Combining Scaffolds and Osteogenic Cells in Regenerative Bone Surgery: A Preliminary Histological Report in Human Maxillary Sinus Augmentation

Mangano, Carlo; Piattelli, Adriano; Mangano, Alberto; Mangano, Francesco; Mangano, Alessandro; Iezzi, Giovanna; Borges, Fábio L.; d'Avila, Susana; Shibli, Jamil Awad

doi:10.1111/j.1708-8208.2009.00227.x

Cited by 30 publications

(36 citation statements)

References 35 publications

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“…Consequently, different approaches have been developed to deal with this problem, and maxillary sinus floor elevation is an effective way to restore the posterior upper jaw [3-5]. Although various bone-grafting materials, including autogenous bone, allogeneic bone and xenografts, are currently being used for maxillary augmentation, these grafts have disadvantages, including finite donor availability, potential donor site morbidity, disease transmission, immunogenic response and high cost [6-8]. As a consequence, many biomaterials with good biocompatibility have been developed as an alternative to traditional graft materials.…”

Section: Introductionmentioning

confidence: 99%

The use of injectable sonication-induced silk hydrogel for VEGF165 and BMP-2 delivery for elevation of the maxillary sinus floor

et al. 2011

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Sonication-induced silk hydrogels were previously prepared as an injectable bone replacement biomaterial, with a need to improve osteogenic features. Vascular endothelial growth factor (VEGF165) and bone morphogenic protein-2 (BMP-2) are key regulators of angiogenesis and osteogenesis, respectively, during bone regeneration. Therefore, the present study aimed at evaluating in situ forming silk hydrogels as a vehicle to encapsulate dual factors for rabbit maxillary sinus floor augmentation. Sonication-induced silk hydrogels were prepared in vitro and the slow release of VEGF165 and BMP-2 from these silk gels was evaluated by ELISA. For in vivo studies for each time point (4 and 12 weeks), 24 sinus floors elevation surgeries were made bilaterally in 12 rabbits for the following four treatment groups: silk gel (group Silk gel), silk gel/VEGF165 (group VEGF), silk gel/BMP-2 (group BMP-2), silk gel/VEGF165/BMP-2 (group V+B) (n=6 per group). Sequential florescent labeling and radiographic observations were used to record new bone formation and mineralization, along with histological and histomorphometric analysis. At week 4, VEGF165 promoted more tissue infiltration into the gel and accelerated the degradation of the gel material. At this time point, the bone area in group V+B was significantly larger than those in the other three groups. At week 12, elevated sinus floor heights of groups BMP-2 and V+B were larger than those of the Silk gel and VEGF groups, and the V+B group had the largest new bone area among all groups. In addition, a larger blood vessel area formed in the remaining gel areas in groups VEGF and V+B. In conclusion, VEGF165 and BMP-2 released from injectable and biodegradable silk gels promoted angiogenesis and new bone formation, with the two factors demonstrating an additive effect on bone regeneration. These results indicate that silk hydrogels can be used as an injectable vehicle to deliver multiple growth factors in a minimally invasive approach to regenerate irregular bony cavities.

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Section: Introductionmentioning

confidence: 99%

The use of injectable sonication-induced silk hydrogel for VEGF165 and BMP-2 delivery for elevation of the maxillary sinus floor

et al. 2011

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“…Among these regenerative techniques, maxillary sinus augmentation [3][4][5][6][7], guided bone regeneration (GBR) [8], and split-crest techniques [9] are the most commonly used procedures to restore the ideal anatomical bone conditions and to allow simultaneous and/or subsequent placement of dental implants.…”

