1
|
Castilla A, Filliquist B, Spriet M, Garcia TC, Arzi B, Chou PY, Kapatkin AS. Long-Term Assessment of Bone Regeneration in Nonunion Fractures Treated with Compression-Resistant Matrix and Recombinant Human Bone Morphogenetic Protein-2 in Dogs. Vet Comp Orthop Traumatol 2023; 36:29-38. [PMID: 35760364 DOI: 10.1055/s-0042-1749451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The aim of this study was to assess bone density, bone architecture and clinical function of canine nonunion distal appendicular long bone fractures with a defect treated with fixation, compression-resistant matrix and recombinant human bone morphogenetic protein-2 (rhBMP-2). STUDY DESIGN Prospective cohort study with dogs at least 1-year post treatment. Computed tomography was performed and quantitative measurements from previous fracture sites were compared with measurements from contralateral limbs. Subjective evaluation included gait assessment and palpation. RESULTS Six patients met the inclusion criteria. The rhBMP-2 treated bone exhibited higher density at the periphery and lower density in the centre, similar to the contralateral limb. All patients were weight bearing on the treated limb and all fractures were healed. CONCLUSION The rhBMP-2-treated bone underwent restoration of normal architecture and density. Acceptable limb function was present in all patients. The results of this study can serve as a basis for long-term response in treating nonunion fractures in veterinary patients.
Collapse
Affiliation(s)
- Andrea Castilla
- Veterinary Medical Teaching Hospital, Davis, University of California, California, United States
| | - Barbro Filliquist
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States
| | - Mathieu Spriet
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States
| | - Tanya C Garcia
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States.,Veterinary Institute for Regenerative Cures, School of Veterinary Medicine, University of California, Davis, California, United States
| | - Po-Yen Chou
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States
| | - Amy S Kapatkin
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States
| |
Collapse
|
2
|
Susin C, Lee J, Fiorini T, Koo KT, Schüpbach P, Finger Stadler A, Wikesjö UME. Screening of Hydroxyapatite Biomaterials for Alveolar Augmentation Using a Rat Calvaria Critical-Size Defect Model: Bone Formation/Maturation and Biomaterials Resolution. Biomolecules 2022; 12:1677. [PMID: 36421691 PMCID: PMC9687935 DOI: 10.3390/biom12111677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Natural (bovine-/equine-/porcine-derived) or synthetic hydroxyapatite (HA) biomaterials appear to be the preferred technologies among clinicians for bone augmentation procedures in preparation for implant dentistry. The aim of this study was to screen candidate HA biomaterials intended for alveolar ridge augmentation relative to their potential to support local bone formation/maturation and to assess biomaterial resorption using a routine critical-size rat calvaria defect model. METHODS Eighty adult male Sprague Dawley outbred rats obtained from a approved-breeder, randomized into groups of ten, were used. The calvaria defects (ø8 mm) either received sham surgery (empty control), Bio-Oss (bovine HA/reference control), or candidate biomaterials including bovine HA (Cerabone, DirectOss, 403Z013), and bovine (403Z014) or synthetic HA/ß-TCP (Reprobone, Ceraball) constructs. An 8 wk healing interval was used to capture the biomaterials' resolution. RESULTS All biomaterials displayed biocompatibility. Strict HA biomaterials showed limited, if any, signs of biodegradation/resorption, with the biomaterial area fraction ranging from 22% to 42%. Synthetic HA/ß-TCP constructs showed limited evidence of biodegradation/erosion (biomaterial area fraction ≈30%). Mean linear defect closure in the sham-surgery control approximated 40%. Mean linear defect closure for the Bio-Oss reference control approximated 18% compared with 15-35% for the candidate biomaterials without significant differences between the controls and candidate biomaterials. CONCLUSIONS None of the candidate HA biomaterials supported local bone formation/maturation beyond the native regenerative potential of this rodent model, pointing to their limitations for regenerative procedures. Biocompatibility and biomaterial dimensional stability could suggest their potential utility as long-term defect fillers.
