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Deepanjali M, Prasad TS, Manodh P. Efficacy of simvastatin in bone regeneration after surgical removal of mandibular third molars. Oral Maxillofac Surg 2023; 27:427-432. [PMID: 35648294 DOI: 10.1007/s10006-022-01081-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/26/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study was to assess the efficacy of simvastatin in bone regeneration in extraction sockets of mandibular third molars using cone beam computed tomography (CBCT) at 6th post-operative month. METHODS This is a prospective randomized split-mouth study involving 15 patients who underwent surgical extraction of bilaterally impacted mandibular third molars with similar morphology on the same day. The efficacy of drug was analyzed by implanting 10 mg of simvastatin into the socket (study site) and observations were made over 6 months to compare the healing with the control site. RESULTS The study results demonstrated a statistically significant difference in bone regeneration: mean gray value of 429.133 in study site compared with mean gray value of 310.153 in the control site. CONCLUSION These values demonstrate significant change in bone regeneration in simvastatin site as compared to that of control site.
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Affiliation(s)
| | | | - Pedamally Manodh
- Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
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Pruthi G, Mahajan R, Gupta A, Patil AN, Paramasivam V, Kaundal S. The Effects of Statins on Bone Formation Around Implants Placed in Animal Bones: A Systematic Review and Meta-Analysis. J Maxillofac Oral Surg 2023; 22:265-286. [PMID: 37122799 PMCID: PMC10130266 DOI: 10.1007/s12663-023-01873-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/11/2023] [Indexed: 03/02/2023] Open
Abstract
Background Implants are preferred for replacement of missing teeth by the clinicians as well as the patients. Lesser alveolar bone density doesn't preclude any individual for choosing this option but warrants for extra caution. Preclinical studies have explored the osteoinductive potential of statins, but results should be analyzed vigorously before implementing them in humans. There is no meta-analysis to document effect of statins on bone formation around implants in osteoporotic animals. Methods and material PubMed, Embase and Cochrane were searched for studies investigating the effect of statins on bone implant contact (BIC %), bone mineral density (BMD %) and bone volume (BV %) around implants at 2, 4 and 12 weeks. Meta-analysis was performed on subgroups with osteoporotic animals which were administered statins through different routes. Results Quantitative data from 12 studies showed favorable effect of statins on bone around implants. Positive difference was observed at 4 weeks in BIC (parenteral [SMD = 4.33 (2.89, 5.77); I 2 = 3%)], BMD (local [SMD = 1.33 (0.51, 2.15); I 2 = 0%] and BV (local [SMD = 1.58 (0.76, 2.40); I 2 = 0%]. BIC [SMD = 1.40 (0.89, 1.90); I 2 = 0%] and BV [SMD = 3.91 (2.33, 5.50); I 2 = 43%] were higher in experimental group after 12 weeks of oral administration. Conclusions Statins can be investigated as potential bone graft materials to increase the predictability of osseointegration especially in osteoporotic individuals. Future research should focus to reproduce homogeneous data and conclusive recommendations which can be applied in clinical trials. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-023-01873-z.
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Affiliation(s)
- Gunjan Pruthi
- Prosthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, 160012 India
| | - Rhea Mahajan
- Prosthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, 160012 India
| | - Arpit Gupta
- Public Health Dentistry, Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | | | - Vijayabharathi Paramasivam
- Prosthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, 160012 India
- Present Address: Prosthodontics, AIIMS, Raipur, India
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Harsha G, Madhavi S, Arthi S, Haritha S. Evaluation of efficacy of simvastatin in bone regeneration following local application in third molar extraction socket: A randomized control trial. Natl J Maxillofac Surg 2023; 14:286-293. [PMID: 37661989 PMCID: PMC10474535 DOI: 10.4103/njms.njms_317_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 08/27/2021] [Accepted: 09/30/2021] [Indexed: 09/05/2023] Open
Abstract
Aims and Objectives The aim of this study is to study the efficacy of simvastatin in bone regeneration following the local application in third molar extraction sockets. Materials and Methods This is a randomized controlled trial done on 50 patients involving 100 third molar teeth extraction sockets. The patients were randomly divided based on the placement of simvastatin. Extraction sockets which were treated with simvastatin were considered study sockets and without simvastatin were considered control sockets. The study socket was assigned for the placement of simvastatin (10 mg) powder along with gelfoam as carrier moistened with normal saline solution and control socket was assigned for the placement of gelfoam moistened with saline. Intraoral periapical radiographs were taken on the 1st, 4th, 8th, and 12th weeks, and mean gray scale values indicating bone density were evaluated for both the groups. Cone-beam computed tomography (CBCT) was taken by the end of the 12th week to further evaluate the osseous regeneration. Patients were compared and evaluated for bone density, pain, and swelling. Pain and swelling were evaluated on postoperative days 1 and 7. Results The mean gray-level histogram values (bone density) were statistically highly significant in the study group compared to the control group in the 1st, 4th, 8th, and 12th weeks, and CBCT also showed statistically significant difference between the control and study group by the end of the 12th week. Conclusion The present data suggest that the local application of simvastatin promotes and enhances bone formation in the extraction sockets, which provides a very cost-effective way for faster bone regeneration.
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Affiliation(s)
- Gorrela Harsha
- Department of Oral and Maxillofacial Surgery, MNR Dental College and Hospital, Hyderabad, Telangana, India
| | - Sunnam Madhavi
- Department of Oral and Maxillofacial Surgery, MNR Dental College and Hospital, Hyderabad, Telangana, India
| | - Sirivore Arthi
- Department of Oral and Maxillofacial Surgery, MNR Dental College and Hospital, Hyderabad, Telangana, India
| | - Siripuram Haritha
- Department of Oral and Maxillofacial Surgery, MNR Dental College and Hospital, Hyderabad, Telangana, India
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Shakeri H, Haghbin Nazarpak M, Imani R, Tayebi L. Poly (l-lactic acid)-based modified nanofibrous membrane with dual drug release capability for GBR application. Int J Biol Macromol 2023; 231:123201. [PMID: 36642362 PMCID: PMC10603761 DOI: 10.1016/j.ijbiomac.2023.123201] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/08/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
Electrospun multilayer nanofibers guided bone regeneration (GBR) with a new design were developed in this study. The synthesized multilayer GBR was composed of two distinct layers. Poly l-lactic acid (PLA) incorporated with simvastatin (SIM) was designed as PLA/SIM layer to contact with a bone defect. In addition, the hydrophilic gelatin (GT) containing thymol (THY) was fabricated as GT/THY layer to contact connective tissue, potentially for bacterial gathering. Due to the different chemical nature and weak cohesion of the hydrophilic and hydrophobic layers, hybrid fibers made of PLA/SIM and GT/THY were electrospun as cohesion promoters between these layers. The microstructure and characteristics of the synthesized multilayer substrate, named GT/PLA, were evaluated, and different fibrous monolayers were fabricated to determine the optimal concentrations of drugs. Scanning electron microscopy (SEM) images showed continuous, smooth, randomly aligned, and bead-free fibers. In addition, there were no drug particles on the fiber surfaces which displayed the good placement of those inside the fibers. The mats exhibited satisfactory tensile strength (4.60 ± 0.14 MPa) and favorable physicochemical properties, including proper porosity percentage (<50 %) and appropriate pore size. Suitable swelling behavior (293 ± 0.05 %) and adequate degradation rates were also approved by characterizing swelling and degradability in vitro. The GT/PLA membrane exhibited a prolonged and sustained SIM release and controlled THY release with high antibacterial efficiency. Cell viability, cell attachment assay, and nuclear staining using 4',6-diamidino-2-phenylindole (DAPI) showed that the designed GT/PLA substrate had good biocompatibility and cell attachment. Cell infiltration testing also showed that the cells were finely prevented by the outer layer (GT/THY). Overall, the obtained results in this study indicated the great potential of the prepared GT/PLA for use as a GBR which can develop osteogenic and antibacterial biomimetic periosteum optimizing the clinical application of GBR strategies.
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Affiliation(s)
- Haniyeh Shakeri
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Iran
| | - Masoumeh Haghbin Nazarpak
- New Technologies Research Center (NTRC), Amirkabir University of Technology (Tehran Polytechnic), Iran.
| | - Rana Imani
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Iran.
| | - Lobat Tayebi
- School of Dentistry, Marquette University, WI, United States
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Simvastatin promotes rat Achilles tendon-bone interface healing by promoting osteogenesis and chondrogenic differentiation of stem cells. Cell Tissue Res 2023; 391:339-355. [PMID: 36513828 DOI: 10.1007/s00441-022-03714-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/19/2022] [Indexed: 12/15/2022]
Abstract
To investigate the effect and mechanism of simvastatin on cell components of tendon-bone healing interface. The tendon-bone healing model was established by inserting the end of the Achilles tendon into the tibial tunnel on 24 rats, and simvastatin was used locally at the tendon-bone interface. Healing was evaluated at 8 weeks by mechanical testing, micro-CT, and qualitative histology including H&E, Toluidine blue, and immunohistochemical staining. In vitro, bone marrow stromal cells (BMSCs) and tendon-derived mesenchymal stem cells (TDSCs) underwent osteogenic and chondrogenic differentiation respectively by plate co-culture. An analysis was performed on days 7 and 14 of cell differentiation. Biomechanical testing demonstrated a significant increase in maximum stiffness in the simvastatin-treated group. Micro-CT analysis showed that the bone tunnels in the simvastatin group were smaller in diameter and had higher bone density. H&E and Toluidine blue staining demonstrated that tendon-bone healing was significantly greater with better tissue arrangement and more extracellular matrix in the simvastatin-treated group than that in the control group, and immunohistochemical staining showed the expression of VEGF in simvastatin group was significantly higher. Histological staining and RT-PCR confirmed that simvastatin could promote the differentiation of co-cultured BMSCs and TDSCs into osteoblasts and chondroblasts, respectively. The effect of promoting osteogenic differentiation was more tremendous at 14 days, while its effect on promoting chondroblast differentiation was more evident on the 7th day of differentiation. In conclusion, local administration of simvastatin can promote the tendon-bone healing by enhancing neovascularization, chondrogenesis, and osteogenesis in different stages of the tendon-bone healing process.
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Karanikola T, Cheva A, Sarafidou K, Myronidou-Tzouveleki M, Tsavdaridis I, Kontonasaki E, Tsirlis A. Effect of Diclofenac and Simvastatin on Bone Defect Healing-An In Vivo Animal Study. Biomimetics (Basel) 2022; 7:143. [PMID: 36278700 PMCID: PMC9589953 DOI: 10.3390/biomimetics7040143] [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: 08/07/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 08/12/2023] Open
Abstract
Non-steroidal, anti-inflammatory drugs and statins are two widely prescribed drug classes that affect bone formation. The aim of this study was to elucidate the effect of diclofenac and simvastatin in artificial bone defect healing. One hundred and forty-four male Wistar rats were used, and the specimens were divided into groups, with respect to the route of drug administration and the type of defect healing (with or without collagen membrane), and subgroups, with respect to the study duration (2, 4 or 8 weeks). Diclofenac was intramuscularly administered while simvastatin was administered both systemically and locally. Animals were euthanized and specimens were histomorphometrically analyzed to evaluate the percentage of new bone formation (%). Bone healing that occurred without any intervention developed more steadily than that of all other groups. Diclofenac exerted a clear, direct inhibitory effect on bone healing and its systemic administration should be avoided. The systemic administration of simvastatin was related to severe myopathy, while the solvent for the local administration of simvastatin seemed to play significant role in bone growth, as simvastatin, when it is administered intraperitoneally in a DMSO solution, appeared to promote bone healing. Local administration may have a significant impact on bone healing and it should be further investigated with the type of solvent or carrier that is used, which both may play a significant role in bone repair induction.
