Bone Healing Research Articles

Nanocomposite films of polycaprolactone and amorphous/sintered wollastonite nanoparticles for potential biomedical applications

Precipitation of an apatite layer on the surface of bioactive materials is considered an important step in the bone healing procedure. Wollastonite (CaSiO3) bioglass has been recently employed as a bone replacement material and also, a carrier for targeted drug delivery. Regarding the impact of a material structure on its biological activity, to achieve the 100 % clinical success, realizing the material crystallinity and bone bonding potential can be important. Therefore, this study tried to prepare pure wollastonite (WS) nano-powders (<20 nm) via an easy and fast hydrothermal process. Different quantities (5, 10 and 15 wt%) of the amorphous and crystalline particles have been added to polycaprolactone (PCL) to obtain composite films via a simple solvent casting technique. The in-vitro bioactivity of the prepared particles as well as composite films was studied by placing the samples in the simulated body fluid (SBF) for 21 days. The physicochemical and microstructural properties of the products were then characterized by XRD, FTIR, FESEM, EDS and TEM. Moreover, the influence of the crystallinity on the bioactivity of the synthesized nanoparticles and also the obtained composite films was investigated for the first time. The results indicated that the amorphous bioglass and the surface of composite containing 15 wt% WS were completely covered by a thick bone-like apatite layer Therefore, these findings revealed that the prepared composite films composed of amorphous WS could be regarded as promising bioactive candidates for bone filling applications.

The role of hematopoiesis in bone repair: an update.

The repair of bone after injury requires the participation of many different immune cell populations, which are derived from the hematopoietic lineage. The field of osteoimmunology, or the study of the interactions between bone and the immune system, is a growing field with emerging impact on both the basic science and clinical aspects of fracture healing. Despite previous focus on the innate immune system in fracture healing, recent studies have revealed an important role for the adaptive immune system in bone repair. The composition of adaptive and innate immune cell populations present at the fracture site is significantly altered during aging and diet-induced obesity, which may contribute to delayed healing. Recent data also suggest a complicated relationship between fracture repair and systemic inflammation, raising the possibility that immune populations from distant sites such as the gut can impact the bone repair process. These findings have important implications for the treatment of fracture patients with antibiotics or anti-inflammatory drugs. Furthermore, the effects of systemic inflammation on fracture repair in the contexts of aging or obesity should be carefully interpreted, as they may not be uniformly detrimental.

Skeletal stem and progenitor cells in bone development and repair.

Bone development, growth, and repair are complex processes involving various cell types and interactions, with central roles played by skeletal stem and progenitor cells. Recent research brought new insights into the skeletal precursor populations that mediate intramembranous and endochondral bone development. Later in life, many of the cellular and molecular mechanisms determining development are reactivated upon fracture, with powerful trauma-induced signaling cues triggering a variety of postnatal skeletal stem/progenitor cells (SSPCs) residing near the bone defect. Interestingly, in this injury context, the current evidence suggests that the fates of both SSPCs and differentiated skeletal cells can be considerably flexible and dynamic, and that multiple cell sources can be activated to operate as functional progenitors generating chondrocytes and/or osteoblasts. The combined implementation of in vivo lineage tracing, cell surface marker-based selection, single-cell molecular analyses, and high-resolution in situ imaging has strongly improved our insights into the diversity and roles of developmental and reparative stem/progenitor subsets, while also unveiling the complexity of their dynamics, hierarchies, and relationships. Albeit incompletely understood at present, findings supporting lineage flexibility and possibly plasticity among sources of osteogenic cells challenge the classical dogma of a single primitive, self-renewing, multipotent stem cell driving bone tissue formation and regeneration from the apex of a hierarchical and strictly unidirectional differentiation tree. We here review the state of the field and the newest discoveries in the origin, identity, and fates of skeletal progenitor cells during bone development and growth, discuss the contributions of adult SSPC populations to fracture repair, and reflect on the dynamism and relationships among skeletal precursors and differentiated cell lineages. Further research directed at unraveling the heterogeneity and capacities of SSPCs, as well as the regulatory cues determining their fate and functioning, will offer vital new options for clinical translation toward compromised fracture healing and bone regenerative medicine.