Collapse
Affiliation(s)
- Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR), Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR), Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Tiago Fiorini
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR), Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre 90000-000, Brazil
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 110-460, Korea
| | | | - Amanda Finger Stadler
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR), Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Ulf ME Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR), Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| |
Collapse
|
3
|
Cha JK, Song YW, Kim S, Thoma DS, Jung UW, Jung RE. Core Ossification of Bone Morphogenetic Protein-2-Loaded Collagenated Bone Mineral in the Sinus. Tissue Eng Part A 2020; 27:905-913. [PMID: 32940142 DOI: 10.1089/ten.tea.2020.0151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The objective of this study was to investigate in vitro release kinetics and ossification patterns of bone morphogenetic protein-2-soaked collagenated porcine bone mineral (BMP-2/CPBM) in rabbit sinuses. Release kinetics of BMP-2/CPBM was determined in vitro up to 56 days. In 16 rabbits, BMP-2/CPBM (BMP group) and CPBM alone (control group) were bilaterally grafted in both sinuses. After 4 (N = 8) and 12 (N = 8) weeks, radiographic and histologic analyses were performed. Approximately 40% of BMP-2 was released from CPBM during 3 days in vitro; release maintained at a reduced level until day 56. In vivo, new bone formation in BMP group was dominant at the center and decreased toward the borders of the sinus, while it mainly possessed close to the sinus membrane and basal bone in control group. At the center, significantly more new bone was found in BMP group compared to control group at 4 weeks (29.14% vs. 16.50%; p < 0.05). The total augmented volume of BMP group was significantly greater than control group at 4 (370.13 mm3 vs. 299.32 mm3) and 12 (400.40 mm3 vs. 290.10 mm3) weeks (p < 0.05). In conclusion, BMP-2/CPBM demonstrated a core ossification with a greater augmented volume and new bone formation in the center of the sinus compared to CPBM alone. Impact statement The center of the augmented maxillary sinus tends to show a slower and inferior new bone formation compared to the sites near the sinus membrane and basal bone. In this study, bone morphogenetic protein-2 (BMP-2) loaded onto collagenated porcine bone mineral (CPBM) resulted in a greater augmented volume and new bone formation at the center of the grafted sinus compared to CPBM alone. Therefore, BMP-2-added CPBM in maxillary sinus augmentation may potentially be beneficial to the clinicians, in terms of accelerating the new bone formation at the center area where the apical half of the implant fixture usually places.
Collapse
Affiliation(s)
- Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Daniel S Thoma
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
4
|
Polo CI, Sendyk WR, Correa L, Sendyk D, Deboni MCZ, Naclério-Homem MDG. Synergism between recombinant human bone morphogenetic protein 2/absorbable collagen sponge and bone substitutes favors vertical bone augmentation and the resorption rate of the biomaterials: Histomorphometric and 3D microcomputed tomography analysis. J Periodontol 2020; 91:1295-1306. [PMID: 32052436 DOI: 10.1002/jper.19-0571] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/25/2020] [Accepted: 01/28/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Recombinant human bone morphogenetic protein 2 (rhBMP-2) is an osteoinductor frequently used for bone regeneration in oral and maxillofacial surgery. There is no consensus about the ideal carrier for this growth factor. The aim of this study was to compare the bone augmentation, bone microarchitecture, and biodegradation rate of additional carriers to rhBMP-2/absorbable collagen sponge (ACS) in a vertical guided bone regeneration model. METHODS Four titanium cylinders were fixed onto the calvaria of rabbits (n = 20) that received (n = 10) or not (n = 10) rhBMP-2/ACS in conjunction with one of the carriers: beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), bovine bone mineral (BBM) or blood clot. The samples were analyzed by means of microcomputed tomography and histomorphology after 14 weeks. RESULTS All the materials with rhBMP-2/ACS exhibited improvement on bone augmentation, mainly BCP (P = 0.033) and β-TCP (P = 0.038), in the upper portion of the cylinder. Although trabecular anisotropy was improved in all the materials groups, trabecular connectivity was diminished when the biomaterials received rhBMP-2/ACS. Resorption rate of the remaining biomaterial was improved by rhBMP-2/ACS, mainly in BBM (P <0.01) and β-TCP (P <0.01). BBM exhibited the highest osteoclast density compared with the other materials groups. CONCLUSIONS BCP and β-TCP biomaterials exhibited a synergic effect with rhBMP-2/ACS, acting as suitable and viable carriers for vertical bone augmentation. The addition of rhBMP-2 significantly affected the biodegradation of β-TCP and BBM, accelerating the resorption of these materials.
