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Bice MLL, Ortega VL, Yu MH, McHugh KJ. Methacrylated poly(glycerol sebacate) as a photocurable, biocompatible, and biodegradable polymer with tunable degradation and drug release kinetics. RESEARCH SQUARE 2023:rs.3.rs-3384762. [PMID: 37886600 PMCID: PMC10602112 DOI: 10.21203/rs.3.rs-3384762/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Poly(glycerol sebacate) (PGS) is a biodegradable, elastomeric polymer that has been explored for applications ranging from tissue engineering to drug delivery and wound repair. Despite its promise, its biomedical utility is limited by its rapid, and largely fixed, degradation rate. Additionally, its preparation requires high temperatures for long periods of time, rendering it incompatible with heat-sensitive molecules, complex device geometries, and high-throughput production. In this study, we synthesized methacrylated PGS (PGS-M), imparting the ability to rapidly photocross-link the polymer. Increasing the degree of methacrylation was found to slow PGS-M degradation; PGS-M (5.5 kDa) disks with 21% methacrylation lost 43% of their mass over 11 weeks in vivo whereas 47% methacrylated disks lost just 14% of their mass over the same period. Increasing the methacrylation also extended the release of encapsulated daunorubicin by up to two orders of magnitude in vitro, releasing drug over months instead of one week. Like PGS, PGS-M exhibited good biocompatibility, eliciting limited inflammation and fibrous encapsulation when implanted subcutaneously. These studies are the first to perform long-term studies demonstrating the ability to tune PGS-M degradation rate, use PGS-M to release drug, demonstrate sustained release of drug from PGS-M, and evaluate PGS-M behavior in vivo. Taken together, these studies show that PGS-M offers several key advantages over PGS for drug delivery and tissue engineering, including rapid curing, facile loading of drugs without exposure to heat, tunable degradation rates, and tunable release kinetics, all while retaining the favorable biocompatibility of PGS.
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2
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She Y, Tang S, Zhu Z, Sun Y, Deng W, Wang S, Jiang N. Comparison of temporomandibular joint disc, meniscus, and intervertebral disc in fundamental characteristics and tissue engineering. J Biomed Mater Res B Appl Biomater 2023; 111:717-729. [PMID: 36221912 DOI: 10.1002/jbm.b.35178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/24/2022] [Accepted: 09/27/2022] [Indexed: 01/21/2023]
Abstract
The temporomandibular joint (TMJ) disc, meniscus and intervertebral disc (IVD) are three fibrocartilage discs, which play critical roles in our daily life. Their degeneration contributes to diseases such as TMJ disorders, osteoarthritis and degenerative disc disease, affecting patients' quality of life and causing substantial morbidity and mortality. Interestingly, similar in some aspects of fundamental characteristics, they exhibit differences in other aspects such as biomechanical properties. Highlighting these similarities and differences can not only benefit a comprehensive understanding of them and their pathology but also assist in future research of tissue engineering. Likewise, comparing their tissue engineering in cell sources, scaffold and stimuli can guide imitation and improvement of their engineered discs. However, the anatomical structure, function, and biomechanical characteristics of the IVD, TMJ, and Meniscus have not been compared in any meaningful depth needed to advance current tissue engineering research on these joints, resulting in incomplete understanding of them and their pathology and ultimately limiting future research of tissue engineering. This review, for the first time, comprehensively compares three fibrocartilage discs in those aspects to cast light on their similarities and differences.
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Affiliation(s)
- Yilin She
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shiyi Tang
- West China Medical School, Sichuan University, Chengdu, China
| | - Zilin Zhu
- College of Life Sciences, Sichuan University, Chengdu, China
| | - Yixin Sun
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wanyu Deng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Sicheng Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
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3
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Yazdanian M, Alam M, Abbasi K, Rahbar M, Farjood A, Tahmasebi E, Tebyaniyan H, Ranjbar R, Hesam Arefi A. Synthetic materials in craniofacial regenerative medicine: A comprehensive overview. Front Bioeng Biotechnol 2022; 10:987195. [PMID: 36440445 PMCID: PMC9681815 DOI: 10.3389/fbioe.2022.987195] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/26/2022] [Indexed: 07/25/2023] Open
Abstract
The state-of-the-art approach to regenerating different tissues and organs is tissue engineering which includes the three parts of stem cells (SCs), scaffolds, and growth factors. Cellular behaviors such as propagation, differentiation, and assembling the extracellular matrix (ECM) are influenced by the cell's microenvironment. Imitating the cell's natural environment, such as scaffolds, is vital to create appropriate tissue. Craniofacial tissue engineering refers to regenerating tissues found in the brain and the face parts such as bone, muscle, and artery. More biocompatible and biodegradable scaffolds are more commensurate with tissue remodeling and more appropriate for cell culture, signaling, and adhesion. Synthetic materials play significant roles and have become more prevalent in medical applications. They have also been used in different forms for producing a microenvironment as ECM for cells. Synthetic scaffolds may be comprised of polymers, bioceramics, or hybrids of natural/synthetic materials. Synthetic scaffolds have produced ECM-like materials that can properly mimic and regulate the tissue microenvironment's physical, mechanical, chemical, and biological properties, manage adherence of biomolecules and adjust the material's degradability. The present review article is focused on synthetic materials used in craniofacial tissue engineering in recent decades.
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Affiliation(s)
- Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Rahbar
- Department of Restorative Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Amin Farjood
- Orthodontic Department, Dental School, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran
| | - Reza Ranjbar
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Arian Hesam Arefi
- Dental Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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4
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Applications of Biotechnology to the Craniofacial Complex: A Critical Review. Bioengineering (Basel) 2022; 9:bioengineering9110640. [DOI: 10.3390/bioengineering9110640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Biotechnology shows a promising future in bridging the gap between biomedical basic sciences and clinical craniofacial practice. The purpose of the present review is to investigate the applications of biotechnology in the craniofacial complex. Methods: This critical review was conducted by using the following keywords in the search strategy: “biotechnology”, “bioengineering”, “craniofacial”, “stem cells”, “scaffolds”, “biomarkers”, and ”tissue regeneration”. The databases used for the electronic search were the Cochrane Library, Medline (PubMed), and Scopus. The search was conducted for studies published before June 2022. Results: The applications of biotechnology are numerous and provide clinicians with the great benefit of understanding the etiology of dentofacial deformities, as well as treating the defected areas. Research has been focused on craniofacial tissue regeneration with the use of stem cells and scaffolds, as well as in bioinformatics with the investigation of growth factors and biomarkers capable of providing evidence for craniofacial growth and development. This review presents the biotechnological opportunities in the fields related to the craniofacial complex and attempts to answer a series of questions that may be of interest to the reader. Conclusions: Biotechnology seems to offer a bright future ahead, improving and modernizing the clinical management of cranio-dento-facial diseases. Extensive research is needed as human studies on this subject are few and have controversial results.
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Ângelo DF, Gil FM. Tissue Engineering in Temporomandibular Joint Reconstruction. Atlas Oral Maxillofac Surg Clin North Am 2022; 30:235-246. [PMID: 36116883 DOI: 10.1016/j.cxom.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- David Faustino Ângelo
- Faculdade de Medicina da Universidade de Lisboa, Avenida Prof. Egas Moniz, Lisboa 1649-028, Portugal; Instituto Português da Face, Rua Tomás Ribeiro, N°71, 5°andar, Lisboa 1050-227, Portugal.
| | - Florencio Monje Gil
- Oral and Maxillofacial Department, University Hospital of Badajoz, Badajoz, Spain
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Ângelo DF, Wang Y, Morouço P, Monje F, Mónico L, González-Garcia R, Moura C, Alves N, Sanz D, Gao J, Sousa R, Neto L, Faísca P, Salvado F, López Peña M, Permuy M, Munñoz F. A randomized controlled preclinical trial on 3 interposal temporomandibular joint disc implants: TEMPOJIMS-Phase 2. J Tissue Eng Regen Med 2021; 15:852-868. [PMID: 34323386 DOI: 10.1002/term.3230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/31/2021] [Accepted: 07/22/2021] [Indexed: 01/03/2023]
Abstract
The effort to develop an effective and safe temporomandibular joint (TMJ) disc substitute has been one of the mainstreams of tissue engineering. Biodegradable customized scaffolds could approach safety and effectiveness to regenerate a new autologous disc, rather than using non-biodegradable materials. However, it is still technically challenging to mimic the biomechanical properties of the native disc with biodegradable polymers. In this study, new 3D tailored TMJ disc implants were developed: (1) Poly(glycerol sebacate) (PGS) scaffold reinforced with electrospun Poly(εcaprolactone) (PCL) fibers on the outer surface (PGS+PCL); (2) PCL and polyethylene glycol diacrylate (PEGDA) (PCL+PEGDA); and (3) PCL. The TMJ implants were tested in a randomized preclinical trial, conducted in 24 black Merino sheep TMJ, perfoming bilateral interventions. Histologic, imaging, and kinematics analysis was performed. No statistical changes were observed between the PGS+PCL disc and the control group. The PCL+PEGDA and PCL groups were associated with statistical changes in histology (p = 0.004 for articular cartilage mid-layer; p = 0.019 for structure changes and p = 0.017 for cell shape changes), imaging (p = 0.027 for global appreciation) and dangerous material fragmentation was observed. No biomaterial particles were observed in the multi-organ analysis in the different groups. The sheep confirmed to be a relevant animal model for TMJ disc surgery and regenerative approaches. The PCL and PCL+PEGDA discs presented a higher risk to increase degenerative changes, due to material fragmentation. None of the tested discs regenerate a new autologous disc, however, PGS+PCL was safe, demonstrated rapid resorption, and was capable to prevent condyle degenerative changes.
