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Ferraz MP. Bone Grafts in Dental Medicine: An Overview of Autografts, Allografts and Synthetic Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16114117. [PMID: 37297251 DOI: 10.3390/ma16114117] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
This review provides an overview of various materials used in dentistry and oral and maxillofacial surgeries to replace or repair bone defects. The choice of material depends on factors such as tissue viability, size, shape, and defect volume. While small bone defects can regenerate naturally, extensive defects or loss or pathological fractures require surgical intervention and the use of substitute bones. Autologous bone, taken from the patient's own body, is the gold standard for bone grafting but has drawbacks such as uncertain prognosis, surgery at the donor site, and limited availability. Other alternatives for medium and small-sized defects include allografts (from human donors), xenografts (from animals), and synthetic materials with osteoconductive properties. Allografts are carefully selected and processed human bone materials, while xenografts are derived from animals and possess similar chemical composition to human bone. Synthetic materials such as ceramics and bioactive glasses are used for small defects but may lack osteoinductivity and moldability. Calcium-phosphate-based ceramics, particularly hydroxyapatite, are extensively studied and commonly used due to their compositional similarity to natural bone. Additional components, such as growth factors, autogenous bone, and therapeutic elements, can be incorporated into synthetic or xenogeneic scaffolds to enhance their osteogenic properties. This review aims to provide a comprehensive analysis of grafting materials in dentistry, discussing their properties, advantages, and disadvantages. It also highlights the challenges of analyzing in vivo and clinical studies to select the most suitable option for specific situations.
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Affiliation(s)
- Maria Pia Ferraz
- Departamento de Engenharia Metalúrgica e de Materiais, Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4099-002 Porto, Portugal
- INEB-Instituto de Engenharia Biomédica, Universidade do Porto, 4099-002 Porto, Portugal
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Kamolratanakul P, Mattheos N, Yodsanga S, Jansisyanont P. The impact of deproteinized bovine bone particle size on histological and clinical bone healing outcomes in the augmented sinus: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:361-371. [PMID: 35320619 DOI: 10.1111/cid.13083] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The effect of different deproteinized bovine bone mineral (DBBM) particle sizes on bone healing in maxillary sinus floor augmentation remains unclear. This study compared the newly formed tissue and angiogenesis-related bone healing after sinus floor augmentation using large or small DBBM particles. MATERIALS AND METHODS Overall 32 patients were randomly divided into two groups using either large (1-2 mm) or small (0.25-1 mm) DBBM particles for sinus floor augmentation. After 6 months, the mineralized tissue volume was calculated using micro-computed tomography (micro-CT) analysis. The newly formed tissue composition was histomorphometrically analyzed. Angiogenesis was also examined by means of vascular endothelial growth factor (VEGF) expression. Implant failure and marginal bone loss were measured at a 1-year follow-up. Statistical analysis was performed using independent samples t-test. RESULTS Micro-CT analysis demonstrated that grafting with large particles resulted in higher bone volume (6.99 ± 2.72 mm3 , p = 0.002) and Bone Volume/Tissue Volume (0.25 ± 0.1, p = 0.03) compared with small particles (3.76 ± 1.83 mm3 and 0.14 ± 0.13, respectively). Small particles showed higher non-mineralized tissue volume (26.31 mm3 ) compared with large particle group (17.4 ± 5.34 mm3 ) with p = 0.001. The histological data revealed significantly higher area of newly formed bone (32.15% ± 14.04% for the large particle and 15.99% ± 14.12% for the small particle groups, p = 0.004). Likewise, non-mineralized tissue was significantly greater in the small particle group (66.48% ± 20.97%) compared with the large particle group (44.36%, p = 0.016). Moreover, use of large particles resulted in a significantly higher VEGF staining intensity score and VEFG positive cells. No implant failure was recorded in both groups, while no difference was found in terms of marginal bone loss at the 1-year follow-up. CONCLUSIONS Sinus floor augmentation using large DBBM particles resulted in more angiogenesis expression, higher bone volume, and new bone formation at 6 months after sinus augmentation. However, clinical outcomes with regards to implant placement were similar in both groups.