Collapse
Affiliation(s)
- Cristiane Ibanhes Polo
- Department of Oral and Maxillofacial Surgery and Traumatology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - Wilson Roberto Sendyk
- Department of Implantology, School of Dentistry, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Luciana Correa
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - Daniel Sendyk
- Department of Oral and Maxillofacial Surgery and Traumatology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - Maria Cristina Zindel Deboni
- Department of Oral and Maxillofacial Surgery and Traumatology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - Maria da Graça Naclério-Homem
- Department of Oral and Maxillofacial Surgery and Traumatology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| |
Collapse
|
5
|
Susin C, Lee J, Fiorini T, Freitas RM, Chiu H, Prasad HS, Buxton AN, Wikesjö UME. Sinus augmentation using rh
BMP
‐2/
ACS
in a mini‐pig model: Influence of an adjunctive ceramic bone biomaterial. J Clin Periodontol 2018; 45:1005-1013. [DOI: 10.1111/jcpe.12921] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 02/23/2018] [Accepted: 05/08/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Tiago Fiorini
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Rubens Moreno Freitas
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Hsien‐Chung Chiu
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Hari S. Prasad
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Amanda N. Buxton
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| | - Ulf ME Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Research (LAPCR)Dental College of GeorgiaAugusta University Augusta Georgia
| |
Collapse
|
6
|
Sohn B, Hwang M, Kim S, Kim HI, Ku Y. Ridge preservation using basic fibroblast growth factor-2 and collagenated biphasic calcium phosphate in beagle dogs. J Periodontal Implant Sci 2017; 47:381-387. [PMID: 29333324 PMCID: PMC5764764 DOI: 10.5051/jpis.2017.47.6.381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 12/20/2017] [Indexed: 11/08/2022] Open
Abstract
Purpose The aim of this study was to evaluate volumetric and histologic changes in edentulous alveolar ridge areas after ridge preservation using basic fibroblast growth factor-2 (bFGF-2) in combination with collagenated biphasic calcium phosphate (BCP). Methods The experiments were performed in 6 adult male beagle dogs. The following 3 groups were created: 1) ridge preservation with bFGF-2 and collagenated BCP (experimental group), 2) ridge preservation with collagenated BCP (positive control group), and 3) a negative control group in which no ridge preservation procedure was performed. Volumetric change analysis was performed using an optical scanner and casts. Histological observations were made using light microscopy. Results After the initial swelling subsided, the magnitude of the volumetric change in the experimental group and positive control group was smaller than in the negative control group. In the experimental group, a distinct trend was observed for the resorption of residual bone and collagen fibers at 4 weeks and for more mature bone and faster healing at 12 weeks. Conclusions Based on the findings of the present study, bFGF-2 may be considered for use as a therapeutic molecule in ridge preservation procedures.
Collapse
Affiliation(s)
- Byungjin Sohn
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Minkyoon Hwang
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Hyeong-Il Kim
- Department of Restorative Dentistry, University at Buffalo School of Dental Medicine, Buffalo, NY, USA
| | - Young Ku
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| |
Collapse
|
7
|
Outcome of nonunion fractures in dogs treated with fixation, compression resistant matrix, and recombinant human bone morphogenetic protein-2. Vet Comp Orthop Traumatol 2017; 30:153-159. [DOI: 10.3415/vcot-16-05-0082] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 11/09/2016] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To report the use of compression resistant matrix (CRM) infused with recombinant human bone morphogenetic protein (rhBMP-2) prospectively in the healing of non union long-bone fractures in dogs.Methods: A longitudinal cohort of dogs that were presented with nonunion fractures were classified and treated with CRM soaked with rhBMP-2 and fracture fixation. They were followed with serial radiographs and evaluated for healing times and complications according to the time frame and definitions previously established for orthopaedic clinical cases.Results: Eleven nonunion fractures in nine dogs were included. Median healing time was 10 weeks (range: 7–20 weeks). Major perioperative complications due to bandage morbidity were encountered in two of 11 limbs and resolved. All other complications were minor. They occurred perioperatively in eight of 11 limbs. Minor follow-up complications included short-term in one of two limbs, mid-term in one of three, and long-term in four of five limbs. Nine limbs returned to full function and two limbs returned to acceptable function at the last follow-up.Clinical significance: Nonunion fractures given a poor prognosis via standard-of-care treatment were successfully repaired using CRM with rhBMP-2 accompanying fixation. These dogs, previously at high risk of failure, returned to full or acceptable function.
