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Shaikh MS, Zafar MS, Alnazzawi A, Javed F. Nanocrystalline hydroxyapatite in regeneration of periodontal intrabony defects: A systematic review and meta-analysis. Ann Anat 2021; 240:151877. [PMID: 34864225 DOI: 10.1016/j.aanat.2021.151877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/09/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Alveolar bone loss and mobility of teeth is commonly observed in periodontitis patients. Regeneration of periodontal intrabony defects is indicated to restore the lost bone and periodontal tissues. The aim of the present study was to evaluate the clinical outcomes of periodontal intrabony lesions by using nanocrystalline hydroxyapatite (NHA) graft and comparing it with open flap debridement (OFD) alone. MATERIALS AND METHODS The eligibility criteria encompassed randomized (RCTs) and controlled clinical trials (CCTs). Weighted mean differences were calculated for clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction and gingival recession (REC) change, demonstrated as forest plots. The revised Cochrane Risk of Bias tool for randomized trials (RoB2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool were used for quality assessment of RCTs and non-randomized trials respectively. RESULTS From 22 full-text articles identified, three RCTs, one CCT and one retrospective follow-up of RCT were included. All the five papers comprised the quantitative evaluation. The use of NHA graft provided additional CAL gain of 0.96 mm (p = 0.0009) and PPD reduction of 0.97 mm (p < 0.00001) when compared to OFD alone. However, in terms of REC changes, no considerable benefits of NHA graft were demonstrated than OFD alone (p = 0.48). CONCLUSIONS The bioactive NHA graft showed promising results clinically in regenerative periodontology and can be considered for the management of periodontal intrabony defects. The use of NHA graft considerably provided better clinical outcomes in intrabony defects compared to using the OFD alone. Future research investigating NHA graft against other regenerative materials including specific BGs, at longer follow-up periods and bigger sample sizes and in furcation defects warranted.
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Affiliation(s)
- Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia; Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan.
| | - Ahmad Alnazzawi
- Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia
| | - Fawad Javed
- Department of Orthodontics, Eastman Institute for Oral Health, University of Rochester, New York 14620, United States
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Yetisgin AA, Cetinel S, Zuvin M, Kosar A, Kutlu O. Therapeutic Nanoparticles and Their Targeted Delivery Applications. Molecules 2020; 25:E2193. [PMID: 32397080 PMCID: PMC7248934 DOI: 10.3390/molecules25092193] [Citation(s) in RCA: 280] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 12/12/2022] Open
Abstract
Nanotechnology offers many advantages in various fields of science. In this regard, nanoparticles are the essential building blocks of nanotechnology. Recent advances in nanotechnology have proven that nanoparticles acquire a great potential in medical applications. Formation of stable interactions with ligands, variability in size and shape, high carrier capacity, and convenience of binding of both hydrophilic and hydrophobic substances make nanoparticles favorable platforms for the target-specific and controlled delivery of micro- and macromolecules in disease therapy. Nanoparticles combined with the therapeutic agents overcome problems associated with conventional therapy; however, some issues like side effects and toxicity are still debated and should be well concerned before their utilization in biological systems. It is therefore important to understand the specific properties of therapeutic nanoparticles and their delivery strategies. Here, we provide an overview on the unique features of nanoparticles in the biological systems. We emphasize on the type of clinically used nanoparticles and their specificity for therapeutic applications, as well as on their current delivery strategies for specific diseases such as cancer, infectious, autoimmune, cardiovascular, neurodegenerative, ocular, and pulmonary diseases. Understanding of the characteristics of nanoparticles and their interactions with the biological environment will enable us to establish novel strategies for the treatment, prevention, and diagnosis in many diseases, particularly untreatable ones.
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Affiliation(s)
- Abuzer Alp Yetisgin
- Materials Science and Nano-Engineering Program, Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul 34956, Turkey;
| | - Sibel Cetinel
- Nanotechnology Research and Application Center (SUNUM), Sabanci University, Istanbul 34956, Turkey;
| | - Merve Zuvin
- Mechatronics Engineering Program, Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul 34956, Turkey; (M.Z.); (A.K.)
| | - Ali Kosar
- Mechatronics Engineering Program, Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul 34956, Turkey; (M.Z.); (A.K.)
