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Aghaloo T. Are Poor Outcomes Always a Surgeon's Complication? J Oral Maxillofac Surg 2024; 82:507-508. [PMID: 38697687 DOI: 10.1016/j.joms.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
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2
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Chen C, Li Z, Xu C, Kang M, Lee CS, Aghaloo T, Lee M. Self-Assembled Nanocomposite Hydrogels as Carriers for Demineralized Bone Matrix Particles and Enhanced Bone Repair. Adv Healthc Mater 2024; 13:e2303592. [PMID: 38275216 PMCID: PMC11023793 DOI: 10.1002/adhm.202303592] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/17/2024] [Indexed: 01/27/2024]
Abstract
Demineralized bone matrix (DBM) has been widely used as an allogeneic alternative to autologous bone graft for bone repair. However, more extensive use of DBM is limited due to its particulate nature after demineralization and rapid particle dispersion following irrigation, resulting in unpredictable osteoinductivity. Here, a new design of injectable hydrogel carriers for DBM that combine self-healing ability and osteogenic properties based on the self-assembly of guanidinylated hyaluronic acid and silica-rich nanoclays is reported. The nanoclays serve as reversible linkages to form a dynamic hydrogel network with the guanidine moieties on the polymer chains. Gelation kinetics and mechanical properties can be controlled by altering nanoclay content in the hydrogel. The resulting hydrogel exerts self-healing ability due to its dynamic crosslinks and well retains its overall performance with high DBM loading. The hydrogel exhibits great cytocompatibility and osteogenic effects mediated by the nanoclays. In vivo delivery of DBM using the nanocomposite hydrogel further demonstrates robust bone regeneration in a mouse calvarial defect model in comparison to DBM delivered with aqueous HA. This work suggests a promising hydrogel platform for many applications including therapeutic delivery and tissue engineering.
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Affiliation(s)
- Chen Chen
- Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, CA 90095, USA
| | - Zhi Li
- Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, CA 90095, USA
| | - Changlu Xu
- Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, CA 90095, USA
| | - Minjee Kang
- Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, CA 90095, USA
| | - Chung-Sung Lee
- Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, CA 90095, USA
- Department of Pharmaceutical Engineering, Soonchunhyang University, Asan 31538, Republic of Korea
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, CA 90095, USA
| | - Min Lee
- Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, CA 90095, USA
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA
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3
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Carrasco-Labra A, Polk DE, Urquhart O, Aghaloo T, Claytor JW, Dhar V, Dionne RA, Espinoza L, Gordon SM, Hersh EV, Law AS, Li BSK, Schwartz PJ, Suda KJ, Turturro MA, Wright ML, Dawson T, Miroshnychenko A, Pahlke S, Pilcher L, Shirey M, Tampi M, Moore PA. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in adolescents, adults, and older adults: A report from the American Dental Association Science and Research Institute, the University of Pittsburgh, and the University of Pennsylvania. J Am Dent Assoc 2024; 155:102-117.e9. [PMID: 38325969 PMCID: PMC10919895 DOI: 10.1016/j.adaj.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/25/2023] [Accepted: 10/11/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND A panel convened by the American Dental Association Science and Research Institute, the University of Pittsburgh, and the University of Pennsylvania conducted systematic reviews and meta-analyses and formulated evidence-based recommendations for the pharmacologic management of acute dental pain after simple and surgical tooth extraction(s) and for the temporary management (ie, definitive dental treatment not immediately available) of toothache associated with pulp and periapical diseases in adolescents, adults, and older adults. TYPES OF STUDIES REVIEWED The panel conducted 4 systematic reviews to determine the effect of opioid and nonopioid analgesics, local anesthetics, corticosteroids, and topical anesthetics on acute dental pain. The panel used the Grading of Recommendations, Assessment, Development and Evaluation approach to assess the certainty of the evidence and the Grading of Recommendations, Assessment, Development and Evaluation Evidence-to-Decision Framework to formulate recommendations. RESULTS The panel formulated recommendations and good practice statements using the best available evidence. There is a beneficial net balance favoring the use of nonopioid medications compared with opioid medications. In particular, nonsteroidal anti-inflammatory drugs alone or in combination with acetaminophen likely provide superior pain relief with a more favorable safety profile than opioids. CONCLUSIONS AND PRACTICAL IMPLICATIONS Nonopioid medications are first-line therapy for managing acute dental pain after tooth extraction(s) and the temporary management of toothache. The use of opioids should be reserved for clinical situations when the first-line therapy is insufficient to reduce pain or there is contraindication of nonsteroidal anti-inflammatory drugs. Clinicians should avoid the routine use of just-in-case prescribing of opioids and should exert extreme caution when prescribing opioids to adolescents and young adults.
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Aghaloo T. Are We Too Critical of Others? "Jousting" in Oral and Maxillofacial Surgery. J Oral Maxillofac Surg 2024; 82:137-138. [PMID: 38191207 DOI: 10.1016/j.joms.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
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Sukato DC, Kerr R, Aghaloo T, Yu JW, Blackwell KE, Jayanetti J. The Implant-borne Articulation Splint in Fibula Free Flap Mandibular Reconstruction: A Technical Note. J Craniofac Surg 2023; 34:2455-2459. [PMID: 37800941 DOI: 10.1097/scs.0000000000009751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/31/2023] [Indexed: 10/07/2023] Open
Abstract
Computer-aided design and computer-aided manufacturing and digitally simulated surgeries have revolutionized maxillomandibular reconstruction. In particular, this technology has increased the accuracy and facilitated the process of dental implantation in fibula free flaps. Despite the efficacy of virtual planning, there is a minor degree of translational difference between digital and intraoperative measurements, which may affect the precision of implant and fibula orientations. This is especially concerning during the last stage of fibula insetting, where the graft segments have the potential to roll, yaw, or pitch. The objective of this study is to describe an advanced prosthodontic technique that ensures the fibula grafts and implants remain in a restorable position during final insetting. We describe the technique and workflow of the implant-borne articulation splint through a case presentation and demonstrate results at 4 months postoperative and postradiotherapy. Given the degree of investment placed in virtual planning, free flap reconstruction, and endosteal implants, a technique that ensures optimal restorability of each implant is pivotal. Larger studies are still required to fully elucidate the cost-effectiveness and long-term results of the implant-borne articulation splint.
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Affiliation(s)
- Daniel C Sukato
- Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland
| | - Rhorie Kerr
- Department of Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, David Geffen School of Medicine at UCLA
| | - Tara Aghaloo
- UCLA School of Dentistry, Section of Oral and Maxillofacial Surgery, Los Angeles, CA
| | - Jason W Yu
- University of Colorado Health, Plastic and Reconstructive Surgery, Aurora, CO
| | - Keith E Blackwell
- Department of Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, David Geffen School of Medicine at UCLA
| | - Jay Jayanetti
- Section of Maxillofacial Prosthetics, UCLA School of Dentistry, Los Angeles, CA
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6
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Aghaloo T. How Important Is Nutrition in Oral and Maxillofacial Surgery? J Oral Maxillofac Surg 2023; 81:1321-1322. [PMID: 37634543 DOI: 10.1016/j.joms.2023.08.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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Al-Nawas B, Aghaloo T, Aparicio C, Bedrossian E, Brecht L, Brennand-Roper M, Chow J, Davó R, Fan S, Jung R, Kämmerer PW, Kumar VV, Lin WS, Malevez C, Morton D, Pijpe J, Polido WD, Raghoebar GM, Stumpel LJ, Tuminelli FJ, Verdino JB, Vissink A, Wu Y, Zarrine S. ITI consensus report on zygomatic implants: indications, evaluation of surgical techniques and long-term treatment outcomes. Int J Implant Dent 2023; 9:28. [PMID: 37698775 PMCID: PMC10497463 DOI: 10.1186/s40729-023-00489-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVES The aim of the ITI Consensus Workshop on zygomatic implants was to provide Consensus Statements and Clinical Recommendations for the use of zygomatic implants. MATERIALS AND METHODS Three systematic reviews and one narrative review were written to address focused questions on (1) the indications for the use of zygomatic implants; (2) the survival rates and complications associated with surgery in zygomatic implant placement; (3) long-term survival rates of zygomatic implants and (4) the biomechanical principles involved when zygoma implants are placed under functional loads. Based on the reviews, three working groups then developed Consensus Statements and Clinical Recommendations. These were discussed in a plenary and finalized in Delphi rounds. RESULTS A total of 21 Consensus Statements were developed from the systematic reviews. Additionally, the group developed 17 Clinical Recommendations based on the Consensus Statements and the combined expertise of the participants. CONCLUSIONS Zygomatic implants are mainly indicated in cases with maxillary bone atrophy or deficiency. Long-term mean zygomatic implant survival was 96.2% [95% CI 93.8; 97.7] over a mean follow-up of 75.4 months (6.3 years) with a follow-up range of 36-141.6 months (3-11.8 years). Immediate loading showed a statistically significant increase in survival over delayed loading. Sinusitis presented with a total prevalence of 14.2% [95% CI 8.8; 22.0] over a mean 65.4 months follow-up, representing the most common complication which may lead to zygomatic implant loss. The international experts suggested clinical recommendations regarding planning, surgery, restoration, outcomes, and the patient's perspective.
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Affiliation(s)
- Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Operations, University Medical Center Mainz, Mainz, Germany.
| | - Tara Aghaloo
- Section of Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Carlos Aparicio
- Indiana University School of Dentistry, Indianapolis, USA
- Hepler Bone Clinic, ZAGA Center Barcelona, Barcelona, Spain
| | - Edmond Bedrossian
- Department of Oral and Maxillofacial Surgery University of the Pacific, Dugoni School of Dentistry, San Francisco, CA, USA
| | - Lawrence Brecht
- Department of Dental Medicine and Oral and Maxillofacial Surgery, Northwell Health, New Hyde Park, New York, USA
- Division of Prosthodontics and Restorative Dentistry, NYC College of Dentistry, New York, USA
| | | | - James Chow
- Brånemark Osseointegration Center, Hong Kong SAR, China
| | - Rubén Davó
- Medimar International Hospital, Department of Implantology and Maxillofacial Surgery, Vithas Davó Instituto Dental, Alicante, Spain
| | - Shengchi Fan
- Department of Oral and Maxillofacial Surgery, Plastic Operations, University Medical Center Mainz, Mainz, Germany
- Second Dental Center, School of Medicine, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Operations, University Medical Center Mainz, Mainz, Germany
| | - Vinay V Kumar
- Oral Rehabilitation Center, Bangalore, India
- Department of Surgical Sciences, Odontology and Maxillofacial Surgery, Medical Faculty, Uppsala University, Uppsala, Sweden
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, USA
| | - Chantal Malevez
- Department of Oral and Maxillofacial Surgery, Clinique Saint-Jean, Brussels, Belgium
| | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, USA
| | - Justin Pijpe
- Department of Oral and Maxillofacial Surgery, Special Care and Orthodontics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Waldemar D Polido
- Department of Oral and Maxillofacial Surgery, Indiana University School of Dentistry, Indianapolis, USA
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Frank J Tuminelli
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, USA
| | | | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Yiqun Wu
- Second Dental Center, School of Medicine, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
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Carrasco-Labra A, Polk DE, Urquhart O, Aghaloo T, Claytor JW, Dhar V, Dionne RA, Espinoza L, Gordon SM, Hersh EV, Law AS, Li BSK, Schwartz PJ, Suda KJ, Turturro MA, Wright ML, Dawson T, Miroshnychenko A, Pahlke S, Pilcher L, Shirey M, Tampi M, Moore PA. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in children: A report from the American Dental Association Science and Research Institute, the University of Pittsburgh School of Dental Medicine, and the Center for Integrative Global Oral Health at the University of Pennsylvania. J Am Dent Assoc 2023; 154:814-825.e2. [PMID: 37634915 PMCID: PMC10910586 DOI: 10.1016/j.adaj.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/26/2023] [Accepted: 06/01/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND A guideline panel convened by the American Dental Association Council on Scientific Affairs, American Dental Association Science and Research Institute, University of Pittsburgh School of Dental Medicine, and Center for Integrative Global Oral Health at the University of Pennsylvania conducted a systematic review and meta-analyses and formulated evidence-based recommendations for the pharmacologic management of acute dental pain after 1 or more simple and surgical tooth extractions and the temporary management of toothache (that is, when definitive dental treatment not immediately available) associated with pulp and furcation or periapical diseases in children (< 12 years). TYPES OF STUDIES REVIEWED The authors conducted a systematic review to determine the effect of analgesics and corticosteroids in managing acute dental pain. They used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of the evidence and the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework to formulate recommendations. RESULTS The panel formulated 7 recommendations and 5 good practice statements across conditions. There is a small beneficial net balance favoring the use of nonsteroidal anti-inflammatory drugs alone or in combination with acetaminophen compared with not providing analgesic therapy. There is no available evidence regarding the effect of corticosteroids on acute pain after surgical tooth extractions in children. CONCLUSIONS AND PRACTICAL IMPLICATIONS Nonopioid medications, specifically nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen alone or in combination with acetaminophen, are recommended for managing acute dental pain after 1 or more tooth extractions (that is, simple and surgical) and the temporary management of toothache in children (conditional recommendation, very low certainty). According to the US Food and Drug Administration, the use of codeine and tramadol in children for managing acute pain is contraindicated.
