or a xenograft. METHODS This prospective clinical trial recruited 16 partially edentulous patients to undergo vertical ridge augmentation in one or more sites, making up a total of 24 samples for histological evaluation. Patients were sequentially stratified into Group A (treated with a freeze-dried bone allograft [FDBA] mixed with autogenous bone) or to Group B (treated with a bovine xenograft mixed with autogenous bone). Histological samples were analyzed according to the biomaterial used for VRA. Histological samples were obtained on the same day of membrane removal and implant placement. RESULTS Thirty-three implants were placed in 16 sites of regenerated bone via VRA, 13 patients with ridge augmentation in the posterior mandible, and 3 patients with VRA in the anterior maxilla. Group A (FDBA + autogenous) and Group B (xenograft + autogenous) showed a percent vital mineralized tissue (VMT) area of 67.64 ± 16.84 and 60.93 ± 18.25, respectively. A significant difference between the two biomaterials was not observed. CONCLUSION When mixed with autogenous bone, either allografts or xenografts may provide a successful augmentation. Either mixture could serve as reliable alternative in VRA for obtaining a high percentage of VMT.
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Affiliation(s)
- Pier Gallo
- Department of Implant Dentistry, Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo MandicCampinasBrazil
| | - David Díaz‐Báez
- Researcher of Oral Basic Research Unit ‐UIBO, School of DentistryEl Bosque UniversityBogotáColombia
| | - Sandra Perdomo
- Researcher of Oral Basic Research Unit ‐UIBO, School of DentistryEl Bosque UniversityBogotáColombia
| | - Antonio Carlos Aloise
- Department of Implant Dentistry, Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo MandicCampinasBrazil
| | - Mustafa Tattan
- Department of PeriodonticsCollege of Dentistry, University of IowaIowa CityIowaUSA
| | - Muhammad H. A. Saleh
- Department of Periodontics and Oral MedicineUniversity of Michigan, School of DentistryAnn ArborMichiganUSA
| | - André Antonio Pelegrine
- Department of Implant Dentistry, Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo MandicCampinasBrazil
| | - Andrea Ravidà
- Department of Periodontics and Oral MedicineUniversity of Michigan, School of DentistryAnn ArborMichiganUSA
| | - Hom‐Lay Wang
- Department of Periodontics and Oral MedicineUniversity of Michigan, School of DentistryAnn ArborMichiganUSA
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Reich KM, Beck F, Heimel P, Lettner S, Redl H, Ulm C, Tangl S. Bone Graft Packing and Its Association with Bone Regeneration in Maxillary Sinus Floor Augmentations: Histomorphometric Analysis of Human Biopsies. Biology (Basel) 2022; 11:biology11101431. [PMID: 36290335 PMCID: PMC9598793 DOI: 10.3390/biology11101431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022]
Abstract
Research in maxillary sinus floor augmentation (MSFA) focussed on the optimisation of microstructural parameters such as microporosity and particle size of bone substitute particles (BS). However, little is known about the impact of BS packing and the corresponding (void) interparticular space on bone regeneration. The aim of this study was to characterise the spatial distribution of BS and its association with BS integration 6 ± 1 months after MSFA. Histological thin-ground sections of 70 human sinus biopsies were histomorphometrically analysed: In serial zones of 100 µm proceeding from the sinus floor (SF) up to the apical end of the biopsy, we measured the distribution of BS particles within these zones in terms of volume (BSV/TV), number and size of BS particles, interparticle spacing (BS.Sp) and bone-to-BS contact. BS particles were not homogeneously distributed over the length of biopsies: The first 200 µm directly adjacent to the SF represented a zone poor in BS particles but with high osteogenic potential. Graft packing density increased from the SF towards the apical part of the AA. Integration of BS particles was inversely associated with the distance to the SF and the graft packing density. A high packing density through excessive compaction of BS particles should be avoided to optimise the macrostructural environment for bone regeneration.
