1
|
Ali M, Mohd Noor SNF, Mohamad H, Ullah F, Javed F, Abdul Hamid ZA. Advances in guided bone regeneration membranes: a comprehensive review of materials and techniques. Biomed Phys Eng Express 2024; 10:032003. [PMID: 38224615 DOI: 10.1088/2057-1976/ad1e75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/15/2024] [Indexed: 01/17/2024]
Abstract
Guided tissue/bone regeneration (GTR/GBR) is a widely used technique in dentistry to facilitate the regeneration of damaged bone and tissue, which involves guiding materials that eventually degrade, allowing newly created tissue to take its place. This comprehensive review the evolution of biomaterials for guided bone regeneration that showcases a progressive shift from non-resorbable to highly biocompatible and bioactive materials, allowing for more effective and predictable bone regeneration. The evolution of biomaterials for guided bone regeneration GTR/GBR has marked a significant progression in regenerative dentistry and maxillofacial surgery. Biomaterials used in GBR have evolved over time to enhance biocompatibility, bioactivity, and efficacy in promoting bone growth and integration. This review also probes into several promising fabrication techniques like electrospinning and latest 3D printing fabrication techniques, which have shown potential in enhancing tissue and bone regeneration processes. Further, the challenges and future direction of GTR/GBR are explored and discussed.
Collapse
Affiliation(s)
- Mohammed Ali
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300, Nibong Tebal, Pulau Pinang, Malaysia
| | - Siti Noor Fazliah Mohd Noor
- Dental Stimulation and Virtual Learning, Research Excellence Consortium, Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Bertam 13200 Kepala Batas, Pulau Pinang, Malaysia
| | - Hasmaliza Mohamad
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300, Nibong Tebal, Pulau Pinang, Malaysia
| | - Faheem Ullah
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300, Nibong Tebal, Pulau Pinang, Malaysia
- Department of Biological Sciences, Biopolymer Research Centre (BRC), National University of Medical Sciences, 46000, Rawalpindi, Pakistan
| | - Fatima Javed
- Department of Chemistry, Shaheed Benazir Butto Women University Peshawar, Charsadda Road Laramma, 25000, Peshawar, Pakistan
| | - Zuratul Ain Abdul Hamid
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300, Nibong Tebal, Pulau Pinang, Malaysia
| |
Collapse
|
2
|
Epicoco L, Pellegrino R, Madaghiele M, Friuli M, Giannotti L, Di Chiara Stanca B, Palermo A, Siculella L, Savkovic V, Demitri C, Nitti P. Recent Advances in Functionalized Electrospun Membranes for Periodontal Regeneration. Pharmaceutics 2023; 15:2725. [PMID: 38140066 PMCID: PMC10747510 DOI: 10.3390/pharmaceutics15122725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/26/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
Periodontitis is a global, multifaceted, chronic inflammatory disease caused by bacterial microorganisms and an exaggerated host immune response that not only leads to the destruction of the periodontal apparatus but may also aggravate or promote the development of other systemic diseases. The periodontium is composed of four different tissues (alveolar bone, cementum, gingiva, and periodontal ligament) and various non-surgical and surgical therapies have been used to restore its normal function. However, due to the etiology of the disease and the heterogeneous nature of the periodontium components, complete regeneration is still a challenge. In this context, guided tissue/bone regeneration strategies in the field of tissue engineering and regenerative medicine have gained more and more interest, having as a goal the complete restoration of the periodontium and its functions. In particular, the use of electrospun nanofibrous scaffolds has emerged as an effective strategy to achieve this goal due to their ability to mimic the extracellular matrix and simultaneously exert antimicrobial, anti-inflammatory and regenerative activities. This review provides an overview of periodontal regeneration using electrospun membranes, highlighting the use of these nanofibrous scaffolds as delivery systems for bioactive molecules and drugs and their functionalization to promote periodontal regeneration.
Collapse
Affiliation(s)
- Luana Epicoco
- Department of Engineering for Innovation, University of Salento, 73100 Lecce, Italy; (R.P.); (M.M.); (M.F.); (C.D.)
