Three-dimensional cultivation of human osteoblast-like cells on highly porous natural bone mineral

Bone regeneration in critical-size defects of the mandible using biomechanically adapted CAD/CAM hybrid scaffolds: An in vivo study in miniature pigs

The study aimed to analyze bone regeneration in critical-size defects using hybrid scaffolds biomechanically adapted to the specific defect and adding the growth factor rhBMP-2. For this animal study, ten minipigs underwent bilateral defects in the corpus mandibulae and were subsequently treated with novel cylindrical hybrid scaffolds. These scaffolds were designed digitally to suit the biomechanical requirements of the mandibular defect, utilizing finite element analysis. The scaffolds comprised zirconium dioxide-tricalcium phosphate (ZrO2-TCP) support struts and TCP foam ceramics. One scaffold in each animal was loaded with rhBMP-2 (100 μg/cm³), while the other served as an unloaded negative control. Fluorescent dyes were administered every 2 weeks, and computed tomography (CT) scans were conducted every 4 weeks. Euthanasia was performed after 3 months, and samples were collected for examination using micro-CT and histological evaluation of both hard and soft tissue. Intravital CT examinations revealed minor changes in radiographic density from 4 to 12 weeks postoperatively. In the group treated with rhBMP-2, radiographic density shifted from 2513 ± 128 (mean ± SD) to 2606 ± 115 Hounsfield units (HU), while the group without rhBMP-2 showed a change from 2430 ± 131 to 2601 ± 67 HU. Prior to implantation, the radiological density of samples measured 1508 ± 30 mg HA/cm³, whereas post-mortem densities were 1346 ± 71 mg HA/cm³ in the rhBMP-2 group and 1282 ± 91 mg HA/cm³ in the control group (p = 0.045), as indicated by micro-CT measurements. The histological assessment demonstrated successful ossification in all specimens. The newly formed bone area proportion was significantly greater in the rhBMP-2 group (48 ± 10%) compared with the control group without rhBMP-2 (42 ± 9%, p = 0.03). The mean area proportion of remaining TCP foam was 23 ± 8% with rhBMP-2 and 24 ± 10% without rhBMP-2. Successful bone regeneration was accomplished by implanting hybrid scaffolds into critical-size mandibular defects. Loading these scaffolds with rhBMP-2 led to enhanced bone regeneration and a uniform distribution of new bone formation within the hybrid scaffolds. Further studies are required to determine the adaptability of hybrid scaffolds for larger and potentially segmental defects in the maxillofacial region.

Laddec® versus Bio-Oss®: The effect on the healing of critical-sized defect - Calvaria rabbit model

The aim of this study was to evaluate the in vivo performance of two different deproteinized bovine bone (DBB) grafting materials: DBBB (Bio-Oss®) and DBBL (Laddec®), for the regeneration of critically sized (8 mm) defects in rabbit's calvaria. Three round-shaped defects were surgically created in the calvaria of 13 New Zealand White rabbits proximal to the coronal suture in the parietal bone. Two of the defects were filled with one of the grafting materials while a third was left empty to serve as a negative control. Bone regeneration properties were evaluated at 4- and 8-weeks after implantation by means of histological and histomorphometrical analyses. Statistical analyses were performed through a mixed model analysis with fixed factors of time and material. Histological evaluation of the control group evidenced a lack of bridging bone formation across the defect sites at both evaluation time points. For the experimental groups, new bone formation was observed around the defect periphery and to progress radially inwards to the center of the defect site, regardless of the grafting material. Histomorphometric analyses at 4 weeks demonstrated higher amount of bone formation through the defect for DBBB group. However, at 8 weeks, DBBL and DBBB demonstrated osteoconductivity and low resorption rates with evidence of statistically similar bone regeneration through the complete boney defect. Finally, DBBB presented lower soft tissue migration within the defect when compared to DBBL at both evaluation time points. DBBB and DBBL presented similar bone regeneration performance and slow resorption rates. Although both materials promoted bone regeneration through the complete defect, DBBB presented lower soft tissue migration within the defects at 4- and 8-weeks.

Bone Reconstruction Using Two-Layer Porcine-Derived Bone Scaffold Composed of Cortical and Cancellous Bones in a Rabbit Calvarial Defect Model

In this study, we aimed to investigate the bone regeneration efficiency of two-layer porcine-derived bone scaffolds composed of cancellous and cortical bones in a rabbit calvarial defect model. Four circular calvaria defects were formed on cranium of rabbit and were filled with block bone scaffolds of each group: cortical bone block (Cortical group), cancellous bone block (Cancellous group), and two-layer bone block (2layer group). After 8 weeks, new bones were primarily observed in cancellous parts of the Cancellous and 2layer groups, while the Cortical group exhibited few new bones. In the results of new bone volume and area analyses, the Cancellous group showed the highest value, followed by the 2layer group, and were significantly higher than the Cortical group. Within the limitations of this study, the cancellous and two-layer porcine-derived bone scaffolds showed satisfactory bone regeneration efficiency; further studies on regulating the ratio of cortical and cancellous bones in two-layer bones are needed.

Scaffold implantation in the omentum majus of rabbits for new bone formation

Restoration of the mandible after defects caused by ablative surgery remains challenging. Microvascular free flaps from the scapula, fibula or iliac crest remain the 'gold standard'. A drawback of these methods is donor-side morbidity, availability and the shape of the bone. Former cases have shown that prefabrication of a customized bone flap in the latissimus dorsi muscle may be successful; however, this method is still associated with high donor-side morbidity. Osteogenesis in the omentum majus of rabbits by wrapping the periosteum into it was confirmed recently and is particularly interesting for bone endocultivation. Twelve adult male New Zealand white rabbits were used. In each, two hydroxyapatite blocks were implanted in the greater omentum with autologous bone or autologous bone + rhBMP-2. Bone density measurements were performed by CT scans. Fluorochrome labelling was used for new bone formation detection. The animals were sacrificed at week 10, and the specimens were harvested for histological and histomorphometric analysis. In histological and fluorescence microscopic analysis, new bone formation could be found, as well as new blood vessels and connective tissue. No significant differences were found regarding the histological analysis and bone density measurements between the groups. It could be demonstrated that the omentum majus is a practical way to use one's own body as a bioreactor for prefabrication of tissue-engineered bony constructs. Regarding the influence and exact dose of rhBMP-2, further research is necessary. To establish and improve this method, further large-animal experimental studies are also necessary.

Bone Healing Evaluation in Critical-Size Defects Treated With Xenogenous Bone Plus Porcine Collagen

PURPOSE

This study aimed to evaluate the osteoconductive features of Bio-Oss Collagen in large critical-size defects (8 mm).

MATERIALS AND METHODS

Thirty-six adult Wistar Albinus male adult rats were carried out a critical-size defect with a trephine bur of 8 mm in the calvaria. Groups were divided depending on the filling biomaterial as follows: group BO: Bio-Oss (n = 18); group BOC: Bio-Oss Collagen (n = 18). After 7, 30, and 60 days, 6 rats of each group were euthanized with anesthetic overdose. Specimens were laboratory processed for histomorphometric analysis. Histomorphometric data were statistically analyzed by analysis of variance and post-Tukey test (P < 0.05).

RESULTS

Statistical differences were found in new bone formation just in the intragroup comparison among periods after 7 and 60 postoperative days, indicating more new bone formation after 60 days (Tukey test, P = 0.029).

CONCLUSION

Under the limitation of this research, it could be concluded that Bio-Oss and Bio-Oss Collagen in this experimental model did not show osteoconductive features.

