Bone Graft Material Research Articles

The Dual Angiogenesis Effects via Nrf2/HO-1 Signaling Pathway of Melatonin Nanocomposite Scaffold on Promoting Diabetic Bone Defect Repair.

Given the escalating prevalence of diabetes, the demand for specific bone graft materials is increasing, owing to the greater tendency towards bone defects and more difficult defect repair resulting from diabetic bone disease (DBD). Melatonin (MT), which is known for its potent antioxidant properties, has been shown to stimulate both osteogenesis and angiogenesis. MT was formulated into MT@PLGA nanoparticles (NPs), mixed with sodium alginate (SA) hydrogel, and contained within a 3D printing polycaprolactone/β-Tricalcium phosphate (PCL/β-TCP) scaffold. The osteogenic capacity of the MT nanocomposite scaffold under diabetic conditions was demonstrated via in vitro and in vivo studies and the underlying mechanisms were investigated. Physicochemical characterization experiments confirmed the successful fabrication of the MT nanocomposite scaffold, which can achieve long-lasting sustained release of MT. The in vitro and in vivo studies demonstrated that the MT nanocomposite scaffold exhibited enhanced osteogenic capacity, which was elucidated by the dual angiogenesis effects activated through the NF-E2-related factor 2/Heme oxygenase 1 (Nrf2/HO-1) signaling pathway, including the enhancement of antioxidant enzyme activity to reduce the oxidative stress damage of vascular endothelial cells (VECs) and directly stimulating vascular endothelial growth factor (VEGF) production, which reversed the angiogenesis-osteogenesis uncoupling and promoted osteogenesis under diabetic conditions. This study demonstrated the research prospective and clinical implications of the MT nanocomposite scaffold as a novel bone graft for treating bone defect and enhancing bone fusion in diabetic individuals.

Ridge Preservation and Augmentation Using a Carbonated Apatite Bone Graft Substitute: A Case Series.

The newly developed mineral carbonated apatite has recently been proposed as a bone graft material for bone regenerative treatment in implant therapy. This case series details the clinical and radiographic outcomes of ridge preservation and ridge augmentation using only carbonated apatite as bone graft material for implant treatment. Twenty patients (36 sites) who required bone regeneration and implant placement were retrospectively assessed. Simultaneous carbonated apatite implant placement was performed using the simultaneous ridge preservation or augmentation approach on 24 sites in 13 patients with sufficient bone quantity for primary stabilization based on preoperative evaluation results. A staged ridge preservation or augmentation approach was used for the remaining 12 sites in seven patients with insufficient bone quantity. The mean regenerated bone height for each treatment method was as follows: simultaneous preservation, 7.4 ± 3.3 mm; simultaneous augmentation, 3.6 ± 2.3 mm; staged preservation, 7.2 ± 4.5 mm; and staged augmentation, 6.1 ± 2.7 mm. The mean regenerated bone width for each treatment method was as follows: simultaneous preservation, 6.5 ± 2.9 mm; simultaneous augmentation, 3.3 ± 2.5 mm; staged preservation, 5.5 ± 1.7 mm; and staged augmentation, 3.5 ± 1.9 mm. Ultimately, the use of carbonated apatite alone as a bone graft material in implant therapy resulted in stable and favorable bone regeneration.

Exploring the potential of strontium oxide-enriched borate bioactive glass as a bone graft material: Comprehensive analysis of physical characteristics and gamma shielding properties

This study explores the physical, elastic, and radiation shielding properties of SrO–B2O3 -based bioactive glass systems. The interest in BAG has grown significantly in recent years due to their applications in biomedicine, including bone transplants, wound care, and dental treatments. Borate-based glass matrices have emerged as a promising alternative to silicate-based BAG, exhibiting faster conversion to hydroxyapatite (HA) in physiological fluids and promoting cell proliferation for bone healing. The procedure known as melt quenching is used to prepare the glasses. The effects of varying SrO content on the glass properties were evaluated to understand their potential applications in the field of radiation shielding. Experimental results were compared with theoretical models, including the Makishima, Mackenzie, and Rocherulle models, to determine the most appropriate model for analyzing the elastic properties. The Rocherulle model was found to be in better agreement with experimental results. It was observed that the elastic modulus increased with increasing SrO content, suggesting improved mechanical strength due to higher cross-link density in the glass network. Furthermore, the glasses exhibited low Poisson's ratio values, indicating increased resistance to deformation under stress. The Phy-X program was used to determine the mass attenuation coefficient (GMAC), which is the fundamental parameter for evaluating the interaction of radiation with shielding materials. The GMAC results increase as the amount of SrO is increased from 0 to 6 wt%. In addition, the findings demonstrated that the effective atomic number (Zeff) of the produced glasses rise when the amount of SrO is increased from 0 to 6 wt%. The comprehensive analysis of physical, elastic, and radiation shielding properties provides valuable insights into the optimization of glass systems for specific applications in industries that require mechanical strength and radiation protection.