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Affiliation(s)
- Karoline Maria Reich
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Correspondence:
| | - Florian Beck
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
| | - Stefan Lettner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
| | - Heinz Redl
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
| | - Christian Ulm
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
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Martins SHL, Cadore UB, Novaes AB, Messora MR, Ghiraldini B, Bezerra FJB, Botticelli D, de Souza SLS. Evaluation of Bone Response to a Nano HA Implant Surface on Sinus Lifting Procedures: Study in Rabbits. J Funct Biomater 2022; 13:jfb13030122. [PMID: 35997460 PMCID: PMC9397014 DOI: 10.3390/jfb13030122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate the bone response to two different implant surfaces on sinus lift procedures in rabbits. Bilateral sinus lifting with inorganic bovine bone associated with collagen membrane and immediate implantation were performed in 16 rabbits. Custom mini-implants were randomly installed in the prepared sites: one side received a double acid-etched (DAE) surface and the other a nano-hydroxyapatite (NHA) surface. The animals were euthanized 30 and 60 days after surgery, and biopsies were collected for microtomographic and histomorphometric analysis. After 30 days, no intra- and inter-group statistical differences were observed in microtomographic analysis, while at 60 days, bone analysis showed statistically significant differences between groups (p < 0.05) for all the evaluated parameters. Histomorphometric analysis showed, after 30 days, mean % of Bone-to-Implant Contact (BIC) for DAE and NHA of 31.70 ± 10.42% vs. 40.60 ± 10.22% (p > 0.05), respectively; for % of Bone Area Fraction Occupancy (BAFO), mean values were 45.43 ± 3.597% for DAE and 57.04 ± 5.537% for NHA (p < 0.05). After 60 days, mean %BIC and %BAFO for DAE and NHA implants were statistically significant (p < 0.05). The NHA surface showed superior biological features compared to the DAE treatment, promoting higher bone formation around the implants in an experimental model of bone repair in a grafted area.
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Affiliation(s)
- Sergio H. L. Martins
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Uislen B. Cadore
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Arthur B. Novaes
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Michel R. Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Bruna Ghiraldini
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Fabio J. B. Bezerra
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Daniele Botticelli
- ARDEC (Ariminum Research & Dental Education Center) Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
| | - Sergio L. S. de Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
- Correspondence: ; Tel.: +55-16-3315-3980
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Qi Lim P, Huey Lim S, Sherilyn M, Fernandez-Medina T, Ivanovski S, Hosseinpour S. A Clinical Risk Assessment of a 3D-Printed Patient-Specific Scaffold by Failure Modes and Effects Analysis. Materials (Basel) 2022; 15:5442. [PMID: 35955377 PMCID: PMC9369557 DOI: 10.3390/ma15155442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/04/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
This study aims to carry out a risk assessment to identify and rectify potential clinical risks of a 3D-printed patient-specific scaffold for large-volume alveolar bone regeneration. A survey was used to assess clinicians' perceptions regarding the use of scaffolds in the treatment of alveolar defects and conduct a clinical risk assessment of the developed scaffold using the Failure Modes and Effects Analysis (FMEA) framework. The response rate was 69.4% with a total of 41 responses received. Two particular failure modes were identified as a high priority through the clinical risk assessment conducted. The highest mean Risk Priority Number was obtained by "failure of healing due to patient risk factors" (45.7 ± 27.7), followed by "insufficient soft tissue area" (37.8 ± 24.1). Despite the rapid developments, finding a scaffold that is both biodegradable and tailored to the patient's specific defect in cases of large-volume bone regeneration is still challenging for clinicians. Our results indicate a positive perception of clinicians towards this novel scaffold. The FMEA clinical risk assessment has revealed two failure modes that should be prioritized for risk mitigation (safe clinical translation). These findings are important for the safe transition to in-human trials and subsequent clinical use.