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Affiliation(s)
- Theodora Karanikola
- Department of Oral Surgery, Implantology and Dental Radiology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), 54124 Thessaloniki, Greece
| | - Angeliki Cheva
- Pathology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), 54124 Thessaloniki, Greece
| | - Katia Sarafidou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), 54124 Thessaloniki, Greece
| | - Maria Myronidou-Tzouveleki
- 1st Laboratory of Pharmacology, School of Health Sciences, Faculty of Medicine, Aristotle University of Thessaloniki, 56224 Thessaloniki, Greece
| | - Ioannis Tsavdaridis
- 1st Laboratory of Pharmacology, School of Health Sciences, Faculty of Medicine, Aristotle University of Thessaloniki, 56224 Thessaloniki, Greece
| | - Eleana Kontonasaki
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), 54124 Thessaloniki, Greece
| | - Anastasios Tsirlis
- Department of Oral Surgery, Implantology and Dental Radiology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), 54124 Thessaloniki, Greece
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Potential bioactive coating system for high-performance absorbable magnesium bone implants. Bioact Mater 2022; 12:42-63. [PMID: 35087962 PMCID: PMC8777287 DOI: 10.1016/j.bioactmat.2021.10.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 12/11/2022] Open
Abstract
Magnesium alloys are considered the most suitable absorbable metals for bone fracture fixation implants. The main challenge in absorbable magnesium alloys is their high corrosion/degradation rate that needs to be controlled. Various coatings have been applied to magnesium alloys to slow down their corrosion rates to match their corrosion rate to the regeneration rate of the bone fracture. In this review, a bioactive coating is proposed to slow down the corrosion rate of magnesium alloys and accelerate the bone fracture healing process. The main aim of the bioactive coatings is to enhance the direct attachment of living tissues and thereby facilitate osteoconduction. Hydroxyapatite, collagen type I, recombinant human bone morphogenetic proteins 2, simvastatin, zoledronate, and strontium are six bioactive agents that show high potential for developing a bioactive coating system for high-performance absorbable magnesium bone implants. In addition to coating, the substrate itself can be made bioactive by alloying magnesium with calcium, zinc, copper, and manganese that were found to promote bone regeneration. Bioactive-coated magnesium implant could accelerate bone fracture healing time to match with magnesium degradation. Hydroxyapatite, collagen type I, recombinant human bone morphogenetic proteins 2, simvastatin, zoledronate, and strontium are high potential bioactive coating materials. The incorporation of Ca, Zn, Cu, Sr, and Mn in Mg base-metal could further enhance bone formation.
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Liu X, Li T, Wang F, Sun F, Hu J, Ye X, Wang D, Yang X. Controlling sustained statins release in multi-layered composite scaffolds for healing of osteoporotic bone defects. BIOMATERIALS ADVANCES 2022; 137:212838. [PMID: 35929268 DOI: 10.1016/j.bioadv.2022.212838] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 04/06/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
The risk of fragility fracture sharply increases due to the decreased bone mineral density and toughness in patients with osteoporosis (OP). The local use of bone tissue scaffolds with both mechanical stability and drug-delivery functionality is one of the key strategies for the efficient curing of OP. In this work, we reported a layer-by-layer constructing strategy to fabricate 3-D composite bone tissue scaffolds (eSTPS) by assembling β-tri‑calcium phosphate (β-TCP)/polycaprolactone (PCL) microchips and lovastatin-loaded nanofiber membranes (eLOV/PCL). The eSTPS scaffolds show a strong and suited compressive strength as well as long-term delivery of lovastatin. The in vitro tests indicate well biocompatibility and alkaline phosphatase activity of the scaffolds. The eSTPS scaffolds were implanted into the femur of OP modeled rabbits. After 12 weeks curing, the bone parameters are significantly improved, meanwhile ingrowth of new bone and vascular-like tissue were observed. These results suggest the eSTPS scaffolds to be a promising candidate for the local treatment of OP.
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Affiliation(s)
- Xilin Liu
- Department of Orthopaedic Surgery, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Science, Affiliated Hospital of University of Electronic Science and Technology, Chengdu 610072, China; Department of Orthopaedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Ting Li
- Department of Orthopaedic Surgery, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Science, Affiliated Hospital of University of Electronic Science and Technology, Chengdu 610072, China; Chengdu Medical College, Chengdu 610500, China
| | - Fei Wang
- Department of Orthopaedic Surgery, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Science, Affiliated Hospital of University of Electronic Science and Technology, Chengdu 610072, China
| | - Fanxi Sun
- School of Optoelectronic Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Jiang Hu
- Department of Orthopaedic Surgery, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Science, Affiliated Hospital of University of Electronic Science and Technology, Chengdu 610072, China
| | - Xiaojian Ye
- Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China; Department of Orthopaedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
| | - Dongsheng Wang
- School of Optoelectronic Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
| | - Xiao Yang
- Department of Orthopaedic Surgery, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Science, Affiliated Hospital of University of Electronic Science and Technology, Chengdu 610072, China.
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Farzan A, Moshiri A, Andalib S, Shamsi M, Motamed N. Effect of Simvastatin and Low-Level Laser Therapy on Sutural Bone Formation After Expansion in Rats: Biomechanical, Computed Tomography and Immunohistochemical Assessment. J Lasers Med Sci 2022; 13:e21. [PMID: 35996495 PMCID: PMC9392889 DOI: 10.34172/jlms.2022.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 02/12/2022] [Indexed: 09/03/2024]
Abstract
Introduction: The application of low-level laser therapy (LLLT) and some medications have been shown to accelerate bone formation in rapid palatal expansion (RPE). A combination of these two therapeutic modalities may reduce the time required for the retention period. This study sought to assess the effects of simvastatin and LLLT, alone and combined, on sutural bone formation in rats. Methods: Sixty male Wistar rats averagely weighing 150 g were divided into five groups (n=12) of control (group 1), 5 mg simvastatin (group 2), 10 mg simvastatin (group 3), LLLT (group 4), and LLLT plus 10 mg simvastatin (group 5). The expansion appliance was placed in the parietal bone in all groups. One week after placing the appliance, the spring was fixed with Duralay acrylic resin to serve as a retainer during the rest of the experiment. The rats were sacrificed after 30 (for biomechanical and computed tomography [CT] assessments) or 60 days (for biomechanical, CT and immunohistochemical [IHC] assessments). Results: Groups 3 and 4 showed a significant improvement in osteogenesis (confirmed by CT findings, histological analysis and biomechanical test) compared to the control group. Group 5 was significantly superior to all other groups in terms of all parameters (P < 0.001). Group 2 and the control group were not significantly different (P>0.05). Conclusion: Although LLLT, simvastatin treatment and the combination of both significantly improved sutural bone formation in rats compared to the control group, the combined treatment showed significantly superior clinical results compared to other interventions.
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Affiliation(s)
- Arash Farzan
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Ali Moshiri
- Department of Surgery and Radiology, Dr Moshiri Veterinary Clinic, Tehran, Iran
| | - Sina Andalib
- Pharmacy School, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Nima Motamed
- Department of Social Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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The evaluation of cytotoxicity and cytokine IL-6 production of root canal sealers with and without the incorporation of simvastatin: an invitro study. BMC Oral Health 2022; 22:6. [PMID: 35012572 PMCID: PMC8751161 DOI: 10.1186/s12903-022-02039-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/28/2021] [Indexed: 12/07/2022] Open
Abstract
Background Freshly mixed root canal sealers when proximate the periapical tissues, trigger varying degrees of cytotoxicity/inflammatory reactions. Simvastatin, a class of the drug statin, is a widely used cholesterol-lowering agent with additional anti-inflammatory activities. This study assessed the effects of simvastatin on cytotoxicity and the release of IL-6 (Interleukin-6) production when incorporated in zinc oxide eugenol and methacrylate resin-based sealers. Methods Experimental groups consisted of conventional zinc oxide eugenol and methacrylate based-EndoREZ sealers (ZE & ER respectively) and 0.5 mg/mL simvastatin incorporated sealers (ZES & ERS). L929 mouse fibroblast cells were exposed to freshly mixed experimental sealers and evaluated for cytotoxicity (MTT assay) and inflammation levels (inflammatory marker IL-6 for ELISA) at various time intervals (0h, 24h and 7th day). The values were compared to the cell control (CC; L929 cells alone) and solvent control (SC; L929 cells + DMSO) groups. All the experiments were conducted in triplicates and subjected to statistical analysis using IBM SPSS Statistics software. Non parametric tests were conducted using Kruskal-Wallis and Friedman tests for inter-group and intra-group comparisons respectively. Pairwise comparison was conducted by post hoc Dunn test followed by Bonferroni correction. P values < 0.05 were considered statistically significant. Results All the experimental groups (ZE, ER, ZES, ERS) exhibited varying degree of cytotoxicity and IL-6 expression compared to the control groups CC and SC. The cell viability for ZE and ER decreased on day 7 as compared to 24 h. ZES and ERS had higher viable cells (75.93% & 79.90%) compared to ZE and ER (54.39% & 57.84%) at all time periods. Increased expression of IL-6 was observed in ZE & ER (25.49 pg/mL & 23.14 pg/mL) when compared to simvastatin incorporated ZE & ER (ZES-12.70 pg/mL & ERS-14.68 pg/mL) at all time periods. Highest level of cytotoxicity and inflammation was observed in ZE compared to all the other groups on day 7. Conclusions Addition of 0.5 mg/mL of simvastatin to the sealers (ZES and ERS) decreased the cytotoxicity in the freshly mixed state and reduces their inflammatory effect.
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Ma X, Gao Y, Zhao D, Zhang W, Zhao W, Wu M, Cui Y, Li Q, Zhang Z, Ma C. Titanium Implants and Local Drug Delivery Systems Become Mutual Promoters in Orthopedic Clinics. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 12:47. [PMID: 35009997 PMCID: PMC8746425 DOI: 10.3390/nano12010047] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Titanium implants have always been regarded as one of the gold standard treatments for orthopedic applications, but they still face challenges such as pain, bacterial infections, insufficient osseointegration, immune rejection, and difficulty in personalizing treatment in the clinic. These challenges may lead to the patients having to undergo a painful second operation, along with increased economic burden, but the use of drugs is actively solving these problems. The use of systemic drug delivery systems through oral, intravenous, and intramuscular injection of various drugs with different pharmacological properties has effectively reduced the levels of inflammation, lowered the risk of endophytic bacterial infection, and regulated the progress of bone tumor cells, processing and regulating the balance of bone metabolism around the titanium implants. However, due to the limitations of systemic drug delivery systems-such as pharmacokinetics, and the characteristics of bone tissue in the event of different forms of trauma or disease-sometimes the expected effect cannot be achieved. Meanwhile, titanium implants loaded with drugs for local administration have gradually attracted the attention of many researchers. This article reviews the latest developments in local drug delivery systems in recent years, detailing how various types of drugs cooperate with titanium implants to enhance antibacterial, antitumor, and osseointegration effects. Additionally, we summarize the improved technology of titanium implants for drug loading and the control of drug release, along with molecular mechanisms of bone regeneration and vascularization. Finally, we lay out some future prospects in this field.