- Center of Excellence for Functional Surfaces and Interfaces for Nano Diagnostics (EFSUN), Sabanci University, Istanbul 34956, Turkey
| | - Ozlem Kutlu
- Nanotechnology Research and Application Center (SUNUM), Sabanci University, Istanbul 34956, Turkey;
- Center of Excellence for Functional Surfaces and Interfaces for Nano Diagnostics (EFSUN), Sabanci University, Istanbul 34956, Turkey
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Khaled H, Atef M, Hakam M. Maxillary sinus floor elevation using hydroxyapatite nano particles vs tenting technique with simultaneous implant placement: A randomized clinical trial. Clin Implant Dent Relat Res 2019; 21:1241-1252. [PMID: 31743571 DOI: 10.1111/cid.12859] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/06/2019] [Accepted: 10/08/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE The present study was conducted to evaluate the amount of bone height gain, density values, and implant stability after maxillary sinus floor elevation using graftless tenting technique or the use of Hydroxyapatite Nanoparticles bone substitute for augmentation with simultaneous implant placement. MATERIALS AND METHODS A total of 20 sinuses with a residual alveolar bone height ranging from 4-6 mm were divided into two groups and underwent sinus augmentation using nano hydroxyapatite bone substitute material and the graftless tenting technique with simultaneous implant placement. Computed tomography CT scans and ISQ measurements were conducted to evaluate bone quality, quantity, and implant stability. RESULTS Radiographic analysis revealed that the mean bone height gain of the nano group was (7.0 ± 0.8 mm) compared to (5.0 ± 1.5 mm) in the tent group, which was statistically significant (P = .002) being higher in the nano group. The mean bone density value of the nano group was (548 ± 25 HU) compared to (420 ± 23 HU) in the tent group, which was statistically significant (P < .001) being higher in the nano group. The mean ISQ value after 6 months in the nano group was (78 ± 5) compared to (77 ± 5) in the tent group, which was statistically nonsignificant (P = .901). CONCLUSION Nano hydroxyapatite bone graft offered superior results in terms of the bone height gain and the relative bone density as compared to graftless tenting technique. However, both techniques showed accepted results regarding implant stability.
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Affiliation(s)
- Hossam Khaled
- Department of Oral Implantology, Faculty of Dentistry, Cairo University, Cairo, Egypt.,Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Pharos University, Alexandria, Egypt
| | - Mohammed Atef
- Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Maha Hakam
- Oral & Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Alagl AS, Madi M. Localized ridge augmentation in the anterior maxilla using titanium mesh, an alloplast, and a nano-bone graft: a case report. J Int Med Res 2018; 46:2001-2007. [PMID: 29529906 PMCID: PMC5991235 DOI: 10.1177/0300060518758226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 01/18/2018] [Indexed: 11/18/2022] Open
Abstract
Alveolar ridge deficiency is considered a major limitation for successful implant placement, as well as for the long-term success rate, especially in the anterior maxillary region. Various approaches have been developed to increase bone volume. Among those approaches, inlay and onlay grafts, alveolar ridge distraction, and guided bone regeneration have been suggested. The use of titanium mesh is a reliable method for ridge augmentation. We describe a patient who presented with a localized, combined, horizontal and vertical ridge defect in the anterior maxilla. The patient was treated using titanium mesh and alloplast material mixed with a nano-bone graft to treat the localized ridge deformity for future implant installation. The clinical and radiographic presentation, as well as relevant literature, are presented.
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Affiliation(s)
- Adel S Alagl
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Histologic and Histomorphometric Comparison between Sintered Nanohydroxyapatite and Anorganic Bovine Xenograft in Maxillary Sinus Grafting: A Split-Mouth Randomized Controlled Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9489825. [PMID: 28845435 PMCID: PMC5563399 DOI: 10.1155/2017/9489825] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/25/2017] [Indexed: 12/30/2022]
Abstract
The presence of vital bone after maxillary sinus augmentation is crucial to enhance the quality of bone-implant interface, ensuring predictable long-term results. The aims of this RCT with split-mouth design were the histologic and histomorphometric comparison of two different biomaterials in sinus elevation after 6 months of healing and the evaluation of the clinical outcomes of implants inserted in the augmented areas after 12 months of prosthetic loading. Twenty-eight patients (10 females, 18 males) were treated with bilateral sinus floor elevation with lateral approach. Pure sintered nanohydroxyapatite (NHA) and anorganic bovine bone (ABB) were used as test and active control, respectively. After six months, 52 bone biopsies were harvested from 26 patients, and 107 implants were inserted in the augmented areas. Histomorphometry showed that, in the two groups, vital bone percentages were 34.9 ± 15% (NHA) and 38.5 ± 17% (ABB) (p = 0.428), marrow spaces percentages were 44.5 ± 18% (NHA) and 43.5 ± 23% (ABB) (p = 0.866), and residual graft percentages were 20.6 ± 13% (NHA) and 22.3 ± 12% (ABB) (p = 0.638). After 6 months of healing, no statistically significant difference was present in histomorphometric outcomes between NHA and ABB groups. Implant survival rate in NHA group after 12 months of loading was 96.4%, showing no statistically significant differences with ABB group.