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Affiliation(s)
- David Faustino Ângelo
- Instituto Português da Face, Lisboa, Portugal.,Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.,Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | | | | | - Florencio Monje
- Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
| | | | | | - Carla Moura
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Nuno Alves
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - David Sanz
- Instituto Português da Face, Lisboa, Portugal
| | - Jin Gao
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rita Sousa
- Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Lia Neto
- Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Pedro Faísca
- Gulbenkian Institute of Science, Oeiras, Portugal
| | | | | | - Maria Permuy
- University of Santiago de Compostela-Lugo Campus, Lugo, Spain
| | - Fernando Munñoz
- University of Santiago de Compostela-Lugo Campus, Lugo, Spain
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Mohamed MA, Shahini A, Rajabian N, Caserto J, El-Sokkary AM, Akl MA, Andreadis ST, Cheng C. Fast photocurable thiol-ene elastomers with tunable biodegradability, mechanical and surface properties enhance myoblast differentiation and contractile function. Bioact Mater 2021; 6:2120-2133. [PMID: 33511311 PMCID: PMC7810627 DOI: 10.1016/j.bioactmat.2020.12.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 01/04/2023] Open
Abstract
Biodegradable elastomers are important emerging biomaterials for biomedical applications, particularly in the area of soft-tissue engineering in which scaffolds need to match the physicochemical properties of native tissues. Here, we report novel fast photocurable elastomers with readily tunable mechanical properties, surface wettability, and degradability. These elastomers are prepared by a 5-min UV-irradiation of thiol-ene reaction systems of glycerol tripentenoate (GTP; a triene) or the combination of GTP and 4-pentenyl 4-pentenoate (PP; a diene) with a carefully chosen series of di- or tri-thiols. In the subsequent application study, these elastomers were found to be capable of overcoming delamination of myotubes, a technical bottleneck limiting the in vitro growth of mature functional myofibers. The glycerol-based elastomers supported the proliferation of mouse and human myoblasts, as well as myogenic differentiation into contractile myotubes. More notably, while beating mouse myotubes detached from conventional tissue culture plates, they remain adherent on the elastomer surface. The results suggest that these elastomers as novel biomaterials may provide a promising platform for engineering functional soft tissues with potential applications in regenerative medicine or pharmacological testing.
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Affiliation(s)
- Mohamed Alaa Mohamed
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, 14260, USA
- Chemistry Department, College of Science, Mansoura University, Mansoura, 35516, Egypt
| | - Aref Shahini
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, 14260, USA
| | - Nika Rajabian
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, 14260, USA
| | - Julia Caserto
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, 14260, USA
| | - Ahmed M.A. El-Sokkary
- Chemistry Department, College of Science, Mansoura University, Mansoura, 35516, Egypt
| | - Magda A. Akl
- Chemistry Department, College of Science, Mansoura University, Mansoura, 35516, Egypt
| | - Stelios T. Andreadis
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, 14260, USA
- Department of Biomedical Engineering, University at Buffalo, The State University of New York, Buffalo, NY, 14260, USA
- Center of Excellence in Bioinformatics and Life Sciences, Buffalo, NY, 14263, USA
| | - Chong Cheng
- Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, NY, 14260, USA
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8
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Trindade D, Cordeiro R, José HC, Ângelo DF, Alves N, Moura C. Biological Treatments for Temporomandibular Joint Disc Disorders: Strategies in Tissue Engineering. Biomolecules 2021; 11:biom11070933. [PMID: 34201698 PMCID: PMC8301995 DOI: 10.3390/biom11070933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/14/2021] [Accepted: 06/18/2021] [Indexed: 01/22/2023] Open
Abstract
The temporomandibular joint (TMJ) is an important structure for the masticatory system and the pathologies associated with it affect a large part of the population and impair people's lifestyle. It comprises an articular disc, that presents low regeneration capacities and the existing clinical options for repairing it are not effective. This way, it is imperative to achieve a permanent solution to guarantee a good quality of life for people who suffer from these pathologies. Complete knowledge of the unique characteristics of the disc will make it easier to achieve a successful tissue engineering (TE) construct. Thus, the search for an effective, safe and lasting solution has already started, including materials that replace the disc, is currently growing. The search for a solution based on TE approaches, which involve regenerating the disc. The present work revises the TMJ disc characteristics and its associated diseases. The different materials used for a total disc replacement are presented, highlighting the TE area. A special focus on future trends in the field and part of the solution for the TMJ problems described in this review will involve the development of a promising engineered disc approach through the use of decellularized extracellular matrices.
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Affiliation(s)
- Daniela Trindade
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-028 Marinha Grande, Portugal; (D.T.); (R.C.); (D.F.Â.)
| | - Rachel Cordeiro
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-028 Marinha Grande, Portugal; (D.T.); (R.C.); (D.F.Â.)
| | | | - David Faustino Ângelo
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-028 Marinha Grande, Portugal; (D.T.); (R.C.); (D.F.Â.)
- Instituto Português da Face, 1050-227 Lisboa, Portugal;
- Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Nuno Alves
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-028 Marinha Grande, Portugal; (D.T.); (R.C.); (D.F.Â.)
- Correspondence: (N.A.); (C.M.); Tel.: +351-24-456-9441 (C.M.)
| | - Carla Moura
- Centre for Rapid and Sustainable Product Development, Polytechnic of Leiria, 2430-028 Marinha Grande, Portugal; (D.T.); (R.C.); (D.F.Â.)
- Correspondence: (N.A.); (C.M.); Tel.: +351-24-456-9441 (C.M.)
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9
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Wrzecionek M, Ruśkowski P, Gadomska‐Gajadhur A. Mathematically described preparation process of poly(glycerol succinate) resins and elastomers—Meeting science with industry. POLYM ADVAN TECHNOL 2021. [DOI: 10.1002/pat.5233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
| | - Paweł Ruśkowski
- Faculty of Chemistry Warsaw University of Technology Warsaw Poland
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10
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Chin AR, Taboas JM, Almarza AJ. Regenerative Potential of Mandibular Condyle Cartilage and Bone Cells Compared to Costal Cartilage Cells When Seeded in Novel Gelatin Based Hydrogels. Ann Biomed Eng 2020; 49:1353-1363. [PMID: 33155145 DOI: 10.1007/s10439-020-02674-y] [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: 07/30/2020] [Accepted: 10/21/2020] [Indexed: 11/25/2022]
Abstract
The field of temporomandibular joint (TMJ) condyle regeneration is hampered by a limited understanding of the phenotype and regeneration potential of cells in mandibular condyle cartilage. It has been shown that chondrocytes derived from hyaline and costal cartilage exhibit a greater chondro-regenerative potential in vitro than those from mandibular condylar cartilage. However, our recent in vivo studies suggest that mandibular condyle cartilage cells do have the potential for cartilage regeneration in osteochondral defects, but that bone regeneration is inadequate. The objective of this study was to determine the regeneration potential of cartilage and bone cells from goat mandibular condyles in two different photocrosslinkable hydrogel systems, PGH and methacrylated gelatin, compared to the well-studied costal chondrocytes. PGH is composed of methacrylated poly(ethylene glycol), gelatin, and heparin. Histology, biochemistry and unconfined compression testing was performed after 4 weeks of culture. For bone derived cells, histology showed that PGH inhibited mineralization, while gelatin supported it. For chondrocytes, costal chondrocytes had robust glycosaminoglycan (GAG) deposition in both PGH and gelatin, and compression properties on par with native condylar cartilage in gelatin. However, they showed signs of hypertrophy in gelatin but not PGH. Conversely, mandibular condyle cartilage chondrocytes only had high GAG deposition in gelatin but not in PGH. These appeared to remain dormant in PGH. These results show that mandibular condyle cartilage cells do have innate regeneration potential but that they are more sensitive to hydrogel material than costal cartilage cells.
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Affiliation(s)
- A R Chin
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, 409 Salk Pavilion, 335 Sutherland Drive, Pittsburgh, PA, 15213, USA
| | - J M Taboas
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, 409 Salk Pavilion, 335 Sutherland Drive, Pittsburgh, PA, 15213, USA
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Center of Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - A J Almarza
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, 409 Salk Pavilion, 335 Sutherland Drive, Pittsburgh, PA, 15213, USA.
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
- Center of Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA, USA.