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Yu D, Huang C, Jiang C, Zhu H. Features of a simvastatin-loaded multi-layered co-electrospun barrier membrane for guided bone regeneration. Exp Ther Med 2021; 22:713. [PMID: 34007322 PMCID: PMC8120663 DOI: 10.3892/etm.2021.10145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
A novel tri-layer membrane consisting of polycaprolactone (PCL) fibrous sheets and structured nanofibers with a gelatin (Gt) shell and a simvastatin-containing PCL core (PCL-Gt/PCL-simvastatin membrane) was prepared. The soft external layer comprised of Gt/PCL-simvastatin, the external layer of PCL and the middle layer of both microfilaments, interwoven together. The membrane was designed to promote osteoinduction and act as a barrier against cells but not against water and molecules in order to promote guided bone regeneration. The structure of the membrane was characterized by scanning electronic microscopy. The in vitro release rates of simvastatin over 32 days were determined by high-performance liquid chromatography. For in vitro biological assays, bone marrow mesenchymal stem cells and human fibroblasts were cultured on the different surfaces of the membrane. Cell adhesion, proliferation, distribution, and differentiation were examined. For in vivo testing, cranial defects were created in rabbits to assess the amount of new bone formed for each membrane. The results revealed that membranes with multi-layered structures showed good cell viability and effective osteoinductive and barrier properties. These results suggest that the novel multi-layered PCL-Gt/PCL-simvastatin membranes have great potential for bone tissue engineering.
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Affiliation(s)
- Dan Yu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Chongshang Huang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Chu Jiang
- Department of Stomatology, Jiangshan People's Hospital, Jiangshan, Zhejiang 324100, P.R. China
| | - Huiyong Zhu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
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13
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In-vivo evaluation of tissue scaffolds containing simvastatin loaded nanostructured lipid carriers and mesenchymal stem cells in diabetic wound healing. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.102140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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14
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Koç O, Tüz HH, Ocak M, Bilecenoğlu B, Fırat A, Kaymaz FF. Can the Combination of Simvastatin and Melatonin Create a Synergistic Effect on Bone Regeneration? J Oral Maxillofac Surg 2021; 79:1672-1682. [PMID: 33524327 DOI: 10.1016/j.joms.2020.12.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The present study evaluated the potential bone regeneration capacity of combining melatonin and simvastatin, with a goal of producing more osteogenic bone substitutes. MATERIALS AND METHODS A total of 48 male Wistar rats were randomly divided into 4 groups. The following were administered into critical-sized calvarial defects of the rats: Group I-human allograft; Group II-human allograft + 10 mg melatonin; Group III-human allograft + 0.1 mg simvastatin; and Group IV-human allograft + 10 mg melatonin + 0.1 mg simvastatin. Histopathologic, histomorphometric, and microcomputed tomographic evaluations were performed postprocedurally at 4 and 8 weeks. A P value < .05 was considered significant for all evaluations. RESULTS Groups II and III had significantly superior regeneration compared to Group I at weeks 4 and 8. Group III had significantly superior regeneration compared to Group II, particularly in week 4. Group IV had significantly superior regeneration compared to all groups at week 8. CONCLUSIONS The local administration of melatonin and simvastatin resulted in increased new bone mass and quality of bone microstructure than was seen in the control group. Simvastatin shortened the defect regeneration time more effectively than melatonin did. The combined use of melatonin and simvastatin provided a synergic effect on bone regeneration, particularly in the late phase of healing.
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Affiliation(s)
- Onur Koç
- Doctor, Department of Oral and Maxillofacial Surgery, Hacettepe University, Faculty of Dentistry, Ankara, Turkey.
| | - Hıfzı Hakan Tüz
- Professor, Department of Oral and Maxillofacial Surgery, Hacettepe University, Faculty of Dentistry, Ankara, Turkey
| | - Mert Ocak
- Assistant Professor, Department of Anatomy, Ankara University, Faculty of Dentistry, Ankara, Turkey
| | - Burak Bilecenoğlu
- Professor of Anatomy, Department of Anatomy, Ankara Medipol University, Faculty of Medicine, Ankara, Turkey
| | - Ayşegül Fırat
- Associate Professor, Department of Anatomy, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Figen Fevziye Kaymaz
- Professor, Department of Histology and Embryology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
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15
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Shaheen MY, Basudan AM, Niazy AA, van den Beucken JJJP, Jansen JA, Alghamdi HS. Impact of Single or Combined Drug Therapy on Bone Regeneration in Healthy and Osteoporotic Rats. Tissue Eng Part A 2020; 27:572-581. [PMID: 32838702 DOI: 10.1089/ten.tea.2020.0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Complications in bone regeneration in patients with systemic impaired bone metabolism (e.g., osteoporosis) represent a rapidly increasing clinical challenge. Alendronate and simvastatin are drugs commonly used to promote bone metabolism in osteoporotic conditions. The aim of this study was to evaluate initial bone regeneration within osseous defects grafted with beta-tricalcium phosphate (β-TCP) in adjunction with systemic coadministrations of alendronate and simvastatin (i.e., daily subcutaneous injection for 3 weeks) in healthy and osteoporotic rats. Eighty Wistar female rats were ovariectomized (OVX; n = 40) or sham operated (n = 40). Six weeks later, osseous defects (a 3-mm critical-sized defect) were created in the left femoral condyles and then grafted with β-TCP. From the day following graft installation, OVX and sham animals received for 3 weeks a daily subcutaneous injection of alendronate (50 μg/kg of body weight) and simvastatin (5 mg/kg of body weight), alone or in combination. A control group was included, which received subcutaneous saline administration. At the end of the 3 weeks, rats were euthanized and specimens (femoral condyles) were retrieved for histological evaluation and histomorphometric measurements, that is, bone area (BA%) and remaining bone graft (RBG%). In osteoporotic rats, 3 weeks of daily subcutaneous injection of combined therapy (alendronate plus simvastatin) led to a significant (p < 0.05) increase in BA% and a significant decrease in RBG% compared to healthy controls in osseous defects grafted with β-TCP (BA%: 28.6 ± 12.0 vs. 18.2 ± 7.6, RBG% 61.3 ± 11.1 vs. 70.7 ± 7.3). No significant differences in BA% and RBG% were found in the OVX rats for single treatments. Furthermore, healthy controls showed similar BA% and RBG% upon single or combined therapy compared to nontreated control rats. Daily coinjections (for 3 weeks) of alendronate plus simvastatin result in a significant enhancement of bone regeneration within osseous defects grafted with β-TCP in osteoporotic rats. Despite the expected effects on osteoporotic bone, our study did not confirm the hypothesized benefit of alendronate and simvastatin on bone regeneration in osseous defects in healthy conditions. The efficacy of the combination drug therapy on bone regeneration demands further investigation to elucidate molecular and cellular aspects underlying this therapy.
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Affiliation(s)
- Marwa Y Shaheen
- Department of Periodontics and Community Dentistry and College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Amani M Basudan
- Department of Periodontics and Community Dentistry and College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdurahman A Niazy
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - John A Jansen
- Department of Dentistry - Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hamdan S Alghamdi
- Department of Periodontics and Community Dentistry and College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Department of Dentistry - Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands
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16
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Cruz R, Pesce G, Calasans-Maia J, Moraschini V, Calasans-Maia MD, Granjeiro JM. Calcium Phosphate Carrying Simvastatin Enhances Bone Regeneration: A Systematic Review. Braz Dent J 2020; 31:93-102. [PMID: 32556021 DOI: 10.1590/0103-6440202002971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/11/2019] [Indexed: 12/28/2022] Open
Abstract
Several studies have aimed to develop alternative therapeutic biomaterials for bone repair. The purpose of this systematic review was to evaluate how statins carried by calcium phosphate affect the formation and regeneration of bone tissue in animal models when compared to other biomaterials or spontaneous healing. This systematic review followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, the PRISMA guidelines, and the Preclinical Systematic Review & Meta-analysis Facility (SyRF). The protocol of this systematic review was registered in PROSPERO (CRD42018091112) and in CAMARADES. In addition, ARRIVE checklists were followed in order to increase the quality and transparency of the search. An electronic search was performed using the MEDLINE/PubMed, Scopus, SciELO, and PROSPERO library databases. The authors used a specific search strategy for each database, and they also conducted a search in the grey literature and cross-references. The eligibility criteria were animal studies, which evaluated bone repair treated with calcium phosphate as a simvastatin carrier. The selection process yielded 8 studies from the 657 retrieved. All manuscripts concluded that locally applied simvastatin carried by calcium phosphate is biocompatible, enhanced bone repair and induced statistically greater bone formation than cloth or calcium phosphate alone. In conclusion, the pertinent pre-clinical studies evidenced the calcium phosphate biocompatibility and its effectiveness in delivering SIM to improve the repair of bone defects. So, clinical trials are encouraged to investigate the impact of SIM associated with calcium phosphate bone graft in repairing bone defect in humans.
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Affiliation(s)
- Rebecca Cruz
- Laboratory of Dental Clinical Research, Dentistry school, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Giovanna Pesce
- Laboratory of Dental Clinical Research, Dentistry school, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - José Calasans-Maia
- Department of Orthodontics, Dentistry School, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Vittorio Moraschini
- Laboratory of Dental Clinical Research, Dentistry school, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Monica Diuana Calasans-Maia
- Laboratory of Dental Clinical Research, Dentistry school, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - José Mauro Granjeiro
- Laboratory of Dental Clinical Research, Dentistry school, UFF - Universidade Federal Fluminense, Niterói, RJ, Brazil.,Bioengineering Laboratory, INMETRO - Instituto Nacional de Metrologia, Qualidade e Tecnologia, Duque de Caxias, RJ, Brazil
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17
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Ion R, Necula MG, Mazare A, Mitran V, Neacsu P, Schmuki P, Cimpean A. Drug Delivery Systems Based on Titania Nanotubes and Active Agents for Enhanced Osseointegration of Bone Implants. Curr Med Chem 2020; 27:854-902. [PMID: 31362646 DOI: 10.2174/0929867326666190726123229] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 01/16/2019] [Accepted: 05/04/2019] [Indexed: 12/31/2022]
Abstract
TiO2 nanotubes (TNTs) are attractive nanostructures for localized drug delivery. Owing to their excellent biocompatibility and physicochemical properties, numerous functionalizations of TNTs have been attempted for their use as therapeutic agent delivery platforms. In this review, we discuss the current advances in the applications of TNT-based delivery systems with an emphasis on the various functionalizations of TNTs for enhancing osteogenesis at the bone-implant interface and for preventing implant-related infection. Innovation of therapies for enhancing osteogenesis still represents a critical challenge in regeneration of bone defects. The overall concept focuses on the use of osteoconductive materials in combination with the use of osteoinductive or osteopromotive factors. In this context, we highlight the strategies for improving the functionality of TNTs, using five classes of bioactive agents: growth factors (GFs), statins, plant derived molecules, inorganic therapeutic ions/nanoparticles (NPs) and antimicrobial compounds.
