Bone Regeneration In Dentistry Research Articles

Exploring the Potential of Phytogenic Materials for Bone Regeneration: A Narrative Review of Current Advances and Future Directions.

In dentistry, bone regeneration in areas following tooth loss, the removal of a tumor or cyst, and craniofacial surgery can be accomplished by using bone grafts. Many biocompatible materials have been employed for bone regeneration in dentistry; however, all these bone graft materials come with various drawbacks. Therefore, there is a growing demand for natural, cost-effective, and biocompatible plant-based bone grafts. This review explores the emerging field of phytogenic elements in bone restoration and their specific applications in dentistry. The review focuses on key phytogenic compounds, such as algae-based and plant-based bone substitutes, delineating their roles in bone regeneration in dental bone defects. It also highlights the existing challenges associated with phytogenic grafts, such as limited bioavailability and high-dose toxicity. This calls for increased research into compatible, affordable carriers and a broader spectrum of studies to determine the most effective phytogenic solutions in dental regenerative medicine.

Synthesis and Characterization of Naringin Functionalized Nano-Hydroxyapatite for Bone Tissue Engineering.

Bone is a unique nanocomposite tissue composed of organic and inorganic materials. Bone grafting is a common surgical method used to improve bone regeneration in dentistry and orthopedic surgery. Because standard therapies have substantial drawbacks, nanomaterials provide alternative options for bone repair. Owing to its high bioactivity, osteoconductivity, biocompatibility, and topography that matches the architecture of real bone, hydroxyapatite nanoparticles (n-HA) are commonly used in bone treatment. We report here the synthesis and characterization of Naringin (NA) functionalized n-HA using HRTEM, FTIR, XRD, and UV-visible spectroscopy. The obtained results indicated that the n-HA can be functionalized with Naringin and they might be used as a bone regenerative material in medical and dental fields.

Regeneration of Horizontal Bone Defect in Edentulous Maxilla Using the Allogenic Bone-Plate Shell Technique and a Composite Bone Graft—A Case Report

An insufficient volume of the alveolar bone may prevent implants from being placed in the prosthetically optimal position. Complex restoration of bony structures is required to achieve long-term peri-implant bone stability and represents an adequate prosthetic solution. Background and Objectives: The shell technique has become a widespread and important method for guided bone regeneration in dentistry. Allogeneic bone materials appear to be the most similar substitution for autogenous bone transplants. However, there are few studies using cortical bone allografts in combination with a mix of autogenous and xenograft materials for the augmentation of horizontal ridge defects. This combination offers the advantage of reduced patient morbidity while adding adequate volume and contour to the alveolar ridge. Case report: The present case study aimed to clinically and radiographically evaluate the efficacy of allogenic cortical bone lamina combined with a composite bone graft in the augmentation of a horizontal bone defect in the edentulous maxilla during a 6-year follow-up period. Three CB CT scans taken before treatment, 6 months after the augmentation period/before implant placement, and after a 6-year follow-up period, were analyzed using stable referent points. After the 6 -year follow-up period, the average resorption rate was 21.65% on the augmented buccal side, with no implant exposure being observed. Conclusions: The bone shell technique used in conjunction with allogenic bone plates combined with autogenous bone, xenografts, and collagen membranes is an effective technique to manage horizontal ridge defects.

Injectable platelet-rich fibrin positively regulates osteogenic differentiation of stem cells from implant hole via the ERK1/2 pathway

Bone regeneration in dentistry is a dynamic approach for treating critical size bone defects that are unlikely to self-heal. Human bone marrow stem cell (hBMSCs) therapies are being tested clinically for various disorders and have remarkable clinical advancements in bone regeneration. Injectable platelet-rich fibrin (i-PRF), which is obtained from autologous blood centrifuged at 700 rpm (60 G) for 3 min can promote osteogenic differentiation of this cell, but the mechanism remains unclear. The objectives of this study were to explore the contents of i-PRF further and investigate its effect on the cell behavior of hBMSCs and the underlying molecular mechanisms. The results showed that i-PRF contained 41 cytokines, including macrophage colony-stimulating factor (M-CSF) and β-nerve growth factor (β-NGF), which had not been reported before. The Cell Counting Kit-8 and wound healing assay showed that 10% and 20% i-PRF improved the proliferation rate and the migration capacity of hBMSCs without toxicity to cells. Besides, the expression of osteogenic markers and the capacity to form mineralized nodules of hBMSCs were promoted by 20% i-PRF. Furthermore, i-PRF activated the ERK pathway, and the ERK inhibitor attenuated its effects. In summary, i-PRF promotes hBMSCs proliferation and migration and facilitates cell osteogenesis through the ERK pathway, which has promising potential in bone regeneration.