* Endocultivation of Scaffolds with Recombinant Human Bone Morphogenetic Protein-2 and VEGF165 in the Omentum Majus in a Rabbit Model

The reconstruction of defects in the mandible are still challenging. Despite several adequate microvascular bone reconstruction techniques, there is a need for ectopic bone endocultivation without drawbacks by donor-site morbidity. The omentum majus is described as a good vascularized fleece with undifferentiated cells with potential for bone culturing. In the omentum majus of six rabbits, two hydroxyapatite blocks were incorporated for 12 weeks each. The blocks were prepared with recombinant human bone morphogenetic protein-2 (rhBMP-2) or VEGF₁₆₅ + rhBMP-2 and wrapped into the omentum. For ectopic bone endocultivation observation computed tomography (CT) scans were performed, and fluorescence markers were applied. After harvesting the block, histological sections were performed with hematoxylin and eosin and toluidine blue staining. In the CT scans, the Hounsfield units of the blocks increased within the trail. In some sections, new bone formation was observed within the hydroxyapatite blocks, however, the histological staining showed soft-tissue invasion only, no gross bone formation was observed. The ectopic bone endocultivation in the omentum majus is technically a good approach. An adequate mixture of osteoinductive proteins is still missing.

Programmable cells of monocytic origin as a source of osteochondroprogenitors: Effect of growth factors on osteogenic differentiation

We have demonstrated previously that peripheral blood monocytes can be converted in vitro to a multipotent stem cell-like cell termed programmable cell of monocytic origin (PCMO) and subsequently into cells with chondrocyte-like phenotype. Here, we investigated whether PCMO could also be differentiated into osteoblast-like cells using growth factors with known osteoinductive potency. Following stimulation with BMP-2, BMP-7, IGF-1 or TGF-β1 for 7 and 14 days, PCMOs were analyzed for mRNA expression of collagen types I and V, alkaline phosphatase, osteocalcin, runt-related transcription factor-2 (Runx2) and Osterix (Osx) by quantitative RT-PCR (qPCR) and the levels of collagen I in culture supernatants by ELISA. The expression of osteoblastic markers was evident, albeit at a different extent in cultures of PCMOs after treatment with the above-mentioned growth factors. Culture supernatants from PCMOs stimulated for 6-10 days with BMP-2, BMP-7, IGF-1 or TGF-β1 contained high levels of collagen type I, together with earlier data indicating synthesis and proper secretion. The findings suggest that PCMOs can transform into cells that are phenotypically similar to osteoblasts and identify these cells as osteochondroprogenitors. The possibility of differentiating PCMOs from peripheral blood in sizable quantities could be a novel way to obtain autologous bone-like substitutes without donor-site morbidity.

Ultrastructural evaluation of mesenchymal stem cells from inflamed periodontium in different in vitro conditions

This research aimed to observe the behavior of mesenchymal stem cells (MSCs) isolated from periodontal granulation tissue (gt) when manipulated ex vivo to induce three-dimensional (3D) spheroid (aggregates) formation as well as when seeded on two bone scaffolds of animal origin. Periodontal gt was chosen as a MSC source because of its availability, considering that it is eliminated as a waste material during conventional surgical therapies. 3D aggregates of cells were generated; they were grown for 3 and 7 days, respectively, and then prepared for transmission electron microscopic analysis. The two biomaterials were seeded for 72 h with gtMSCs and prepared for scanning electronic microscopic observation. The ultrastructural analysis of 3D spheroids remarked some differences between the inner and the outer cell layers, with a certain commitment observed at the inner cells. Both scaffolds showed a relatively smooth surface at low magnification. Macro- and micropores having a scarce distribution were observed on both bone substitutes. gtMSCs grew with relative difficulty on the biomaterials. After 72 h of proliferation, gtMSCs scarcely covered the surface of bovine bone scaffolds, demonstrating fibroblast-like or star-like shapes with elongated filiform extensions. Our results add other data on the possible usefulness of gtMSC and could question the current paradigm regarding the complete removal of chronically inflamed gts from the defects during periodontal surgeries. Until optimal protocols for ex vivo manipulation of MSCs are available for clinical settings, it is advisable to use biocompatible bone substitutes that allow the development of progenitor cells.

Enhanced differentiation of human embryonic stem cells on extracellular matrix-containing osteomimetic scaffolds for bone tissue engineering

Current methods of treating critical size bone defects include autografts and allografts, however, both present major limitations including donor-site morbidity, risk of disease transmission, and immune rejection. Tissue engineering provides a promising alternative to circumvent these shortcomings through the use of autologous cells, three-dimensional scaffolds, and growth factors. We investigated the development of a scaffold with native bone extracellular matrix (ECM) components for directing the osteogenic differentiation of human embryonic stem cells (hESCs). Toward this goal, a microsphere-sintering technique was used to fabricate poly(lactic-co-glycolic acid) (PLGA) scaffolds with optimum mechanical and structural properties. Human osteoblasts (hOBs) were seeded on these scaffolds to deposit bone ECM for 14 days. This was followed by a decellularization step leaving the mineralized matrix intact. Characterization of the decellularized PLGA scaffolds confirmed the deposition of calcium, collagen II, and alkaline phosphatase by osteoblasts. hESCs were seeded on the osteomimetic substrates in the presence of osteogenic growth medium, and osteogenicity was determined according to calcium content, osteocalcin expression, and bone marker gene regulation. Cell proliferation studies showed a constant increase in number for hESCs seeded on both PLGA and ECM-coated PLGA scaffolds. Calcium deposition by hESCs was significantly higher on the osteomimetic scaffolds compared with the control groups. Consistently, immunofluorescence staining demonstrated an increased expression of osteocalcin in hESCs seeded on ECM-coated osteomimetic PLGA scaffolds. Gene expression analysis of RUNX2 and osteocalcin further confirmed osteogenic differentiation of hESCs at the highest expression level on osteomimetic PLGA. These results together demonstrate the potential of PLGA scaffolds with native bone ECM components to direct osteogenic differentiation of hESCs and induce bone formation.

Tri-lineage potential of intraoral tissue-derived mesenchymal stromal cells

The purpose of this study was to analyse the potential of intraoral tissues as a source of mesenchymal stromal and progenitor cells (MSPCs) for usage in future cell-based therapy models. Cells were isolated from four different tissues harvested during oral surgery intervention: (1) bone explants from the posterior maxilla, (2) bone explants from the oblique line, (3) from the mandibular periosteum, and (4) from the dental pulp. Donor sites and tissues were evaluated in terms of their accessibility, donor-site morbidity and average time period until appearance of MSPC colonies. Cell characterization was performed by flow cytometry and evaluation of in vitro osteogenic, adipogenic and chondrogenic differentiation potential. Adherent cell colonies were isolated from tissues from all sites after 4-8 days. The cells showed characteristics of MSPCs, so they were expanded up to clinical scales and demonstrated multipotency. The lowest donor-site morbidity was observed in the posterior maxilla harvests, while the highest donor-site morbidity was associated with harvests from mandibular sites. All sites seem to be potential sources of mesenchymal stromal and progenitor cells for tissue engineering approaches. Therefore, harvest morbidity and patient acceptance should affect the choice of the appropriate site.

The cytotoxic effects of three different bisphosphonates in-vitro on human gingival fibroblasts, osteoblasts and osteogenic sarcoma cells

INTRODUCTION

Osteonecrosis of the jaw (ONJ) is an emerging condition in patients undergoing long-term administration of bisphosphonates (BP) for the treatment of osteoporosis and hypercalcaemia associated with malignancy, multiple myeloma, and metastatic breast and prostate cancers. This is a follow-up study, its purpose was to examine the effects in-vitro of intravenous zoledronic acid (ZOL) and pamidronate (PAM) and oral alendronate (FOS) on the human oral cavity using gingival fibroblasts and osteoblasts cells and, in addition, osteogenic sarcoma cells (SaOS-2-cells).