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Affiliation(s)
- Raluca Ion
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Madalina Georgiana Necula
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Anca Mazare
- University of Erlangen-Nuremberg, Department of Materials Science, Erlangen, Germany
| | - Valentina Mitran
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Patricia Neacsu
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Patrik Schmuki
- University of Erlangen-Nuremberg, Department of Materials Science, Erlangen, Germany
| | - Anisoara Cimpean
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
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18
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Jo K, Hong KB, Suh HJ. Effects of the Whey Protein Hydrolysates of Various Protein Enzymes on the Proliferation and Differentiation of 3T3-E1 Osteoblasts. Prev Nutr Food Sci 2020; 25:71-77. [PMID: 32292758 PMCID: PMC7143006 DOI: 10.3746/pnf.2020.25.1.71] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 12/14/2019] [Indexed: 11/21/2022] Open
Abstract
In this study, we used various proteinases to investigate the effect of whey protein hydrolysates on proliferation and differentiation of MC3T3-E1 osteoblasts. To confirm hydrolysis of the whey protein hydrolysates, the yield and α-amino acid content were determined. Since osteogenic cell activity is an important factor in osteogenesis, we evaluated the proliferation of osteogenic cells by measuring 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and alkaline phosphatase (ALP) activity. To analyze bone matrix formation, we identified calcium deposition by staining with Alizaline red-S. The free amino acid content was significantly higher in the whey protein hydrolysates prepared using Protamex, Flavourzyme, and Alcalase than in the control. When cells were treated with 500 μg/mL of whey protein hydrolysates prepared using Protamex and Alcalase, cell proliferation increased by 120% and 130%, respectively, compared with the control group. In addition, ALP activity was significantly higher following treatment with 500 μg/mL of whey protein hydrolysates prepared using Protamex and Alcalase (142.61% and 135.06%, respectively; P<0.05). Furthermore, when treated with 125 μg/mL of the same hydrolysates, the rate of calcium deposition increased significantly to 157.56% compared with the control group (P<0.05). Therefore, our results suggest that whey protein hydrolysates prepared using Protamex and Alcalase may have more beneficial effects on osteoblast proliferation and bone health than those prepared using other proteolytic enzymes.
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Affiliation(s)
- Kyungae Jo
- BK21Plus, College of Health Science, Korea University, Seoul 02841, Korea
| | - Ki-Bae Hong
- BK21Plus, College of Health Science, Korea University, Seoul 02841, Korea
| | - Hyung Joo Suh
- Department of Public Health Science, Korea University, Seoul 02841, Korea
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19
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Yaghobee S, Panjnoush M, Chokami Rafiei S, Amini Shakib P, Mahmoodi S, Rasouli-Ghahroudi AAR, Poursafar F. Effect of Simvastatin on Bone Regeneration: A Histologic and Histomorphometric Analysis. J Oral Maxillofac Surg 2020; 78:927-934. [PMID: 32084353 DOI: 10.1016/j.joms.2020.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE The purpose of the present study was to evaluate the efficacy of simvastatin administration as an osteoinductive agent combined with bovine bone material (BBM) for augmentation of human maxillary sinuses. MATERIALS AND METHODS In the present randomized clinical trial with a split-mouth design, 24 maxillary sinuses in 12 patients were augmented using BBM alone or BBM combined with simvastatin. Biopsy samples were taken 9 months after maxillary sinus floor augmentation for histologic and histomorphometric analyses. A total of 44 implants were placed in the augmented bone. RESULTS The results of the microscopic assessment of most samples revealed no inflammation or only mild chronic inflammation. Lamellation was detectable in old bone trabeculae under polarized light microscopy but was not observed in newly formed bone. Osteocytes were found with a lower frequency in the lacunae of newly formed bone compared with normal bone. No significant differences were found in the amount of newly formed bone and the amount of residual particles between the 2 groups. CONCLUSIONS Despite the greater mean percentage of newly formed bone in the test group, the histomorphometric analysis results did not show a significant positive effect for the use of simvastatin in maxillary sinus augmentation.
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Affiliation(s)
- Siamak Yaghobee
- Associate Professor, Department of Periodontology, Dental Implant Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Panjnoush
- Associate Professor, Department of Oral and Maxillofacial Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Chokami Rafiei
- Assistant Professor, Department of Periodontology, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Pouyan Amini Shakib
- Assistant Professor, Department of Oral Pathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Mahmoodi
- PhD in Pharmaceutics, Private Practitioner, Tehran, Iran
| | - Amir Ali Reza Rasouli-Ghahroudi
- Associate Professor, Department of Periodontology, Dental Implant Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Poursafar
- Resident, Department of Periodontology, Tehran University of Medical Sciences, Tehran, Iran.
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20
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Issa DR, Abdel-Ghaffar KA, Al-Shahat MA, Hassan AAA, Iacono VJ, Gamal AY. Guided tissue regeneration of intrabony defects with perforated barrier membranes, simvastatin, and EDTA root surface modification: A clinical and biochemical study. J Periodontal Res 2019; 55:85-95. [PMID: 31448832 DOI: 10.1111/jre.12692] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 07/08/2019] [Accepted: 07/28/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Perforated barrier membranes (PBM) were suggested to enhance periodontal regeneration by allowing positive charity of wanted elements from the gingival tissue side. The present study was designed to evaluate clinically and biochemically the use of PBM combined with simvastatin (SMV) gel with and without an associated EDTA gel root surface etching as a suggested option that could improve SMV availability and clinical outcomes of PBM. METHODS Forty patients having moderate-to-severe chronic periodontitis with 40 intrabony defects were randomly divided into four treatment groups (10 sites each). Patients in group 1 received 1.2% SMV gel and covering the defect with occlusive membrane (OM). Patients in group 2 received 1.2% SMV gel and covering the defect with PBM. Group 3 received 24% EDTA root surface etching, 1.2% SMV gel, and defect coverage with OM (eOM). Patients in group 4 were treated as in group 3 but the defect was covered with PBM (ePBM). Clinical parameters were recorded at baseline before surgical procedures and were reassessed at 6 and 9 months after therapy. The mean concentration of SMV in gingival crevicular fluid (GCF) was estimated by reverse-phase high-performance liquid chromatography at days 1, 7, 14, 21, and 30. RESULTS At 6- and 9-month observation periods, groups 3 and 4 showed a statistically significant improvement in PD reduction and CAL gain compared with groups 1 and 2. Group 4 showed a statistically significant more defect fill compared with groups 1, 2, and 3 (P ≤ .05). Group 2 showed statistically significant higher defect fill compared with group 1 and group 3 (P < .05). Bone density was significantly increased with no significant difference between the four groups at 6- and 9-month observation periods. SMV-GCF concentration in group 4 showed the highest mean concentration with no significant difference than that of group 3. CONCLUSION The use of perforated barrier membranes in association with SMV enhances the clinical hard tissue parameters compared with occlusive ones in treating intrabony periodontal defects. Moreover, EDTA root surface treatment could enhance SMV availability in the defect area.
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Affiliation(s)
- Dalia Rasheed Issa
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Kafrelsheikh University, Kafr El Sheikh, Egypt
| | - Khaled A Abdel-Ghaffar
- Department of Periodontology, Faculty of Dental Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed A Al-Shahat
- Department of Periodontology, Faculty of Dental Medicine, Delta University for science and technology, Cairo, Egypt
| | - Ahmed Abdel Aziz Hassan
- Department of Periodontology, Faculty of Dental Medicine, Ain Shams University, Cairo, Egypt
| | - Vincent J Iacono
- School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ahmed Y Gamal
- Department of Periodontology, Faculty of Oral and Dental Medicine, Nahda University, Benisweif, Egypt
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21
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Formulation of transdermal nanoemulsion gel drug delivery system of lovastatin and its in vivo characterization in glucocorticoid induced osteoporosis rat model. J Drug Deliv Sci Technol 2019. [DOI: 10.1016/j.jddst.2019.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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22
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Li X, Liu X, Ni S, Liu Y, Sun H, Lin Q. Enhanced osteogenic healing process of rat tooth sockets using a novel simvastatin-loaded injectable microsphere-hydrogel system. J Craniomaxillofac Surg 2019; 47:1147-1154. [DOI: 10.1016/j.jcms.2019.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/01/2019] [Accepted: 04/18/2019] [Indexed: 12/21/2022] Open
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23
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Kalani MM, Nourmohammadi J, Negahdari B, Rahimi A, Sell SA. Electrospun core-sheath poly(vinyl alcohol)/silk fibroin nanofibers with Rosuvastatin release functionality for enhancing osteogenesis of human adipose-derived stem cells. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 99:129-139. [DOI: 10.1016/j.msec.2019.01.100] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 01/31/2023]
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Xue Y, Wu M, Liu Z, Song J, Luo S, Li H, Li Y, Jin L, Guan B, Lin M, Chen F, Jin C, Liu D, Li Y, Zhang X. In vitro and in vivo evaluation of chitosan scaffolds combined with simvastatin-loaded nanoparticles for guided bone regeneration. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:47. [PMID: 30980130 DOI: 10.1007/s10856-019-6249-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 04/03/2019] [Indexed: 06/09/2023]
Abstract
The objective of this study was to fabricate and characterize chitosan combined with different amounts of simvastatin-loaded nanoparticles and to investigate their potential for guided bone regeneration in vitro and in vivo. Different SIM-CSN formulations were combined into a chitosan scaffold (SIM-CSNs-S), and the morphology, simvastatin release profile, and effect on cell proliferation and differentiation were investigated. For in vivo experiments, ectopic osteogenesis and the critical-size cranial defect model in SD rats were chosen to evaluate bone regeneration potential. All three SIM-CSNs-S formulations had a porous structure and exhibited sustained simvastatin release. CSNs-S showed excellent degradation and biocompatibility characteristics. The 4 mg SIM-CSNs-S formulation stimulated higher BMSC ALP activity levels, demonstrated significantly earlier collagen enhancement, and led to faster bone regeneration than the other formulations. SIM-CSNs-S should have a significant effect on bone regeneration.
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Affiliation(s)
- Yan Xue
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Mingyao Wu
- LangFang Health Vocational College, South Siguang Road, 065001, Langfang, China
| | - Zongren Liu
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
- Department of Stomatology of Tianjin Medical University General Hospital, Binhai Hospital, No. 28, Hangu hospital road, Binhai new district, 300480, Tianjin, China
| | - Jinhua Song
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Shuyu Luo
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Hongjie Li
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Yuan Li
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Lichun Jin
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Binbin Guan
- Department of Stomatology of Tianjin Medical University General Hospital, No.154, FeiLong road, 300052, Tianjin, China
| | - Mingli Lin
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Fuyu Chen
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Chenxin Jin
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China
| | - Deping Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, 100730, Beijing, China.
| | - Yanqiu Li
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China.
| | - Xu Zhang
- School and Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, 300070, Tianjin, China.
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Gupta S, Del Fabbro M, Chang J. The impact of simvastatin intervention on the healing of bone, soft tissue, and TMJ cartilage in dentistry: a systematic review and meta-analysis. Int J Implant Dent 2019; 5:17. [PMID: 30963362 PMCID: PMC6453984 DOI: 10.1186/s40729-019-0168-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 02/19/2019] [Indexed: 11/10/2022] Open
Abstract
The review aimed at assessing the osteopromotive potential as well as soft tissue and temporomandibular joint (TMJ) cartilage healing properties of simvastatin by summarizing its efficacy on the current dental treatment of periodontal bone and soft tissue defects, and temporomandibular joint (TMJ) arthritis from the available animals and human studies. An electronic search was performed on MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) using a combination of keywords. A hand search was undertaken on seven oral surgery journals. No limitation of publication year in the English language was placed. Controlled randomized animal and human clinical trials, as well as prospective comparative studies, were included. Data on the comparison of topical/systemic simvastatin on bone healing in intrabony and furcation defects, extraction sockets, distraction osteogenesis, as well as soft tissue healing in mucogingival grafting procedures and cartilage protection in TMJ arthritis were extracted from all the eligible studies. Studies with a minimum of ten participants and follow up at least 6 months were included. Ten animal studies and six clinical studies were included in this study. All the animal studies included a minimum of eight sites per group assessed clinically, histologically, and radiographically. All human studies included clinical and radiological evaluation. The results of the review show that simvastatin administration displays positive treatment outcomes in the full range of therapies investigated in the oral regions such as periodontal infection control, periodontal and alveolar bone regeneration, soft tissue grafting, TMJ inflammation reduction, and cartilage repair. Its mechanism includes stimulating bone formation, promoting soft tissue healing, increasing articular and condylar cartilage thickness, as well as reducing inflammation at surgical sites in TMJ disorders. Simvastatin administration is beneficial to the healing of oral bone and cartilage. More studies are desired to determine its potential in soft tissue healing.