Calcium Sulfate in Implantology (Biphasic Calcium Sul-Fate/Hydroxyapatite, BCS/HA, Bond Apatite®): Review of the Literature and Case Reports

Calcium sulfate is used as a synthetic graft material in orthopedics, plastic surgery, oncological surgery, and dentistry, and it has been used in a variety of clinical applications, such as the repair of periodontal defects, the treatment of osteomyelitis, maxillary sinus augmentation, and as a complement to the placement of dental implants. To carry out this systematic review, a bibliographic search was carried out. The PICO (Patient, Intervention, Comparison, Outcome) question was: Does the use of calcium sulfate as a material in guided bone regeneration in dentistry have better results compared to other bone graft materials? Finally, a case series is presented using the calcium sulfate for different procedures. Currently, the available literature on the use of calcium sulfate as a graft material in implant surgery is scarce, and what is available provides low-quality evidence. That is why more research studies on the subject are necessary to allow more comparisons and meaningful conclusions. After using Bond Apatite® in our case series, we can conclude that it is a useful and easy-to-handle material in implantology practice, but more controlled studies should be carried out in this regard to assess its long-term efficacy, especially in horizontal and/or vertical regeneration.

Granular honeycomb scaffolds composed of carbonate apatite for simultaneous intra- and inter-granular osteogenesis and angiogenesis.

Granular porous calcium phosphate scaffolds are used for bone regeneration in dentistry. However, in conventional granules, the macropore interconnectivity is poor and has varying size. Herein, we developed a productive method for fabricating carbonate apatite honeycomb granules with uniformly sized macropores based on extrusion molding. Each honeycomb granule possesses three hexagonal macropores of ∼290 ​μm along its diagonal. Owing to these macropores, honeycomb granules simultaneously formed new and mature bone and blood vessels in both the interior and exterior of the granules at 4 weeks after implantation. The honeycomb granules are useful for achieving rapid osteogenesis and angiogenesis.

Zn-Containing Membranes for Guided Bone Regeneration in Dentistry.

Barrier membranes are employed in guided bone regeneration (GBR) to facilitate bone in-growth. A bioactive and biomimetic Zn-doped membrane with the ability to participate in bone healing and regeneration is necessary. The aim of the present study is to state the effect of doping the membranes for GBR with zinc compounds in the improvement of bone regeneration. A literature search was conducted using electronic databases, such as PubMed, MEDLINE, DIMDI, Embase, Scopus and Web of Science. A narrative exploratory review was undertaken, focusing on the antibacterial effects, physicochemical and biological properties of Zn-loaded membranes. Bioactivity, bone formation and cytotoxicity were analyzed. Microstructure and mechanical properties of these membranes were also determined. Zn-doped membranes have inhibited in vivo and in vitro bacterial colonization. Zn-alloy and Zn-doped membranes attained good biocompatibility and were found to be non-toxic to cells. The Zn-doped matrices showed feasible mechanical properties, such as flexibility, strength, complex modulus and tan delta. Zn incorporation in polymeric membranes provided the highest regenerative efficiency for bone healing in experimental animals, potentiating osteogenesis, angiogenesis, biological activity and a balanced remodeling. Zn-loaded membranes doped with SiO2 nanoparticles have performed as bioactive modulators provoking an M2 macrophage increase and are a potential biomaterial for promoting bone repair. Zn-doped membranes have promoted pro-healing phenotypes.

Alloplastic Bone Substitutes for Periodontal and Bone Regeneration in Dentistry: Current Status and Prospects.

