Peri-implant Bone Regeneration Research Articles

Bone regeneration driven by a nano-hydroxyapatite/chitosan composite bioaerogel for periodontal regeneration.

The most recent progress in reconstructive therapy for the management of periodontitis and peri-implantitis bone defects has relied on the development of highly porous biodegradable bioaerogels for guided bone regeneration. The objective of this work was to evaluate in vitro the osteoinduction of periodontal-originating cells (human dental follicle mesenchymal cells, DFMSCs) promoted by a nano-hydroxyapatite/chitosan (nHAp/CS) bioaerogel, which was purified and sterilized by a sustainable technique (supercritical CO2). Moreover, the in vivo bone regeneration capacity of the nHAp/CS bioaerogel was preliminarily assessed as a proof-of-concept on a rat calvaria bone defect model. The quantification of DNA content of DFMSCs seeded upon nHAp/CS and CS scaffolds (control material) showed a significant increase from the 14th to the 21st day of culture. These results were corroborated through confocal laser scanning microscopy analysis (CLSM). Furthermore, the alkaline phosphatase (ALP) activity increased significantly on the 21st day, similarly for both materials. Moreover, the presence of nHAp promoted a significantly higher expression of osteogenic genes after 21days when compared to CS scaffolds and control. CLSM images of 21days of culture also showed an increased deposition of OPN over the nHAp/CS surface. The in vivo bone formation was assessed by microCT and histological analysis. The in vivo evaluation showed a significant increase in bone volume in the nHAp/CS test group when compared to CS and the empty control, as well as higher new bone formation and calcium deposition within the nHAp/CS structure. Overall, the present study showed that the nHAp/CS bioaerogel could offer a potential solution for periodontal and peri-implant bone regeneration treatments since the in vitro results demonstrated that it provided favorable conditions for DFMSC proliferation and osteogenic differentiation, while the in vivo outcomes confirmed that it promoted higher bone ingrowth.

Improved Biocompatibility and Osseointegration of Nanostructured Calcium-Incorporated Titanium Implant Surface Treatment (XPEED®).

Surface treatment of implants facilitates osseointegration, with nanostructured surfaces exhibiting accelerated peri-implant bone regeneration. This study compared bone-to-implant contact (BIC) in implants with hydroxyapatite (HA), sand-blasted and acid-etched (SLA), and SLA with calcium (Ca)-coated (XPEED®) surfaces. Seventy-five disk-shaped grade 4 Ti specimens divided into three groups were prepared, with 16 implants per group tested in New Zealand white rabbits. Surface characterization was performed using X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), digital microscopy, and a contact angle analyzer. Cell viability, proliferation, and adhesion were assessed using MC3T3-E1 cells. Apatite formation was evaluated using modified simulated body fluid (m-SBF) incubation. After 4 weeks of healing, the outcomes reviewed were BIC, bone area (BA), removal torque tests, and histomorphometric evaluation. A microstructure analysis revealed irregular pores across all groups, with the XPEED group exhibiting a nanostructured Ca-coated surface. Surface characterization showed a crystalline CaTiO3 layer on XPEED surfaces, with evenly distributed Ca penetrating the implants. All surfaces provided excellent environments for cell growth. The XPEED and SLA groups showed significantly higher cell density and viability with superior osseointegration than HA (p < 0.05); XPEED exhibited the highest absorbance values. Thus, XPEED surface treatment improved implant performance, biocompatibility, stability, and osseointegration.

Fabrication and in vitro biological performance of a double-layered nanoparticles-microarc oxidation composite coating on titanium for dental implant application