Comparative Analysis of Bone Regeneration According to Particle Type and Barrier Membrane for Octacalcium Phosphate Grafted into Rabbit Calvarial Defects.

This animal study was aimed to evaluate the efficacy of new bone formation and volume maintenance according to the particle type and the collagen membrane function for grafted octacalcium phosphate (OCP) in rabbit calvarial defects. The synthetic bone substitutes were prepared in powder form with 90% OCP and granular form with 76% OCP, respectively. The calvarial defects were divided into four groups according to the particle type and the membrane application. All specimens were acquired 2 weeks (n = 5) and 8 weeks (n = 5) after surgery. According to the micro-CT results, the new bone volume increased at 2 weeks in the 76% OCP groups compared to the 90% OCP groups, and the bone volume ratio was significantly lower in the 90% OCP group after 2 weeks. The histomorphometric analysis results indicated that the new bone area and its ratio in all experimental groups were increased at 8 weeks except for the group with 90% OCP without a membrane. Furthermore, the residual bone graft area and its ratio in the 90% OCP groups were decreased at 8 weeks. In conclusion, all types of OCP could be applied as biocompatible bone graft materials regardless of its density and membrane application. Neither the OCP concentration nor the membrane application had a significant effect on new bone formation in the defect area, but the higher the OCP concentration, the less graft volume maintenance was needed.

Modifying of physical, biodegradation, drug delivery characteristics of bioactive borophosphate glass by addition of molybdenum

In this study, high valence MoO3 was added to bioactive glass based on (50-x) P2O5 - 20 B2O3 – 20 CaO - 10 Na2O (x = 0, 5, 10–15 mol. %; the corresponding samples encoded as 0-Mo, 5-Mo, 10-Mo, and 15-Mo) to modify its physical, biodegradation, drug delivery properties. The glasses were prepared via melt-quenching process. The obtained glasses were analyzed by XRD, FTIR, SEM, Raman, and zeta potential (-42, - 31.8, - 34.5, and - 26.4 mV for 0-Mo, 5-Mo, 10-Mo, and 15-Mo, respectively). The in vitro bioactivity and biodegradation were examined in the simulated body fluid (SBF). The glasses were checked for ability for drug delivery by using ciprofloxacin (CIP) antibiotic as a drug model to attain an anticipated therapeutic response to avoid infections, and the drug release kinetic was studied by fitting the release data with Higuchi and Hixon-Crowell models. Finally, the antibacterial activity of the glasses conjugated with drug and drug-free glasses was tested against gram positive bacteria (Streptococcus aureus), gram negative bacteria (Escherchia coli) and Pathogenic yeast (Candida albicans). The results showed that the glasses were characterized by amorphous structure, and it showed a good bioactivity after immersion in SBF. Moreover, the results presented that addition of molybdenum increased the degradation rate of the glasses and affected their surface charge to less negative. In addition, it increased the drug loading efficiency and drug release rate, where 11.2 %, 56.9 %, 75.4 %, and 83.6 % of the drug released from 0-Mo, 5-Mo, 10-Mo, and 15-Mo, respectively, at the end of incubation time. The drug release occurred by combined diffusion and dissolution mechanism. Finally, antibacterial activity showed that drug-free glasses possessed antibacterial activity against the bacterial, meanwhile the antibacterial activity increased by loading CIP on the glass particles. In conclusion, different physical properties, as well as biodegradation and drug release can be tailored by addition of molybdenum. On the other hand, the prepared glasses are expected to be used successfully as multifunctional bone grafting materials.