MATERIALS AND METHODS

Human gingival fibroblasts, osteoblasts and SaOS-2-cells were seeded on multiple 6-well plates at a density of 5 × 10(5)cells in a 4-week cell culture. Four different concentrations (1, 5, 10, 20 μM) of each BP (ZOL, PAM, FOS) and pyrophosphate were used in this study.

RESULTS

All BP decreased collagen production and lowered cell proliferation in-vitro. ZOL was the component with most inhibitory effect.

CONCLUSION

The findings in this study suggest that ZOL, PAM and FOS generally diminish cell proliferation and collagen production of human gingival fibroblasts, osteoblasts and SaOS-2-cells. The present follow-up study shows that not only ZOL and PAM but also FOS have a strong inhibitory effect on collagen production and cell survival in-vitro.

Initial adhesion of bone marrow stromal cells to various bone graft substitutes

Purpose

The aim of this study is to determine whether certain biomaterials have the potential to support cell attachment. After seeding bone marrow stromal cells onto the biomaterials, we investigated their responses to each material in vitro.

Methods

Rat bone marrow derived stromal cells were used. The biomaterials were deproteinized bovine bone mineral (DBBM), DBBM coated with fibronectin (FN), synthetic hydroxyapatite (HA), HA coated with FN, HA coated with β-tricalcium phosphate (TCP), and pure β-TCP. With confocal laser scanning microscopy, actin filaments and vinculin were observed after 6, 12, and 24 hours of cell seeding. The morphological features of cells on each biomaterial were observed using scanning electron microscopy at day 1 and 7.

Results

The cells on HA/FN and HA spread widely and showed better defined actin cytoskeletons than those on the other biomaterials. At the initial phase, FN seemed to have a favorable effect on cell adhesion. In DBBM, very few cells adhered to the surface.

Conclusions

Within the limitations of this study, we can conclude that in contrast with DBBM not supporting cell attachment, HA provided a more favorable environment with respect to cell attachment.

Bridging the gap: bone marrow aspiration concentrate reduces autologous bone grafting in osseous defects

Although autologous bone grafting represents an effective tool to induce osteogenic regeneration in local bone defects or pseudarthroses, it is associated with significant donor site morbidity and limited by the amount available for grafting. We investigate the potency of bone marrow aspiration concentrate (BMAC) to augment bone grafting and support bone healing. The functional and radiographic outcome of 39 patients with volumetric bone deficiencies treated with BMAC are presented and evaluated in a prospective clinical trial. A collagen sponge (Col) served as scaffold in 12 patients and a bovine hydroxyapatite (HA) was applied in the other 27 individuals. The minimal follow-up was 6 months. Clinical and radiographic findings were completed by in vitro data. All patients showed new bone formation in radiographs during follow-up. However, two patients underwent revision surgery due to a lack in bone healing. In contrast to the Col group, the postoperative bone formation appeared earlier in the HA group (HA group: 6.8 weeks vs. Col group 13.6 weeks). Complete bone healing was achieved in the HA group after 17.3 weeks compared to 22.4 weeks in the Col group. The average concentration factor of BMAC was 5.2 (SD 1.3). Flow cytometry confirmed the mesenchymal nature of the cells. Cells from BMAC created earlier and larger colonies of forming units fibroblasts (CFU-F) compared to cells from bone marrow aspirate. BMAC combined with HA can reduce the time needed for healing of bone defects when compared to BMAC in combination with collagen sponge.

Behaviour of multipotent maxillary bone-derived cells on beta-tricalcium phosphate and highly porous bovine bone mineral

OBJECTIVES

The aim of this study was to test the applicability of multipotent maxillary cells (MMC) for cell therapy concepts and to evaluate their in vitro behaviour on two different bone substitutes.

MATERIAL AND METHODS

Cells isolated from maxillary bone from 10 donors were expanded using media containing human platelet lysate (HPL) replacing foetal bovine serum and differentiated towards both the osteogenic and the adipogenic lineage. Surface markers were determined by fluorescence-activated cell sorting analysis. Calcium deposits, alkaline phosphatase (ALP) and osteocalcin (OC) were used as biomarkers of osteogenic differentiation. Oil Red O was used to verify adipogenic differentiation. The osteogenic lineage and undifferentiated controls were further cultured on natural bone mineral of bovine origin (BioOss) and beta-tricalcium phosphate (Vitoss) scaffolds. Scaffold efficacy and cell migration were evaluated with live cell imaging.

RESULTS

Isolated cells presented characteristics of bone marrow (BM)-stromal cells and could easily be expanded to clinical scales. Cells expressed osteogenic and adipogenic markers when cultured with inductive media. There were no obvious differences in cell migration and growth behaviour between the two bone substitutes, but significantly higher OC expression was observed on BioOss scaffolds. Both osteogenically differentiated and undifferentiated cell lines expressed ALP activity on the scaffolds.

CONCLUSION

Isolated maxillary cells demonstrate multipotent in vitro characteristics comparable with those of BM-stromal cells. HPL can predictably be used for clinical-scale expansion of MMCs. Both grafting materials provide potential carrier characteristics when loaded with MMCs.

Biocompatibility of individually designed scaffolds with human periosteum for use in tissue engineering

The aim of this study was to evaluate and compare the biocompatibility of computer-assisted designed (CAD) synthetic hydroxyapatite (HA) and tricalciumphosphate (TCP) blocks and natural bovine hydroxyapatite blocks for augmentations and endocultivation by supporting and promoting the proliferation of human periosteal cells. Human periosteum cells were cultured using an osteogenic medium consisting of Dulbecco's modified Eagle medium supplemented with fetal calf serum, Penicillin, Streptomycin and ascorbic acid at 37 degrees C with 5% CO(2). Three scaffolds were tested: 3D-printed HA, 3D-printed TCP and bovine HA. Cell vitality was assessed by Fluorescein Diacetate (FDA) and Propidium Iodide (PI) staining, biocompatibility with LDH, MTT, WST and BrdU tests, and scanning electron microscopy. Data were analyzed with ANOVAs.

RESULTS

After 24 h all samples showed viable periosteal cells, mixed with some dead cells for the bovine HA group and very few dead cells for the printed HA and TCP groups. The biocompatibility tests revealed that proliferation on all scaffolds after treatment with eluate was sometimes even higher than controls. Scanning electron microscopy showed that periosteal cells formed layers covering the surfaces of all scaffolds 7 days after seeding.

CONCLUSION

It can be concluded from our data that the tested materials are biocompatible for periosteal cells and thus can be used as scaffolds to augment bone using tissue engineering methods.

Development of an in vitro model on cellular adhesion on granular natural bone mineral under dynamic seeding conditions--a pilot study

Adhesion of osteogenic cells on biomaterials can be studied with static in vitro models, whereas models representing dynamic seeding conditions are rare. Herein, we present an in vitro model to study cell adhesion on granular biomaterials under dynamic seeding conditions. Radiolabeled osteogenic MC3T3-E1 cells were allowed to adhere to granules of natural bovine bone mineral (NBM) under constant rotation. Adhesion of MC3T3-E1 cells was determined by liquid scintillation counting, and cell morphology was visualized by scanning electron microscopy. Cell viability was determined by MTT assay under static and dynamic conditions, at room and body temperature, and in the presence or absence of serum. We show here that MC3T3-E1 cells rapidly adhere to NBM, reaching a peak 3 h after seeding. Attached cells display characteristic signs of spreading. Five to ten percent of total radioactivity remained on NBM after the removal of nonadherent cells. Viability is maintained at room temperature and under rotation for upto 3 h. This data suggests that the dynamic in vitro model presented here provides a tool to study cell adhesion on granular biomaterials.