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Affiliation(s)
- Swati Gupta
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - Jia Chang
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA.
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Alhamdi JR, Peng T, Al-Naggar IM, Hawley KL, Spiller KL, Kuhn LT. Controlled M1-to-M2 transition of aged macrophages by calcium phosphate coatings. Biomaterials 2019; 196:90-99. [PMID: 30075952 PMCID: PMC6336526 DOI: 10.1016/j.biomaterials.2018.07.012] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/07/2018] [Accepted: 07/08/2018] [Indexed: 12/11/2022]
Abstract
Older adults suffer from weakened and delayed bone healing due to age-related alterations in bone cells and in the immune system. Given the interaction between the immune system and skeletal cells, therapies that address deficiencies in both the skeletal and the immune system are required to effectively treat bone injuries of older patients. The sequence of macrophage activation observed in healthy tissue repair involves a transition from a pro-inflammatory state followed by a pro-reparative state. In older patients, inflammation is slower to resolve and impedes healing. The goal of this study was to design a novel drug delivery system for temporal guidance of the polarization of macrophages using bone grafting materials. A biomimetic calcium phosphate coating (bCaP) physically and temporally separated the pro-inflammatory stimulus interferon-gamma (IFNγ) from the pro-reparative stimulus simvastatin (SIMV). Effective doses were identified using a human monocyte line (THP-1) and testing culminated with bone marrow macrophages obtained from old mice. Sequential M1-to-M2 activation was achieved with both cell types. These results suggest that this novel immunomodulatory drug delivery system holds potential for controlling macrophage activation in bones of older patients.
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Affiliation(s)
- Jumana R Alhamdi
- Biomedical Engineering, University of Connecticut (UConn) Health, Farmington, CT, USA
| | - Tao Peng
- Biomedical Engineering, University of Connecticut (UConn) Health, Farmington, CT, USA
| | - Iman M Al-Naggar
- Center on Aging, University of Connecticut (UConn) Health, Farmington, CT, USA
| | - Kelly L Hawley
- Department of Pediatrics, University of Connecticut (UConn) Health, Farmington, CT, USA; Division of Infectious Diseases, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Kara L Spiller
- School of Biomedical Engineering, Science and Health Systems, Drexel University, PA, USA
| | - Liisa T Kuhn
- Biomedical Engineering, University of Connecticut (UConn) Health, Farmington, CT, USA.
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Contribution of Statins towards Periodontal Treatment: A Review. Mediators Inflamm 2019; 2019:6367402. [PMID: 30936777 PMCID: PMC6415285 DOI: 10.1155/2019/6367402] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 12/23/2018] [Indexed: 01/09/2023] Open
Abstract
The pleiotropic effects of statins have been evaluated to assess their potential benefit in the treatment of various inflammatory and immune-mediated diseases including periodontitis. Herein, the adjunctive use of statins in periodontal therapy in vitro, in vivo, and in clinical trials was reviewed. Statins act through several pathways to modulate inflammation, immune response, bone metabolism, and bacterial clearance. They control periodontal inflammation through inhibition of proinflammatory cytokines and promotion of anti-inflammatory and/or proresolution molecule release, mainly, through the ERK, MAPK, PI3-Akt, and NF-κB pathways. Moreover, they are able to modulate the host response activated by bacterial challenge, to prevent inflammation-mediated bone resorption and to promote bone formation. Furthermore, they reduce bacterial growth, disrupt bacterial membrane stability, and increase bacterial clearance, thus averting the exacerbation of infection. Local statin delivery as adjunct to both nonsurgical and surgical periodontal therapies results in better periodontal treatment outcomes compared to systemic delivery. Moreover, combination of statin therapy with other regenerative agents improves periodontal healing response. Therefore, statins could be proposed as a potential adjuvant to periodontal therapy. However, optimization of the combination of their dose, type, and carrier could be instrumental in achieving the best treatment response.
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Leite ML, Soares DG, de Oliveira Duque CC, Bordini EAF, Anovazzi G, Basso FG, Spolidorio DMP, Hebling J, de Souza Costa CA. Positive influence of simvastatin used as adjuvant agent for cavity lining. Clin Oral Investig 2018; 23:3457-3469. [DOI: 10.1007/s00784-018-2757-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/22/2018] [Indexed: 11/29/2022]
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Raafat SN, Amin RM, Elmazar MM, Khattab MM, El-Khatib AS. The sole and combined effect of simvastatin and platelet rich fibrin as a filling material in induced bone defect in tibia of albino rats. Bone 2018; 117:60-69. [PMID: 30208342 DOI: 10.1016/j.bone.2018.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/30/2022]
Abstract
Statins like simvastatin (SIM) have demonstrated to have pleiotropic actions other than their conventional use as antilipidemic drugs. Also, nowadays natural scaffolds like platelets rich fibrin (PRF) showed promising results on bone regeneration. Aim This study compare the regenerative power of SIM and PRF added locally each as a sole filling material on induced bone defect and evaluate the combined effect using PRF loaded with SIM. MATERIALS AND METHODS: A critical size bone defect was induced in 48 male albino rats of average weight 150-200 g and were divided into 4 groups according to the filling material. Control, PRF, SIM, and SIM/PRF group. Each group was subdivided according to the sacrificing period into two subgroups (one and two-months postoperatively). Tibial specimens were evaluated histologically using masson trichrome (MT) special stain to detect areas of new bone formation, immunohistochemically using anti- BMP2 and anti-VEGF, serum levels of Osteoprotegerin (OPG), RANKL, osteocalcin and alkaline phosphatase enzyme (ALP) were measured one and two months postoperatively using ELISA, Finally bone mineral density (BMD) at the bone defect area was analyzed using digital X-ray one and two-months postoperatively. RESULTS: The percentage of newly formed bone increased significantly in the three groups vs the control group with the highest significant increase (p < 0.001) in the SIM/PRF group one month postoperatively. Also, SIM/PRF group was the only group which showed significant bone maturation two-months postoperatively compared to the other groups. Immunohistochemical analysis showed significant increase in positively stained BMP-2 and VEGF expression (p < 0.001) in the three groups vs the control group with the highest significant increase (p < 0.001) in the SIM/PRF group. Serum bone anabolic markers increased significantly in the SIM and SIM/PRF groups. In contrast, RANKL serum level decreased significantly in the SIM and SIM/PRF group one month postoperatively with no significant decrease in the PRF group vs the control group. Digital X-ray results revealed the highest BMD percent change was found in the SIM/PRF group and showed complete bone healing two-months postoperatively.
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Affiliation(s)
- Shereen N Raafat
- Department of Pharmacology and Toxicology, Faculty of Dentistry, The British University in Egypt (BUE), Egypt.
| | - Reham M Amin
- Department of Oral Biology, Faculty of Dentistry, The British University in Egypt (BUE), Egypt
| | - M M Elmazar
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, The British University in Egypt (BUE), Egypt
| | - Mahmoud M Khattab
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Egypt
| | - Aiman S El-Khatib
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Egypt
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Lai M, Yan X, Jin Z. The response of bone cells to titanium surfaces modified by simvastatin-loaded multilayered films. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2018; 29:1895-1908. [PMID: 30156968 DOI: 10.1080/09205063.2018.1517483] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this study was to enhance cytocompatibility of titanium substrates by loading a multilayer film of chitosan (Chi), gelatin (Gel) and simvastatin (SV). This was fabricated using a spin-assisted layer-by-layer (LBL) technique. The surface properties of the different substrates were characterized by field emission scanning electron microscopy (FE-SEM), atomic force microscope (AFM), X-ray photoelectron spectroscopy (XPS) and contact angle measurement, respectively. Simvastatin release in vitro was measured by ultraviolet-visible spectrophotometer. A well morphology with filopodia extensions was observed in mesenchymal stem cells (MSCs) grown on simvastatin loaded multilayered films-modified titanium substrates. After 7, 14 and 21 days of culture, the simvastatin loaded multilayered films increased cell proliferation, improved osteoblastic differentiation of alkaline phosphatase (ALP) and mineralization. Additionally, osteoclast diffentiation marker tartrate-resistant acid phosphatase (TRAP) was decreased in simvastatin loaded multilayered films. This study provides a new insight for the fabrication of titanium-based implants to enhance osseointegration especially for osteoporosis patients in orthopedic application.
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Affiliation(s)
- Min Lai
- a School of Life Science , Jiangsu Normal University , Xuzhou , Jiangsu , China
| | - Xufeng Yan
- a School of Life Science , Jiangsu Normal University , Xuzhou , Jiangsu , China
| | - Ziyang Jin
- a School of Life Science , Jiangsu Normal University , Xuzhou , Jiangsu , China
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Ferracini R, Martínez Herreros I, Russo A, Casalini T, Rossi F, Perale G. Scaffolds as Structural Tools for Bone-Targeted Drug Delivery. Pharmaceutics 2018; 10:pharmaceutics10030122. [PMID: 30096765 PMCID: PMC6161191 DOI: 10.3390/pharmaceutics10030122] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 12/19/2022] Open
Abstract
Although bone has a high potential to regenerate itself after damage and injury, the efficacious repair of large bone defects resulting from resection, trauma or non-union fractures still requires the implantation of bone grafts. Materials science, in conjunction with biotechnology, can satisfy these needs by developing artificial bones, synthetic substitutes and organ implants. In particular, recent advances in materials science have provided several innovations, underlying the increasing importance of biomaterials in this field. To address the increasing need for improved bone substitutes, tissue engineering seeks to create synthetic, three-dimensional scaffolds made from organic or inorganic materials, incorporating drugs and growth factors, to induce new bone tissue formation. This review emphasizes recent progress in materials science that allows reliable scaffolds to be synthesized for targeted drug delivery in bone regeneration, also with respect to past directions no longer considered promising. A general overview concerning modeling approaches suitable for the discussed systems is also provided.
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Affiliation(s)
- Riccardo Ferracini
- Department of Surgical Sciences, Orthopaedic Clinic-IRCCS A.O.U. San Martino, 16132 Genova, Italy.
| | - Isabel Martínez Herreros
- Department of Surgical Sciences, Orthopaedic Clinic-IRCCS A.O.U. San Martino, 16132 Genova, Italy.
| | - Antonio Russo
- Department of Surgical Sciences, Orthopaedic Clinic-IRCCS A.O.U. San Martino, 16132 Genova, Italy.
| | - Tommaso Casalini
- Department of Chemistry and Applied Biosciences, Institute for Chemical and Bioengineering, ETH Zurich, Vladimir-Prelog-Weg 1, 8093 Zurich, Switzerland.
- Biomaterials Laboratory, Institute for Mechanical Engineering and Materials Technology, University of Applied Sciences and Arts of Southern Switzerland, Via Cantonale 2C, Galleria, 26928 Manno, Switzerland.