Various bone graft products are commercially available worldwide. However, there is no clear consensus regarding the appropriate bone graft products in different clinical situations. This review is intended to summarize bone graft products, especially alloplastic bone substitutes that are available in multiple countries. It also provides dental clinicians with detailed and accurate information concerning these products. Furthermore, it discusses the prospects of alloplastic bone substitutes based on an analysis of the current market status, as well as a comparison of trends among countries. In this review, we focus on alloplastic bone substitutes approved in the United States, Japan, and Korea for use in periodontal and bone regeneration. According to the Food and Drug Administration database, 87 alloplastic bone graft products have been approved in the United States since 1996. According to the Pharmaceuticals and Medical Devices Agency database, 10 alloplastic bone graft products have been approved in Japan since 2004. According to the Ministry of Health and Welfare database, 36 alloplastic bone graft products have been approved in Korea since 1980. The approved products are mainly hydroxyapatite, β-tricalcium phosphate, and biphasic calcium phosphate. The formulations of the products differed among countries. The development of new alloplastic bone products has been remarkable. In the near future, alloplastic bone substitutes with safety and standardized quality may be the first choice instead of autologous bone; they may offer new osteoconductive and osteoinductive products with easier handling form and an adequate resorption rate, which can be used with growth factors and/or cell transplantation. Careful selection of alloplastic bone graft products is necessary to achieve predictable outcomes according to each clinical situation.

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Elaboration and Biocompatibility of an Eggshell-Derived Hydroxyapatite Material Modified with Si/PLGA for Bone Regeneration in Dentistry.

Hydroxyapatite (HAp) is the most commonly used biomaterial in modern bone regeneration studies because of its chemical similarity to bone, biocompatibility with different polymers, osteoconductivity, low cost, and lack of immune response. However, to overcome the disadvantages of HAp, which include fragility and low mechanical strength, current studies typically focus on property modification through the addition of other materials. Objective. To develop and evaluate the biocompatibility of a HAp material extracted from eggshells and modified with silicon (Si) and poly(lactic-co-glycolic) acid (PLGA). Materials and Methods. An in vitro experimental study in which a HAp material prepared from eggshells was synthesized by wet chemical and conventional chemical precipitation. Subsequently, this material was reinforced with Si/PLGA using the freezing/lyophilization method, and then osteoblast cells were seeded on the experimental material (HAp/Si/PLGA). To analyse the biocompatibility of this composite material, scanning electron microscopy (SEM) and fluorescence confocal microscopy (FCM) techniques were used. PLGA, bovine bone/PLGA (BB/PLGA), and HAp/PLGA were used as controls. Results. A cellular viability of 96% was observed for the experimental HAp/Si/PLGA material as well as for the PLGA. The viability for the BB/PLGA material was 90%, and the viability for the HAp/PLGA was 86%. Cell adhesion was observed on the exterior surface of all materials. However, a continuous monolayer and the presence of filopodia were observed over both external and internal surface of the experimental materials. Conclusions. The HAp/Si/PLGA material is highly biocompatible with osteoblastic cells and can be considered promising for the construction of three-dimensional scaffolds for bone regeneration in dentistry.

BMP-2 Gene Delivery-Based Bone Regeneration in Dentistry.

Bone morphogenetic protein-2 (BMP-2) is a potent growth factor affecting bone formation. While recombinant human BMP-2 (rhBMP-2) has been commercially available in cases of non-union fracture and spinal fusion in orthopaedics, it has also been applied to improve bone regeneration in challenging cases requiring dental implant treatment. However, complications related to an initially high dosage for maintaining an effective physiological concentration at the defect site have been reported, although an effective and safe rhBMP-2 dosage for bone regeneration has not yet been determined. In contrast to protein delivery, BMP-2 gene transfer into the defect site induces BMP-2 synthesis in vivo and leads to secretion for weeks to months, depending on the vector, at a concentration of nanograms per milliliter. BMP-2 gene delivery is advantageous for bone wound healing process in terms of dosage and duration. However, safety concerns related to viral vectors are one of the hurdles that need to be overcome for gene delivery to be used in clinical practice. Recently, commercially available gene therapy has been introduced in orthopedics, and clinical trials in dentistry have been ongoing. This review examines the application of BMP-2 gene therapy for bone regeneration in the oral and maxillofacial regions and discusses future perspectives of BMP-2 gene therapy in dentistry.