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9
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Jensen SS, Aghaloo T, Jung RE, Bertl K, Buser D, Chappuis V, de Stavola L, Monje A, Pispero A, Roccuzzo A, Shahdad S, Stefanini M, Tavelli L, Wang HL, Zucchelli G. Group 1 ITI Consensus Report: The role of bone dimensions and soft tissue augmentation procedures on the stability of clinical, radiographic, and patient-reported outcomes of implant treatment. Clin Oral Implants Res 2023; 34 Suppl 26:43-49. [PMID: 37750519 DOI: 10.1111/clr.14154] [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: 05/25/2023] [Revised: 07/20/2023] [Accepted: 07/20/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aims of Working Group 1 were to address the role (i) of the buccolingual bone dimensions after implant placement in healed alveolar ridge sites on the occurrence of biologic and aesthetic complications, and (ii) of soft tissue augmentation (STA) on the stability of clinical, radiographic, and patient-related outcomes of implant treatments. MATERIALS AND METHODS Two systematic reviews were prepared in advance of the Consensus Conference and were discussed among the participants of Group 1. Consensus statements, clinical recommendations, recommendations for future research, and reflections on patient perspectives were based on structured group discussions until consensus was reached among the entire group of experts. The statements were then presented and accepted following further discussion and modifications as required by the plenary. RESULTS Dimensional changes of the alveolar ridge occurred after implant placement in healed sites, and a reduction in buccal bone wall thickness (BBW) of 0.3 to 1.8 mm was observed. In healed sites with a BBW of <1.5 mm after implant placement, increased vertical bone loss, and less favorable clinical and radiographic outcomes were demonstrated. Implants with buccal dehiscence defects undergoing simultaneous guided bone regeneration, showed less vertical bone loss, and more favorable clinical and radiographic outcomes, compared to non-augmented dehiscence defects during initial healing. At healthy single implant sites, probing depths, bleeding and plaque scores, and interproximal bone levels evaluated at 1 year, remained stable for up to 5 years, with or without STA. When single implant sites were augmented with connective tissue grafts, either for soft tissue phenotype modification or buccal soft tissue dehiscence, stable levels of the soft tissue margin, and stable or even increased soft tissue thickness and/or width of keratinized mucosa could be observed from 1 to 5 years. In contrast, non-augmented sites were more prone to show apical migration of the soft tissue margin in the long-term. Favorable aesthetic and patient-reported outcomes after STA were documented to be stable from 1 to 5 years. CONCLUSIONS It is concluded that dimensional changes of the alveolar ridge occur after implant placement in healed sites and that sites with a thin BBW after implant placement are prone to exhibit less favorable clinical and radiographic outcomes. In addition, it is concluded that STA can provide stable clinical, radiographic, aesthetic, and patient-reported outcomes in the medium and long-term.
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Affiliation(s)
- Simon S Jensen
- Research Area Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, University of Copenhagen, Copenhagen, Denmark
- Department of Oral & Maxillfacial Surgery, Centre for Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tara Aghaloo
- Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, California, USA
| | - Ronald E Jung
- Center of Dental Medicine, Clinic of Reconstructive Dentistry, University of Zürich, Zürich, Switzerland
| | - Kristina Bertl
- Department of Periodontology, Dental Clinic, Faculty of Medicine, Sigmund Freud University, Vienna, Austria
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Daniel Buser
- School of Dental Medicine, University of Bern, Bern, Switzerland
- Private Practice, Bern, Switzerland
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, Division of Oral Diagnostic Sciences, University of Bern, Bern, Switzerland
| | - Luca de Stavola
- Department of Implantology, School of Dentistry, University of Padua, Padua, Italy
- Private Practice, Padua, Italy
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, The University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, ZMK University of Bern, Bern, Switzerland
- Private Practice, Badajoz, Spain
| | - Alberto Pispero
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Shakeel Shahdad
- Department of Restorative Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Martina Stefanini
- Periodontology, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Lorenzo Tavelli
- Department of Oral Medicine, Infection, and Immunology, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, The University of Michigan, School of Dentistry, Ann Arbor, Michigan, USA
| | - Giovanni Zucchelli
- Periodontology, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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10
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Polido WD, Machado-Fernandez A, Lin WS, Aghaloo T. Indications for zygomatic implants: a systematic review. Int J Implant Dent 2023; 9:17. [PMID: 37391575 DOI: 10.1186/s40729-023-00480-4] [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: 02/06/2023] [Accepted: 05/09/2023] [Indexed: 07/02/2023] Open
Abstract
PURPOSE The purpose of this systematic review was to assess the evidence regarding the indications for placement of zygomatic implants to rehabilitate edentulous maxillae. MATERIAL AND METHODS A focused question using the PIO format was developed, questioning "in patients in need of an implant-supported rehabilitation of the edentulous maxillae, what are the indications for the use of zygomatic implants''. The primary information analyzed and collected was a clear description of the indication for the use of zygomatic implants. RESULTS A total of 1266 records were identified through database searching. The full-text review was conducted for 117 papers, and 10 were selected to be included in this review. Zygomatic implant indications were extreme bone atrophy or deficiency secondary to different factors. The quad zygoma concept (two zygomatic implants bilaterally placed and splinted) was applied to 107 patients, the classic zygoma concept (one zygomatic implant bilaterally placed and splinted to standard anterior implants) was used in 88 patients, and the unilateral concept (one zygomatic implant on one side, splinted with one or more conventional implants) was employed in 14 patients. CONCLUSIONS The main indication for the use of zygomatic implants was considered extreme maxillary bone atrophy, resulting from many factors. The clear definition of what was considered "extreme bone atrophy" is not uniquely defined in each paper. Further studies are needed to develop clear indications for zygomatic implants.
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Affiliation(s)
- Waldemar D Polido
- Department of Oral and Maxillofacial Surgery, Indiana University School of Dentistry, Indianapolis, USA.
| | | | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, USA
| | - Tara Aghaloo
- Section of Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, CA, USA
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11
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Aghaloo T, Hadaya D, Schoenbaum TR, Pratt L, Favagehi M. Guided and Navigation Implant Surgery: A Systematic Review. Int J Oral Maxillofac Implants 2023; 38:7-15. [PMID: 37436945 DOI: 10.11607/jomi.10465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
Purpose: To evaluate how guided and navigation surgical approaches for implant placement affect survival and accuracy. Materials and Methods: An electronic literature search was conducted in PubMed/Medline and the Cochrane Library. The reviews were refereed by two independent investigators using the following PICO question: population-patients with missing maxillary or mandibular teeth; intervention-dental implant guided surgery, dental implant navigation surgery; comparison-conventional implant surgery or historical control; outcome-implant survival, implant accuracy. Single-arm, weighted meta-analyses were performed on navigational and static guided surgery groups for cumulative survival rate and accuracy of implant placement (ie, angular, depth, and horizontal deviation). Group metrics with less than five reports were not synthesized. The study was compiled under PRISMA 2020 guidelines. Results: A total of 3,930 articles were screened. Full-text review of 93 articles resulted in a total of 56 articles included for quantitative synthesis and analysis. Implant placement with a fully guided approach resulted in the following means and 95% CI: cumulative survival rate of 97% (96%, 98%), angular deviation of 3.8 degrees (3.4 degrees, 4.2 degrees), depth deviation of 0.5 mm (0.4 mm, 0.6 mm), and horizontal deviation at the implant neck of 1.2 mm (1.0 mm, 1.3 mm). Implant placement with a navigation approach resulted in an angular deviation of 3.4 degrees (3.0 degrees, 3.9 degrees), horizontal deviation at the implant neck of 0.9 mm (0.8 mm, 1.0 mm), and horizontal deviation at the implant apex of 1.2 mm (0.8 mm, 1.5 mm). Conclusion: Static guided and navigation surgical approaches for dental implant placement have survival rates comparable to historical controls. Accuracy of implant placement does not differ markedly between these two approaches.
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12
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Nakhla MN, Richards PQ, Miller JE, Afework D, Manzoor D, Lin YL, Aghaloo T, Blackwell KE, St John MA. Ghost Cell Odontogenic Carcinoma: A Case Report and Literature Review. Laryngoscope 2023; 133:830-833. [PMID: 36533581 DOI: 10.1002/lary.30521] [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: 09/08/2022] [Revised: 10/26/2022] [Accepted: 11/20/2022] [Indexed: 12/23/2022]
Abstract
Ghost cell odontogenic carcinoma (GCOC) is an exceptionally rare malignant odontogenic neoplasm with a significant potential for aggressive growth. Although the literature on this tumor is limited, its high recurrence rates suggest that early and multimodal intervention may be beneficial. This study reports a case of GCOC of the mandible that was successfully treated with surgical resection, reconstruction, and radiation. A comprehensive literature review was performed, and the relevant genomic and histopathological characteristics of this malignancy were determined. Laryngoscope, 133:830-833, 2023.
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Affiliation(s)
- Morcos N Nakhla
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Phillip Q Richards
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jessa E Miller
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - David Afework
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Daniel Manzoor
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,UCLA Head and Neck Cancer Program, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Yi-Ling Lin
- Oral Pathology, UCLA School of Dentistry, Los Angeles, California, USA
| | - Tara Aghaloo
- UCLA Head and Neck Cancer Program, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,Oral Pathology, UCLA School of Dentistry, Los Angeles, California, USA
| | - Keith E Blackwell
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,UCLA Head and Neck Cancer Program, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Maie A St John
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,UCLA Head and Neck Cancer Program, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Lee CS, Fan J, Hwang HS, Kim S, Chen C, Kang M, Aghaloo T, James AW, Lee M. Bone-Targeting Exosome Mimetics Engineered by Bioorthogonal Surface Functionalization for Bone Tissue Engineering. Nano Lett 2023; 23:1202-1210. [PMID: 36762874 PMCID: PMC10106420 DOI: 10.1021/acs.nanolett.2c04159] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Extracellular vesicles have received a great interest as safe biocarriers in biomedical engineering. There is a need to develop more efficient delivery strategies to improve localized therapeutic efficacy and minimize off-target adverse effects. Here, exosome mimetics (EMs) are reported for bone targeting involving the introduction of hydroxyapatite-binding moieties through bioorthogonal functionalization. Bone-binding ability of the engineered EMs is verified with hydroxyapatite-coated scaffolds and an ex vivo bone-binding assay. The EM-bound construct provided a biocompatible substrate for cell adhesion, proliferation, and osteogenic differentiation. Particularly, the incorporation of Smoothened agonist (SAG) into EMs greatly increased the osteogenic capacity through the activation of hedgehog signaling. Furthermore, the scaffold integrated with EM/SAG significantly improved in vivo reossification. Lastly, biodistribution studies confirmed the accumulation of systemically administered EMs in bone tissue. This facile engineering strategy could be a versatile tool to promote bone regeneration, offering a promising nanomedicine approach to the sophisticated treatment of bone diseases.