Comparison of the Clinical Efficacy of Anabolic Agents and Bisphosphonates in the Patients With Osteoporotic Vertebral Fracture: Systematic Review and Meta-analysis of Randomized Controlled Trials.

We investigated the clinical efficacy of anabolic agents compared with bisphosphonates (BPs) for the incidence of new osteoporotic vertebral fracture (OVF) and fracture healing of OVF in the patients with OVF via meta-analyses of randomized controlled trials (RCTs). Electronic databases, including PubMed, Embase, and Cochrane Library were searched for published RCTs till December 2022. The RCTs that recruited participants with osteoporosis at high-/very high-risk of fracture (a history of osteoporotic vertebral or hip fracture) or fresh OVF were included in this study. We assessed the risk of bias on every included RCTs, estimated relative risk (RR) for the incidence of new OVF and fracture healing of OVF, and overall certainty of evidence. Meta-analyses were performed by Cochrane review manager (RevMan) version 5.3. Cochrane risk of bias 2.0 and GRADEpro/GDT were applied for evaluating methodological quality and overall certainty of evidence, respectively. Five hundred eighteen studies were screened, and finally 6 eligible RCTs were included in the analysis. In the patients with prevalent OVF, anabolic agents significantly reduced the incidence of new OVF (teriparatide and romosozumab vs alendronate and risedronate [RR = 0.57, 95% CI 0.45 - 0.71; p < 0.00001; high-certainty of evidence]; teriparatide vs risedronate [RR = 0.50, 95% CI 0.37 - 0.68; p < 0.0001; high-certainty of evidence]. However, there was no evidence of teriparatide compared to alendronate in fracture healing of OVF (RR = 1.23, 95% CI 0.95 - 1.60; p = 0.12; low-certainty of evidence). In the patients with prevalent OVF, anabolic agents showed a significant superiority for preventing new OVF than BPs, with no significant evidence for promoting fracture healing of OVF. However, considering small number of RCTs in this study, additional studies with large-scale data are required to obtain more robust evidences.

Promoting bone callus formation by taking advantage of the time-dependent fracture gap strain modulation.

Delayed union and non-union of fractures continue to be a major problem in trauma and orthopedic surgery. These cases are challenging for the surgeon. In addition, these patients suffer from multiple surgeries, pain and disability. Furthermore, these cases are a major burden on healthcare systems. The scientific community widely agrees that the stability of fixation plays a crucial role in determining the outcome of osteosynthesis. The extent of stabilization affects factors like fracture gap strain and fluid flow, which, in turn, influence the regenerative processes positively or negatively. Nonetheless, a growing body of literature suggests that during the fracture healing process, there exists a critical time frame where intervention can stimulate the bone's return to its original form and function. This article provides a summary of existing evidence in the literature regarding the impact of different levels of fixation stability on the strain experienced by newly forming tissues. We will also discuss the timing and nature of this "window of opportunity" and explore how current knowledge is driving the development of new technologies with design enhancements rooted in mechanobiological principles.

Study on the therapeutic effect of Kirschner wire tension band combined with anchor cross-stitch technique in the treatment of comminuted patellar inferopolar fractures.