Towards bone regeneration: Understanding the nucleating ability of proline-rich peptides in biomineralisation

Obtaining rapid mineralisation is a challenge in current bone graft materials, which has been attributed to the difficulty of guiding the biological processes towards osteogenesis. Amelogenin, a key protein in enamel formation, inspired the design of two intrinsically disordered peptides (P2 and P6) that enhance in vivo bone formation, but the process is not fully understood. In this study, we have elucidated the mechanism by which these peptides induce improved mineralisation. Our molecular dynamics analysis demonstrated that in an aqueous environment, P2 and P6 fold to interact with the surrounding Ca2+, PO43− and OH− ions, which can lead to apatite nucleation. Although P2 has a less stable backbone, it folds to a stable structure that allows for the nucleation of larger calcium phosphate aggregates than P6. These results were validated experimentally in a concentrated simulated body fluid solution, where the peptide solutions accelerated the mineralisation process compared to the control and yielded mineral structures mimicking the amorphous calcium phosphate crystals that can be found in lamella bone. A pH drop for the peptide groups suggests depletion of calcium and phosphate, a prerequisite for intrinsic osteoinduction, while S/TEM and SEM suggested that the peptide regulated the mineral nucleation into lamella flakes. Evidently, the peptides accelerate and guide mineral formation, elucidating the mechanism for how these peptides can improve the efficacy of P2 or P6 containing devices for bone regeneration. The work also demonstrates how experimental mineralisation study coupled with molecular dynamics is a valid method for understanding and predicting in vivo performance prior to animal trials.

Quantitative analysis of change in bone volume 5 years after sinus floor elevation using plate-shaped bone substitutes: a prospective observational study

PurposeTricalcium phosphate (TCP) has osteoconductive ability and reportedly offers similar clinical results as autogenous bone grafts in dental implant treatment. However, few reports quantify temporal changes in augmented bone volume after sinus augmentation. We aimed to establish a three-dimensional (3D) quantification method to assess bone volume after sinus augmentation and to evaluate biocompatibility of the TCP plate.MethodsMaxillary sinus floor augmentation was performed employing the lateral window technique, and plate-shaped β-TCP (TCP plate) was used instead of granular bone grafting materials. After lifting the sinus membrane, the TCP plate was inserted and supported by dental implants or micro-screws. The changes in bone volumes in the maxillary sinus before and after surgery were recorded using cone-beam computed tomography, saved as Digital Imaging and Communications in Medicine-formatted files, and transformed to Standard Triangle Language (STL)-formatted files. Pre- and post-operative STL data of bone volume were superimposed, and the augmented bone volume was calculated. Moreover, changes in bone volumes, TCP plate resorption rates, and bone heights surrounding the implants were three dimensionally quantified.ResultsFifteen implants in nine subjects were included in this study. TCP plates secured long-term space making, with results similar to those of granular bone substitutes. Newly formed bone was identified around the implant without bone graft material. TCP plate was absorbed and gradually disappeared.ConclusionsA novel 3D quantification method was established to evaluate changes in bone volume. Clinical application of TCP plate in sinus augmentation could be a better procedure in terms of prognosis and safety.

Risk Factors for Early Implant Failure and Selection of Bone Grafting Materials for Various Bone Augmentation Procedures: A Narrative Review.

Implant therapy is now an established treatment with high long-term success and survival rates. However, early implant failure, which occurs within one year of superstructure placement, occurs at a higher rate than late failure, which is represented by peri-implantitis caused by bacterial infection. Furthermore, various risk factors for early failure have been reported, including patient-related factors, such as systemic diseases, smoking, and bone quality and quantity, as well as surgery-related factors, such as surgeons' skill, osteogenesis technique, and selection of graft material, and implant-related factors, such as initial implant fixation and implant length diameter. Due to the wide variety of relevant factors reported, it is difficult to identify the cause of the problem. The purpose of this review is to discuss the risk factors associated with various types of bone augmentation which have a close causal relationship with early implant failure, and to determine the optimal bone grafting material for bone augmentation procedures to avoid early implant failure.

