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Wang Y, Fu G, Zhang J, Xu Y, Shen M, Yi Z, Lan J, Li Q, Zhao Y, Wu R, Zhang Y. Bioceramics for Guided Bone Regeneration: A Multicenter Randomized Controlled Trial. Clin Implant Dent Relat Res 2025; 27:e13437. [PMID: 39823242 DOI: 10.1111/cid.13437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 12/12/2024] [Accepted: 12/20/2024] [Indexed: 01/19/2025]
Abstract
OBJECTIVES To compare the clinical effectiveness of a novel bioceramic (BC) with a control xenograft (BO) for guided bone regeneration (GBR) performed simultaneously with implant placement. MATERIALS AND METHODS This clinical study enrolled patients with insufficient bone volume who required GBR during implant placement to increase bone width using either BC or BO. Outcome measures included a dimensional reduction in buccal bone thickness measured by cone beam computed tomography performed immediately post-surgery and at 6 months postoperatively (ΔHBBT), soft tissue healing at 14 days, 1 month, and 6 months postoperatively, and complications rates. The primary outcome was the change in buccal bone thickness around the implant. RESULTS Of the total 152 patients included, 76 from each group received BC and BO treatments. The ΔHBBT in BC and BO groups were -0.276 mm (-0.432, -0.121) and -0.614 mm (-0.769, -0.459) mm, respectively, rejecting the null hypothesis. No significant difference in soft tissue healing was observed between the two groups, with no inflammatory changes in 96.05% and 90.79% of the BC and BO groups, respectively, at 2 weeks postoperatively. However, the BC group exhibited a lower overall complication rate (3.95%), including mild inflammation, poor soft tissue healing, and bone graft extrusion in 3 out of 76 patients. CONCLUSIONS Both BC and BO demonstrated favorable outcomes in bone regeneration and soft tissue healing when used for simultaneous implant placement and bone augmentation.
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Affiliation(s)
- Yulan Wang
- 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, China
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Gang Fu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Zhang
- Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine, Nankai University & Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, China
| | - Yan Xu
- Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases (Nanjing Medical University), Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Ming Shen
- Department of General Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases (Nanjing Medical University), Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Zhe Yi
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Jing Lan
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Yantai, China
| | - Qiang Li
- Shandong Engineering Technology Research Center for Medical Regenerative Repair Materials, Yantai Zhenghai Bio-Tech Co. Ltd., Yantai, China
| | - Yangsheng Zhao
- Shandong Engineering Technology Research Center for Medical Regenerative Repair Materials, Yantai Zhenghai Bio-Tech Co. Ltd., Yantai, China
| | - Runfa Wu
- School of Stomatology, Jiangxi Medical College, Nanchang University, Jiangxi Province Key Laboratory of Oral Biomedicine, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, China
| | - Yufeng Zhang
- 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, China
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Xuan Y, Li L, Zhang C, Zhang M, Cao J, Zhang Z. The 3D-Printed Ordered Bredigite Scaffold Promotes Pro-Healing of Critical-Sized Bone Defects by Regulating Macrophage Polarization. Int J Nanomedicine 2023; 18:917-932. [PMID: 36844434 PMCID: PMC9951604 DOI: 10.2147/ijn.s393080] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/29/2023] [Indexed: 02/22/2023] Open
Abstract
Background Repairing critical-sized bone defects secondary to traumatic or tumorous damage is a complex conundrum in clinical practice; in this case, artificial scaffolds exhibited preferable outcomes. Bredigite (BRT, Ca7MgSi4O16) bioceramic possesses excellent physicochemical properties and biological activity as a promising candidate for bone tissue engineering. Methods Structurally ordered BRT (BRT-O) scaffolds were fabricated by a three-dimensional (3D) printing technique, and the random BRT (BRT-R) scaffolds and clinically available β-tricalcium phosphate (β-TCP) scaffolds were compared as control groups. Their physicochemical properties were characterized, and RAW 264.7 cells, bone marrow mesenchymal stem cells (BMSCs), and rat cranial critical-sized bone defect models were utilized for evaluating macrophage polarization and bone regeneration. Results The BRT-O scaffolds exhibited regular morphology and homogeneous porosity. In addition, the BRT-O scaffolds released higher concentrations of ionic products based on coordinated biodegradability than the β-TCP scaffolds. In vitro, the BRT-O scaffolds facilitated RWA264.7 cells polarization to pro-healing M2 macrophage phenotype, whereas the BRT-R and β-TCP scaffolds stimulated more pro-inflammatory M1-type macrophages. A conditioned medium derived from macrophages seeding on the BRT-O scaffolds notably promoted the osteogenic lineage differentiation of BMSCs in vitro. The cell migration ability of BMSCs was significantly enhanced under the BRT-O-induced immune microenvironment. Moreover, in rat cranial critical-sized bone defect models, the BRT-O scaffolds group promoted new bone formation with a higher proportion of M2-type macrophage infiltration and expression of osteogenesis-related markers. Therefore, in vivo, BRT-O scaffolds play immunomodulatory roles in promoting critical-sized bone defects by enhancing the polarization of M2 macrophages. Conclusion 3D-printed BRT-O scaffolds can be a promising option for bone tissue engineering, at least partly through macrophage polarization and osteoimmunomodulation.
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Affiliation(s)
- Yaowei Xuan
- Department of Stomatology, The First Medical Centre, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Lin Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Chenping Zhang
- Department of Oral Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China
| | - Min Zhang
- Department of Stomatology, The First Medical Centre, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Junkai Cao
- Department of Stomatology, The First Medical Centre, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Zhen Zhang
- Department of Oral Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China
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Kargozar S, Lotfibakhshaeish N, Ebrahimi-Barough S, Nazari B, Hill RG. Stimulation of Osteogenic Differentiation of Induced Pluripotent Stem Cells (iPSCs) Using Bioactive Glasses: An in vitro Study. Front Bioeng Biotechnol 2019; 7:355. [PMID: 31850324 PMCID: PMC6901961 DOI: 10.3389/fbioe.2019.00355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 11/08/2019] [Indexed: 11/13/2022] Open
Abstract
Selection and use of an optimal cell source for bone tissue engineering (BTE) remain a challenging issue; the invention of induced pluripotent stem cells (iPSCs) have created new hopes on this regard. At the present study, we attempted to show the usability of iPSCs in combination with bioactive glasses (BGs) for bone regeneration applications. For this aim, iPSCs were cultured and incubated with the strontium and cobalt-containing BGs for different intervals (1, 5, and 7 days). The cell cytotoxicity and attachment were assessed using MTT assay and scanning electron microscopy (SEM), respectively. Moreover, the osteogenic differentiation of iPSCs seeded onto the glasses was evaluated using alkaline phosphatase (ALP) activity assay and real-time PCR. The obtained results clarified that although the cell viability is decreased during a 7 day period, the iPSCs could adhere and expand onto the BGs particles and over-express the osteogenic markers, including osteocalcin, osteonectin, and Runx2. Based on the data, we conclude that iPSCs in a combination of BGs can be considered as a potential candidate for BTE strategies.
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Affiliation(s)
- Saeid Kargozar
- Tissue Engineering Research Group, Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasrin Lotfibakhshaeish
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Ebrahimi-Barough
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Nazari
- Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Robert G. Hill
- Unit of Dental Physical Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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