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Refahi P, Shaikh S. Utilizing partially demineralized dentin plate for horizontal ridge augmentation: A case report. Clin Adv Periodontics 2024. [PMID: 38696543 DOI: 10.1002/cap.10291] [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: 02/29/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND This article intends to showcase a case of guided bone regeneration (GBR) utilizing a partially demineralized dentin plate processed from an extracted second molar for horizontal augmentation of the posterior ridge for implant placement. METHODS AND RESULTS A 60-year-old patient presented with horizontal ridge deficiency at site #30 and an endodontically treated tooth #31 with recurrent decay. A treatment plan was proposed to extract tooth #31 and utilize a dentin graft from the tooth for ridge augmentation at site #30. Following the atraumatic extraction of tooth #31, it was sectioned into a 1 mm thick dentin plate, sterilized, and processed to obtain a demineralized dentin graft. Following a mid-crestal incision and full-thickness flap elevation, the dentin plate was adapted on the buccal defect of site #30 with 10 mm fixation screws, and the gap between the plate and the buccal bone was filled with 0.5 cc of 50/50 cortico-cancellous bone allograft hydrated with saline, covered with collagen membrane followed by primary closure. At 6 months, a postoperative cone-beam computed tomography (CBCT) was obtained to evaluate the ridge width revealing sufficient ridge width for optimal implant placement. The radio-opaque dentin plate was visible on the CBCT depicting integration with the alveolar ridge. Following surgical implant preparation protocol, a 4 mm diameter and 8.5 mm length implant was placed in a restoratively driven position. CONCLUSION This case reports favorable outcomes for GBR using a partially demineralized dentin plate as an alternative to an autogenous bone block graft for horizontal ridge augmentation for future implant placement. KEY POINTS This case introduces a novel method utilizing partially demineralized dentin plates derived from extracted teeth for guided bone regeneration, showcasing its potential efficacy in addressing ridge deficiencies. Success, in this case, relies on meticulous sectioning of the tooth and processing of the dentin graft, precise adaptation and fixation of the graft to the residual ridge, and achieving primary closure for undisturbed healing. Limitations to success include the availability of teeth for extraction coinciding with the need for ridge augmentation and unstable graft fixation.
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Affiliation(s)
- Pooyan Refahi
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- Private Practice, Boston, Massachusetts, USA
| | - Samar Shaikh
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
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Gomez Meda R, Esquivel J. Perio-prosthodontic pontic site management, part II: Pontic site reconstruction strategies to enhance the esthetic and biological outcomes. J ESTHET RESTOR DENT 2024; 36:737-745. [PMID: 38186222 DOI: 10.1111/jerd.13192] [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: 10/25/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE Ridge deformities are present in most patients after tooth extraction; these defects make the management of future implant and pontic sites challenging to deal with. The restorative team should be able to diagnose and treat these deformities to allow for successful outcomes. Many approaches have been described to reconstruct pontic sites, each with specific indications. This article describes the different approaches to reconstructing pontic sites and their indications to allow for a proper esthetic and biological environment for future restorations. CLINICAL CONSIDERATIONS Depending on the severity of the defect, location, and the esthetic necessity, pontic site enhancement can be done through different approaches, some requiring soft tissue grafting, hard tissue grafting, or both. Understanding the indications of the treatment options is essential to allow the clinician to make the right therapeutic decision and achieve the best possible perio-prosthodontic outcomes. CONCLUSIONS An adequate balance between the soft tissue and prosthetics is essential to achieve successful results on implant-supported or tooth-supported fixed dental prostheses (FDPs). Selecting the right approach to treat ridge deformities is necessary to increase treatment success, reduce over-treatment, and create a biologically sound environment for restorations. CLINICAL SIGNIFICANCE Pontic site enhancement through reconstructive surgery will allow for esthetically pleasing and biologically stable results, allowing restorations to emulate natural structures lost after tooth extraction.
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Affiliation(s)
- Ramon Gomez Meda
- Adjunct Assistant Professor, Department of Prosthodontics, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
| | - Jonathan Esquivel
- Adjunct Associate Professor, Department of Prosthodontics, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
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Yuan S, Chen Q, Guo M, Xu Y, Wang W, Li Z. Fabrication of Bioresorbable Barrier Membranes from Gelatin/Poly(4-Hydroxybutyrate) (P4HB). Macromol Biosci 2024:e2400036. [PMID: 38621113 DOI: 10.1002/mabi.202400036] [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: 01/29/2024] [Revised: 04/01/2024] [Indexed: 04/17/2024]
Abstract
Dental implant surgery is a procedure that replaces damaged or missing teeth with an artificial implant. During this procedure, guided bone regeneration (GBR) membranes are commonly used to inhibit the migration of epithelium and GBR at the surgical sites. Due to its biodegradability, good biocompatibility, and unique biological properties, gelatin (GT) is considered a suitable candidate for guiding periodontal tissue regeneration. However, GT-based membranes come with limitations, such as poor mechanical strength and mismatched degradation rates. To confront this challenge, a series of GT/poly(4-hydroxybutyrate) (P4HB) composite membranes are fabricated through electrospinning technology. The morphology, composition, wetting properties, mechanical properties, biocompatibility, and in vivo biodegradability of the as-prepared composite membranes are carefully characterized. The results demonstrate that all the membranes present excellent biocompatibility. Moreover, the in vivo degradation rate of the membranes can be manipulated by changing the ratio of GT and P4HB. The results indicate that the optimized GT/P4HB membranes with a high P4HB content (75%) may be suitable for periodontal tissue engineering because of their good mechanical properties and biodegradation rate compatible with tissue growth.
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Affiliation(s)
- Shuaishuai Yuan
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, Qingdao, 266042, P. R. China
| | - Qi Chen
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, Qingdao, 266042, P. R. China
| | - Manman Guo
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, Qingdao, 266042, P. R. China
| | - Yongzhi Xu
- Department of Stomatology, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, 266003, China
| | - Wanchun Wang
- Department of Stomatology, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, 266003, China
| | - Zhibo Li
- Key Lab of Biobased Polymer Materials of Shandong Provincial Education Department, College of Polymer Science and Engineering, Qingdao University of Science and Technology, Qingdao, 266042, P. R. China
- College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao, 266042, P. R. China
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Orlando F, Foiani S, Dellavia C, Graziano D, Di Stefano DA. Horizontal GBR with anorganic equine bone combined with a customized titanium mesh. Clin Case Rep 2024; 12:e8780. [PMID: 38659499 PMCID: PMC11039487 DOI: 10.1002/ccr3.8780] [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: 02/13/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Abstract
This case report describes the fixed rehabilitation of the lower left arch in a patient following an horizontal GBR procedure by means of a customized titanium mesh and a new slow resorption bone substitute of equine origin.
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Affiliation(s)
- Francesco Orlando
- Private Practice, Centro Odontoiatrico e Protesico Civitali S.R.L.MilanItaly
- Dental SchoolVita‐Salute University IRCCS San RaffaeleMilanItaly
| | - Simone Foiani
- Private Practice, Centro Odontoiatrico e Protesico Civitali S.R.L.MilanItaly
| | - Claudia Dellavia
- Department of Biomedical Surgical and Dental SciencesUniversità Degli Studi di MilanoMilanItaly
| | - Daniele Graziano
- Department of Biomedical Surgical and Dental SciencesUniversità Degli Studi di MilanoMilanItaly
| | - Danilo Alessio Di Stefano
- Private Practice, Centro Odontoiatrico e Protesico Civitali S.R.L.MilanItaly
- Department of DentistryVita‐Salute San Raffaele University MilanMilanItaly
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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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Strauss FJ, Fukuba S, Naenni N, Jung R, Jonker B, Wolvius E, Pijpe J. Alveolar ridge changes 1-year after early implant placement, with or without alveolar ridge preservation at single-implant sites in the aesthetic region: A secondary analysis of radiographic and profilometric outcomes from a randomized controlled trial. Clin Implant Dent Relat Res 2024; 26:356-368. [PMID: 38105498 DOI: 10.1111/cid.13297] [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: 07/06/2023] [Revised: 11/08/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES To assess both the radiographic and profilometric outcomes of early implant placement with or without alveolar ridge preservation (ARP) (using two different ARP techniques) after 1 year of loading. MATERIALS AND METHODS Seventy-five patients with a failing single tooth in the anterior maxilla were randomly allocated to three groups (1:1:1): (a) ARP using demineralized bovine bone mineral containing 10% collagen (DBBM-C) covered by a collagen matrix (CM), (b) ARP using DBBM-C covered with a palatal graft (PG), and (c) unassisted socket healing (control). Eight weeks after tooth extraction, early implant placement was performed in all patients. Cone-beam computed tomography (CBCT) and impressions were taken 8 weeks after tooth extraction (ARP/unassisted healing) prior to implant placement and 1-year post-loading. Radiographic and profilometric outcomes were evaluated. RESULTS Out of the 70 patients available for re-examination at 1-year post-loading, 55 datasets could be assessed (ARP-CM 19; ARP-PG 17; Control 19). The need for additional guided bone regeneration (GBR) at implant placement amounted to 31.6% (ARP-CM), 29.4% (ARP-PG), and 68.4% (unassisted healing). Adjusted models revealed that residual buccal bone height and additional GBR at implant placement significantly influenced the magnitude of the alveolar changes at 1 year (p < 0.05). In patients with ARP (group ARP-CM or ARP-PG) without additional GBR, the presence of bone convexity amounted to 36.0% (9/25) at 1-year post-loading. For patients that received ARP and additional GBR at implant placement, the frequency of bone convexity increased to 72.7% (8/11) (p = 0.042). Regarding profilometric measurements, a tendency toward agreement with radiographic outcomes was observed. CONCLUSIONS Early implant placement with ARP can attenuate alveolar ridge changes at 1-year post loading by minimizing both radiographic and profilometric alterations. However, early implant placement with simultaneous GBR consistently yields superior radiographic and profilometric outcomes, regardless of whether ARP is performed.
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Affiliation(s)
- Franz Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
| | - Shunsuke Fukuba
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Brend Jonker
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eppo Wolvius
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Justin Pijpe
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
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Qasim SSB, Trajkovski B, Zafiropoulos GG. The response of human osteoblasts on bovine xenografts with and without hyaluronate used in bone augmentation. J Biomater Sci Polym Ed 2024; 35:880-897. [PMID: 38346177 DOI: 10.1080/09205063.2024.2311454] [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: 12/24/2023] [Accepted: 01/24/2024] [Indexed: 04/13/2024]
Abstract
The aim of the in vitro study was to asses the effect of hyaluronate in conjunction with bovine derived xenografts on the viability, proliferation on day 4, 7 and 10, expression of early osteogenic differentiation marker Alkaline phosphatase on day 14 and 21, collagen, calcium deposition on day 14, 21 and 28 and cellular characteristics, as assessed through live cell image analysis, confocal laser scanning microscopy and scanning electron microscopy, in primary human osteoblasts compared to three bovine xenografts without hyaluronate. All experiments were performed in triplicates. Data were compared between groups and timepoints using one-way analysis of variance (ANOVA). Bonferroni post hoc test were further used for multiple comparison between groups (p < .05) An increase in cell viability (p < .05) and enhanced ALP activity was observed in all xenografts. Specimens containing hyaluronate showed a highest significant difference (23755 ± 29953, p < .0001). The highest levels of calcium (1.60 ± 0.30) and collagen (1.92 ± 0.09, p < .0001) deposition were also observed with hyaluronate loaded groups. The osteoblasts were well attached and spread on all xenograft groups. However, a higher number of cells were observed with hyaluronate functionalized xenograft (76.27 ± 15.11, (p < .0001) in live cell image analysis and they migrated towards the graft boundaries. The biofunctionalization of xenografts with hyaluronate improves their in vitro performance on human osteoblasts. This suggests that hyaluronate might be able to improve the bone regeneration when using such xenografts.
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Affiliation(s)
- Syed Saad Bin Qasim
- Department of Bioclinical Sciences, College of Dentistry, Kuwait University, Safat, Kuwait
| | - Branko Trajkovski
- Faculty of Dentistry, College of Dentistry, Kuwait University, Safat, Kuwait
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Su H, Fujiwara T, Skalli O, Selders GS, Li T, Mao L, Bumgardner JD. Porous Nano-Fiber Structure of Modified Electrospun Chitosan GBR Membranes Improve Osteoblast Calcium Phosphate Deposition in Osteoblast-Fibroblast Co-Cultures. Mar Drugs 2024; 22:160. [PMID: 38667777 PMCID: PMC11051071 DOI: 10.3390/md22040160] [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: 02/29/2024] [Revised: 03/23/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Desirable characteristics of electrospun chitosan membranes (ESCM) for guided bone regeneration are their nanofiber structure that mimics the extracellular fiber matrix and porosity for the exchange of signals between bone and soft tissue compartments. However, ESCM are susceptible to swelling and loss of nanofiber and porous structure in physiological environments. A novel post-electrospinning method using di-tert-butyl dicarbonate (tBOC) prevents swelling and loss of nanofibrous structure better than sodium carbonate treatments. This study aimed to evaluate the hypothesis that retention of nanofiber morphology and high porosity of tBOC-modified ESCM (tBOC-ESCM) would support more bone mineralization in osteoblast-fibroblast co-cultures compared to Na2CO3 treated membranes (Na2CO3-ESCM) and solution-cast chitosan solid films (CM-film). The results showed that only the tBOC-ESCM retained the nanofibrous structure and had approximately 14 times more pore volume than Na2CO3-ESCM and thousands of times more pore volume than CM-films, respectively. In co-cultures, the tBOC-ESCM resulted in a significantly greater calcium-phosphate deposition by osteoblasts than either the Na2CO3-ESCM or CM-film (p < 0.05). This work supports the study hypothesis that tBOC-ESCM with nanofiber structure and high porosity promotes the exchange of signals between osteoblasts and fibroblasts, leading to improved mineralization in vitro and thus potentially improved bone healing and regeneration in guided bone regeneration applications.