Enhanced Osteogenic Activity and Antibacterial Properties of Graphene Oxide-Poly(Lactic Acid) Films for the Repair of Cranial Defects in Rats

The failure of bone defect repair caused by bacterial infection is a significant clinical challenge. However, the currently utilized bone graft materials lack antibacterial properties, necessitating the development of bone repair materials with both osteoinductive and antibacterial capabilities. Graphene oxide (GO) has garnered considerable attention due to its distinctive physical, chemical, and biological characteristics. In this study, we prepared a graphene oxide-poly(lactic acid) (GO-PLA) film with exceptional biological properties. In vitro investigations demonstrated that the GO-PLA film substantially enhanced the adhesion and proliferation capacity of rat bone marrow mesenchymal stem cells (rBMSCs). Furthermore, we observed augmented alkaline phosphatase activity as well as increased expression levels of osteogenic genes in rBMSCs cultured on the GO-PLA film. Additionally, we evaluated the antibacterial activity of our samples using gram-positive Streptococcus mutans (Sm) and gram-negative Actinobacillus actinomycetemcomitans (Aa). Our findings revealed that GO doping significantly inhibited bacterial growth. Moreover, implantation experiments conducted on rat skull defects demonstrated excellent guided bone regeneration performance exhibited by the GO-PLA film. Overall, our results indicate that the GO-PLA film possesses outstanding osteogenic and antibacterial properties, making it a promising biomaterial for bone tissue regeneration.

Customized three-dimensional printed ceramic bone grafts for osseous defects: a prospective randomized study

Ridge resorption can result in insufficient bone volume for implant surgery, necessitating bone substitutes to restore the resorption area. Recent advances in computer-aided design and manufacturing enable the use of alloplastic bone graft materials with customizable compositions or shapes. This randomized study evaluated the clinical effectiveness of a customized three-dimensional (3D) printed alloplastic bone material. Sixty patients requiring guided bone regeneration for implant installation following tooth extraction due to alveolar bone resorption were recruited at two institutions. The participants were randomly allocated to either a group that received 3D-printed patient-customized bone graft material or a group that received conventional block bone graft material. Implant installation with bone harvesting was performed approximately 5 months after bone grafting. Histological and radiological assessments of the harvested bone area were performed. The experimental group had a significantly higher percent bone volume and a smaller tissue surface than the control group. Bone volume, bone surface, bone surface/volume ratio, bone surface density (bone surface/total volume), and bone mineral density did not differ significantly between groups. Patient-customized bone graft materials offer convenience and reduce patient discomfort. The findings suggest 3D-printed patient-customized bone graft materials could be used as an alternative for simpler bone grafting procedures.

Volume change after maxillary sinus floor elevation with apatite carbonate and octacalcium phosphate

PurposeMaxillary molars have low alveolar bone height diameter due to the presence of the maxillary sinus; thus, a sinus lift may be required in some cases. Changes in the volume of bone substitutes can affect the success of implant therapy. Therefore, this study aimed to compare the changes in the volume of two different bone substitutes—one based on carbonate apatite and the other on octacalcium phosphate—used in maxillary sinus floor elevation.MethodsNineteen patients and 20 sites requiring maxillary sinus floor elevation were included in the study. Digital Imaging and Communications in Medicine data for each patient obtained preoperatively and immediately and 6 months postoperatively were used to measure the volume of the bone grafting material using a three-dimensional image analysis software. The immediate postoperative volume of octacalcium phosphate was 95.3775 mm3 per piece of grafting material used. It was multiplied by the number of pieces used and converted to mL to determine the immediate postoperative volume.ResultsThe mean resorption values of carbonate apatite and octacalcium phosphate were 12.7 ± 3.6% and 17.3 ± 3.9%, respectively. A significant difference in the amount of resorption of the two bone replacement materials was observed (P = 0.04).ConclusionsThe results of this study indicate that both bone substitute materials tend to resorb. The two bone grafting materials that are currently medically approved in Japan have not been in the market for a long time, and their long-term prognosis has not yet been reported. Further clinical data are warranted.