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Affiliation(s)
- Ping Qi Lim
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
| | - Sue Huey Lim
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
| | - Maria Sherilyn
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
| | - Tulio Fernandez-Medina
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
- College of Medicine and Dentistry, James Cook University, Cairns Campus, Cairns 4870, Australia
| | - Sašo Ivanovski
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
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Lim J, Jun SH, Tallarico M, Park JB, Park DH, Hwang KG, Park CJ. A Randomized Controlled Trial of Guided Bone Regeneration for Peri-Implant Dehiscence Defects with Two Anorganic Bovine Bone Materials Covered by Titanium Meshes. Materials (Basel) 2022; 15:ma15155294. [PMID: 35955229 PMCID: PMC9369984 DOI: 10.3390/ma15155294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/17/2022] [Accepted: 07/21/2022] [Indexed: 12/10/2022]
Abstract
The aim of this study is to compare two low-temperature sintered anorganic bovine bone materials (ABBMs), Bio-Oss (Geistlich, Wolhusen, Switzerland) and A-Oss (Osstem, Seoul, Korea), for GBR in dehiscence defects. A single implant was placed simultaneously with GBR in the buccal or bucco-proximal osseous defect by double-layering of inner allograft and outer ABBM, covered by a preformed ultrafine titanium mesh and an absorbable collagen membrane. Grafted volume changes were evaluated by cone-beam computed tomography, taken preoperatively (T0), immediately after implant surgery (T1), after re-entry surgery (T2), and after delivery of the final restoration (T3). The density of the regenerated bone was assessed by measuring the probing depth on the buccal mid-center of the mesh after removing the mesh at T2. Postoperative sequelae were also recorded. Grafted volume shrinkage of 46.0% (0.78 ± 0.37 cc) and 40.8% (0.79 ± 0.33 cc) in the Bio-Oss group (8 patients) and A-Oss group (8 patients), respectively, was observed at T3 (p < 0.001). There were no significant differences in grafted volume changes according to time periods or bone density between the two groups. Despite postoperative mesh exposure (3 patients), premature removal of these exposed meshes and additional grafting was not necessary, and all implants were functional over the 1-year follow-up period. Both ABBMs with titanium meshes showed no significant difference in the quantity and density of the regenerated bone after GBR for peri-implant defects.
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Affiliation(s)
- JaeHyung Lim
- Department of Oral and Maxillofacial Surgery, Korea University Ansan Hospital, Ansan-si 15355, Korea;
| | - Sang Ho Jun
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul 02841, Korea;
| | - Marco Tallarico
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy;
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Dae-Ho Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
| | - Kyung-Gyun Hwang
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
| | - Chang-Joo Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
- Correspondence: ; Tel.: +82-2-2290-8646
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41
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Montero E, Roccuzzo A, Molina A, Monje A, Herrera D, Roccuzzo M. Minimal invasiveness in the reconstructive treatment of peri-implantitis defects. Periodontol 2000 2022; 91:199-216. [PMID: 35899987 DOI: 10.1111/prd.12460] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/30/2022] [Accepted: 06/05/2022] [Indexed: 11/30/2022]
Abstract
Peri-implantitis is a plaque-associated pathologic condition occurring in tissues around dental implants, clinically characterized by increased peri-implant probing pocket depth and progressive loss of supporting bone. Consequently, to arrest further disease progression and to increase the chance to obtain re-osseointegration, surgical reconstructive procedures have been adopted. In particular, following a paradigm gathered from periodontal therapy, recent protocols have underlined the importance of a minimally invasive approach to optimize the outcomes of therapy while minimizing the risks of postoperative complications. The present review summarizes the level of evidence on the surgical reconstructive protocols focusing on the new approaches aiming to minimize surgical trauma and patients' postoperative discomfort, underlining the pros and cons of each treatment modality.
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Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Mario Roccuzzo
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Division of Maxillofacial Surgery, University of Torino, Torino, Italy
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Juodzbalys G. Dental Implant Placement in Focal Osteoporotic Bone Marrow Defect: a Case Report and Treatment Recommendations. J Oral Maxillofac Res 2022; 13:e5. [PMID: 36382015 PMCID: PMC9617253 DOI: 10.5037/jomr.2022.13305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Focal osteoporotic bone marrow defect is asymptomatic radiolucent area usually discovered incidentally during radiographic examination of the jaws. This bone condition can lead to clinical complications during dental implant placement or during osseointegration process. METHODS A 54-year-old woman was referred to private dental implant centre for a dental implant rehabilitation treatment in May 17, 2016. Oral examination revealed a healthy mucosa with no visible pathology. Adentia of tooth #46 and moderate atrophy of the edentulous alveolar process were found. Panoramic radiography of the jaws showed 2 cm x 2 cm radiolucency with irregular borders located in tooth #46 region. The margins of the bone defect were uneven, single trabeculae were visible, and the cortical layer was not deformed. In the absence of signs of pathology, it was decided to perform a dental implant surgery in the edentulous jaw segment #46. RESULTS The osteoporotic focus was filled with natural bovine bone substitute Cerabone®. The granules were gently condensed to the sides - to the buccal and lingual walls until they filled the entire cavity. A 10 mm long, 4.1 mm diameter Straumann® Tissue Level implant was surgically placed with the shoulder of the implant resting on the margins of the osteotomy. It was proposed six steps protocol for surgical dental implant installation in focal osteoporotic bone marrow defect in mandible. CONCLUSIONS A six-step protocol for surgical placement of dental implants in focal osteoporotic bone marrow defects may be a useful tool for clinicians in implant dentistry.