Sufficient residual alveolar bone volume plays an important role in the success rate and service life of dental implants. However, alveolar bone deficiency is a common clinical phenomenon, and the alveolar bone would be further absorbed by peri-implant infection. Therefore, it is highly desirable to promote peri-implant alveolar bone regeneration and inhibit alveolar bone resorption when the alveolar bone mass is insufficient. For this purpose, a pH-sensitive double-layered nanoparticles-microarc oxidation (MAO) composite coating was fabricated on titanium for dental implant application in this study. The pH-sensitive double-layered nanoparticles were prepared by a poly(L-lactic acid) inner layer and a chitosan outer shell, containing stromal-cell derived factor-1, recombinant human bone morphogenetic protein 2 and osteoprotegerin. The composite coating was fabricated on MAO coating by cross-linking the pH-sensitive double-layered nanoparticles with gelatin. The surface morphology of the composite coating showed that the pH-sensitive double-layered nanoparticles were well distributed and tightly cross-linked in the pores of MAO coating. The composite coating could sustain release the three drugs for more than 30 days. With decreasing pH, the release of osteoprotegerin from the composite coating increased (p < 0.05). In vitro biological studies suggested that the composite coating exhibited no cytotoxicity, and can recruit bone marrow-derived mesenchymal stem cells (BMSCs), promote BMSC differentiation into osteoblasts, and inhibit osteoclast generation. Moreover, with decreasing pH, the inhibitory effect on osteoclast generation was enhanced (p < 0.05). It can be concluded that the fabricated composite coating, which can promote bone regeneration and inhibit bone resorption, has the potential to be applied on the surface of dental implant, especially when the residual alveolar bone is in poor condition.

A Comparison of Guided Bone Regeneration vs. the Shell Technique Using Xenogeneic Bone Blocks in Horizontal Bone Defects: A Randomized Clinical Trial.

In cases of severe horizontal atrophy, implant placement requires bone reconstruction procedures. The aim of this randomized controlled trial is to compare the outcomes of bone augmentation with simultaneous implant placement using the shell technique to the outcomes of guided bone regeneration (GBR) in cases of severely horizontal bone atrophy. This study was designed as a monocentric, parallel-group, randomized controlled trial with a six-month follow-up. Among the primary outcomes of this study, peri-implant bone regeneration and peri-implant bone defect closure were selected. Forty-four patients were recruited and equally divided between two groups. In the GRB group, a horizontal regeneration of 2.31 ± 0.23 mm was observed opposed to a horizontal regeneration of 2.36 ± 0.17 mm in the shell group (p = 0.87). A volumetric increase was observed in both groups, with an increase of 0.30 ± 0.12 cm3 in the GBR group and an increase of 0.39 ± 0.09 cm3 in the shell group, highlighting a significant difference between the two groups (p = 0.02). In conclusion, bone augmentation with simultaneous implant placement using the shell technique or guided bone regeneration in horizontal bone atrophy are both predictable therapeutic options.

Bone regeneration as treatment of peri-implant disease: A narrative review.

Analysis of the 3-dimensional implant position, the bone defect morphology, and the soft tissue situation guides the decision to preserve or to remove an implant with a severe peri-implantitis lesion. The aim of this narrative review was to analyze and to comprehensively illustrate the treatment options focusing on peri-implant bone regeneration in presence of severe peri-implant bone loss. A database search was performed independently by the two reviewers to identify case reports, case series, cohort, retrospective, and prospective studies about peri-implant bone regeneration with a follow-up of at least 6 months. Of the 344 studies issued during the database analysis, 96 publications were selected by the authors for this review. Deproteinized bovine bone mineral remains the best documented material for defect regeneration in peri-implantitis in combination with or without a barrier membrane. While studies using autogenous bone in peri-implantitis therapy are rarely found, they do report favorable potential of vertical bone regeneration. Moreover, while membranes are an inherent part of the guided bone regeneration, a 5-year follow-up study demonstrated clinical and radiographic improvements with and without a membrane. The administration of systemic antibiotics is frequently performed in clinical studies observing regenerative surgical peri-implantitis therapy, but the analysis of the literature does not support a positive effect of this medication. Most studies for regenerative peri-implantitis surgery recommend the removal of the prosthetic rehabilitation and the use a marginal incision with a full-thickness access flap elevation. This allows for a good overview for regenerative procedures with a certain risk of wound dehiscences and incomplete regeneration. An alternative approach referring to the poncho technique may reduce the risk of dehiscence. The effectiveness of implant surface decontamination might have an impact on peri-implant bone regeneration without any clinical superiority of a certain technique. The available literature reveals that the success of peri-implantitis therapy is limited to the reduction of bleeding on probing, the improvement of the peri-implant probing depth and a small amount of vertical defect fill. On this basis, no specific recommendations for bone regeneration in surgical peri-implantitis therapy can be made. Innovative approaches for flap design, surface decontamination, bone defect grafting material, and soft tissue augmentation should be followed closely to find advanced techniques for favorable peri-implant bone augmentation.