Regulation of the antibiotic elution profile from tricalcium phosphate bone cement by addition of bioactive glass

This work aimed at tailoring of different properties of antibacterial drug delivery Ca-phosphate cements by incorporation of bioactive glass (BG). The cements were prepared from beta-tricalcium phosphate cement (β-TCP) and BG based on 50 SiO2—20 CaO—15 Na2O—7 B2O3—4 P2O5—4 Al2O3 wt% with different percentages of BG [5, 10, 15, and 20% (w/w)]. The composite cements were characterized by XRD, FTIR, and TEM. Moreover, in vitro bioactivity and biodegradation were evaluated in the simulated body fluid (SBF) at 37 °C. In addition, physical properties and mechanical strength were determined. Also, the effect of glass addition on the drug release profile was examined using gentamicin. Finally, the antimicrobial activity was studied against Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumonia bacteria, one unicellular fungal strain (Candida albicans), and one multicellular fungal strain (Mucor racemosus). The results showed that after soaking in SBF, the compression strength values ranged from 14 to 36 MPa, the bulk densities and porosities were within 1.35 to 1.49 g/cm3 and 51.3 to 44.71%, respectively. Furthermore, gentamicin was released in a sustained manner, and BG decreased the released drug amount from ~ 80% (in pure β-TCP) to 47–53% in the composite cements. A drug release profile that is sustained by all samples was achieved. The antimicrobial test showed good activity of gentamicin-conjugated cements against bacteria and fungi used in this study. Additionally, cytotoxicity results proved that all samples were safe on MG-63 cells up to 50 µg/mL with no more than 7–12% dead cells. From the view of the physico-mechanical properties, bioactivity, biodegradation, and drug release rate, 20BG/β-TCP sample was nominated for practical bone grafting material, where it showed appropriate setting time and a relatively high mechanical strength suitable for cancellous bone.

Assessment of Postoperative Edema in Different Bone Graft Cases in Vertical Defects in Periodontal Surgery: An Original Research

ABSTRACT Background: To replace missing periodontal tissues in vertical defects during periodontal surgery, bone graft materials are frequently used. A frequent occurrence that can affect healing outcomes is postoperative edema. The purpose of this study was to evaluate postoperative edema in various vertical bone graft defects following periodontal surgery. Materials and Methods: 50 participants were split into two groups for a prospective study: Group A received xenografts, whereas Group B received synthetic grafts. Up to 14 days after surgery, baseline and routine postoperative edema measurements were made. Edema levels in each group were compared using statistical analysis. Results: At all postoperative time points, Group A showed substantially more edema than Group B (P < 0.05). Furthermore, edema persisted longer in Group A than it did in Group B. Conclusion: In conclusion, the substance of the bone graft used in vertical defects during periodontal surgery affects postoperative edema. Compared to synthetic grafts, xenografts caused swelling to last longer and at higher levels. To maximize healing results, clinicians should take these findings into account when choosing graft materials.

In vivo behavior in rabbit radius bone defect of scaffolds based on nanocarbonate hydroxyapatite.

Bone defects treatment may require the use of biomaterials that behave as a support and promote bone regeneration. Limitations associated with the use of autografts and allografts make it necessary to design new synthetic bone substitutes. Some of the most promising biomaterials currently under investigation are based on nanocarbonate hydroxyapatite (nCHA). In this study, we studied the bone-inducing capacity of nCHA-based scaffolds alone (SAG) and enriched with osteostatin (SAGO) or with bone marrow aspirate(SAGB) after implantation for 12 weeks in a 15-mm long critical defect performed in the radius of New Zealand rabbits. Bone formation obtained was compared with a group with the unfilled defect (CE), as control group, and other with the defect filed with iliac crest autograft (GS), as gold standard. X-ray follow-up was performed at 2, 4, 6 and 12 weeks and μCT and histological studies at 12 weeks. The radiological results showed a greater increment in bone formation in the GS group (75%-100%), followed by the SAG and SAGB groups (50%-75%). μCT results showed an increase of bone volume/tissue volume values in GS group followed by SAG and SAGB groups (0.53, 0.40, and 0.31 respectively) compared with CE group (0.26). Histological results showed limited resorption of the nCHA scaffolds and partial osseointegration in the SAG and SAGB groups. However, in the SAGO group, the presence of connective tissue encapsulating the scaffold was detected. In SAG, SAGB, and increase of bone formation were observed compared with CE group, but less than the GS group. Thus, the investigated materials represent a significant advance in the design of synthetic materials for bone grafting, but further studies are needed to bring their in vivo behavior closer to autograft, the gold standard.

The development of non-resorbable bone allografts: Biological background and clinical perspectives.