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Affiliation(s)
- Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Faculty of Odontology, Medical Academy Lithuanian University of Health Sciences, KaunasLithuania.
- Dental implant centre 'Stilus Optimus', KaunasLithuania.
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43
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Desbord M, Soulié J, Rey C, Combes C. Tunable Behavior in Solution of Amorphous Calcium Ortho/Pyrophosphate Materials: An Acellular In Vitro Study. ACS Biomater Sci Eng 2022; 8:2363-2374. [PMID: 35533345 DOI: 10.1021/acsbiomaterials.1c01618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Amorphous calcium phosphate-based materials are of major interest in the field of bone substitution. Very recently, the low-temperature synthesis of a new family of amorphous calcium phosphate containing both orthophosphate and pyrophosphate ions in controlled proportions has been reported. Despite their interest, especially due to the biochemical role and the hydrolysis of pyrophosphate occurring in vivo, the behavior of such materials when interacting with aqueous media has never been described. Consequently, we herein report the in vitro acellular evolution of three compositions of mixed calcium ortho- and pyrophosphate amorphous materials including a different orthophosphate proportion. As a first step to assess the physicochemical reactivity of these amorphous materials, they were tested in two different media at 37 °C, acidified water and simulated body fluid solution, from 1 h up to 15 days. The results demonstrated that they were quite stable and that they progressively released part of their constitutive ions, highlighting their potential for controlled delivery of bioactive ions (calcium, orthophosphate, and pyrophosphate ions). In addition to these properties, we showed that the material with the highest ortho/(ortho + pyro) phosphate ratio started to crystallize into nanocrystalline apatite analogous to bone mineral within 2 days or 2 weeks depending on the medium. For the other material compositions, no layer of apatite was detected at their surface with SBF testing despite the favorable supersaturation indexes, crystallization being probably inhibited by pyrophosphate ions released in the medium. This varying apatite-forming ability emphasizes the key role of the ortho/(ortho + pyro) phosphate ratio of these materials in their in vitro reactivity and bioactivity, which paves the way for the development of this promising family of amorphous calcium phosphate materials with tunable physicochemical and biological properties.
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Affiliation(s)
- Maximilien Desbord
- CIRIMAT, Université de Toulouse, CNRS, Toulouse INP- ENSIACET, 4 allée Emile Monso, 31030 Toulouse cedex 4, France
| | - Jérémy Soulié
- CIRIMAT, Université de Toulouse, CNRS, Toulouse INP- ENSIACET, 4 allée Emile Monso, 31030 Toulouse cedex 4, France
| | - Christian Rey
- CIRIMAT, Université de Toulouse, CNRS, Toulouse INP- ENSIACET, 4 allée Emile Monso, 31030 Toulouse cedex 4, France
| | - Christèle Combes
- CIRIMAT, Université de Toulouse, CNRS, Toulouse INP- ENSIACET, 4 allée Emile Monso, 31030 Toulouse cedex 4, France
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44
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Xu L, Qin X, Mozaffari MS, Yan D, Sun X, Cao Y. Hybrid system with stable structure of hard/soft tissue substitutes induces re-osseointegration in a rat model of biofilm-mediated peri-implantitis. J Biomed Mater Res B Appl Biomater 2022; 110:2452-2463. [PMID: 35620882 DOI: 10.1002/jbm.b.35102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/19/2022] [Accepted: 05/09/2022] [Indexed: 11/07/2022]
Abstract
Re-osseointegration of an infected/contaminated dental implant poses major clinical challenges. We tested the hypothesis that the application of an antibiotic-releasing construct, combined with hard/soft tissue replacement, increases the efficacy of reconstructive therapy. We initially fabricated semi-flexible hybrid constructs of β-TCP/PHBHHx, with tetracycline (TC) (TC amounts: 5%, 10%, and 15%). Thereafter, using in vitro assays, TC release profile, attachment to rat bone marrow-derived stem cells (rBMSCs) and their viability as well as anti-bacterial activity were determined. Thereafter, regenerative efficacies of the three hybrid constructs were assessed in a rat model of peri-implantitis induced by Aggregatibacter actinomycetemcomitans biofilm; control animals received β-TCP/Bio-Gide and TC injection. Eight weeks later, maxillae were obtained for radiological, histological, and histomorphometric analyses of peri-implant tissues. Sulcus bleeding index was chronologically recorded. Serum cytokines levels of IL-6 and IL-1β were also evaluated by enzyme-linked immunosorbent assay. Substantial amounts of tetracycline, from hybrid constructs, were released for 2 weeks. The medium containing the released tetracycline did not affect the adhesion or viability of rBMSCs; however, it inhibited the proliferation of A. actinomycetemcomitans. Osteogenesis and osseointegration were more marked for the 15% hybrid construct group than the other two groups. The height of attachment and infiltration of inflammatory cells within fibrous tissue was significantly reduced in the experimental groups than the control group. Our protocol resulted in re-osseointegration on a biofilm-contaminated implant. Thus, an antibiotic releasing inorganic/organic construct may offer a therapeutic option to suppress infection and promote guided tissue regeneration thereby serving as an integrated multi-layer substitute for both hard/soft tissues.
