Abstract
Microscopic and molecular events related to alveolar ridge augmentation are less known because of the lack of experimental models and limited molecular markers used to evaluate this process. We propose here the chick embryo chorioallantoic membrane (CAM) as an in vivo model to study the interaction between CAM and bone substitutes (B) combined with hyaluronic acid (BH), saline solution (BHS and BS, respectively), or both, aiming to point out the microscopic and molecular events assessed by Runt-related transcription factor 2 (RUNX 2), osteonectin (SPARC), and Bone Morphogenic Protein 4 (BMP4). The BH complex induced osteoprogenitor and osteoblastic differentiation of CAM mesenchymal cells, certified by the RUNX2 +, BMP4 +, and SPARC + phenotypes capable of bone matrix synthesis and mineralization. A strong angiogenic response without inflammation was detected on microscopic specimens of the BH combination compared with an inflammatory induced angiogenesis for the BS and BHS combinations. A multilayered organization of the BH complex grafted on CAM was detected with a differential expression of RUNX2, BMP4, and SPARC. The BH complex induced CAM mesenchymal cells differentiation through osteoblastic lineage with a sustained angiogenic response not related with inflammation. Thus, bone granules resuspended in hyaluronic acid seem to be the best combination for a proper non-inflammatory response in alveolar ridge augmentation. The CAM model allows us to assess the early events of the bone substitutes–mesenchymal cells interaction related to osteoblastic differentiation, an important step in alveolar ridge augmentation.
Highlights
Alveolar ridge augmentation represents a preliminary step in dental implant procedures
Based on the versatility of chorioallantoic membrane (CAM) given by its immature mesenchymal structure and its ability to have no immune system, we propose here CAM as a model for testing one of the bone substitutes usually used for alveolar ridge augmentation
This study is the first CAM experimental model testing biomaterials used in bone augmentation
Summary
Alveolar ridge augmentation represents a preliminary step in dental implant procedures. Several studies and highly heterogeneous data have been reported regarding the techniques applied and biomaterials used for alveolar ridge augmentation. Despite the fast development of alveolar ridge augmentation techniques, bone substitutes are still largely used for this procedure. The osteoconductive properties of these bone substitutes are widely recognized, but the most frequent criticism of these materials is that they only have osteoconductive properties, but not osteoinductive properties [8] In contrast with these data, a few recent reports highlighted the osteoinductive properties of a calcium-phosphate complex ( found in bone substitutes) based on several pathways, as stimulation of mesenchymal stem cells recruitment and commitment through an osteoblastic lineage, together with a strong angiogenic process [9,10]
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