- Institute of Medical Physics and Biophysics, University of Leipzig, 04103 Leipzig, Germany
| | - Rebecca Pellegrino
- Department of Engineering for Innovation, University of Salento, 73100 Lecce, Italy; (R.P.); (M.M.); (M.F.); (C.D.)
| | - Marta Madaghiele
- Department of Engineering for Innovation, University of Salento, 73100 Lecce, Italy; (R.P.); (M.M.); (M.F.); (C.D.)
| | - Marco Friuli
- Department of Engineering for Innovation, University of Salento, 73100 Lecce, Italy; (R.P.); (M.M.); (M.F.); (C.D.)
| | - Laura Giannotti
- Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy; (L.G.); (B.D.C.S.); (L.S.)
| | - Benedetta Di Chiara Stanca
- Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy; (L.G.); (B.D.C.S.); (L.S.)
| | - Andrea Palermo
- Implant Dentistry College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Luisa Siculella
- Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy; (L.G.); (B.D.C.S.); (L.S.)
| | - Vuk Savkovic
- Clinic and Polyclinic for Oral and Maxillofacial Plastic Surgery, University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Christian Demitri
- Department of Engineering for Innovation, University of Salento, 73100 Lecce, Italy; (R.P.); (M.M.); (M.F.); (C.D.)
| | - Paola Nitti
- Department of Engineering for Innovation, University of Salento, 73100 Lecce, Italy; (R.P.); (M.M.); (M.F.); (C.D.)
| |
Collapse
|
3
|
Bieszczad D, Wichlinski J, Kaczmarzyk T. Treatment-Related Factors Affecting the Success of Endodontic Microsurgery and the Influence of GTR on Radiographic Healing-A Cone-Beam Computed Tomography Study. J Clin Med 2023; 12:6382. [PMID: 37835026 PMCID: PMC10573613 DOI: 10.3390/jcm12196382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
The primary objective of this retrospective study was to assess the correlation between treatment-related factors (resection angle, depth of retrograde filling, length of resected root and use of guided tissue regeneration-GTR) evaluated using cone-beam computed tomography (CBCT) scans and the treatment outcomes of endodontic microsurgery (EMS). The secondary purpose of this research was to evaluate the influence of the GTR technique on the radiographic healing state, taking into account the initial parameters of periapical lesions. In 161 cases, the local factors (volume of a lesion, bone destruction pattern, presence/absence of cortical bone destruction) were measured using preoperative CBCT images before undergoing EMS. At least one year after surgery, the outcome of EMS was classified as a success or a failure (based on radiographic and clinical criteria). Using postoperative CBCT, treatment-related factors (resection angle, depth of retrograde filling, and length of resected root) were measured. Additionally, the status of radiographic healing was evaluated (in accordance with modified PENN 3D criteria). Eighteen cases (11.18%) were classified as failures, and 143 were classified as successes (88.82%). Univariate analysis showed that there was no statistically significant influence of treatment-related factors on the healing outcome of EMS. An exact Fischer's test showed the significant impact of GTR on radiographic healing (P < 0.001) in apical lesions (P < 0.001), lesions with a volume between 100 mm3 and 450 mm3 (P < 0.009) and over 450 mm3 (P < 0.001), lesions with the destruction of one plate (P < 0.001), and lesions with the destruction of two plates (through and through) (P = 0.022). The use of GTR in apical lesions, lesions with volumes over 100 mm3, and lesions with the destruction of at least one plate is significantly associated with better radiographic healing.
Collapse
Affiliation(s)
- Daniel Bieszczad
- NZOZ Centrum Stomatologii s.c. Justyna Wichlinska, Jaroslaw Wichlinski, ul. 3-go Maja 16, 38-300 Gorlice, Poland; (D.B.); (J.W.)
| | - Jarosław Wichlinski
- NZOZ Centrum Stomatologii s.c. Justyna Wichlinska, Jaroslaw Wichlinski, ul. 3-go Maja 16, 38-300 Gorlice, Poland; (D.B.); (J.W.)