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
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11
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Yu C, Schimelman J, Wang P, Miller KL, Ma X, You S, Guan J, Sun B, Zhu W, Chen S. Photopolymerizable Biomaterials and Light-Based 3D Printing Strategies for Biomedical Applications. Chem Rev 2020; 120:10695-10743. [PMID: 32323975 PMCID: PMC7572843 DOI: 10.1021/acs.chemrev.9b00810] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Since the advent of additive manufacturing, known commonly as 3D printing, this technology has revolutionized the biofabrication landscape and driven numerous pivotal advancements in tissue engineering and regenerative medicine. Many 3D printing methods were developed in short course after Charles Hull first introduced the power of stereolithography to the world. However, materials development was not met with the same enthusiasm and remained the bottleneck in the field for some time. Only in the past decade has there been deliberate development to expand the materials toolbox for 3D printing applications to meet the true potential of 3D printing technologies. Herein, we review the development of biomaterials suited for light-based 3D printing modalities with an emphasis on bioprinting applications. We discuss the chemical mechanisms that govern photopolymerization and highlight the application of natural, synthetic, and composite biomaterials as 3D printed hydrogels. Because the quality of a 3D printed construct is highly dependent on both the material properties and processing technique, we included a final section on the theoretical and practical aspects behind light-based 3D printing as well as ways to employ that knowledge to troubleshoot and standardize the optimization of printing parameters.
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Affiliation(s)
- Claire Yu
- Department of NanoEngineering, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Jacob Schimelman
- Department of NanoEngineering, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Pengrui Wang
- Materials Science and Engineering Program, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Kathleen L Miller
- Department of NanoEngineering, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Xuanyi Ma
- Department of Bioengineering, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Shangting You
- Department of NanoEngineering, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Jiaao Guan
- Department of Electrical and Computer Engineering, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Bingjie Sun
- Department of NanoEngineering, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Wei Zhu
- Department of NanoEngineering, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Shaochen Chen
- Department of NanoEngineering, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
- Materials Science and Engineering Program, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
- Department of Bioengineering, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
- Chemical Engineering Program, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
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12
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Ding X, Chen Y, Chao CA, Wu Y, Wang Y. Control the Mechanical Properties and Degradation of Poly(Glycerol Sebacate) by Substitution of the Hydroxyl Groups with Palmitates. Macromol Biosci 2020; 20:e2000101. [DOI: 10.1002/mabi.202000101] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/12/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Xiaochu Ding
- Nancy E. and Peter C. Meinig School of Biomedical Engineering Cornell University 277 Kimball Hall 134 Hollister Drive Ithaca NY 14853 USA
| | - Ying Chen
- Nancy E. and Peter C. Meinig School of Biomedical Engineering Cornell University 277 Kimball Hall 134 Hollister Drive Ithaca NY 14853 USA
| | - Corson Andrew Chao
- Nancy E. and Peter C. Meinig School of Biomedical Engineering Cornell University 277 Kimball Hall 134 Hollister Drive Ithaca NY 14853 USA
| | - Yen‐Lin Wu
- Nancy E. and Peter C. Meinig School of Biomedical Engineering Cornell University 277 Kimball Hall 134 Hollister Drive Ithaca NY 14853 USA
| | - Yadong Wang
- Nancy E. and Peter C. Meinig School of Biomedical Engineering Cornell University 277 Kimball Hall 134 Hollister Drive Ithaca NY 14853 USA
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13
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Moura C, Trindade D, Vieira M, Francisco L, Ângelo DF, Alves N. Multi-Material Implants for Temporomandibular Joint Disc Repair: Tailored Additive Manufacturing Production. Front Bioeng Biotechnol 2020; 8:342. [PMID: 32373604 PMCID: PMC7186357 DOI: 10.3389/fbioe.2020.00342] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/27/2020] [Indexed: 12/22/2022] Open
Abstract
Temporomandibular disorders (TMD) affect a substantial percentage of the population, and the resources spent on their treatment are considerable. Despite the worldwide efforts around Tissue Engineering of the temporomandibular joint (TMJ) disc, a proper implant offering a long-term solution for TMD was not yet developed. To contribute to these efforts, this work is focused on the research and development of implants for TMJ disc regeneration. Scaffolds and hydrogels mimicking the TMJ disc of black Merino sheep were produced using different materials, poly(ε-caprolactone) (PCL) and poly(ethylene glycol) diacrylate (PEGDA), and as a multi-material structure. Different parameters of the scaffold manufacturing were assessed: the influence of processing temperatures, filament diameter, and biological environment. Moreover, two multi-material approaches were also assessed, scaffold with a hydrogel shell and scaffold with a hydrogel core. It was found that increasing temperature, the scaffolds' porosity decreases, increasing their compressive modulus. Decreasing the filament size (300 to 200 μm) decreases the compressive modulus to almost half of the initial value. Scaffolds with 200 μm filaments are the ones with a closer modulus to the native disc and their properties are maintained under hydrated conditions. The introduction of a hydrogel core in these scaffolds presented better mechanical properties to TMJ disc substitution.
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Affiliation(s)
- Carla Moura
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Daniela Trindade
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Milena Vieira
- ESTG – School of Technology and Management, Polytechnic Institute of Leiria, Leiria, Portugal
- SEG-CEMMPRE – Department of Mechanical Engineering, University of Coimbra, Coimbra, Portugal
| | - Luís Francisco
- ESTG – School of Technology and Management, Polytechnic Institute of Leiria, Leiria, Portugal
| | - David Faustino Ângelo
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
- Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
- Instituto Português da Face, Lisbon, Portugal
| | - Nuno Alves
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
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14
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Pashneh-Tala S, Moorehead R, Claeyssens F. Hybrid manufacturing strategies for tissue engineering scaffolds using methacrylate functionalised poly(glycerol sebacate). J Biomater Appl 2020; 34:1114-1130. [DOI: 10.1177/0885328219898385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Poly(glycerol sebacate) is an attractive biomaterial for tissue engineering due to its biocompatibility, elasticity and rapid degradation rate. However, poly(glycerol sebacate) requires harsh processing conditions, involving high temperatures and vacuum for extended periods, to produce an insoluble polymer matrix. These conditions make generating accurate and intricate geometries from poly(glycerol sebacate), such as those required for tissue engineering scaffolds, difficult. Functionalising poly(glycerol sebacate) with methacrylate groups produces a photocurable polymer, poly(glycerol sebacate)-methacrylate, which can be rapidly crosslinked into an insoluble matrix. Capitalising on these improved processing capabilities, here, we present a variety of approaches for fabricating porous tissue engineering scaffolds from poly(glycerol sebacate)-methacrylate using sucrose porogen leaching combined with other manufacturing methods. Mould-based techniques were used to produce porous disk-shaped and tubular scaffolds. Porogen size was shown to influence scaffold porosity and mechanical performance, and the porous poly(glycerol sebacate)-methacrylate scaffolds supported the proliferation of primary fibroblasts in vitro. Additionally, scaffolds with spatially variable mechanical properties were generated by combining variants of poly(glycerol sebacate)-methacrylate with different stiffness. Finally, subtractive and additive manufacturing methods were developed with the capabilities to generate porous poly(glycerol sebacate)-methacrylate scaffolds from digital designs. These hybrid manufacturing strategies offer the ability to produce accurate macroscale poly(glycerol sebacate)-methacrylate scaffolds with tailored microscale porosity and spatially resolved mechanical properties suitable for a broad range of applications across tissue engineering.
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Affiliation(s)
| | - Robert Moorehead
- Kroto Research Institute, The University of Sheffield, Sheffield, UK
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15
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Belleghem SMV, Mahadik B, Snodderly KL, Fisher JP. Overview of Tissue Engineering Concepts and Applications. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00081-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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16
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Farr N, Pashneh‐Tala S, Stehling N, Claeyssens F, Green N, Rodenburg C. Characterizing Cross‐Linking Within Polymeric Biomaterials in the SEM by Secondary Electron Hyperspectral Imaging. Macromol Rapid Commun 2019; 41:e1900484. [DOI: 10.1002/marc.201900484] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/29/2019] [Indexed: 01/23/2023]
Affiliation(s)
- Nicholas Farr
- Department of Materials Science and EngineeringSir Robert Hadfield Building Mappin Street Sheffield S1 3JD UK
| | - Samand Pashneh‐Tala
- Department of Materials Science and EngineeringSir Robert Hadfield Building Mappin Street Sheffield S1 3JD UK
| | - Nicola Stehling
- Department of Materials Science and EngineeringSir Robert Hadfield Building Mappin Street Sheffield S1 3JD UK
| | - Frederik Claeyssens
- Department of Materials Science and EngineeringSir Robert Hadfield Building Mappin Street Sheffield S1 3JD UK
| | - Nicola Green
- Department of Materials Science and EngineeringSir Robert Hadfield Building Mappin Street Sheffield S1 3JD UK
- INSIGNEO Institute for In Silico MedicineThe Pam Liversidge BuildingSir Robert Hadfield Building Mappin Street Sheffield S1 3JD UK
| | - Cornelia Rodenburg
- Department of Materials Science and EngineeringSir Robert Hadfield Building Mappin Street Sheffield S1 3JD UK
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17
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Zamboulis A, Nakiou EA, Christodoulou E, Bikiaris DN, Kontonasaki E, Liverani L, Boccaccini AR. Polyglycerol Hyperbranched Polyesters: Synthesis, Properties and Pharmaceutical and Biomedical Applications. Int J Mol Sci 2019; 20:E6210. [PMID: 31835372 PMCID: PMC6940955 DOI: 10.3390/ijms20246210] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 12/13/2022] Open
Abstract
In a century when environmental pollution is a major issue, polymers issued from bio-based monomers have gained important interest, as they are expected to be environment-friendly, and biocompatible, with non-toxic degradation products. In parallel, hyperbranched polymers have emerged as an easily accessible alternative to dendrimers with numerous potential applications. Glycerol (Gly) is a natural, low-cost, trifunctional monomer, with a production expected to grow significantly, and thus an excellent candidate for the synthesis of hyperbranched polyesters for pharmaceutical and biomedical applications. In the present article, we review the synthesis, properties, and applications of glycerol polyesters of aliphatic dicarboxylic acids (from succinic to sebacic acids) as well as the copolymers of glycerol or hyperbranched polyglycerol with poly(lactic acid) and poly(ε-caprolactone). Emphasis was given to summarize the synthetic procedures (monomer molar ratio, used catalysts, temperatures, etc.,) and their effect on the molecular weight, solubility, and thermal and mechanical properties of the prepared hyperbranched polymers. Their applications in pharmaceutical technology as drug carries and in biomedical applications focusing on regenerative medicine are highlighted.