Bone engineering-vitalisation of alloplastic and allogenic bone grafts by human osteoblast-like cells

Human osteoblasts on non-sintered hydroxyapatite and demineralised bone matrix (DBX) were analysed in vitro to find out whether they would be suitable for reconstruction of bones in oral surgery. Human osteoblasts were isolated from the jaw during routine dental operations and seeded onto the two biomaterials. Cells were characterised by assay of alkaline phosphatase, detection of type 1 collagen, and production of osteocalcin. After 21 days of cultivation, the cell/biomaterial constructs were examined by scanning electron microscopy, thin sections, and propidium iodide/fluorescein diacetate staining. The osteoblasts formed a vital multiple cell layer on DBX within 3 weeks of cultivation. On hydroxyapatite, the cells showed no tendency to proliferate or migrate onto the synthetic biomaterial, or to form well-spread and viable cell constructs. These findings suggest that surface morphology or the presence of osteoinductive factors may have an important role in the adhesion and proliferation of osteoblasts. Human DBX can be colonised by human osteoblast-like cells in vitro, indicating the potential of allogeneic carriers for future procedures in bone engineering.

Effect of solely applied platelet-rich plasma on osseous regeneration compared to Bio-Oss: a morphometric and densitometric study on rabbit calvaria

BACKGROUND

The use of platelet-rich plasma (PRP) in bone augmentation procedures is well documented; however, the exact benefit of this material is not yet established.

PURPOSE

This study aimed to evaluate the benefits of using PRP, when only used, and compare it to Bio-Oss (Geistlich Biomaterials, Wolhusen, Switzerland) in vertical bone augmentation capacity.

MATERIALS AND METHODS

The study was performed in calvaria of eight adult female New Zealand rabbits using titanium bone conduction cylinder. Two titanium cylinders were fixed into perforated slits made on the parietal bone of each rabbit. On each rabbit, one chamber was grafted with Bio-Oss, and the contralateral was filled with PRP. Animals were sacrificed 4 weeks after intervention and biopsies were taken. Densitometric, histological, and histomorphometric analyses were performed to evaluate bone mineral density, vertical bone augmentation, and remaining graft volume, respectively. Statistical analyses were performed with Mann-Whitney test, using a significance level of p < .05.

RESULTS

Densitometric and histomorphometric data analysis revealed that mean bone mineral densities and bone augmentation were significantly lower in the cylinders treated with PRP (p < .0001) 4 weeks after implantation.

CONCLUSION

This study showed no beneficial effect of using PRP on osseous regeneration. In addition, it was emphasized that Bio-Oss presents good osteoconductive properties by achieving suitable bone volume values.

Missing osteogenic effect of expanded autogenous osteoblast-like cells in a minipig model of sinus augmentation with simultaneous dental implant installation

OBJECTIVES

With natural bovine bone mineral (BioOss) as carrier, the study aimed at investigating the effect of autogenous osteoblast-like cells on bone regeneration in an orthotopic (maxillary sinus) and an ectopic (muscle) site.

MATERIALS AND METHODS

Autogenous osteoblast-like cells were isolated from iliac cancellous bone of six minipigs and expanded in an autogenous serum-supplemented osteogenic medium. After confirmation of osteogenicity, the expanded cells were precultivated on BioOss granules for 1 week. Four milliliter of cell-seeded BioOss were used for sinus augmentation of right sinus and a Straumann solid screw (dental) implant was simultaneously installed. The contralateral (control) side was filled with cell-free BioOss. Besides, 2 ml of the corresponding granules were placed in a pouch in the latissimus dorsi muscles bilaterally. Polychrome sequential labeling was performed postoperatively. Specimens were harvested at week 6. Undecalcified sections were evaluated with microradiography, fluorescence microscopy, histology and histomorphometry.

RESULTS

In the test side, the coronal part of dental implant demonstrated higher bone-implant contact (BIC) than the apical part (34.88+/-28.86% vs. 16.68+/-13.80%, P=0.039), as well as higher bone density (BD) in the corresponding zone (14.88+/-6.37% vs. 11.10+/-4.54%, P=0.021). However, the test side demonstrated no advantage over control side in either BD (12.25+/-4.22% vs. 8.45+/-11.04%, P=0.473) or BIC (24.15+/-21.97% vs. 22.05+/-19.00%, P=0.270). Rare bone was formed in the muscles in both sides.

CONCLUSIONS

The expanded autogenous osteoblast-like cells failed to enhance bone formation in the minipig model of sinus augmentation.

Comparative in vitro study of the proliferation and growth of ovine osteoblast-like cells on various alloplastic biomaterials manufactured for augmentation and reconstruction of tissue or bone defects

In this in vitro study ovine osteoblast-like cells were cultured on seven different alloplastic biomaterials used for augmentation and for reconstruction of bone defects in dental and craniomaxillofacial surgery. The aim of this study was to examine the growth behaviour (viability, cell density and morphology) of ovine osteoblast-like cells on the investigated biomaterials to get knowledge which biomaterial is qualified to act as a cell carrier system in further in vivo experiments. The biomaterials were either synthetically manufactured or of natural origin. As synthetically manufactured biomaterials Ethisorb, MakroSorb, PalacosR, and PDS film were used. As biomaterials of natural origin BeriplastP, Bio-Oss and Titanmesh were investigated. The cell proliferation and cell colonization were analyzed by a proliferation assay and scanning electron microscopy. Osteoblast-like cells proliferated and attached on all biomaterials, except on Beriplast. On Ethisorb the highest cell proliferation rate was measured followed by PalacosR. Both biomaterials offer suitable growth and proliferation conditions for ovine osteoblast-like cells. The proliferation rates of Bio-Oss, MakroSorb, PDS-film and Titanmesh were low and SEM examinations of these materials showed less spread osteoblast-like cells. The results showed that ovine osteoblast-like cells appear to be sensitive to substrate composition and topography. This in vitro study provides the basis for further in vivo studies using the sheep model to examine the biocompatibility and the long-term interaction between the test material and tissue (bone regeneration).

In vitro osteogenesis induced by cells derived from sites submitted to sinus grafting with anorganic bovine bone

OBJECTIVES

This study evaluated key parameters of the in vitro osteogenesis induced by osteoblastic cells obtained from sites submitted to sinus grafting with anorganic bovine bone (ABB) in comparison with cells derived from bone sites of the same patients.

MATERIALS AND METHODS

In three patients, the augmentation of maxillary sinus was carried out using ABB (Bio-Oss). After at least 6 months, during the surgical intervention for titanium implants placement, biopsies were taken from these areas using trephine burs (grafted group). Bone fragments, of the same patients, from sites that had not received graft were also obtained with trephine burs and used as a control group. Osteoblastic cells were obtained from grafted and control groups by enzymatic digestion and cultured under standard osteogenic condition until subconfluence. First passaged cells were cultured in 24-well culture plates. Cell adhesion was evaluated at 24 h. For proliferation and viability assay, cells were cultured for 1, 3, 7, and 10 days. Total protein content and alkaline phosphatase (ALP) activity were measured at 3, 7, 10, 14, 17, and 21 days. Cultures were stained with Alizarin red S at 21 days, for detection of mineralized matrix. Data were compared by Student's t-test.