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Affiliation(s)
- Paksinee Kamolratanakul
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Somchai Yodsanga
- Faculty of Dentistry, The Center of Excellence on Biomaterial, Chulalongkorn University, Bangkok, Thailand
| | - Pornchai Jansisyanont
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Bangkok, Thailand
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Thompson FC, Matsumoto MA, Biguetti CC, Rennó ACM, de Andrade Holgado L, Santiago Junior JF, Munerato MS, Saraiva PP. Distinct healing pattern of maxillary sinus augmentation using the vitroceramic Biosilicate®: Study in rabbits. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 99:726-734. [PMID: 30889746 DOI: 10.1016/j.msec.2019.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 04/20/2018] [Accepted: 02/02/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To follow healing process of augmented maxillary sinus in rabbits analyzing the histological pattern of bone tissue formation, along with the osteogenic activity and vascularization using a bioactive vitroceramic in comparison to deproteinized bovine bone associated or not with autogenous bone graft. DESIGN Forty five male adult New Zealand rabbits, 5 months of age, mean weight of 4 Kg, underwent bilateral sinus augmentation surgeries to be divided in five groups: G - (Control) particulate autogenous bone graft (AG), BO - deproteinized bovine bone, BO+G - deproteinized bovine bone + AG, BSi -vitroceramic, and BSi + G - vitroceramic +AG. After 15, 45 and 90 days, all animals were euthanized for specimen's removal to be analyzed under light microscopy, histomorphometry, and immunohistochemistry for Runx2 and VEGF labeling. RESULTS G, BO and BO+G groups healed uneventfully, allowing the formation of mature remodeling bone at day 90, regarding the association of AG with the biomaterial. On the other hand, BSi and BSi + G groups showed an important cellular reaction and granulation/fibrous tissue formation from the first to the last period of observation. Runx-2 and VEGF immunolabeling were coherent with this result. However, histomorphometry did not reveal significant differences considering new bone formation. CONCLUSIONS Reconstructed maxillary sinuses using Biosilicate® permitted satisfactory new bone formation in comparison to the deproteinized bovine bone and AG. However, the presence of granulation/fibrous tissue and inflammatory cells associated to the degrading biomaterial indicate that further studies should be careful performed considering the immunological aspect of this new biomaterial.
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Affiliation(s)
- Francis Cazzeli Thompson
- Oral Biology Post-graduation Program, Sagrado Coração University - USC, Rua Irmã Arminda 10-50 - Bauru -, SP 17011-160, Brazil
| | - Mariza Akemi Matsumoto
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Rua José Bonifácio 1193, 16015-050 Araçatuba, SP, Brazil.
| | - Claudia Cristina Biguetti
- Faculty of Medicine of Jau - Universidade do Oeste Paulista - UNOESTE, Jaú - Brazil, R. Ângelo Martins, 498 - Jardim Estadio, Jaú - SP, 17203-480, Brazil
| | - Ana Claudia Muniz Rennó
- Department of Bioscience, Federal University of Sao Paulo, Campus Baixada Santista - UNIFESP, Avenida Ana Costa, 95, Santos, SP 11060-001, Brazil
| | - Leandro de Andrade Holgado
- Oral Biology Post-graduation Program, Sagrado Coração University - USC, Rua Irmã Arminda 10-50 - Bauru -, SP 17011-160, Brazil
| | - Joel Ferreira Santiago Junior
- Oral Biology Post-graduation Program, Sagrado Coração University - USC, Rua Irmã Arminda 10-50 - Bauru -, SP 17011-160, Brazil.
| | - Marcelo Salles Munerato
- Oral Biology Post-graduation Program, Sagrado Coração University - USC, Rua Irmã Arminda 10-50 - Bauru -, SP 17011-160, Brazil
| | - Patrícia Pinto Saraiva
- Faculty of Medicine of Jau - Universidade do Oeste Paulista - UNOESTE, Jaú - Brazil, R. Ângelo Martins, 498 - Jardim Estadio, Jaú - SP, 17203-480, Brazil
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Bonardi JP, Pereira RDS, Boos Lima FBDJ, Faverani LP, Griza GL, Okamoto R, Hochuli-Vieira E. Prospective and Randomized Evaluation of ChronOS and Bio-Oss in Human Maxillary Sinuses: Histomorphometric and Immunohistochemical Assignment for Runx 2, Vascular Endothelial Growth Factor, and Osteocalcin. J Oral Maxillofac Surg 2017; 76:325-335. [PMID: 29100829 DOI: 10.1016/j.joms.2017.09.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/15/2017] [Accepted: 09/25/2017] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of this study was to compare ChronOS (β-tricalcium phosphate), Bio-Oss, and their addition to an autogenous bone graft in a 1:1 ratio in human maxillary sinus bone augmentation. MATERIALS AND METHODS Thirty maxillary sinuses were divided in 5 groups: group 1 included 6 maxillary sinuses grafted with autogenous bone graft alone; group 2 included 6 maxillary sinuses grafted with ChronOS; group 3 included 6 maxillary sinuses grafted with ChronOS and autogenous bone graft in a 1:1 ratio; group 4 included 6 maxillary sinuses grafted with Bio-Oss; and group 5 included 6 maxillary sinuses grafted with Bio-Oss and autogenous bone graft in a 1:1 ratio. The number of samples for each group was determined by the statistical power test. RESULTS The median areas of new bone formation in groups 1, 2, 3, 4, and 5 were 121,917.0, 83,787.0, 99,295.0, 65,717.0, and 56,230.0 μm2, respectively. Statistically significant differences were found between groups 3 and 5, groups 1 and 4, and groups 1 and 5 (P < .05). The median areas of remaining biomaterial were 2,900.5, 5,291.0, 2,662.0, 56,258.5, and 64,753.5 μm2 in groups 1, 2, 3, 4 and 5, respectively. Statistically significant differences occurred between groups 1 and 5, groups 3 and 5, and groups 2 and 5 (P < .05). Areas of connective tissue were 67,829.0 ± 22,984.6 μm2 in group 1, 97,445.9 ± 18,983.3 μm2 in group 2, 88,256.0 ± 21,820.5 μm2 in group 3, 65,501.8 ± 6,297.6 in group 4, and 70,203.2 ± 13,421.3 μm2 in group 5. CONCLUSIONS ChronOS combined with autogenous bone graft presented a behavior similar to that of autogenous bone graft alone. However, the groups treated with Bio-Oss showed immuno-labeling results indicating maturation of grafted bone.