Fractures of the inferior patellar pole, unlike other patellar fractures, present challenges for traditional surgical fixation methods. This article introduces the clinical technique and outcomes of using Kirschner wire tension band combined with anchor screw cross-stitch fixation for comminuted inferior patellar pole fractures. This retrospective case series study included 14 patients with comminuted inferior patellar pole fractures treated at our institution from September 1, 2020, to April 30, 2022. All patients underwent surgery using the Kirschner wire tension band with anchor screw cross-stitch technique. Follow-up assessments involved postoperative X-rays to evaluate fracture healing, as well as clinical parameters such as healing time, Visual Analog Scale (VAS) scores, range of motion (ROM), and Bostman scores. All patients were followed for an average of over 12 months, with no cases of internal fixation failure. Knee joint stability and function were excellent. X-rays revealed an average healing time of approximately 10.79 ± 1.53 weeks, hospitalization lasted 5.64 ± 1.15 days, surgery took approximately 37.86 ± 5.32 minutes, and intraoperative blood loss was 33.29 ± 8.15 ml. One patient experienced irritation from the internal fixation material. At the final follow-up, the Bostman score averaged 28.29 ± 0.83, knee joint flexion reached 131.07° ± 4.88°, all patients achieved full knee extension, and the VAS score was 0.36 ± 0.63. Kirschner wire tension band with anchor screw cross-stitch fixation for comminuted inferior patellar pole fractures delivered satisfactory clinical outcomes. This surgical method, characterized by its simplicity and reliability, is a valuable addition to clinical practice.

Cemented vs cementless stems for revision arthroplasties due to Vancouver B2 periprosthetic hip fracture.

According to Vancouver classification, B2 type fractures are most often treated with removal of the loose stem and implantation of a long stem that bypasses the fracture site. However, there is a controversy about the stem fixation that should be used: cemented or cementless. Hence, this study aims to compare cemented and cementless stems in prosthetic revision due to Vancouver B2 (VB2) periprosthetic hip fracture. A retrospective study was done including all the patients treated with stem exchange due to VB2 periprosthetic hip fracture in a tertiary hospital between 2015 and 2022. Patients were divided into two groups according to the stem fixation used: cemented or cementless. Functional outcomes, hospital stay, surgical time, complication rate, and mortality were compared between the two groups of patients. Of the 30 included patients, 13 (43.4%) were treated with cementless stems and 17 (56.7%) with cemented stems. There were no statistically significant differences in age, gender, anesthesia risk scale (ASA) or functional capacity prior to the intervention. Patients treated with cementless stems had a higher complication and reintervention rate than those treated with cemented stems: 62 and 45% versus 34 and 6% (p = 0.035; p = 0.010), respectively. Furthermore, in the group of cementless stems a higher proportion of non-union was found (53.8% vs. 17.6%; p = 0.037). Also, the hospital stay (33 vs. 24days; p = 0.037) and the time to full weight-bearing (21days vs. 9days; p < 0.001) were longer in the cementless stem group. Cemented fixation in stem revision due to Vancouver B2 periprosthetic hip fracture could be an optimal option with faster recovery which could decrease the rate of complications and reintervention, without compromising the fracture healing and patient mortality. Thus, this option can be considered when an anatomical reduction can be obtained, especially in elderly patients with multiple comorbidities in which a less aggressive surgical option should be considered.

Hydrogen Sulfide Delivery to Enhance Bone Tissue Engineering Cell Survival.

Though crucial for natural bone healing, local calcium ion (Ca2+) and phosphate ion (Pi) concentrations can exceed the cytotoxic limit leading to mitochondrial overload, oxidative stress, and cell death. For bone tissue engineering applications, H2S can be employed as a cytoprotective molecule to enhance mesenchymal stem cell (MSC) tolerance to cytotoxic Ca2+/Pi concentrations. Varied concentrations of sodium hydrogen sulfide (NaSH), a fast-releasing H2S donor, were applied to assess the influence of H2S on MSC proliferation. The results suggested a toxicity limit of 4 mM for NaSH and that 1 mM of NaSH could improve cell proliferation and differentiation in the presence of cytotoxic levels of Ca2+ (32 mM) and/or Pi (16 mM). To controllably deliver H2S over time, a novel donor molecule (thioglutamic acid-GluSH) was synthesized and evaluated for its H2S release profile. Excitingly, GluSH successfully maintained cytoprotective level of H2S over 7 days. Furthermore, MSCs exposed to cytotoxic Ca2+/Pi concentrations in the presence of GluSH were able to thrive and differentiate into osteoblasts. These findings suggest that the incorporation of a sustained H2S donor such as GluSH into CaP-based bone graft substitutes can facilitate considerable cytoprotection, making it an attractive option for complex bone regenerative engineering applications.