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Affiliation(s)
- Chung-Sung Lee
- Division of Advanced Prosthodontics, University of California, Los Angeles, CA 90095, United States
| | - Jiabing Fan
- Division of Advanced Prosthodontics, University of California, Los Angeles, CA 90095, United States
| | - Hee Sook Hwang
- Division of Advanced Prosthodontics, University of California, Los Angeles, CA 90095, United States
| | - Soyon Kim
- Division of Advanced Prosthodontics, University of California, Los Angeles, CA 90095, United States
| | - Chen Chen
- Division of Advanced Prosthodontics, University of California, Los Angeles, CA 90095, United States
| | - Minjee Kang
- Division of Advanced Prosthodontics, University of California, Los Angeles, CA 90095, United States
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, CA, 90095, USA
| | - Aaron W. James
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, United States
- Orthopedic Hospital Research Center, University of California, Los Angeles, CA 90095, United States
| | - Min Lee
- Division of Advanced Prosthodontics, University of California, Los Angeles, CA 90095, United States
- Department of Bioengineering, University of California, Los Angeles, CA 90095, United States
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Aghaloo T. Who Is Your Biggest Fan? J Oral Maxillofac Surg 2023; 81:131. [PMID: 36737169 DOI: 10.1016/j.joms.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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15
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Kurnick B, Madrigal J, Han AY, Benharash P, St. John MA, Aghaloo T. Does ASA Classification Effect Hospital Course and Post-Operative Complications Following Oral and Maxillofacial Surgical Procedures? Oral Surg Oral Med Oral Pathol Oral Radiol 2023. [PMID: 37316419 DOI: 10.1016/j.oooo.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The purpose of the present study was to assess the duration of operative time and outcomes related to patients with an increased American Society of Anesthesiologists (ASA) Physical Status classification in the setting of hospital-based maxillofacial surgical procedures. STUDY DESIGN The study was a retrospective multi-institutional cohort study using the American College of Surgeons National Surgical Quality Improvement Program database to enroll patients who underwent maxillofacial procedures between 2012 and 2019. The primary independent variable was ASA Physical Status Classification (I, II, III, IV). Descriptive, univariate, and multiple logistic regression statistics were used to evaluate the relationship between ASA classification, body mass index (BMI), operative time, and perioperative complications. RESULTS The study cohort was comprised of 1807 patients, with 946 males and 861 females. The ASA Physical Status Classification ranged from class I to IV. On bivariate analysis, patients classified as ASA III (286 [IQR 152-503], P < .001) and ASA IV (412 [IQR 156.5-547.5], P = .003) were associated with longer operative times. The risk of perioperative complications was 2.6% for ASA I patients (n = 19), 6.3% for ASA II (n = 48; P = .005), 24.5% for ASA III (n = 76; P < .001), and 55.0% for ASA IV (n = 11; P < .001). On multivariate-adjusted analysis, using ASA I as the reference, ASA III (β +53.2 minutes, 95% CI +28.6 to +77.8, P < .001) and ASA IV (β +81.5 minutes, 95% CI +21.0 to +141.9, P = .008) were variables associated with longer operative time. CONCLUSIONS Increased ASA Physical Status Classification was associated with increased operative time and perioperative complications.
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Aghaloo T. Attaining Work-Life Balance. J Oral Maxillofac Surg 2022; 80:1721-1722. [DOI: 10.1016/j.joms.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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17
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Liu Z, Suh JS, Deng P, Bezouglaia O, Do M, Mirnia M, Cui ZK, Lee M, Aghaloo T, Wang CY, Hong C. Epigenetic Regulation of NGF-Mediated Osteogenic Differentiation in Human Dental Mesenchymal Stem Cells. Stem Cells 2022; 40:818-830. [PMID: 35728620 PMCID: PMC9512103 DOI: 10.1093/stmcls/sxac042] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022]
Abstract
Nerve growth factor (NGF) is the best-characterized neurotrophin and is primarily recognized for its key role in the embryonic development of the nervous system and neuronal cell survival/differentiation. Recently, unexpected actions of NGF in bone regeneration have emerged as NGF is able to enhance the osteogenic differentiation of mesenchymal stem cells. However, little is known regarding how NGF signaling regulates osteogenic differentiation through epigenetic mechanisms. In this study, using human dental mesenchymal stem cells (DMSCs), we demonstrated that NGF mediates osteogenic differentiation through p75NTR, a low-affinity NGF receptor. P75NTR-mediated NGF signaling activates the JNK cascade and the expression of KDM4B, an activating histone demethylase, by removing repressive H3K9me3 epigenetic marks. Mechanistically, NGF-activated c-Jun binds to the KDM4B promoter region and directly upregulates KDM4B expression. Subsequently, KDM4B directly and epigenetically activates DLX5, a master osteogenic gene, by demethylating H3K9me3 marks. Furthermore, we revealed that KDM4B and c-Jun from the JNK signaling pathway work in concert to regulate NGF-mediated osteogenic differentiation through simultaneous recruitment to the promoter region of DLX5. We identified KDM4B as a key epigenetic regulator during the NGF-mediated osteogenesis both in vitro and in vivo using the calvarial defect regeneration mouse model. In conclusion, our study thoroughly elucidated the molecular and epigenetic mechanisms during NGF-mediated osteogenesis.
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Affiliation(s)
- Zhenqing Liu
- Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Jin Sook Suh
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Peng Deng
- Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Olga Bezouglaia
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Megan Do
- School of Dentistry, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Mojan Mirnia
- School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Zhong-Kai Cui
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Min Lee
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Cun-Yu Wang
- Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Christine Hong
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco (UCSF), San Francisco, CA, USA
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Gkouveris I, Hadaya D, Elzakra N, Soundia A, Bezouglaia O, Dry SM, Pirih F, Aghaloo T, Tetradis S. Inhibition of HMGB1/RAGE Signaling Reduces the Incidence of Medication-Related Osteonecrosis of the Jaw (MRONJ) in Mice. J Bone Miner Res 2022; 37:1775-1786. [PMID: 35711109 PMCID: PMC9474692 DOI: 10.1002/jbmr.4637] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/07/2022] [Accepted: 06/04/2022] [Indexed: 11/06/2022]
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication of antiresorptive or antiangiogenic medications, used in the treatment of bone malignancy or osteoporosis. Bone necrosis, mainly represented by osteocytic death, is always present in MRONJ sites; however, the role of osteocyte death in MRONJ pathogenesis is unknown. High mobility group box 1 (HMGB1) is a non-histone nucleoprotein that in its acetylated form accumulates in the cytoplasm, whereas non-acetylated HMGB1 localizes in the nucleus. SIRT1 deacetylase regulates cellular localization of HMGB1. Interestingly, HMGB1 is released during cell necrosis and promotes inflammation through signaling cascades, including activation of the RAGE receptor. Here, we utilized a well-established mouse MRONJ model that utilizes ligature-induced experimental periodontitis (EP) and treatment with either vehicle or zolendronic acid (ZA). Initially, we evaluated HMGB1-SIRT1 expression in osteocytes at 1, 2, and 4 weeks of treatment. Significantly increased cytoplasmic and perilacunar HMGB1 expression was observed at EP sites of ZA versus vehicle (Veh) animals at all time points. SIRT1 colocalized with cytoplasmic HMGB1 and presented a statistically significant increased expression at the EP sites of ZA animals for all time points. RAGE expression was significantly higher in the submucosal tissues EP sites of ZA animals compared with those in vehicle group. To explore the significance of increased cytoplasmic and extracellular HMGB1 and increased RAGE expression in MRONJ pathogenesis, we used pharmacologic inhibitors of these molecules. Combined HMGB1/RAGE inhibition resulted in lower MRONJ incidence with statistically significant decrease in osteonecrotic areas and bone exposure versus non-inhibitor treated ZA animals. Together, our data point to the role of HMGB1 as a central alarmin, overexpressed at early phase of MRONJ pathogenesis during osteocytic death. Moreover, HMGB1-RAGE pathway may represent a new promising therapeutic target in patients at high risk of MRONJ. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Ioannis Gkouveris
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Danny Hadaya
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Naseim Elzakra
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Akrivoula Soundia
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Olga Bezouglaia
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Sarah M Dry
- UCLA Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Flavia Pirih
- Division of Constitutive and Regenerative Sciences, UCLA School of Dentistry, Los Angeles, CA, 90095, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Sotirios Tetradis
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA 90095, USA
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Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaws-2022 Update. J Oral Maxillofac Surg 2022; 80:920-943. [PMID: 35300956 DOI: 10.1016/j.joms.2022.02.008] [Citation(s) in RCA: 251] [Impact Index Per Article: 125.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 12/13/2022]
Abstract
Strategies for management of patients with, or at risk for, medication-related osteonecrosis of the jaws (MRONJ) - formerly referred to as bisphosphonate-related osteonecrosis of the jaws (BRONJ)-were set forth in the American Association of Oral and Maxillofacial Surgeons (AAOMS) position papers in 2007, 2009 and 2014. The position papers were developed by a committee appointed by the AAOMS Board of Trustees and comprising clinicians with extensive experience in caring for these patients, as well as clinical and basic science researchers. The knowledge base and experience in addressing MRONJ continues to evolve and expand, necessitating modifications and refinements to the previous position papers. Three members of the AAOMS Committee on Oral, Head, and Neck Oncologic and Reconstructive Surgery (COHNORS) and three authors of the 2014 position paper were appointed to serve as a working group to analyze the current literature and revise the guidance as indicated to reflect current knowledge in this field. This update contains revisions to diagnosis and management strategies and highlights the current research status. AAOMS maintains that it is vitally important for this information to be disseminated to other relevant healthcare professionals and organizations.
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Affiliation(s)
- Salvatore L Ruggiero
- Clinical Professor, Division of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Hofstra North Shore-LIJ School of Medicine, New York Center for Orthognathic and Maxillofacial Surgery, Lake Success, NY.
| | - Thomas B Dodson
- Professor and Chair, University of Washington School of Dentistry, Department of Oral and Maxillofacial Surgery, Seattle, Wash
| | - Tara Aghaloo
- Professor, Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, Calif
| | - Eric R Carlson
- Professor and Kelly L. Krahwinkel Endowed Chairman, Department of Oral and Maxillofacial Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tenn
| | - Brent B Ward
- Chalmers J Lyons Professor of Oral and Maxillofacial Surgery, Associate Professor of Dentistry, Chair of the Department of Oral and Maxillofacial Surgery/Hospital Dentistry in the School of Dentistry and Associate Professor of Surgery for the Medical School, University of Michigan Hospital, Ann Arbor, Mich
| | - Deepak Kademani
- Chief of Staff North Memorial Health, Fellowship Director, Oral/Head and Neck Oncologic and Reconstructive Surgery Attending Surgeon, North Memorial Health and the University of Minnesota. Private practice, Minnesota Oral and Facial Surgery and Minnesota Head and Neck Surgery, Minneapolis, Minn
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Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. Reply: Can RECIST 1.1 Criteria Provide a Solution to the Achilles' Heel in the Management of Medication-Related Osteonecrosis of Jaws? J Oral Maxillofac Surg 2022; 80:1148. [DOI: 10.1016/j.joms.2022.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
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21
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Zhang X, Hasani-Sadrabadi MM, Zarubova J, Dashtimighadam E, Haghniaz R, Khademhosseini A, Butte MJ, Moshaverinia A, Aghaloo T, Li S. Immunomodulatory Microneedle Patch for Periodontal Tissue Regeneration. Matter 2022; 5:666-682. [PMID: 35340559 PMCID: PMC8942382 DOI: 10.1016/j.matt.2021.11.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Periodontal diseases are caused by microbial infection and the recruitment of destructive immune cells. Current therapies mainly deal with bacteria elimination, but the regeneration of periodontal tissues remains a challenge. Here we developed a modular microneedle (MN) patch that delivered both antibiotic and cytokines into the local gingival tissue to achieve immunomodulation and tissue regeneration. This MN patch included a quickly dissolvable gelatin membrane for an immediate release of tetracycline and biodegradable GelMA MNs that contained tetracycline-loaded poly(lactic-co-glycolic acid) nanoparticles and cytokine-loaded silica microparticles for a sustained release. Antibiotic release completely inhibited bacteria growth, and the release of IL-4 and TGF-β induced the repolarization of anti-inflammatory macrophages and the formation of regulatory T cells in vitro. In vivo delivery of MN patch into periodontal tissues suppressed proinflammatory factors and promoted pro-regenerative signals and tissue healing, which demonstrated the therapeutic potential of local immunomodulation for tissue regeneration.
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Affiliation(s)
- Xuexiang Zhang
- Department of Bioengineering, University of California, Los Angeles, CA 90095, United States
| | | | - Jana Zarubova
- Department of Bioengineering, University of California, Los Angeles, CA 90095, United States
| | - Erfan Dashtimighadam
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-3290 United States
| | - Reihaneh Haghniaz
- Department of Bioengineering, University of California, Los Angeles, CA 90095, United States
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064 USA
| | - Ali Khademhosseini
- Department of Bioengineering, University of California, Los Angeles, CA 90095, United States
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, 90064 USA
| | - Manish J. Butte
- Department of Pediatrics, Division of Immunology, Allergy, and Rheumatology, University of California Los Angeles, Los Angeles, CA 90095, United States
- Department of Microbiology, Immunology, and Molecular Genetics, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Alireza Moshaverinia
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, California 90095, United States
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Song Li
- Department of Bioengineering, University of California, Los Angeles, CA 90095, United States
- Corresponding Author: (S.L.)