| | - Tomasz Kaczmarzyk
- Chair of Oral Surgery, Institute of Dentistry, Medical College, Jagiellonian University, ul. Montelupich 4, 31-155 Krakow, Poland
| |
Collapse
|
4
|
Brodzikowska A, Górski B, Szerszeń M, Sanz M. Efficacy of Guided Tissue Regeneration Using Frozen Radiation-Sterilized Allogenic Bone Graft as Bone Replacement Graft Compared with Deproteinized Bovine Bone Mineral in the Treatment of Periodontal Intra-Bony Defects: Randomized Controlled Trial. J Clin Med 2023; 12:jcm12041396. [PMID: 36835930 PMCID: PMC9964170 DOI: 10.3390/jcm12041396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
(1) Background: The aim of this study was to compare the clinical and radiographic outcomes of guided tissue regeneration (GTR) using two biomaterials as bone replacement grafts in the treatment of periodontal intra-bony defects. (2) Methods: Using a split-mouth design, 30 periodontal intra-bony defects were treated with either frozen radiation-sterilized allogenic bone grafts (FRSABG tests) or deproteinized bovine bone mineral (DBBM, controls) combined with a bioabsorbable collagen membrane in 15 patients. Clinical attachment level gains (CAL-G), probing pocket depth reductions (PPD-R), and radiographic changes in linear defect fill (LDF) were evaluated 12 months postoperatively. (3) Results: The CAL, PPD, and LDF values improved significantly in both groups 12 months after the surgery. However, in the test group, the PPD-R and LDF values were significantly higher compared to the controls (PPD-R 4.66 mm versus 3.57 mm, p = 0.0429; LDF 5.22 mm versus 4.33, p = 0.0478, respectively). Regression analysis showed that baseline CAL was a significant predictor for PPD-R (p = 0.0434), while the baseline radiographic angle was a predictor for CAL-G (p = 0.0026) and LDF (p = 0.064). (4) Conclusions: Both replacement grafts when used for GTR with a bioabsorbable collagen membrane yielded successful clinical benefits in teeth with deep intra-bony defects 12 months postoperatively. The use of FRSABG significantly enhanced PPD reduction and LDF.
Collapse
Affiliation(s)
- Aniela Brodzikowska
- Department of Conservative Dentistry, Medical University of Warsaw, 02-097 Warsaw, Poland
- Correspondence: ; Tel.: +48-501019990
| | - Bartłomiej Górski
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Marcin Szerszeń
- Department of Prosthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Mariano Sanz
- ETEP Research Group, Department of Dental Clinical Specialties, Faculty of Odontology, University Complutense of Madrid, 28040 Madrid, Spain
| |
Collapse
|
5
|
Vahdatinia F, Hooshyarfard A, Jamshidi S, Shojaei S, Patel K, Moeinifard E, Haddadi R, Farhadian M, Gholami L, Tayebi L. 3D-Printed Soft Membrane for Periodontal Guided Tissue Regeneration. Materials (Basel) 2023; 16:1364. [PMID: 36836994 PMCID: PMC9967512 DOI: 10.3390/ma16041364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES The current study aimed to perform an in vivo examination using a critical-size periodontal canine model to investigate the capability of a 3D-printed soft membrane for guided tissue regeneration (GTR). This membrane is made of a specific composition of gelatin, elastin, and sodium hyaluronate that was fine-tuned and fully characterized in vitro in our previous study. The value of this composition is its potential to be employed as a suitable replacement for collagen, which is the main component of conventional GTR membranes, to overcome the cost issue with collagen. METHODS Critical-size dehiscence defects were surgically created on the buccal surface of the roots of canine bilateral mandibular teeth. GTR treatment was performed with the 3D-printed membrane and two commercially available collagen membranes (Botiss Jason® and Smartbrane-Regedent membranes) and a group without any membrane placement was considered as the control group. The defects were submerged with tension-free closure of the gingival flaps. Histologic and histometric analyses were employed to assess the periodontal healing over an 8-week experimental period. RESULTS Histometric evaluations confirmed higher levels of new bone formation in the 3D-printed membrane group. Moreover, in all defects treated with the membranes, the formation of periodontal tissues, bone, periodontal ligaments, and cementum was observed after 8 weeks, while in the control group, only connective tissue was found in the defect sites. There was no clinical sign of inflammation or recession of gingiva in any of the groups. SIGNIFICANCE The 3D-printed gelatin/elastin/sodium hyaluronate membrane can be safe and effective for use in GTR for periodontal tissue regeneration therapies, with better or comparable results to the commercial collagen membranes.