The Histopathological Evaluation of Effects of Application of the Bovine Amniotic Fluid with Graft on Peri-Implant Bone Regeneration

The Histopathological Evaluation of Effects of Application of the Bovine Amniotic Fluid with Graft on Peri-Implant Bone Regeneration

Clinical and patient-reported outcomes of tissue engineering strategies for periodontal and peri-implant reconstruction.

Scientific advancements in biomaterials, cellular therapies, and growth factors have brought new therapeutic options for periodontal and peri-implant reconstructive procedures. These tissue engineering strategies involve the enrichment of scaffolds with living cells or signaling molecules and aim at mimicking the cascades of wound healing events and the clinical outcomes of conventional autogenous grafts, without the need for donor tissue. Several tissue engineering strategies have been explored over the years for a variety of clinical scenarios, including periodontal regeneration, treatment of gingival recessions/mucogingival conditions, alveolar ridge preservation, bone augmentation procedures, sinus floor elevation, and peri-implant bone regeneration therapies. The goal of this article was to review the tissue engineering strategies that have been performed for periodontal and peri-implant reconstruction and implant site development, and to evaluate their safety, invasiveness, efficacy, and patient-reported outcomes. A detailed systematic search was conducted to identify eligible randomized controlled trials reporting the outcomes of tissue engineering strategies utilized for the aforementioned indications. A total of 128 trials were ultimately included in this review for a detailed qualitative analysis. Commonly performed tissue engineering strategies involved scaffolds enriched with mesenchymal or somatic cells (cell-based tissue engineering strategies), or more often scaffolds loaded with signaling molecules/growth factors (signaling molecule-based tissue engineering strategies). These approaches were found to be safe when utilized for periodontal and peri-implant reconstruction therapies and implant site development. Tissue engineering strategies demonstrated either similar or superior clinical outcomes than conventional approaches for the treatment of infrabony and furcation defects, alveolar ridge preservation, and sinus floor augmentation. Tissue engineering strategies can promote higher root coverage, keratinized tissue width, and gingival thickness gain than scaffolds alone can, and they can often obtain similar mean root coverage compared with autogenous grafts. There is some evidence suggesting that tissue engineering strategies can have a positive effect on patient morbidity, their preference, esthetics, and quality of life when utilized for the treatment of mucogingival deformities. Similarly, tissue engineering strategies can reduce the invasiveness and complications of autogenous graft-based staged bone augmentation. More studies incorporating patient-reported outcomes are needed to understand the cost-benefits of tissue engineering strategies compared with traditional treatments.

Effectiveness and Mechanisms of Low-Intensity Pulsed Ultrasound on Osseointegration of Dental Implants and Biological Functions of Bone Marrow Mesenchymal Stem Cells.

Dental implant restoration is the preferred choice for patients with dentition defects or edentulous patients, and obtaining stable osseointegration is the determining factor for successful implant healing. The risk of implant failure during the healing stage is still an urgent problem in clinical practice due to differences in bone quality at different implant sites and the impact of some systemic diseases on bone tissue metabolism. Low-intensity pulsed ultrasound (LIPUS) is a noninvasive physical intervention method widely recognized in the treatment of bone fracture and joint damage repair. Moreover, many studies indicated that LIPUS could effectively promote the osseointegration of dental implants and improve the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). This review is aimed at investigating the research progress on the use of LIPUS in dental implant medicine from three aspects: (1) discuss the promoting effects of LIPUS on osseointegration and peri-implant bone regeneration, (2) summarize the effects and associated mechanisms of LIPUS on the biological functions of BMSCs, and (3) introduce the application and prospects of LIPUS in the clinical work of dental implantation. Although many challenges need to be overcome in the future, LIPUS is bound to be an efficient and convenient therapeutic method to improve the dental implantation success rate and expand clinical implant indications.

Evaluation of the effects of the systemic proton pump inhibitor-omeprazole on periimplant bone regeneration and osseointegration: An experimental study

ObjectiveInvestigations of the effects of proton pump inhibitors (PPIs) on bone healing have revealed that they affect bone regeneration negatively. The exact mechanism by which this adverse effect on bone tissue is not known. The aim of this study is to biomechanic and biochemical investigation of the effects of the PPIs on guided periimplant bone regeneration. Material & methodsSpraque dawley rats were divided controls (n = 8): there is no treatment during 8 week experimental period, PPI- Dosage 1 (n = 8) and Dosage 2 (n = 8): 5 mg/kg and 10 mg/kg omeprazol applied 3 times in a week with oral gavage during 8 weeks respectfully. Bone defects created half of the implant length circumferencial after implant insertion and defects filled with bone grafts. After experimental period the rats sacrified and implants with surrounding bone tissues were removed to reverse torque analysis (Newton), blood samples collected to biochemical analysis (glucose, AST, ALT, ALP, urea, creatinin, calcium, P). ResultsBiomechanic reverse torque values did not revealed any statistical differences between the groups (P > 0,05). ConclusionAccording the biomechanical and biochemical parameters PPIs does not effect the periimplant guided bone regeneration.