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Affiliation(s)
- João Paulo Bonardi
- PhD Student, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil
| | - Rodrigo Dos Santos Pereira
- Oral and Maxillofacial Surgeon, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil.
| | - Fernanda Brasil Daura Jorge Boos Lima
- Oral and Maxillofacial Surgeon, Universidade Federal de Minas Gerais, Department of Clinics, Pathology and Surgery, Pampulha, Belo Horizonte - MG, Brazil
| | - Leonardo Perez Faverani
- Oral and Maxillofacial Surgery Professor, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil
| | - Geraldo Luiz Griza
- Oral and Maxillofacial Surgeon, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil
| | - Roberta Okamoto
- Anatomy Professor, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil
| | - Eduardo Hochuli-Vieira
- Oral and Maxillofacial Surgery Professor, Surgery and Integrated Clinic Department, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo, SP, Brazil
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Yilmaz S, Ozden B, Bas B, Altun G, Altunkaynak BZ. Could Calcified Triglyceride Bone Cement Be an Alternative Graft Material in Maxillary Sinus Augmentation? J Craniofac Surg 2017; 28:97-103. [PMID: 27977491 DOI: 10.1097/scs.0000000000003236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The ideal graft material for maxillary sinus augmentation is still a matter of controversy and the search for a more appropriate bone substitute for use continues. The aim of this study was to evaluate bone formation as a sign of the regeneration following maxillary sinus augmentation in rabbits using 3 different biomaterials, one of which is a newly developed graft material; calcified triglyceride bone cement (CTBC).Twenty-one New Zealand rabbits were used and randomly divided into 3 groups. Bilateral maxillary sinus augmentation was carried out and autogenous bone (AB), bovine hydroxyapatite (BHA), and CTBC were administered. Maxillary sinuses were dissected after fourth and eighth weeks of the operation. The bone formation was evaluated by stereological and histopathological analysis and the data were analyzed statistically.When the volume of primary bone is compared, statistically significant differences were found among all groups at both of the fourth and eighth weeks. The highest value was obtained from AB applied group. In BHA and CTBC applied groups, active bone formation, osseointegration of graft materials were observed at both fourth and eighth weeks. In CTBC applied group, primary bone formation was only seen as linked to the continuation of parent sinus bony wall.The efficiency of primary bone formation of CTBC was found less than AB and BHA. Of the 3 graft materials tested, BHA is the strongest alternative to AB graft for maxillary sinus augmentation.
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Affiliation(s)
- Seda Yilmaz
- *Department of Oral and Maxillofacial Surgery, Private Dental Clinic, Istanbul †Department of Oral and Maxillofacial Surgery, Faculty of Dentistry ‡Department of Histology and Embryology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Pereira R, Gorla L, Boos F, Okamoto R, Garcia Júnior I, Hochuli-Vieira E. Use of autogenous bone and beta-tricalcium phosphate in maxillary sinus lifting: histomorphometric study and immunohistochemical assessment of RUNX2 and VEGF. Int J Oral Maxillofac Surg 2017; 46:503-510. [DOI: 10.1016/j.ijom.2017.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 10/14/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
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Kim SK, Cho TH, Han JJ, Kim IS, Park Y, Hwang SJ. Comparative study of BMP-2 alone and combined with VEGF carried by hydrogel for maxillary alveolar bone regeneration. Tissue Eng Regen Med 2016; 13:171-181. [PMID: 30603397 DOI: 10.1007/s13770-015-0046-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 07/16/2015] [Accepted: 07/22/2015] [Indexed: 10/22/2022] Open
Abstract
The effect of vascular endothelial growth factor (VEGF) combined with bone morphogenetic protein-2 (BMP-2) for bone regeneration is still controversial as to whether or not VEGF has a synergistic or additive effect. This study attempted to evaluate the synergistic effect of VEGF and BMP-2 compared to BMP-2 alone for maxillary alveolar bone regeneration using collagen sponge/hydrogel complex sheets in a canine model. After mixing BMP-2 and VEGF with a hyaluronic acid-based hydrogel (HAH), the collagen sponge/hydrogel complex was transplanted into maxillary alveolar bone defects (n=14) after the extraction of canine upper first molars on both sides. Bone regeneration was evaluated in three groups (control group without growth factors, experimental groups I and II with BMP-2 alone and BMP-2 and VEGF, respectively) using micro-computed tomography and histological staining. The total amount of new bone formations and bone mineral density were significantly higher in the group with BMP-2 only and the group with BMP-2 combined with VEGF than it in the control group. The area with positive staining of von Willebrand factor bone defect was significantly greater in the group with BMP-2 only and with dual growth factors than the control. BMP-2 released from the HAH promoted new bone formation. However, the combination of BMP-2 and VEGF did not show a synergistic or additive effect on bone regeneration at canine maxillary alveolar bone defects.