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Affiliation(s)
- Lianyi Xu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Qin
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mahmood S Mozaffari
- Department of Oral Biology, Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Di Yan
- Department of Oral and Maxillofacial Surgery, General Hospital, Ningxia Medical University, Yinchuan, China
| | - Xiaojuan Sun
- Department of Oral and Maxillofacial Surgery, General Hospital, Ningxia Medical University, Yinchuan, China
| | - Yingguang Cao
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Minetti E, Corbella S, Taschieri S, Canullo L. Tooth as graft material: Histologic study. Clin Implant Dent Relat Res 2022; 24:488-496. [PMID: 35507503 PMCID: PMC9544007 DOI: 10.1111/cid.13097] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 12/22/2022]
Abstract
Background An effective regenerative protocol is key to reestablish and maintain the hard and soft tissue dimensions over time. The choice of the graft material and its properties also could have an impact on the results. To prevent alveolar ridge dimensional changes, since numerous graft materials have been suggested and in the past years, a growing interest in teeth material has been observed as a valuable alternative to synthetic biomaterials. Aim The aim of the study was to explore the histomorphometric outcomes of tooth derivative materials as used as bone substitute material in socket preservation procedure. Methods After alveolar socket preservation (ASP) procedures using autologous demineralized tooth as graft material prepared by means of an innovative device, was evaluated. A total of 101 histological samples, from 96 subjects, were analyzed by evaluating the total amount of bone (BV), residual tooth material (residual graft, TT), and vital bone (VB). The section from each sample was then split in nine subsections, resulting in 909 subsections, to allow statistical comparison between the different areas. Results It was not noticed a statistically significant difference between maxillary and mandibular sites, being the amount of VB in upper jaw sites 37.9 ± 21.9% and 38.0 ± 22.0% in lower jaw sites and the amount of TT was 7.7 ± 12.2% in maxilla and 7.0 ± 11.1% in mandibles. None of the other considered parameters, including defect type and section position, were statistically correlated to the results of the histomorphometric analysis. Conclusions ASP procedure using demineralized autologous tooth‐derived biomaterial may be a predictable procedure to produce new vital bone potentially capable to support dental implant rehabilitation.