Induction of Osseointegration by Nacre in Pigs.

Nacre is a biomaterial that has shown osteoinductive and osteoconductive properties in vitro and in vivo. These properties make nacre a material of interest for inducing bone regeneration. However, information is very limited regarding the introduction of nacre to dental implant surgery for promoting osteogenesis. This study investigated the potential of nacre powder for peri-implant bone regeneration in a porcine model. Ninety-six dental implants were placed into the tibia of twelve male domestic pigs. The dental implants were coated with nacre powder from the giant oyster before implantation. Implantations without nacre powder were used as control groups. Euthanization took place at 2, 4 and 6 weeks after implantation, after which we measured bone-to-implant contact (BIC) and bone volume density (BVD) of the implanted bone samples using micro-computed tomography (micro-CT), and examined the histology of the surrounding bone using histological sections stained with Stevenel’s blue and Alizarin red S. The micro-CT analyses showed that the BIC of dental implantations with nacre powder were significantly higher than those without nacre powder, by 7.60%. BVD of implantations with nacre powder were significantly higher than those without nacre powder, by 12.48% to 13.66% in cortical bone, and by 3.37% to 6.11% in spongy bone. Histological study revealed more peri-implant bone regeneration toward the surface of the dental implants after implantation with nacre powder. This was consistent with the micro-CT results. This study demonstrates the feasibility of using nacre to promote peri-implant bone regeneration in dental implantation.

PTH 1-34-functionalized bioactive glass improves peri-implant bone repair in orchiectomized rats: Microscale and ultrastructural evaluation

The objective of this work was to investigate the use of Biogran® functionalized with parathyroid hormone (PTH) 1–34 by sonochemistry for the local delivery of this anabolic agent to the implant site. The effects of Biogran® and topical administration of PTH 1–34 on peri-implant bone regeneration were evaluated from the microscale to ultrastructural levels in healthy (SHAM) and orchiectomized (ORQ). While some animals only received a titanium implant in their tibial metaphyses (CLOT group), in others the peri-implant defect was first filled with Biogran® either without or with PTH 1–34 functionalization (BG and BGPTH groups, respectively) prior to implant installation. Osseointegration was characterized from a biomechanical perspective by measuring the removal torque with the counter-torque technique. Micro-CT was used to evaluate the percentage of bone volume, trabecular thickness, number and separation, and bone-implant contact (BIC). Dynamics of new bone formation were assessed by measuring fluorochrome area, daily mineral apposition rate, and neoformed bone area using confocal laser microscopy. RT-PCR was performed to evaluate ALP and osteocalcin expression. The interface between newly formed bone and Biogran® was examined using scanning electron microscopy (SEM) and scanning transmission electron microscopy (STEM) at the micro-and nanoscale, respectively, while elemental analyses were completed in SEM with energy-dispersive X-ray spectroscopy (EDS). STEM imaging demonstrated the intimate attachment of bone to Biogran® (nanoscale level). Overall, the results suggest that the effectiveness of the topical administration of PTH 1–34 at the implant site seems enhanced in osteoporotic bone, promoting peri-implant bone regeneration to comparable levels in healthy conditions.

Bone Stress Evaluation with and without Cortical Bone Using Several Dental Restorative Materials Subjected to Impact Load: A Fully 3D Transient Finite-Element Study.