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Affiliation(s)
- Hengjie Su
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, China
- Department of Biomedical Engineering, University of Tennessee Health Science Center-Memphis Joint Graduate Biomedical Engineering Program, The University of Memphis, Memphis, TN 38152, USA
| | - Tomoko Fujiwara
- Department of Chemistry, The University of Memphis, Memphis, TN 38152, USA;
| | - Omar Skalli
- Integrated Microscopy Center, The University of Memphis, Memphis, TN 38152, USA
| | - Gretchen Schreyack Selders
- Department of Biomedical Engineering, University of Tennessee Health Science Center-Memphis Joint Graduate Biomedical Engineering Program, The University of Memphis, Memphis, TN 38152, USA
| | - Ting Li
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, China
| | - Linna Mao
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, China
| | - Joel D. Bumgardner
- Department of Biomedical Engineering, University of Tennessee Health Science Center-Memphis Joint Graduate Biomedical Engineering Program, The University of Memphis, Memphis, TN 38152, USA
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Astudillo Potes MD, Mitra I, Hanson K, Camilleri ET, Gaihre B, Shafi M, Hamouda A, Lu L, Elder BD. Biodegradable poly(caprolactone fumarate) 3D printed scaffolds for segmental bone defects within the Masquelet technique. J Orthop Res 2024. [PMID: 38522018 DOI: 10.1002/jor.25839] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/21/2024] [Accepted: 03/08/2024] [Indexed: 03/25/2024]
Abstract
Segmental bone defects, often clinically treated with nondegradable poly(methylmethacrylate) (PMMA) in multistage surgeries, present a significant clinical challenge. Our study investigated the efficacy of 3D printed biodegradable polycaprolactone fumarate (PCLF)/PCL spacers in a one-stage surgical intervention for these defects, focusing on early bone regeneration influenced by spacer porosities. We compared nonporous PCLF/PCL and PMMA spacers, conventionally molded into cylinders, with porous PCLF/PCL spacers, 3D printed to structurally mimic segmental defects in rat femurs for a 4-week implantation study. Histological analysis, including tissue staining and immunohistochemistry with bone-specific antibodies, was conducted for histomorphometry evaluation. The PCLF/PCL spacers demonstrated compressive properties within 6 ± 0.5 MPa (strength) and 140 ± 15 MPa (modulus). Both porous PCLF/PCL and Nonporous PMMA formed collagen-rich membranes (PCLF/PCL: 92% ± 1.3%, PMMA: 86% ± 1.5%) similar to those induced in the Masquelet technique, indicating PCLF/PCL's potential for one-stage healing. Immunohistochemistry confirmed biomarkers for tissue regeneration, underscoring PCLF/PCL's regenerative capabilities. This research highlights PCLF/PCL scaffolds' ability to induce membrane formation in critical-sized segmental bone defects, supporting their use in one-stage surgery. Both solid and porous PCLF/PCL spacers showed adequate compressive properties, with the porous variants exhibiting BMP-2 expression and woven bone formation, akin to clinical standard PMMA. Notably, the early ossification of the membrane into the pores of porous scaffolds suggests potential for bone interlocking and regeneration, potentially eliminating the need for a second surgery required for PMMA spacers. The biocompatibility and biodegradability of PCLF/PCL make them promising alternatives for treating critical bone defects, especially in vulnerable patient groups.
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Affiliation(s)
- Maria D Astudillo Potes
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA
- Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minnesota, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Indranath Mitra
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Kari Hanson
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Emily T Camilleri
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Bipin Gaihre
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mahnoor Shafi
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Lichun Lu
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Benjamin D Elder
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Zhao Y, Sun W, Wu X, Gao X, Song F, Duan B, Lu A, Yang H, Huang C. Janus Membrane with Intrafibrillarly Strontium-Apatite-Mineralized Collagen for Guided Bone Regeneration. ACS Nano 2024; 18:7204-7222. [PMID: 38373291 DOI: 10.1021/acsnano.3c12403] [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] [Indexed: 02/21/2024]
Abstract
Commercial collagen membranes face difficulty in guided bone regeneration (GBR) due to the absence of hierarchical structural design, effective interface management, and diverse bioactivity. Herein, a Janus membrane called SrJM is developed that consists of a porous collagen face to enhance osteogenic function and a dense face to maintain barrier function. Specifically, biomimetic intrafibrillar mineralization of collagen with strontium apatite is realized by liquid precursors of amorphous strontium phosphate. Polycaprolactone methacryloyl is further integrated on one side of the collagen as a dense face, which endows SrJM with mechanical support and a prolonged lifespan. In vitro experiments demonstrate that the dense face of SrJM acts as a strong barrier against fibroblasts, while the porous face significantly promotes cell adhesion and osteogenic differentiation through activation of calcium-sensitive receptor/integrin/Wnt signaling pathways. Meanwhile, SrJM effectively enhances osteogenesis and angiogenesis by recruiting stem cells and modulating osteoimmune response, thus creating an ideal microenvironment for bone regeneration. In vivo studies verify that the bone defect region guided by SrJM is completely repaired by newly formed vascularized bone. Overall, the outstanding performance of SrJM supports its ongoing development as a multifunctional GBR membrane, and this study provides a versatile strategy of fabricating collagen-based biomaterials for hard tissue regeneration.
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Affiliation(s)
- Yaning Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430072, China
| | - Wei Sun
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430072, China
| | - Xiaoyi Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430072, China
| | - Xin Gao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430072, China
| | - Fangfang Song
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430072, China
| | - Bo Duan
- Interdisciplinary Institute of NMR and Molecular Sciences, School of Chemistry and Chemical Engineering, Wuhan University of Science and Technology, Wuhan 430081, China
| | - Ang Lu
- College of Chemistry and Molecular Sciences, Wuhan University, Wuhan 430072, China
| | - Hongye Yang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430072, China
| | - Cui Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430072, China
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Xiao JH, Zhang ZB, Li J, Chen SM, Gao HL, Liao Y, Chen L, Wang Z, Lu Y, Hou Y, Wu H, Zou D, Yu SH. Bioinspired polysaccharide-based nanocomposite membranes with robust wet mechanical properties for guided bone regeneration. Natl Sci Rev 2024; 11:nwad333. [PMID: 38333231 PMCID: PMC10852990 DOI: 10.1093/nsr/nwad333] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/27/2023] [Accepted: 12/12/2023] [Indexed: 02/10/2024] Open
Abstract
Polysaccharide-based membranes with excellent mechanical properties are highly desired. However, severe mechanical deterioration under wet conditions limits their biomedical applications. Here, inspired by the structural heterogeneity of strong yet hydrated biological materials, we propose a strategy based on heterogeneous crosslink-and-hydration (HCH) of a molecule/nano dual-scale network to fabricate polysaccharide-based nanocomposites with robust wet mechanical properties. The heterogeneity lies in that the crosslink-and-hydration occurs in the molecule-network while the stress-bearing nanofiber-network remains unaffected. As one demonstration, a membrane assembled by bacterial cellulose nanofiber-network and Ca2+-crosslinked and hydrated sodium alginate molecule-network is designed. Studies show that the crosslinked-and-hydrated molecule-network restricts water invasion and boosts stress transfer of the nanofiber-network by serving as interfibrous bridge. Overall, the molecule-network makes the membrane hydrated and flexible; the nanofiber-network as stress-bearing component provides strength and toughness. The HCH dual-scale network featuring a cooperative effect stimulates the design of advanced biomaterials applied under wet conditions such as guided bone regeneration membranes.
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Affiliation(s)
- Jian-Hong Xiao
- Department of Chemistry, New Cornerstone Science Laboratory, Institute of Biomimetic Materials & Chemistry, Anhui Engineering Laboratory of Biomimetic Materials, Division of Nanomaterials & Chemistry, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230026, China
- Department of Dental Implant Center, Stomatologic Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, China
| | - Zhen-Bang Zhang
- Department of Chemistry, New Cornerstone Science Laboratory, Institute of Biomimetic Materials & Chemistry, Anhui Engineering Laboratory of Biomimetic Materials, Division of Nanomaterials & Chemistry, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230026, China
| | - JiaHao Li
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, CAS Center for Excellence in Complex System Mechanics, University of Science and Technology of China, Hefei 230027, China
| | - Si-Ming Chen
- Department of Chemistry, New Cornerstone Science Laboratory, Institute of Biomimetic Materials & Chemistry, Anhui Engineering Laboratory of Biomimetic Materials, Division of Nanomaterials & Chemistry, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230026, China
| | - Huai-Ling Gao
- Department of Chemistry, New Cornerstone Science Laboratory, Institute of Biomimetic Materials & Chemistry, Anhui Engineering Laboratory of Biomimetic Materials, Division of Nanomaterials & Chemistry, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230026, China
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, CAS Center for Excellence in Complex System Mechanics, University of Science and Technology of China, Hefei 230027, China
| | - YinXiu Liao
- Department of Oral Surgery, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
| | - Lu Chen
- Department of Oral Surgery, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
| | - ZiShuo Wang
- Department of Oral Surgery, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
| | - YiFan Lu
- Department of Dental Implant Center, Stomatologic Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, China
| | - YuanZhen Hou
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, CAS Center for Excellence in Complex System Mechanics, University of Science and Technology of China, Hefei 230027, China
| | - HengAn Wu
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, CAS Center for Excellence in Complex System Mechanics, University of Science and Technology of China, Hefei 230027, China
| | - DuoHong Zou
- Department of Dental Implant Center, Stomatologic Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, China
- Department of Oral Surgery, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
| | - Shu-Hong Yu
- Department of Chemistry, New Cornerstone Science Laboratory, Institute of Biomimetic Materials & Chemistry, Anhui Engineering Laboratory of Biomimetic Materials, Division of Nanomaterials & Chemistry, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230026, China
- Institute of Innovative Materials (I2M), Department of Chemistry, Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China
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Valamvanos TF, Dereka X, Katifelis H, Gazouli M, Lagopati N. Recent Advances in Scaffolds for Guided Bone Regeneration. Biomimetics (Basel) 2024; 9:153. [PMID: 38534838 DOI: 10.3390/biomimetics9030153] [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: 02/04/2024] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
The rehabilitation of alveolar bone defects of moderate to severe size is often challenging. Currently, the therapeutic approaches used include, among others, the guided bone regeneration technique combined with various bone grafts. Although these techniques are widely applied, several limitations and complications have been reported such as morbidity, suboptimal graft/membrane resorption rate, low structural integrity, and dimensional stability. Thus, the development of biomimetic scaffolds with tailor-made characteristics that can modulate cell and tissue interaction may be a promising tool. This article presents a critical consideration in scaffold's design and development while also providing information on various fabrication methods of these nanosystems. Their utilization as delivery systems will also be mentioned.
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Affiliation(s)
- Theodoros-Filippos Valamvanos
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Xanthippi Dereka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Hector Katifelis
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Gazouli
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- School of Science and Technology, Hellenic Open University, 26335 Patra, Greece
| | - Nefeli Lagopati
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Greece Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece
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13
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Park JY, Kwon YH, Song YW, Cha JK, Jung UW, Thoma D, Jung R. Is transmucosal healing of an implant as effective as submerged healing when simultaneous guided bone regeneration is performed? A preclinical study. J Clin Periodontol 2024; 51:330-337. [PMID: 38087817 DOI: 10.1111/jcpe.13913] [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: 06/22/2023] [Revised: 10/15/2023] [Accepted: 11/16/2023] [Indexed: 02/17/2024]
Abstract
AIM To investigate whether transmucosal healing is as effective as submerged healing in terms of buccal bone regeneration when guided bone regeneration (GBR) is performed simultaneously with implant placement. MATERIALS AND METHODS In six dogs, buccal dehiscence defects were created in the edentulous mandibular ridge, sized 5 × 5 × 3 mm (length × height × depth). In each defect, a bone-level implant was placed, and four experimental groups were randomly assigned as follows: (i) transmucosal healing with GBR (T-GBR), (ii) transmucosal healing without GBR (T-control), (iii) submerged healing with GBR (S-GBR) and (iv) submerged healing without GBR (S-control). Data analyses were based on histological slides 5 months after implant placement. RESULTS The T-GBR group showed significant differences compared to the control groups regarding defect height resolution, buccal bone thickness and mineralized tissue area (p < .05), but showed no significant differences when compared with the S-GBR group (p > .05). CONCLUSIONS The mode of healing (transmucosal vs. submerged) does not influence bone regeneration at implant sites. The clinician may therefore choose the approach based on further clinical and patient-specific parameters.
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Affiliation(s)
- Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Yoon-Hee Kwon
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Daniel Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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Lei M, Liao H, Wang S, Zhou H, Zhu J, Wan H, Payne GF, Liu C, Qu X. Electro-Sorting Create Heterogeneity: Constructing A Multifunctional Janus Film with Integrated Compositional and Microstructural Gradients for Guided Bone Regeneration. Adv Sci (Weinh) 2024; 11:e2307606. [PMID: 38225697 DOI: 10.1002/advs.202307606] [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: 10/11/2023] [Revised: 12/25/2023] [Indexed: 01/17/2024]
Abstract
Biology remains the envy of flexible soft matter fabrication because it can satisfy multiple functional needs by organizing a small set of proteins and polysaccharides into hierarchical systems with controlled heterogeneity in composition and microstructure. Here, it is reported that controlled, mild electronic inputs (<10 V; <20 min) induce a homogeneous gelatin-chitosan mixture to undergo sorting and bottom-up self-assembly into a Janus film with compositional gradient (i.e., from chitosan-enriched layer to chitosan/gelatin-contained layer) and tunable dense-porous gradient microstructures (e.g., porosity, pore size, and ratio of dense to porous layers). This Janus film performs is shown multiple functions for guided bone regeneration: the integration of compositional and microstructural features confers flexible mechanics, asymmetric properties for interfacial wettability, molecular transport (directional growth factor release), and cellular responses (prevents fibroblast infiltration but promotes osteoblast growth and differentiation). Overall, this work demonstrates the versatility of electrofabrication for the customized manufacturing of functional gradient soft matter.