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Affiliation(s)
- Elio Minetti
- Department of Biomedical, Surgical, and Dental Science, Università degli Studi di Milano, Milan
| | - Stefano Corbella
- Department of Biomedical, Surgical, and Dental Science, Università degli Studi di Milano, Milan.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Oral Surgery, Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Silvio Taschieri
- Department of Biomedical, Surgical, and Dental Science, Università degli Studi di Milano, Milan.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Oral Surgery, Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Luigi Canullo
- Department of Periodontics and Implantology, University Of Bern, Bern, Switzerland
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Quiroz VF, Lima JR, Pinotti FE, Marcantonio RA, Marcantonio E, Oliveira GJ. Comparison of osseointegration in areas grafted with deproteinized bovine bone and native bone. A preclinical study. Acta Odontol Latinoam 2022; 35:3-9. [PMID: 35700535 DOI: 10.54589/aol.35/1/3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/01/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to evaluate the osseointegration of implants placed in rat tibia sites grafted with Deproteinized Bovine Bone (DBB) and Native Bone (NB). Twenty-eight rats were divided into two groups according to the type of substrate in which the implants were to be placed: NB - implants placed in native bone; DBB - implants placed in areas grafted with DBB. In the DBB group, the bone defect was made and filled with the bone substitute 60 days before placing the implant. The animals were euthanized 15 or 45 days after implant placement. Osseointegration was assessed by the removal torque, volume of mineralized tissues around the implants (BV/TV), bone-implant contact (%BIC), and bone between threads (%BBT). The implants placed in NB presented higher removal torque (8.00 ± 1.26 Ncm vs. 2.33 ± 0.41 Ncm at 15 days and 22.00 ± 2.44 Ncm vs. 4.00 ± 1.41 Ncm at 45 days), higher %BV/TV (47.92 ± 1.54% vs. 33.33 ± 4.77% at 15 days and 70.06 ± 0.91% vs. 39.89±5.90%at 45 days), higher %BIC (39.68 ± 5.02% vs. 9.12 ± 5.56% at 15 days and 83.23 ± 4.42% vs. 18.81 ± 7.21% at 45 days), and higher %BBT (34.33 ± 5.42% vs. 13.24 ± 8.72% at 15 days and 82.33 ± 3.13% vs. 22.26 ± 8.27% at 45 days) than the implants placed in DBB grafted areas. The degree of osseointegration was lower in implants placed in the area grafted with DBB than in NB in rat tibias.
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Affiliation(s)
- Victor F Quiroz
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Periodontía e Implantodontia, Uberlândia, Brasil
| | - Júlia R Lima
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Periodontía e Implantodontia, Uberlândia, Brasil
| | - Felipe E Pinotti
- Universidade de Araraquara, Faculdade de Odontologia, Departamento de Diagnostico e Cirurgía, Araraquara, Brasil
| | - Rosemary Ac Marcantonio
- Universidade de Araraquara, Faculdade de Odontologia, Departamento de Diagnostico e Cirurgía, Araraquara, Brasil
| | - Elcio Marcantonio
- Universidade de Araraquara, Faculdade de Odontologia, Departamento de Diagnostico e Cirurgía, Araraquara, Brasil
| | - Guilherme Jpl Oliveira
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Periodontía e Implantodontia, Uberlândia, Brasil.
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47
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Lima JR, Soares PBF, Pinotti FE, Marcantonio RAC, Marcantonio-Junior E, de Oliveira GJPL. Comparison of the osseointegration of implants placed in areas grafted with HA/TCP and native bone. Microsc Res Tech 2022; 85:2776-2783. [PMID: 35397154 DOI: 10.1002/jemt.24126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 03/04/2022] [Accepted: 03/31/2022] [Indexed: 11/10/2022]
Abstract
This study evaluated the osseointegration of implants in areas grafted with biphasic ceramic based on hydroxyapatite/β-tricalcium phosphate (HA/TCP) and in native bone (NB). Twenty-eight rats were randomly assigned into two groups of 14 animals each: HA/TCP group: implants installed in areas grafted with HA/TCP and NB group: implants installed in areas of native bone. Bone defects were made in both tibiae of the rats belonging to the HA/TCP group and then filled with this bone substitute. After 60 days, the rats were submitted to surgical procedures for implant placement in grafted areas in both tibiae in the HA/TCP group while the implants were installed directly in native bone in the NB group. The animals were euthanized 15 and 45 days, respectively, after the implant placement. Biomechanical (removal torque), microtomographic (volume of mineralized tissues around the implants), and histomorphometric (Bone-Implant contact-%BIC and bone area between the implant threads-%BBT) analyzes were conducted to assess the osseointegration process. The HA/TCP group showed lower values of removal torque, volume of mineralized tissue around the implants, lower %BIC, and %BBT compared to the NB group in both experimental periods. Osseointegration of implants placed in grafted areas with HA/TCP was lower compared to the osseointegration observed in native bone areas.