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Affiliation(s)
- Sook Kyoung Kim
- 1Department of Biomedical Engineering, College of Medicine, Korea University, Seoul, Korea
| | - Tae Hyung Cho
- 2Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jeong Joon Han
- 2Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
| | - In Sook Kim
- 3Dental Research Institute, BK 21 Plus, Seoul National University, Seoul, Korea
| | - Yongdoo Park
- 1Department of Biomedical Engineering, College of Medicine, Korea University, Seoul, Korea
| | - Soon Jung Hwang
- 2Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea.,3Dental Research Institute, BK 21 Plus, Seoul National University, Seoul, Korea
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Vivan RR, Mecca CE, Biguetti CC, Rennó ACM, Okamoto R, Cavenago BC, Duarte MH, Matsumoto MA. Experimental maxillary sinus augmentation using a highly bioactive glass ceramic. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2016; 27:41. [PMID: 26712707 DOI: 10.1007/s10856-015-5652-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/16/2015] [Indexed: 06/05/2023]
Abstract
Physicochemical characteristics of a biomaterial directly influence its biological behavior and fate. However, anatomical and physiological particularities of the recipient site also seem to contribute with this process. The present study aimed to evaluate bone healing of maxillary sinus augmentation using a novel bioactive glass ceramic in comparison with a bovine hydroxyapatite. Bilateral sinus augmentation was performed in adult male rabbits, divided into 4 groups according to the biomaterial used: BO-particulate bovine HA Bio-Oss(®) (BO), BO+G-particulate bovine HA + particulate autogenous bone graft (G), BS-particulate glass ceramic (180-212 μm) Biosilicate(®) (BS), and BS+G-particulate glass ceramic + G. After 45 and 90 days, animals were euthanized and the specimens prepared to be analyzed under light and polarized microscopy, immunohistochemistry, scanning electron microscopy (SEM), and micro-computed tomography (μCT). Results revealed different degradation pattern between both biomaterials, despite the association with bone graft. BS caused a more intense chronic inflammation with foreign body reaction, which led to a difficulty in bone formation. Besides this evidence, SEM and μCT confirmed direct contact between newly formed bone and biomaterial, along with osteopontin and osteocalcin immunolabeling. Bone matrix mineralization was late in BS group but became similar to BO at day 90. These results clearly indicate that further studies about Biosilicate(®) are necessary to identify the factors that resulted in an unfavorable healing response when used in maxillary sinus augmentation.
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Affiliation(s)
- Rodrigo Ricci Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo - FOB/USP, Al. Octávio Pinheiro Brisola, 9-75, Bauru, SP, 17012-901, Brazil
| | - Carlos Eduardo Mecca
- Oral Biology Master's Program, Sagrado Coração University - USC, Rua Irmã Arminda 10-50, Baur, SP, 17011-160, Brazil
| | - Claudia Cristina Biguetti
- Oral Biology Doctoral's Program, Bauru School of Dentistry, University of São Paulo - FOB/USP, Al. Octávio Pinheiro Brisola, 9-75, Bauru, SP, 17012-901, Brazil
| | - Ana Claudia Muniz Rennó
- Department of Bioscience, Federal University of Sao Paulo, Campus Baixada Santista - UNIFESP, Avenida Ana Costa, 95, Santos, SP, 11060-001, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, Araçatuba School of Dentistry, São Paulo State University, FOA/UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
- CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico), Brasília, Brazil
| | - Bruno Cavalini Cavenago
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo - FOB/USP, Al. Octávio Pinheiro Brisola, 9-75, Bauru, SP, 17012-901, Brazil
| | - Marco Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo - FOB/USP, Al. Octávio Pinheiro Brisola, 9-75, Bauru, SP, 17012-901, Brazil
| | - Mariza Akemi Matsumoto
- Department of Basic Sciences, Araçatuba School of Dentistry, São Paulo State University, FOA/UNESP, Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.
- Oral Biology Doctoral's Program, Sagrado Coração University, USC, Bauru, Brazil.