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Corbella S, Taschieri S, Weinstein R, Del Fabbro M. Histomorphometric outcomes after lateral sinus floor elevation procedure: a systematic review of the literature and meta-analysis. Clin Oral Implants Res 2015; 27:1106-22. [DOI: 10.1111/clr.12702] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - Roberto Weinstein
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
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Berberi A, Bouserhal L, Nader N, Assaf RB, Nassif NB, Bouserhal J, Salameh Z. Evaluation of Three-Dimensional Volumetric Changes After Sinus Floor Augmentation with Mineralized Cortical Bone Allograft. J Maxillofac Oral Surg 2015; 14:624-9. [PMID: 26225054 PMCID: PMC4511887 DOI: 10.1007/s12663-014-0736-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 12/04/2014] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of this retrospective study was to quantify three-dimensional (3D) volumetric bone changes over a two-year period in maxillary sinuses augmented with a mineralized cortical bone allograft material (MCBA) material. PATIENTS AND METHODS Eleven patients (6 males and 5 females) with mean of age of 51.6 (range: 46-61) years were treated to increase the vertical dimension of the alveolar crest by maxillary sinus floor augmentation procedure. Study data were collected from patient records and by analyzing preoperative radiographs and cone beam computed tomography (CBCT) scans taken within the first two weeks after maxillary sinus lift (T0), immediately before implant placement four months after grafting (T1), and after one year of implant loading (T2). All DICOM-formatted images were rendered into volumetric images using software that automatically calculated the volume of the grafted material in cubic centimeters. RESULTS Mean graft volume was 16.24 ± 1.54 cm(3) at T0, 14.48 ± 1.48 cm(3) at T1 and 13.06 ± 1.39 cm(3) at T2. Mean volume retraction resulted in 1.76 ± 0.34 cm(3) ΔV1 (T0-T1) and 1.42 ± 0.4 cm(3) ΔV2 (T1-T2) and was 10.83 % of the initial total volume at (T0-T1) and 9.8 % of the total volume (T1-T2). CONCLUSION The present retrospective investigation demonstrated a 20.63 % decrease in graft volume. Volumetric 3D assessment of CBCT scans with the selected software appeared to be a promising approach to quantifying long-term changes in the grafted area.
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Affiliation(s)
- Antoine Berberi
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
- />Oral Surgery Section, ENT Department, Sacre-Coeur Hospital, Lebanese University, Beirut, Lebanon
| | - Lea Bouserhal
- />Department of Orthodontics, Case Western Reserve University, Cleveland, OH USA
| | - Nabih Nader
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
| | - Rita Bou Assaf
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
| | - Nayla Bassil Nassif
- />Orthodontics Department, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Joseph Bouserhal
- />Orthodontics Department, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Ziad Salameh
- />Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
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Heinemann F, Hasan I, Bourauel C, Biffar R, Mundt T. Bone stability around dental implants: Treatment related factors. Ann Anat 2015; 199:3-8. [PMID: 25770887 DOI: 10.1016/j.aanat.2015.02.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 02/10/2015] [Accepted: 02/11/2015] [Indexed: 11/15/2022]
Abstract
The bone bed around dental implants is influenced by implant and augmentation materials, as well as the insertion technique used. The primary influencing factors include the dental implant design, augmentation technique, treatment protocol, and surgical procedure. In addition to these treatment-related factors, in the literature, local and systemic factors have been found to be related to the bone stability around implants. Bone is a dynamic organ that optimises itself depending on the loading condition above it. Bone achieves this optimisation through the remodelling process. Several studies have confirmed the importance of the implant design and direction of the applied force on the implant system. Equally dispersed strains and stresses in the physiological range should be achieved to ensure the success of an implant treatment. If a patient wishes to accelerate the treatment time, different protocols can be chosen. However, each one must consider the amount and quality of the available local bone. Immediate implantation is only successful if the primary stability of the implant can be provided from residual bone in the socket after tooth extraction. Immediate loading demands high primary stability and, sometimes, the distribution of mastication forces by splinting or even by inserting additional implants to ensure their success. Augmentation materials with various properties have been developed in recent years. In particular, resorption time and stableness affect the usefulness in different situations. Hence, treatment protocols can optimise the time for simultaneous implant placements or optimise the follow-up time for implant placement.