Statement of problem. Previous peri-implantitis, peri-implant bone regeneration, or immediate implant placement postextraction may be responsible for the absence of cortical bone. Single crown materials are then relevant when dynamic forces are transferred into bone tissue and, therefore, the presence (or absence) of cortical bone can affect the long-term survival of the implant. Purpose: the purpose of this study is to assess the biomechanical response of dental rehabilitation when selecting different crown materials in models with and without cortical bone. Methods: several crown materials were considered for modeling six types of crown rehabilitation: full metal (MET), metal-ceramic (MCER), metal-composite (MCOM), peek-composite (PKCOM), carbon fiber-composite (FCOM), and carbon fiber-ceramic (FCCER). An impact-load dynamic finite-element analysis was carried out on all the 3D models of crowns mentioned above to assess their mechanical behavior against dynamic excitation. Implant-crown rehabilitation models with and without cortical bone were analyzed to compare how the load-impact actions affect both type of models. Results: numerical simulation results showed important differences in bone tissue stresses. The results show that flexible restorative materials reduce the stress on the bone and would be especially recommendable in the absence of cortical bone. Conclusions: this study demonstrated that more stress is transferred to the bone when stiffer materials (metal and/or ceramic) are used in implant supported rehabilitations; conversely, more flexible materials transfer less stress to the implant connection. Also, in implant-supported rehabilitations, more stress is transferred to the bone by dynamic forces when cortical bone is absent.

The Applications of Enamel Matrix Derivative in Implant Dentistry: A Narrative Review.

Enamel matrix derivative (EMD) has been successfully used for periodontal regeneration in intrabony defects. Recently, its use for peri-implant bone regeneration has also been hypothesized. The aim of this paper is to review preclinical and clinical studies investigating the use of EMD in correspondence with titanium implants, alone or as an adjunct to other biomaterials. Clinical trials and case series with more than five cases were included. Seven in vitro studies evaluated the effect of EMD, placed on titanium surfaces: An increase in proliferation and viability of osteoblasts was observed in all but two studies. An increase in TGF-β1 and osteocalcin production, alkaline phosphatase activity, and angiogenesis was also reported. Nine animal studies investigated the use of EMD at implant placement or for bone regeneration of peri-implant bone defects, and some of them reported a significant increase in bone formation or bone-to-implant contact. In four of eleven clinical trials on humans, EMD was successfully used at implant placement. The other seven evaluated the use of EMD in protocols for the treatment of peri-implantitis. In conclusion, the results of EMD seem promising, but further randomized clinical trials are needed to evaluate its efficacy.

Preliminary evaluation of BMP-2-derived peptide in repairing a peri-implant critical size defect: A canine model

A synthetic bone morphogenetic protein (BMP)-2-derived peptide has been discovered to promote bone regeneration. The present study investigated the potential of the BMP-2 peptide combined with hydroxyapatite (HAp)/β-tricalcium phosphate (TCP)/collagen (Col) composite in repairing a peri-implant critical size defect. Twenty-four saddle-type alveolar defects (10mm mesiodistally and 4mm apicocoronally) were surgically prepared in edentulous ridges in four male beagle dogs. Following implant placement, the defects with vertically exposed implant fixtures received (a) HAp/TCP/Col composite, (b) HAp/TCP/Col+4mg/mL BMP-2 peptide, (c) HAp/TCP/Col+20mg/mL BMP-2 peptide, or (d) HAp/TCP/Col+0.2mg/mL recombinant human BMP-2 (rhBMP-2). Bone regeneration and mineralization were assessed using radiography, micro-computed tomography (micro-CT), fluorescence labeling, and histologic analyses after healing for 4 or 8 weeks. Implant stability was measured using resonance frequency analysis. The 20mg/mL BMP-2 peptide groups demonstrated a distinguishable advantage in bone regeneration potential over the control groups, as observed on radiographic imaging and histologic examination, although no significant difference was found in implant stability and histomorphometric analysis of mineralization levels. However, the performance of the 20mg/mL BMP-2 peptide groups were inferior to that of the 0.2mg/mL rhBMP-2 groups. The BMP-2 peptide may accelerate peri-implant bone regeneration. The BMP-2 peptide at 20mg/mL still cannot complete bone repair of peri-implant critical size defect. The BMP-2 peptide at 20mg/mL has similar osteoinductive performance to the rhBMP-2 at 0.02mg/mL.