Collapse
Affiliation(s)
- Farshid Vahdatinia
- Dental Implants Research Center, Hamadan University of Medical Sciences, Hamadan 6517838636, Iran
| | - Amirarsalan Hooshyarfard
- Department of Periodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran 1946853314, Iran
| | - Shokoofeh Jamshidi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Dental Research Center, Hamadan University of Medical Sciences, Hamadan 6517838636, Iran
| | - Setareh Shojaei
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan 6517838636, Iran
| | - Kishan Patel
- School of Dentistry, Marquette University, Milwaukee, WI 53233, USA
| | | | - Rasool Haddadi
- Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan 6517838636, Iran
| | - Maryam Farhadian
- Department of Biostatistics, School of Public Health, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan 6517838636, Iran
| | - Leila Gholami
- Dental Research Center, Hamadan University of Medical Sciences, Hamadan 6517838636, Iran
| | - Lobat Tayebi
- School of Dentistry, Marquette University, Milwaukee, WI 53233, USA
| |
Collapse
|
6
|
Wei YW, Sayed SM, Zhu WW, Xu KF, Wu FG, Xu J, Nie HP, Wang YL, Lu XL, Ma Q. Antibacterial and Fluorescence Staining Properties of an Innovative GTR Membrane Containing 45S5BGs and AIE Molecules In Vitro. Nanomaterials (Basel) 2022; 12:nano12040641. [PMID: 35214970 PMCID: PMC8874606 DOI: 10.3390/nano12040641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 12/04/2022]
Abstract
This study aimed to add two functional components-antibacterial 45S5BGs particles and AIE nanoparticles (TPE-NIM+) with bioprobe characteristics-to the guided tissue regeneration (GTR) membrane, to optimize the performance. The PLGA/BG/TPE-NIM+ membrane was synthesized. The static water contact angle, morphologies, and surface element analysis of the membrane were then characterized. In vitro biocompatibility was tested with MC3T3-E1 cells using CCK-8 assay, and antibacterial property was evaluated with Streptococcus mutans and Porphyromonas gingivalis by the LIVE/DEAD bacterial staining and dilution plating procedure. The fluorescence staining of bacteria was observed by Laser Scanning Confocal Microscope. The results showed that the average water contact angle was 46°. In the cytotoxicity test, except for the positive control group, there was no significant difference among the groups (p > 0.05). The antibacterial effect in the PLGA/BG/TPE-NIM+ group was significantly (p < 0.01), while the sterilization rate was 99.99%, better than that in the PLGA/BG group (98.62%) (p < 0.01). Confocal images showed that the membrane efficiently distinguished G+ bacteria from G- bacteria. This study demonstrated that the PLGA/BG/TPE-NIM+ membrane showed good biocompatibility, efficient sterilization performance, and surface mineralization ability and could be used to detect pathogens in a simple, fast, and wash-free protocol.
Collapse
Affiliation(s)
- Yu-Wen Wei
- Jiangsu Province Key Laboratory of Oral Diseases, Department of General Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China; (Y.-W.W.); (W.-W.Z.); (J.X.); (H.-P.N.); (Y.-L.W.)
| | - Sayed Mir Sayed
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing 210096, China; (S.M.S.); (K.-F.X.); (F.-G.W.)
| | - Wei-Wen Zhu
- Jiangsu Province Key Laboratory of Oral Diseases, Department of General Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China; (Y.-W.W.); (W.-W.Z.); (J.X.); (H.-P.N.); (Y.-L.W.)
| | - Ke-Fei Xu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing 210096, China; (S.M.S.); (K.-F.X.); (F.-G.W.)
| | - Fu-Gen Wu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing 210096, China; (S.M.S.); (K.-F.X.); (F.-G.W.)
| | - Jing Xu
- Jiangsu Province Key Laboratory of Oral Diseases, Department of General Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China; (Y.-W.W.); (W.-W.Z.); (J.X.); (H.-P.N.); (Y.-L.W.)
| | - He-Peng Nie
- Jiangsu Province Key Laboratory of Oral Diseases, Department of General Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China; (Y.-W.W.); (W.-W.Z.); (J.X.); (H.-P.N.); (Y.-L.W.)
| | - Yu-Li Wang
- Jiangsu Province Key Laboratory of Oral Diseases, Department of General Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China; (Y.-W.W.); (W.-W.Z.); (J.X.); (H.-P.N.); (Y.-L.W.)
| | - Xiao-Lin Lu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, 2 Sipailou Road, Nanjing 210096, China; (S.M.S.); (K.-F.X.); (F.-G.W.)