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, via Mancinelli 7, 20131 Milano, Italy.
| | - Giuseppe Perale
- Department of Surgical Sciences, Orthopaedic Clinic-IRCCS A.O.U. San Martino, 16132 Genova, Italy.
- Biomaterials Laboratory, Institute for Mechanical Engineering and Materials Technology, University of Applied Sciences and Arts of Southern Switzerland, Via Cantonale 2C, Galleria, 26928 Manno, Switzerland.
- Industrie Biomediche Insubri SA, Via Cantonale 67, 6805 Mezzovico-Vira, Switzerland.
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Wang X, Jia Z, Almoshari Y, Lele SM, Reinhardt RA, Wang D. Local Application of Pyrophosphorylated Simvastatin Prevents Experimental Periodontitis. Pharm Res 2018; 35:164. [PMID: 29943090 PMCID: PMC7424626 DOI: 10.1007/s11095-018-2444-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/08/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Simvastatin (SIM), a HMG-CoA reductase inhibitor widely prescribed for hypercholesterolemia, has been reported to ameliorate inflammation and promote osteogenesis. Its clinical applications on these potential secondary indications, however, have been hampered by its lack of osteotropicity and poor water solubility. To address this challenge, we propose to design and evaluate the therapeutic efficacy of a novel simvastatin prodrug with better water solubility and bone affinity. METHOD The prodrug (SIM-PPi) was synthesized by directly conjugating a SIM trimer to a pyrophosphate (PPi). It was characterized and evaluated in vitro for its water solubility, osteotropicity, toxicity, anti-inflammatory and osteoinductive properties. It was then tested for anti-inflammatory and osteoinductive properties in vivo by three weekly injections into gingiva of a ligature-induced experimental periodontitis rat model. RESULTS In vitro studies showed that SIM-PPi has greatly improved water-solubility of SIM and shows strong binding to hydroxyapatite (HA). In macrophage culture, SIM-PPi inhibited LPS-induced pro-inflammatory cytokines (IL-1β, IL-6). In osteoblast culture, it was found to significantly increase alkaline phosphatase (ALP) activity with accelerated mineral deposition, confirming the osteogenic potential of SIM-PPi. When tested in vivo on an experimental periodontal bone-loss model, SIM-PPi exhibited a superior prophylactic effect compared to dose equivalent SIM in reducing inflammatory cells and in preserving alveolar bone structure, as shown in the histological and micro-CT data. CONCLUSION SIM-PPi may have the potential to be further developed for better clinical management of bone loss associated with periodontitis.
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Affiliation(s)
- Xiaobei Wang
- The Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska, 68198-6125, USA
| | - Zhenshan Jia
- The Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska, 68198-6125, USA
| | - Yosif Almoshari
- The Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska, 68198-6125, USA
- The Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
| | - Subodh M Lele
- The Department of Pathology & Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, 6819-3135, USA
| | - Richard A Reinhardt
- The Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, Lincoln, Nebraska, 68583-0740, USA
| | - Dong Wang
- The Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska, 68198-6125, USA.
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Meza-Mauricio J, Soto-Peñaloza D, Peñarrocha-Oltra D, Montiel-Company JM, Peruzzo DC. Locally applied statins as adjuvants to non-surgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis. Clin Oral Investig 2018; 22:2413-2430. [DOI: 10.1007/s00784-018-2507-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 05/30/2018] [Indexed: 12/22/2022]
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Degala S, Bathija NA. Evaluation of the Efficacy of Simvastatin in Bone Regeneration after Surgical Removal of Bilaterally Impacted Third Molars-A Split-Mouth Randomized Clinical Trial. J Oral Maxillofac Surg 2018; 76:1847-1858. [PMID: 29859160 DOI: 10.1016/j.joms.2018.04.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE Simvastatin has been reported to promote osteoblastic activity, inhibit osteoclastic activity, and support osteoblast differentiation induced by bone morphogenetic protein. This split-mouth randomized clinical trial evaluated the effect of local application of simvastatin (10 mg) on bone regeneration after surgical removal of bilaterally impacted mandibular third molars. MATERIALS AND METHODS A randomized, split-mouth, single-blinded, single-center trial was performed in 30 patients 18 to 40 years old requiring surgical extraction of bilaterally impacted mandibular third molars. These patients underwent 2 surgical sessions, with extraction of 1 third molar during each session. Each participant was randomly assigned to receive Gelfoam soaked with normal saline or with the drug simvastatin (10 mg) at the first session and were blinded to the use of drug for that particular socket. The alternate regimen was used during the second session. The study was conducted over a period of 3 months. Patients were evaluated for pain, postoperative swelling, and bone density measurement and analysis using intraoral periapical radiographs at the end of 1, 4, 8 and 12 weeks, respectively. In addition, cone-beam computed tomographic (CBCT) images were obtained for every fifth patient at the end of 12 weeks. RESULTS Mean gray-level histographic values were significantly higher for the study sockets at the end of 1, 4, 8, and 12 weeks (P = .001) compared with the control sockets (30 sockets each). CBCT analysis further substantiated accelerated bone regeneration in the study sockets. CONCLUSION The study was statistically and radiographically in favor of the drug, indicating that local application of simvastatin could be a cost-effective and simple way to stimulate and hasten osseous regeneration.
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Affiliation(s)
- Saikrishna Degala
- Professor and Head of Department, Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital (Constituent College), Jagadguru Sri Shivarathreeshwara University, Mysuru, Karnataka, India.
| | - Nikita A Bathija
- Postgraduate Student, Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital (Constituent College), Jagadguru Sri Shivarathreeshwara University, Mysuru, Karnataka, India
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Wang Y, Newman MR, Benoit DSW. Development of controlled drug delivery systems for bone fracture-targeted therapeutic delivery: A review. Eur J Pharm Biopharm 2018; 127:223-236. [PMID: 29471078 DOI: 10.1016/j.ejpb.2018.02.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/17/2018] [Accepted: 02/17/2018] [Indexed: 01/09/2023]
Abstract
Impaired fracture healing is a major clinical problem that can lead to patient disability, prolonged hospitalization, and significant financial burden. Although the majority of fractures heal using standard clinical practices, approximately 10% suffer from delayed unions or non-unions. A wide range of factors contribute to the risk for nonunions including internal factors, such as patient age, gender, and comorbidities, and external factors, such as the location and extent of injury. Current clinical approaches to treat nonunions include bone grafts and low-intensity pulsed ultrasound (LIPUS), which realizes clinical success only to select patients due to limitations including donor morbidities (grafts) and necessity of fracture reduction (LIPUS), respectively. To date, therapeutic approaches for bone regeneration rely heavily on protein-based growth factors such as INFUSE, an FDA-approved scaffold for delivery of bone morphogenetic protein 2 (BMP-2). Small molecule modulators and RNAi therapeutics are under development to circumvent challenges associated with traditional growth factors. While preclinical studies has shown promise, drug delivery has become a major hurdle stalling clinical translation. Therefore, this review overviews current therapies employed to stimulate fracture healing pre-clinically and clinically, including a focus on drug delivery systems for growth factors, parathyroid hormone (PTH), small molecules, and RNAi therapeutics, as well as recent advances and future promise of fracture-targeted drug delivery.
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Affiliation(s)
- Yuchen Wang
- Department of Biomedical Engineering, 308 Robert B. Goergen Hall, University of Rochester, Rochester, NY 14627, USA; Center for Musculoskeletal Research, 601 Elmwood Ave, University of Rochester Medical Center, Rochester, NY 14642, USA.
| | - Maureen R Newman
- Department of Biomedical Engineering, 308 Robert B. Goergen Hall, University of Rochester, Rochester, NY 14627, USA; Center for Musculoskeletal Research, 601 Elmwood Ave, University of Rochester Medical Center, Rochester, NY 14642, USA.
| | - Danielle S W Benoit
- Department of Biomedical Engineering, 308 Robert B. Goergen Hall, University of Rochester, Rochester, NY 14627, USA; Center for Musculoskeletal Research, 601 Elmwood Ave, University of Rochester Medical Center, Rochester, NY 14642, USA; Department of Chemical Engineering, 4517 Wegmans Hall, University of Rochester, Rochester, NY 14627, USA; Department of Orthopaedics, 601 Elmwood Ave, University of Rochester, Rochester, NY 14642, USA; Department of Biomedical Genetics, 601 Elmwood Ave, University of Rochester, Rochester, NY 14642, USA; Center for Oral Biology, 601 Elmwood Ave, University of Rochester Medical Center, Rochester, NY 14642, USA.
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Gouda A, Helal E, Ali S, Bakry S, Yassin S. Maxillary sinus lift using osteoinductive simvastatin combined with β-TCP versus β-TCP - a comparative pilot study to evaluate simvastatin enhanced and accelerated bone formation. Acta Odontol Scand 2018; 76:39-47. [PMID: 28952824 DOI: 10.1080/00016357.2017.1381345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study was to evaluate available bone quality and quantity after performing sinus augmentation using simvastatin/β-TCP combination versus β-TCP alone. MATERIALS AND METHODS This study included eight sinus lift procedures conducted on six patients. The sinuses were divided into two equal groups. The patients were recalled one, two weeks two, five, nine months post-operatively for post-operative evaluation. Radiographic evaluation involved cone beam computed tomography (CBCT) radiographs taken for every patient one week and nine months post-operatively to evaluate the changes in bone height, while histomorphometric evaluation involved transcortical bone biopsies taken after nine months during the second-stage surgery for implant placement. RESULTS The histomorphometric results showed that the amount of newly formed bone was higher in the simvastatin group when compared to the β-TCP group nine months after the surgery; the difference between the two groups was statistically significant. On the other hand, the radiographic evaluation showed that the rate of resorption of the simvastatin group was found to be higher than the control group; however, the difference between both groups was statistically insignificant. CONCLUSION These results showed that Simvastatin is safe to be used in sinus lift with promising osteoinductive capacity, yet further studies using larger sample size is needed.