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Affiliation(s)
- Miao Lei
- Key Laboratory for Ultrafine Materials of Ministry of Education, Frontiers Science Center for Materiobiology and Dynamic Chemistry, School of materials science and engineering, East China University of Science and Technology, Shanghai, 200237, China
| | - Haitao Liao
- Key Laboratory for Ultrafine Materials of Ministry of Education, Frontiers Science Center for Materiobiology and Dynamic Chemistry, School of materials science and engineering, East China University of Science and Technology, Shanghai, 200237, China
| | - Shijia Wang
- Key Laboratory for Ultrafine Materials of Ministry of Education, Frontiers Science Center for Materiobiology and Dynamic Chemistry, School of materials science and engineering, East China University of Science and Technology, Shanghai, 200237, China
| | - Hang Zhou
- Key Laboratory for Ultrafine Materials of Ministry of Education, Frontiers Science Center for Materiobiology and Dynamic Chemistry, School of materials science and engineering, East China University of Science and Technology, Shanghai, 200237, China
| | - Jianwei Zhu
- Key Laboratory for Ultrafine Materials of Ministry of Education, Frontiers Science Center for Materiobiology and Dynamic Chemistry, School of materials science and engineering, East China University of Science and Technology, Shanghai, 200237, China
| | - Haoran Wan
- Key Laboratory for Ultrafine Materials of Ministry of Education, Frontiers Science Center for Materiobiology and Dynamic Chemistry, School of materials science and engineering, East China University of Science and Technology, Shanghai, 200237, China
| | - Gregory F Payne
- Institute for Bioscience and Biotechnology Research and Robert E. Fischell Biomedical Device Institute, 5118 A. James Clark Hall, College Park, Maryland, 20742, USA
| | - Changsheng Liu
- Key Laboratory for Ultrafine Materials of Ministry of Education, Frontiers Science Center for Materiobiology and Dynamic Chemistry, School of materials science and engineering, East China University of Science and Technology, Shanghai, 200237, China
| | - Xue Qu
- Key Laboratory for Ultrafine Materials of Ministry of Education, Frontiers Science Center for Materiobiology and Dynamic Chemistry, School of materials science and engineering, East China University of Science and Technology, Shanghai, 200237, China
- Shanghai Frontier Science Research Base of Optogenetic Techniques for Cell Metabolism, East China University of Science and Technology, Shanghai, 200237, China
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Hernández-Alfaro F, Valls-Ontañón A, Bertos-Quílez J, Giralt-Hernando M, Ragucci GM. Vascular Delay Soft Tissue Technique in Oral/Maxillary Bone Reconstructive Surgery: A Technical Note. Int J Oral Maxillofac Implants 2024; 39:135-141. [PMID: 38416007 DOI: 10.11607/jomi.10477] [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 The present study describes a new presurgical soft tissue technique in oral/maxillary bone reconstructive surgery for reducing the risk of soft tissue dehiscence and its related complications. MATERIALS AND METHODS Ten consecutive patients with Cawood and Howell type V atrophy were scheduled for CAD/CAM titanium mesh bone reconstructive surgery after applying the vascular delay technique 21 days before regenerative surgery. The surgical and healing complications were clinically assessed at nine time points, ranging from the time of bone regenerative surgery to 9 months after surgery. Surgical complications included flap damage and neurologic and vascular complications. Healing complications were subdivided into four classes. These classes comprised Class I: small membrane exposure (≤ 3 mm) without purulent exudate; Class II: large membrane exposure (> 3 mm) without purulent exudate; Class III: membrane exposure with purulent exudate; and Class IV: abscess formation without membrane. RESULTS The study sample included seven men and three women (mean age: 48.2 ± 3.5 years) with seven mandibular cases and three maxillary cases. The defect length ranged from three to six teeth, with a mean mesiodistal distance of 29.9 ± 8.5 mm and a mean volume augmentation of 2.03 ± 0.9 cm3. There were no surgical complications. One patient presented a Class I healing complication that did not affect the regeneration outcome. CONCLUSIONS The vascular delay technique appears to reduce the risk of soft tissue dehiscence and exposure in bone regenerative surgery, though randomized studies involving larger samples and longer follow-up periods are needed in order to draw firm conclusions.
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Devina AA, Halim FC, Sulijaya B, Sumaringsih PR, Dewi RS. Simultaneous Implant and Guided Bone Regeneration Using Bovine-Derived Xenograft and Acellular Dermal Matrix in Aesthetic Zone. Dent J (Basel) 2024; 12:52. [PMID: 38534276 DOI: 10.3390/dj12030052] [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: 01/20/2024] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION Implant placement in the maxillary anterior area requires sufficient quantity and quality of both soft and hard tissue. In cases where soft and hard tissues are insufficient, additional regeneration using biomaterials is recommended. Treatment using bovine-derived xenograft and acellular dermal matrix (ADM) may increase bone volume and soft tissue thickness. Case and management: A 65-year-old woman sought help for discomfort and aesthetic issues with her denture, reporting missing teeth (11, 12, 13, 14, and 21) and bone volume shrinkage due to disuse atrophy. Intraoral examination revealed 1 mm gingival thickness. CBCT showed labio-palatal bone thickness of 6.0 mm, 5.8 mm, and 4.7 mm for teeth 21, 12 and 14, respectively. Implant planning and surgical guide fabrication were carried out before the surgery. Surgery included the placement of implants 3.3 mm in diameter and 12 mm in length, with the use of xenograft and ADM. Three months post-op, improvements in soft and hard tissues were observed, with a final prosthesis being a long-span implant-supported bridge. CONCLUSIONS Disuse alveolar atrophy causes soft and hard tissue deficiency. The use of xenograft and ADM show favourable results even on a geriatric patient.
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Affiliation(s)
- Anggun Alfreda Devina
- Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Felita Clarissa Halim
- Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Benso Sulijaya
- Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Patricia Rinanti Sumaringsih
- Prosthodontics Specialist Program, Department of Prosthodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Ratna Sari Dewi
- Department of Prosthodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
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Sohn DS, Lui A, Choi H. Utilization of Tenting Pole Abutments for the Reconstruction of Severely Resorbed Alveolar Bone: Technical Considerations and Case Series Reports. J Clin Med 2024; 13:1156. [PMID: 38398468 PMCID: PMC10889334 DOI: 10.3390/jcm13041156] [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: 12/15/2023] [Revised: 01/18/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION Although various surgical techniques have been utilized in the reconstruction of severely resorbed alveolar bone, its regeneration is still regarded as a major challenge. Most of the surgical techniques used in advanced ridge augmentation have the disadvantages of prolonging the patient's edentulous healing and increasing the need for surgical revisits because simultaneous implant placement is not allowed. This report presents a new and simplified method for advanced ridge augmentation, which utilizes a vertical tenting device. CASE PRESENTATION The first case presented the reconstruction of the mandibular posterior region with severely resorbed alveolar bone due to peri-implantitis using tenting pole abutment for ridge augmentation. The second and third cases presented three-dimensional ridge augmentations in severely resorbed ridges due to periodontitis. The last case presented horizontal ridge augmentation using a vertical tenting device. All cases were performed under local anesthesia. Implants were simultaneously placed in the bone defect area. A vertical tensioning device was then connected to the implant platform to minimize the collapse of the bone graft during the bone regeneration period due to the contraction of the soft tissue matrix. A sticky bone graft was transplanted onto the exposed surface of the implant and on top of the vertical tensioning device. After covering with an absorbable barrier membrane, the soft tissues were sutured without tension. CONCLUSIONS In all cases, prosthetic restorations were provided to patients after a bone grafting period of 5-6 months, leading to a rapid restoration of masticatory function. Results tracked for up to 6 years revealed observed stable reconstruction of the alveolar bone. The use of a vertical tenting device can prevent the collapse of biomaterials in the augmented ridge during the healing period, leading to predictable outcomes when achieving three-dimensional ridge augmentation.
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Affiliation(s)
- Dong-Seok Sohn
- Department of Dentistry and Oral and Maxillofacial Surgery, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea
| | - Albert Lui
- Private Practice, Calgary, AB T2P 2Y3, Canada;
| | - Hyunsuk Choi
- Department of Dentistry and Prosthodontics, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea;
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Park JY, Kwon YH, Song YW, Cha JK, Jung UW, Jung RE, Thoma DS. Flapless early implant placement into the uncalcified provisional matrix-Does it lead to osseointegration of the implant? A preclinical study. J Clin Periodontol 2024. [PMID: 38356227 DOI: 10.1111/jcpe.13963] [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: 09/05/2023] [Revised: 01/08/2024] [Accepted: 02/01/2024] [Indexed: 02/16/2024]
Abstract
AIM To test whether early implant placement into the extraction socket containing an uncalcified provisional matrix leads to successful osseointegration and stable marginal bone levels. MATERIALS AND METHODS In six mongrel dogs, the mandibular molars were extracted. Three weeks later, early implant placement was performed according to three experimental protocols: (i) flapless implant placement with preservation of the provisional matrix; (ii) flap elevation, socket debridement and implant placement; and (iii) flap elevation, socket debridement, implant placement and guided bone regeneration (GBR). One untreated extraction socket served as a control group. Data analyses were based on histologic slides 3 months after implant placement. RESULTS There were no differences in bone-to-implant contact between the three experimental groups (66.97%, 58.89% and 60.89%, respectively) (inter-group comparison p = .42). Marginal bone levels, first bone-to-implant contact as well as the thickness of the connective tissue did not reveal any significant differences between the groups (p = .85, .60 and .65, respectively). CONCLUSIONS Flapless early implant placement into posterior extraction sockets was as effective as an open flap approach in conjunction with GBR. Mineralization of the socket seems to occur irrespective of the presence of dental implants or biomaterials.
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Affiliation(s)
- Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Yoon-Hee Kwon
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Young Woo Song
- Department of Periodontology, Dental Hospital, Veterans Health Service Medical Center, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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Shanbhag S, Al-Sharabi N, Kampleitner C, Mohamed-Ahmed S, Kristoffersen EK, Tangl S, Mustafa K, Gruber R, Sanz M. The use of mesenchymal stromal cell secretome to enhance guided bone regeneration in comparison with leukocyte and platelet-rich fibrin. Clin Oral Implants Res 2024; 35:141-154. [PMID: 37964421 DOI: 10.1111/clr.14205] [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: 06/02/2023] [Revised: 09/25/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES Secretomes of mesenchymal stromal cells (MSC) represent a novel strategy for growth-factor delivery for tissue regeneration. The objective of this study was to compare the efficacy of adjunctive use of conditioned media of bone-marrow MSC (MSC-CM) with collagen barrier membranes vs. adjunctive use of conditioned media of leukocyte- and platelet-rich fibrin (PRF-CM), a current growth-factor therapy, for guided bone regeneration (GBR). METHODS MSC-CM and PRF-CM prepared from healthy human donors were subjected to proteomic analysis using mass spectrometry and multiplex immunoassay. Collagen membranes functionalized with MSC-CM or PRF-CM were applied on critical-size rat calvaria defects and new bone formation was assessed via three-dimensional (3D) micro-CT analysis of total defect volume (2 and 4 weeks) and 2D histomorphometric analysis of central defect regions (4 weeks). RESULTS While both MSC-CM and PRF-CM revealed several bone-related proteins, differentially expressed proteins, especially extracellular matrix components, were increased in MSC-CM. In rat calvaria defects, micro-CT revealed greater total bone coverage in the MSC-CM group after 2 and 4 weeks. Histologically, both groups showed a combination of regular new bone and 'hybrid' new bone, which was formed within the membrane compartment and characterized by incorporation of mineralized collagen fibers. Histomorphometry in central defect sections revealed greater hybrid bone area in the MSC-CM group, while the total new bone area was similar between groups. CONCLUSION Based on the in vitro and in vivo investigations herein, functionalization of membranes with MSC-CM represents a promising strategy to enhance GBR.
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Affiliation(s)
- Siddharth Shanbhag
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Niyaz Al-Sharabi
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Carina Kampleitner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, The Research Center in Cooperation with AUVA, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Samih Mohamed-Ahmed
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Einar K Kristoffersen
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Kamal Mustafa
- Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Reinhard Gruber
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mariano Sanz
- ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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Bianconi S, Romanos G, Testori T, Del Fabbro M. Management of Advanced Peri-Implantitis by Guided Bone Regeneration in Combination with Trabecular Metal Fixtures, Two Months after Removal of the Failed Implants: Two-Year Results of a Single-Cohort Clinical Study. J Clin Med 2024; 13:713. [PMID: 38337407 PMCID: PMC10856143 DOI: 10.3390/jcm13030713] [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: 12/27/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Implant replacement is among the treatment options for severe peri-implantitis. The aim of this single-cohort study was to evaluate the feasibility of replacing compromised implants affected by advanced peri-implantitis with new implants with a porous trabecular metal (TM) structure. Materials and Methods: Patients with one or more implants in the posterior region showing a defect depth >50% of implant length, measured from the residual crest, were consecutively included. Two months after implant removal, patients received a TM implant combined with a xenograft and a resorbable membrane. The implant stability quotient (ISQ) was measured at placement and re-assessed five months later (at uncovering), then after 6, 12, and 24 months of function. Marginal bone loss was radiographically evaluated. Results: Twenty consecutive cases were included. One patient dropped out due to COVID-19 infection, and nineteen cases were evaluated up to 24 months. At placement, the mean ISQ was 53.08 ± 13.65 (standard deviation), which increased significantly to 69.74 ± 9.01 after five months of healing (p < 0.001) and to 78.00 ± 7.29 after six months of loading (p < 0.001). Thereafter, the ISQ remained stable for up to 24 months (80.55 ± 4.73). All implants successfully osseointegrated and were restored as planned. After two years, the average marginal bone level change was -0.41 ± 0.38 mm (95% confidence interval -0.60, -0.21), which was limited yet significantly different from the baseline (p < 0.05). Conclusions: The treatment of advanced peri-implant defects using TM implants inserted two months after explantation in combination with guided bone regeneration may achieve successful outcomes up to two years follow-up, even in the presence of low primary stability.