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22
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Zhang X, Fan J, Chen C, Aghaloo T, Lee M. Co-delivery of simvastatin and demineralized bone matrix hierarchically from nanosheet-based supramolecular hydrogels for osteogenesis. J Mater Chem B 2021; 9:7741-7750. [PMID: 34586142 DOI: 10.1039/d1tb01256h] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Supramolecular hydrogels are widely used as 3D scaffolds and delivery platforms in tissue engineering applications. However, hydrophobic therapeutic agents exhibit weak compatibility in hydrogel scaffolds along with aggregation and precipitation. Herein, simvastatin drugs used as BMP-2 stimulators are encapsulated into the layer space of LAPONITE® via electrostatic interactions and ion exchange efficiently, and supramolecular hydrogels could be fabricated with a self-healing, injectable and sustained drug release nature. Hydrogels encapsulated with 10 μg mL-1 simvastatin drug show good osteogenic differentiation in vitro. Moreover, the loading of demineralized bone matrix particles could enhance the capacity for osteogenesis via improving the expression of BMP-2 synergistically. The integrated hydrogels could be implanted into cranial defect sites for bone regeneration in vivo. This work provides the first demonstration of molecular and supramolecular engineering of hydrogels to load osteoinductive agents hierarchically for bone regeneration, contributing to the development of a brand-new strategy for dealing with compatibility between scaffolds and osteogenic agents.
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Affiliation(s)
- Xiao Zhang
- Department of Pharmacy, Second Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi 030001, P. R. China. .,Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, USA.
| | - Jiabing Fan
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, USA.
| | - Chen Chen
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, USA.
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, USA
| | - Min Lee
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, USA. .,Department of Bioengineering, University of California at Los Angeles, 420 Westwood Plaza, Los Angeles, California 90095, USA
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Soundia A, Hadaya D, Chau Y, Gkouveris I, Bezouglaia O, Dry S, Pirih F, Aghaloo T, Tetradis S. Local RANKL delivery improves socket healing in bisphosphonate treated rats. Bone 2021; 148:115945. [PMID: 33836308 PMCID: PMC9396533 DOI: 10.1016/j.bone.2021.115945] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 01/15/2023]
Abstract
Medication related osteonecrosis of the Jaws (MRONJ) is a severe complication of antiresorptive and anti-angiogenic medications. Osteoclast inhibition is central in MRONJ pathogenesis. Here, we investigated if local application of RANKL (a key molecule in osteoclast activation) could enhance osteoclast generation and improve extraction socket healing in the presence of bisphosphonates. Thirty Wistar-Han rats received one saline or 66 μg/kg zoledronate (ZA) i.p. dose before surgery. A week later, mandibular molars were extracted bilaterally. Collagen tapes infused with water or RANKL were placed in the extraction sockets of 60 hemimandibles of veh (veh/RANKL-, veh/RANKL+) or ZA treated rats (ZA/RANKL-, ZA/RANKL+). Rats were euthanized 3 or 12 days after surgery. Animals euthanized at 12 days received two additional veh or ZA injections. Clinical, radiographic and histologic assessments were performed. Visually, at the 3-day timepoint, no sockets demonstrated complete healing. At the 12-day timepoint, sockets of veh/RANKL- and veh/RANKL+ rats showed intact mucosa, while mucosal defects were noted in ZA/RANKL- rats. Importantly, ZA/RANKL+ sockets showed absence of bone exposure. RANKL delivery increased bone healing in the ZA/RANKL+ sites 12 days after extraction compared to the ZA/RANKL- sites. Histologically, at the 3-day timepoint, ZA/RANKL- sockets demonstrated extensive bone exposure and osteonecrosis. In contrast, ZA/RANKL+ rats showed granulation tissue coverage and significantly reduced osteonecrosis, similar to the veh groups. Importantly, in the ZA/RANKL+ group, osteoclasts attached to the bone surface and osteoclast numbers were higher compared to ZA/RANKL- sites. At the 12-day timepoint, persistent osteonecrosis and bone exposure were detected in the sockets of ZA/RANKL- animals. Contrary, ZA/RANKL+ rats demonstrated socket epithelialization and reduced osteonecrosis. Significantly more total and bony attached osteoclasts persisted in the ZA/RANKL+ vs the ZA/RANKL- group. We present a novel approach towards improving socket healing, in the presence of ZA, by enhancing osteoclastic numbers and attachment through local RANKL application. Our approach is clinically applicable and could improve treatment outcomes of patients on high-dose ZA therapy.
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Affiliation(s)
- Akrivoula Soundia
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Danny Hadaya
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Yee Chau
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Ioannis Gkouveris
- Department of Oral and Maxillofacial Pathology and Medicine, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Olga Bezouglaia
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Sarah Dry
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Flavia Pirih
- Division of Constitutive and Regenerative Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA.
| | - Sotirios Tetradis
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA.
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Schoenbaum TR, Moy PK, Aghaloo T, Elashoff D. Risk Factors for Dental Implant Failure in Private Practice: A Multicenter Survival Analysis. Int J Oral Maxillofac Implants 2021; 36:388-394. [PMID: 33909732 DOI: 10.11607/jomi.8983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The objective of this study was to quantify the probability of implant failure over time from intrinsic patient factors using a population of patients from multiple private practices. MATERIALS AND METHODS The records for this retrospective, multicenter cohort study were randomly selected from eight private practices. The primary outcome variable was time to event (implant failure or last known follow-up). The included independent variables were age, sex, diabetes status, smoking status, and arch location. Analyses were performed with Cox proportional hazards on three models: univariate, full multivariate, and systemic factor multivariate. The probability of implant survival at 1, 5, and 10 years was calculated using univariate time-to-event modeling on log-normal distribution with 95% CIs and Cox proportional hazard tests for significance. The Kaplan-Meier survival curve was calculated for patients < 71 years of age. RESULTS Eight hundred thirty-five implant-level records from 378 patients were collected for analyses. The mean patient age was 60 years, and 48% were men, 15% reported a history of smoking, and 16% reported having diabetes. The follow-up time was as long as 17 years, with a mean of 23.1 months, and a median of 7 months. The hazard ratio (HR) for implant failure due to sex (HR = 1.18; 95% CI: 0.52 to 2.66), smoking (HR = 1.30; 95% CI: 0.49 to 3.46), diabetes (HR = 1.17; 95% CI: 0.35 to 3.86), and arch location (HR = 2.13 to 3.39) failed to reach the threshold within any Cox proportional hazards model (P > .05). CONCLUSION The implant survival probability for patients ≤ 70 years of age is 86.4% at 10 years in the course of routine private practice by experienced providers. Cautious interpretation of these results is critical, as the effects of known systemic risk factors are likely tempered by effective modifications in clinical decisions and protocols with short- and long-term follow-up maintenance.
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Chen C, Rehnama M, Kim S, Lee CS, Zhang X, Aghaloo T, Fan J, Lee M. Enhanced Osteoinductivity of Demineralized Bone Matrix with Noggin Suppression in Polymer Matrix. Adv Biol (Weinh) 2021; 5:e202000135. [PMID: 33585837 PMCID: PMC7877805 DOI: 10.1002/adbi.202000135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Demineralized bone matrix (DBM), a potential alternative to autologous bone-graft, has been increasingly used for clinical bone repair; however, its application in larger defects isn't successful partly due to the rapid dispersion of DBM particles and relatively lower osteoinductivity. Here, a novel strategy is created to complement the osteoinductivity of DBM by incorporating DBM in biopolymer hydrogel combined with the abrogation of BMP antagonism. Combined treatment of DBM + noggin-suppression displays increased osteogenic potency of human bone marrow mesenchymal stem cells (hBMSCs) in vitro. Injectable chitosan (MeGC)-based hydrogel with heparinization (Hep-MeGC) is further developed to localize and stabilize DBM. Noggin-suppression reveals the significant increase in osteogenesis of hBMSCs in the photopolymerizable Hep-MeGC hydrogels with the encapsulation of DBM. Moreover, the combination of DBM + noggin-suppression in the injectable Hep-MeGC hydrogel displays a robust bone healing in mouse critical-sized calvarial defects in vivo. The mechanistic analysis demonstrates that noggin-suppression increased DBM osteoinductivity by stimulating endogenous BMP/Smad signals. These results have shown promise in DBM's ability as a prominent bone grafting material while being coupled with gene editing mechanism and a localizing three-dimensional scaffold. Together, this approach poses a significant increase in the efficiency of DBM-mediated craniofacial bone repair and dental osteointegration.
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Affiliation(s)
- Chen Chen
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668, USA
| | - Matthew Rehnama
- Division of Advanced Prosthodontics, University of California, Los Angeles, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668, USA
| | - Soyon Kim
- Division of Advanced Prosthodontics, University of California, Los Angeles, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668, USA
| | - Chung-Sung Lee
- Division of Advanced Prosthodontics, University of California, Los Angeles, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668, USA
| | - Xiao Zhang
- Division of Advanced Prosthodontics, University of California, Los Angeles, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, United States
| | - Jiabing Fan
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668, USA
| | - Min Lee
- Division of Advanced Prosthodontics, School of Dentistry, Department of Bioengineering, University of California, Los Angeles, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668, USA
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Lee CS, Hwang HS, Kim S, Fan J, Aghaloo T, Lee M. Inspired by nature: facile design of nanoclay-organic hydrogel bone sealant with multifunctional properties for robust bone regeneration. Adv Funct Mater 2020; 30:2003717. [PMID: 33122980 PMCID: PMC7591105 DOI: 10.1002/adfm.202003717] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Indexed: 05/19/2023]
Abstract
Bone repair is a complex process involving the sophisticated interplay of osteogenic stem cells, extracellular matrix, and osteoinductive factors, and it is affected by bacterial toxins and oxidative stress. Inspired by the nature of plant-derived phytochemicals and inorganic-organic analogues of the bone extracellular matrix, we report herein the facile design of a nanoclay-organic hydrogel bone sealant (NoBS) that integrates multiple physico-chemical cues for bone regeneration into a single system. Assembly of phytochemical-modified organic chitosan and silica-rich inorganic nanoclay serves as highly biocompatible and osteoconductive extracellular matrix mimics. The decorated phytochemical exerts inherent bactericidal and antioxidant activities, and acts as an intermolecular networking precursor for gelation with injectable and self-healing capabilities. Moreover, the NoBS exerts osteoinductive effects mediated by the nanoclay, which regulates the Wnt/β-catenin pathway, along with the addition of osteoinductive signals, resulting in bone regeneration in a non-healing cranial defect. Engineering of this integrated bone graft substitute with multifunctional properties inspired by natural materials may suggest a promising and effective approach for creating a favorable microenvironment for optimal bone healing.
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Affiliation(s)
- Chung-Sung Lee
- Division of Advanced Prosthodontics, University of California Los Angeles, CA 90095, USA
| | - Hee Sook Hwang
- Division of Advanced Prosthodontics, University of California Los Angeles, CA 90095, USA
| | - Soyon Kim
- Division of Advanced Prosthodontics, University of California Los Angeles, CA 90095, USA
| | - Jiabing Fan
- Division of Advanced Prosthodontics, University of California Los Angeles, CA 90095, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, University of California Los Angeles, CA 90095, USA
| | - Min Lee
- Division of Advanced Prosthodontics, University of California Los Angeles, CA 90095, USA
- Department of Bioengineering, University of California Los Angeles, CA 90095, USA
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Abstract
Administration of exosomes is considered an attractive cell-free approach to skeletal repair and pathological disease treatment. However, poor yield for the production technique and unexpected therapeutic efficacy of exosomes have been obstacles to their widespread use in clinical practices. Here, we report an alternative strategy to produce exosome-related vesicles with high yields and improved regenerative capability. An extrusion approach was employed to amass exosome mimetics (EMs) from human mesenchymal stem cells (hMSCs). The collected EMs had a significantly increased proportion of vesicles positive for the exosome-specific CD-63 marker compared with MSC-derived exosomes. EMs were further obtained from genetically modified hMSCs in which expression of noggin, a natural bone morphogenetic protein antagonist, was down-regulated to enhance osteogenic properties of EMs. Moreover, the administration of hMSC-EMs in conjunction with an injectable chitosan hydrogel into mouse nonhealing calvarial defects demonstrated robust bone regeneration. Importantly, mechanistic studies revealed that the enhanced osteogenesis by EMs in which noggin was suppressed was mediated via inhibition of miR-29a. These findings demonstrate the great promise of MSC-mediated EMs and modulation of small RNA signaling for skeletal regeneration and cell-free therapy.