Collapse
|
8
|
Cho TH, Kim IS, Lee B, Park SN, Ko JH, Hwang SJ. Early and Marked Enhancement of New Bone Quality by Alendronate-Loaded Collagen Sponge Combined with Bone Morphogenetic Protein-2 at High Dose: A Long-Term Study in Calvarial Defects in a Rat Model. Tissue Eng Part A 2017; 23:1343-1360. [DOI: 10.1089/ten.tea.2016.0557] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tae Hyung Cho
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Clinical Dental Research Institute, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - In Sook Kim
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Beomseok Lee
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Si-Nae Park
- Regenerative Medicine Research Center, Dalim Tissen Co., Ltd., Seoul, Republic of Korea
| | - Jae-Hyung Ko
- Regenerative Medicine Research Center, Dalim Tissen Co., Ltd., Seoul, Republic of Korea
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Clinical Dental Research Institute, Seoul National University Dental Hospital, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, School of Dentistry, BK21 Plus Program, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
9
|
Susin C, Fiorini T, Lee J, de Freitas RM, Chiu HC, Prasad HS, Buxton AN, Wikesjö UME. Sinus augmentation using a mini-pig model: Effect of ceramic and allogeneic bone biomaterials. J Clin Periodontol 2017. [PMID: 28644556 DOI: 10.1111/jcpe.12766] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Present clinical practice broadly relies on off-the-shelf allogeneic, xenogeneic or synthetic bone biomaterials in support of sinus augmentation. Also, recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier (rhBMP-2/ACS) has been shown to support clinically relevant bone formation when used to augment the maxillary sinus. OBJECTIVES To evaluate local bone formation/dental implant osseointegration following implantation of two particulate bone biomaterials using the mini-pig sinus augmentation model. METHODS Nine adult Göttingen mini-pigs were used for evaluation of a biphasic ceramic (15%/85% HA/ß-TCP) and an allogeneic mineralized bone biomaterial. Treatments randomized to contralateral sinus sites included sham-surgery (control) and biomaterials. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each sinus site. The animals were euthanized at 8 weeks for histologic analysis. RESULTS Execution of the surgical protocol and healing was unremarkable. Limited infraorbital swelling was observed until suture removal. The biphasic ceramic and allogeneic bone biomaterials produced significantly increased bone formation (5.2 ± 1.9 mm and 4.9 ± 1.6 mm vs. 2.6 ± 0.5 mm, p < 0.05) and osseointegration (18.0 ± 6.0% and 25.1 ± 18.2% vs. 10.1 ± 8.0%, p < 0.05) over the sham-surgery control. No significant differences were observed between biomaterials. CONCLUSIONS Implantation of biphasic ceramic or allogeneic bone biomaterials enhances bone formation in the mini-pig maxillary sinus, however, dental implant bone support is incomplete resulting in overall limited osseointegration.