- Correspondence: (Q.M.); (X.-L.L.); Tel.: +86-13770963117 (Q.M.)
| | - Qian Ma
- Jiangsu Province Key Laboratory of Oral Diseases, Department of General Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China; (Y.-W.W.); (W.-W.Z.); (J.X.); (H.-P.N.); (Y.-L.W.)
- Correspondence: (Q.M.); (X.-L.L.); Tel.: +86-13770963117 (Q.M.)
| |
Collapse
|
7
|
Weng D, Stapf L, Kern M, Kohal RJ. Platelet-Derived Growth Factor-Modulated Guided Tissue Regeneration with a Bioresorbable Membrane in Class III Furcation Defects: A Histometric Study in the Monkey. Materials (Basel) 2021; 14:ma14092420. [PMID: 34066496 PMCID: PMC8124450 DOI: 10.3390/ma14092420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/25/2021] [Accepted: 05/03/2021] [Indexed: 11/17/2022]
Abstract
It was the aim of this study to histometrically evaluate guided tissue regeneration (bioresorbable membrane plus bone mineral) (GTR) with or without platelet-derived growth factor (PDGF) in two different types of class III furcation defects (small keyhole defects and horizonal defects) in monkeys. In six cynomolgus monkeys, two types of class III furcation defects were created and allowed to chronify for 5 months in mandibular first and second molars. After a hygiene program the molars were assigned to GTR group (collagen membrane plus bovine bone mineral), PDGF group (collagen membrane plus bovine bone mineral plus PDGF), or negative control group (flap reposition only). Histologic sections were made after 7 months of healing and descriptive statistics were provided from the histometric parameters. Postoperative healing was uneventful despite marginal membrane exposures in the GTR and PDGF group. Bone regeneration of 23–35% of the original defect area was found in the two treatment groups. In none of the evaluated key parameters (formation of bone, root cementum, connective tissue, or epithelium) differences were detected between GTR and PDGF groups. However, the negative control teeth exhibited better bone regeneration than the treatment groups. The type of class III defect did not influence the regenerative outcome. Within the limits of this study PDGF was not able to enhance the histologic regeneration of class III furcation areas in monkeys compared to bone mineral enhanced GTR treatment regardless of the defect configuration. Membrane exposure during early healing might have influenced these outcomes.
Collapse
Affiliation(s)
- Dietmar Weng
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Arnold-Heller-Str. 16, 24105 Kiel, Germany; (L.S.); (M.K.)
- Correspondence:
| | - Lina Stapf
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Arnold-Heller-Str. 16, 24105 Kiel, Germany; (L.S.); (M.K.)
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Arnold-Heller-Str. 16, 24105 Kiel, Germany; (L.S.); (M.K.)
| | - Ralf-Joachim Kohal
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
| |
Collapse
|
8
|
Aldemir Dikici B, Dikici S, Reilly GC, MacNeil S, Claeyssens F. A Novel Bilayer Polycaprolactone Membrane for Guided Bone Regeneration: Combining Electrospinning and Emulsion Templating. Materials (Basel) 2019; 12:E2643. [PMID: 31434207 PMCID: PMC6721100 DOI: 10.3390/ma12162643] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/05/2019] [Accepted: 08/16/2019] [Indexed: 01/08/2023]
Abstract
Guided bone regeneration is a common dental implant treatment where a barrier membrane (BM) is used between epithelial tissue and bone or bone graft to prevent the invasion of the fast-proliferating epithelial cells into the defect site to be able to preserve a space for infiltration of slower-growing bone cells into the periodontal defect site. In this study, a bilayer polycaprolactone (PCL) BM was developed by combining electrospinning and emulsion templating techniques. First, a 250 µm thick polymerised high internal phase emulsion (polyHIPE) made of photocurable PCL was manufactured and treated with air plasma, which was shown to enhance the cellular infiltration. Then, four solvent compositions were investigated to find the best composition for electrospinning a nanofibrous PCL barrier layer on PCL polyHIPE. The biocompatibility and the barrier properties of the electrospun layer were demonstrated over four weeks in vitro by histological staining. Following in vitro assessment of cell viability and cell migration, cell infiltration and the potential of PCL polyHIPE for supporting blood vessel ingrowth were further investigated using an ex-ovo chick chorioallantoic membrane assay. Our results demonstrated that the nanofibrous PCL electrospun layer was capable of limiting cell infiltration for at least four weeks, while PCL polyHIPE supported cell infiltration, calcium and mineral deposition of bone cells, and blood vessel ingrowth through pores.