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Affiliation(s)
- Julia Raulino Lima
- Department of Periodontology/Implantology, Universidade Federal de Uberlândia - UFU, School of Dentistry, Uberlândia, MG, Brazil
| | | | - Felipe Eduardo Pinotti
- Department of Diagnosis and Surgery, Universidade Estadual Paulista - UNESP, School of Dentistry, Araraquara, SP, Brazil
| | | | - Elcio Marcantonio-Junior
- Department of Diagnosis and Surgery, Universidade Estadual Paulista - UNESP, School of Dentistry, Araraquara, SP, Brazil
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Lee JS, Park JY, Chung HM, Song YW, Strauss FJ. Vertical ridge augmentation feasibility using unfixed collagen membranes and particulate bone substitutes: A 1- to 7-year retrospective single-cohort observational study. Clin Implant Dent Relat Res 2022; 24:372-381. [PMID: 35324059 PMCID: PMC9314959 DOI: 10.1111/cid.13084] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/15/2022] [Accepted: 03/07/2022] [Indexed: 12/28/2022]
Abstract
Aim To determine whether vertical ridge augmentation (VRA) can be obtained through guided bone regeneration (GBR) using exclusively resorbable collagen membranes and particulate bone substitutes without additional stabilization. Materials and Methods This study retrospectively examined 22 participants who underwent VRA with staged or simultaneous implant placement. The vertical defects of all participants were filled with particulate bone substitutes and covered with resorbable collagen membranes. The augmented sites were stabilized with unfixed collagen membranes and the flap without any additional fixation. The augmented tissue height was assessed using cone‐beam computed tomography at baseline, immediately after surgery, and at annual follow‐ups. Results The vertical bone gain of the 22 augmented sites amounted to 6.48 ± 2.19 mm (mean ± SD) immediately after surgery and 5.78 ± 1.72 mm at 1‐ to 7‐year follow‐up. Of the 22 augmented sites, 18 exhibited changes of less than 1 mm, while the other 4 showed changes of greater than 1 mm. Histological observation of three representative cases revealed new bone apposition on the remaining material. Conclusion The present findings indicate that GBR procedures using exclusively collagen membranes and particulate biomaterials without any additional fixation are feasible options for VRA.
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Affiliation(s)
- Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Republic of Korea.,Department of Oral Biology, Medical University of Vienna, Vienna, Austria
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Republic of Korea
| | - Hye-Min Chung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Republic of Korea.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Franz-Josef Strauss
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria.,Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.,Clinic of Reconstructive Dentistry, University of Zurich, Zürich, Switzerland
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Mendes BC, Pereira RDS, Mourão CFDAB, Montemezzi P, Santos AMDS, Moreno JML, Okamoto R, Hochuli-Vieira E. Evaluation of Two Beta-Tricalcium Phosphates with Different Particle Dimensions in Human Maxillary Sinus Floor Elevation: A Prospective, Randomized Clinical Trial. Materials (Basel) 2022; 15:ma15051824. [PMID: 35269056 PMCID: PMC8911852 DOI: 10.3390/ma15051824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
This study aimed to compare two beta-tricalcium phosphates with different particle sizes in human maxillary sinuses lifting. The immunolabeling of cells for RUNX2 and VEGF were performed to evaluate the osteoblast precursor cells and the vascular formation after 6 months of bone repair. Ten maxillary sinuses were grafted with autogenous bone graft (Group 1), 10 were grafted with ChronOs® (Group 2), and 10 were grafted with BETA-TCP® (Group 3). After 6 months of bone healing, biopsies were obtained to assess the new bone formed by histomorphometric and immunohistochemical evaluation for RUNX2 and VEGF. The mean bone formation for Group 1 was 51.4 ± 17.4%. Group 2 presented 45.5 ± 9.9%, and Group 3 conferred 35.4 ± 8.0% of new bone formation. The RUNX2 offered low for Groups 1 and 2 with high cellular activity for osteoblast in Group 3. The VEGF immunolabeling was moderate for Groups 1 and 2 and intense for Group 3. In conclusion, it was possible to show that the bone substitutes evaluated in the present study presented suitable outcomes for bone regeneration, being an alternative for the autogenous bone graft in maxillary sinus bone height reconstruction.
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Affiliation(s)
- Bruno Coelho Mendes
- Department of Oral & Maxillofacial Surgery, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil; (A.M.d.S.S.); (E.H.-V.)