Proteomic analysis of exosomal proteins associated with bone healing speed in a rat tibial fracture model.

This study investigates the impact of exosomes on bone fracture healing in a rat tibial model, distinguishing between fast and slow healing processes. Bone healing and protein expression were assessed through X-ray examinations, hematoxylin and eosin staining, and immunohistochemical staining. Exosomes were isolated, characterized and subjected to liquid chromatography-mass spectrometry for protein analysis. Molecular differences were explored using differentially expressed protein analysis, Kyoto Encyclopedia of Genes and Genomes pathway enrichment and protein-protein interaction networks. Differential bone healing patterns and protein expressions were observed between the control and model groups. Exosomes were successfully isolated and characterized, revealing 2004 identified proteins, including distinct expression profiles. Notably, ribosomal proteins, ferritin and beta-actin emerged as pivotal players in bone fracture healing. This study unveils dynamic changes in bone healing and underscores the role of exosomes in the process. Identified proteins and pathways offer valuable insights for developing innovative therapeutic strategies for bone healing.

The effect of cannabinoids on single-level lumbar arthrodesis outcomes in a rat model

BACKGROUND CONTEXTThe opioid epidemic is a public health crisis affecting spine care and pain management. Medical marijuana is a potential non-opioid analgesic yet to be studied in the surgical setting since its effects on bone healing are not fully understood. Studies have demonstrated analgesic and potentially osteoinductive properties of cannabinoids with endocannabinoid receptor expression in bone tissue. PURPOSEWe hypothesize that tetrahydrocannabinol (THC) and cannabidiol (CBD) will not decrease bone healing in spinal fusion. STUDY DESIGNSeventy-eight adult Sprague-Dawley rats were used for this study. Utilizing allogenic bone grafts (6 donor rats), posterolateral inter-transverse lumbar fusion at the L4–L5 level was performed. The animals were equally divided into four treatment groups, each receiving 0.1 ml intraperitoneal injections weekly as follows: placebo (saline), 5 mg/kg THC, 5 mg/kg CBD, and a combination of 5 mg/kg THC and 5mg/kg CBD (Combo). METHODSCallus tissue was harvested 2- and 8-weeks post-surgery for qPCR assessment to quantify changes in the expression of osteogenic genes. Manual palpation was done to assess the strength of the L4–L5 arthrodesis on all rats. μCT image-based callus analysis and histology were performed. One-way ANOVA followed by post hoc comparisons was performed. RESULTSμCT demonstrated no significant differences. Treatment groups had slightly increased bone volume and density compared to control. qPCR at two weeks indicated downregulated RANKL/OPG ratios skewing towards osteogenesis in the CBD group, with the THC and CBD+THC groups demonstrating a downward trend (p>.05). ALPL, BMP4, and SOST were significantly higher in the CBD group, with CTNNB1 and RUNX2 also showing an upregulating trend. The CBD group showed elevation in Col1A1 and MMP13. Data at eight weeks showed ALPL, RUNX2, BMP4, and SOST were downregulated for all treatment groups. In the CBD+THC group, RANK, RANKL, and OPG were downregulated. OPG downregulation reached significance for the THC and CBD+THC group compared to saline. Interestingly, the RANKL/OPG ratio showed upregulation in the CBD and CBD+THC groups. RANKL showed upregulation in the CBD group. At 2 and 8 weeks, the CBD treatment group showed superior histological progression, increasing between time points. CONCLUSIONThis study demonstrates that CBD and THC have no adverse effect on bone healing and the rate of spinal fusion in rats. Osteogenic factors were upregulated in the CBD-treated groups at two weeks, which indicates a potential for bone regeneration. In this group, compared to control, the RANKL/OPG ratio at the early healing phase demonstrates the inhibition of osteoclast differentiation, enhancing bone formation. Interestingly, it shows promoted osteoclast differentiation at the later healing phase, enhancing bone remodeling. This aligns with the physiological expectation of a lower ratio in the early phases and a higher ratio in the later remodeling phases. CLINICAL SIGNIFICANCECBD and THC showed no inhibitory effects on bone healing in a spinal fusion model. Moreover, histologic and gene expression analysis demonstrated that CBD may, in fact, enhance bone healing. Further research is needed to confirm the safe usage of THC and CBD in the post-operative setting following spinal fusions.