Collapse
Affiliation(s)
- Cristiano Susin
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Tiago Fiorini
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Jaebum Lee
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Rubens Moreno de Freitas
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Hsien-Chung Chiu
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Hari S Prasad
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Amanda N Buxton
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| | - Ulf M E Wikesjö
- Laboratory for Applied Periodontal and Craniofacial Regeneration (LAPCR), Augusta University
- Dental College of Georgia, Augusta, GA, USA
| |
Collapse
|
10
|
Lee JS, Jung GU, Pang EK. Effects of block bone substitutes loaded with Escherichia Coli-produced recombinant human bone morphogenetic protein-2 on space maintenance and bone formation in rat calvarial onlay model. Tissue Eng Regen Med 2016; 13:311-321. [PMID: 30603413 PMCID: PMC6170820 DOI: 10.1007/s13770-016-0011-4] [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] [Received: 01/20/2016] [Revised: 04/05/2016] [Accepted: 04/08/2016] [Indexed: 12/01/2022] Open
Abstract
We aimed to evaluate the effects of onlay-type grafted human freeze-dried corticocancellous bone block (FDBB) and deproteinized bovine bone with collagen (DBBC) loaded with Escherichia coli-produced recombinant human bone morphogenetic protein-2 (ErhBMP-2) on space maintenance and new bone formation in rat calvaria. Collagen sponge (CS), FDBB, or DBBC disks (8×4 mm) with ErhBMP-2 (2.5 μg) were implanted onto the calvaria of male Sprague-Dawley rats, whereas CS with buffer was implanted onto the calvaria as controls (n=20/carrier). Rats were killed at 2 or 8 weeks post-surgery for histologic and histomorphometric analyses; total augmented area, new bone area, and bone density were evaluated. At both time-points, all ErhBMP-2 groups showed significantly higher new bone area and bone density than the control group (p<0.05). ErhBMP-2/FDBB and ErhBMP-2/DBBC groups showed significantly higher total augmented area than ErhBMP-2/CS group (8 weeks), and ErhBMP-2/FDBB group showed significantly higher new bone area and bone density than ErhBMP-2/DBBC group (p<0.05). ErhBMP-2/CS group showed the highest bone density (p<0.05). Combining ErhBMP-2 with FDBB or DBBC could significantly improve onlay graft outcomes, by new bone formation and bone density increase. Moreover, onlay-grafted FDBB and DBBC with ErhBMP-2 could be an alternative to autogenous block onlay bone graft.
Collapse
Affiliation(s)
- Jae-Sook Lee
- Department of Periodontology, School of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 09785 Korea
| | - Gyu-Un Jung
- Department of Periodontology, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| | - Eun-Kyoung Pang
- Department of Periodontology, School of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 09785 Korea
- Department of Periodontology, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| |
Collapse
|
11
|
Curry AS, Pensa NW, Barlow AM, Bellis SL. Taking cues from the extracellular matrix to design bone-mimetic regenerative scaffolds. Matrix Biol 2016; 52-54:397-412. [PMID: 26940231 DOI: 10.1016/j.matbio.2016.02.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 02/25/2016] [Accepted: 02/25/2016] [Indexed: 12/30/2022]
Abstract
There is an ongoing need for effective materials that can replace autologous bone grafts in the clinical treatment of bone injuries and deficiencies. In recent years, research efforts have shifted away from a focus on inert biomaterials to favor scaffolds that mimic the biochemistry and structure of the native bone extracellular matrix (ECM). The expectation is that such scaffolds will integrate with host tissue and actively promote osseous healing. To further enhance the osteoinductivity of bone graft substitutes, ECM-mimetic scaffolds are being engineered with a range of growth factors (GFs). The technologies used to generate GF-modified scaffolds are often inspired by natural processes that regulate the association between endogenous ECMs and GFs. The purpose of this review is to summarize research centered on the development of regenerative scaffolds that replicate the fundamental collagen-hydroxyapatite structure of native bone ECM, and the functionalization of these scaffolds with GFs that stimulate critical events in osteogenesis.
Collapse
Affiliation(s)
- Andrew S Curry
- Department of Biomedical Engineering, University of Alabama at Birmingham, 1918 University Boulevard, Birmingham, AL 35294, United States
| | - Nicholas W Pensa
- Department of Biomedical Engineering, University of Alabama at Birmingham, 1918 University Boulevard, Birmingham, AL 35294, United States
| | - Abby M Barlow
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, 1918 University Boulevard, Birmingham, AL 35294, United States
| | - Susan L Bellis
- Department of Biomedical Engineering, University of Alabama at Birmingham, 1918 University Boulevard, Birmingham, AL 35294, United States; Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, 1918 University Boulevard, Birmingham, AL 35294, United States.