Bone grafts are typically categorized into four categories: autografts, allografts, xenografts, and synthetic alloplasts. While it was originally thought that all bone grafts should be slowly resorbed and replaced with native bone over time, accumulating evidence has in fact suggested that the use of nonresorbable xenografts is favored for certain clinical indications. Thus, many clinicians take advantage of the nonresorbable properties/features of xenografts for various clinical indications, such as contour augmentation, sinus grafting, and guided bone regeneration, which are often combined with allografts (e.g., human freeze-dried bone allografts [FDBAs] and human demineralized freeze-dried bone allografts [DFDBAs]). Thus, many clinicians have advocated different 50/50 or 70/30 ratios of allograft/xenograft combination approaches for various grafting procedures. Interestingly, many clinicians believe that one of the main reasons for the nonresorbability or low substitution rates of xenografts has to do with their foreign animal origin. Recent research has indicated that the sintering technique and heating conducted during their processing changes the dissolution rate of hydroxyapatite, leading to a state in which osteoclasts are no longer able to resorb (dissolve) the sintered bone. While many clinicians often combine nonresorbable xenografts with the bone-inducing properties of allografts for a variety of bone augmentation procedures, clinicians are forced to use two separate products owing to their origins (the FDA/CE does not allow the mixture of allografts with xenografts within the same dish/bottle). This has led to significant progress in understanding the dissolution rates of xenografts at various sintering temperature changes, which has since led to the breakthrough development of nonresorbable bone allografts sintered at similar temperatures to nonresorbable xenografts. The advantage of the nonresorbable bone allograft is that they can now be combined with standard allografts to create a single mixture combining the advantages of both allografts and xenografts while allowing the purchase and use of a single product. This review article presents the concept with evidence derived from a 52-week monkey study that demonstrated little to no resorption along with invitro data supporting this novel technology as a "next-generation" biomaterial with optimized bone grafting material properties.

Early Results on the Efficacy of Demineralized Bone Matrix, Bone Morphogenic Protein, and Freeze-dried Bone Chips in Alveolar Cleft Repair.

Conventional treatment for alveolar cleft repair is done using autologous iliac crest alveolar bone graft (ABG). However, this method may not be ideal in all patients. Analysis of the efficacy of a mixture of demineralized bone matrix (DBX), bone morphogenic protein (rhBMP-2), and freeze-dried bone chips (FDBC) as an alternative for alveolar cleft repair was performed. Consecutive patients from August 2019 to June 2022 undergoing early alveolar cleft repair, concomitant hard palate and alveolar cleft repair, secondary alveolar cleft repair, and regrafting from a previously failed ABG were analyzed. Computed tomography scans were performed to evaluate graft take at least 6 months postoperatively. Images were reviewed and scored. Alveolar graft height and graft thickness were recorded. A standardized scoring system was developed, with a score of 0 representing no graft take and 3 representing best possible graft take. Fifty-five consecutive alveolar clefts (43 patients) were identified as having undergone ABG and satisfied all the other inclusion criteria. Of these, 29 underwent first time ABG and 26 underwent redo ABG. The mean graft height and graft thickness recorded for all clefts was 2.2 and 2.0, respectively. Early results evaluating the efficacy of ABG using DBX, rhBMP-2, and FDBC show feasibility in regard to both graft height and thickness when using a maxillary computed tomography scan to measure the bone graft take. These results suggest that DBX, rhBMP-2, and FDBC may act as a versatile bone graft material in cleft care, although further studies are needed to determine long-term outcomes.

Application of Three-Dimension Printing Nano-Carbonated-Hydroxylapatite to the Repair of Defects in Rabbit Bone.

Hydroxylapatite (HAp) is a biodegradable bone graft material with high biocompatibility. However, the clinical application of HAp has been limited due to the poor absorption rate in vivo. In this study, carbonated hydroxylapatite (CHAp) with a chemical composition similar to natural bone was synthesized. HAp and CHAp scaffolds were fabricated by 3D printing. Each material was designed by two types of scaffold model with a maximum width of 8 mm and a thickness of 2 mm, ie, structure I (round shape) and structure II (grid shape). Then, the HAp scaffolds were loaded with lutein. These scaffolds were implanted into the 8 mm bone defect on the top of the rabbit skull within 3 hours in the morning. The curative effects of the scaffolds were assessed two months after implantation. The 3D printed scaffolds did not cause severe inflammation or rejection after implantation. It showed that the porous structures allow bone cells to enter into the scaffolds. Furthermore, CHAp scaffolds were more biocompatible than HAp scaffolds, and showed a higher level of degradation and new bone formation after implantation. Structure II scaffolds with a smaller mineral content degraded faster than structure I, while structure I had better osteoconductive properties than structure II. Besides, the addition of lutein significantly enhanced the rate of new bone formation. The uniqueness of this study lies in the synthesis of 3D printed CHAp scaffolds and the implantation of CHAp in rabbit bone defects. The incorporation of suitable carbonate and lutein into HAp can enhance the osteoinductivity of the graft, and CHAp has a faster degradation rate in vivo, all of which provide a new reference for the research and application of apatite-based composites.