Transoral endoscopic assisted reduction and internal fixation of mandibular condylar neck fractures with short condylar segment

This study aimed to assess the reliability and safety of transoral endoscopic-assisted reduction internal fixation (TERIF) for treating short-segment condylar neck fractures (CNF), including hardware removal.Patients with displaced CNF and short condylar segments treated using TERIF were included in the study. Clinical evaluation covered dental occlusion, range of mouth opening, deviation during mouth opening, protrusion, laterotrusion, pain, and chewing. Radiological evaluation was used to assess fracture displacement, angulation, head dislocation, postoperative reduction, fixation stability, and bone healing. The same technique was used to treat 15 patients with 18 CNF and short condylar segments. Hardware removal was performed for nine fractures in eight patients after fracture healing using the same approach.All patients regained satisfactory, pain-free mouth opening with no deviation and complete bone healing. Computed tomographic images displayed adequate reduction and stable fixation during the follow-up period for all patients. No temporary or permanent facial nerve impairment occurred in any of the patients.TERIF is a reliable and safe treatment for CNF with short condylar segments, even in the presence of head dislocation, medial override, and malunited fractures; hardware can be safely removed after healing using the same approach.

Sea cucumber intestinal osteotropic peptide promotes tibial fracture healing in osteoporotic mice by promoting glutamine metabolism

Sea cucumber (Stichopus japonicus) intestinal high-value-added compounds have not been fully used in sea cucumber processing. Here, the osteotropic effects of sea cucumber intestinal peptides (SCIP) on tibial fractures in osteoporotic mice were investigated. Mice were bilaterally ovariectomized to model osteoporosis and achieved open fracture surgery on the right tibia. The results exhibited that SCIP intervention significantly elevated localized callus and total glutamine levels after fracture in osteoporotic mice. SCIP intervention enhanced the level of acetyl coenzyme A-mediated histone H3 acetylation by up-regulation of the GLS1-GLUD1 axis, thereby significantly promoting the expression of genes specific to chondrocytes. Also, it enhanced aspartate-mediated purine and pyrimidine synthesis by up-regulation of the GLS1-GOT2 axis, thereby significantly promoting the proliferation of chondrocytes. Moreover, it enhanced glutathione-mediated antioxidant damage by upregulating the GLS1-GCLC axis, thereby significantly rescuing the pathological apoptosis of hypertrophic chondrocytes. In conclusion, SCIP promoted chondrocyte generation, proliferation, mineralization, and bone remodeling through glutamine metabolism, thus facilitating fracture healing in osteoporotic mice.

Dynamic intramedullary crosspinning technique for the treatment of distal femoral metaphyseal fracture in a free‐ranging jaguarundi (Herpailurus yagouaroundi)

AbstractAn approximately 3‐month‐old female free‐ranging jaguarundi (Herpailurus yagouaroundi) was admitted for evaluation of swelling near the right stifle and inability to use the right hindlimb. Radiographic examination revealed a closed, short oblique fracture of the right distal femoral metaphysis, and the bone cortex appeared thin. Because of the poor body condition, the surgical procedure was performed 6 days after admission. The fracture was stabilised using a dynamic intramedullary crosspinning technique. Two 1.5 mm diameter Kirschner (K) wires were introduced at an approximately 20° angle to the sagittal plane of the femur. Radiographic evaluation 3 months after surgery revealed an open distal physis, fracture healing in the remodelling phase and K‐wires engulfed by the bone, which made removal impossible. At the 6‐month follow‐up, a length discrepancy of 0.8 cm in the right femur compared to the left femur was noted. Despite this complication, the locomotion pattern was considered normal according to visual gait analysis.