RESULTS

Cell adhesion and viability were not affected by cell source (P>0.05). Total protein content was greater (P<0.05) for grafted group. Cell proliferation, ALP activity, and bone-like nodule formation were all greater (P<0.05) for the control group.

CONCLUSION

Taken together, these results indicate that the in vivo long-term contact of cells with ABB downregulates the expression of osteoblast phenotype and consequently the in vitro osteogenesis.

Comparativein vitro study of the proliferation and growth of human osteoblast-like cells on various biomaterials

In vitro studies about the growth behavior of osteoblasts onto biomaterials is a basic knowledge and a screening method for the development and application of scaffolds in vivo. In this in vitro study human osteoblast-like (HOB) cells were cultured on seven different biomaterials used in dental and craniomaxillofacial surgery, respectively. The tested biomaterials were synthetic biodegradable (MacroPore, Ethisorb, PDS, Beriplast P) and nonbiodegradable polymers (Palacos) as well as calcium phosphate cement (BoneSource) and titanium. The cell proliferation and cell colonization were analyzed by scanning electron microscopy and EZ4U-test. Statistical analysis were performed. HOB-like cells cultivated on Ethisorb showed the highest proliferation rate. The proliferation rate was statistically significant compared with Palacos, MacroPore, and BoneSource. Whereas, Beriplast, PDS, and titanium yielded lower proliferation rates. However, there was no statistically significant difference compared with Palacos, MacroPore, and BoneSource. SEM analysis showed no significant difference in individual cell features and cell colonization. But an infiltration and a growth of HOB-like cells throughout the porous structure of Ethisorb, which is formed by crossing fibers, is a striking different feature (macrotopography). This feature can explain the highest proliferation rate of Ethisorb. The results showed that HOB-like cells appear to be sensitive to substrate composition and topography. Moreover, the basis for further studies with such biomaterial/osteoblast constructs in vivo are provided. Further focusing points are developing techniques to fabricate three-dimensional porous biomaterial/cell constructs, studying the tissue reaction and the bone regeneration of such constructs compared with the use of autologous bone.

Guided bone regeneration at dehiscence-type defects using biphasic hydroxyapatite + beta tricalcium phosphate (Bone Ceramic) or a collagen-coated natural bone mineral (BioOss Collagen): an immunohistochemical study in dogs

The aim of this study was to immunohistochemically investigate bone regeneration following application of either hydroxyapatite+beta tricalcium phosphate (BCG) or a collagen-coated natural bone mineral (BOC) in combination with a collagen membrane at dehiscence-type defects in dogs. Standardized buccal dehiscence defects were surgically created following implant bed preparation in six beagle dogs. Defects were randomly filled with either BOC (BioOss Collagen) or BCG (Bone Ceramic) according to a split-mouth design, and covered with a native porcine derived collagen membrane (BioGide). After 1, 4 and 9 weeks of submerged healing, dissected blocks were processed for immunohistochemical (osteocalcin) and histomorphometrical analysis (residual defect length, new bone-implant contact, area of new bone fill, percentage of osseointegrated bone-graft particles). Both groups revealed a significant decrease in mean residual defect length, and increases in mean new bone-implant contact, bone fill and percentage of osseointegrated bone-graft particles after 4 and 9 weeks of healing. Remaining BCG and BOC granules were completely integrated into a secondarily formed network of spongiosa, but there was no osteoclastic activity at the surface of either type of bone-graft particle. Both BCG and BOC may provide an osteoconductive scaffold to support guided bone regeneration procedures at dehiscence-type defects.

Bone augmentation in rabbit calvariae: comparative study between Bio-Oss and a novel beta-TCP/DCPD granulate

AIM

In the present in vivo study, we compare the bone regeneration capacity of a novel brushite cement synthesized in our laboratory (DTG) with Bio-Oss using rabbits as an animal model.

METHODS

The study was performed in a group of 14 adult New Zealand rabbits using the bone conduction model. Two titanium cylinders were fixed into perforated slits made on the parietal cortical bone of each rabbit. One cylinder was left empty (negative control) and the other was filled with either Bio-Oss or brushite set-cement granules (test cylinder). Four weeks after the intervention, the animals were sacrificed and biopsies were taken. The following parameters were analysed: bone tissue augmentation, bone mineral density and biomaterial resorption. The comparison of data between the different groups was performed using the Mann-Whitney test with a significance level of p<0.05.

RESULTS

The mean bone mineral density and augmented mineral tissue inside the test cylinders were similar but higher than those of negative controls. Material resorption and bone tissue augmentation were significantly higher in the defects treated with the brushite-based set cement (p<0.05).

CONCLUSIONS

Brushite cement granules were more resorbable and generated more bone tissue than Bio-Oss inside the titanium cylinders placed in the rabbit calvaria.

Evaluation of the cytocompatibility of mixed bovine bone

Treatment of bovine bone with peroxides and chaotropic agents aims to obtain an acellular bone matrix that is able to maintain the collagen-apatite complex and a higher mechanical resistance, a mixed biomaterial hereby named mixed bovine bone (MBB). The purpose of this study was to evaluate the cytocompatibility of MBB and cell-MBB interaction. Cell morphology, number of viable cells, ability to reduce methyltetrazolium and to incorporate neutral red upon exposure to different concentrations of the hydrosoluble extract of MBB were assessed in Balb-c 3T3 cells according to ISO 10993-5 standard. The interaction between cells and MBB surface was evaluated by scanning electron microscopy. The water-soluble MBB extracts were cytotoxic and led to cell death possibly due to its effect on mitochondrial function and membrane permeability. Cells plated directly onto the MBB did not survive, although after dialysis and material conditioning in DMEM + 10% FCS, the cells adhered and proliferated onto the material. It may be concluded that, in vitro, water-soluble MBB extracts were cytotoxic. Nevertheless, MBB cytotoxic effect was reverted by dialysis resulting in a material that is suitable for cell based-therapy in the bioengineering field.

Proliferation rate of human osteoblast-like cells on alloplastic biomaterials and their clinical application for the transnasal duraplasty procedure

The possibility of transmission of slow virus infection (HIV) and Creutzfeld-Jakob disease by cadaveric dura implants makes it necessary to find synthetic, absorbable materials for the reconstruction of the dura mater. Various procedures with autologous or alloplastic material are described. Four commerically available biomaterials were choosen to study the proliferation rate and the biocompatibility of human osteoblast-like cells (HOB-like cells) on 2-dimensional material by biochemical analysis. With a proliferation assay, the viability and the proliferation capacity of osteoblast-like cells were evaluated. A clinical trial was added to study resorbable fleece as one of the previously tested biomaterial in a small patient group (8 patients) to close anterior cranial fossa dura defects. The results of the proliferation assay showed the highest proliferation rate of HOB-like cells on resorbable fleece. All patients in our clinical trial with anterior cranial fossa dura defects were successfully treated with resorbable fleece. There was no evidence for persisting cerebrospinal fluid rhinorrhea or foreign body reaction after the period of wound healing. The present study demonstrated an excellent biocompatibility of resorbable fleece. The vicryl fleece is an alternative alloplastic material for endonasal closure of defined substantial defects of the dura with cerebrospinal fluid.