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Azenha MR, de Lacerda SA, Marão HF, Filho OP, Filho OM. Evaluation of Crystallized Biosilicate in the Reconstruction of Calvarial Defects. J Maxillofac Oral Surg 2015; 14:659-65. [PMID: 26225059 PMCID: PMC4511902 DOI: 10.1007/s12663-015-0755-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 02/03/2015] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The objective of this study was to assess the bone repair process of crystallized Biosilicate in surgically created defects on rats' calvaria. This biomaterial was recently developed for odontological use. MATERIALS AND METHODS We used fifteen rats (rattus norvegicus albinus, Wistar), and two 5 mm surgical defects were performed on each of them; the defects were made with trephine drill on the calvarium region prior to the biomaterial placement. Groups were divided as follows: Group 1-defect filled with clot; Group 2-defect filled with crystallized Biosilicate. After 7, 14 and 28 days the animals were killed, the parts were retrieved and slides were prepared for histological studies. RESULTS Bone formation was satisfactory in all groups, with direct contact between biomaterial surface and bone and absence of infection signs. The 28 days periods showed better results, and statistically significant difference between Clot Group (90.2 %) and Biosilicate (58 %; p = 0.002) was seen, regarding presence of bone tissue on the surgical defects. CONCLUSION Our study revealed that defects filled with clot present better results on bone formation compared to crystallized Biosilicate, which is considered a biocompatible material with favorable osteoconductive properties.
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Affiliation(s)
- Marcelo Rodrigues Azenha
- />Dentistry School of Ribeirão Preto, Stomatology Department, Universidade de São Paulo (USP), Avenida do café s/n, Bairro Monte Alegre, Ribeirão Preto, Brazil
- />Dentistry School of Araçatuba, Universidade Estadual Paulista (UNESP), São Paulo, Brazil
| | - Suzie Aparecida de Lacerda
- />Dentistry School of Ribeirão Preto, Stomatology Department, Universidade de São Paulo (USP), Avenida do café s/n, Bairro Monte Alegre, Ribeirão Preto, Brazil
| | - Heloísa Fonseca Marão
- />Dentistry School of Araçatuba, Universidade Estadual Paulista (UNESP), São Paulo, Brazil
| | | | - Osvaldo Magro Filho
- />Dentistry School of Araçatuba, Universidade Estadual Paulista (UNESP), São Paulo, Brazil
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Kusumoto Y, Tachikawa N, Munakata M, Miyahara T, Kasugai S. Lateral Bone Window Closing Technique with Poly-L-Lactic Acid (PLLA) Membrane in the Augmentation of the Maxillary Sinus without Grafting Material: Evaluation of Bone Healing in a Rabbit Model. Clin Implant Dent Relat Res 2015; 18:261-9. [PMID: 25873068 DOI: 10.1111/cid.12293] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND When augmenting the maxillary sinus without grafting material, the method used to cover the bony window is a subject of debate. PURPOSE The purpose of this study was to evaluate the poly-L-lactic acid (PLLA) membrane as closing material of the lateral window in a maxillary sinus augmentation without bone grafting. MATERIALS AND METHODS Augmentation of the maxillary sinus without grafting material and installation of titanium screws that fix the Schneiderian membrane were performed in 18 Japanese male white rabbits. The bony window was covered with a collagen membrane or PLLA membrane or no membrane. The animals were sacrificed at 4 or 8 weeks. New bone volume was calculated radiologically using microcomputed tomography (micro-CT). The samples were analyzed histologically after toluidine blue staining. RESULTS No significant differences were observed in the new bone volume, as measured by micro-CT. However, histomorphometric analysis demonstrated the superiority of the PLLA membrane in new bone formation compared with the collagen membrane. CONCLUSION The PLLA membrane is a suitable material to be applied for tissue regeneration in this animal model.
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Affiliation(s)
- Yuki Kusumoto
- Oral Implantology and Regenerative Dental Medicine, Department of Masticatory Function Rehabilitation, Graduate School of Medical Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Tachikawa
- Oral Implantology and Regenerative Dental Medicine, Department of Masticatory Function Rehabilitation, Graduate School of Medical Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohiro Munakata
- Department of Prosthodontic Dentistry for the Function of the TMJ and Occlusion, Kanagawa Dental University, Kanagawa, Japan
| | - Takayuki Miyahara
- Oral Implantology and Regenerative Dental Medicine, Department of Masticatory Function Rehabilitation, Graduate School of Medical Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Kasugai
- Oral Implantology and Regenerative Dental Medicine, Department of Masticatory Function Rehabilitation, Graduate School of Medical Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Valiense H, Barreto M, Resende RF, Alves AT, Rossi AM, Mavropoulos E, Granjeiro JM, Calasans-Maia MD. In vitro and in vivo evaluation of strontium-containing nanostructured carbonated hydroxyapatite/sodium alginate for sinus lift in rabbits. J Biomed Mater Res B Appl Biomater 2015; 104:274-82. [PMID: 25716009 DOI: 10.1002/jbm.b.33392] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 01/08/2015] [Accepted: 01/29/2015] [Indexed: 11/09/2022]
Abstract
Various synthetic bone substitutes have been developed to reconstruct bone defects. One of the most prevalent ceramics in bone treatment is hydroxyapatite (HA) that is a useful material as bone substitute, however, with a low rate of biodegradation. Its structure allows isomorphic cationic and anionic substitutions to be easily introduced, which can alter the crystallinity, morphology, biocompatibility, and osteoconductivity. The objective of this study was to investigate the in vitro and in vivo biological responses to strontium-containing nanostructured carbonated HA/sodium alginate (SrCHA) spheres (425<ϕ <600 μm) that were used for sinus lifts in rabbits using nanostructured carbonated HA/sodium alginate (CHA) as a reference. Cytocompatibility was determined using a multiparametric assay after exposing murine preosteoblasts to the extracts of these materials. Twelve male and female rabbits underwent bilateral sinus lift procedures and were divided into two groups (CHA or SrCHA) and in two experimental periods (4 and 12 weeks), for microscopic and histomorphometric analyses. The in vitro test revealed the overall viability of the cells exposed to the CHA and SrCHA extracts; thus, these extracts were considered cytocompatible, which was confirmed by three different parameters in the in vitro tests. The histological analysis showed chronic inflammation with a prevalence of macrophages around the CHA spheres after 4 weeks, and this inflammation decreased after 12 weeks. Bone formation was observed in both groups, and smaller quantities of SrCHA spheres were observed after 12 weeks, indicating greater bioresorption of SrCHA than CHA. SrCHA spheres are biocompatible and osteoconductive and undergo bioresorption earlier than CHA spheres.