Collapse
Affiliation(s)
- Betül Aldemir Dikici
- Department of Materials Science and Engineering, University of Sheffield, Kroto Research Institute, Sheffield S3 7HQ, UK
| | - Serkan Dikici
- Department of Materials Science and Engineering, University of Sheffield, Kroto Research Institute, Sheffield S3 7HQ, UK
| | - Gwendolen C Reilly
- Department of Materials Science and Engineering, University of Sheffield, INSIGNEO Institute for in silico Medicine, The Pam Liversidge Building, Sheffield S1 3JD, UK
| | - Sheila MacNeil
- Department of Materials Science and Engineering, University of Sheffield, Kroto Research Institute, Sheffield S3 7HQ, UK
| | - Frederik Claeyssens
- Department of Materials Science and Engineering, University of Sheffield, Kroto Research Institute, Sheffield S3 7HQ, UK.
| |
Collapse
|
9
|
Chen CC, Lee SY, Teng NC, Hu HT, Huang PC, Yang JC. In Vitro and In Vivo Studies of Hydrophilic Electrospun PLA95/β-TCP Membranes for Guided Tissue Regeneration (GTR) Applications. Nanomaterials (Basel) 2019; 9:nano9040599. [PMID: 30979018 PMCID: PMC6523545 DOI: 10.3390/nano9040599] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 11/28/2022]
Abstract
The guided tissue regeneration (GTR) membrane is a barrier intended to maintain a space for alveolar bone and periodontal ligament tissue regeneration but prevent the migration of fast-growing soft tissue into the defect sites. This study evaluated the physical properties, in vivo animal study, and clinical efficacy of hydrophilic PLA95/β-TCP GTR membranes prepared by electrospinning (ES). The morphology and cytotoxicity of ES PLA95/β-TCP membranes were evaluated by SEM and 3-(4,5-cimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) respectively. The cementum and bone height were measured by an animal study at 8 and 16 weeks after surgery. Fifteen periodontal patients were selected for the clinical trial by using a commercial product and the ES PLA95/β-TCP membrane. Radiographs and various indexes were measured six months before and after surgery. The average fiber diameter for this ES PLA95/β-TCP membrane was 2.37 ± 0.86 µm. The MTT result for the ES PLA95/β-TCP membrane showed negative for cytotoxicity. The significant differences in the cementum and bone height were observed between empty control and the ES PLA95/β-TCP membrane in the animal model (p < 0.05). Clinical trial results showed clinical attachment level (CAL) of both control and ES PLA95/β-TCP groups, with a significant difference from the pre-surgery results after six months. This study demonstrated that the ES PLA95/β-TCP membrane can be used as an alternative GTR membrane for clinical applications.
Collapse
Affiliation(s)
- Chien-Chung Chen
- Graduate Institute of Biomedical Materials & Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan.
- Ph.D. Program in Biotechnology Research and Development, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan.
| | - Sheng-Yang Lee
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
- Department of Dentistry, Wan-Fang Medical Center, Taipei Medical University, Taipei 116, Taiwan.
| | - Nai-Chia Teng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Hsin-Tai Hu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Pei-Chi Huang
- Department of Dentistry, Wan-Fang Medical Center, Taipei Medical University, Taipei 116, Taiwan.
| | - Jen-Chang Yang
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan.
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan.
| |
Collapse
|
10
|
Artzi Z, Sudri S, Platner O, Kozlovsky A. Regeneration of the Periodontal Apparatus in Aggressive Periodontitis Patients. Dent J (Basel) 2019; 7:E29. [PMID: 30857253 PMCID: PMC6473354 DOI: 10.3390/dj7010029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/09/2019] [Accepted: 02/22/2019] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study is to evaluate and compare, retrospectively, the outcome of two different periodontal regeneration procedures in patients suffering from aggressive periodontitis (AgP). Twenty-eight patients were diagnosed with AgP, suffering from several intra-bony defects (IBD); that were treated by one of two periodontal regeneration techniques randomly assigned to each patient: a. guided tissue regeneration (GTR) or b. an application of extracted enamel matrix derivatives (EMD) combined with demineralized bone xenograft particles (DBX). Probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession were recorded. Pre-treatment and follow-up (up to 10 years from the surgery) recordings were analyzed statistically within and between groups. A significant reduction was shown at time on PPD and CAL values, however, not between subject groups. CAL values decreased in all sites. At the EMD group (44 sites), CAL gain was 1.92 mm (±1.68) from pre-treatment to follow-up (p < 0.001) and at the GTR group (12 sites) CAL gain of 2.27 (±1.82) mm. In conclusion, 1⁻10 years observations have shown that surgical treatment of AgP patients by either GTR or by application of EMD/DBX results in similar successful clinical results.