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Affiliation(s)
- Stefano Bianconi
- Department of Oral Surgery and Dentistry, General Hospital, 39100 Bolzano, Italy;
| | - Georgios Romanos
- Department of Periodontics and Endodontics, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Tiziano Testori
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 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
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 01451, USA
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy;
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Bragaglia M, Sciarretta F, Filetici P, Lettieri-Barbato D, Dassatti L, Nicoletti F, Sibilia D, Aquilano K, Nanni F. Soybean Oil-Based 3D Printed Mesh Designed for Guided Bone Regeneration (GBR) in Oral Surgery. Macromol Biosci 2024:e2300458. [PMID: 38198834 DOI: 10.1002/mabi.202300458] [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: 10/08/2023] [Revised: 12/22/2023] [Indexed: 01/12/2024]
Abstract
This study aims to obtain a cyto-compatible 3D printable bio-resin for the manufacturing of meshes designed from acquired real patients' bone defect to be used in future for guided bone regeneration (GBR), achieving the goal of personalized medicine, decreasing surgical, recovery time, and patient discomfort. To this purpose, a biobased, biocompatible, and photo-curable resin made of acrylated epoxidized soybean oil (AESO) diluted with soybean oil (SO) is developed and 3D printed using a commercial digital light processing (DLP) 3D printer. 3D printed samples show good thermal properties, allowing for thermally-based sterilization process and mechanical properties typical of crosslinked natural oils (i.e., E = 12 MPa, UTS = 1.5 MPa), suitable for the GBR application in the oral surgery. The AESO-SO bio-resin proves to be cytocompatible, allowing for fibroblast cells proliferation (viability at 72 h > 97%), without inducing severe inflammatory response when co-cultured with macrophages, as demonstrated by cytokine antibody arrays, that is anyway resolved in the first 24 h. Moreover, accelerated degradation tests prove that the bio-resin is biodegradable in hydrolytic environments.
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Affiliation(s)
- Mario Bragaglia
- Department of Enterprise Engineering, University of Rome "Tor Vergata", Via del Politecnico 1, Rome, 00133, Italy
| | | | - Pierfrancesco Filetici
- Multispecialty Department of Oral Surgery - Periodontology and Implant-Prosthodontic Rehabilitation, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome, 00168, Italy
| | | | - Leonardo Dassatti
- Multispecialty Department of Oral Surgery - Periodontology and Implant-Prosthodontic Rehabilitation, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome, 00168, Italy
| | - Fabrizio Nicoletti
- Multispecialty Department of Oral Surgery - Periodontology and Implant-Prosthodontic Rehabilitation, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Rome, 00168, Italy
| | - Diego Sibilia
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Largo F. Vito, 1, Rome, 00168, Italy
| | - Katia Aquilano
- Department of Biology, University of Rome "Tor Vergata", Via della Ricerca scientifica 1, Rome, 00133, Italy
| | - Francesca Nanni
- Department of Enterprise Engineering, University of Rome "Tor Vergata", Via del Politecnico 1, Rome, 00133, Italy
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Wang X, Shen P, Gu N, Shao Y, Lu M, Tang C, Wang C, Chu C, Xue F, Bai J. Dual Mg-Reinforced PCL Membrane with a Janus Structure for Vascularized Bone Regeneration and Bacterial Elimination. ACS Biomater Sci Eng 2024; 10:537-549. [PMID: 38065085 DOI: 10.1021/acsbiomaterials.3c01360] [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] [Indexed: 01/09/2024]
Abstract
Commercially available guided bone regeneration (GBR) membranes often exhibit limited mechanical properties or bioactivity, leading to poor performance in repairing bone defects. To surmount this limitation, we developed a Janus structural composite membrane (Mg-MgO/PCL) reinforced by dual Mg (Mg sheets and MgO NPs) by using a combined processing technique involving casting and electrospinning. Results showed that the addition of Mg sheets and MgO NPs enhanced the mechanical properties of the composite membrane for osteogenic space maintenance, specifically tensile strength (from 10.2 ± 1.2 to 50.3 ± 4.5 MPa) and compression force (from 0 to 0.94 ± 0.09 N mm-1), through Mg sheet reinforcement and improved crystallization. The dense cast side of the Janus structure membrane displayed better fibroblast barrier capacity than a single fiber structure; meanwhile, the PCL matrix protected the Mg sheet from severe corrosion due to predeformation. The porous microfibers side supported preosteoblast cell adhesion, enhanced osteogenesis, and angiogenesis in vitro, through the biomimetic extracellular matrix and sustainable Mg2+ release. Furthermore, the Mg-MgO/PCL membrane incorporating 2 wt % MgO NPs exhibited remarkable antimicrobial properties, inducing over 88.75% apoptosis in Staphylococcus aureus. An in vivo experiment using the rat skull defect model (Φ = 5 mm) confirmed that the Mg-MgO/PCL membrane significantly improved new bone formation postsurgery. Collectively, our investigation provides valuable insights into the design of multifunctional membranes for clinical oral GBR application.
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Affiliation(s)
- Xianli Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Peiqi Shen
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Nannan Gu
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Yi Shao
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Mengmeng Lu
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
| | - Chunbo Tang
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
| | - Cheng Wang
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Chenglin Chu
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Feng Xue
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Jiangning, Nanjing 211189, Jiangsu, China
- Jiangsu Key Laboratory for Advanced Metallic Materials, Jiangning, Nanjing 211189, Jiangsu, China
- Institute of Medical Devices (Suzhou), Southeast University, Suzhou 215000, China
- Jiangsu Key Laboratory for Light Metal Alloys, Nanjing 211224, Jiangsu, China
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Abe GL, Sasaki JI, Tsuboi R, Kohno T, Kitagawa H, Imazato S. Poly(lactic acid/caprolactone) bilayer membrane achieves bone regeneration through a prolonged barrier function. J Biomed Mater Res B Appl Biomater 2024; 112:e35365. [PMID: 38247248 DOI: 10.1002/jbm.b.35365] [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: 08/24/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 01/23/2024]
Abstract
Guided bone regeneration (GBR) is a treatment strategy used to recover bone volume. Barrier membranes are a key component of GBR protocols, and their properties can impact treatment outcomes. This study investigated the efficacy of an experimental, slow-degrading, bilayer barrier membrane for application in GBR using in vivo animal models. A synthetic copolymer of poly(lactic acid/caprolactone) (PLCL) was used to prepare a slow-degrading bilayer membrane. The biodegradability of PLCL was evaluated by subcutaneous implantation in a rat model. The barrier function of the PLCL membrane was investigated in a rat calvaria defect model and compared with commercially available membranes composed of type I collagen (Col) and poly(lactic-co-glycolic acid) (PLGA). An alveolar bone defect model in beagle dogs was used to simulate GBR protocols to evaluate the bone regeneration ability of the experimental PLCL membrane. The PLCL membrane showed slow biodegradation, resulting in an efficient and prolonged barrier function compared with commercial materials. In turn, this barrier function enabled the space-making ability of PLCL membrane and facilitated bone regeneration. In the alveolar bone defect model, significantly greater regeneration was achieved by treatment with PLCL membrane compared with Col and PLGA membranes. Additionally, a continuous alveolar ridge contour was observed in PLCL-treated bone defects. In conclusion, the PLCL bilayer membrane is a promising biomaterial for use in GBR given its slow degradation and prolonged barrier function.
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Affiliation(s)
- Gabriela L Abe
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Osaka, Japan
- Joint Research Laboratory of Advanced Functional Materials Science, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Jun-Ichi Sasaki
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ririko Tsuboi
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Tomoki Kohno
- Joint Research Laboratory of Advanced Functional Materials Science, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Haruaki Kitagawa
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Osaka, Japan
- Joint Research Laboratory of Advanced Functional Materials Science, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Satoshi Imazato
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Osaka, Japan
- Joint Research Laboratory of Advanced Functional Materials Science, Osaka University Graduate School of Dentistry, Osaka, Japan
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Romito GA, Fonseca MA, Soares HH, de Oliveira Lazarin R, Sapata VM, Nishyama R, Conde MC, Hammerle CHF, Schwarz F, Villar CC. Clinical outcomes following atrophic alveolar ridge reconstruction using collagenated xenogeneic bone block or autogenous bone block: One-year follow-up of a randomized controlled clinical. J Clin Periodontol 2024; 51:14-23. [PMID: 37846853 DOI: 10.1111/jcpe.13891] [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: 09/21/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
AIM This investigation aimed to evaluate the 1-year survival of implants placed after staged lateral alveolar ridge augmentation using equine-derived collagenated xenogeneic bone blocks (CXBBs) or autogenous bone block (ABB). MATERIALS AND METHODS Fifty patients who underwent lateral augmentation in a previous trial were included. The primary outcome measure was implant survival at the 1-year follow-up, and secondary outcomes included implant success, peri-implant clinical and volumetric parameters, pink aesthetic scores (PES) and patient-reported outcome measures. Data analysis involved Fisher's exact test, the Mann-Whitney U-test and the Wilcoxon signed-rank test. RESULTS In this study, no late implant failures were observed. The cumulative survival rates were 78.6% for the CXBB group and 90.9% for the ABB group, with no difference between the groups. Similarly, the success rates were 53.6% and 63.6%, respectively, showing no significant difference. Peri-implant clinical and volumetric parameters indicated the presence of healthy peri-implant tissues surrounding implants placed in both CXBB- and ABB-augmented sites. PES were 8.5 and 11.0 for implants placed in CXBB- and ABB-augmented sites, respectively. Furthermore, patient satisfaction rates were high and similar between the groups. CONCLUSIONS Dental implants placed in both CXBB- and ABB-augmented ridges demonstrated no statistically significant differences in clinical, volumetric and aesthetic outcomes, along with high patient satisfaction rates.
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Affiliation(s)
| | | | - Herbert Horiuti Soares
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Vitor Marques Sapata
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Roger Nishyama
- Discipline of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marina Clemente Conde
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Cristina Cunha Villar
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
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25
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Kan JYK, Rungcharassaeng K, Yin S, Kang P, Celenza F, Spear F, Chung JY, Lozada JL. Orthodontic tooth extrusion to regenerate missing papilla adjacent to maxillary anterior single implants: A 2- to 7-year retrospective study. J ESTHET RESTOR DENT 2024; 36:124-134. [PMID: 37830507 DOI: 10.1111/jerd.13147] [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: 09/13/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Regeneration of the missing papilla adjacent to single implants in the esthetic zone has always been challenging, despite advances in vertical hard and soft tissue regeneration. Orthodontic tooth extrusion has been shown to effectively gain alveolar bone and gingival tissue. This retrospective study evaluated the effectiveness of orthodontic tooth extrusion on regenerating missing papilla between existing maxillary anterior single implant and its adjacent tooth. METHODS Patients who underwent orthodontic tooth extrusion to regenerate missing papilla adjacent to a single implant in the esthetic zone were included in this study. The gingival phenotype, orthodontic extrusion movement, proximal bone level, dento-implant papilla level, facial gingival level, mucogingival junction level, and keratinized tissue width, of the extruded tooth were recorded at pre-orthodontic extrusion (T0 ), post-orthodontic extrusion and retention (T1 ), and latest follow-up (T2 ). RESULTS A total of 17 maxillary single tooth had orthodontic tooth extrusion to regenerate missing papilla adjacent to 14 maxillary anterior single implants in 14 patients. After a mean follow-up time of 48.4 months, implant success rate was 100% (14/14), with none of the orthodontically extruded teeth being extracted. After a mean extrusion and retention period of 14.3 months, a mean orthodontic extrusion movement of 4.62 ± 0.78 mm was noted with a mean proximal bone level gain of 3.54 ± 0.61 mm (77.0% efficacy), dento-implant papilla level gain of 3.98 ± 0.81 mm (86.8% efficacy), and facial gingival tissue gain of 4.27 mm ± 0.55 mm (93.4% efficacy). A mean keratinized tissue width gain of 4.17 ± 0.49 mm with minimal mean mucogingival junction level change of 0.10 ± 0.30 mm were observed. The efficacy of orthodontic eruption movement on dento-implant papilla gain was less in the thin (80.5%) phenotype group when compared with that in the thick (91.5%) phenotype group. CONCLUSIONS Within the confines of this study, orthodontic extrusion is an effective, noninvasive method in regenerating mid-term stable proximal bone and papilla adjacent to maxillary anterior single implants. CLINICAL SIGNIFICANCE This retrospective study presents a mid-term result on orthodontic extrusion as a mean to regenerate dento-implant papilla defect. The extended retention period following orthodontic extrusion showed stable and efficacious proximal bone and papilla gain.