Simultaneous application of diamond-like carbon coating and surface amination on polyether ether ketone: Towards superior mechanical performance and osseointegration

Poor osseointegration ability and the release of worn debris after implantation are the main issues impeding the clinic application of polyether ether ketone (PEEK) as orthopedics. To address these problems, we expect that the initial deposition of diamond-like carbon (DLC) coating on PEEK substrate and the subsequent introduction of amino groups onto sample surface using plasma immersion ion implantation (PIII) have the potential to simultaneously improve the mechanical performance and osseointegration. On one hand, the surface hardness is raised from 0.38 ​GPa to 2.99 ​GPa and the elastic modulus reaches 35 ​GPa after DLC deposition, while no failure is observed in the scratch tests even the loading force is up to 100 ​N. On the other hand, the introduced amino groups facilitate the adhesion, proliferation, and osteogenic differentiation of the osteoblasts in vitro, and further enhanced the peri-implant bone regeneration in vivo. With the merits of low cost, clean approach, and ease of operation, the approach described here holds great potential for biomedical applications.

Implant and Prosthetic Success Following Peri-implant Guided Bone Regeneration in the Esthetic Zone Using an Equine Cortical Bone Membrane and an Equine Enzyme-Treated Bone Graft: A Retrospective Study with 9-year Follow-Up.

A barrier membrane consisting of an equine-derived, demineralized cortical bone sheet has been made available, yet evidence of its effectiveness is currently only anecdotal. This study aimed to obtain preliminary evidence concerning the medium-term prosthetic and implant success rates that may be achieved when such a membrane is used in combination with an equine, enzyme-treated bone graft, concomitantly to implant placement in the esthetic zone. Records of patients who had one or two implants placed in the anterior sectors of the two arches and had peri-implant bone regeneration carried out using the equine-derived membrane and equine-derived collagen-preserving bone granules were retrospectively collected. Peri-implant marginal bone loss (MBL) was used to assess implant survival. When available, histologic data concerning the equine membrane and cone beam computed tomography (CBCT) scans were analyzed as well. Records of 32 patients (ages 36 to 73 years), corresponding to 44 implants placed, were retrieved and analyzed. The mean follow-up was 113.9 ± 10.2 months. Two implants failed. The implant success rate was 90.9%. Twelve membrane samples could be retrieved and analyzed, showing the membrane was still occlusive at 4.2 ± 1.1 months and only beginning to undergo remodeling. Twelve CBCT scans showed that 65.1 ± 9.8 months after surgery, a newly formed cortical layer could be observed in the zone that had undergone grafting. The equine cortical bone membrane and the enzyme-treated bone graft used in this case series achieved a medium-term implant and prosthetic success rate that was not dissimilar to that of other resorbable membranes and grafts for peri-implant guided bone regeneration augmentation. Preliminary medium-term histologic and CBCT data suggest that the membrane may be occlusive for a period of at least 4 months and may contribute to preserve the ridge thickness over time.

Low-intensity pulsed ultrasound improves osseointegration of dental implant in mice by inducing local neuronal production of αCGRP

ObjectiveThis study aimed to explore the effect of Low-intensity pulsed ultrasound (LIPUS) on implant osseointegration and elucidate the role of α-calcitonin gene-related peptide (αCGRP) in this process. DesignIn vivo, αCGRP+/+ (Wild-type model) mice and αCGRP-/- (Knock-out model) mice with implants immediately placed in the maxillary first molars extraction sockets were treated with LIPUS. We detected details of peri-implant bone tissues by micro-CT, real-time PCR and histological analysis. In vitro, αCGRP+/+ and αCGRP-/- dorsal root ganglia (DRG) neurons were cultured and exposed to LIPUS. Then conditioned media from these neurons were collected and added to osteoblasts to analyze cell differentiation, mineralization and proliferation by real-time PCR, alkaline phosphatase (ALP) and cell counting kit‐8 (CCK‐8) assay. Besides, ELISA was performed to determine the effect of LIPUS on the αCGRP secretion in neurons. ResultsIn vivo tests revealed that αCGRP-/- mice displayed worse osseointegration when compared to αCGRP+/+ mice. LIPUS could enhance implant osseointegration in αCGRP+/+ mice but had little effect on αCGRP-/- mice. Meanwhile, αCGRP was elevated during the osseointegration with LIPUS treatment. In vitro, LIPUS promoted αCGRP secretion in DRG neurons, thereby enhanced osteogenic differentiation and mineralization of osteoblasts. Also we proved that the effects of LIPUS was duty cycle-related and LIPUS of 80% duty cycle had the strongest impacts. ConclusionsOur findings demonstrated that LIPUS could enhance osseointegration of dental implant by inducing local neuronal production of αCGRP, providing a new idea to promote peri-implant osseointegration and bone regeneration.