Novel injectable composite incorporating denosumab promotes bone regeneration via bone homeostasis regulation

Repair of large bone defects remains to be clinically challenging, yet current bone repair strategies focus on optimizing the osteogenic capacity of bone grafts, while the role of osteoclasts in bone regeneration has been largely ignored. Herein, we designed a injectable self-curing bone grafting paste capable of regulating both anabolic/catabolic activities during bone healing by immobilizing the RANKL inhibitor denosumab on dermal-derived extracellular matrix (ECM) microfibres, which were then incorporated into an injectable paste via a hydration reaction between β-tricalcium phosphate (β-TCP), monocalcium phosphate monohydrate (MCPM) and calcium sulfate hemihydrate (CSH). The incorporation of ECM microfibres not only serves as a sustained-release denosumab carrier to inhibit osteoclastogenesis but also improves the mechanical properties of the resulting composite by increasing the interaction between the organic and inorganic phases. In vitro, calcium supply from the composite along with ECM enhanced osteogenic differentiation of BMSC while release of denosumab effectively inhibits osteoclast fusion and alleviate osteoclastic activity. In vivo, it was observed that CSH/CP@ECM-Deno significantly reduced the number of osteoclasts, slowed down the process of bone resorption, and accelerated collagen deposition to promote new bone generation. These results suggest that modulation of osteoclastogenesis by interfering with bone homeostasis may be an effective bone repair strategy.

Long bone uninfected non-union: grafting techniques.

Long bone non-unions represent a serious clinical and socioeconomical problem due to the prolonged episodes, frequent sequelae, and variable treatment effectiveness. Bone grafts, classically involving the autologous iliac crest graft as the 'gold standard' bone graft, enhance bone regeneration and fracture healing incorporating osteoconductive and/or osteoinductive/osteogenic capacity to the non-union under treatment. Structural alternatives to autologous bone grafts include allografts and bone substitutes, expanding the available stock but loosing biological properties associated with cells in the graft. Biological alternatives to autologous bone grafts include bone marrow concentration from iliac crest aspiration, bone marrow aspiration from reaming of the diaphyseal medullary canal in the long bones, and isolated, expanded mesenchymal stem cells under investigation. When the combination with natural and synthetic bone substitutes allows for larger volumes of structural grafts, the enhancement of the biological regenerative properties through the incorporation of cells and their secretoma permits to foresee new bone grafting solutions and techniques.

The Influence of Honey Consumption on Tibia Bone Fracture Healing in Wistar Rats: A Comprehensive Study

The Influence of Honey Consumption on Tibia Bone Fracture Healing in Wistar Rats: A Comprehensive Study

A novel approach in orthodontics: Archwise distraction osteogenesis

Distraction osteogenesis can be described as a procedure that is based on the principles of physiologic remodeling and indirect fracture healing. In dentoalveolar level, conventional appliances may present some difficulties such as the need for multiple stages of DO to achieve a good occlusion due to distraction on a straight vector; incompetency to reduce the oronasal fistula in cleft patients; and the difficulty in achieving complete hard and soft tissue reconstruction, especially in cases with large alveolar defects.ArchWise Distraction Appliance (AWDA) have been developed to overcome these limitations and obtain a regenerated bone curvilinear in shape, similar to the original alveolar bone configuration. This article aims to introduce and explain the AWDA method in detail so that every clinician will be able to perform the treatment. The reader can observe the application of the procedure on a variety of cases including cleft lip and palate, trauma, and bone pathology. Possible complications and their solutions are also explained on actual cases.

Role of epigenetic regulatory mechanisms in age-related bone homeostasis imbalance.