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Affiliation(s)
- Alexandra Zamboulis
- Laboratory of Polymer Chemistry & Technology, Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.Z.); (E.A.N.); (E.C.)
| | - Eirini A. Nakiou
- Laboratory of Polymer Chemistry & Technology, Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.Z.); (E.A.N.); (E.C.)
| | - Evi Christodoulou
- Laboratory of Polymer Chemistry & Technology, Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.Z.); (E.A.N.); (E.C.)
| | - Dimitrios N. Bikiaris
- Laboratory of Polymer Chemistry & Technology, Department of Chemistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.Z.); (E.A.N.); (E.C.)
| | - Eleana Kontonasaki
- Department of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Liliana Liverani
- Institute of Biomaterials, Department of Material Science and Engineering, University of Erlangen-Nuremberg, Cauerstr. 6, 91058 Erlangen, Germany;
| | - Aldo R. Boccaccini
- Institute of Biomaterials, Department of Material Science and Engineering, University of Erlangen-Nuremberg, Cauerstr. 6, 91058 Erlangen, Germany;
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18
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Vapniarsky N, Huwe LW, Arzi B, Houghton MK, Wong ME, Wilson JW, Hatcher DC, Hu JC, Athanasiou KA. Tissue engineering toward temporomandibular joint disc regeneration. Sci Transl Med 2019; 10:10/446/eaaq1802. [PMID: 29925634 DOI: 10.1126/scitranslmed.aaq1802] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 05/25/2018] [Indexed: 12/11/2022]
Abstract
Treatments for temporomandibular joint (TMJ) disc thinning and perforation, conditions prevalent in TMJ pathologies, are palliative but not reparative. To address this, scaffold-free tissue-engineered implants were created using allogeneic, passaged costal chondrocytes. A combination of compressive and bioactive stimulation regimens produced implants with mechanical properties akin to those of the native disc. Efficacy in repairing disc thinning was examined in minipigs. Compared to empty controls, treatment with tissue-engineered implants restored disc integrity by inducing 4.4 times more complete defect closure, formed 3.4-fold stiffer repair tissue, and promoted 3.2-fold stiffer intralaminar fusion. The osteoarthritis score (indicative of degenerative changes) of the untreated group was 3.0-fold of the implant-treated group. This tissue engineering strategy paves the way for developing tissue-engineered implants as clinical treatments for TMJ disc thinning.
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Affiliation(s)
- Natalia Vapniarsky
- Department of Pathology, Microbiology, and Immunology, University of California, Davis, Davis, CA 95616, USA
| | - Le W Huwe
- Department of Biomedical Engineering, University of California, Davis, Davis, CA 95616, USA
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Meghan K Houghton
- Directorate for Computer and Information Science and Engineering, National Science Foundation, Alexandria, VA 22314, USA
| | - Mark E Wong
- Department of Oral and Maxillofacial Surgery, University of Texas School of Dentistry, Houston, TX 77054, USA
| | - James W Wilson
- Department of Oral and Maxillofacial Surgery, University of Texas School of Dentistry, Houston, TX 77054, USA
| | - David C Hatcher
- Diagnostic Digital Imaging Center, Sacramento, CA 95825, USA
| | - Jerry C Hu
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697, USA.
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19
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Liao W, Xu L, Wangrao K, Du Y, Xiong Q, Yao Y. Three-dimensional printing with biomaterials in craniofacial and dental tissue engineering. PeerJ 2019; 7:e7271. [PMID: 31328038 PMCID: PMC6622164 DOI: 10.7717/peerj.7271] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 06/10/2019] [Indexed: 02/05/2023] Open
Abstract
With the development of technology, tissue engineering (TE) has been widely applied in the medical field. In recent years, due to its accuracy and the demands of solid freeform fabrication in TE, three-dimensional printing, also known as additive manufacturing (AM), has been applied for biological scaffold fabrication in craniofacial and dental regeneration. In this review, we have compared several types of AM techniques and summarized their advantages and limitations. The range of printable materials used in craniofacial and dental tissue includes all the biomaterials. Thus, basic and clinical studies were discussed in this review to present the application of AM techniques in craniofacial and dental tissue and their advances during these years, which might provide information for further AM studies in craniofacial and dental TE.
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Affiliation(s)
- Wen Liao
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lin Xu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Kaijuan Wangrao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yu Du
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qiuchan Xiong
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yang Yao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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20
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Xiao B, Yang W, Lei D, Huang J, Yin Y, Zhu Y, You Z, Wang F, Sun S. PGS Scaffolds Promote the In Vivo Survival and Directional Differentiation of Bone Marrow Mesenchymal Stem Cells Restoring the Morphology and Function of Wounded Rat Uterus. Adv Healthc Mater 2019; 8:e1801455. [PMID: 30734535 DOI: 10.1002/adhm.201801455] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 12/26/2018] [Indexed: 01/23/2023]
Abstract
Intrauterine adhesion (IUA) causing infertility and recurrent miscarriage of reproductive female mammals usually results from endometrium injury. Nevertheless, there is no efficient therapeutic method to avoid IUA. Bone marrow derived mesenchymal stem cells (BMSCs) are an important cell source for tissue regeneration. This study designs and explores the ability of BMSC-loaded elastic poly(glycerol sebacate) (PGS) scaffold to prevent IUA and compares the effect of PGS with poly(lactic-co-glycolic acid) (PLGA) and collagen scaffolds in resumption of damaged rat uteruses. The 3D architecture provided by PGS scaffolds favors the attachment and growth of rat BMSCs. In vivo bioluminescence imaging shows that compared with direct BMSC intrauterine injection, PLGA, and collagen scaffolds, the PGS scaffold significantly prolongs the retention time of BMSCs in a wounded rat uterus model. More importantly, BMSCs can directly differentiate into endometrial stromal cells after transplantation of PGS/BMSCs constructs, but not PLGA/BMSCs and collagen/BMSCs. It is found that the level of transforming growth factor β1 (TGF-β1), basic fibroblast growth factor (bFGF), vascular endothelial growth factor, and insulin-like growth factors in the injured endometrium adjacent to PGS/BMSCs constructs is higher than those of rats receiving PLGA/BMSCs, collagen/BMSCs, or BMSCs intrauterine transplantation. Besides, transplantation of PGS/BMSCs leads to better morphology recovery of the damaged uterus than PLGA/BMSCs and collagen/BMSCs. The receptive fertility of PGS/BMSCs is 72.2 ± 6.4%, similar to the one of collagen/BMSCs, but significantly higher than 42.3 ± 3.9% in PLGA/BMSCs. Taken together, PGS/BMSCs may be a promising candidate for preventing IUA.
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Affiliation(s)
- Bang Xiao
- Department of Medical Genetics; Second Military Medical University; 800 Xiangyin Road Shanghai 200433 P. R. China
| | - Wenjun Yang
- Department of Medical Genetics; Second Military Medical University; 800 Xiangyin Road Shanghai 200433 P. R. China
| | - Dong Lei
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials; International Joint Laboratory for Advanced Fiber and Low-dimension Materials; College of Materials Science and Engineering; Donghua University; Shanghai 201620 P. R. China
| | - Jinfeng Huang
- Department of Medical Genetics; Second Military Medical University; 800 Xiangyin Road Shanghai 200433 P. R. China
| | - Yupeng Yin
- Department of Medical Genetics; Second Military Medical University; 800 Xiangyin Road Shanghai 200433 P. R. China
| | - Yiqing Zhu
- Department of Medical Genetics; Second Military Medical University; 800 Xiangyin Road Shanghai 200433 P. R. China
| | - Zhengwei You
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials; International Joint Laboratory for Advanced Fiber and Low-dimension Materials; College of Materials Science and Engineering; Donghua University; Shanghai 201620 P. R. China
| | - Fang Wang
- Department of Medical Genetics; Second Military Medical University; 800 Xiangyin Road Shanghai 200433 P. R. China
| | - Shuhan Sun
- Department of Medical Genetics; Second Military Medical University; 800 Xiangyin Road Shanghai 200433 P. R. China
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21
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Acri TM, Shin K, Seol D, Laird NZ, Song I, Geary SM, Chakka JL, Martin JA, Salem AK. Tissue Engineering for the Temporomandibular Joint. Adv Healthc Mater 2019; 8:e1801236. [PMID: 30556348 DOI: 10.1002/adhm.201801236] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/17/2018] [Indexed: 12/24/2022]
Abstract
Tissue engineering potentially offers new treatments for disorders of the temporomandibular joint which frequently afflict patients. Damage or disease in this area adversely affects masticatory function and speaking, reducing patients' quality of life. Effective treatment options for patients suffering from severe temporomandibular joint disorders are in high demand because surgical options are restricted to removal of damaged tissue or complete replacement of the joint with prosthetics. Tissue engineering approaches for the temporomandibular joint are a promising alternative to the limited clinical treatment options. However, tissue engineering is still a developing field and only in its formative years for the temporomandibular joint. This review outlines the anatomical and physiological characteristics of the temporomandibular joint, clinical management of temporomandibular joint disorder, and current perspectives in the tissue engineering approach for the temporomandibular joint disorder. The tissue engineering perspectives have been categorized according to the primary structures of the temporomandibular joint: the disc, the mandibular condyle, and the glenoid fossa. In each section, contemporary approaches in cellularization, growth factor selection, and scaffold fabrication strategies are reviewed in detail along with their achievements and challenges.