Two Techniques for the Preparation of Cell-Scaffold Constructs Suitable for Sinus Augmentation: Steps into Clinical Application

The objective of this clinical trial was the analysis of 2 methods for engineering of autologous bone grafts for maxillary sinus augmentation with secondary implant placement. Group 1 (8 patients, 12 sinuses): cells of mandibular periosteum were cultured in a good manufacturing practice laboratory (2 weeks) with autologous serum and then transferred onto a collagen matrix. After another week, these composites were transplanted into the sinuses. In group 2A (2 patients, 3 sinuses), cells of maxillary bone were cultivated with autologous serum for 2 weeks, seeded onto natural bone mineral (NBM, diameter [Ø] = 8 mm) blocks, and cultivated for another 1.5 months. These composites were transplanted into the sinuses. Group 2B (control, 3 patients, 5 sinuses) received NBM blocks alone. In the course of implant placement 6 (group 1) and 8 (group 2) months later, core biopsy were taken. Clinical follow-up period was 1 to 2.5 years in group 1 and approximately 7 years in groups 2A and 2B. New vital bone was found in all cases at median densities of 38% (n = 12) in group 1, 32% in group 2A (n = 3), and 25% in group 2B (n = 5). Differences between group 1 and 2B as well as 2A and 2B were statistically significant ( p = 0.025). No adverse effects were seen. All methods described were capable of creating new bone tissue with sufficient stability for successful implant placement.

Effects ofin vitro bone formation on the mechanical properties of a trabeculated hydroxyapatite bone substitute

This study was designed to test the hypothesis that the mechanical properties of a trabecular bone substitute can be enhanced through in vitro tissue formation. Our specific objectives were to (1) determine the effects of in vitro marrow stromal cell-mediated tissue deposition upon a trabeculated hydroxyapatite scaffold on the strength and toughness of the resulting bone substitute; and (2) identify and characterize regions of newly deposited matrix and mineral. This work provides a basis for future investigations aimed at transforming a brittle hydroxyapatite scaffold into an osteoinductive, biomechanically functional implant through in vitro bone deposition. As hypothesized, the mechanical properties of the trabecular bone substitutes were significantly enhanced by in vitro tissue formation. As a result of cell seeding and a 5 week culture protocol, mean strength increased by 85% (p = 0.008) and energy to fracture increased by 130% (p = 0.003). Accompanying the enhancement of mechanical properties was the deposition of significant amounts of bone matrix and mineral. Fluorescence imaging, scanning electron microscopy, electron probe microanalysis, and nanoindentation confirmed the presence of bonelike mineral with Ca/P ratio, modulus, and hardness similar to that within human and rat trabecular bone tissue. This new mineralization was found to exist within a newly deposited parallel-fibered matrix both encasing and bridging between scaffold trabeculae. Taken as a whole, our results establish the feasibility of the production of an osteoinductive hydroxyapatite-based trabecular bone substitute with mechanical properties enhanced through in vitro bone deposition.

Comparison of osteoblast-like cell responses to calcium silicate and tricalcium phosphate ceramicsin vitro

Calcium silicate ceramics have been proposed as new bone repair biomaterials, since they have proved to be bioactive, degradable, and biocompatible. Beta-tricalcium phosphate ceramic is a well-known degradable material for bone repair. This study compared the effects of CaSiO3 (alpha-, and beta-CaSiO3) and beta-Ca3(PO4)2 (beta-TCP) ceramics on the early stages of rat osteoblast-like cell attachment, proliferation, and differentiation. Osteoblast-like cells were cultured directly on CaSiO3 (alpha-, and beta-CaSiO3) and beta-TCP ceramics. Attachment of a greater number of cells was observed on CaSiO3 (alpha-, and beta-CaSiO3) ceramics compared with beta-TCP ceramics after incubation for 6 h. SEM observations showed an intimate contact between cells and the substrates, significant cells adhesion, and that the cells spread and grew on the surfaces of all the materials. In addition, the proliferation rate and alkaline phosphatase (ALP) activity of the cells on the CaSiO3 (alpha-, and beta-CaSiO3) ceramics were improved when compared with the beta-TCP ceramics. In the presence of CaSiO3, elevated levels of calcium and silicon in the culture medium were observed throughout the 7-day culture period. In conclusion, the results of the present study revealed that CaSiO3 ceramics showed greater ability to support cell attachment, proliferation, and differentiation than beta-TCP ceramic.

Effect of bone extracellular matrix synthesized in vitro on the osteoblastic differentiation of marrow stromal cells

Alternative materials for bone grafts are gaining greater importance in dentistry and orthopaedics, as the limitations of conventional methods become more apparent. We are investigating the generation of osteoinductive matrix in vitro by culturing cell/scaffold constructs for tissue engineering applications. The main strategy involves the use of a scaffold composed of titanium (Ti) fibers seeded with progenitor cells. In this study, we investigated the effect of extracellular matrix (ECM) laid down by osteoblastic cells on the differentiation of marrow stromal cells (MSCs) towards osteoblasts. Primary rat MSCs were harvested from bone marrow, cultured in dexamethasone containing medium and seeded directly onto the scaffolds. Constructs were grown in static culture for 12 days and then decellularized by rapid freeze-thaw cycling. Decellularized scaffolds were re-seeded with pre-cultured MSCs at a density of 2.5 x 10(5) cells/construct and osteogenicity was determined according to DNA, alkaline phosphatase, calcium and osteopontin analysis. DNA content was higher for cells grown on decellularized scaffolds with a maximum content of about 1.3 x 10(6) cells/construct. Calcium was deposited at a greater rate by cells grown on decellularized scaffolds than the constructs with only one seeding on day-16. The Ti/MSC constructs showed negligible calcium content by day-16, compared with 213.2 (+/- 13.6) microg/construct for the Ti/ECM/MSC constructs cultured without any osteogenic supplements after 16 days. These results indicate that bone-like ECM synthesized in vitro can enhance the osteoblastic differentiation of MSCs.

Invitro study of adherent mandibular osteoblast-like cells on carrier materials

Augmentation of the craniofacial region is necessary for many aesthetic and reconstructive procedures. Tissue engineering offers a new option to supplement existing treatment regimens. In this procedure, materials composed of hydroxyapatite (HA), of synthetic or natural origin, are used as scaffolds. The aim of this study was to evaluate the effects of three HA materials on cultured human osteoblasts in vitro. Explant cultures of cells from human alveolar bone were established. Human osteoblasts were cultured on the surface of HA calcified from red algae (C GRAFT/Algipore), deproteinized bovine HA (Bio-Oss) and bovine HA carrying the cell binding peptide P-15 (Pep Gen P-15). Cultured cells were evaluated with respect to cell attachment, proliferation and differentiation. Cells were cultured for 6 and 21 days under osteogenic differentiation conditions, and tissue-culture polystyrene dishes were used as control. The ability of cells to proliferate and form extracellular matrix on these scaffolds was assessed by a DNA quantification assay, protein synthesis analysis and by scanning electron microscopical examination. Osteogenic differentiation was screened by the expression of alkaline phosphatase. The osteoblastic phenotype of the cells was monitored using mRNA levels of the bone-related proteins including osteocalcin, osteopontin and collagen Type I. We found that cells cultured on C GRAFT/Algipore) and Pep Gen P-15 showed a continuous increase in DNA content and protein synthesis. Cells cultured on Bio-Oss showed a decrease in DNA content from Day 6 (P < 0.05) to Day 21 (P < 0.0001) and protein synthesis on Day 21 (P < 0.005). Alkaline phosphatase activity increased in cells grown on C GRAFT/Algipore and Pep Gen P-15 in contrast to cells grown on Bio-Oss, in which the lowest levels of activity could be observed on Day 21 (P < 0.05). Reverse transcriptase polymerase chain reaction analysis confirmed the osteoblastic phenotype of the cells grown on all three materials throughout the whole culture period. The results of our in vitro study show that the differences in metabolic activity of cells grown on HA materials are directly related to the substrate on which they are grown. They confirm the excellent properties of HA carrying the cell binding peptide P-15 and HA calcified from red algae as used in maxillofacial surgery procedures.