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Affiliation(s)
- Helder Valiense
- Department of Implantology, Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Mauricio Barreto
- Department of Implantology, Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Rodrigo F Resende
- Department of Oral Surgery, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Adriana T Alves
- Department of Oral Pathology, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Alexandre M Rossi
- Graduate Programm in Dentistry, LABIOMAT, Brazilian Center for Physics Research, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elena Mavropoulos
- Graduate Programm in Dentistry, LABIOMAT, Brazilian Center for Physics Research, Rio de Janeiro, Rio de Janeiro, Brazil
| | - José M Granjeiro
- Department of Oral Surgery, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil.,Division of Bioengineering, Applied Physics Department, Brazilian Center for Physics Research, National Institute of Metrology, Quality and Technology, Duque de Caxias, Rio de Janeiro, Brazil
| | - Mônica D Calasans-Maia
- Department of Oral Surgery, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
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Rocha CA, Cestari TM, Vidotti HA, de Assis GF, Garlet GP, Taga R. Sintered anorganic bone graft increases autocrine expression of VEGF, MMP-2 and MMP-9 during repair of critical-size bone defects. J Mol Histol 2014; 45:447-61. [PMID: 24482159 DOI: 10.1007/s10735-014-9565-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 01/20/2014] [Indexed: 12/14/2022]
Abstract
This study aimed to evaluate morphometrically the bone formation and immunohistochemically the expression of vascular endothelial growth factor (VEGF) and metalloproteinase (MMP)-2 and -9 during the healing of critical-size defects treated with sintered anorganic bone (sAB). The 8-mm diameter full-thickness trephine defects created in the parietal bones of rats were filled with sAB (test group) or blood clot (CSD-control group). At 7, 14, 21, 30, 90 and 180 days postoperatively (n = 6/period) the volume of newly formed bone and total number of immunolabeled cells (Ntm) for each protein were determined. Bone formation was smaller and faster in the CSD-control group, stabilizing at 21 days (6.74 mm(3)). The peaks of VEGF, MMP-2 and MMP-9 occurred at 7 and 14 days in fibroblasts and osteoblasts, with mean reduction of 0.80 time at 21 days, keeping constant until 180 days. In the test group, sAB provided continuous bone formation between particles throughout all periods. The peak of MMP-2 was observed at 7-14 days in connective tissue cells and for VEGF and MMP-9 at 30 days in osteoblasts and osteocytes. Ntm for VEGF, MMP-2 and MMP-9 were in average, respectively, 3.70, 2.03 and 5.98 times higher than in the control group. At 180 days, newly formed bone (22.9 mm(3)) was 3.74 times greater in relation to control. The physical and chemical properties of sAB allow increased autocrine expression of VEGF, MMP-2 and MMP-9, favoring bone formation/remodeling with very good healing of cranial defects when compared to natural repair in the CSD-control.
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Affiliation(s)
- Caroline Andrade Rocha
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, SP, 17012-901, Brazil,
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13
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Stübinger S, Dard M. The rabbit as experimental model for research in implant dentistry and related tissue regeneration. J INVEST SURG 2013; 26:266-82. [PMID: 23617292 DOI: 10.3109/08941939.2013.778922] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The use of rabbits for experimental research has a long historical tradition. The aim of this review consists in outlining the use of the rabbit for research in implant dentistry and related tissue regeneration. Rabbits appear as a first-hand choice for fundamental implant design studies because of their size, easy handling, short life span, and economical aspects in purchasing and sustaining. In the following, the various anatomical sites in the rabbit will be summarized to provide an overview of current possibilities and limitations of this model for bone research in oral implantology.