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Affiliation(s)
- Timothy M. Acri
- Department of Pharmaceutical Sciences and Experimental Therapeutics; College of Pharmacy; University of Iowa; Iowa City, Iowa 52242 USA
| | - Kyungsup Shin
- Department of Orthodontics; College of Dentistry and Dental Clinics; University of Iowa; Iowa City, Iowa 52242 USA
| | - Dongrim Seol
- Department of Orthopedics and Rehabilitation; Carver College of Medicine; University of Iowa; Iowa City, Iowa 52242 USA
| | - Noah Z. Laird
- Department of Pharmaceutical Sciences and Experimental Therapeutics; College of Pharmacy; University of Iowa; Iowa City, Iowa 52242 USA
| | - Ino Song
- Department of Orthopedics and Rehabilitation; Carver College of Medicine; University of Iowa; Iowa City, Iowa 52242 USA
| | - Sean M. Geary
- Department of Pharmaceutical Sciences and Experimental Therapeutics; College of Pharmacy; University of Iowa; Iowa City, Iowa 52242 USA
| | - Jaidev L. Chakka
- Department of Pharmaceutical Sciences and Experimental Therapeutics; College of Pharmacy; University of Iowa; Iowa City, Iowa 52242 USA
| | - James A. Martin
- Department of Orthopedics and Rehabilitation; Carver College of Medicine; University of Iowa; Iowa City, Iowa 52242 USA
| | - Aliasger K. Salem
- Department of Pharmaceutical Sciences and Experimental Therapeutics; College of Pharmacy; University of Iowa; Iowa City, Iowa 52242 USA
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22
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Donahue RP, Gonzalez-Leon EA, Hu JC, Athanasiou KA. Considerations for translation of tissue engineered fibrocartilage from bench to bedside. J Biomech Eng 2018; 141:2718210. [PMID: 30516244 PMCID: PMC6611470 DOI: 10.1115/1.4042201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 11/27/2018] [Indexed: 12/25/2022]
Abstract
Fibrocartilage is found in the knee meniscus, the temporomandibular joint (TMJ) disc, the pubic symphysis, the annulus fibrosus of intervertebral disc, tendons, and ligaments. These tissues are notoriously difficult to repair due to their avascularity, and limited clinical repair and replacement options exist. Tissue engineering has been proposed as a route to repair and replace fibrocartilages. Using the knee meniscus and TMJ disc as examples, this review describes how fibrocartilages can be engineered toward translation to clinical use. Presented are fibrocartilage anatomy, function, epidemiology, pathology, and current clinical treatments because they inform design criteria for tissue engineered fibrocartilages. Methods for how native tissues are characterized histomorphologically, biochemically, and mechanically to set gold standards are described. Then, provided is a review of fibrocartilage-specific tissue engineering strategies, including the selection of cell sources, scaffold or scaffold-free methods, and biochemical and mechanical stimuli. In closing, the Food and Drug Administration paradigm is discussed to inform researchers of both the guidance that exists and the questions that remain to be answered with regard to bringing a tissue engineered fibrocartilage product to the clinic.
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Affiliation(s)
- Ryan P. Donahue
- Department of Biomedical Engineering,
University of California, Irvine,
Irvine, CA 92697
e-mail:
| | - Erik A. Gonzalez-Leon
- Department of Biomedical Engineering,
University of California, Irvine,
Irvine, CA 92697
e-mail:
| | - Jerry C. Hu
- Department of Biomedical Engineering,
University of California, Irvine,
Irvine, CA 92697
e-mail:
| | - Kyriacos A. Athanasiou
- Fellow ASME
Department of Biomedical Engineering,
University of California, Irvine
Irvine, CA 92697
e-mail:
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23
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Regenerative Potential of Various Soft Polymeric Scaffolds in the Temporomandibular Joint Condyle. J Oral Maxillofac Surg 2018; 76:2019-2026. [DOI: 10.1016/j.joms.2018.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/01/2018] [Accepted: 02/10/2018] [Indexed: 11/21/2022]
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24
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Bousnaki M, Bakopoulou A, Papadogianni D, Barkoula NM, Alpantaki K, Kritis A, Chatzinikolaidou M, Koidis P. Fibro/chondrogenic differentiation of dental stem cells into chitosan/alginate scaffolds towards temporomandibular joint disc regeneration. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:97. [PMID: 29946796 DOI: 10.1007/s10856-018-6109-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 06/15/2018] [Indexed: 06/08/2023]
Abstract
Tissue engineering (TE) may provide effective alternative treatment for challenging temporomandibular joint (TMJ) pathologies associated with disc malpositioning or degeneration and leading to severe masticatory dysfunction. Aim of this study was to evaluate the potential of chitosan/alginate (Ch/Alg) scaffolds to promote fibro/chondrogenic differentiation of dental pulp stem cells (DPSCs) and production of fibrocartilage tissue, serving as a replacement of the natural TMJ disc. Ch/Alg scaffolds were fabricated by crosslinking with CaCl2 combined or not with glutaraldehyde, resulting in two scaffold types that were physicochemically characterized, seeded with DPSCs or human nucleus pulposus cells (hNPCs) used as control and evaluated for cell attachment, viability, and proliferation. The DPSCs/scaffold constructs were incubated for up to 8 weeks and assessed for extracellular matrix production by means of histology, immunofluorescence, and thermomechanical analysis. Both Ch/Alg scaffold types with a mass ratio of 1:1 presented a gel-like structure with interconnected pores. Scaffolds supported cell adhesion and long-term viability/proliferation of DPSCs and hNPCs. DPSCs cultured into Ch/Alg scaffolds demonstrated a significant increase of gene expression of fibrocartilaginous markers (COLI, COL X, SOX9, COM, ACAN) after up to 3 weeks in culture. Dynamic thermomechanical analysis revealed that scaffolds loaded with DPSCs significantly increased storage modulus and elastic response compared to cell-free scaffolds, obtaining values similar to those of native TMJ disc. Histological data and immunochemical staining for aggrecan after 4 to 8 weeks indicated that the scaffolds support abundant fibrocartilaginous tissue formation, thus providing a promising strategy for TMJ disc TE-based replacement.
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Affiliation(s)
- Maria Bousnaki
- Department of Prosthodontics, Faculty of Dentistry, Aristotle University of Thessaloniki, University Campus, Dentistry Building, 54124, Thessaloniki, Greece
| | - Athina Bakopoulou
- Department of Prosthodontics, Faculty of Dentistry, Aristotle University of Thessaloniki, University Campus, Dentistry Building, 54124, Thessaloniki, Greece
| | - Danai Papadogianni
- Department of Materials Science and Technology, University of Crete, Voutes Campus, Heraklion, 71003, Crete, Greece
| | - Nektaria-Marianthi Barkoula
- Department of Materials Science and Engineering, University of Ioannina, University Campus, 45500, Ioannina, Greece
| | - Kalliopi Alpantaki
- Department of Materials Science and Technology, University of Crete, Voutes Campus, Heraklion, 71003, Crete, Greece
| | - Aristidis Kritis
- Department of Physiology and Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, 54006, Thessaloniki, Greece
- cGMP Regenerative Medicine facility, Department of Physiology and Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54006, Greece
| | - Maria Chatzinikolaidou
- Department of Materials Science and Technology, University of Crete, Voutes Campus, Heraklion, 71003, Crete, Greece
- Institute of Electronic Structure and Laser, Foundation for Research and Technology-Hellas, Nikolaou Plastira 100, Vassilika Vouton, Heraklion, 70013, Crete, Greece
| | - Petros Koidis
- Department of Prosthodontics, Faculty of Dentistry, Aristotle University of Thessaloniki, University Campus, Dentistry Building, 54124, Thessaloniki, Greece.