Search for ideal biomaterials to cultivate human osteoblast-like cells for reconstructive surgery

In this study we cultured human osteoblast-like cells on 16 different biomaterials to find an optimal biomaterial for subsequent use in reconstructive surgery. The tested biomaterials can be divided into five groups: collagen-based membranes of bovine, equine or calf origin, tricalcium phosphate based membranes (alpha and beta), hyaluronic acid based, anorganic bovine bone and anorganic silicone-based membranes. Cell proliferation and cell colonization (Environmental Scanning Electron Microscope, ESEM) analysis were performed. The results of the study demonstrated that four of the examined biomaterial/cell constructs showed a very good proliferation rate and cell density: No. 3 (Tissue Vlies), No. 7 (Sepra film), No. 16 (Biobrane) and No. 17 (Biomend). No favourable group of biomaterials was noticeable. Moreover, the results indicate that these four biomaterials as a part of bone constructs are the best tools for engineering new bone tissue. In contrast, biomaterials No. 19a (Bio-Oss) and 19b (Bio-Oss Collagen) showed the lowest proliferation rates. The result of No. 19b was improved by treatment in the perfusion chamber for 48 h as well as by additional use of vacuum. The present study is an important base for further analysis of biomaterials and consequently for the development of tissue engineering.

Frei modellierbare Hydroxylapatit-Kollagen-Komposite zur Sanierung oss�rer Defekte

AIM

In the following study we evaluated the biological response of a new freely moldable bone substitute in an animal model.

MATERIAL AND METHODS

Critically sized defects were created surgically in the lower jaw of ten adult minipigs. The drill defects were filled with hydroxyapatite collagen paste. After observation periods of 1, 3, 6, 12, and 18 months the mandibles were harvested without wound healing defects for histological evaluation of resorption and bone ingrowth with a sawing and grinding technique.

RESULTS

The result of the remodeling process was a complete degradation of hydroxyapatite collagen implants after 12-18 months with reorganization of vital trabeculae oriented in a mature pattern.

CONCLUSION

The hydroxyapatite collagen cement works as an osteoconductor and shows signs of direct osseointegration and resorption.

Growth and proliferation of human osteoblasts on different bone graft substitutes: an in vitro study

The purpose of this study was to investigate the effect of different bone graft substitutes onto the growth and proliferation pattern of bone cells derived from human iliac cancellous bone. Five different bone graft materials were used to investigate the effect on the proliferation of osteoblasts in vitro: phytogene hydroxyapatite (Algipore), alpha-Tricalcium phosphate (Bio-Base), bovine hydroxyapatite (low temperature) (Bio-Oss), bovine hydroxyapatite (high temperature) (Osteograf), and bovine hydroxyapatite (high temperature) enhanced with p-15, synthetic peptide (PepGen p-15). The osteoblasts were derived from human iliac cancellous bone and seeded with the different bone substitutes. The cell proliferation and viability (WST-1), alkaline phosphatase as an early marker of osteoblast proliferation, was evaluated after 6 and 9 days. The cultures were examined for cell growth pattern and morphology by normal light and scanning electron microscopy. The human osteoblasts showed a different proliferation pattern according to the type of applied bone graft substitute. PepGen P-15 showed the highest proliferation and differentiation rate followed by Osteograf, Algipore, and Bio-base. Bio-Oss showed the lowest. These results were confirmed by electron microscopy and light microscopy evaluation in which similar growth pattern were observed. Distinct bone graft materials have different impact onto the proliferation pattern of human osteoblasts in vitro.

Particulated bone grafts - effectiveness of bone cell supply

OBJECTIVE

The objective of this study was to measure the amount of viable bone cells present in different types of bone graft.

MATERIAL AND METHODS

Bone chips were harvested from the trabecular or cortical bone of the mandible or the iliac crest and either milled or not. The average size of unmilled bone particles was 5 x 5 x 5 mm and that of milled was 2 x 2 x 2 mm. Drill sludge was obtained using either a ball reamer, a diamond ball or an implant drill (the latter from mandibular bone and of average dimension 1 x 1 x 1 mm). A measure of 0.5 g of each category was cultured in Dulbecco's modified Eagle's medium with additives for four weeks. Cell counts were performed. An analysis of the osteocalcin synthesis, the alkaline phosphatase (ALP) activity, the collagen types and the concentration of bone-specific collagen cross-links in medium supernatants was performed.

RESULTS

Cells stained positively for osteocalcin and ALP in all groups. Bone-specific collagen cross-links could be quantified and collagen of types I and V was present with no difference in all groups. Unmilled spongy bone chips revealed greater cell counts than milled (P<0.05). Spongy bone chips revealed greater cell counts than cortical bone chips (P<0.05). Drill sludge obtained by hard alloy ball reamer showed the least amount of viable cells (P<0.05).

CONCLUSIONS

Bone milling reduces the quantity of osteoblasts. Bone obtained by the ball reamer supplies a smaller number of cells than bone obtained by other methods. Unmilled spongy bone chips appear to offer the greatest amount of viable osteoblasts.

The influence on gene-expression profiling of osteoblasts behavior following treatment with the ionic products of sintered β-dicalcium pyrophosphate dissolution

Sintered dicalcium pyrophosphate (SDCP) is biocompatible to bone tissue both in the in vivo and in vitro model. However, the molecular mechanisms that mediated these processes have yet to be identified. In this study, we investigated the influence of SDCP ions on in vitro osteoblasts behavior. The powder of sintered beta-dicalcium pyrophosphate (SDCP) was dissolved by HCl and then diluted into different concentration of solutions by culture medium used in the osteoblast cell culture. The effects of various concentration of SDCP on bone cell activities were evaluated by using MTT assay. For the differentiation of osteoblasts, alkaline phosphatase (AP) staining, von Kossa stain for mineralized nodules and bone markers messenger ribonucleic acid (mRNA) isolation and identification were performed at 3h, days 1, 3, 7 and 14. In the presence of 10(-8)M SDCP for 14 days, the osteoblasts population was still significantly higher than that of control. In the qualitative analysis for the formation of AP staining colonies and mineralization nodules formation were not affected by SDCP ions. When osteoblasts cultured in the presence of 10(-8)M SDCP ions, the osteocalcin mRNA expression was up-regulated; while the collagen, osteonectin and osteopontin mRNA expression were down-regulated. In this study, we demonstrated that the elevated concentration of calcium and pyrophosphate ions can activate genes of the bone cells. This study will contribute to a better understanding of cell/biomaterial interactions and mechanisms that SDCP affect the bone cells.

In vitro study of osteogenic differentiation of bone marrow stromal cells on heat-treated porcine trabecular bone blocks

This in vitro study investigated the potential of the heat-treated porcine trabecular bone block as a bone substitute for the treatment of bone defects or related diseases. Chemical, mechanical, and morphological studies of bone blocks were performed. The resultant properties were compared with the properties of currently available commercial products from bovine trabecular bones. The major component of the bone block was hydroxyapatite, and the ratio of Ca/P was 1.65-1.66. The average values of the compressive Young's modulus and the ultimate strength were 346.33 +/- 83.15 and 6.66 +/- 1.62 MPa, respectively. The pore size of the heat-treated bone blocks was approximately 300-500 microm. For the biological investigations, expanded bone marrow stromal cells (BMSCs) were isolated from the femurs of New Zealand White rabbits and were dynamically seeded into the heat-treated porcine bone block (10x10x5 mm3). Before the cells were seeded, the heat-treated porcine bone blocks were divided into two groups: collagen coated blocks (n=16) and uncoated blocks (n=16). Within each group, the blocks were again divided into two groups, depending on the culture method, i.e., static or rotating culture. Cells were cultured in the blocks for up to 6 weeks. Scanning electron microscopic examination after 4 weeks showed that the cell layers attached to the porcine bone block. Proliferation and osteogenic differentiation were analyzed by cell counting, an MTT assay, alkaline phosphatase activity, and total protein content. The deposition of extracellular substances and osteoid formation surrounded by osteoblast-like cuboidal cells were confirmed through histochemical staining and transmission electron microscopy. Based on the results of this study, we conclude that heat-treated porcine trabecular bone has great potential as a bone substitute and may even be superior to currently available commercial products.