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Affiliation(s)
- Jiabing Fan
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, California, 90095, USA
- Weintraub Center for Reconstructive Biotechnology, School of Dentistry, University of California, Los Angeles, California, 90095, USA
| | - Chung-Sung Lee
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, California, 90095, USA
| | - Soyon Kim
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, California, 90095, USA
| | - Chen Chen
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, California, 90095, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, California, 90095, USA
| | - Min Lee
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, California, 90095, USA
- Weintraub Center for Reconstructive Biotechnology, School of Dentistry, University of California, Los Angeles, California, 90095, USA
- Department of Bioengineering, University of California, Los Angeles, California, 90095, USA
- To whom correspondence should be addressed: Min Lee, PhD, Professor, Division of Advanced Prosthodontics, Weintraub Center for Reconstructive Biotechnology, Department of Bioengineering, University of California, Los Angeles, Phone: 310-825-6674, Fax: (310) 825-6345,
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28
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Lee CS, Kim S, Fan J, Hwang HS, Aghaloo T, Lee M. Smoothened agonist sterosome immobilized hybrid scaffold for bone regeneration. Sci Adv 2020; 6:eaaz7822. [PMID: 32494652 PMCID: PMC7176430 DOI: 10.1126/sciadv.aaz7822] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/28/2020] [Indexed: 05/24/2023]
Abstract
Biomaterial delivery of bioactive agents and manipulation of stem cell fate are an attractive approach to promote tissue regeneration. Here, smoothened agonist sterosome is developed using small-molecule activators [20S-hydroxycholesterol (OHC) and purmorphamine (PUR)] of the smoothened protein in the hedgehog pathway as carrier and cargo. Sterosome presents inherent osteoinductive property even without drug loading. Sterosome is covalently immobilized onto three-dimensional scaffolds via a bioinspired polydopamine intermediate to fabricate a hybrid scaffold for bone regeneration. Sterosome-immobilized hybrid scaffold not only provides a favorable substrate for cell adhesion and proliferation but also delivers bioactive agents in a sustained and spatially targeted manner. Furthermore, this scaffold significantly improves osteogenic differentiation of bone marrow stem cells through OHC/PUR-mediated synergistic activation of the hedgehog pathway and also enhances bone repair in a mouse calvarial defect model. This system serves as a versatile biomaterial platform for many applications, including therapeutic delivery and endogenous regenerative medicine.
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Affiliation(s)
- Chung-Sung Lee
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Soyon Kim
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Jiabing Fan
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Hee Sook Hwang
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Min Lee
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
- Department of Bioengineering, University of California at Los Angeles, 420 Westwood Plaza, Los Angeles, CA 90095, USA
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Zhang X, Fan J, Lee CS, Kim S, Chen C, Aghaloo T, Lee M. Apatite-binding nanoparticulate agonist of hedgehog signaling for bone repair. Adv Funct Mater 2020; 30:1909218. [PMID: 32952492 PMCID: PMC7494204 DOI: 10.1002/adfm.201909218] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Indexed: 05/11/2023]
Abstract
The hedgehog signaling pathway plays a critical role in bone development and regeneration. Applications of hedgehog morphogens or small molecular agonists are of interest in bone repair but constrained by low stability, high dose requirement, and nonspecific targeting in vivo. Herein, a nanoparticulate agonist as a new type of hedgehog signaling activator is developed for efficacious bone healing. The shell of nanoparticulate agonist consists of palmitic acid and oxysterol, which could modify hedgehog function and bind with the smoothened receptor to positively modulate hedgehog signaling. Meanwhile, the core is assembled with sonic hedgehog gene/polyethyleneimine complex, which could synergistically enhance hedgehog signaling with oxysterol constituents. Moreover, alendronate is introduced into nanoparticulate agonist to bind with hydroxyapatite for potential bone tissue targeting. Lastly, the nanoparticulate agonist surface is decorated with the guanidine group to overcome cell membrane barriers. The created multifunctional nanoparticulate agonist is successfully integrated onto apatite-coated three-dimensional scaffolds and demonstrates greatly improved osteogenesis in vitro and calvarial bone healing. This work suggests a novel biomaterial design to specifically promote hedgehog signaling for the treatment of bone defects.
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Affiliation(s)
- Xiao Zhang
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, United States
| | - Jiabing Fan
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, United States
| | - Chung-Sung Lee
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, United States
| | - Soyon Kim
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, United States
| | - Chen Chen
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, United States
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, United States
| | - Min Lee
- Division of Advanced Prosthodontics, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, California 90095, United States; Department of Bioengineering, University of California at Los Angeles, 420 Westwood Plaza, Los Angeles, California 90095, United States
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30
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Hasani-Sadrabadi MM, Sarrion P, Pouraghaei S, Chau Y, Ansari S, Li S, Aghaloo T, Moshaverinia A. An engineered cell-laden adhesive hydrogel promotes craniofacial bone tissue regeneration in rats. Sci Transl Med 2020; 12:12/534/eaay6853. [DOI: 10.1126/scitranslmed.aay6853] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 02/14/2020] [Indexed: 01/06/2023]
Abstract
Cell-laden hydrogels are widely used in tissue engineering and regenerative medicine. However, many of these hydrogels are not optimized for use in the oral environment, where they are exposed to blood and saliva. To address these challenges, we engineered an alginate-based adhesive, photocrosslinkable, and osteoconductive hydrogel biomaterial (AdhHG) with tunable mechanical properties. The engineered hydrogel was used as an injectable mesenchymal stem cell (MSC) delivery vehicle for craniofacial bone tissue engineering applications. Subcutaneous implantation in mice confirmed the biodegradability, biocompatibility, and osteoconductivity of the hydrogel. In a well-established rat peri-implantitis model, application of the adhesive hydrogel encapsulating gingival mesenchymal stem cells (GMSCs) resulted in complete bone regeneration around ailing dental implants with peri-implant bone loss. Together, we have developed a distinct bioinspired adhesive hydrogel with tunable mechanical properties and biodegradability that effectively delivers patient-derived dental-derived MSCs. The hydrogel is photocrosslinkable and, due to the presence of MSC aggregates and hydroxyapatite microparticles, promotes bone regeneration for craniofacial tissue engineering applications.
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Affiliation(s)
- Mohammad Mahdi Hasani-Sadrabadi
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Patricia Sarrion
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Sevda Pouraghaei
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Yee Chau
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Sahar Ansari
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Song Li
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Alireza Moshaverinia
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
- California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA
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31
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Bouloux GF, Aghaloo T, Campbell JA, Chou J, Edwards SP, Kademani D, Reese DC, Cillo J, Dodson TB, Peacock Z. Proceedings From the Clinical and Scientific Innovations in Oral and Maxillofacial Surgery Conference 2019. J Oral Maxillofac Surg 2019; 78:327-334. [PMID: 31838088 DOI: 10.1016/j.joms.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 11/05/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Gary F Bouloux
- J. David Allen and Family Professor and Residency Program Director, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Tara Aghaloo
- Professor and Assistant Dean for Clinical Research, Section of Oral and Maxillofacial Surgery, Division of Diagnostic and Surgical Sciences, University of California, Los Angeles, School of Dentistry, Los Angeles, CA.
| | - Joshua A Campbell
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Tennessee School of Medicine, Knoxville, TN
| | - Jolie Chou
- Associate Professor, Department of Oral and Maxillofacial Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Sean P Edwards
- Professor, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI
| | - Deepak Kademani
- Chief, Department of Oral and Maxillofacial Surgery, North Memorial Health Hospital, Minneapolis, MN
| | - Daniel C Reese
- Resident, Department of Oral and Maxillofacial Surgery, Case Western Reserve University School of Dental Medicine, Cleveland, OH
| | - Joe Cillo
- Oral Surgeon, Allegheny Oral and Maxillofacial Surgery, Pittsburgh, PA
| | - Thomas B Dodson
- Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA
| | - Zachary Peacock
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA
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Abstract
Bone augmentation is an extremely common procedure in implant dentistry today because of significant advancements with reactive biomaterials, a better understanding of the mechanism of action that is found with growth factors contained in platelets, and improvements in surgical techniques. The expectation is for the surgeon to place the dental implant in the position that best serves the requirements of the prosthetic restorations. With the increasing demands that patients have for ideal prosthetic results, surgeons are expected to predictably augment both hard and soft tissues to provide the anticipated esthetic and functional outcomes. Bone grafting can be performed before, during, and after the implant placement; however, these augmentation procedures come with increased cost, the risk of complications such as infection or failure, and lengthening of the total treatment time. In addition, a plethora of grafting materials are available commercially, where they are often inadequately studied, or there is minimal information regarding their predictability or long-term success, or ability to support dental implants. It is clear that although the surgical field has seen major progress since early implant surgical techniques in the 1980s, major challenges still exist with hard tissue augmentation procedures. This review will discuss these challenges that are increased and often specific to bone graft healing, and which are becoming more common as implant site development often requires bone augmentation to improve volume or contour deficiencies. The risk factors that patients may present with that will affect outcomes with bone augmentation procedures are identified, and recommendations for the prevention of complications or managing complications once they have occurred are provided.
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Affiliation(s)
- Peter K Moy
- Department of Oral & Maxillofacial Surgery, UCLA, School of Dentistry, Los Angeles, California, USA
| | - Tara Aghaloo
- Department of Oral & Maxillofacial Surgery, UCLA, School of Dentistry, Los Angeles, California, USA
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Abstract
Traditional tobacco products have well-known systemic and local oral effects, including inflammation, vasoconstriction, delayed wound healing, and increased severity of periodontal disease. Specifically in the oral cavity and the lung, cigarette smoking produces cancer, increased infectivity, acute and chronic inflammation, changes in gene expression in epithelial lining cells, and microbiome changes. In recent years, cigarette smoking has greatly decreased in the United States, but the use of new tobacco products has gained tremendous popularity. Without significant knowledge of the oral sequelae of products such as electronic cigarettes, researchers must evaluate current in vitro and in vivo methods to study these agents, as well as develop new tools to adequately study their effects. Some in vitro testing has been performed for electronic cigarettes, including toxicologic models and assays, but these mostly study the effect on the respiratory tract. Recently, direct exposure of the aerosol to in vitro 3-dimensional tissue constructs has been performed, demonstrating changes in cell viability and inflammatory cytokines. For in vivo studies, a universal e-cigarette testing machine or standard vaping regime is needed. A standard research electronic cigarette has recently been developed by the National Institute of Drug Abuse, and other devices delivering aerosols with different nicotine concentrations are becoming available. One of the biggest challenges in this research is keeping up with the new products and the rapidly changing technologies in the industry.
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Affiliation(s)
- T Aghaloo
- Section of Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, CA, USA
| | - J J Kim
- Volpe Research Center, American Dental Association Foundation, Gaithersburg, MD, USA
| | - T Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - H P Behrsing
- Institute for In Vitro Sciences, Gaithersburg, MD, USA
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Aghaloo T, Pi-Anfruns J, Moshaverinia A, Sim D, Grogan T, Hadaya D. The Effects of Systemic Diseases and Medications on Implant Osseointegration: A Systematic Review. Int J Oral Maxillofac Implants 2019; 34:s35-s49. [PMID: 31116832 DOI: 10.11607/jomi.19suppl.g3] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Since their development, dental implants have become one of the most common procedures to rehabilitate patients with single missing teeth or fully edentulous jaws. As implants become more mainstream, determining the factors that affect osseointegration is extremely important. Medical risk factors identified to negatively affect osseointegration include diabetes and osteoporosis. However, other systemic conditions and medications that interfere with wound healing have not been as widely investigated. The aim of this systematic review was to evaluate the effect of systemic disorders including diabetes and osteoporosis on implant osseointegration. The aim was also to evaluate the effect of other diseases, such as neurocognitive diseases, cardiovascular disease, human immunodeficiency virus (HIV), hypothyroidism, rheumatoid arthritis, and medications, such as selective serotonin reuptake inhibitors (SSRIs), proton pump inhibitors (PPIs), and antihypertensives. Although the literature does not demonstrate that diabetes negatively affects implant osseointegration, most studies focus on well-controlled diabetics and the use of prophylactic antibiotics. In addition, studies have shown increased long-term bone and soft tissue complications. For osteoporosis, recent studies and reviews also fail to demonstrate a lower osseointegration rate. However, caution must be exercised in these patients due to the risk for osteonecrosis of the jaws (ONJ), especially in patients with bone malignancies. There is also no direct evidence that patients with HIV, cardiovascular disease, neurologic disorders, hypothyroidism, or rheumatoid arthritis have a decreased rate of implant osseointegration. However, some preliminary evidence suggests that medications such as SSRIs or PPIs may have a negative effect on implant osseointegration. These studies are fairly recent and must be validated with continuous research. Moreover, disease control, concomitant medications, and other comorbidities complicate implant osseointegration and must guide our treatment approaches and clinical guidelines.
