Regenerative Potential of Bone Morphogenetic Protein 7-Engineered Mesenchymal Stem Cells in Ligature-Induced Periodontitis

The role of rhBMP-2 in mandibular bone regeneration following tooth extraction through HIF-1α and VEGF-A expression: An Immunohistochemical study

Background

Dentists frequently conduct tooth extractions when there is damage to the tooth or the tissue that supports it. When a tooth is extracted, the alveolar bone will sustain injury. Most of the initial bone volume is lost following the healing phase after extraction. Rehabilitation must start as soon as a tooth is missing, mainly because the alveolar bone is severely damaged during the tooth extraction, particularly in the buccal region where the tooth is removed. Dental implant is one method of replacing lost teeth. One of the most important elements influencing the clinical result of dental implants is a change in the dimension of the alveolar bone. Several bone-grafting techniques, such as socket preservation techniques, have been developed to increase the volume of bone throughout the healing phase after tooth extraction. This study aims to assess the impact rhBMP-2 on creating bone regeneration through VEGF and HIF-1α in the mandibular socket post-extraction in Wistar rats.

Method

On the anterior side of the mandible, in the socket area where the tooth was extracted, rhBMP-2 was injected into the socket, and the xenograft material was applied with a syringe. Male, 9-week-old Wistar rats were chosen (n = 30).

Result

Our statistical evaluations have revealed a significantly higher VEGF-A and HIF-1α expression post-extraction of the rhBMP-2 and xenograft group compared to other group treatments. These findings are significant as they provide a deeper understanding of the mechanisms involved in bone regeneration post-extraction.

Conclusion

Our study suggests that injecting rhBMP-2 into the grafted material and socket extraction during GBR dramatically increases the expression of VEGF-A and HIF-1α. These findings have the potential to significantly impact oral surgery and regenerative dentistry, opening up new possibilities for enhancing bone regeneration techniques.

Systematic Review Regarding the Clinical Implications of Allograft and Alloplastic Bone Substituents Used for Periodontal Regenerative Therapy

Background/Objectives: Regenerative periodontal therapy is a treatment method that focuses on restoring the periodontium affected by chronic inflammatory disease or injury. It involves using different biomaterials and techniques to completely restore the periodontal structures. The main objective was to identify and critically evaluate relevant studies comparing the clinical efficacy of allograft and alloplastic materials in regenerative periodontal therapy. Methods: For evaluation, a systematic review based on PRISMA guidelines was conducted. Data were extracted using only specific types of study designs, which included randomized controlled trials, cohort studies, and case-control studies. Target patients with periodontal disease or periodontal lesions undergoing periodontal therapy using allograft or alloplastic materials were selected. Periodontal parameters such as clinical attachment level, probing pocket depth, radiographic bone fill, or patient-reported outcomes were analyzed. Results: The results showed that allograft and alloplastic materials offered reduced pocket depth, a gain in clinical attachment, and bone repairment. The variation observed indicated that allografts showed a slightly more significant clinical attachment gain and a superior bone fill than alloplastic ones, suggesting that allografts enhance osteogenesis and provide a greater capacity for repair in periodontal defects. Conclusions: The results of the present study suggest that allograft and alloplastic materials offered reduced pocket depth, a gain in clinical attachment, and bone repairment, with both methods having similar clinical efficacy.

Potential Role of BMP7 in Regenerative Dentistry

In recent years, the field of regenerative dentistry has garnered considerable attention for its focus on restoring and renewing damaged dental tissue. This narrative review explores the potential of bone morphogenetic protein 7 (BMP7) and its diverse applications in the regeneration of dental tissue. Recently, significant efforts have been made to understand BMP7's role in advancing regenerative dentistry. Amongst the various signalling molecules investigated for their regenerative capabilities, BMP7 emerges as a pivotal candidate, demonstrating the ability to stimulate the regeneration of dental pulp, periodontal, craniofacial, and alveolar bone tissues for dental implant placement. Whilst BMP7 exhibits significant promise as a therapeutic agent in regenerative dentistry, further research and clinical trials are necessary to fully unlock its potential and optimise its clinical effectiveness in addressing diverse dental and craniofacial conditions. This review highlights BMP7's substantial potential and emphasises the ongoing need for continued research to effectively harness its clinical utility in diverse dental and craniofacial contexts.

Mesenchymal Stem Cell-based Scaffolds in Regenerative Medicine of Dental Diseases

Biomedical engineering breakthroughs and increased patient expectations and requests for more comprehensive care are propelling the field of regenerative dentistry forward at a fast pace. Stem cells (SCs), bioactive compounds, and scaffolds are the mainstays of tissue engineering, the backbone of regenerative dentistry. Repairing damaged teeth and gums is a significant scientific problem at present. Novel therapeutic approaches for tooth and periodontal healing have been inspired by tissue engineering based on mesenchymal stem cells (MSCs). Furthermore, as a component of the MSC secretome, extracellular vesicles (EVs) have been shown to contribute to periodontal tissue repair and regeneration. The scaffold, made of an artificial extracellular matrix (ECM), acts as a supporting structure for new cell development and tissue formation. To effectively promote cell development, a scaffold must be non-toxic, biodegradable, biologically compatible, low in immunogenicity, and safe. Due to its promising biological characteristics for cell regeneration, dental tissue engineering has recently received much attention for its use of natural or synthetic polymer scaffolds with excellent mechanical properties, such as small pore size and a high surface-to-volume ratio, as a matrix. Moreover, as a bioactive material for carrying MSC-EVs, the combined application of scaffolds and MSC-EVs has a better regenerative effect on dental diseases. In this paper, we discuss how MSCs and MSC-derived EV treatment may be used to regenerate damaged teeth, and we highlight the role of various scaffolds in this process.

Effect of rh-BMP-2 in the Initiation of Neovascularization in Human Gingival Tissue: A Split-Mouth Clinical Study

The aim of this study is to evaluate the effect on the initiation of new blood vessel formation of rh-BMP-2 administration in the human gingival tissue during bone regeneration surgery.

MATERIAL AND METHODS

The randomized controlled clinical trial included twenty patients with bilateral partial edentulous of the mandibular premolar and molar region. Each patient received one implants on each side. Only one side received a 0.25 µg injection of rhBMP-2 into the gingival flap and grafted material during guided bone regeneration (GBR) for dental implantation. And the other side received GBR without injection. Three samples were collected from each patient as follows: one from the anterior area of the mandible (control group #1) collected at the time of all implant surgeries, and the two other samples during the placement of healing abutments at 4 months of follow-up, from treated side with rh-BMP-2 (test group) and untreated ones (control group #2). A total of 60 gingival samples were collected. Samples were stained with hematoxylin-eosin, and immunohistochemistry was performed with a vascular endothelial growth factor marker. The number of new vessels in each sample was counted.

RESULT

Statistical analyses showed a significantly higher number of new vessels in the gingival tissue of the test group.

CONCLUSIONS

Rh-BMP-2 injections into the gingival flap significantly improved new blood vessel formation.