Bone formation in the presence of platelet-rich plasma vs. bone morphogenetic protein-7

Growth factors contained in platelet-rich plasma (PRP) have recently been proposed to enhance maturation of bone grafts and, in combination with anorganic bovine bone, to support repair in the treatment of small bone defects in maxillofacial surgery. Bone morphogenetic proteins (BMP) carried in a matrix may be able to replace the autologous bone graft in the treatment of critical size defects. However, no studies have compared the bone stimulating capacity of PRP and BMP. Likewise there is no data comparing the effects of PRP in either an autologous bone graft or in anorganic bovine bone. We augmented the mandible of Wistar rats (n = 28) on both sides with either anorganic bovine bone (Bio-Oss) or autologous rib bone. On the test side we applied either 20 microl of autologous PRP or 10 microl of rhBMP-7 (4 groups, n = 7). In addition, bone induction was evaluated in an extraskeletal site (n = 14). A polychrome sequential labeling was performed. The animals were sacrificed by intra-vital perfusion on day 50. Undecalcified ground sections were evaluated by microradiography, digitized histomorphometry and under fluorescent light. The qualitative analysis of fluorochrome labels suggested that PRP and rhBMP-7 accelerated bone growth. However, histomorphometric analysis revealed no significant differences in the area of newly mineralized bone under either the influence of PRP or rhBMP-7 on autologous bone graft. Likewise, the addition of PRP to anorganic bovine bone showed no statistical difference to the control group. The strongest bone stimulating effect was seen for the combination of rhBMP-7 with anorganic bovine bone (p = 0.028). In the extraskeletal model, newly formed bone was evident in the presence of rhBMP-7, but not of PRP. In conclusion, according to the histomorphometry, the addition of platelet-rich plasma failed to enhance bone formation on anorganic bovine bone and on autologous bone grafts.

Follow-up of collagen crosslink excretion in patients with oral squamous cell carcinoma and analysis of tissue samples

The presence of an oral squamous cell carcinoma (OSCC) may be associated with increased urinary excretion of the markers of collagen degradation, hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP). We investigated the possibility of these markers predicting the presence of active disease. Patients from a current study on HP and LP were included as follows: Group 1a (OSCC with confirmed mandibular bony infiltration, n=12), group 1b (group 1a patients >6 months after successful treatment), group 2a (OSCC without evidence of mandibular bone infiltration, n=8), group 2b (group 2a patients >6 months after successful treatment), group 3a (recurrent OSCC, n=8), group 3b (group 3a patients >6 weeks later, symptoms unchanged) and group 4 (control group, n=74). Tissue samples from tumour tissue and adjacent healthy mucosa were additionally investigated for HP and LP concentrations (n=8). The decrease in the urinary concentrations of HP and LP was statistically significant between groups 1a and 1b (P<0.001 for HP and LP), but not between groups 2a and 2b (P=0.07 for HP and LP), while values in groups 1b and 2b were within the normal range. When comparing groups 3a and 3b, a significant increase was observed for LP (P=0.050), but not HP (P=0.208). In conclusion, successful treatment of OSCC with bony involvement may be associated with a reduction of urinary HP and LP, whereas ongoing disease may result in an increase of LP. HP and LP may both be useful markers of tumour progression in patients with OSCC.

Characterization of a bovine collagen–hydroxyapatite composite scaffold for bone tissue engineering

Different biomaterials have been used as scaffolds for bone tissue engineering. Here we characterize a biomaterial composed of sintered (1100 degrees C) and powdered hydroxyapatite (HA) and type I collagen (Coll), both of bovine origin, designed for osteoconductive and osteoinductive scaffolds. Coll/HA proportions were 1/2.6 and 1/1 (wet weight), and particles sizes varied from 200 to 400 microm. Vv (volume density) and Sv (surface to volume density) for the HA particles in the composite ranged from 0.48 +/- 0.06 to 0.55 +/- 0.02 and 5.090 +/- 0.545 to 6.366 +/- 0.289 microm(-1), respectively. Due to the relatively small changes in Vv and Sv, a macroporosity could be characterized for the biocomposite. X-ray diffraction and infrared spectroscopy showed that the sintered bone was composed essentially of HA with minimum additional groups such as surface calcium hydroxide, surface and crystal water, free carbon dioxide and possibly brushite. Mass spectrometry detected carbonates at A and B sites of HA, and weakly bound to the structure. Human osteoblasts adhered and spread on both the HA particle surface and the collagen fibers, which seemed to guide cells between adjacent particles. The biocomposite studied has several characteristics considered as ideal for its use as a scaffold for osteoconduction and osteoinduction.

Efficacy of bovine bone mineral for alveolar augmentation: a human histologic study

The purpose of this study was to evaluate the osteoconductivity of bovine bone mineral in humans. Fifteen patients referred to a private specialist surgical practice were treated consecutively for the repair of alveolar defects, and/or ridge maintenance at the site of extraction sockets, prior to implantation. Bio-Oss xenograft (Geistlich Pharma, Wolhusen, Switzerland) was utilized as the principal grafting material. Bone cores were trephined out at the time of implant placement and processed and examined to evaluate the tissue response under the light microscope. A total of 22 trephines were processed for histomorphometric evaluation to calculate the mean percentage of bone, residual graft and connective tissue by area. In addition, the mean percentage bone-to-graft contact was also calculated. The mean percentage area of new bone formation was 26.9%, and the percentage of residual graft and connective tissue as 25.6% and 47.4% respectively. The mean percentage contact length between bone and residual graft was 34%. One implant placed into a site, which was histologically identified as having little new bone and, unusually, an inflammatory infiltrate, failed with mobility at abutment connection. All other implants were restored into function, with a survival rate at baseline of 97%.

Nachweis der Osteokalzinexpression osteoblastärer Zellen mandibulären Ursprungs, wachsend auf Biomaterialien, mittels RT-PCR und SDS-PAGE/Western Blotting

A new approach to addressing difficult tissue reconstructive or replacement problems in the oral cavity is to engineer new tissue by using selective cell transplantation on polymer scaffolds. The current study characterized the osteoblastic nature of adherent mandibular cells on biomaterials, which could have a potential use as scaffolds for tissue engineering strategies. Cells of mandibular origin from one patient were cultivated on three different biomaterials (PepGen P-15 trade mark, Frios Algipore, and OsteoGraf/LD-700) for 7 and 14 days and osteocalcin expression was demonstrated by RT-PCR and SDS-PAGE/Western blotting. In order to explicitly characterize only the adherent cells on the biomaterials, we first separated the biomaterials with adherent cells from the culture plate before trypsinization. We could demonstrate that cell growth of adherent mandibular osteoblast-like cells was significantly higher on biomaterials with an organic component (PepGen P-15 trade mark ) in comparison to Frios Algipore and OsteoGraf/LD-700, respectively. In conclusion, only the explicit study of adherent cells at the gene and protein levels gives information about the osteoconductivity of biomaterials.