Membranes for guided bone regeneration in dentistry: a review of human randomized blinded clinical trials

Objetivo: revisar a literatura atualmente disponível sobre membranas para a regeneração óssea guiada na prática odontológica clínica. Material e Métodos: uma pesquisa da literatura foi realizada no PubMed, Web of Science e Scopus. A Escala de Jadad foi usada para coleta e seleção de dados. A qualidade dos estudos foi avaliada através das Diretrizes do Centro Cochrane. Ensaios clínicos randomizados e cegos publicados em português, espanhol e inglês foram incluídos. Revisões bibliográficas de estudos sem randomização e mascaramento ou quando uma percentagem igual ou superior a 20% da amostra não prosseguiu com o seguimento do estudo foram excluídos. Nós selecionamos 27 estudos que foram categorizados de acordo com os achados. Resultados: o número de publicações encontradas limitou as conclusões sobre o sucesso da GBR na odontologia. Conclusão: a variedade de técnicas e membranas aplicadas, bem como o pequeno número de estudos encontrados, carecem de estudos bem desenhados para melhor avaliar o potencial de GBR em pacientes submetidos a estas abordagens de tratamento, bem como para determinar protocolos de tratamento precisos.

Three-Dimensional Architecture and Mechanical Properties of Bovine Bone Mixed with Autologous Platelet Liquid, Blood, or Physiological Water: An In Vitro Study.

In recent years, several techniques and material options have been investigated and developed for bone defect repair and regeneration. The progress in studies of composite graft materials and autologous platelet-derived growth factors for bone regeneration in dentistry and their biological and biomechanical properties has improved clinical strategies and results. The aim of this study was to evaluate the three-dimensional architecture and mechanical properties of three different combinations of composite bovine graft, adding autologous platelet liquid (APL), blood, or physiological water. One experimental group for each combination of biomaterials was created. In particular, in Group I, the bovine graft was mixed with APL; in Group II, it was mixed with blood, and in Group III, the biomaterial graft was combined with physiological water. Then, the composite biomaterials were evaluated by scanning electron microscopy (SEM), and a compression-loading test was conducted. The evaluation showed a statistical significance (p < 0.01) of the elastic regime of deformation resistance, in which the combination of APL with bone graft resulted in an 875% increase in the mechanical resistance. The protocol of APL mixed with bovine bone graft produced a composite sticky graft block that was capable of increasing the mechanical properties in order to improve its clinical use in the treatment of the maxillary bone defects.

Bioactive nano-fibrous scaffold for vascularized craniofacial bone regeneration.

There has been a growing demand for bone grafts for correction of bone defects in complicated fractures or tumours in the craniofacial region. Soft flexible membrane like material that could be inserted into defect by less invasive approaches; promote osteoconductivity and act as a barrier to soft tissue in growth while promoting bone formation is an attractive option for this region. Electrospinning has recently emerged as one of the most promising techniques for fabrication of extracellular matrix such as nano-fibrous scaffolds that can serve as a template for bone formation. To overcome the limitation of cell penetration of electrospun scaffolds and improve on its osteoconductive nature, in this study, we fabricated a novel electrospun composite scaffold of polyvinyl alcohol (PVA)-poly (ε) caprolactone (PCL)-Hydroxyapatite based bioceramic (HAB), namely, PVA-PCL-HAB. The scaffold prepared by dual electrospinning of PVA and PCL with HAB overcomes reduced cell attachment associated with hydrophobic PCL by combination with a hydrophilic PVA and the HAB can contribute to enhance osteoconductivity. We characterized the physicochemical and biocompatibility properties of the new scaffold material. Our results indicate PVA-PCL-HAB scaffolds support attachment and growth of stromal stem cells; [human bone marrow skeletal (mesenchymal) stem cells and dental pulp stem cells]. In addition, the scaffold supported in vitro osteogenic differentiation and in vivo vascularized bone formation. Thus, PVA-PCL-HAB scaffold is a suitable potential material for therapeutic bone regeneration in dentistry and orthopaedics.