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Affiliation(s)
- Ayman Gouda
- Oral and Maxillofacial Surgery Department, Cairo University, Cairo, Egypt
| | - Eman Helal
- Fixed and Removable Prosthodontics Department, National Research Center, Cairo, Egypt
| | - Sherif Ali
- Oral and Maxillofacial Surgery Department, Cairo University, Cairo, Egypt
| | - Saleh Bakry
- Oral and Maxillofacial Surgery Department, Cairo University, Cairo, Egypt
| | - Salah Yassin
- Oral and Maxillofacial Surgery Department, Cairo University, Cairo, Egypt
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Ghadri N, Anderson KM, Adatrow P, Stein SH, Su H, Garcia-Godoy F, Karydis A, Bumgardner JD. Evaluation of Bone Regeneration of Simvastatin Loaded Chitosan Nanofiber Membranes in Rodent Calvarial Defects. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/jbnb.2018.92012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Burdurlu C, Deniz E, Olgac V. Histopathologic evaluation of the effects of local simvastatin application and photobiomodulation by light-emitting diode on bone healing of rat calvarial defects. BIOTECHNOL BIOTEC EQ 2017. [DOI: 10.1080/13102818.2017.1416673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Cagri Burdurlu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Ediz Deniz
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Vakur Olgac
- Department of Pathology, Faculty of Medicine, Oncology Institute, Istanbul University, Istanbul, Turkey
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Hao J, Chou J, Kuroda S, Otsuka M, Kasugai S, Lang NP. Injectable simvastatin gel for minimally invasive periosteal distraction: In vitro and in vivo studies in rat. Clin Oral Implants Res 2017; 29:227-234. [PMID: 29250831 DOI: 10.1111/clr.13105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate whether the subperiosteal injection of simvastatin (SIM) with a novel in situ gel-forming system, SrHA/Alg (strontium hydroxyapatite/alginate), can stimulate vertical bone augmentation in a rat calvarial model. MATERIAL AND METHODS The SrHA/Alg solution was synthesized and combined with different doses of SIM (0.01, 0.02, 0.1, and 0.2 mg) to form the following groups: (1) SrHA/Alg only, (2) SrHA/Alg/0.01, (3) SrHA/Alg/0.02, (4) SrHA/Alg/0.1, and (5) SrHA/Alg/0.2. The SIM release pattern was analyzed, and rat primary periosteum-derived cell (PDC) responses were investigated. Twenty male Wistar rats were enrolled in the calvarial subperiosteal injection experiment with each animal receiving a 200-μl single subperiosteal injection of SrHA/Alg with different amounts of SIM (0, 0.01, 0.02, and 0.1 mg) incorporated (n = 5). The 0.2 mg dose group was not tested in vivo due to the severe toxicity found in vitro. The new bone formation was assessed histologically and radiologically at 8 weeks. RESULTS The slow release of SIM was confirmed, and PDC viability decreased in the SrHA/Alg/0.2 group. Alkaline phosphatase positive areas and mineralization areas were significantly greater in the SrHA/Alg/0.01 and SrHA/Alg/0.02 groups (p < .05). The mRNA expression level of Runx2 significantly increased in the SrHA/Alg/SIM-0.02 group by day 7 (p < .05) and significantly higher levels of VEGF were found in the SrHA/Alg/0.01 and SrHA/Alg/0.02 groups at different time points (p < .05). In vivo, no prominent clinical sign of inflammation was observed, and the most significant bone gain was shown in the SrHA/Alg/0.02 group (p < .05). The osteoclast formation within the newly formed bone area was reduced in the SrHA/Alg/0.1 group (p < .05). CONCLUSIONS When combined with SrHA/Alg system, the 0.02 mg SIM seemed to be the optimal dose to stimulate subperiosteal bone formation without inducing inflammation. This combination may hold potential therapeutic benefits for clinical bone augmentation in a minimally invasive manner.
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Affiliation(s)
- Jia Hao
- Department of Oral Implantology and Regenerative Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Joshua Chou
- Division of Bone and Mineral Research, Harvard School of Dental Medicine, Boston, MA, USA.,Advanced Tissue Regeneration and Drug Delivery Group, University of Technology Sydney, Ultimo, NSW, Australia
| | - Shinji Kuroda
- Department of Oral Implantology and Regenerative Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Makoto Otsuka
- Research Institute of Pharmaceutical Science, Faculty of Pharmacy, Musashino University, Tokyo, Japan
| | - Shohei Kasugai
- Department of Oral Implantology and Regenerative Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Niklaus P Lang
- Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Leite MLDAES, Soares DG, Basso FG, Hebling J, Costa CADS. Biostimulatory effects of simvastatin on MDPC-23 odontoblast-like cells. Braz Oral Res 2017; 31:e104. [DOI: 10.1590/1807-3107bor-2017.vol31.0104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 11/10/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | - Josimeri Hebling
- Universidade Estadual Paulista “Júlio de Mesquita Filho” – Unesp, Brazil
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Ridge Preservation After Maxillary Third Molar Extraction Using 30% Porosity PLGA/HA/β-TCP Scaffolds With and Without Simvastatin. IMPLANT DENT 2017; 26:832-840. [DOI: 10.1097/id.0000000000000655] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Moshiri A, Sharifi AM, Oryan A. Role of Simvastatin on fracture healing and osteoporosis: a systematic review on in vivo investigations. Clin Exp Pharmacol Physiol 2017; 43:659-84. [PMID: 27061579 DOI: 10.1111/1440-1681.12577] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 04/04/2016] [Accepted: 04/05/2016] [Indexed: 01/15/2023]
Abstract
Simvastatin is a lipid lowering drug whose beneficial role on bone metabolism was discovered in 1999. Several in vivo studies evaluated its role on osteoporosis and fracture healing, however, controversial results are seen in the literature. For this reason, Simvastatin has not been the focus of any clinical trials as yet. This systematic review clears the mechanisms of action of Simvastatin on bone metabolism and focuses on in vivo investigations that have evaluated its role on osteoporosis and fracture repair to find out (i) whether Simvastatin is effective on treatment of osteoporosis and fracture repair, and (ii) which of the many available protocols may have the ability to be translated in the clinical setting. Simvastatin induces osteoinduction by increasing osteoblast activity and differentiation and inhibiting their apoptosis. It also reduces osteoclastogenesis by decreasing both the number and activity of osteoclasts and their differentiation. Controversial results between the in vivo studies are mostly due to the differences in the route of administration, dose, dosage and carrier type. Local delivery of Simvastatin through controlled drug delivery systems with much lower doses and dosages than the systemic route seems to be the most valuable option in fracture healing. However, systemic delivery of Simvastatin with much higher doses and dosages than the clinical ones seems to be effective in managing osteoporosis. Simvastatin, in a particular range of doses and dosages, may be beneficial in managing osteoporosis and fracture injuries. This review showed that Simvastatin is effective in the treatment of osteoporosis and fracture healing.
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Affiliation(s)
- Ali Moshiri
- RAZI Drug Research Centre, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammad Sharifi
- RAZI Drug Research Centre, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Tissue Engineering Group, Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ahmad Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz, Iran
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Ishihara T, Miyazaki M, Notani N, Kanezaki S, Kawano M, Tsumura H. Locally Applied Simvastatin Promotes Bone Formation in a Rat Model of Spinal Fusion. J Orthop Res 2017; 35:1942-1948. [PMID: 27862237 DOI: 10.1002/jor.23479] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/07/2016] [Indexed: 02/04/2023]
Abstract
Simvastatin, an inexpensive lipid-lowering drug widely used to prevent cardiovascular disorders, is known to increase osteoblastic activity, inhibit osteoclastic activity, and stimulate osteoblastic production of bone morphogenetic protein 2. Furthermore, local simvastatin application increased bone formation in animal models of fracture or bone defects. We investigated the effect of locally applied simvastatin in a rat model of spinal fusion. We performed posterolateral lumbar fusion surgery with iliac crest autograft in 36 rats divided into group I (n = 17; implanted with a gelatin scaffold) and group II (n = 19; implanted with a gelatin scaffold infused with 0.5 mg simvastatin). The rats were euthanized at 6 or 12 weeks postoperatively, and the spines were explanted and assessed. The fusion rates in group II (16.7%: 6 weeks, 30%: 12 weeks) were considerably higher than those in groups I (0%: 6 weeks, 0%: 12 weeks). The 6- and 12-week radiographic scores were significantly higher in group II than in group I. High-resolution micro-computerized tomography revealed that the tissue and bone volumes of the callus tended to be higher in group II than in group I. Histologic analysis of the spines explanted after 12 weeks demonstrated new bone formation between the transverse processes in group II, but thicker and wider individual trabeculae with fibrotic tissue and muscle fiber between the transverse processes in group I. Locally applied simvastatin was efficacious in accelerating bone formation in our rat model of spinal fusion, supporting its potential clinical application as a promoter of bone morphogenesis in spinal fusion. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1942-1948, 2017.
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Affiliation(s)
- Toshinobu Ishihara
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| | - Masashi Miyazaki
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| | - Naoki Notani
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| | - Shozo Kanezaki
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| | - Masanori Kawano
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
| | - Hiroshi Tsumura
- Faculty of Medicine, Department of Orthopaedic Surgery, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
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Zhao W, Jin K, Li J, Qiu X, Li S. Delivery of stromal cell-derived factor 1α for in situ tissue regeneration. J Biol Eng 2017; 11:22. [PMID: 28670340 PMCID: PMC5492719 DOI: 10.1186/s13036-017-0058-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/29/2017] [Indexed: 02/06/2023] Open
Abstract
In situ tissue regeneration approach aims to exploit the body's own biological resources and reparative capability and recruit host cells by utilizing cell-instructive biomaterials. In order to immobilize and release bioactive factors in biomaterials, it is important to engineer the load effectiveness, release kinetics and cell recruiting capabilities of bioactive molecules by using suitable bonding strategies. Stromal cell-derived factor 1α (SDF-1α) is one of the most potent chemokines for stem cell recruitment, and SDF-1α-loaded scaffolds have been used for the regeneration of many types of tissues. This review summarizes the strategies to incorporate SDF-1α into scaffolds, including direct loading or adsorption, polyion complexes, specific heparin-mediated interaction and particulate system, which may be applied to the immobilization of other chemokines or growth factors. In addition, we discuss the application of these strategies in the regeneration of tissues such as blood vessel, myocardium, cartilage and bone.
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Affiliation(s)
- Wen Zhao
- Key Laboratory for Space Biosciences and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi 710072 China
| | - Kaixiang Jin
- Key Laboratory for Space Biosciences and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi 710072 China
| | - Jiaojiao Li
- Key Laboratory for Space Biosciences and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi 710072 China
| | - Xuefeng Qiu
- Department of Bioengineering and Department of Medicine, University of California, Los Angeles, CA 90095 USA
| | - Song Li
- Department of Bioengineering and Department of Medicine, University of California, Los Angeles, CA 90095 USA
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Gunjiganur Vemanaradhya G, Emani S, Mehta DS, Bhandari S. Effect of 1.2% of simvastatin gel as a local drug delivery system on Gingival Crevicular Fluid interleukin-6 & interleukin-8 levels in non surgical treatment of chronic periodontitis patients. Arch Oral Biol 2017; 82:55-61. [PMID: 28601733 DOI: 10.1016/j.archoralbio.2017.05.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 05/29/2017] [Accepted: 05/30/2017] [Indexed: 11/16/2022]
Abstract
AIM The present study was carried out to evaluate the effect of 1.2% simvastatin gel as local drug delivery (LDD) system on Gingival Crevicular Fluid (GCF) Interleukin -6 (IL-6) and Interleukin-8 (IL-8) levels in chronic periodontitis patients, in addition to scaling and root planing (SRP). METHODS A total of 46 chronic periodontitis patients were equally divided into two groups. Group I patients were treated by SRP; Group II patients were treated by SRP followed by LDD of 1.2% simvastatin (SMV) gel. Plaque index (PI), Gingival index(GI), Sulcus Bleeding Index (SBI), Probing pocket depth (PPD) and Relative clinical attachment level (CAL) were recorded & GCF samples were collected at baseline (0day) and at 45th day from both the groups. The collected GCF samples were analysed for IL-6 and IL-8 levels with enzyme-linked immunosorbent assay (ELISA). RESULTS Both the groups showed significant reduction in all the clinical parameters scores and IL-6 and IL-8 levels after non-surgical periodontal therapy (SRP for group I/SRP+1.2% SMV gel for group II) in contrast to baseline values. However, a greater reduction was observed in group II. A non-significant positive correlation was observed between clinical parameters and IL-6 and IL-8 levels except at baseline, a significant correlation was observed between PPD &IL 6 levels in group II. CONCLUSIONS In adjunct to SRP, 1.2% Simvastatin gel acts as an effective local drug delivery agent for the management of chronic periodontitis.
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Affiliation(s)
| | - Shilpa Emani
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, 577004, Karnataka, India.
| | - Dhoom Singh Mehta
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, 577004, Karnataka, India.
| | - Shilpy Bhandari
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, 577004, Karnataka, India.