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Affiliation(s)
- Friedhelm Heinemann
- Department of Prosthodontics, Gerodontology and Biomaterials, University of Greifswald, Rotgerberstr. 8, 17489 Greifswald, Germany.
| | - Istabrak Hasan
- Endowed Chair of Oral Technology, Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany; Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
| | - Christoph Bourauel
- Endowed Chair of Oral Technology, Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
| | - Reiner Biffar
- Department of Prosthodontics, Gerodontology and Biomaterials, University of Greifswald, Rotgerberstr. 8, 17489 Greifswald, Germany
| | - Torsten Mundt
- Department of Prosthodontics, Gerodontology and Biomaterials, University of Greifswald, Rotgerberstr. 8, 17489 Greifswald, Germany
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Seifi M, Arayesh A, Shamloo N, Hamedi R. Effect of nanocrystalline hydroxyapatite socket preservation on orthodontically induced inflammatory root resorption. CELL JOURNAL 2015; 16:514-27. [PMID: 25685742 PMCID: PMC4297490 DOI: 10.22074/cellj.2015.496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 12/01/2013] [Indexed: 11/07/2022]
Abstract
Objective Orthodontically induced inflammatory root resorption (OIIRR) is considered to be
an important sequel associated with orthodontic tooth movement (OTM). OTM after Socket
preservation enhances the periodontal condition before orthodontic space closure. The purpose of this study is to investigate the histologic effects of NanoBone®, a new highly nonsintered porous nano-crystalline hydroxyapatite bone on root resorption following OTM.
Materials and Methods This experimental study was conducted on four male dogs. In
each dog, four defects were created at the mesial aspects of the maxillary and mandibular
first premolars. The defects were filled with NanoBone®. We used the NiTi closed coil for
mesial movement of the first premolar tooth. When the experimental teeth moved approximately halfway into the defects, after two months, the animals were sacrificed and we harvested the area of interest. The first premolar root and adjacent tissues were histologically
evaluated. The three-way ANOVA statistical test was used for comparison.
Results The mean root resorption in the synthetic bone substitute group was 22.87 ±
11.25×10-4mm2 in the maxilla and 21.41 ± 11.25×10-4mm2 in the mandible. Statistically,
there was no significant difference compared to the control group (p>0.05).
Conclusion The use of a substitution graft in the nano particle has some positive effects
in accessing healthy periodontal tissue following orthodontic procedures without significant influence on root resorption (RR). Histological evaluation in the present study showed
osteoblastic activity and remodeling environment of nanoparticles in NanoBone®.
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Affiliation(s)
- Massoud Seifi
- Department of Orthodontic, Dentofacial Deformities Research Center, Research Institute of Dental Sciences of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Arayesh
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nafise Shamloo
- Department of Oral and Maxillofacial Pathology, Dental School of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Hamedi
- Department of Orthodontic, Dentofacial Deformity Research Center, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mohamed Zahid Z, Abdul Rahman S, Khursheed Alam M, Pohchi A, Jinno M, Sugita Y, Maeda H. Prospective 3D Assessment of CORAGRAF and Bio-Oss as Bone Substitutes in Maxillary Sinus Augmentation for Implant Placement. J HARD TISSUE BIOL 2015. [DOI: 10.2485/jhtb.24.43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | | | - Abdullah Pohchi
- Oral and Maxillofacial Surgery, School of Dental Science, Universiti Sains Malaysia
| | - Masato Jinno
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Yoshihiko Sugita
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Hatsuhiko Maeda
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
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Shakib K, Tan A, Soskic V, Seifalian AM. Regenerative nanotechnology in oral and maxillofacial surgery. Br J Oral Maxillofac Surg 2014; 52:884-93. [PMID: 25218313 DOI: 10.1016/j.bjoms.2014.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 08/14/2014] [Indexed: 11/15/2022]
Abstract
Regenerative nanotechnology is at the forefront of medical research, and translational medicine is a challenge to both scientists and clinicians. Although there has been an exponential rise in the volume of research generated about it for both medical and surgical uses, key questions remain about its actual benefits. Nevertheless, some people think that therapeutics based on its principles may form the core of applied research for the future. Here we give an account of its current use in oral and maxillofacial surgery, and implications and challenges for the future.