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25
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Harris JJ, Lu S, Gabriele P. Commercial challenges in developing biomaterials for medical device development. POLYM INT 2018. [DOI: 10.1002/pi.5590] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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26
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Lee SH, Lee KW, Gade PS, Robertson AM, Wang Y. Microwave-assisted facile fabrication of porous poly (glycerol sebacate) scaffolds. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2018; 29:907-916. [PMID: 28569644 PMCID: PMC5738282 DOI: 10.1080/09205063.2017.1335076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 05/23/2017] [Indexed: 12/31/2022]
Abstract
The biodegradable elastomeric polyester poly(glycerol sebacate) (PGS) was developed for soft-tissue engineering. It has been used in various research applications such as wound healing, cartilage tissue engineering, and vascular grafting due to its biocompatibility and elastomeric properties. However conventional PGS manufacture is generally limited by the laborious reaction conditions needed for curing which requires elevated reaction temperatures, high vacuum and multi-day reaction times. In this study, we developed a microwave irradiation methodology to fabricate PGS scaffolds under milder conditions with curing times that are 8 times faster than conventional methods. In particular, we determined microwave reaction temperatures and times for maximum crosslinking of PGS elastomers, demonstrating that PGS is fully crosslinked using gradual heating up to 160 °C for 3 h. Porosity and mechanical properties of these microwave-cured PGS elastomers were shown to be similar to PGS elastomers fabricated by the conventional polycondensation method (150 °C under 30 Torr for 24 h). To move one step closer to clinical application, we also examined the biocompatibility of microwave-cured PGS using in vitro cell viability assays with primary baboon arterial smooth muscle cells (SMCs). These combined results show microwave curing of PGS is a viable alternative to conventional curing.
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Affiliation(s)
- Soo Hyon Lee
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Kee-Won Lee
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Piyusha S. Gade
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Anne M. Robertson
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA 15261
- McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Yadong Wang
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA 15261
- Department of Chemical and Petroleum Engineering, University of Pittsburgh, Pittsburgh, PA 15261, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15260, USA, USA
- Clinical Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
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Lowe J, Bansal R, Badylak S, Brown B, Chung W, Almarza A. Properties of the Temporomandibular Joint in Growing Pigs. J Biomech Eng 2018; 140:2675984. [PMID: 29560497 DOI: 10.1115/1.4039624] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Indexed: 11/08/2022]
Abstract
A subset of temporomandibular joint (TMJ) disorders are attributed to joint degeneration. The pig has been considered the preferred in-vivo model for the evaluation of potential therapies for TMJ disorders, and practical considerations such as cost and husbandry issues have favored the use of young, skeletally immature animals. However, the effect of growth on the biochemical and biomechanical properties of the TMJ disc and articulating cartilage has not been examined. The present study investigates the effect of age on the biochemical and biomechanical properties of healthy porcine TMJs at 3, 6, and 9 months of age. DNA , hyrdroxyproline, and glycosaminoglycan (GAG) content were determined and the discs and condyles were tested in uniaxial unconfined stress relaxation compression from 10% - 30% strain. TMJ discs were further assessed with a tensile test to failure technique, which included the ability to test multiple samples from the same region of an individual disc to minimize the intra-specimen variation. No differences in biochemical properties for the disc or compressive properties at 30% stress relaxation in the disc and condylar cartilage were found. In tension, no differences were observed for peak stress and tensile modulus. The collagen content of the condyle were higher at 9 months than 3 months (p<0.05), and the GAG content was higher at 9 months than 6 months (p<0.05). There was a trend of increased compressive instantaneous modulus with age. As such, age matched controls for growing pigs are probably appropriate for most parameters measured.
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Affiliation(s)
- Jesse Lowe
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260; Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA 15260
| | - Rohan Bansal
- Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA 15260
| | - Stephen Badylak
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15260; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15260
| | - Bryan Brown
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15260
| | - William Chung
- Oral and Maxillofacial Surgery, University of Pittsburgh, Pittsburgh, PA 15260
| | - Alejandro Almarza
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, PA 15260; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260; Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA 15260; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15260
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Van Bellinghen X, Idoux-Gillet Y, Pugliano M, Strub M, Bornert F, Clauss F, Schwinté P, Keller L, Benkirane-Jessel N, Kuchler-Bopp S, Lutz JC, Fioretti F. Temporomandibular Joint Regenerative Medicine. Int J Mol Sci 2018; 19:E446. [PMID: 29393880 PMCID: PMC5855668 DOI: 10.3390/ijms19020446] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 01/09/2023] Open
Abstract
The temporomandibular joint (TMJ) is an articulation formed between the temporal bone and the mandibular condyle which is commonly affected. These affections are often so painful during fundamental oral activities that patients have lower quality of life. Limitations of therapeutics for severe TMJ diseases have led to increased interest in regenerative strategies combining stem cells, implantable scaffolds and well-targeting bioactive molecules. To succeed in functional and structural regeneration of TMJ is very challenging. Innovative strategies and biomaterials are absolutely crucial because TMJ can be considered as one of the most difficult tissues to regenerate due to its limited healing capacity, its unique histological and structural properties and the necessity for long-term prevention of its ossified or fibrous adhesions. The ideal approach for TMJ regeneration is a unique scaffold functionalized with an osteochondral molecular gradient containing a single stem cell population able to undergo osteogenic and chondrogenic differentiation such as BMSCs, ADSCs or DPSCs. The key for this complex regeneration is the functionalization with active molecules such as IGF-1, TGF-β1 or bFGF. This regeneration can be optimized by nano/micro-assisted functionalization and by spatiotemporal drug delivery systems orchestrating the 3D formation of TMJ tissues.
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Affiliation(s)
- Xavier Van Bellinghen
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
| | - Ysia Idoux-Gillet
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
| | - Marion Pugliano
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
| | - Marion Strub
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
| | - Fabien Bornert
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
| | - Francois Clauss
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
| | - Pascale Schwinté
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
| | - Laetitia Keller
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
| | - Nadia Benkirane-Jessel
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
| | - Sabine Kuchler-Bopp
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
| | - Jean Christophe Lutz
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
- Faculté de Médecine, Université de Strasbourg, 11 rue Humann, 67000 Strasbourg, France.
| | - Florence Fioretti
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, 11 rue Humann, 67000 Strasbourg, France.
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Ste Elisabeth, 67000 Strasbourg, France.
- Médecine et Chirurgie Bucco-Dentaires & Chirurgie Maxillo-Facial, Hôpitaux Universitaires de Strasbourg (HUS), 1 place de l'Hôpital, 67000 Strasbourg, France.
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Gutman S, Kim D, Tarafder S, Velez S, Jeong J, Lee CH. Regionally variant collagen alignment correlates with viscoelastic properties of the disc of the human temporomandibular joint. Arch Oral Biol 2017; 86:1-6. [PMID: 29128675 DOI: 10.1016/j.archoralbio.2017.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine the regionally variant quality of collagen alignment in human TMJ discs and its statistical correlation with viscoelastic properties. DESIGN For quantitative analysis of the quality of collagen alignment, horizontal sections of human TMJ discs with Pricrosirius Red staining were imaged under circularly polarized microscopy. Mean angle and angular deviation of collagen fibers in each region were analyzed using a well-established automated image-processing for angular gradient. Instantaneous and relaxation moduli of each disc region were measured under stress-relaxation test both in tensile and compression. Then Spearman correlation analysis was performed between the angular deviation and the moduli. To understand the effect of glycosaminoglycans on the correlation, TMJ disc samples were treated by chondroitinase ABC (C-ABC). RESULTS Our imaging processing analysis showed the region-variant direction of collagen alignment, consistently with previous findings. Interestingly, the quality of collagen alignment, not only the directions, was significantly different in between the regions. The angular deviation of fiber alignment in the anterior and intermediate regions were significantly smaller than the posterior region. Medial and lateral regions showed significantly bigger angular deviation than all the other regions. The regionally variant angular deviation values showed statistically significant correlation with the tensile instantaneous modulus and the relaxation modulus, partially dependent on C-ABC treatment. CONCLUSION Our findings suggest the region-variant degree of collagen fiber alignment is likely attributed to the heterogeneous viscoelastic properties of TMJ disc that may have significant implications in development of regenerative therapy for TMJ disc.
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Affiliation(s)
- Shawn Gutman
- Regenerative Engineering Laboratory, Section for Oral and Maxillofacial Surgery, College of Dental Medicine, Columbia University, 630 W. 168 St. - VC12-230, New York, NY 10032, United States
| | - Daniel Kim
- Regenerative Engineering Laboratory, Section for Oral and Maxillofacial Surgery, College of Dental Medicine, Columbia University, 630 W. 168 St. - VC12-230, New York, NY 10032, United States
| | - Solaiman Tarafder
- Regenerative Engineering Laboratory, Section for Oral and Maxillofacial Surgery, College of Dental Medicine, Columbia University, 630 W. 168 St. - VC12-230, New York, NY 10032, United States
| | - Sergio Velez
- Regenerative Engineering Laboratory, Section for Oral and Maxillofacial Surgery, College of Dental Medicine, Columbia University, 630 W. 168 St. - VC12-230, New York, NY 10032, United States
| | - Julia Jeong
- Regenerative Engineering Laboratory, Section for Oral and Maxillofacial Surgery, College of Dental Medicine, Columbia University, 630 W. 168 St. - VC12-230, New York, NY 10032, United States
| | - Chang H Lee
- Regenerative Engineering Laboratory, Section for Oral and Maxillofacial Surgery, College of Dental Medicine, Columbia University, 630 W. 168 St. - VC12-230, New York, NY 10032, United States.