Collapse
Affiliation(s)
- Zvi Artzi
- Department of Periodontology and Oral Implantology, Tel Aviv University, Tel Aviv-Yafo 69979, Israel.
| | - Shiran Sudri
- Department of Periodontology and Oral Implantology, Tel Aviv University, Tel Aviv-Yafo 69979, Israel.
| | - Ori Platner
- Department of Periodontology and Oral Implantology, Tel Aviv University, Tel Aviv-Yafo 69979, Israel.
| | - Avital Kozlovsky
- Department of Periodontology and Oral Implantology, Tel Aviv University, Tel Aviv-Yafo 69979, Israel.
| |
Collapse
|
11
|
da Silva MAC, Oliveira RN, Mendonça RH, Lourenço TGB, Colombo APV, Tanaka MN, Tude EMO, da Costa MF, Thiré RMSM. Evaluation of metronidazole-loaded poly(3-hydroxybutyrate) membranes to potential application in periodontitis treatment. J Biomed Mater Res B Appl Biomater 2015; 104:106-15. [PMID: 25655488 DOI: 10.1002/jbm.b.33357] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 10/23/2014] [Accepted: 12/09/2014] [Indexed: 01/31/2023]
Abstract
Guided tissue regeneration is a technique used for periodontium reconstruction. This technique uses barrier membranes, which prevent epithelial growth in the wound site and may also be used to release antibiotics, to protect the wound against opportunistic infections. Periodontal poly(3-hydroxybutyrate) membranes containing metronidazole (a drug used to help in infection control) were produced and characterized. The kinetic mechanism of the metronidazole delivery of leached and nonleached membrane as well as its cytotoxicity and structural integrity were evaluated. Poly(3-hydroxybutyrate) membranes containing 0.5-2 wt % of the drug and 20 wt % of the plasticizer were manufactured via compression molding. Based on morphological analysis, membranes loaded with 2% metronidazole were considered for detailed studies. The results revealed that metronidazole delivery by the leached membranes seemed to follow the Fick's law. Membranes were noncytotoxic. The amount of metronidazole delivered was in the range of the minimal inhibitory concentration for Porphyromonas gingivalis, and the membranes inhibited the proliferation of these bacteria. Besides, they maintained their mechanical resistance after 30 days of immersion in phosphate buffer at pH 7.4.
Collapse
Affiliation(s)
- Marcio A C da Silva
- COPPE/Program of Metallurgical and Materials Engineering, Federal University of Rio de Janeiro, Rio de Janeiro City, Rio de Janeiro, Brazil
| | - Renata N Oliveira
- COPPE/Program of Metallurgical and Materials Engineering, Federal University of Rio de Janeiro, Rio de Janeiro City, Rio de Janeiro, Brazil
| | - Roberta Helena Mendonça
- Chemical Engineering Department of the Technology Institute, Federal Rural University of Rio de Janeiro, Rio de Janeiro City, Rio de Janeiro, Brazil
| | - Talita G B Lourenço
- Institute of Microbiology Paulo de Góes, Centre of Health Sciences, Federal University of Rio de Janeiro, Rio de Janeiro City, Rio de Janeiro, Brazil
| | - Ana Paula V Colombo
- Institute of Microbiology Paulo de Góes, Centre of Health Sciences, Federal University of Rio de Janeiro, Rio de Janeiro City, Rio de Janeiro, Brazil
| | - Marcelo N Tanaka
- Bioceramics and Cell Culture Lab, Brazilian Center for Physics Research, Rio de Janeiro City, Rio de Janeiro, Brazil
| | - Elena M O Tude
- Bioceramics and Cell Culture Lab, Brazilian Center for Physics Research, Rio de Janeiro City, Rio de Janeiro, Brazil
| | - Marysilvia F da Costa
- COPPE/Program of Metallurgical and Materials Engineering, Federal University of Rio de Janeiro, Rio de Janeiro City, Rio de Janeiro, Brazil
| | - Rossana Mara S M Thiré
- COPPE/Program of Metallurgical and Materials Engineering, Federal University of Rio de Janeiro, Rio de Janeiro City, Rio de Janeiro, Brazil
| |
Collapse
|
12
|