Surgical Management of Radicular Cyst with the Application of a Natural Platelet Concentrate and Ostoden: A Case Report

ABSTRACT The most frequent cystic lesions that affect the jaw are radicular cysts. The current case report describes the surgical management of a radicular cyst in the periapical region of maxillary central and lateral incisors, and highlights the efficacy of natural platelet concentrate [platelet-rich fibrin (PRF)] along with Ostoden bone graft material used for postoperative healing. A 46-year-old male patient presented to the department with swelling in the palatal aspect of the maxillary anterior region. On radiographic examination, a radiolucent periapical lesion was evident in relation to the left maxillary central and lateral incisor. In the maxillary anterior region, root canal therapy was performed, followed by periapical surgery, and PRF with Ostoden bone graft was placed in the surgical site to initiate the healing at a faster rate. The patient was recalled at follow-ups after 7 days, 3, 6, and 9 months. No symptoms such as pain, inflammation, or discomfort were observed during the review period.

The Effects of Systemic Vitamin D Level on the Healing of Different Graft Materials: An Experimental Histological Study

The aim of this study is to investigate the effects of serum vitamin D levels on the healing of different bone graft materials. Thirty-six male rats were divided into three groups and fed special feeds containing different amounts of vitamin D for 6 weeks before the surgical phase: the high serum vitamin D level group (group H) 10,000 iu/kg vitamin D3; the standard serum vitamin D level group (group C) 1000 iu/kg D3; and the low-level vitamin D group (group L) 100 iu/kg vitamin D3. Under general anesthesia, four defects with a diameter of 5 mm were created in the calvaria of the rats. The defects were augmented with autogenous grafts, allografts, xenografts, or left empty. The serum vitamin D level was measured before the surgery and before sacrifice. At the end of the 6th week, the subjects were sacrificed, and histological and histomorphometric analyses were performed. Study results show that in all graft types, as vitamin D levels increase, the number of new bone formations increases. There was no significant difference between the graft materials in terms of new bone formation criteria in group L. In group H and group C, the highest new bone formation was seen in the allograft group (1.48 ± 0.07, 0.66 ± 0.19, respectively). Prospective randomized clinical studies are required to evaluate the effect of vitamin D dose on the success of augmentation procedures in the clinic.

Osphronemus goramy scales-derived type 1 Collagen induces RUNX2 and Osteocalcin expression: An in vivo Study

Introduction: Alveolar bone defects need bone augmentation therapies by subtituting with bone material. Gourami (Osphronemus goramy) fish scale comprises type 1 collagen and it has been used as scaffolding material in bone tissue engineering. As alternative bone graft material, the scales have a big potency to promote osteogenesis in periodontal bone defect when autografts are not feasible. This study will analise Runx2 and Osteocalcin expression in wistar rat alveolar bone induced by type 1 collagen derived from gourami fish scale. Methods: 32 male Wistar rats were divided into four groups; control group—7 days (C7), treatment group—7 days (P7), control group—14 days (C14), and treatment group—14 days (P14). The left mandibular incisivus was extracted and the tooth socket was treated with 10mg collagen. The rats were euthanized (at day 7th and 14th) and immunohistochemistry was performed using monoclonal antibodies anti-RUNX2 and anti-osteocalcin. Results: After seven days and 14days, the expression of RUNX2 and osteocalcin in the treatment group increased significantly (p<0.05) compared with the control group. Conclusion: Type 1 collagen from gourami (Osphronemus goramy) fish scales increases RUNX2 and osteocalcin expression as a bone growth marker.