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Affiliation(s)
- Kaveh Shakib
- Department of Oral and Maxillofacial Surgery, Royal Free London NHS Foundation Trust, London, UK; UCL Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK.
| | - Aaron Tan
- UCL Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK; UCL Medical School, University College London (UCL), London, UK
| | | | - Alexander M Seifalian
- UCL Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK; Royal Free London NHS Foundation Trust, London, UK.
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Potential lack of "standardized" processing techniques for production of allogeneic and xenogeneic bone blocks for application in humans. Acta Biomater 2014; 10:3557-62. [PMID: 24769111 DOI: 10.1016/j.actbio.2014.04.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 04/09/2014] [Accepted: 04/16/2014] [Indexed: 11/22/2022]
Abstract
In the present study, the structure of two allogeneic and three xenogeneic bone blocks, which are used in dental and orthopedic surgery, were histologically analyzed. The ultimate goal was to assess whether the components postulated by the manufacturer can be identified after applying conventional histological and histochemical staining techniques. Three samples of each material, i.e. allogeneic material-1 and -2 as well as xenogeneic material-1, -2 and -3, were obtained commercially. After decalcification and standardized embedding processes, conventional histological staining was performed in order to detect inorganic matrix, cellular or organic matrix components. Allogeneic material-1 showed trabecular bone-like structures, which were free of cellular components as well as of organic matrix. The allogeneic material-2 showed trabecular bone structures, in which connective tissue and cellular remnants were embedded. Additionally, some connective tissue, which resembled fat-like tissue, was found within this material. The xenogeneic material-1 showed trabecular bone-like structures and contained organic components comparable to that demonstrated for the allogeneic material-2. The xenogeneic material-2 showed trabecular bone structures with single cells located in lacunae. The xenogeneic material-3 also showed trabecular structures. Neither cellular nor organic matrix components were found within this material. According to the data of the present study, the allogeneic material-1 and the xenogeneic material-3 were the only investigated materials for which the obtained histological data were in accordance with the manufactureŕs advertised information. The remaining three materials showed discrepancies-although the manufacturers of all five bone substitute materials stated that their blocks were free of organic/cellular remnants. These data are of great clinical and material science interest. It seems that even patented processing techniques are not always able to deliver reproducible materials. Although the manufacturers of all five bone blocks stated that their blocks were free of organic/cellular remnants, our histological analysis revealed that three out of five bone blocks did contain such remnants. Such specimens might be able to induce an immune response within the recipient.
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13
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Möller B, Acil Y, Birkenfeld F, Behrens E, Terheyden H, Wiltfang J. Highly porous hydroxyapatite with and without local harvested bone in sinus floor augmentation: a histometric study in pigs. Clin Oral Implants Res 2013; 25:871-8. [DOI: 10.1111/clr.12161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Björn Möller
- Clinic of Oral and Maxillofacial Surgery; University Hospital Schleswig-Holstein; Kiel Germany
| | - Yahya Acil
- Clinic of Oral and Maxillofacial Surgery; University Hospital Schleswig-Holstein; Kiel Germany
| | - Falk Birkenfeld
- Institute of Anatomy; Christian-Albrechts University Kiel; Kiel Germany
| | - Eleonore Behrens
- Clinic of Oral and Maxillofacial Surgery; University Hospital Schleswig-Holstein; Kiel Germany
| | - Hendrik Terheyden
- Department of Oral and Maxillofacial Surgery; Red Cross Hospital; Kassel Germany
| | - Jörg Wiltfang
- Clinic of Oral and Maxillofacial Surgery; University Hospital Schleswig-Holstein; Kiel Germany
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14
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Dellavia C, Speroni S, Pellegrini G, Gatto A, Maiorana C. A new method to evaluate volumetric changes in sinus augmentation procedure. Clin Implant Dent Relat Res 2013; 16:684-90. [PMID: 23509966 DOI: 10.1111/cid.12058] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In sinus augmentation procedure, the assessment of volume changes of grafted materials is important both in the clinical practice and in dental research to evaluate the features of filling materials. PURPOSE In this study, we assessed the repeatability of a new method proposed to evaluate volumetric changes following sinus lift augmentation procedure. MATERIALS AND METHODS In 10 patients, maxillary sinus augmentation procedure with simultaneous implant placement was performed. Maxillary cone beam computer tomographies were taken 1 week after surgery (T1) and 6 months after surgery (T2). At each evaluation the gap inside the implant between the fixture and the bottom of the screw was used as reference point (Rp), and a standardized volume of interest (VOI) centered on the Rp was selected. Masks were chosen to select the graft and bone tissue within the VOI; the volume at T1, T2, and the difference of volume between T1 and T2 were computed. Expert and non-expert operators performed the analysis. Method errors were computed. RESULTS The error of the method was 1% for both intra-operator and inter-operator measurements. Tissue contraction at T2 was 19 ± 4% of the total initial volume. CONCLUSIONS The standardization of the method allows to obtain repeatable measurements.