Barbeck M, Lorenz J, Kubesch A, Böhm N, Booms P, Choukroun J, Sader R, Kirkpatrick CJ, Ghanaati S. Porcine Dermis-Derived Collagen Membranes Induce Implantation Bed Vascularization Via Multinucleated Giant Cells: A Physiological Reaction? J ORAL IMPLANTOL 2014; 41:e238-51. [PMID: 25546240 DOI: 10.1563/aaid-joi-d-14-00274] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In this study, the tissue reactions to 2 new porcine dermis-derived collagen membranes of different thickness were analyzed. The thicker material (Mucoderm) contained sporadically preexisting vessel skeletons and fatty islands. The thinner membrane (Collprotect) had a bilayered structure (porous and occlusive side) without any preexisting structures. These materials were implanted subcutaneously in mice to analyze the tissue reactions and potential transmembranous vascularization. Histological and histomorphometrical methodologies were performed at 4 time points (3, 10, 15, and 30 days). Both materials permitted stepwise connective tissue ingrowth into their central regions. In the Mucoderm matrix, newly built microvessels were found within the preexisting vessel and fatty island skeletons after 30 days. This vascularization was independent of the inflammation-related vascularization on both material surfaces. The Collprotect membrane underwent material disintegration by connective tissue strands in combination with vessels and multinucleated giant cells. The histomorphometric analyses revealed that the thickness of Mucoderm did not decrease significantly, while an initial significant decrease of membrane thickness in the case of Collprotect was found at day 15. The present results demonstrate that the 2 analyzed collagen membranes underwent a multinucleated giant cell-associated vascularization. Neither of the materials underwent transmembraneous vascularization. The microvessels were found within the preexisting vessel and fatty island skeletons. Additional long-term studies and clinical studies are necessary to determine how the observed foreign body giant cells affect tissue regeneration.
Collapse
Affiliation(s)
- Mike Barbeck
- 1 Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jonas Lorenz
- 1 Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Alica Kubesch
- 1 Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Nicole Böhm
- 1 Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Patrick Booms
- 1 Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | | | - Robert Sader
- 1 Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | | | - Shahram Ghanaati
- 1 Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| |
Collapse
|
13
|
Chi CS, Andrade DB, Kim SG, Solomon CS. Guided tissue regeneration in endodontic surgery by using a bioactive resorbable membrane. J Endod 2014; 41:559-62. [PMID: 25492491 DOI: 10.1016/j.joen.2014.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/13/2014] [Accepted: 10/21/2014] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Guided tissue regeneration is a valuable technique available to the endodontist because the quality, quantity, or extent of bone loss cannot be visualized by the surgeon until the tissue is reflected and the surgical site is exposed. METHODS After repeated attempts at nonsurgical treatment, a patient with a recurring sinus tract over the distobuccal root of an upper molar ultimately had the distobuccal root resected, leaving a 10 × 10 mm bony defect. This dehiscence was filled with freeze-dried bone and covered with a flexible and absorbable bioactive membrane that was new to endodontics. RESULTS Healing was uneventful, and bone regeneration was rapid and extensive as observed at the time of a second surgery just 5 months later. This can be attributed at least in part to the use of the bioactive membrane that contains an array of growth factors that enhance cell proliferation, inflammation, recruitment of progenitor cells, and metalloproteinase activity. CONCLUSIONS The use of the bioactive membrane in endodontic surgery should be considered to best restore the attachment apparatus to the tooth and prevent the downgrowth of a long junctional epithelium. The endodontist's attention must not be limited to the apical region alone.
Collapse
Affiliation(s)
- C Susan Chi
- Division of Endodontics, Columbia University College of Dental Medicine, New York, New York
| | - Diego B Andrade
- Division of Endodontics, Columbia University College of Dental Medicine, New York, New York
| | - Sahng G Kim
- Division of Endodontics, Columbia University College of Dental Medicine, New York, New York
| | - Charles S Solomon
- Division of Endodontics, Columbia University College of Dental Medicine, New York, New York.
| |
Collapse
|