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Affiliation(s)
- Joseph Y K Kan
- Advanced Education in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | | | - Shi Yin
- Advanced Education in Periodontics and Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | - Philip Kang
- Division of Periodontics, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Frank Celenza
- Private practice in Orthodontics and Periodontics, New York, New York, USA
- Department of Orthodontics, Rutgers University, Newark, New Jersey, USA
| | | | - Ji Yeon Chung
- Advanced Education in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | - Jaime L Lozada
- Advanced Education in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, California, USA
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Mirica IC, Furtos G, Moldovan M, Prodan D, Petean I, Campian RS, Pall E, Lucaciu O. Morphology, Cytotoxicity, and Antimicrobial Activity of Electrospun Polycaprolactone Biomembranes with Gentamicin and Nano-Hydroxyapatite. Membranes (Basel) 2023; 14:10. [PMID: 38248701 PMCID: PMC10819002 DOI: 10.3390/membranes14010010] [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: 11/13/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024]
Abstract
The aim of this research is to develop new nanocomposite membranes (NMs) for guided bone regeneration from polycaprolactone (PCL), with different concentrations of gentamicin sulfate (GEN) and nano-hydroxyapatite (nHAP) through electrospinning. The obtained NMs were characterized for structure through SEM and AFM, which revealed the influence of GEN and nHAP on the fiber diameter. The addition of GEN lowered the fiber diameter, and the addition of nHAP increased the diameter of the fibers. The NMs demonstrated antibacterial properties against P. aeruginosa, S. aureus, B. cereus, and E. coli depending on the drug concentration, while being negligibly affected by the nHAP content. NM cytotoxicity assessment, performed once using the MTT assay, revealed no cytotoxicity. The developed NMs could be a promising alternative for guided bone regeneration.
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Affiliation(s)
- Ioana-Codruta Mirica
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania; (I.-C.M.); (R.-S.C.); (O.L.)
| | - Gabriel Furtos
- Department of Dental Materials, Raluca Ripan, Institute of Research in Chemistry, Babes-Bolyai University, 400294 Cluj-Napoca, Romania; (M.M.); (D.P.)
| | - Marioara Moldovan
- Department of Dental Materials, Raluca Ripan, Institute of Research in Chemistry, Babes-Bolyai University, 400294 Cluj-Napoca, Romania; (M.M.); (D.P.)
| | - Doina Prodan
- Department of Dental Materials, Raluca Ripan, Institute of Research in Chemistry, Babes-Bolyai University, 400294 Cluj-Napoca, Romania; (M.M.); (D.P.)
| | - Ioan Petean
- Faculty of Chemistry and Chemical Engineering, Babes-Bolyai University, 400294 Cluj-Napoca, Romania;
| | - Radu-Septimiu Campian
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania; (I.-C.M.); (R.-S.C.); (O.L.)
| | - Emoke Pall
- Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania;
| | - Ondine Lucaciu
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania; (I.-C.M.); (R.-S.C.); (O.L.)
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Chantiri M, Nammour S, El Toum S, Zeinoun T. Effect of rh-BMP-2 in the Initiation of Neovascularization in Human Gingival Tissue: A Split-Mouth Clinical Study. Life (Basel) 2023; 13:2298. [PMID: 38137899 PMCID: PMC10744365 DOI: 10.3390/life13122298] [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: 10/08/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
The aim of this study is to evaluate the effect on the initiation of new blood vessel formation of rh-BMP-2 administration in the human gingival tissue during bone regeneration surgery. MATERIAL AND METHODS The randomized controlled clinical trial included twenty patients with bilateral partial edentulous of the mandibular premolar and molar region. Each patient received one implants on each side. Only one side received a 0.25 µg injection of rhBMP-2 into the gingival flap and grafted material during guided bone regeneration (GBR) for dental implantation. And the other side received GBR without injection. Three samples were collected from each patient as follows: one from the anterior area of the mandible (control group #1) collected at the time of all implant surgeries, and the two other samples during the placement of healing abutments at 4 months of follow-up, from treated side with rh-BMP-2 (test group) and untreated ones (control group #2). A total of 60 gingival samples were collected. Samples were stained with hematoxylin-eosin, and immunohistochemistry was performed with a vascular endothelial growth factor marker. The number of new vessels in each sample was counted. RESULT Statistical analyses showed a significantly higher number of new vessels in the gingival tissue of the test group. CONCLUSIONS Rh-BMP-2 injections into the gingival flap significantly improved new blood vessel formation.
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Affiliation(s)
- Mansour Chantiri
- Department of Periodontology, Faculty of Dental Medicine, Lebanese University, Beirut 27798, Lebanon;
| | - Samir Nammour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Sami El Toum
- Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut 27798, Lebanon;
| | - Toni Zeinoun
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut 27798, Lebanon;
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Surendran S, Rohinikumar S, Eswaramoorthy R, M K, Nesappan T, Rp A. Chitosan-Reinforced Gelatin Microspheres-Modified Glass Ionomer Cement (GIC): A Novel Bone Alloplast Graft Material Synthesis and an In Vivo Analysis. Cureus 2023; 15:e50384. [PMID: 38213376 PMCID: PMC10782189 DOI: 10.7759/cureus.50384] [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: 10/01/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
Aim and objective The study aimed to assess and evaluate the efficacy of glass ionomer modified with chitosan-reinforced gelatin microspheres on bone formation. Materials and methods The study involved three groups: Group I comprised plain glass ionomer cement; Group II comprised glass ionomer cement/gelatin (70:30 wt%); in Group III, glass ionomer cement/gelatin/chitosan (70:30%) scaffold were made into discs; the gelatin microspheres were synthesized by oil emulsion method. The synthesized scaffold was subjected to the following in vitro testing, Instron Universal Testing Machine (UTM), U3000, (Instron Corporation, Norwood, Massachusetts, United States) to assess compressive strength, scanning electron microscope (SEM) examination, and biocompatibility testing using hemocompatibility assay. The material was then tested in vivo; male Wistar albino rats, a total of nine animals, were utilized for this purpose. Three animals were used in each group; a femoral defect model was the model of choice for the experiment and the animals were observed for a period of four weeks, following which the animals were sacrificed and sent for histopathological analysis. Results The compression testing was carried out using UTM; test group I was 33 MPa, test group II was 2.3 MPa, and test group III was 25.75 MPa. SEM (JSM-IT800 Schottky Field Emission NANO SEM (JEOL, Tokyo, Japan)) analysis was done to observe the porosity of the fabricated scaffold with the average measurement of 0.12 ± 0.2 μm in test group II and 0.29 ± 0.4 μm in test group III. Hemocompatibility reports noted 0.4-0.8% lysis for the synthesized scaffolds. Histopathology staining of the femur defects showed that group III favoured bone formation. One-way analysis of variance (ANOVA) and post hoc Bonferroni test was done on the data. The optical density values of the alizarin red stained slide showed statistical significance for group III. Conclusion In conclusion, the synthesized scaffolds are biocompatible, distribution of porosity and pore characteristics in the glass ionomer cement/gelatin/chitosan group is better than that of the glass ionomer cement/gelatin group. The glass ionomer cement/gelatin/chitosan group had better compressive strength and induced more bone formation compared to the other test group and the control. Thus, the novel glass ionomer modified with chitosan-reinforced gelatin microspheres has optimal properties to be used as a bone graft material.
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Affiliation(s)
- Sundaram Surendran
- Prosthodontics and Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Subhashree Rohinikumar
- Prosthodontics and Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Rajalakshmanan Eswaramoorthy
- Prosthodontics and Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Karthik M
- Prosthodontics and Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Thiyaneswaran Nesappan
- Prosthodontics and Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Abhinav Rp
- Prosthodontics and Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Shah B, Dukka H, Alhachache S, Hill M, Cheng G, Sekula M. Analysis of risk factors for early crestal bone loss in osseointegrated, submerged implants prior to restoration. J Periodontol 2023; 94:1405-1413. [PMID: 37436693 DOI: 10.1002/jper.23-0161] [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: 03/13/2023] [Revised: 05/09/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Evidence on the etiology behind bone loss around submerged, prosthetically nonloaded implants is still limited. The long-term stability and success of implants with early crestal bone loss (ECBL), especially when placed as two-stage implants, is uncertain. Hence, the aim of this retrospective study is to analyze the potential patient-level, tooth- and implant-related factors for ECBL around osseointegrated, submerged implants, before restoration as compared with healthy implants with no bone loss. METHODS Retrospective data were collected from patient electronic health records between 2015 and 2022. Control sites included healthy implants with no bone loss and test sites included implants with ECBL, both of which were submerged. Patient, tooth and implant level data were collected. ECBL was assessed using periapical radiographs obtained during implant placement and second-stage surgeries. Generalized estimating equation logistic regression models were used to account for multiple implants within patients. RESULTS The total number of implants included in the study was 200 from 120 patients. Lack of supportive periodontal therapy (SPT) was shown to have nearly five-times higher risk of developing ECBL and was statistically significant (p < 0.05). Guided bone regeneration (GBR) procedures before implant placement had a protective effect with an odds ratio of 0.29 (p < 0.05). CONCLUSIONS Lack of SPT was significantly associated with ECBL, while sites that received GBR procedures prior to implant placement were less likely to exhibit ECBL. Our results underscore the importance of periodontal treatment and SPT for peri-implant health, even when the implants are submerged and unrestored.
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Affiliation(s)
- Bansari Shah
- Private Practice, Naperville, Naperville, Illinois, USA
| | - Himabindu Dukka
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Sara Alhachache
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Margaret Hill
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - GuoLiang Cheng
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Michael Sekula
- Department of Bioinformatics & Biostatistics, University of Louisville School of Public Health, Louisville, Kentucky, USA
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La Monaca G, Di Giorgio G, Pranno N, Serafini G, De Biase A, Cristalli MP. Implant-Prosthetic Rehabilitation of Mandibular Posttraumatic Severe Dentoalveolar Loss With a Reconstructive Staged Approach: A Clinical Report With 3-Year Follow-Up. J ORAL IMPLANTOL 2023; 49:567-572. [PMID: 38279654 DOI: 10.1563/aaid-joi-d-23-00143] [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] [Indexed: 01/28/2024]
Abstract
This clinical report describes the oral rehabilitation of a 25-year-old male patient who lost the lower incisors, right canine, and a significant amount of anterior mandibular bony and soft tissue following severe dentoalveolar trauma due to a car accident. The patient's young age, anterior esthetic zone in the lower jaw, previous mandibular fracture, and extended bony and soft-tissue defect hindering ideal 3-dimensional implant placement oriented the therapeutic plan toward a staged approach, with several reconstructive surgical procedures before implant rehabilitation. The treatment involved deepening the labiobuccal vestibule and lingual sulcus to correct cicatricial shrinkage due to previous surgical fixation of the mandibular fracture, vertical guided bony augmentation to regenerate adequate volumes of bone, free gingival graft to achieve sufficient height and thickness of peri-implant soft tissues, and a prosthetic-driven surgical procedure to place the implants in a good functional and esthetic position. This therapeutic approach restored function and esthetics and achieved outcome stability at 3-year follow-up.
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Affiliation(s)
- Gerardo La Monaca
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Gianni Di Giorgio
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Nicola Pranno
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Giorgio Serafini
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Alberto De Biase
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Maria Paola Cristalli
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
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Simion M, Pistilli R, Vignudelli E, Pellegrino G, Barausse C, Bonifazi L, Roccoli L, Iezzi G, Felice P. Semi-occlusive CAD/CAM titanium mesh for guided bone regeneration: Preliminary clinical and histological results. Int J Oral Implantol (Berl) 2023; 16:327-336. [PMID: 37994820] [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: 11/24/2023]
Abstract
PURPOSE Guided bone regeneration is a widely used technique for the treatment of atrophic arches. A broad range of devices have been employed to achieve bone regeneration. The present study aimed to investigate the clinical and histological findings for a new titanium CAD/CAM device for guided bone regeneration, namely semi-occlusive titanium mesh. MATERIALS AND METHODS Nine partially edentulous patients with vertical and/or horizontal bone defects underwent a guided bone regeneration procedure to enable implant placement. The device used as a barrier was a semi-occlusive CAD/CAM titanium mesh with a laser sintered microperforated scaffold with a pore size of 0.3 mm, grafted with autogenous and xenogeneic bone in a ratio of 80:20. Eight months after guided bone regeneration, surgical and healing complications were evaluated and histological analyses of the regenerated bone were performed. RESULTS A total of 9 patients with 11 treated sites were enrolled. Two healing complications were recorded: one late exposure of the device and one early infection (18.18%). At 8 months, well-structured new regenerated trabecular bone with marrow spaces was mostly present. The percentage of newly formed bone was 30.37% ± 4.64%, that of marrow spaces was 56.43% ± 4.62%, that of residual xenogeneic material was 12.16% ± 0.49% and that of residual autogenous bone chips was 1.02% ± 0.14%. CONCLUSION Within the limitations of the present study, the results show that semi-occlusive titanium mesh could be used for vertical and horizontal ridge augmentation. Nevertheless, further follow-ups and clinical and histological studies are required.