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Ghazal S, Huynh-Ba G, Aghaloo T, Dibart S, Froum S, O’Neal R, Cochran D. Randomized Controlled Multicenter Clinical Study Evaluating Crestal Bone Level Change of Narrow-Diameter Versus Standard-Diameter Ti-Zr Implants for Single Tooth Replacement in Anterior and Premolar Region. Int J Oral Maxillofac Implants 2019; 34:708–718. [DOI: 10.11607/jomi.6927] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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36
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Hasani-Sadrabadi MM, Sarrion P, Nakatsuka N, Young TD, Taghdiri N, Ansari S, Aghaloo T, Li S, Khademhosseini A, Weiss PS, Moshaverinia A. Hierarchically Patterned Polydopamine-Containing Membranes for Periodontal Tissue Engineering. ACS Nano 2019; 13:3830-3838. [PMID: 30895772 DOI: 10.1021/acsnano.8b09623] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Periodontitis is a common chronic inflammatory disease that affects tooth-supporting tissues. We engineer a multifunctional periodontal membrane for the guided tissue regeneration of lost periodontal tissues. The major drawback of current periodontal membranes is the lack of tissue regeneration properties. Here, a series of nanofibrous membranes based on poly(ε-caprolactone) with tunable biochemical and biophysical properties were developed for periodontal tissue regeneration. The engineered membranes were surface coated using biomimetic polydopamine to promote the adhesion of therapeutic proteins and cells. We demonstrate successful cellular localization on the surface of the engineered membrane by morphological patterning. Polydopamine accelerates osteogenic differentiation of dental-derived stem cells by promoting hydroxyapatite mineralization. Such multiscale designs can mimic the complex extracellular environment of periodontal tissue and serve as functional tissue constructs for periodontal regeneration. In a periodontal defect model in rats, our engineered periodontal membrane successfully promoted the regeneration of periodontal tissue and bone repair. Altogether, our data demonstrate that our biomimetic membranes have potential as protein/cell delivery platforms for periodontal tissue engineering.
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Affiliation(s)
- Mohammad Mahdi Hasani-Sadrabadi
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry , University of California, Los Angeles , Los Angeles , California 90095-1668 , United States
- California NanoSystems Institute , University of California, Los Angeles , 570 Westwood Plaza , Los Angeles , California 90095-7227 , United States
- Department of Chemistry and Biochemistry , University of California, Los Angeles , 607 Charles E. Young Drive South , Los Angeles , California 90095-1569 , United States
- Department of Bioengineering , University of California, Los Angeles , 420 Westwood Plaza, 5121 Engineering V , Los Angeles , California 90095-1600 , United States
| | - Patricia Sarrion
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry , University of California, Los Angeles , Los Angeles , California 90095-1668 , United States
| | - Nako Nakatsuka
- California NanoSystems Institute , University of California, Los Angeles , 570 Westwood Plaza , Los Angeles , California 90095-7227 , United States
- Department of Chemistry and Biochemistry , University of California, Los Angeles , 607 Charles E. Young Drive South , Los Angeles , California 90095-1569 , United States
| | - Thomas D Young
- California NanoSystems Institute , University of California, Los Angeles , 570 Westwood Plaza , Los Angeles , California 90095-7227 , United States
- Department of Chemistry and Biochemistry , University of California, Los Angeles , 607 Charles E. Young Drive South , Los Angeles , California 90095-1569 , United States
| | - Nika Taghdiri
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry , University of California, Los Angeles , Los Angeles , California 90095-1668 , United States
| | - Sahar Ansari
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry , University of California, Los Angeles , Los Angeles , California 90095-1668 , United States
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, School of Dentistry , University of California, Los Angeles , Los Angeles , California 90095-1668 , United States
| | - Song Li
- Department of Bioengineering , University of California, Los Angeles , 420 Westwood Plaza, 5121 Engineering V , Los Angeles , California 90095-1600 , United States
- Center for Minimally Invasive Therapeutics (C-MIT) , University of California, Los Angeles , Los Angeles , California 90095-7227 , United States
| | - Ali Khademhosseini
- California NanoSystems Institute , University of California, Los Angeles , 570 Westwood Plaza , Los Angeles , California 90095-7227 , United States
- Department of Bioengineering , University of California, Los Angeles , 420 Westwood Plaza, 5121 Engineering V , Los Angeles , California 90095-1600 , United States
- Center for Minimally Invasive Therapeutics (C-MIT) , University of California, Los Angeles , Los Angeles , California 90095-7227 , United States
- Department of Chemical and Biomolecular Engineering , University of California, Los Angeles , Los Angeles , California 90095-1592 , United States
| | - Paul S Weiss
- California NanoSystems Institute , University of California, Los Angeles , 570 Westwood Plaza , Los Angeles , California 90095-7227 , United States
- Department of Chemistry and Biochemistry , University of California, Los Angeles , 607 Charles E. Young Drive South , Los Angeles , California 90095-1569 , United States
- Center for Minimally Invasive Therapeutics (C-MIT) , University of California, Los Angeles , Los Angeles , California 90095-7227 , United States
- Department of Materials Science and Engineering , University of California, Los Angeles , 410 Westwood Plaza , Los Angeles , California 90095-1595 , United States
| | - Alireza Moshaverinia
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry , University of California, Los Angeles , Los Angeles , California 90095-1668 , United States
- California NanoSystems Institute , University of California, Los Angeles , 570 Westwood Plaza , Los Angeles , California 90095-7227 , United States
- Center for Minimally Invasive Therapeutics (C-MIT) , University of California, Los Angeles , Los Angeles , California 90095-7227 , United States
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Ruggiero S, Saxena D, Tetradis S, Aghaloo T, Ioannidou E. Task Force on Design and Analysis in Oral Health Research: Medication-Related Osteonecrosis of the Jaw. JDR Clin Trans Res 2019; 3:222-225. [PMID: 30938596 DOI: 10.1177/2380084418770662] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Knowledge Transfer Statement: This article discusses the proceedings of the conference organized by the Task Force on Design and Analysis in Oral Health Research on the understanding of the translational evidence on the etiology and pathogenesis of medication-related osteonecrosis of the jaw as well as the clinical protocols on patient management.
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Affiliation(s)
- S Ruggiero
- 1 New York Center for Orthognathic and Maxillofacial Surgery, New York, NY, USA.,2 Stony Brook School of Dental Medicine, Stony Brook, NY, USA.,3 School of Medicine, Hofstra-Northwell Health, Hempstead, NY, USA
| | - D Saxena
- 4 Department of Basic Sciences and Craniofacial Biology College of Dentistry, New York University, New York, NY, USA
| | - S Tetradis
- 5 School of Dentistry, University of California at Los Angeles, CA, USA
| | - T Aghaloo
- 6 Section of Oral and Maxillofacial Surgery, School of Dentistry, University of California at Los Angeles, CA, USA
| | - E Ioannidou
- 7 Division of Periodontology, UConn Health, Farmington, CT, USA.,8 Task Force on Design and Analysis in Oral Health Research, Princeton, NJ, USA
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Morton D, Gallucci G, Lin WS, Pjetursson B, Polido W, Roehling S, Sailer I, Aghaloo T, Albera H, Bohner L, Braut V, Buser D, Chen S, Dawson A, Eckert S, Gahlert M, Hamilton A, Jaffin R, Jarry C, Karayazgan B, Laine J, Martin W, Rahman L, Schlegel A, Shiota M, Stilwell C, Vorster C, Zembic A, Zhou W. Group 2 ITI Consensus Report: Prosthodontics and implant dentistry. Clin Oral Implants Res 2019; 29 Suppl 16:215-223. [PMID: 30328196 DOI: 10.1111/clr.13298] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [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: 05/18/2018] [Accepted: 05/26/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Working Group 2 was convened to address topics relevant to prosthodontics and dental implants. Systematic reviews were developed according to focused questions addressing (a) the number of implants required to support fixed full-arch restorations, (b) the influence of intentionally tilted implants compared to axial positioned implants when supporting fixed dental prostheses (FDPs), (c) implant placement and loading protocols, (d) zirconia dental implants, (e) zirconia and metal ceramic implant supported single crowns and (f) zirconia and metal ceramic implant supported FDPs. MATERIALS AND METHODS Group 2 considered and discussed information gathered in six systematic reviews. Group participants discussed statements developed by the authors and developed consensus. The group developed and found consensus for clinical recommendations based on both the statements and the experience of the group. The consensus statements and clinical recommendations were presented to the plenary (gathering of all conference attendees) and discussed. Final versions were developed after consensus was reached. RESULTS A total of 27 consensus statements were developed from the systematic reviews. Additionally, the group developed 24 clinical recommendations based on the combined expertise of the participants and the developed consensus statements. CONCLUSIONS The literature supports the use of various implant numbers to support full-arch fixed prostheses. The use of intentionally tilted dental implants is indicated when appropriate conditions exist. Implant placement and loading protocols should be considered together when planning and treating patients. One-piece zirconia dental implants can be recommended when appropriate clinical conditions exist although two-piece zirconia implants should be used with caution as a result of insufficient data. Clinical performance of zirconia and metal ceramic single implant supported crowns is similar and each demonstrates significant, though different, complications. Zirconia ceramic FDPs are less reliable than metal ceramic. Implant supported monolithic zirconia prostheses may be a future option with more supporting evidence.
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Affiliation(s)
- Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - German Gallucci
- Department of Restorative Dentistry, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Bjarni Pjetursson
- Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland
| | - Waldemar Polido
- Department of Oral and Maxillofacial Surgery, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Stefan Roehling
- Clinic for Oral and Cranio-Maxillofacial Surgery, High-Tech Research Center, University of Basel, Basel, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University of Geneva, Geneva, Switzerland
| | - Tara Aghaloo
- Department of Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, California
| | - Hugo Albera
- Faculty of Dentistry, Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Lauren Bohner
- Department of Prosthodontics, University of Sao Paulo, Sao Paulo, Brazil
| | - Vedrana Braut
- Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland.,Private Practice, Rijeka, Croatia
| | - Daniel Buser
- Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
| | - Stephen Chen
- Private Practice, University of Melbourne, Melbourne, Vic., Australia
| | | | - Steven Eckert
- Department of Dental Specialties, Mayo Clinic School of Medicine, Rochester, Minnesota
| | - Michael Gahlert
- Private Practice, Munich, Germany.,Clinic for Oral and Cranio-Maxillofacial Surgery, High-Tech Research Center, University of Basel, Basel, Switzerland
| | - Adam Hamilton
- Department of Restorative Dentistry, Harvard School of Dental Medicine, Boston, Massachusetts
| | | | | | - Banu Karayazgan
- Department of Prosthodontics, Okan University, Istanbul, Turkey
| | - Juhani Laine
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Yurku, Finland
| | - William Martin
- Department of Oral and Maxillofacial Surgery, University of Florida, Gainesville, Florida
| | | | - Andreas Schlegel
- Private Practice, Munich, Germany.,Department of Maxillofacial Surgery, University of Erlangen, Erlangen, Germany
| | - Makato Shiota
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Charlotte Stilwell
- Private Practice, London, UK.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | | | - Anja Zembic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Wenjie Zhou
- Department of Restorative Dentistry, Harvard School of Dental Medicine, Boston, Massachusetts.,Ninth People's Hospital, Shanghai, China
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Kim S, Cui ZK, Koo B, Zheng J, Aghaloo T, Lee M. Chitosan-Lysozyme Conjugates for Enzyme-Triggered Hydrogel Degradation in Tissue Engineering Applications. ACS Appl Mater Interfaces 2018; 10:41138-41145. [PMID: 30421603 PMCID: PMC6453716 DOI: 10.1021/acsami.8b15591] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Tuning hydrogel degradation enables effective and successful tissue regeneration by modulating cellular behaviors and matrix formation. In this work, we develop a novel degradable hydrogel scaffold on the basis of a unique enzyme-substrate complex by photocrosslinking. Chitosan and lysozyme are chemically modified with methacrylate moieties to be tethered in hydrogels, and in the presence of riboflavin initiator, these hydrogels are cured by blue light irradiation. The incorporation of lysozyme to chitosan hydrogels accelerates the degradation rate of the crosslinked hydrogels in a dose-dependent manner, as evidenced by an increase in pore size and interconnectivity through cryogenic scanning electron microscopy over time. Those noncytotoxic materials significantly enhance cellular proliferation and migration, which contribute to osteogenic differentiation of encapsulated mesenchymal stem cells in vitro and bone formation in mouse calvarial defects. These findings suggest a promising strategy to modulate the degradation behavior of hydrogels for use in tissue engineering.