- Correspondence: (B.C.M.); (C.F.d.A.B.M.); Tel.: +55-(18)-36363270 (B.C.M.); +1-(941)-830-1302 (C.F.d.A.B.M.)
| | - Rodrigo dos Santos Pereira
- Department of Oral & Maxillofacial Surgery, University of Grande Rio—UNIGRANRIO, Rio de Janeiro 25071-202, Brazil;
| | - Carlos Fernando de Almeida Barros Mourão
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil;
- Correspondence: (B.C.M.); (C.F.d.A.B.M.); Tel.: +55-(18)-36363270 (B.C.M.); +1-(941)-830-1302 (C.F.d.A.B.M.)
| | - Pietro Montemezzi
- Clinical Research Unit of the Antonio Pedro Hospital, Fluminense Federal University, Niteroi 24033-900, Brazil;
| | - Anderson Maikon de Souza Santos
- Department of Oral & Maxillofacial Surgery, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil; (A.M.d.S.S.); (E.H.-V.)
| | - Jéssica Monique Lopes Moreno
- Department of Dental Prosthesis, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil;
| | - Roberta Okamoto
- Department of Human Anatomy, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil;
| | - Eduardo Hochuli-Vieira
- Department of Oral & Maxillofacial Surgery, Aracatuba School of Dentistry, Sao Paulo State University, Sao Paulo 16066-840, Brazil; (A.M.d.S.S.); (E.H.-V.)
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Saxena N, Mizels J, Cremer MA, Guarnizo V, Rodriguez DE, Gower LB. Comparison of Synthetic vs. Biogenic Polymeric Process-Directing Agents for Intrafibrillar Mineralization of Collagen. Polymers (Basel) 2022; 14:polym14040775. [PMID: 35215688 PMCID: PMC8879695 DOI: 10.3390/polym14040775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 12/10/2022] Open
Abstract
With the aging population, there is a growing need for mineralized tissue restoration and synthetic bone substitutes. Previous studies have shown that a polymer-induced liquid-precursor (PILP) process can successfully mineralize collagen substrates to achieve compositions found in native bone and dentin. This process also leads to intrafibrillar apatitic crystals with their [001] axes aligned roughly parallel to the long axis of the collagen fibril, emulating the nanostructural organization found in native bone and dentin. When demineralized bovine bone was remineralized via the PILP process using osteopontin (OPN), the samples were able to activate mouse marrow-derived osteoclasts to similar levels to those of native bone, suggesting a means for fabricating bioactive bone substitutes that could trigger remodeling through the native bone multicellular unit (BMU). In order to determine if OPN derived from bovine milk could be a cost-effective process-directing agent, the mineralization of type I collagen scaffolds using this protein was compared to the benchmark polypeptide of polyaspartic acid (sodium salt; pAsp). In this set of experiments, we found that OPN led to much faster and more uniform mineralization when compared with pAsp, making it a cheaper and commercially attractive alternative for mineralized tissue restorations.
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Affiliation(s)
- Neha Saxena
- Department of Materials Science & Engineering, University of Florida, Gainesville, FL 32611, USA; (N.S.); (J.M.); (M.A.C.); (V.G.); (D.E.R.)
- Bio-Therapeutics Drug Product Development, Janssen Pharmaceuticals, Inc., Malvern, PA 19355, USA
| | - Joshua Mizels
- Department of Materials Science & Engineering, University of Florida, Gainesville, FL 32611, USA; (N.S.); (J.M.); (M.A.C.); (V.G.); (D.E.R.)
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT 84112, USA
| | - Maegan A. Cremer
- Department of Materials Science & Engineering, University of Florida, Gainesville, FL 32611, USA; (N.S.); (J.M.); (M.A.C.); (V.G.); (D.E.R.)
- College of Medicine, University of Florida, Gainesville, FL 32611, USA
| | - Vanessa Guarnizo
- Department of Materials Science & Engineering, University of Florida, Gainesville, FL 32611, USA; (N.S.); (J.M.); (M.A.C.); (V.G.); (D.E.R.)
- Quality Engineering, Medtronic ENT, Jacksonville, FL 32611, USA
| | - Douglas E. Rodriguez
- Department of Materials Science & Engineering, University of Florida, Gainesville, FL 32611, USA; (N.S.); (J.M.); (M.A.C.); (V.G.); (D.E.R.)
- R&D, Novabone Products LLC, Alachua, FL 32611, USA
| | - Laurie B. Gower
- Department of Materials Science & Engineering, University of Florida, Gainesville, FL 32611, USA; (N.S.); (J.M.); (M.A.C.); (V.G.); (D.E.R.)
- Correspondence:
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