| |
Collapse
|
12
|
Jung IH, Lim HC, Lee EU, Lee JS, Jung UW, Choi SH. Comparative analysis of carrier systems for delivering bone morphogenetic proteins. J Periodontal Implant Sci 2015; 45:136-44. [PMID: 26339523 PMCID: PMC4556799 DOI: 10.5051/jpis.2015.45.4.136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 08/15/2015] [Indexed: 01/13/2023] Open
Affiliation(s)
- Im-Hee Jung
- Department of Dental Hygiene, Eulji University College of Health Science, Seongnam, Korea. ; Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Eun-Ung Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| |
Collapse
|
13
|
Kim H, Chung J, Shin S, Shin S, Kye S, Kim N, Kwon T, Paeng J, Kim J, Oh O, Kook M, Yang H, Hwang S. Efficacy of rhBMP-2/Hydroxyapatite on Sinus Floor Augmentation. J Dent Res 2015; 94:158S-65S. [DOI: 10.1177/0022034515594573] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this randomized single-blinded active-controlled clinical study was to evaluate the early efficacy of low-dose Escherichia coli–derived recombinant human bone morphogenetic protein 2 (rhBMP-2) soaked with hydroxyapatite granules (BMP-2/H) as compared with an inorganic bovine bone xenograft (ABX) in maxillary sinus floor augmentation. In a total of 127 subjects who were enrolled at 6 centers, maxillary sinus floors were augmented with 1 mg/mL of rhBMP-2 (0.5 to 2.0 mg per sinus) and BMP-2/H (0.5 to 2.0 g; n = 65) or with ABX alone (0.5 to 2.0 g; n = 62). Core biopsies were obtained 3 mo after the augmentation surgery and were analyzed histomorphometrically. The mean new bone formation with BMP-2/H and ABX augmentation was 16.10% ± 10.52% and 8.25% ± 9.47%, respectively. The BMP-2/H group was noninferior to the ABX group; the lower limit of the 1-sided 97.5% confidence interval for the difference between the 2 groups was calculated as 4.33%, which was greater than the prespecified noninferiority margin of −3.75%. An additional test with the Wilcoxon rank-sum test with a 2-sided 5% significance level showed that bone formation between the 2 groups was significantly different ( P < 0.0001). The soft tissue and residual graft areas showed no significant differences between the groups. With regard to safety, no significant difference between the 2 groups was observed; there was no significant increase in the amount of rhBMP-2 antibody in the serum after BMP-2/H grafting. Our study suggested that low-dose Escherichia coli–derived rhBMP-2 with hydroxyapatite was effective in early stages for enhanced bone formation after maxillary sinus floor augmentation without harmful adverse events ( Clinicaltrials.gov NCT01634308).
Collapse
Affiliation(s)
- H.J. Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - J.H. Chung
- Department of Periodontology, Institute of Oral Biology, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - S.Y. Shin
- Department of Periodontology, Institute of Oral Biology, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - S.I. Shin
- Department of Periodontology, Institute of Oral Biology, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - S.B. Kye
- Department of Periodontology, Samsung Seoul Hospital, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - N.K. Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - T.G. Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - J.Y. Paeng
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - J.W. Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - O.H. Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - M.S. Kook
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - H.J. Yang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, BK 21 2nd Program, Seoul National University, Seoul, Korea
| | - S.J. Hwang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, BK 21 2nd Program, Seoul National University, Seoul, Korea
| |
Collapse
|
14
|
Lee JH, Baek HR, Lee KM, Zheng GB, Shin SJ, Shim HJ. Effects of Ovariectomy and Corticosteroid-Induced Osteoporosis on the Osteoinductivity of rhBMP-2 in a Segmental Long-Bone Defect Model. Tissue Eng Part A 2015; 21:2262-71. [PMID: 25996180 DOI: 10.1089/ten.tea.2014.0659] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study used the segmental long-bone defect model to assess the effects of osteoporosis on the formation of new bones and the osteoinductivity of recombinant human bone morphogenetic protein-2 (rhBMP-2). Seventy-two female Sprague-Dawley rats were divided into two groups: an osteoporosis group with ovariectomies and dexamathasone intramuscular injections and a sham group. When they reached 22 weeks in age, each group was further divided into two groups and a 5-mm defect was made in both fibular mid-shafts of each rat. One fibula in each rat was picked randomly and was injected with 0.05 mL of hydrogel carrier; the opposite fibula