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Affiliation(s)
- Stefan Stübinger
- Musculoskeletal Research Unit, University of Zurich , Zurich , Switzerland
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14
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Influence of BONITmatrix® and OSSA NOVA on the expression of bone specific genes. Ann Anat 2012; 194:524-8. [DOI: 10.1016/j.aanat.2012.02.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 02/08/2012] [Accepted: 02/20/2012] [Indexed: 11/17/2022]
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Choi H, Park NJ, Jamiyandorj O, Hong MH, Oh S, Park YB, Kim S. Improvement of osteogenic potential of biphasic calcium phosphate bone substitute coated with synthetic cell binding peptide sequences. J Periodontal Implant Sci 2012. [PMID: 23185697 PMCID: PMC3498301 DOI: 10.5051/jpis.2012.42.5.166] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose The aim of this study was to evaluate the improvement of osteogenic potential of biphasic calcium phosphate (BCP) bone substitute coated with synthetic cell-binding peptide sequences in a standardized rabbit sinus model. Methods Standardized 6-mm diameter defects were created bilaterally on the maxillary sinus of ten male New Zealand white rabbits, receiving BCP bone substitute coated with synthetic cell binding peptide sequences on one side (experimental group) and BCP bone substitute without coating (control group) on the other side. Histologic and histomorphometric analysis of bone formation was carried out after a healing period of 4 or 8 weeks. Results Histological analysis revealed signs of new bone formation in both experimental groups (4- and 8-week healing groups) with a statistically significant increase in bone formation in the 4-week healing group compared to the control group. However, no statistically significant difference in bone formation was found between the 8-week healing group and the control group. Conclusions This study found that BCP bone substitute coated with synthetic cell-binding peptide sequences enhanced osteoinductive potential in a standardized rabbit sinus model and its effectiveness was greater in the 4-week healing group than in the 8-week healing group.
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Affiliation(s)
- Hyunmin Choi
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea
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16
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Choi H, Park NJ, Jamiyandorj O, Choi KH, Hong MH, Oh S, Park YB, Kim S. Improvement of osteogenic potential of biphasic calcium phosphate bone substitute coated with two concentrations of expressed recombinant human bone morphogenetic protein 2. J Periodontal Implant Sci 2012; 42:119-26. [PMID: 22977741 PMCID: PMC3439523 DOI: 10.5051/jpis.2012.42.4.119] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 08/03/2012] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The aim of this study was to determine whether biphasic calcium phosphate (BCP) bone substitute with two different concentrations of Escherichia coli-expressed recombinant human bone morphogenetic protein 2 (ErhBMP-2) enhances new bone formation in a standardized rabbit sinus model and to evaluate the concentration-dependent effect of ErhBMP-2. METHODS Standardized, 6-mm diameter defects were made bilaterally on the maxillary sinus of 20 male New Zealand white rabbits. Following removal of the circular bony windows and reflection of the sinus membrane, BCP bone substitute without coating (control group) was applied into one defect and BCP bone substitute coated with ErhBMP-2 (experimental group) was applied into the other defect for each rabbit. The experimental group was divided into 2 subgroups according to the concentration of ErhBMP-2 (0.05 and 0.5 mg/mL). The animals were allowed to heal for either 4 or 8 weeks and sections of the augmented sinus and surrounding bone were analyzed by microcomputed tomography and histologically. RESULTS Histologic analysis revealed signs of new bone formation in both the control and experimental groups with a statistically significant increase in bone formation in experimental group 1 (0.05 mg/mL ErhBMP-2 coating) after a 4-week healing period. However, no statistically significant difference was found between experimental group 1 and experimental group 2 (0.5 mg/mL ErhBMP-2 coating) in osteoinductive potential (P<0.05). CONCLUSIONS ErhBMP-2 administered using a BCP matrix significantly enhanced osteoinductive potential in a standardized rabbit sinus model. A concentration-dependent response was not found in the present study.
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Affiliation(s)
- Hyunmin Choi
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea
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Matsumoto MA, Caviquioli G, Biguetti CC, Holgado LDA, Saraiva PP, Rennó ACM, Kawakami RY. A novel bioactive vitroceramic presents similar biological responses as autogenous bone grafts. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2012; 23:1447-1456. [PMID: 22426745 DOI: 10.1007/s10856-012-4612-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 03/06/2012] [Indexed: 05/31/2023]
Abstract
Bioactive glasses represent an interesting class of bone substitute's biomaterials. The present study investigated the repair of bone defects filled with a novel bioactive vitroceramic (Biosilicate(®)), alone or in association with particulate autogenous bone grafts in calvaria defects of rabbits. After 7, 14, and 30 days the specimens were retrieved for histological, histomorphometric and immunohistochemistry analysis. Satisfactory bone formation was observed in all groups, and direct bone-biomaterial surface was noted. Histomorphometric assessment did not show statistically significant differences in bone formation among the groups and periods, except for BG group at day 14. Immunoexpression of Runx-2 was similar among the groups containing the graft and the biomaterial, being more intense than in control group. Similar result was observed for VEGF expression, especially in the last experimental period. These results revealed that Biosilicate(®) presented a favorable behavior, comparable to autogenous bone graft.