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30
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Pan Q, Guo Y, Kong F. Poly(glycerol sebacate) combined with chondroitinase ABC promotes spinal cord repair in rats. J Biomed Mater Res B Appl Biomater 2017; 106:1770-1777. [PMID: 28901688 DOI: 10.1002/jbm.b.33984] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 08/07/2017] [Accepted: 08/16/2017] [Indexed: 01/07/2023]
Affiliation(s)
- Qi Pan
- Department of Neurosurgery; Xinjiang Uygur Autonomous Region Corps Hospital of Chinese People's Armed Police Force; Urumqi 830091 China
| | - Yan Guo
- Department of Ophthalmology; Shanghai Corps Hospital of Chinese People's Armed Police Force; Shanghai 201103 China
| | - Fanyong Kong
- Department of Neurosurgery, Yueyang Hospital of Integrated Chinese and Western Medicine; Shanghai University of Traditional Chinese Medicine; Shanghai 200437 China
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31
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Zaky SH, Lee KW, Gao J, Jensen A, Verdelis K, Wang Y, Almarza AJ, Sfeir C. Poly (glycerol sebacate) elastomer supports bone regeneration by its mechanical properties being closer to osteoid tissue rather than to mature bone. Acta Biomater 2017; 54:95-106. [PMID: 28110067 DOI: 10.1016/j.actbio.2017.01.053] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/10/2017] [Accepted: 01/17/2017] [Indexed: 11/28/2022]
Abstract
Mechanical load influences bone structure and mass. Arguing the importance of load-transduction, we investigated the mechanisms inducing bone formation using an elastomeric substrate. We characterized Poly (glycerol sebacate) (PGS) in vitro for its mechanical properties, compatibility with osteoprogenitor cells regarding adhesion, proliferation, differentiation under compression versus static cultures and in vivo for the regeneration of a rabbit ulna critical size defect. The load-transducing properties of PGS were compared in vitro to a stiffer poly lactic-co-glycolic-acid (PLA/PGA) scaffold of similar porosity and interconnectivity. Under cyclic compression for 7days, we report focal adhesion kinase overexpression on the less stiff PGS and upregulation of the transcription factor Runx2 and late osteogenic markers osteocalcin and bone sialoprotein (1.7, 4.0 and 10.0 folds increase respectively). Upon implanting PGS in the rabbit ulna defect, histology and micro-computed tomography analysis showed complete gap bridging with new bone by the PGS elastomer by 8weeks while minimal bone formation was seen in empty controls. Immunohistochemical analysis demonstrated the new bone to be primarily regenerated by recruited osteoprogenitors cells expressing periostin protein during early phase of maturation similar to physiological endochondral bone development. This study confirms PGS to be osteoconductive contributing to bone regeneration by recruiting host progenitor/stem cell populations and as a load-transducing substrate, transmits mechanical signals to the populated cells promoting differentiation and matrix maturation toward proper bone remodeling. We hence conclude that the material properties of PGS being closer to osteoid tissue rather than to mineralized bone, allows bone maturation on a substrate mechanically closer to where osteoprogenitor/stem cells differentiate to develop mature load-bearing bone. SIGNIFICANCE OF SIGNIFICANCE The development of effective therapies for bone and craniofacial regeneration is a foremost clinical priority in the mineralized tissue engineering field. Currently at risk are patients seeking treatment for craniofacial diseases, traumas and disorders including birth defects such as cleft lip and palate, (1 in 525 to 714 live births), craniosynostosis (300-500 per 1,000,000 live births), injuries to the head and face (20 million ER visits per year), and devastating head and neck cancers (8000 deaths and over 30,000 new cases per year). In addition, approximately 6.2 million fractures occur annually in the United States, of which 5-10% fail to heal properly, due to delayed or non-union [1], and nearly half of adults aged 45-65 have moderate to advanced periodontitis with associated alveolar bone loss, which, if not reversed, will lead to the loss of approximately 6.5 teeth/individual [2]. The strategies currently available for bone loss treatment largely suffer from limitations in efficacy or feasibility, necessitating further development and material innovation. Contemporary materials systems themselves are indeed limited in their ability to facilitate mechanical stimuli and provide an appropriate microenvironment for the cells they are designed to support. We propose a strategy which aims to leverage biocompatibility, biodegradability and material elasticity in the creation of a cellular niche. Within this niche, cells are mechanically stimulated to produce their own extracellular matrix. The hypothesis that mechanical stimuli will enhance bone regeneration is supported by a wealth of literature showing the effect of mechanical stimuli on bone cell differentiation and matrix formation. Using mechanical stimuli, to our knowledge, has not been explored in vivo in bone tissue engineering applications. We thus propose to use an elastomeric platform, based on poly(glycerol sebacate (PGS), to mimic the natural biochemical environment of bone while enabling the transmission of mechanical forces. In this study we report the material's load-transducing ability as well as falling mechanically closer to bone marrow and osteoid tissue rather than to mature bone, allowed osteogenesis and bone maturation. Defying the notion of selecting bone regeneration scaffolds based on their relative mechanical comparability to mature bone, we consider our results in part novel for the new application of this elastomer and in another fostering for reassessment of the current selection criteria for bone scaffolds.
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Affiliation(s)
- S H Zaky
- Center for Craniofacial Regeneration, Department of Oral Biology, University of Pittsburgh, USA
| | - K W Lee
- Department of Bioengineering, University of Pittsburgh, USA
| | - J Gao
- Department of Bioengineering, University of Pittsburgh, USA
| | - A Jensen
- Department of Chemistry, University of Pittsburgh Dietrich School of Arts and Sciences, USA
| | - K Verdelis
- Center for Craniofacial Regeneration, Department of Oral Biology, University of Pittsburgh, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, USA
| | - Y Wang
- Department of Bioengineering, University of Pittsburgh, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, USA
| | - A J Almarza
- Center for Craniofacial Regeneration, Department of Oral Biology, University of Pittsburgh, USA; Department of Bioengineering, University of Pittsburgh, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, USA
| | - C Sfeir
- Center for Craniofacial Regeneration, Department of Oral Biology, University of Pittsburgh, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, USA.
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Francisco L, Moura C, Viana T, Ângelo D, Morouço P, Alves N. Poly(ɛ-caprolactone) and Polyethylene Glycol Diacrylate-based Scaffolds for TMJ Bioengineered Disc Implants. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.promfg.2017.08.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Aryaei A, Vapniarsky N, Hu JC, Athanasiou KA. Recent Tissue Engineering Advances for the Treatment of Temporomandibular Joint Disorders. Curr Osteoporos Rep 2016; 14:269-279. [PMID: 27704395 PMCID: PMC5106310 DOI: 10.1007/s11914-016-0327-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Temporomandibular disorders (TMDs) are among the most common maxillofacial complaints and a major cause of orofacial pain. Although current treatments provide short- and long-term relief, alternative tissue engineering solutions are in great demand. Particularly, the development of strategies, providing long-term resolution of TMD to help patients regain normal function, is a high priority. An absolute prerequisite of tissue engineering is to understand normal structure and function. The current knowledge of anatomical, mechanical, and biochemical characteristics of the temporomandibular joint (TMJ) and associated tissues will be discussed, followed by a brief description of current TMD treatments. The main focus is on recent tissue engineering developments for regenerating TMJ tissue components, with or without a scaffold. The expectation for effectively managing TMD is that tissue engineering will produce biomimetic TMJ tissues that recapitulate the normal structure and function of the TMJ.
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Affiliation(s)
- Ashkan Aryaei
- Department of Biomedical Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA
| | - Natalia Vapniarsky
- Department of Biomedical Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA
| | - Jerry C Hu
- Department of Biomedical Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA
- Department of Orthopedic Surgery, School of Medicine, University of California, Davis, Sacramento, CA 95817, USA
- Corresponding author: , Tel: +1 530 754 6645, Fax: +1 530 754 5739
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Abstract
Temporomandibular Disorders (TMD) represent a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles and/or associated structures. They are a major cause of non-dental orofacial pain. As a group, they are often multi-factorial in nature and have no common etiology or biological explanations. TMD can be broadly divided into masticatory muscle and TMJ disorders. TMJ disorders are characterized by intra-articular positional and/or structural abnormalities. The most common type of TMJ disorders involves displacement of the TMJ articular disc that precedes progressive degenerative changes of the joint leading to osteoarthritis (OA). In the past decade, progress made in the development of stem cell-based therapies and tissue engineering have provided alternative methods to attenuate the disease symptoms and even replace the diseased tissue in the treatment of TMJ disorders. Resident mesenchymal stem cells (MSCs) have been isolated from the synovia of TMJ, suggesting an important role in the repair and regeneration of TMJ. The seminal discovery of pluripotent stem cells including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) have provided promising cell sources for drug discovery, transplantation as well as for tissue engineering of TMJ condylar cartilage and disc. This review discusses the most recent advances in development of stem cell-based treatments for TMJ disorders through innovative approaches of cell-based therapeutics, tissue engineering and drug discovery.