was injected with the same carrier mixed with rhBMP-2 (10 μg). After rearing for a further 5 and 9 weeks, the ratios of the lengths of the newly formed bones in the fibular defects were determined using micro-CT and undecalcified histology. The sham rhBMP-2-injected group-in all of the 5- and 9-week-kept groups-showed a significantly higher bridging bone formation ratio than the other three groups. The osteoporosis rhBMP-2-injected group showed a significantly higher ratio than both the non-rhBMP-2-injected sham hydrogel and the osteoporosis hydrogel groups. The comparison of the micro-CT parameters of the newly formed bones showed that the sham rhBMP-2 group at both 5 and 9 weeks compared with the osteoporosis rhBMP-2 group had significantly higher percentage bone volumes, trabecular thicknesses, and trabecular numbers, in addition to significantly lower specific surfaces, trabecular pattern factors, and structural model indices. The histology results showed that the sham-rhBMP-2 group began forming bridging bones in the defect areas at 5 weeks, and at 9 weeks, trabeculae and marrow spaces were observed. However, the osteoporosis rhBMP-2 group exhibited a relatively minor level of new bone and trabecula formation. Consequently, the rhBMP-2 group showed significantly increased bone formation in the osteoporosis rat fibular defect model compared with the hydrogel group, whereas the new bone quantities, qualities, and remodeling in the osteoporosis rhBMP-2 group were less effective than those in the sham-rhBMP-2 group, signaling that ovariectomy and corticosteroid-induced osteoporosis significantly undermines rhBMP-2 osteoinductivity.
Collapse
Affiliation(s)
- Jae Hyup Lee
- 1 Department of Orthopedic Surgery, Seoul National University , College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea.,2 Institute of Medical and Biological Engineering, Seoul National University Medical Research Center , Seoul, Korea
| | - Hae-Ri Baek
- 1 Department of Orthopedic Surgery, Seoul National University , College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea.,2 Institute of Medical and Biological Engineering, Seoul National University Medical Research Center , Seoul, Korea
| | - Kyung-Mee Lee
- 1 Department of Orthopedic Surgery, Seoul National University , College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Guang Bin Zheng
- 1 Department of Orthopedic Surgery, Seoul National University , College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sung Joon Shin
- 1 Department of Orthopedic Surgery, Seoul National University , College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hee-Jong Shim
- 1 Department of Orthopedic Surgery, Seoul National University , College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| |
Collapse
|
15
|
Chen L, Liu HL, Gu Y, Feng Y, Yang HL. Lumbar interbody fusion with porous biphasic calcium phosphate enhanced by recombinant bone morphogenetic protein-2/silk fibroin sustained-released microsphere: an experimental study on sheep model. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:126. [PMID: 25690620 DOI: 10.1007/s10856-015-5463-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/09/2015] [Indexed: 06/04/2023]
Abstract
Biphasic calcium phosphate (BCP) has been investigated extensively as a bone substitute nowadays. However, the bone formation capacity of BCP is limited owing to lack of osteoinduction. Silk fibroin (SF) has a structure similar to type I collagen, and could be developed to a microsphere for the sustained-release of rhBMP-2. In our previous report, bioactivity of BCP could be enhanced by rhBMP-2/SF microsphere (containing 0.5 µg rhBMP-2) in vitro. However, the bone regeneration performance of the composite in vivo was not investigated. Thus, the purpose of this study was to evaluate the efficacy of BCP/rhBMP-2/SF in a sheep lumbar fusion model. A BCP and rhBMP-2/SF microsphere was developed, and then was integrated into a BCP/rhBMP-2/SF composite. BCP, BCP/rhBMP-2 and BCP/rhBMP-2/SF were implanted randomly into the disc spaces of 30 sheep at the levels of L1/2, L3/4 and L5/6. After sacrificed, the fusion segments were evaluated by manual palpation, CT scan, biomechanical testing and histology at 3 and 6 months, respectively. The composite demonstrated a burst-release of rhBMP-2 (39.1 ± 2.8 %) on the initial 4 days and a sustained-release (accumulative 81.3 ± 4.9 %) for more than 28 days. The fusion rates, semi-quantitative CT scores, fusion stiffness in bending in all directions and histologic scores of BCP/rhBMP-2/SF were significantly greater than BCP and BCP/rhBMP-2 at each time point, respectively (P < 0.05). These findings indicate that the SF microspheres containing a very low dose of rhBMP-2 improve fusion in sheep using BCP constructs.
