Regeneration of mandibular osteoradionecrosis with autologous cross-linked serum albumin scaffold

From Waste to Innovation: A Circular Economy Approach for Tissue Engineering by Transforming Human Bone Waste into Novel Collagen Membranes

The aim of the circular economy is to treat waste as a valuable raw material, reintegrating it into the industrial economy and extending the lifecycle of subsequent products. Efforts to reduce the production of hard-to-recycle waste are becoming increasingly important to manufacturers, not only of consumer goods but also of specialized items that are difficult to manufacture, such as medical supplies, which have now become a priority for the European Union. The purpose of the study is to manufacture a novel human-purified type I collagen membrane from bone remnants typically discarded during the processing of cortico-cancellous bones in tissue banks and to evaluate its mechanical properties and effectiveness in regenerating bone-critical mandibular defects in rabbits. To prepare the novel membrane, cortico-cancellous bone chip samples from a local tissue bank were processed to isolate collagen by demineralization under agitation in HCl, cast into a silicone mold, and air-dried at room temperature and UV irradiation. The average thickness of the four batches analyzed by SEM was 37.3 μm. The average value of Young's modulus and tensile strength obtained from the specimens was 2.56 GPa and 65.43 Mpa, respectively. The membrane's efficacy was tested by creating a critical bicortical and bilateral osteoperiosteal defect in rabbit mandibles. The right-side defects were covered with the collagen membrane, while the left-side defects were left untreated as a control. Nine weeks post-surgery, clinical, radiological, and histological analyses demonstrated new bone formation in the treated areas, whereas the control sites showed no bone regeneration. This innovative approach not only contributes to sustainability in healthcare by optimizing biological waste but also exemplifies efficient resource use in line with the circular economy, offering a cost-effective, biocompatible option that could benefit national health systems.

Biomaterials and osteoradionecrosis of the jaw: Review of the literature according to the SWiM methodology

OBJECTIVES

To systematically present and interpret the current literature on research and treatment perspectives for mandibular osteoradionecrosis (mORN) in the field of biomaterials.

MATERIAL AND METHODS

A systematic review of the literature using the "Synthesis without meta-analysis" (SWiM) methodology was performed on PubMed, Embase and Cochrane, focusing on the implantation of synthetic biomaterials for bone reconstruction in mORN in humans and/or animal models. The primary endpoints were the composition, efficacy on mORN and tolerance of the implanted synthetic biomaterials.

RESULTS

Forty-seven references were obtained and evaluated in full-text by two assessors. Ten (8 in humans and 2 in animal models) met the eligibility criteria and were included for analysis. Materials most often comprised support plates or metal mesh (5 of 10 cases) in combination with grafts or synthetic materials (phosphocalcic ceramics, glutaraldehyde). Other ceramic/polymer composites were also implanted. In half of the selected reports, active compounds (molecules, growth factors, lysates) and/or cells were associated with the reconstruction material. The number of articles referring to implantation of biomaterials for the treatment of mORN was small, and the properties of the implanted biomaterials were generally poorly described, thus limiting a thorough understanding of their role.

CONCLUSION

In preventing the morbidity associated with some reconstructive surgeries, basic research has benefitted from recent advances in tissue engineering and biomaterials to repair limited bone loss.

Comparative analysis of plasma-derived albumin scaffold, alveolar osteoblasts and synthetic membrane in critical mandibular bone defects: An experimental study on rats

Repair of bone deficiencies in the craniofacial skeleton remains a challenging clinical problem. The aim of this study was to evaluate and compare the effects of a plasma-derived albumin scaffold, alveolar osteoblasts and synthetic membrane implanted into experimental mandibular defects. Bilateral mandibular defects were created in twelve immunodeficient rats. The bone defect was filled with serum scaffold alone in left sides and scaffold combined with human alveolar osteoblast in right side defects. Implanted areas were closed directly in Group 1 (n = 6) and covered by a resorbable polyglycolic-polylactic acid membrane in Group 2 (n = 6). Bone regeneration was determined at 12 weeks as measured by and exhaustive multiplanar computed tomography analysis and histological examination. No significant differences in bone density were observed between defects transplanted with scaffold alone or scaffold seeded with osteoblasts. The use of membrane did not result in a determining factor in the grade of bone regeneration between Groups 1 and 2. Based on these results, it could be concluded that the albumin scaffold alone has osteoinductive capacity but presence of seeded ostogenic cells accelerates defect repair without being significantly influenced by covering the defect with a resorbable membrane.