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Affiliation(s)
- Claudia Dellavia
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
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Sadlo J, Strzelczak G, Lewandowska-Szumiel M, Sterniczuk M, Pajchel L, Michalik J. Carbon-centered radicals in γ-irradiated bone substituting biomaterials based on hydroxyapatite. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2012; 23:2061-2068. [PMID: 22639150 DOI: 10.1007/s10856-012-4680-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 05/11/2012] [Indexed: 06/01/2023]
Abstract
Gamma irradiated synthetic hydroxyapatite, bone substituting materials NanoBone(®) and HA Biocer were examined using EPR spectroscopy and compared with powdered human compact bone. In every case, radiation-induced carbon centered radicals were recorded, but their molecular structures and concentrations differed. In compact bone and synthetic hydroxyapatite the main signal assigned to the CO(2) (-) anion radical was stable, whereas the signal due to the CO(3) (3-) radical dominated in NanoBone(®) and HA Biocer just after irradiation. However, after a few days of storage of these samples, also a CO(2) (-) signal was recorded. The EPR study of irradiated compact bone and the synthetic graft materials suggest that their microscopic structures are different. In FT-IR spectra of NanoBone(®), HA Biocer and synthetic hydroxyapatite the HPO(4) (2-) and CO(3) (2-) in B-site groups are detected, whereas in compact bone signals due to collagen dominate.
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Affiliation(s)
- Jaroslaw Sadlo
- Institute of Nuclear Chemistry and Technology, Dorodna 16, 03-195, Warsaw, Poland.
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Ghanaati S, Barbeck M, Willershausen I, Thimm B, Stuebinger S, Korzinskas T, Obreja K, Landes C, Kirkpatrick CJ, Sader RA. Nanocrystalline hydroxyapatite bone substitute leads to sufficient bone tissue formation already after 3 months: histological and histomorphometrical analysis 3 and 6 months following human sinus cavity augmentation. Clin Implant Dent Relat Res 2012; 15:883-92. [PMID: 22251462 DOI: 10.1111/j.1708-8208.2011.00433.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE In this study the de novo bone formation capacity of a nanocrystalline hydroxyapatite bone substitute was assessed 3 and 6 months after its insertion into the human sinus cavity. MATERIALS AND METHODS Sinus cavity augmentation was performed in a total of 14 patients (n = 7 implantation after 3 months; n = 7 implantation after 6 months) with severely atrophic maxillary bone. The specimens obtained after 3 and 6 months were analyzed histologically and histomorphometrically with special focus on bone metabolism within the residual bone and the augmented region. RESULTS This study revealed that bone tissue formation started from the bone-biomaterial-interface and was directed into the most cranial parts of the augmented region. There was no statistically significant difference in new bone formation after 3 and 6 months (24.89 ± 10.22% vs 31.29 ± 2.29%), respectively. CONCLUSIONS Within the limits of the present study and according to previously published data, implant insertion in regions augmented with this bone substitute material could be considered already after 3 months. Further clinical studies with bone substitute materials are necessary to validate these findings.
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Affiliation(s)
- Shahram Ghanaati
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany; Institute of Pathology, REPAIR-Lab, University Medical Center, Johannes Gutenberg University Mainz, Germany; Institute for Dental Material Sciences and Technology, University Medical Center of the Johannes Gutenberg University Mainz, Germany; Institute for Biomechanics, ETH Zurich, Switzerland; Center for Applied Biotechnology and Molecular Medicine, Zurich, Switzerland
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