Collapse
Affiliation(s)
- Liang Chen
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No 188 Shizi Street, Suzhou, 215006, China
| | | | | | | | | |
Collapse
|
16
|
Kim JS, Cha JK, Cho AR, Kim MS, Lee JS, Hong JY, Choi SH, Jung UW. Acceleration of Bone Regeneration by BMP-2-Loaded Collagenated Biphasic Calcium Phosphate in Rabbit Sinus. Clin Implant Dent Relat Res 2014; 17:1103-13. [PMID: 24673932 DOI: 10.1111/cid.12223] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The objective of this study was to determine the effectiveness of collagenated biphasic calcium phosphate (CBCP) as a carrier for bone morphogenetic protein-2 (BMP-2) at the early stage of healing in rabbit sinus. MATERIAL AND METHODS In 16 rabbits, BMP-2-loaded CBCP was grafted into one sinus (the BMP group) and saline-soaked CBCP was grafted into another sinus (the CTL group). The groups were assigned randomly. After 2 weeks (n = 8) or 4 weeks (n = 8), radiographic and histological analysis was performed. RESULTS Total augmented volume was significantly larger in the BMP group at both healing periods. Furthermore, new bone volume was significantly greater in the BMP group at 4 weeks. Marked bone formation near the schneiderian membrane was found in the BMP groups at the early healing period. At 4 weeks, evenly distributed new bone was observed in the BMP group, whereas the new bone was sparsely distributed in the central portion in the CTL group. CONCLUSION It can be concluded that the addition of BMP-2 to CBCP resulted in a greater initial augmented volume as a result of postoperative swelling, which is replaced by early bone formation, and it was prominent near the Schneiderian membrane.
Collapse
Affiliation(s)
- Jung-Soo Kim
- Research Institute for Periodontal Regeneration, Department of Periodontology, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jae-Kook Cha
- Research Institute for Periodontal Regeneration, Department of Periodontology, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ah-Ran Cho
- Research Institute for Periodontal Regeneration, Department of Periodontology, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Min-Soo Kim
- Research Institute for Periodontal Regeneration, Department of Periodontology, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jung-Seok Lee
- Research Institute for Periodontal Regeneration, Department of Periodontology, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ji-Youn Hong
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Seong-Ho Choi
- Research Institute for Periodontal Regeneration, Department of Periodontology, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ui-Won Jung
- Research Institute for Periodontal Regeneration, Department of Periodontology, College of Dentistry, Yonsei University, Seoul, South Korea
| |
Collapse
|
17
|
de Freitas RM, Susin C, Spin-Neto R, Marcantonio C, Wikesjö UME, Pereira LAVD, Marcantonio E. Horizontal ridge augmentation of the atrophic anterior maxilla using rhBMP-2/ACS or autogenous bone grafts: a proof-of-concept randomized clinical trial. J Clin Periodontol 2013; 40:968-75. [DOI: 10.1111/jcpe.12148] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Rubens Moreno de Freitas
- Department of Diagnosis and Surgery - Periodontics; UNESP - Univ Estadual Paulista, Araraquara Dental School; Araraquara SP Brazil
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; College of Dental Medicine; Augusta GA USA
| | - Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; College of Dental Medicine; Augusta GA USA
- Department of Orthopedics, Medical College of Georgia; Georgia Regents University; Augusta GA USA
| | - Rubens Spin-Neto
- Department of Diagnosis and Surgery - Periodontics; UNESP - Univ Estadual Paulista, Araraquara Dental School; Araraquara SP Brazil
- Department of Dentistry; Oral Radiology; Aarhus University; Aarhus; Denmark
| | - Claudio Marcantonio
- Department of Diagnosis and Surgery - Periodontics; UNESP - Univ Estadual Paulista, Araraquara Dental School; Araraquara SP Brazil
| | - Ulf M. E. Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Departments of Periodontics and Oral Biology; College of Dental Medicine; Augusta GA USA
- Department of Orthopedics, Medical College of Georgia; Georgia Regents University; Augusta GA USA
| | | | - Elcio Marcantonio
- Department of Diagnosis and Surgery - Periodontics; UNESP - Univ Estadual Paulista, Araraquara Dental School; Araraquara SP Brazil
| |
Collapse
|