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Affiliation(s)
- Mariza Akemi Matsumoto
- Department of Health Sciences, Universidade Sagrado Coração-USC, Chácara das Flores, Bauru, SP, Brazil.
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Miyamoto S, Shinmyouzu K, Miyamoto I, Takeshita K, Terada T, Takahashi T. Histomorphometric and immunohistochemical analysis of human maxillary sinus-floor augmentation using porous β-tricalcium phosphate for dental implant treatment. Clin Oral Implants Res 2012; 24 Suppl A100:134-8. [PMID: 22220565 DOI: 10.1111/j.1600-0501.2011.02396.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2011] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study utilized the constitution and expression of Runx2/Cbfa1 to conduct 6-month-post-operation histomorphometrical and histochemical analysis of osteocalcin in bone regeneration following sinus-floor augmentation procedures using β-tricalcium phosphate (β-TCP) and autogenous cortical bone. MATERIAL AND METHODS Thirteen sinuses of nine patients were treated with sinus-floor augmentation using 50% β-TCP and 50% autogenous cancellous bone harvested from the ramus of the mandible. Biopsies of augmented sinuses were taken at 6 months for histomorphometric and immunohistochemical measurements. RESULTS Runx2/Cbfa1- and osteocalcin-positive cells were found around TCP particles and on the bone surface. Approximately 60% of cells found around TCP particles stained positive for Runx2/Cbfa1. Fewer cells stained positive for osteocalcin. These positive cells decreased apically with increasing vertical distance from the maxillary bone surface. Histomorphometric analysis showed that the augmented site close to residual bone and periosteum contained approximately 42% bony tissue and 42% soft connective tissue, and the remaining 16% consisted of TCP particles. On the other hand, the augmented bone far from residual bone and periosteum contained 35% bony tissue and 50% soft connective tissue. CONCLUSIONS Our data suggest that TCP particles attract osteoprogenitor cells that migrate into the interconnecting micropores of the bone-substitute material by 6 months. The augmented site close to residual bone contained a higher proportion of bony tissue and a lower proportion of soft connective tissue than did the augmented site far from residual bone.
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Affiliation(s)
- Shinji Miyamoto
- Division of Oral and Maxillofacial Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, Science of Physical Functions, Kyushu Dental College, Kitakyusyu City, Japan
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Choi Y, Yun JH, Kim CS, Choi SH, Chai JK, Jung UW. Sinus augmentation using absorbable collagen sponge loaded with Escherichia coli-expressed recombinant human bone morphogenetic protein 2 in a standardized rabbit sinus model: a radiographic and histologic analysis. Clin Oral Implants Res 2011; 23:682-689. [PMID: 21631596 DOI: 10.1111/j.1600-0501.2011.02222.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of this pilot study was to determine the osteoinductive effect of absorbable collagen sponge (ACS) loaded with Escherichia coli-expressed recombinant human bone morphogenetic protein 2 (ErhBMP-2) and evaluate structural stability of ACS in a standardized rabbit sinus model. MATERIAL AND METHODS The maxillary sinuses were prepared bilaterally in six male white rabbits. The windows were prepared using a 6 mm trephine bur, and circular bony windows were carefully removed. Following reflection of the sinus membrane, a saline-soaked ACS alone and an ErhBMP-2-loaded ACS were inserted into the left and right maxillary sinuses, respectively. After a healing period of 8 weeks, sections of the augmented sinus and surrounding bone were made and analyzed by microcomputed tomography and histologically for signs of window closure and bone augmentation. RESULTS Radiographic analysis revealed new bone formation in both groups of augmented sinus (i.e., with and without ErhBMP-2). The maximum augmented height did not differ significantly between the groups; however, window closure was significantly more advanced in the ErhBMP-2 group than in the control group (P=0.02). The defect was significantly deeper in the control group than in the ErhBMP-2-treated group (P=0.02). CONCLUSIONS In conclusion, ErhBMP-2-loaded ACS showed enhanced osteoinductive potential, particularly with regard to bone closure of a sinus window and facilitated maturation of the newly formed bone within the rabbit sinus cavity. However, the structural durability of ACS was not sufficient to maintain the augmented volume in the sinus.
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Affiliation(s)
- Youna Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, KoreaDepartment of Dentistry, Division of Periodontology, School of Medicine, Inha University, Incheon, Korea
| | - Jeong-Ho Yun
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, KoreaDepartment of Dentistry, Division of Periodontology, School of Medicine, Inha University, Incheon, Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, KoreaDepartment of Dentistry, Division of Periodontology, School of Medicine, Inha University, Incheon, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, KoreaDepartment of Dentistry, Division of Periodontology, School of Medicine, Inha University, Incheon, Korea
| | - Jung-Kiu Chai
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, KoreaDepartment of Dentistry, Division of Periodontology, School of Medicine, Inha University, Incheon, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, KoreaDepartment of Dentistry, Division of Periodontology, School of Medicine, Inha University, Incheon, Korea
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