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Affiliation(s)
- Soyon Kim
- Department of Bioengineering, University of California, Los Angeles, USA
| | - Zhong-Kai Cui
- Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China
- Division of Advanced Prosthodontics, University of California, Los Angeles, USA
| | - Bonhye Koo
- Division of Biology, Chemistry and Materials Science, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, USA
| | - Jiwen Zheng
- Division of Biology, Chemistry and Materials Science, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, University of California, Los Angeles, USA
| | - Min Lee
- Department of Bioengineering, University of California, Los Angeles, USA
- Division of Advanced Prosthodontics, University of California, Los Angeles, USA
- Corresponding author: Min Lee, PhD, UCLA School of Dentistry, 10833 Le Conte Avenue, CHS 23-088F, Los Angeles, CA 90095-1668, USA, , Phone: +1-310-825-6674, Fax: +1-310-825-6345
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40
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Yu Y, Deng P, Yu B, Szymanski JM, Aghaloo T, Hong C, Wang CY. Inhibition of EZH2 Promotes Human Embryonic Stem Cell Differentiation into Mesoderm by Reducing H3K27me3. Stem Cell Reports 2018; 11:1579-1580. [PMID: 30540964 PMCID: PMC6294283 DOI: 10.1016/j.stemcr.2018.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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41
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Daudt Polido W, Aghaloo T, Emmett TW, Taylor TD, Morton D. Number of implants placed for complete‐arch fixed prostheses: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:154-183. [DOI: 10.1111/clr.13312] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 05/03/2018] [Accepted: 05/28/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Waldemar Daudt Polido
- Department of Oral and Maxillofacial SurgeryIndiana University School of Dentistry Indianapolis Indiana
| | - Tara Aghaloo
- Department of Oral and Maxillofacial SurgeryUCLA School of Dentistry Los Angeles California
| | - Thomas W. Emmett
- Ruth Lilly Medical LibraryIndiana University School of Medicine Indianapolis Indiana
| | - Thomas D. Taylor
- Department of Reconstructive SciencesUniversity of Connecticut School of Dental Medicine Farmington Connecticut
| | - Dean Morton
- Department of ProsthodonticsIndiana University School of Dentistry Indianapolis Indiana
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Au JK, Palma Diaz MF, Aghaloo T, St John MA. Scaffold-Assisted Artificial Hair Implantation in a Rat Model. JAMA FACIAL PLAST SU 2018; 20:230-237. [PMID: 29285533 PMCID: PMC6145790 DOI: 10.1001/jamafacial.2017.2186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/08/2017] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Current treatments for alopecia with autograft hair transplantation face limitations that may preclude complete hair restoration and leave patients with donor site scars. Scaffold assisted artificial hair implantation as demonstrated in a rat model may provide an adjunct for hair restoration without donor site morbidity. OBJECTIVE To design and create porous high-density polyethylene (PHDPE) and expanded polytetrafluoroethylene (ePTFE) hair-bearing scaffolds and evaluate their biocompatibility in a rat model. DESIGN, SETTING, AND PARTICIPANTS For this single-institution randomized prospective animal study, 34 Sprague Dawley rats were randomly selected into 2 groups: 24 rats for direct implantation and 10 rats for delayed implantation. The direct-implantation group was randomly divided into 3 subgroups of 8 rats, which were observed for 2, 12, and 24 week. INTERVENTIONS Each rat dorsum was implanted with 4 scaffolds-PHDPE and ePTFE with and without hair-in a randomized 4-quadrant manner. The rats in the direct-implantation group were observed to their selected time points of 2, 12, and 24 weeks. The rats in the delayed-implantation group were observed for 4 weeks at which, all well-healed scaffolds without hair were then percutaneously implanted with 2 follicular units of hair. These rats were then observed for another 4 weeks. MAIN OUTCOMES AND MEASURES During the clinical observation period, scaffolds were observed for signs of infection, extrusion, and persistence of follicular units. Following sacrifice, sagittal sections of scaffold and surrounding skin were fixed in formalin, stained with hematoxylin-eosin, and evaluated for degree of fibrovascular invasion and acute and chronic inflammation. RESULTS Overall 94.5% (86 of 91) of the scaffolds were well healed at time of evaluation (2 week, 100% [32 of 32]; 12 week, 96.3% [26 of 27]; 24 week, 87.5% [28 of 32]); while 85.6% of artificial hair follicular units were intact at time of evaluation (2 week, 93.8% [30 of 32]; 12 week, 86.7% [26 of 30]; 24 week, 75.0% [21 of 28]). Within the delayed implant group 100% (19 of 19) of the hair-implanted scaffolds were well healed at 8 weeks, with 94.7% (36 of 38) of the follicular units intact; 100% of the delayed-hair implant scaffolds were well healed with 86.1% (36 of 38) of the follicular units intact. Kaplan-Meier log-rank analysis showed no significant difference in survival between ePTFE and PHDPE scaffolds, as well as scaffolds with hair and scaffolds without hair. Upon histological analysis, overall scaffolds with hair were noted to have greater chronic inflammation (95% CI, -0.81 to -1.10; P = .01), and PHDPE was noted to have significantly great fibrovascular integration (95% CI, -11.42 to -1.96; P = .01) compared with ePTFE. CONCLUSIONS AND RELEVANCE Overall, PHDPE and ePTFE hair bearing scaffolds were well tolerated in a rat model. Progressive loss of artificial hair may be percutaneously implanted without significant increases in infection or extrusion. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Joshua K Au
- Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, California
| | - Miguel Fernando Palma Diaz
- Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, California
- UCLA Head and Neck Cancer Program, UCLA David Geffen School of Medicine, Los Angeles, California
- Jonsson Comprehensive Cancer Center, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Tara Aghaloo
- Section of Oral & Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, California
| | - Maie A St John
- Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, California
- UCLA Head and Neck Cancer Program, UCLA David Geffen School of Medicine, Los Angeles, California
- Jonsson Comprehensive Cancer Center, UCLA David Geffen School of Medicine, Los Angeles, California
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Aghaloo T. Pathophysiology of Anti‐resorptive Medication‐related Osteonecrosis. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.365.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Tara Aghaloo
- Oral and Maxillofacial SurgeryUCLA School of DentistryLos AngelesCA
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44
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Cillo JE, Aghaloo T, Basi D, Bouloux GF, Campbell JA, Chou J, Dodson T, Edwards SP, Kademani D, Peacock Z. Proceedings of the American Association of Oral and Maxillofacial Surgeon's 2017 Clinical and Scientific Innovations in Oral and Maxillofacial Surgery (CSIOMS). J Oral Maxillofac Surg 2017; 76:248-257. [PMID: 29156177 DOI: 10.1016/j.joms.2017.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 10/18/2017] [Accepted: 10/19/2017] [Indexed: 10/18/2022]
Abstract
The sixth biennial Clinical and Scientific Innovations in Oral and Maxillofacial Surgery, formerly the Research Summit, of the American Association of Oral and Maxillofacial Surgeons and its Committee on Research Planning and Technology Assessment was held in Rosemont, Illinois from April 28 to 30, 2017. The goal of the symposium is to provide a forum for the latest clinical and scientific advances to be brought to the specialty. It also nurtures collaboration and the development of relationships between oral and maxillofacial surgeons and researchers to bridge the gap between clinical and basic science. The goal is to improve the care of oral and maxillofacial surgical patients through the advancement of translational and clinical research.
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Affiliation(s)
- Joseph E Cillo
- Associate Professor and Program Director, Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA.
| | - Tara Aghaloo
- Professor and Assistant Dean for Clinical Research, UCLA School of Dentistry, Los Angeles, CA
| | | | - Gary F Bouloux
- Professor and Residency Program Director, Division of Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA
| | - Joshua A Campbell
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Tennessee, Knoxville, TN
| | - Joli Chou
- Assistant Professor, Thomas Jefferson University Hospital, Philadelphia, PA
| | - Thomas Dodson
- Professor and Chair, Oral and Maxillofacial Surgery, University of Washington, School of Dentistry, Seattle, WA
| | - Sean P Edwards
- Clinical Associate Professor; Director, Residency Program; Chief, Pediatric Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI
| | - Deepak Kademani
- Chairman, Medical Director, and Fellowship Director, Department of Surgery, Oral and Maxillofacial Surgery, Oral-Head and Neck Oncologic and Reconstructive Surgery, North Memorial and Hubert Humphrey Cancer Center, Minneapolis, MN
| | - Zachary Peacock
- Assistant Professor, Oral and Maxillofacial Surgery; Director, Research and the Skeletal Biology Research Center, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA
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45
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Ansari S, Sarrion P, Hasani-Sadrabdi MM, Aghaloo T, Wu BM, Moshaverinia A. Regulation of the fate of dental-derived mesenchymal stem cells using engineered alginate-GelMA hydrogels. J Biomed Mater Res A 2017; 105:2957-2967. [PMID: 28639378 PMCID: PMC5623163 DOI: 10.1002/jbm.a.36148] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 06/14/2017] [Accepted: 06/20/2017] [Indexed: 11/11/2022]
Abstract
Mesenchymal stem cells (MSCs) derived from dental and orofacial tissues provide an alternative therapeutic option for craniofacial bone tissue regeneration. However, there is still a need to improve stem cell delivery vehicles to regulate the fate of the encapsulated MSCs for high quality tissue regeneration. Matrix elasticity plays a vital role in MSC fate determination. Here, we have prepared various hydrogel formulations based on alginate and gelatin methacryloyl (GelMA) and have encapsulated gingival mesenchymal stem cells (GMSCs) and human bone marrow MSCs (hBMMSCs) within these fabricated hydrogels. We demonstrate that addition of the GelMA to alginate hydrogel reduces the elasticity of the hydrogel mixture. While presence of GelMA in an alginate-based scaffold significantly increased the viability of encapsulated MSCs, increasing the concentration of GelMA downregulated the osteogenic differentiation of encapsulated MSCs in vitro due to decrease in the stiffness of the hydrogel matrix. The osteogenic suppression was rescued by addition of a potent osteogenic growth factor such as rh-BMP-2. In contrast, MSCs encapsulated in alginate hydrogel without GelMA were successfully osteo-differentiated without the aid of additional growth factors, as confirmed by expression of osteogenic markers (Runx2 and OCN), as well as positive staining using Xylenol orange. Interestingly, after two weeks of osteo-differentiation, hBMMSCs and GMSCs encapsulated in alginate/GelMA hydrogels still expressed CD146, an MSC surface marker, while MSCs encapsulated in alginate hydrogel failed to express any positive staining. Altogether, our findings suggest that it is possible to control the fate of encapsulated MSCs within hydrogels by tuning the mechanical properties of the matrix. We also reconfirmed the important role of the presence of inductive signals in guiding MSC differentiation. These findings may enable the design of new multifunctional scaffolds for spatial and temporal control over the fate and function of stem cells even post-transplantation. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2957-2967, 2017.