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Rossi R, Carli E, Bambini F, Mummolo S, Licini C, Memè L. The Use of Nano-Hydroxyapatite (NH) for Socket Preservation: Communication of an Upcoming Multicenter Study with the Presentation of a Pilot Case Report. Medicina (Kaunas) 2023; 59:1978. [PMID: 38004027 PMCID: PMC10673145 DOI: 10.3390/medicina59111978] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: The use of biomaterials in dentistry is extremely common. From a commercial perspective, different types of osteoconductive and osteoinductive biomaterials are available to clinicians. In the field of osteoconductive materials, clinicians have biomaterials made of heterologous bones at their disposal, including biomaterials of bovine, porcine, and equine origins, and biomaterials of natural origin, such as corals and hydroxyapatites. In recent years, it has become possible to synthesize nano-Ha and produce scaffolds using digital information. Although a large variety of biomaterials has been produced, there is no scientific evidence that proves their absolute indispensability in terms of the preservation of postextraction sites or in the execution of guided bone regeneration. While there is no scientific evidence showing that one material is better than another, there is evidence suggesting that several products have better in situ permanence. This article describes a preliminary study to evaluate the histological results, ISQ values, and prevalence of nano-HA. Materials and Methods: In this study, we planned to use a new biomaterial based on nanohydroxyapatite for implantation at one postextraction site; the nano-HA in this study was NuvaBONE (Overmed, Buccinasco, Milano, Italy). This is a synthetic bone graft substitute that is based on nanostructured biomimetic hydroxyapatite for application in oral-maxillofacial surgery, orthopedics, traumatology, spine surgery, and neurosurgery. In our pilot case, a patient with a hopeless tooth underwent extraction, and the large defect remaining after the removal of the tooth was filled with nano-HA to restore the volume. Twelve months later, the patient was booked for implant surgery to replace the missing tooth. At the time of the surgery, a biopsy of the regenerated tissue was taken using a trephine of 4 mm in the inner side and 8 mm deep. Results: The histological results of the biopsy showed abundant bone formation, high values of ISQ increasing from the insertion to the prosthetic phase, and a good reorganization of hydroxyapatite granules during resorption. The implant is in good function, and the replaced tooth shows good esthetics. Conclusions: The good results of this pilot case indicate starting the next Multicentric study to have more and clearer information about this nanohydroxyapatite (NH) compared with control sites.
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Affiliation(s)
| | - Elisabetta Carli
- Unit of Pediatric Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56126 Pisa, Italy; (E.C.); (L.M.)
| | - Fabrizio Bambini
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Stefano Mummolo
- Department of Life, Health and Environmental Sciences, Università degli Studi dell’Aquila, 67100 L’Aquila, Italy;
| | - Caterina Licini
- Department of Clinic and Molecular Science, Polytechnic University of Marche, 60126 Ancona, Italy;
| | - Lucia Memè
- Unit of Pediatric Dentistry, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56126 Pisa, Italy; (E.C.); (L.M.)
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Yankov YG. Socket Preservation and Guided Bone Regeneration: Prerequisites for Successful Implant Dentistry. Cureus 2023; 15:e48785. [PMID: 38098920 PMCID: PMC10720259 DOI: 10.7759/cureus.48785] [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] [Accepted: 11/14/2023] [Indexed: 12/17/2023] Open
Abstract
Implant success is measured not only by implant survival but also by the long-term aesthetic and functional results. Implant placement should be prosthetically driven, with proper three-dimensional positioning for optimal support and stability of the tissues. Several procedures could be performed to ensure this requirement. While socket preservation (SP) is performed at the stage of tooth extraction, guided bone regeneration (GBR) takes place before or simultaneous to implant placement. The current review aims to summarize and discuss the procedures used for the preparation of the implant site, the preservation of the existing tissues, and their augmentation in cases of deficiency. An electronic search using Google Scholar, PubMed, and Scopus was conducted up to October 2023, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review summarizes the current knowledge on SP and GBR as prerequisites for future implant placement. Their indications, advantages, and limitations have been thoroughly evaluated and some recommendations for further research have been suggested. Implant placement in sites with severe bone resorption is extremely challenging. It necessitates the application of different surgical techniques, especially augmentation procedures, including guided bone regeneration. The need for such procedures could be avoided or at least minimized by the execution of SP after tooth extraction or immediate/early implant placement.
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Affiliation(s)
- Yanko G Yankov
- Clinic of Maxillofacial Surgery, University Hospital "St. Marina", Varna, BGR
- Department of General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR
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Reddy SB, Arumugam P, Kishore OG, K S. Development, Characterization, and Antibacterial Analysis of the Selenium-Doped Bio-Glass-Collagen-Gelatin Composite Scaffold for Guided Bone Regeneration. Cureus 2023; 15:e48838. [PMID: 38106792 PMCID: PMC10722350 DOI: 10.7759/cureus.48838] [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: 10/26/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
Background Guided bone regeneration (GBR) is an often-used technique to aid the successful placement of dental implants in sites with deficient bone. The search for the ideal GBR membrane with bioactive components improving the regenerative outcomes is still on. In this study, a novel composite GBR membrane was developed using selenium-doped bio-glass, collagen, and gelatin. It was further characterized for surface, chemical, biocompatibility, and antibacterial properties. Methodology Selenium-doped bio-glass was prepared using the sol-gel method. The membrane was fabricated using an equal ratio of collagen and gelatin mixed with 1% selenium-doped bio-glass. The solution was poured to obtain a thin layer of the material which was lyophilized to obtain the final GBR membrane. The membrane was analyzed with scanning electron microscopy, energy dispersive X-ray (EDX) analysis, attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), zebrafish cytotoxicity test, and antibacterial assay. Results The membrane revealed good surface roughness with lamellar and fibrillar arrangement with a minute granular surface ideal for cell attachment and proliferation. The EDX analysis revealed the presence of carbon, oxygen, and nitrogen as predominant components with trace amounts of calcium, phosphorus, silica, and selenium. Fourier transform infrared spectroscopy analysis also proved the presence of collagen, gelatin, and bio-glass. The membrane revealed excellent biocompatibility with zebrafish growth at a normal rate with 90% viability maintained at 48, 72, and 96 hours and 95% viability at 120 hours. It also exhibited excellent antibacterial activity against Staphylococcus aureus and Escherichia coli with minimal growth of bacterial colonies. Conclusion The developed novel selenium bio-glass collagen and gelatin composite scaffold has a good surface and antibacterial properties along with excellent biocompatibility. Further cell line and in vivo studies should be conducted to explore its role in bone regeneration.
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Affiliation(s)
- Sushma B Reddy
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Parkavi Arumugam
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Obuli G Kishore
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Saranya K
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Dos Anjos LM, Rocha ADO, Magrin GL, Kammer PV, Benfatti CAM, Matias de Souza JC, Sanz M, Henriques BAPDC. Bibliometric analysis of the 100 most cited articles on bone grafting in dentistry. Clin Oral Implants Res 2023; 34:1198-1216. [PMID: 37577958 DOI: 10.1111/clr.14152] [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: 03/28/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/15/2023]
Abstract
AIM This bibliometric study analyzed the characteristics of the 100 most cited articles on bone grafts in dentistry. MATERIALS AND METHODS A database search was performed on the Web of Science Core Collection using a specific search strategy. Scopus and Google Scholar were also consulted for citation comparisons. Data extracted included: title, citation metrics, publication year, journal, study design, graft material, surgical technique, authors, institution, and country. Bibliometric networks were generated using VOSviewer. RESULTS The identified articles were published between 1991 and 2019. Citation counts ranged from 120 to 1161 (mean: 240, 30). Clinical Oral Implants Research was the most cited journal (5175 citations; 25/100). Xenogeneic bone graft material was the most frequently used (5130 citations; 22/100). Europe had 62 articles (14,604 citations), and the United States was the most prominent country (5209 citations; 22/100). The University of Bern had the highest number of citations (2565 citations; 13/100), with Buser D as the author with the largest number of articles (2648 citations; 12/100). CONCLUSION This study shows the scientific progress on bone grafts in dentistry. The use of xenogeneic grafts for horizontal and/or vertical ridge augmentation was the most prominent trend.
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Affiliation(s)
- Lucas Menezes Dos Anjos
- Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianopolis, Santa Catarina, Brazil
| | - Aurélio de Oliveira Rocha
- Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianopolis, Santa Catarina, Brazil
| | - Gabriel Leonardo Magrin
- Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianopolis, Santa Catarina, Brazil
- Department of Periodontology, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Pedro Vitali Kammer
- Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianopolis, Santa Catarina, Brazil
| | | | | | - Mariano Sanz
- Department of Periodontology, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
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Bergamo ETP, Balderrama ÍDF, Ferreira MR, Spielman R, Slavin BV, Torroni A, Tovar N, Nayak VV, Slavin BR, Coelho PG, Witek L. Osteogenic differentiation and reconstruction of mandible defects using a novel resorbable membrane: An in vitro and in vivo experimental study. J Biomed Mater Res B Appl Biomater 2023; 111:1966-1978. [PMID: 37470190 DOI: 10.1002/jbm.b.35299] [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: 03/27/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
To evaluate the cellular response of both an intact fish skin membrane and a porcine-derived collagen membrane and investigate the bone healing response of these membranes using a translational, preclinical, guided-bone regeneration (GBR) canine model. Two different naturally sourced membranes were evaluated in this study: (i) an intact fish skin membrane (Kerecis Oral®, Kerecis) and (ii) a porcine derived collagen (Mucograft®, Geistlich) membrane, positive control. For the in vitro experiments, human osteoprogenitor (hOP) cells were used to assess the cellular viability and proliferation at 24, 48, 72, and 168 h. ALPL, COL1A1, BMP2, and RUNX2 expression levels were analyzed by real-time PCR at 7 and 14 days. The preclinical component was designed to mimic a GBR model in canines (n = 12). The first step was the extraction of premolars (P1-P4) and the 1st molars bilaterally, thereby creating four three-wall box type defects per mandible (two per side). Each defect site was filled with bone grafting material, which was then covered with one of the two membranes (Kerecis Oral® or Mucograft®). The groups were nested within the mandibles of each subject and membranes randomly allocated among the defects to minimize potential site bias. Samples were harvested at 30-, 60-, and 90-days and subjected to computerized microtomography (μCT) for three-dimensional reconstruction to quantify bone formation and graft degradation, in addition to histological processing to qualitatively analyze bone regeneration. Neither the intact fish skin membrane nor porcine-based collagen membrane presented cytotoxic effects. An increase in cell proliferation rate was observed for both membranes, with the Kerecis Oral® outperforming the Mucograft® at the 48- and 168-hour time points. Kerecis Oral® yielded higher ALPL expression relative to Mucograft® at both 7- and 14-day points. Additionally, higher COL1A1 expression was observed for the Kerecis Oral® membrane after 7 days but no differences were detected at 14 days. The membranes yielded similar BMP2 and RUNX2 expression at 7 and 14 days. Volumetric reconstructions and histologic micrographs indicated gradual bone ingrowth along with the presence of particulate bone grafts bridging the defect walls for both Kerecis Oral® and Mucograft® membranes, which allowed for the reestablishment of the mandible shape after 90 days. New bone formation significantly increased from 30 to 60 days, and from 60 to 90 days in vivo, without significant differences between membranes. The amount of bovine grafting material (%) within the defects significantly decreased from 30 to 90 days. Collagen membranes led to an upregulation of cellular proliferation and adhesion along with increased expression of genes associated with bone healing, particularly the intact fish skin membrane. Despite an increase in the bone formation rate in the defect over time, there was no significant difference between the membranes.
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Affiliation(s)
- Edmara T P Bergamo
- Biomaterials Division, NYU College of Dentistry, New York, New York, USA
- Department of Prosthodontics, NYU College of Dentistry, New York, New York, USA
| | - Ísis de Fátima Balderrama
- Biomaterials Division, NYU College of Dentistry, New York, New York, USA
- Department of Diagnosis and Surgery, School of Dentistry of Araraquara, Sao Paulo State University, Araraquara, Sao Paulo, Brazil
| | - Marcel Rodrigues Ferreira
- Department of Chemical and Biological Sciences, São Paulo State University (UNESP), Institute of Biosciences, Campus Botucatu, Botucatu, São Paulo, Brazil
| | - Robert Spielman
- Biomaterials Division, NYU College of Dentistry, New York, New York, USA
| | - Blaire V Slavin
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, New York University Grossman School of Medicine, New York, New York, USA
| | - Nick Tovar
- Biomaterials Division, NYU College of Dentistry, New York, New York, USA
- Department of Oral and Maxillofacial Surgery, NYU Langone Medical Center and Bellevue Hospital Center, New York, New York, USA
| | - Vasudev V Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Benjamin R Slavin
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lukasz Witek
- Biomaterials Division, NYU College of Dentistry, New York, New York, USA
- Hansjörg Wyss Department of Plastic Surgery, New York University Grossman School of Medicine, New York, New York, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York, USA
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Ahmed Omar N, Roque J, Galvez P, Siadous R, Chassande O, Catros S, Amédée J, Roques S, Durand M, Bergeaut C, Bidault L, Aprile P, Letourneur D, Fricain JC, Fenelon M. Development of Novel Polysaccharide Membranes for Guided Bone Regeneration: In Vitro and In Vivo Evaluations. Bioengineering (Basel) 2023; 10:1257. [PMID: 38002381 PMCID: PMC10669683 DOI: 10.3390/bioengineering10111257] [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: 09/01/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/26/2023] Open
Abstract
INTRODUCTION Guided bone regeneration (GBR) procedures require selecting suitable membranes for oral surgery. Pullulan and/or dextran-based polysaccharide materials have shown encouraging results in bone regeneration as bone substitutes but have not been used to produce barrier membranes. The present study aimed to develop and characterize pullulan/dextran-derived membranes for GBR. MATERIALS AND METHODS Two pullulan/dextran-based membranes, containing or not hydroxyapatite (HA) particles, were developed. In vitro, cytotoxicity evaluation was performed using human bone marrow mesenchymal stem cells (hBMSCs). Biocompatibility was assessed on rats in a subcutaneous model for up to 16 weeks. In vivo, rat femoral defects were created on 36 rats to compare the two pullulan/dextran-based membranes with a commercial collagen membrane (Bio-Gide®). Bone repair was assessed radiologically and histologically. RESULTS Both polysaccharide membranes demonstrated cytocompatibility and biocompatibility. Micro-computed tomography (micro-CT) analyses at two weeks revealed that the HA-containing membrane promoted a significant increase in bone formation compared to Bio-Gide®. At one month, similar effects were observed among the three membranes in terms of bone regeneration. CONCLUSION The developed pullulan/dextran-based membranes evidenced biocompatibility without interfering with bone regeneration and maturation. The HA-containing membrane, which facilitated early bone regeneration and offered adequate mechanical support, showed promising potential for GBR procedures.