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Legemate K, Tarafder S, Jun Y, Lee CH. Engineering Human TMJ Discs with Protein-Releasing 3D-Printed Scaffolds. J Dent Res 2016; 95:800-7. [PMID: 27053116 DOI: 10.1177/0022034516642404] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The temporomandibular joint (TMJ) disc is a heterogeneous fibrocartilaginous tissue positioned between the mandibular condyle and glenoid fossa of the temporal bone, with important roles in TMJ functions. Tissue engineering TMJ discs has emerged as an alternative approach to overcoming limitations of current treatments for TMJ disorders. However, the anisotropic collagen orientation and inhomogeneous fibrocartilaginous matrix distribution present challenges in the tissue engineering of functional TMJ discs. Here, we developed 3-dimensional (3D)-printed anatomically correct scaffolds with region-variant microstrand alignment, mimicking anisotropic collagen alignment in the TMJ disc and corresponding mechanical properties. Connective tissue growth factor (CTGF) and transforming growth factor beta 3 (TGFβ3) were then delivered in the scaffolds by spatially embedding CTGF- or TGFβ3-encapsulated microspheres (µS) to reconstruct the regionally variant fibrocartilaginous matrix in the native TMJ disc. When cultured with human mesenchymal stem/progenitor cells (MSCs) for 6 wk, 3D-printed scaffolds with CTGF/TGFβ3-µS resulted in a heterogeneous fibrocartilaginous matrix with overall distribution of collagen-rich fibrous structure in the anterior/posterior (AP) bands and fibrocartilaginous matrix in the intermediate zone, reminiscent of the native TMJ disc. High dose of CTGF/TGFβ3-µS (100 mg µS/g of scaffold) showed significantly more collagen II and aggrecan in the intermediate zone than a low dose (50 mg µS/g of scaffold). Similarly, a high dose of CTGF/TGFβ3-µS yielded significantly higher collagen I expression in the AP bands compared with the low-dose and empty µS. From stress relaxation tests, the ratio of relaxation modulus to instantaneous modulus was significantly smaller with CTGF/TGFβ3-µS than empty µS. Similarly, a significantly higher coefficient of viscosity was achieved with the high dose of CTGF/TGFβ3-µS compared with the low-dose and empty µS, suggesting the dose effect of CTGF and TGFβ3 on fibrocartilage formation. Together, our findings may represent an efficient approach to engineering the TMJ disc graft with anisotropic scaffold microstructure, heterogeneous fibrocartilaginous matrix, and region-dependent viscoelastic properties.
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Affiliation(s)
- K Legemate
- Academic Centre for Dentistry Program (ACTA), University of Amsterdam, Amsterdam, Netherlands
| | - S Tarafder
- Regenerative Engineering Laboratory, Section for Oral and Maxillofacial Surgery, College of Dental Medicine, Columbia University, New York, NY, USA
| | - Y Jun
- Regenerative Engineering Laboratory, Section for Oral and Maxillofacial Surgery, College of Dental Medicine, Columbia University, New York, NY, USA
| | - C H Lee
- Regenerative Engineering Laboratory, Section for Oral and Maxillofacial Surgery, College of Dental Medicine, Columbia University, New York, NY, USA
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Zhang X, Li W. [Research process of the preparation of electrostatic spinning of poly-glycerol sebacate and the application in tissue engineering]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2015; 33:539-542. [PMID: 26688952 PMCID: PMC7030315 DOI: 10.7518/hxkq.2015.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 06/20/2015] [Indexed: 06/05/2023]
Abstract
Poly-glycerol sebacate (PGS) is a novel biodegradable elastomer, it has been widely applied in the biomedical fields of heart, blood vessel and cartilage owing to its excellent biological performance, mechanical property and degradability. Electrostatic spinning is a preparation method of tissue engineering scaffolds with the characteristics of convenience, processing controllability and cost efficiency. In this paper, the author reviewed the research process of electrostatic spinning preparation and the application in the field of tissue engineering.
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Tissue engineering of the temporomandibular joint disc: current status and future trends. Int J Artif Organs 2015; 38:55-68. [PMID: 25744198 DOI: 10.5301/ijao.5000393] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Temporomandibular joint disorders are extremely prevalent and there is no ideal treatment clinically for the moment. For severe cases, a discectomy often need to be performed, which will further result in the development of osteoarthritis. In the past thirty years, tissue engineering has provided a promising approach for the effective remedy of severe TMJ disease through the creation of viable, effective, and biological functional implants. METHODS Although TMJ disc tissue engineering is still in early stage, unremitting efforts and some achievements have been made over the past decades. In this review, a comprehensive summary of the available literature on the progress and status in tissue engineering of the TMJ disc regarding cell sources, scaffolds, biochemical and biomechanical stimuli, and other prospects relative to this field is provided. RESULTS AND CONCLUSIONS Even though research studies in this field are too few compared to other fibrocartilage (e.g., knee meniscus) and numerous, difficult tasks still exist, we believe that our ultimate goal of regenerating a biological implant whose histological, biochemical, and biomechanical properties parallel native TMJ discs for clinical therapy will be achieved in the near future.
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Zaky SH, Lee KW, Gao J, Jensen A, Close J, Wang Y, Almarza AJ, Sfeir C. Poly(Glycerol Sebacate) Elastomer: A Novel Material for Mechanically Loaded Bone Regeneration. Tissue Eng Part A 2014; 20:45-53. [DOI: 10.1089/ten.tea.2013.0172] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Samer Helal Zaky
- Department of Oral Biology, Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kee-Won Lee
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jin Gao
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Adrianna Jensen
- Department of Chemistry, Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - John Close
- Department of Dental Public Health and Information Management, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yadong Wang
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alejandro J. Almarza
- Department of Oral Biology, Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Charles Sfeir
- Department of Oral Biology, Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, Pennsylvania
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Mehrotra D. TMJ Bioengineering: A review. J Oral Biol Craniofac Res 2013; 3:140-5. [PMID: 25737903 PMCID: PMC3941445 DOI: 10.1016/j.jobcr.2013.07.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 07/30/2013] [Indexed: 01/09/2023] Open
Abstract
Regeneration using scaffolds, growth factors, and stem cells is being investigated worldwide. Pubmed search for scaffolds for condyle resulted in 102 articles, of which 24 analyzed Temporomandibular joint (TMJ) scaffolds and only 6 evaluated hydroxyapatite scaffolds. 17 articles report studies on TMJ disc regeneration. The ideal bone construct for repair should be able to replicate the lost structure, restore function, be harmless, reliable and biodegradable. Scaffolds act as carriers for mesenchymal stem cells and/or growth factors and are useful for cell adhesion, migration, proliferation, and differentiation. Gene therapy has also led to the accelerated effective bone regeneration. The major materials used as scaffolds are natural or synthetic polymers, ceramics, composite materials, and electrospun nanofibers. Mesenchymal stem cells are responsible for the formation of virtually all dental, oral, and craniofacial structures. Tissue-engineered bone can possess the customized shape and dimensions. It has the potential for the biological replacement of craniofacial bones.
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Affiliation(s)
- Divya Mehrotra
- Professor, Department of Oral & Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
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Murphy MK, Huey DJ, Reimer AJ, Hu JC, Athanasiou KA. Enhancing post-expansion chondrogenic potential of costochondral cells in self-assembled neocartilage. PLoS One 2013; 8:e56983. [PMID: 23437288 PMCID: PMC3578801 DOI: 10.1371/journal.pone.0056983] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 01/16/2013] [Indexed: 11/18/2022] Open
Abstract
The insufficient healing capacity of articular cartilage necessitates mechanically functional biologic tissue replacements. Using cells to form biomimetic cartilage implants is met with the challenges of cell scarcity and donor site morbidity, requiring expanded cells that possess the ability to generate robust neocartilage. To address this, this study assesses the effects of expansion medium supplementation (bFGF, TFP, FBS) and self-assembled construct seeding density (2, 3, 4 million cells/5 mm dia. construct) on the ability of costochondral cells to generate biochemically and biomechanically robust neocartilage. Results show TFP (1 ng/mL TGF-β1, 5 ng/mL bFGF, 10 ng/mL PDGF) supplementation of serum-free chondrogenic expansion medium enhances the post-expansion chondrogenic potential of costochondral cells, evidenced by increased glycosaminoglycan content, decreased type I/II collagen ratio, and enhanced compressive properties. Low density (2 million cells/construct) enhances matrix synthesis and tensile and compressive mechanical properties. Combined, TFP and Low density interact to further enhance construct properties. That is, with TFP, Low density increases type II collagen content by over 100%, tensile stiffness by over 300%, and compressive moduli by over 140%, compared with High density. In conclusion, the interaction of TFP and Low density seeding enhances construct material properties, allowing for a mechanically functional, biomimetic cartilage to be formed using clinically relevant costochondral cells.
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Affiliation(s)
- Meghan K. Murphy
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
| | - Daniel J. Huey
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
| | - Andrew J. Reimer
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
| | - Jerry C. Hu
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
| | - Kyriacos A. Athanasiou
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
- * E-mail:
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