Efficacy of concentrated growth factors combined with mineralized collagen on quality of life and bone reconstruction of guided bone regeneration.

To evaluate the clinical efficacy of concentrated growth factors (CGFs) combined with mineralized collagen (MC) in guided bone regeneration (GBR). A retrospective study involving 29 patients treated with GBR technique, which was performed either CGF and MC complexes or MC alone. Implants were inserted simultaneously and cone-beam computed tomography was taken immediately, at 3 and 6 months postoperation. Questionnaires were completed by all patients so as to evaluate the main symptoms and daily activities during the first week after surgery. The outcomes of the two groups were statistically compared. All implants healed uneventfully. Patients in both groups suffered from different levels of discomfort for the reason of swelling, pain and chewing impairment on 1–2 days. Meanwhile, swelling of the Trial group was weaker than the Control group. When compared with the Control group, pain levels in Trial group were more rapidly reduced and patients took fewer analgesics from Day 3. Furthermore, the reconstitution mean value of the graft was thicker at 3 and 6 months in Trial group. CGFs complex with MC were beneficial to relieve the clinical symptoms, promote the peri-implant bone regeneration and shorten the healing time.

Fabrication and in vitro biological activity of functional pH-sensitive double-layered nanoparticles for dental implant application.

Sufficient bone mass plays a vital role in dental implant fixation and durability. However, bone deficiency is common clinically, and peri-implant infection causes alveolar bone to further resorb. Therefore, inhibiting bone resorption and promoting peri-implant bone regeneration are highly desirable. For this purpose, functional pH-sensitive double-layered nanoparticles were fabricated for application on dental implant surface. These double-layered nanoparticles were composed of a poly(L-lactic acid) inner layer and a chitosan outer shell. Recombinant human bone morphogenetic protein-2-loaded poly(L-lactic acid) nanoparticles were prepared by the emulsification-solvent evaporation method. Osteoprotegerin was conjugated to the chitosan backbone via a pH-sensitive hydrazone bond. The release profile consisted of an initial fast release and a more continuous slow release for at least 30 days. Moreover, the cumulative osteoprotegerin release increased significantly with decreasing pH ( p &lt; 0.05). The results from biological studies indicated that the double-layered nanoparticles could inhibit the generation of osteoclasts, recruit bone marrow-derived mesenchymal stem cells (BMSCs), and promote BMSCs to differentiate into osteoblasts. Meanwhile, the inhibitory effect on osteoclasts increased with decreasing pH ( p &lt; 0.05). It can be concluded that the pH-sensitive double-layered nanoparticles, which had a significant effect on inhibiting bone resorption and promoting bone regeneration, are ideal nanoparticles to be applied on dental implant surface.

Periostin reverses high glucose-inhibited osteogenesis of periodontal ligament stem cells via AKT pathway

AimsDiabetes mellitus leads to impaired osteogenic differentiation and alveolar bone absorption. Periostin (POSTN) is important for bone and tooth maintenance. This study aims to elucidate the expression of POSTN in high glucose and the effects of both high glucose and POSTN on osteogenesis in hPDLSCs, as well as the underlying mechanism. Main methodsCells were incubated with glucose under physiological (5.5 mM normal glucose) or diabetic (30 mM high glucose) conditions in the presence or absence of recombinant human POSTN (rPOSTN). Cell migration was assessed by a scratch assay. Reactive oxygen species (ROS) was used to assess HG-induced oxidative damage. Osteogenesis was evaluated by alkaline phosphatase (ALP) activity and ALP staining, Alizarin Red staining (ARS), as well osteogenic related genes and proteins. Key findingsPOSTN expression was inhibited during a long-term culture with HG. HG diminished the migration and osteogenesis of hPDLSCs as indicated by decreases in ALP activity and ALP staining, ARS and expression of COL I, RUNX2, OSX, OPN and OCN, but an increase in reactive oxygen species overproduction. All of which were reversed by addition of rPOSTN. POSTN knockdown suppressed migration and osteogenesis of hPDLSCs. Moreover, HG inhibited activation of AKT, which was rescued by addition of POSTN. AKT inhibitor significantly reduced POSTN-mediated osteogenic differentiation. SignificancerPOSTN could be a therapeutic regime for defective periodontal and peri-implant bone regeneration in diabetes mellitus.