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Affiliation(s)
- Naïma Ahmed Omar
- Laboratory for Tissue Bioengineering, University of Bordeaux, INSERM 1026, F-33076 Bordeaux, France; (N.A.O.); (O.C.); (M.F.)
| | - Jéssica Roque
- Laboratory for Tissue Bioengineering, University of Bordeaux, INSERM 1026, F-33076 Bordeaux, France; (N.A.O.); (O.C.); (M.F.)
| | - Paul Galvez
- Laboratory for Tissue Bioengineering, University of Bordeaux, INSERM 1026, F-33076 Bordeaux, France; (N.A.O.); (O.C.); (M.F.)
| | - Robin Siadous
- Laboratory for Tissue Bioengineering, University of Bordeaux, INSERM 1026, F-33076 Bordeaux, France; (N.A.O.); (O.C.); (M.F.)
| | - Olivier Chassande
- Laboratory for Tissue Bioengineering, University of Bordeaux, INSERM 1026, F-33076 Bordeaux, France; (N.A.O.); (O.C.); (M.F.)
| | - Sylvain Catros
- Laboratory for Tissue Bioengineering, University of Bordeaux, INSERM 1026, F-33076 Bordeaux, France; (N.A.O.); (O.C.); (M.F.)
- Department of Oral Surgery, University Hospital of Bordeaux, F-33076 Bordeaux, France
| | - Joëlle Amédée
- Laboratory for Tissue Bioengineering, University of Bordeaux, INSERM 1026, F-33076 Bordeaux, France; (N.A.O.); (O.C.); (M.F.)
| | - Samantha Roques
- Centre d’Investigation Clinique de Bordeaux (CIC 1401), University Hospital of Bordeaux, INSERM, F-33000 Bordeaux, France (M.D.)
| | - Marlène Durand
- Centre d’Investigation Clinique de Bordeaux (CIC 1401), University Hospital of Bordeaux, INSERM, F-33000 Bordeaux, France (M.D.)
| | - Céline Bergeaut
- Siltiss, SA, Zac de la Nau, 19240 Saint-Viance, France; (C.B.); (L.B.)
| | - Laurent Bidault
- Siltiss, SA, Zac de la Nau, 19240 Saint-Viance, France; (C.B.); (L.B.)
| | - Paola Aprile
- Laboratory for Vascular Translational Science (LVTS), X Bichat Hospital, University Paris Cité & University Sorbonne Paris Nord, INSERM 1148, F-75018 Paris, France
| | - Didier Letourneur
- Siltiss, SA, Zac de la Nau, 19240 Saint-Viance, France; (C.B.); (L.B.)
- Laboratory for Vascular Translational Science (LVTS), X Bichat Hospital, University Paris Cité & University Sorbonne Paris Nord, INSERM 1148, F-75018 Paris, France
| | - Jean-Christophe Fricain
- Laboratory for Tissue Bioengineering, University of Bordeaux, INSERM 1026, F-33076 Bordeaux, France; (N.A.O.); (O.C.); (M.F.)
- Department of Oral Surgery, University Hospital of Bordeaux, F-33076 Bordeaux, France
- Centre d’Investigation Clinique de Bordeaux (CIC 1401), University Hospital of Bordeaux, INSERM, F-33000 Bordeaux, France (M.D.)
| | - Mathilde Fenelon
- Laboratory for Tissue Bioengineering, University of Bordeaux, INSERM 1026, F-33076 Bordeaux, France; (N.A.O.); (O.C.); (M.F.)
- Department of Oral Surgery, University Hospital of Bordeaux, F-33076 Bordeaux, France
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Jiao Y, Okada M, Nutan B, Nagaoka N, Bikharudin A, Musa R, Matsumoto T. Fabrication of a Fish-Bone-Inspired Inorganic-Organic Composite Membrane. Polymers (Basel) 2023; 15:4190. [PMID: 37896434 PMCID: PMC10611054 DOI: 10.3390/polym15204190] [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: 09/15/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Biological materials have properties like great strength and flexibility that are not present in synthetic materials. Using the ribs of crucian carp as a reference, we investigated the mechanisms behind the high mechanical properties of this rib bone, and found highly oriented layers of calcium phosphate (CaP) and collagen fibers. To fabricate a fish-rib-bone-mimicking membrane with similar structure and mechanical properties, this study involves (1) the rapid synthesis of plate-like CaP crystals, (2) the layering of CaP-gelatin hydrogels by gradual drying, and (3) controlling the shape of composite membranes using porous gypsum molds. Finally, as a result of optimizing the compositional ratio of CaP filler and gelatin hydrogel, a CaP filler content of 40% provided the optimal mechanical properties of toughness and stiffness similar to fish bone. Due to the rigidity, flexibility, and ease of shape control of the composite membrane materials, this membrane could be applied as a guided bone regeneration (GBR) membrane.
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Affiliation(s)
- YuYang Jiao
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (Y.J.); (M.O.); (B.N.); (A.B.); (R.M.)
| | - Masahiro Okada
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (Y.J.); (M.O.); (B.N.); (A.B.); (R.M.)
| | - Bhingaradiya Nutan
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (Y.J.); (M.O.); (B.N.); (A.B.); (R.M.)
| | - Noriyuki Nagaoka
- Advanced Research Center for Oral and Craniofacial Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan;
| | - Ahmad Bikharudin
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (Y.J.); (M.O.); (B.N.); (A.B.); (R.M.)
| | - Randa Musa
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (Y.J.); (M.O.); (B.N.); (A.B.); (R.M.)
| | - Takuya Matsumoto
- Department of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; (Y.J.); (M.O.); (B.N.); (A.B.); (R.M.)
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Kauffmann F, Fickl S, Sculean A, Fischer KR, Friedmann A. Alveolar ridge alterations after lateral guided bone regeneration with and without hyaluronic acid: a prospective randomized trial with morphometric and histomorphometric evaluation. Quintessence Int 2023; 54:712-722. [PMID: 37345441 DOI: 10.3290/j.qi.b4171703] [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: 06/23/2023]
Abstract
OBJECTIVE To clinically and histologically evaluate the potential effect of a cross-linked, high molecular weight hyaluronic acid (xHyA) on the outcomes of guided bone regeneration performed with a demineralized bovine bone mineral (DBBM) covered with a natural collagen membrane. METHOD AND MATERIALS Eleven patients (eight females and three males, mean age 53 years) with a total of 27 surgical sites were treated. Treatments were performed with either DBBM and natural collagen membrane fixed with tacks (group A) or DBBM mixed with xHyA and subsequently covered with natural collagen membrane (group B). Clinical evaluations were made at baseline (T1), immediately after guided bone regeneration (T2), and at the time of implant placement (T3). Additionally, at the time of implant placement, core biopsies were retrieved and submitted for histologic analysis. RESULTS Healing was uneventful in all cases. At 6 months, group B revealed a statistically significantly higher crestal ridge dimension compared to group A (P = .007). The histologic analysis revealed a tendency for greater mineralized tissue formation in group B compared to group A (67.5% versus 41.6%) and contained a higher amount of new bone (37.2%) and less DBBM residues (20.9%) than group A (12.8% new bone and 28.8% DBBM residues, respectively). CONCLUSIONS Within their limits, the present data indicate that, during guided bone regeneration with natural collagen membrane, the combination of DBBM and xHyA may improve the quality and quantity of bone formed with DBBM alone.
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Nayak VV, Mirsky NA, Slavin BV, Witek L, Coelho PG, Tovar N. Non-Thermal Plasma Treatment of Poly(tetrafluoroethylene) Dental Membranes and Its Effects on Cellular Adhesion. Materials (Basel) 2023; 16:6633. [PMID: 37895615 PMCID: PMC10608478 DOI: 10.3390/ma16206633] [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] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023]
Abstract
Non-resorbable dental barrier membranes entail the risk of dehiscence due to their smooth and functionally inert surfaces. Non-thermal plasma (NTP) treatment has been shown to increase the hydrophilicity of a biomaterials and could thereby enhance cellular adhesion. This study aimed to elucidate the role of allyl alcohol NTP treatment of poly(tetrafluoroethylene) in its cellular adhesion. The materials (non-treated PTFE membranes (NTMem) and NTP-treated PTFE membranes (PTMem)) were subjected to characterization using scanning electron microscopy (SEM), contact angle measurements, X-ray photoelectron spectroscopy (XPS), and electron spectroscopy for chemical analysis (ESCA). Cells were seeded upon the different membranes, and cellular adhesion was analyzed qualitatively and quantitatively using fluorescence labeling and a hemocytometer, respectively. PTMem exhibited higher surface energies and the incorporation of reactive functional groups. NTP altered the surface topography and chemistry of PTFE membranes, as seen through SEM, XPS and ESCA, with partial defluorination and polymer chain breakage. Fluorescence labeling indicated significantly higher cell populations on PTMem relative to its untreated counterparts (NTMem). The results of this study support the potential applicability of allyl alcohol NTP treatment for polymeric biomaterials such as PTFE-to increase cellular adhesion for use as dental barrier membranes.
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Affiliation(s)
- Vasudev Vivekanand Nayak
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (V.V.N.); (N.A.M.); (B.V.S.); (P.G.C.)
| | - Nicholas Alexander Mirsky
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (V.V.N.); (N.A.M.); (B.V.S.); (P.G.C.)
| | - Blaire V. Slavin
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (V.V.N.); (N.A.M.); (B.V.S.); (P.G.C.)
| | - Lukasz Witek
- Biomaterials Division, College of Dentistry, New York University, New York, NY 10010, USA;
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, 6 MetroTech Center, Brooklyn, NY 11201, USA
- Hansjörg Wyss Department of Plastic Surgery, Grossman School of Medicine, New York University, New York, NY 10017, USA
| | - Paulo G. Coelho
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (V.V.N.); (N.A.M.); (B.V.S.); (P.G.C.)
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Nick Tovar
- Biomaterials Division, College of Dentistry, New York University, New York, NY 10010, USA;
- Department of Oral and Maxillofacial Surgery, New York University, Langone Medical Center and Bellevue Hospital Center, New York, NY 10016, USA
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Yu SH, Saleh MHA, Wang HL. Simultaneous or staged lateral ridge augmentation: A clinical guideline on the decision-making process. Periodontol 2000 2023; 93:107-128. [PMID: 37529966 DOI: 10.1111/prd.12512] [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: 01/29/2023] [Revised: 06/30/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
Lateral ridge augmentation is a standard surgical procedure that can be performed prior to (staged) or simultaneously with implant placement. The decision between a simultaneous or staged approach involves considering multiple variables. This paper proposed a decision-making process that serves as a guideline for choosing the best treatment choice based on the available evidence and the author's clinical experience.
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Affiliation(s)
- Shan-Huey Yu
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Private Practice, Vienna, Virginia, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Mousavi SJ, Ejeian F, Razmjou A, Nasr-Esfahani MH. In vivo evaluation of bone regeneration using ZIF8-modified polypropylene membrane in rat calvarium defects. J Clin Periodontol 2023; 50:1390-1405. [PMID: 37485621 DOI: 10.1111/jcpe.13855] [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: 12/25/2022] [Revised: 06/02/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023]
Abstract
AIM The profound potential of zeolitic imidazolate framework 8 (ZIF8) thin film for inducing osteogenesis has been previously established under in vitro conditions. As the next step towards the clinical application of ZIF8-modified substrates in periodontology, this in vivo study aimed to evaluate the ability of the ZIF8 crystalline layer to induce bone regeneration in an animal model defect. MATERIALS AND METHODS Following the mechanical characterization of the membranes and analysing the in vitro degradation of the ZIF8 layer, in vivo bone regeneration was evaluated in a critical-sized (5-mm) rat calvarial bone defect model. For each animal, one defect was randomly covered with either a polypropylene (PP) or a ZIF8-modified membrane (n = 7 per group), while the other defect was left untreated as a control. Eight weeks post surgery, bone formation was assessed by microcomputed tomography scanning, haematoxylin and eosin staining and immunohistochemical analysis. RESULTS The ZIF8-modified membrane outperformed the PP membrane in terms of mechanical properties and revealed a trace Zn+2 release. Results of in vivo evaluation verified the superior barrier function of the ZIF8-coated membrane compared with pristine PP membrane. Compared with the limited marginal bone formation in the control and PP groups, the defect area was almost filled with mature bone in the ZIF8-coated membrane group. CONCLUSIONS Our results support the effectiveness of the ZIF8-coated membrane as a promising material for improving clinical outcomes of guided bone regeneration procedures, without using biological components.
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Affiliation(s)
- Seyed Javad Mousavi
- Department of Biotechnology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
- Department of Animal Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Fatemeh Ejeian
- Department of Animal Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Amir Razmjou
- School of Engineering, Edith Cowan University, Perth, Western Australia, Australia
- UNESCO Centre for Membrane Science and Technology, School of Chemical Engineering, University of New South Wales, Sydney, New South Wales, Australia
| | - Mohammad Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
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Zuercher AN, Strauss FJ, Paqué PN, Bienz SP, Jung RE, Thoma DS. Randomized controlled pilot study comparing small buccal defects around dental implants treated with a subepithelial connective tissue graft or with guided bone regeneration. Clin Oral Implants Res 2023; 34:1094-1105. [PMID: 37483129 DOI: 10.1111/clr.14140] [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: 01/26/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
AIM To compare subepithelial connective tissue grafts (SCTG) versus guided bone regeneration (GBR) for the treatment of small peri-implant dehiscence defects in terms of profilometric (primary outcome), clinical, and patient-reported outcome measures (PROMs). METHODS Sixteen patients who presented with small buccal bone dehiscences (≤3 mm) following single implant placement were recruited. Following implant placement, buccal bone defect sites were randomly treated either with a SCTG or GBR. Six patients who lacked bone dehiscences after implant placement were assigned to a negative control. Transmucosal healing was applied in all patients. Patients were examined prior (T1) and after (T2) implant placement, at suture removal (T3), at implant impression (T5), at crown delivery (T6), and 12 (T7) months after crown delivery. Measurements included profilometric outcomes, marginal bone levels, buccal bone and soft tissue thickness, PROMs, and clinical parameters. All data were analyzed descriptively. RESULTS The median changes in buccal contour as assessed by profilometric measures between T1 and T5 showed a decrease of 1.84 mm for the SCTG group and 1.06 mm for the GBR group. Between T2 and T7, the median change in the buccal contour amounted to 0.45 mm for SCTG and -0.94 mm (=loss) for GBR. Patients' pain perception tended to be higher in SCTG than in GBR. All peri-implant soft tissue parameters showed healthy oral tissues and no clinically relevant differences between groups. CONCLUSION Within the limitations of this pilot study, treating small peri-implant dehiscence defects with a SCTG might be a viable alternative to GBR. The use of a SCTG tended to result in more stable profilometric outcomes and comparable clinical outcomes to GBR. However, patient-reported outcome measures tended to favor GBR.