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Affiliation(s)
- Sahar Ansari
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA
| | - Patricia Sarrion
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA
| | - Mohammad Mahdi Hasani-Sadrabdi
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA
- Parker H. Petit Institute for Bioengineering and Bioscience, G. W. Woodruff School of Mechanical Engineering and School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, CA
| | - Benjamin M Wu
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA
| | - Alireza Moshaverinia
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA
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Soundia A, Hadaya D, Esfandi N, Gkouveris I, Christensen R, Dry SM, Bezouglaia O, Pirih F, Nikitakis N, Aghaloo T, Tetradis S. Zoledronate Impairs Socket Healing after Extraction of Teeth with Experimental Periodontitis. J Dent Res 2017; 97:312-320. [PMID: 28954199 DOI: 10.1177/0022034517732770] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Osteonecrosis of the jaws (ONJ) is a rare but severe complication of antiresorptive medications, such as bisphosphonates, used in the treatment of bone malignancy or osteoporosis. Tooth extraction and dental disease have been strongly associated with ONJ development. Here, we investigated molecular and cellular markers of socket healing after extraction of healthy or teeth with experimental periodontitis (EP) in Wistar-Han rats treated with zoledronic acid (ZA). We included 4 experimental groups: vehicle-treated animals with extraction of healthy teeth or teeth with ligature-induced EP and ZA-treated animals with extraction of healthy teeth or teeth with EP. Animals were pretreated with vehicle or ZA for a week, and EP was induced. Four weeks later, the second maxillary molars were extracted; sockets were allowed to heal for 4 wk; animals were euthanized; and maxillae were isolated. Radiographically, extraction sockets in groups 1, 2, and 3 demonstrated normal healing. Contrary incomplete socket healing was noted after extraction of teeth with EP in ZA-treated rats of group 4. Histologically, persistent inflammation and extensive osteonecrosis were seen in group 4. Disorganization of the collagen network, collagen type III predominance, and lack of collagen fiber insertion in the necrotic bone were associated with impaired socket healing. Cells positive for MMP-9, MMP-13, and α-SMA expression were present at the areas of epithelial invagination and adjacent to osteonecrotic bone. Importantly, human biopsies from patients with ONJ showed similar findings. Our data emphasize the importance of dental disease and tooth extraction in ONJ pathogenesis and help delineate an altered profile in wound-healing markers during ONJ development.
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Affiliation(s)
- A Soundia
- 1 Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - D Hadaya
- 1 Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - N Esfandi
- 1 Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - I Gkouveris
- 1 Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - R Christensen
- 1 Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - S M Dry
- 2 Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - O Bezouglaia
- 1 Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - F Pirih
- 3 Division of Constitutive and Regenerative Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - N Nikitakis
- 4 Department of Oral and Maxillofacial Pathology and Medicine, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - T Aghaloo
- 1 Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
| | - S Tetradis
- 1 Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA
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47
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Ansari S, Diniz IM, Chen C, Aghaloo T, Wu BM, Shi S, Moshaverinia A. Alginate/hyaluronic acid hydrogel delivery system characteristics regulate the differentiation of periodontal ligament stem cells toward chondrogenic lineage. J Mater Sci Mater Med 2017; 28:162. [PMID: 28914392 DOI: 10.1007/s10856-017-5974-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 09/01/2017] [Indexed: 06/07/2023]
Abstract
Cartilage tissue regeneration often presents a challenging clinical situation. Recently, it has been shown that Periodontal Ligament Stem Cells (PDLSCs) possess high chondrogenic differentiation capacity. In this study, we developed a stem cell delivery system based on alginate/hyaluronic acid (HA) loaded with TGF-β1 ligand, encapsulating PDLSCs; and investigated the chondrogenic differentiation of encapsulated cells in alginate/HA hydrogel microspheres in vitro and in vivo. The results showed that PDLSCs, as well as human bone marrow mesenchymal stem cells (hBMMSCs), as the positive control, were stained positive for both toluidine blue and alcian blue staining, while exhibiting high levels of gene expression related to chondrogenesis (Col II, Aggrecan and Sox-9), as assessed via qPCR. The quantitative PCR analyses exhibited that the chondrogenic differentiation of encapsulated MSCs can be regulated by the modulus of elasticity of hydrogel delivery system, confirming the vital role of the microenvironment, and the presence of inductive signals for viability and differentiation of MSCs. In vivo, histological and immunofluorescence staining for chondrogenic specific protein markers confirmed ectopic cartilage-like tissue regeneration inside transplanted hydrogels. PDLSCs presented significantly greater capability for chondrogenic differentiation than hBMMSCs (P < 0.05). Altogether, our findings confirmed that alginate/HA hydrogels encapsulating PDLSCs are a promising candidate for cartilage regeneration.
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Affiliation(s)
- Sahar Ansari
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, USA
| | - Ivana M Diniz
- Departamento de Odontologia Restauradora, Faculdade de Odontologia da UFMG, Belo Horizonte, Brazil
| | - Chider Chen
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, CA, USA
| | - Benjamin M Wu
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, USA
| | - Songtao Shi
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alireza Moshaverinia
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, USA.
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Cui ZK, Kim S, Baljon JJ, Doroudgar M, Lafleur M, Wu BM, Aghaloo T, Lee M. Design and Characterization of a Therapeutic Non-phospholipid Liposomal Nanocarrier with Osteoinductive Characteristics To Promote Bone Formation. ACS Nano 2017; 11:8055-8063. [PMID: 28787576 PMCID: PMC5575928 DOI: 10.1021/acsnano.7b02702] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Sterosomes are recently developed types of non-phospholipid liposomes formed from single-chain amphiphiles and high content of sterols. Although sterosomes presented significantly increased stability compared to conventional phospholipid liposomes, current sterosome biomaterials are not truly bioactive and have no intrinsic therapeutic effects. The purpose of this study was to develop a sterosome formulation with osteoinductive properties by an effective selection of sterol, one of the sterosome components. Oxysterols are oxidized derivatives of cholesterol and are known to stimulate osteogenesis and bone formation. Thus, 20S-hydroxycholesterol (Oxy), one of the most potent oxysterols for bone regeneration, was examined as a promising candidate molecule to form fluid lamellar phases with a single-chain amphiphile, namely, stearylamine (SA). First, the optimal composition was identified by investigating the phase behavior of SA/Oxy mixtures. Next, the capacity of the optimized SA/Oxy sterosomes to promote osteogenic differentiation of bone marrow stromal cells was assessed in vitro in a hydrogel environment. Furthermore, we explored the effects of osteogenic oxysterol sterosomes in vivo with the mouse critical-sized calvarial defect model. Our results showed that SA/Oxy sterosomes induced osteogenic differentiation in vitro and enhanced calvarial healing without delivery of additional therapeutic agents, indicating their intrinsic bone-forming potential. This study suggests a promising non-phospholipid liposomal platform with osteoinductive properties for delivery of small molecular drugs and/or other therapeutic genes for enhanced bone formation.
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Affiliation(s)
- Zhong-Kai Cui
- Division of Advanced Prosthodontics, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095
| | - Soyon Kim
- Department of Bioengineering, University of California Los Angeles, 420 Westwood Plaza, Los Angeles, CA 90095
| | - Jessalyn J. Baljon
- Department of Bioengineering, University of California Los Angeles, 420 Westwood Plaza, Los Angeles, CA 90095
| | - Mahmoudreza Doroudgar
- Department of Chemistry, Université de Montréal, C.P.6128, Succ. Centre Ville, Montréal, Québec H3C 3J7, Canada
| | - Michel Lafleur
- Department of Chemistry, Université de Montréal, C.P.6128, Succ. Centre Ville, Montréal, Québec H3C 3J7, Canada
| | - Benjamin M Wu
- Division of Advanced Prosthodontics, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095
- Department of Bioengineering, University of California Los Angeles, 420 Westwood Plaza, Los Angeles, CA 90095
| | - Tara Aghaloo
- Division of Diagnostic and Surgical Sciences, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095
| | - Min Lee
- Division of Advanced Prosthodontics, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095
- Department of Bioengineering, University of California Los Angeles, 420 Westwood Plaza, Los Angeles, CA 90095
- Corresponding author. Tel: +1 310 825 6674, Fax: +1 310 825 6345,
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Yu Y, Deng P, Yu B, Szymanski JM, Aghaloo T, Hong C, Wang CY. Inhibition of EZH2 Promotes Human Embryonic Stem Cell Differentiation into Mesoderm by Reducing H3K27me3. Stem Cell Reports 2017; 9:752-761. [PMID: 28826853 PMCID: PMC5599223 DOI: 10.1016/j.stemcr.2017.07.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 08/24/2016] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 01/16/2023] Open
Abstract
Mesoderm derived from human embryonic stem cells (hESCs) is a major source of the mesenchymal stem/stromal cells (MSCs) that can differentiate into osteoblasts and chondrocytes for tissue regeneration. While significant progress has been made in understanding of molecular mechanisms of hESC differentiation into mesodermal cells, little is known about epigenetic factors controlling hESC fate toward mesoderm and MSCs. Identifying potential epigenetic factors that control hESC differentiation will undoubtedly lead to advancements in regenerative medicine. Here, we conducted an epigenome-wide analysis of hESCs and MSCs and uncovered that EZH2 was enriched in hESCs and was downregulated significantly in MSCs. The specific EZH2 inhibitor GSK126 directed hESC differentiation toward mesoderm and generated more MSCs by reducing H3K27me3. Our results provide insights into epigenetic landscapes of hESCs and MSCs and suggest that inhibiting EZH2 promotes mesodermal differentiation of hESCs. Inhibiting EZH2 directs hESC differentiation to mesoderm and generates more MSCs H3K27me3 levels decrease on specific gene clusters as hESCs differentiate to MSCs EZH2 is downregulated as hESC differentiate to MSCs
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Affiliation(s)
- Yongxin Yu
- Laboratory of Molecular Signaling, Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Peng Deng
- Laboratory of Molecular Signaling, Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Bo Yu
- Laboratory of Molecular Signaling, Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - John M Szymanski
- Laboratory of Molecular Signaling, Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Tara Aghaloo
- Section of Oral and Maxillofacial Surgery, Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Christine Hong
- Section of Orthodontics, Division of Growth and Development, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Cun-Yu Wang
- Laboratory of Molecular Signaling, Division of Oral Biology and Medicine, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA; Broad Stem Cell Research Institute and Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA 90095, USA.
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50
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Cui ZK, Sun JA, Baljon JJ, Fan J, Kim S, Wu BM, Aghaloo T, Lee M. Simultaneous delivery of hydrophobic small molecules and siRNA using Sterosomes to direct mesenchymal stem cell differentiation for bone repair. Acta Biomater 2017; 58:214-224. [PMID: 28578107 DOI: 10.1016/j.actbio.2017.05.057] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/22/2017] [Accepted: 05/30/2017] [Indexed: 01/15/2023]
Abstract
The use of small molecular drugs with gene manipulation offers synergistic therapeutic efficacy by targeting multiple signaling pathways for combined treatment. Stimulation of mesenchymal stem cells (MSCs) with osteoinductive small molecule phenamil combined with suppression of noggin is a promising therapeutic strategy that increases bone morphogenetic protein (BMP) signaling and bone repair. Our cationic Sterosome formulated with stearylamine (SA) and cholesterol (Chol) is an attractive co-delivery system that not only forms stable complexes with small interfering RNA (siRNA) molecules but also solubilizes hydrophobic small molecules in a single vehicle, for directing stem cell differentiation. Herein, we demonstrate the ability of SA/Chol Sterosomes to simultaneously deliver hydrophobic small molecule phenamil and noggin-directed siRNA to enhance osteogenic differentiation of MSCs both in in vitro two- and three-dimensional settings as well as in a mouse calvarial defect model. These results suggest a novel liposomal platform to simultaneously deliver therapeutic genes and small molecules for combined therapy. STATEMENT OF SIGNIFICANCE Application of phenamil, a small molecular bone morphogenetic protein (BMP) stimulator, combined with suppression of natural BMP antagonists such as noggin is a promising therapeutic strategy to enhance bone regeneration. Here, we present a novel strategy to co-deliver hydrophobic small molecule phenamil and noggin-targeted siRNA via cationic Sterosomes formed with stearylamine (SA) and high content of cholesterol (Chol) to enhance osteogenesis and bone repair. SA/Chol Sterosomes demonstrated high phenamil encapsulation efficiency, supported sustained release of encapsulated drugs, and significantly reduced drug dose requirements to induce osteogenic differentiation of mesenchymal stem cells (MSCs). Simultaneous deliver of phenamil and noggin siRNA in a single vehicle synergistically enhanced MSC osteogenesis and calvarial bone repair. This study suggests a new non-phospholipid liposomal formulation to simultaneously deliver small molecules and therapeutic genes for combined treatment.
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