Alterations to the human organism that are brought about by aging are comprehensive and detrimental. Of these, an imbalance in bone homeostasis is a major outward manifestation of aging. In older adults, the decreased osteogenic activity of bone marrow mesenchymal stem cells and the inhibition of bone marrow mesenchymal stem cell differentiation lead to decreased bone mass, increased risk of fracture, and impaired bone injury healing. In the past decades, numerous studies have reported the epigenetic alterations that occur during aging, such as decreased core histones, altered DNA methylation patterns, and abnormalities in noncoding RNAs, which ultimately lead to genomic abnormalities and affect the expression of downstream signaling osteoporosis treatment and promoter of fracture healing in older adults. The current review summarizes the impact of epigenetic regulation mechanisms on age-related bone homeostasis imbalance.

Plasminogen activator inhibitor-1 is involved in glucocorticoid-induced decreases in angiogenesis during bone repair in mice.

Glucocorticoids delay fracture healing and induce osteoporosis. Angiogenesis plays an important role in bone repair after bone injury. Plasminogen activator inhibitor-1 (PAI-1) is the principal inhibitor of plasminogen activators and an adipocytokine that regulates metabolism. However, the mechanisms by which glucocorticoids delay bone repair remain unclear. Therefore, we herein investigated the roles of PAI-1 and angiogenesis in glucocorticoid-induced delays in bone repair after femoral bone injury using PAI-1-deficient female mice intraperitoneally administered dexamethasone (Dex). PAI-1 deficiency significantly attenuated Dex-induced decreases in the number of CD31-positive vessels at damaged sites 4days after femoral bone injury in mice. PAI-1 deficiency also significantly ameliorated Dex-induced decreases in the number of CD31- and endomucin-positive type H vessels and CD31-positive- and endomucin-negative vessels at damaged sites 4days after femoral bone injury. Moreover, PAI-1 deficiency significantly mitigated Dex-induced decreases in the expression of vascular endothelial growth factor as well as hypoxia inducible factor-1α, transforming growth factor-β1, and bone morphogenetic protein-2 at damaged sites 4days after femoral bone injury. The present results demonstrate that Dex-reduced angiogenesis at damaged sites during the early bone-repair phase after femoral bone injury partly through PAI-1 in mice.

Boswellic acid as a potential adjunct for bone healing after endodontic surgery: In vitro study

Abstract Introduction: The role of Acetyl -11-keto-β-boswellic acid (AKBA) in regulating osteoblast differentiation was recently brought to light. Therefore, the current study was designed to explore the osteogenic differentiation capability of AKBA on bone marrow mesenchymal stem cells (BMMSCs) as a potential therapeutic agent to accelerate the healing process in apicoectomy. Materials and Methods: BMMSCs were characterized by flow cytometry. Cellular viability and proliferation assays were used with different concentrations of AKBA. Cells were divided into 5 groups to test osteogenic differentiation: Group I: negative control, Group II: positive control, Group III: BMMSCs were treated with 1 μM AKBA, Group IV: BMMSCs were treated with 0.1 μM AKBA, and Group V: BMMSCs were treated with 0.01 μM AKBA. Mineralization assays and gene expression analysis were assessed, and the significance difference between groups was established at P &lt; 0.05. Results: The flow cytometry analysis demonstrated that BMMSCs had positive expression for mesenchymal stem cell marker and negative expression for hematopoietic markers. The concentration of 0.01 μM gave significantly higher cell density than the untreated cells after 7 days (P &lt; 0.05). Cells treated with 0.1 and 0.01 μM AKBA revealed a significantly higher ALP activity, alizarin red, and von Kossa staining than control groups (P &lt; 0.05). High expression of osteogenic genes was detected in BMMSCs treated with 0.1 μM AKBA (P &lt; 0.05). Conclusions: It was declared that the concentration of 0.1 μM AKBA has no toxicity on BMMSC viability and proliferation with an impact on BMMSC osteogenic differentiation. Therefore, AKBA (0.01 μM) could be used in bone regeneration during periradicular surgery.