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Affiliation(s)
- A N Zuercher
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - F J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P N Paqué
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - S P Bienz
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - R E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - D S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Quirynen M, Siawasch S, Temmerman A, Cortellini S, Dhondt R, Teughels W, Castro AB. Do autologous platelet concentrates (APCs) have a role in intra-oral bone regeneration? A critical review of clinical guidelines on decision-making process. Periodontol 2000 2023; 93:254-269. [PMID: 37845802 DOI: 10.1111/prd.12526] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/05/2023] [Accepted: 08/15/2023] [Indexed: 10/18/2023]
Abstract
In the past decades, personalized regenerative medicine has gained increased attention. Autologous platelet concentrates (APCs) such as PRP, PRGF, and L-PRF, all serving as a source of a large variety of cells and growth factors that participate in hard and soft tissue healing and regeneration, could play a significant role in regenerative periodontal procedures. This narrative review evaluated the relative impact of APCs in alveolar ridge preservation, sinus floor augmentation, and the regeneration of bony craters around teeth, both as a single substitute or in combination with a xenograft. L-PRF has a significant beneficial effect on alveolar ridge preservation ( bone quality). The data for PRGF are less convincing, and PRP is controversial. L-PRF can successfully be used as a single substitute during transcrestal (≥3.5 mm bone gain) as well as 1-stage lateral window sinus floor elevation (>5 mm bone gain). For PRGF and especially PRP the data are very scarce. In the treatment of bony craters around teeth, during open flap debridement, L-PRF as a single substitute showed significant adjunctive benefits (e.g., >PPD reduction, >CAL gain, >crater depth reduction). The data for PRP and PRGF were non-conclusive. Adding PRP or L-PRF to a xenograft during OFD resulted in additional improvements (>PPD reduction, >CAL gain, >bone fill), for PRGF no data were found. Autologous platelet concentrates demonstrated to enhance bone and soft tissue healing in periodontal regenerative procedures. The data for L-PRF were most convincing. L-PRF also has the advantage of a greater simplicity of production, and its 100% autologous character.
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Affiliation(s)
- Marc Quirynen
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Sam Siawasch
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Andy Temmerman
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Simone Cortellini
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Rutger Dhondt
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna B Castro
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Calciolari E, Corbella S, Gkranias N, Viganó M, Sculean A, Donos N. Efficacy of biomaterials for lateral bone augmentation performed with guided bone regeneration. A network meta-analysis. Periodontol 2000 2023; 93:77-106. [PMID: 37752820 DOI: 10.1111/prd.12531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/01/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023]
Abstract
Bone regeneration is often required concomitant with implant placement to treat a bone fenestration, a dehiscence, and for contouring. This systematic review assessed the impact of different biomaterials employed for guided bone regeneration (GBR) simultaneous to implant placement on the stability of radiographic peri-implant bone levels at ≥12 months of follow-up (focused question 1), as well as on bone defect dimension (width/height) changes at re-assessment after ≥4 months (focused question 2). Only randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared different biomaterials for GBR were considered. A Bayesian network meta-analysis (NMA) was performed using a random-effects model. A ranking probability between treatments was obtained, as well as an estimation of the surface under the cumulative ranking value (SUCRA). Overall, whenever the biological principle of GBR was followed, regeneration occurred in a predictable way, irrespective of the type of biomaterial used. A lower efficacy of GBR treatments was suggested for initially large defects, despite the trend did not reach statistical significance. Regardless of the biomaterial employed, a certain resorption of the augmented bone was observed overtime. While GBR was shown to be a safe and predictable treatment, several complications (including exposure, infection, and soft tissue dehiscence) were reported, which tend to be higher when using cross-linked collagen membranes.
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Affiliation(s)
- Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Dental School, Department of Medicine and Dentistry, Università di Parma, Parma, Italy
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS, Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Nikolaos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Marco Viganó
- Medacta International SA, Castel San Pietro, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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Mizraji G, Davidzohn A, Gursoy M, Gursoy U, Shapira L, Wilensky A. Membrane barriers for guided bone regeneration: An overview of available biomaterials. Periodontol 2000 2023; 93:56-76. [PMID: 37855164 DOI: 10.1111/prd.12502] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/13/2023] [Revised: 05/21/2023] [Accepted: 05/29/2023] [Indexed: 10/20/2023]
Abstract
Dental implants revolutionized the treatment options for restoring form, function, and esthetics when one or more teeth are missing. At sites of insufficient bone, guided bone regeneration (GBR) is performed either prior to or in conjunction with implant placement to achieve a three-dimensional prosthetic-driven implant position. To date, GBR is well documented, widely used, and constitutes a predictable and successful approach for lateral and vertical bone augmentation of atrophic ridges. Evidence suggests that the use of barrier membranes maintains the major biological principles of GBR. Since the material used to construct barrier membranes ultimately dictates its characteristics and its ability to maintain the biological principles of GBR, several materials have been used over time. This review, summarizes the evolution of barrier membranes, focusing on the characteristics, advantages, and disadvantages of available occlusive barrier membranes and presents results of updated meta-analyses focusing on the effects of these membranes on the overall outcome.
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Affiliation(s)
- Gabriel Mizraji
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Mervi Gursoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
- Oral Health Care, Welfare Division, City of Turku, Turku, Finland
| | - Ulvi Gursoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Asaf Wilensky
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
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Ramanauskaite A, Becker K, Cafferata EA, Schwarz F. Clinical efficacy of guided bone regeneration in peri-implantitis defects. A network meta-analysis. Periodontol 2000 2023; 93:236-253. [PMID: 37490412 DOI: 10.1111/prd.12510] [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: 03/08/2023] [Revised: 05/17/2023] [Accepted: 06/19/2023] [Indexed: 07/27/2023]
Abstract
Guided bone regeneration (GBR) at peri-implantitis-related bone defects involves the placement of bone-filler particles in the intrabony defects and the application of a barrier membrane. The efficacy of different GBR-supported reconstructive measures as well as their potential superiority compared to non-GBR-supported treatment strategies for bone defects at peri-implantitis sites, however, remains unclear. Therefore, this analysis was designed to evaluate the long-term (≥12 months) clinical efficacy of GBR-supported reconstructive surgical therapy for peri-implantitis-related bone defects. In terms of resolving inflammation, the implementation of GBR protocols applying xenogenic bone substitutes yielded a higher reduction of bleeding on probing and probing depth value compared to the GBR protocol applying autogenous bone. Furthermore, for the changes in bleeding on probing and probing depths, GBR approaches using xenogenic bone showed superiority over the non-GBR treatments. Xenogenic bone with or without a barrier membrane was associated with improved radiographic bone levels and less soft tissue recession compared to the use of a GBR protocol implementing autogenous bone. Nonetheless, when interpreting this findings, the limited number of available studies with low to serious risk of bias and the short follow-up periods limited to 12 months should be considered.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Emilio A Cafferata
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
- Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Peru
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
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Park JY, Chung HM, Strauss FJ, Lee JS. Dimensional changes after horizontal and vertical guided bone regeneration without membrane fixation using the retentive flap technique: A 1-year retrospective study. Clin Implant Dent Relat Res 2023; 25:871-880. [PMID: 37309236 DOI: 10.1111/cid.13237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/14/2023]
Abstract
AIM To evaluate the dimensional changes after horizontal and vertical guided bone regeneration (GBR) without membrane fixation using the retentive flap technique. METHODS This study retrospectively examined two cohorts that received vertical or horizontal ridge augmentations (VA or HA groups). GBR was performed using particulate bone substitutes and resorbable collagen membranes. The augmented sites were stabilized using the retentive flap technique without any additional membrane fixation. The augmented tissue dimensions were assessed using cone-beam computed tomography at preoperative, immediately postoperative (IP), 4 months (4M), and 1 year (1Y). RESULTS Postoperative vertical bone gain in 11 participants of VA group amounted to 5.96 ± 1.88 mm at IP, which decreased to 5.53 ± 1.62 at 4M and to 5.26 ± 1.52 mm at 1Y (intragroup p < 0.05). The horizontal bone gain at IP in 12 participants amounted to 3.98 ± 2.06 mm, which decreased to 3.02 ± 2.06 at 4M and to 2.48 ± 2.09 mm at 1Y (intragroup p < 0.05). The mean implant dehiscence defect height after 1Y was 0.19 ± 0.50 mm in the VA group, and 0.57 ± 0.93 mm in the HA group. CONCLUSION GBR without membrane fixation using the retentive flap technique seems to preserve the radiographic bone dimensions of vertically augmented sites. This technique may be less effective at preserving the width of the augmented tissue.
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Affiliation(s)
- Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, 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, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Republic of Korea
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Urban IA, Montero E, Amerio E, Palombo D, Monje A. Techniques on vertical ridge augmentation: Indications and effectiveness. Periodontol 2000 2023; 93:153-182. [PMID: 36721380 DOI: 10.1111/prd.12471] [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: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 02/02/2023]
Abstract
Vertical ridge augmentation techniques have been advocated to enable restoring function and esthetics by means of implant-supported rehabilitation. There are three major modalities. The first is guided bone regeneration, based on the principle of compartmentalization by means of using a barrier membrane, which has been demonstrated to be technically demanding with regard to soft tissue management. This requisite is also applicable in the case of the second modality of bone block grafts. Nonetheless, space creation and maintenance are provided by the solid nature of the graft. The third modality of distraction osteogenesis is also a valid and faster approach. Nonetheless, owing to this technique's inherent shortcomings, this method is currently deprecated. The purpose of this review is to shed light on the state-of-the-art of the different modalities described for vertical ridge augmentation, including the indications, the step-by-step approach, and the effectiveness.
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Affiliation(s)
- Istvan A Urban
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Eduardo Montero
- Department of Periodontics, Universidad Complutense de Madrid, Madrid, Spain
| | - Ettore Amerio
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - David Palombo
- Department of Periodontics, Universidad Complutense de Madrid, Madrid, Spain
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
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Ariesanti Y, Octavianus PGM, Handayani AT, Abbas B. Characterization of Polyvinyl Alcohol-Collagen-Hydroxyapatite Composite Membrane from Lates calcarifer Scales for Guided Tissue and Bone Regeneration. Eur J Dent 2023; 17:1153-1162. [PMID: 36646107 PMCID: PMC10756778 DOI: 10.1055/s-0042-1759488] [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: 01/18/2023] Open
Abstract
OBJECTIVE To determine the chemical structure, tensile strength, porosity, and degradability of polyvinyl alcohol (PVA)-collagen-hydroxyapatite (HA) composite membranes for guided tissue and bone regeneration. MATERIALS AND METHODS The PVA-collagen-HA composite membrane was divided into three groups: the group without irradiation, the group with 15 kGy irradiation, and 25 kGy irradiation. Each group was tested for chemical structure with Fourier-transform infrared (FT-IR) at a wavelength of 400 to 4,000 cm-1. Tensile strength test was tested in dry and wet conditions with the standard method of American Standard Testing Mechanical (ASTM) D638, and porosity using scanning electron microscope and analyzed using ImageJ software. Degradability test immersed in a solution of phosphate-buffered saline. Data were analyzed using analysis of variance (ANOVA) and Tukey's test. RESULTS FT-IR test before and after storage for 30 days on three media showed a stable chemical structure with the same functional groups. ANOVA analysis showed a significant difference (p < 0.05) in the dry condition (p = 0.006), Tukey's test showed a significant difference in the 15 kGy and 25 kGy irradiated groups (p = 0.005), but the groups without irradiation had no significant difference with the 15 kGy (p = 0.285) and 25 kGy (p = 0.079) irradiation groups. In wet conditions, there was no significant difference (p > 0.05) in each group (p = 373). The size of the porosity in the group without irradiation, 15 kGy irradiation, and 25 kGy irradiation showed a size of 4.65, 6.51, and 8.08 m, respectively. The degradability test showed a decrease in weight in each group, with the total weight of the membrane being completely degraded from the most degraded to the least: the groups without irradiation, 15 kGy irradiation, and 25 kGy irradiation. The ANOVA test on the degradability test shows significant (p < 0.05) in the PVA-collagen-HA composite membrane group over time intervals (p = 0.000). Tukey's post hoc test showed a significant difference (p < 0.05) after 1 week between the groups without irradiation with 15 kGy (p = 0.023). CONCLUSION PVA-collagen-HA composite membrane has a stable chemical structure, optimal tensile strength, porosity, and ideal degradability as guided bone regeneration and guided tissue regeneration.
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Affiliation(s)
- Yessy Ariesanti
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | | | - Annisa Tri Handayani
- Undergraduate Program, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Basril Abbas
- National Research and Innovation Agency (BRIN), Jakarta, Indonesia
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