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Ranjan R, Patil SR, H R V. Effect of in-situ application of simvastatin gel in surgical management of osseous defects in chronic periodontitis-A randomized clinical trial. J Oral Biol Craniofac Res 2017; 7:113-118. [PMID: 28706785 DOI: 10.1016/j.jobcr.2017.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/16/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The present randomized controlled clinical study was designed to investigate the effect of in situ application of 1.2 mg Simvastatin (SV) gel in the surgical management of Intrabony defects in chronic periodontitis patients. METHODOLOGY 20 patients contributing 40 sites were categorized into two treatment groups: Open flap debridement plus 1.2 mg SV gel (Group 1) and Open flap debridement plus Placebo gel (Group 2). Gingival index (GI), Plaque index (PI), Pocket depth (PD) and clinical attachment level (CAL) were recorded at baseline, 3 months, 6 months and 9 months. At baseline and at the end of 6 and 9 months Radiographic evaluation of Intrabony defect fill was done using Image j software. RESULTS Significant reduction of GI, PD and gain in CAL was observed at the end of 9 months in both groups. Amount of bone fill and percentage of original defect fill in Group 1 was statistically highly significant than Group 2 at the end of 6 and 9 months. CONCLUSION Higher amount of decrease in GI and PD along with more amount of CAL gain was observed in treatment group than control group. Radiological assessment confirmed that significant intrabony defect fill and percentage fill of original defect in treatment group than controlled group.
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Affiliation(s)
- Rajeev Ranjan
- Department of Periodontics and Oral Implantology, Kalinga Institute of Dental Sciences, Campus 5, KIIT University, Patia, Bhubaneswar, Odisha, 751024, India
| | - Sudhir R Patil
- Department of Periodontics, K.L.E Society's Institute of Dental Sciences, Number 20, Tumkur Road, Yeshavanthpur Suburbs, suburb Bangalore, 560022, India
| | - Veena H R
- Department of Periodontics, K.L.E Society's Institute of Dental Sciences, Number 20, Tumkur Road, Yeshavanthpur Suburbs, suburb Bangalore, 560022, India
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Willett ES, Liu J, Berke M, Giannini PJ, Schmid M, Jia Z, Wang X, Wang X, Samson K, Yu F, Wang D, Nawshad A, Reinhardt RA. Standardized Rat Model Testing Effects of Inflammation and Grafting on Extraction Healing. J Periodontol 2017; 88:799-807. [PMID: 28440741 DOI: 10.1902/jop.2017.160771] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Loss of alveolar ridge width and height after tooth extraction is well documented, but models to evaluate ridge preservation are neither standardized nor cost-effective. This rat model characterizes the pattern of bone turnover and inflammation after extraction and bone grafting with or without local simvastatin (SIM). METHODS Fifty retired-breeder rats underwent extraction of the maxillary right first molar and standard surgical defect creation under inhalation/local anesthesia. The left side of each animal served as unmanipulated control. Untreated groups (n = 8 to 9 per group) were compared (analysis of variance, t test) at days 0, 7, 14, and 28 for alveolar ridge height and width and for markers of inflammation and bone turnover by microcomputed tomography, histology, and enzyme-linked immunosorbent assay. Seventeen additional specimens had defects grafted with either bone mineralized matrix (BMM) or a BMM+SIM conjugate. RESULTS Extraction-induced bone loss (BL) was noted on buccal, palatal, and interproximal height (P <0.05) and ridge width (P <0.01). Week 1 inflammation positively correlated with ridge height; thereafter, a more intense inflammatory reaction corresponded to reduction in alveolar bone height and density (r = 0.74; P <0.05; Spearman). BMM+SIM preserved the most interproximal bone height (P <0.01), increased ridge width and bone density (P <0.01), enhanced 7-day prostaglandin E2 (P <0.01), and reduced 28-day inflammation density (P <0.05). CONCLUSIONS The standard defect used in the current study paralleled human postextraction alveolar BL. Defect grafting, especially BMM+SIM, reduced inflammation and preserved bone.
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Affiliation(s)
- Emily S Willett
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Jingpeng Liu
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Molly Berke
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Peter J Giannini
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Marian Schmid
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Zhenshan Jia
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE
| | - Xiaobei Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE
| | - Xiaoyan Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE
| | - Kaeli Samson
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Fang Yu
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Dong Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE
| | - Ali Nawshad
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Richard A Reinhardt
- Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center
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Santana WMD, Sousa DND, Ferreira VM, Duarte WR. Simvastatin and biphasic calcium phosphate affects bone formation in critical-sized rat calvarial defects. Acta Cir Bras 2017; 31:300-7. [PMID: 27275850 DOI: 10.1590/s0102-865020160050000002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 04/11/2016] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To investigate the effects of locally applied simvastatin plus biphasic calcium phosphate (BoneCeramic(r)) or collagen sponge on bone formation in critical-sized bone defects. METHODS Thirty defects of 5mm in diameter were created bilaterally with a trephine bur in the calvariae of fifteen Wistar rats. The defects were divided into five groups: group 1 - control, no treatment; group 2 (BoneCeramic(r)); group 3 (BoneCeramic(r) + 0.1mg simvastatin); group 4 (collagen sponge); and group 5 (collagen sponge + 0.1mg simvastatin). After eight weeks the animals were euthanized and their calvariae were histologically processed. Hematoxylin and eosin-stained sections were subjected to histological and histomorphometrical analyses. The area of newly formed bone was calculated and compared between groups. RESULTS The greater amount of a bone-like tissue was formed around the carrier in group 3 (BoneCeramic(r) + 0.1mg simvastatin) followed by group 2 (BoneCeramic(r)), and almost no bone was formed in the other groups. Group 3 was significantly different compared to group 2, and both groups were significantly different compared to the other groups. CONCLUSION Simvastatin combined with BoneCeramic(r) induced significantly greater amounts of newly formed bone and has great potential for the healing of bone defects.
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Affiliation(s)
- Washington Macedo de Santana
- Fellow PhD degree, Postgraduate Program in Health Sciences, School of Health Sciences, Campus Universitário Darcy Ribeiro, Universidade de Brasilia (UnB), Brasília-DF, Brazil. Technical procedures, acquisition and interpretation of data, manuscript writing., Universidade de Brasília, Universidade de Brasilia, Brasília DF , Brazil
| | - Dircilei Nascimento de Sousa
- Fellow PhD degree, Postgraduate Program in Health Sciences, School of Health Sciences, Campus Universitário Darcy Ribeiro, Universidade de Brasilia (UnB), Brasília-DF, Brazil. Technical procedures, acquisition and interpretation of data, manuscript writing., Universidade de Brasília, Universidade de Brasilia, Brasília DF , Brazil
| | - Vania Maria Ferreira
- PhD, Full Professor, School of Health Sciences, Department of Pharmaceutical Sciences, Campus Universitário Darcy Ribeiro, UnB, Brasília-DF, Brazil. Statistical analysis, English language, critical revision., Universidade de Brasília, School of Health Sciences, Department of Pharmaceutical Sciences, UnB, Brasília DF , Brazil
| | - Wagner Rodrigues Duarte
- PhD, Associate Professor, School of Health Sciences, Department of Dentistry, Campus Universitário Darcy Ribeiro, UnB, Brasília-DF, Brazil. Conception and design of the study, manuscript writing., Universidade de Brasília, Department of Dentistry, UnB, Brasília DF , Brazil
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S. Martande S, Kumari M, Pradeep AR, Pal Singh S, Kumar Suke D. Comparative evaluation of efficacy of subgingivally delivered 1.2% Atorvastatin and 1.2% Simvastatin in the treatment of intrabony defects in chronic periodontitis: a randomized controlled trial. J Dent Res Dent Clin Dent Prospects 2017; 11:18-25. [PMID: 28413591 PMCID: PMC5390121 DOI: 10.15171/joddd.2017.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 07/05/2016] [Indexed: 12/24/2022] Open
Abstract
Background. Statins are the recently evolved agents that aid in periodontal regeneration and ultimately in attaining periodontal health. Atorvastatin (ATV) and Simvastatin (SMV) are specific competitive inhibitors of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. The current study was conducted to compare the effectiveness of 1.2% ATV and 1.2% SMV, in addition to scaling and root planing (SRP), in the treatment of intrabony defects in subjects with chronic periodontitis. Methods. Ninety-six individuals were categorized into three treatment groups: SRP plus 1.2% ATV, SRP plus 1.2% SMV and SRP plus placebo. Clinical parameters of full-mouth plaque index (PI), modified sulcus bleeding index (mSBI), probing depth (PD), and relative attachment level (RAL) were recorded at baseline before SRP and at 3, 6 and 9 months. Bone fill was assessed using percentage radiographic defect depth reduction at baseline, 6 months and 9 months. Results. Both ATV and SMV showed significant PD reduction and RAL gain than placebo. ATV group showed greater mean PD reduction and mean RAL gain as compared to SMV group at 3, 6 and 9 months. Furthermore, ATV group sites exhibited a significantly greater percentage of radiographic defect depth reduction (33.23 ± 3.11%; 34.84 ± 3.07%) as compared to SMV (30.39 ± 3.36%; 32.15 ± 3.37%) at 6 and 9 months. Conclusion. ATV resulted in greater improvements in clinical parameters with higher percentage of radiographic defect depth reduction as compared to SMV in the treatment of intrabony defects in CP subjects.
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Affiliation(s)
- Santosh S. Martande
- Department of Periodontics, Dr. D.Y. Patil Dental College and Hospital, Pimpri, Pune, India
| | - Minal Kumari
- Department of Periodontics, Vydehi Institute of Dental Sciences and Research Centre, Bangalore, India
| | - A. R. Pradeep
- Department of Periodontics, Government Dental College & Research Institute, Bangalore, India
| | - Sonender Pal Singh
- Department of Periodontics, Government Dental College & Research Institute, Bangalore, India
| | - Deepak Kumar Suke
- Department of Periodontics, Government Dental College & Research Institute, Bangalore, India
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Analysis of Bone Repair and Inflammatory Process Caused by Simvastatin Combined With PLGA+HA+βTCP Scaffold. IMPLANT DENT 2017; 25:140-8. [PMID: 26606285 DOI: 10.1097/id.0000000000000359] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE This study evaluated the tissue and inflammatory responses to the use of simvastatin and poly(lactic-co-glycolic acid) + hydroxyapatite + β-tricalcium phosphate (PLGA+HA+βTCP) scaffold for bone repair. MATERIALS AND METHODS Two defects of 5 mm in diameter were made in the calvaria of rats, which were shared into the following 6 groups: naive, sham, vehicle, PLGA+HA+βTCP scaffold, simvastatin (4 mg/mL), and simvastatin with the scaffold. Tissue samples were collected at 1, 7, 15, 30, and 60 days after surgery. Inflammation was evaluated by interleukin-1 beta and tumor necrosis factor alpha quantification and by a hemogram, whereas bone repair was evaluated using densitometry and scanning electron microscopy. Data were statistically analyzed using ANOVA followed by post hoc tests (P < 0.05). RESULTS There was an increased cytokine expression in the scaffold and simvastatin groups (P < 0.001 and P < 0.05, respectively) 1 day after surgery but no alterations on the hemogram were observed. It was found on bone tissue samples that 60 days after surgery all groups presented similar densitometry values and morphology characteristics, despite the occurrence of bone formation delay in the simvastatin group (P < 0.01). CONCLUSION The use of simvastatin and PLGA+HA+βTCP scaffold, associated or not, did not lead to improvement in bone repair.
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