Section: Introductionmentioning

confidence: 99%

Implant stability in the posterior maxilla: a controlled clinical trial

Gomes¹

2017

http://isrctn.com/

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Aim. To evaluate the primary and secondary stability of implants in the posterior maxilla. Methods. Patients were allocated into three groups: (A) native bone, (B) partially regenerated bone, and (C) nearly totally regenerated bone. Insertion torque (IT) and implant stability quotient (ISQ) were measured at placement, to evaluate whether satisfactory high primary stability (IT ≥ 45 N/cm; ISQ ≥ 60) was achieved; ISQ was measured 15, 30, 45, and 60 days after placement, to investigate the evolution to secondary stability. Results. 133 implants (Anyridge5, Megagen) were installed in 59 patients: 55 fixtures were placed in Group A, 57 in Group B, and 21 in Group C. Fifty-two implants had satisfactory high primary stability (IT ≥ 45 N/cm; ISQ ≥ 60). A positive correlation was found between all variables (IT, ISQ at t = 0, t = 60), and statistically higher IT and ISQ values were found for implants with satisfactory high primary stability. Significant differences were found for IT and ISQ between the groups (A, B, and C); however, no drops were reported in the median ISQ values during the healing period. Conclusions. The evaluation of the primary and secondary implant stability may contribute to higher implant survival/success rates in critical areas, such as the regenerated posterior maxilla. The present study is registered in the ISRCTN registry with ID ISRCTN33469250.

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“…A few prior studies reported clinical application of TE-bone substitutes derived from alveolar bone cells [29], [30], [31], [50]. Pradel and colleagues used second passage mandibular and maxillary osteoblasts, isolated by establishing explant cultures and cultured on collagen scaffolds 3–4 days, to regenerate bone after mandibular cyst enucleation and for osteoplasty in patients with cleft alveolus [29], [30].…”

Section: Discussionmentioning

confidence: 99%

“…New vital bone formation with sufficient stability for implant placement was found with osteoblast-derived TE-substitutes, similarly to periosteal cells-derived TE-substitutes. Mangano and colleagues used third/fourth passage mandibular bone marrow osteoblasts, isolated from bone cores by collagenase digestion and cultured on polymer scaffolds for 1 week, for sinus augmentation procedures [50]. After 6 months, clinical, histological and computed tomography evaluations revealed a significant average vertical bone gain.…”

Section: Discussionmentioning

confidence: 99%

Primary Human Alveolar Bone Cells Isolated from Tissue Samples Acquired at Periodontal Surgeries Exhibit Sustained Proliferation and Retain Osteogenic Phenotype during In Vitro Expansion

et al. 2014

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ObjectivesBone tissue regeneration requires a source of viable, proliferative cells with osteogenic differentiation capacity. Periodontal surgeries represent an opportunity to procure small amounts of autologous tissues for primary cell isolation. Our objective was to assess the potential of human alveolar bone as a source of autologous osteogenic cells for tissue engineering and biomaterials and drug testing studies.Materials and MethodsAlveolar bone tissue was obtained from 37 patients undergoing routine periodontal surgery. Tissue harvesting and cell isolation procedures were optimized to isolate viable cells. Primary cells were subcultured and characterized with respect to their growth characteristics, gene expression of osteogenic markers, alkaline phosphatase activity and matrix mineralization, under osteogenic stimulation.ResultsAlveolar bone cells were successfully isolated from 28 of the 30 samples harvested with bone forceps, and from 2 of the 5 samples obtained by bone drilling. The yield of cells in primary cultures was variable between the individual samples, but was not related to the site of tissue harvesting and the patient age. In 80% of samples (n = 5), the primary cells proliferated steadily for eight subsequent passages, reaching cumulative numbers over 1010 cells. Analyses confirmed stable gene expression of alkaline phosphatase, osteopontin and osteocalcin in early and late cell passages. In osteogenic medium, the cells from late passages increased alkaline phosphatase activity and accumulated mineralized matrix, indicating a mature osteoblastic phenotype.ConclusionsPrimary alveolar bone cells exhibited robust proliferation and retained osteogenic phenotype during in vitro expansion, suggesting that they can be used as an autologous cell source for bone regenerative therapies and various in vitro studies.

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Combining Scaffolds and Osteogenic Cells in Regenerative Bone Surgery: A Preliminary Histological Report in Human Maxillary Sinus Augmentation

Abstract: Within the limits of the present report, the histological data in humans confirmed that tissue-engineered bone and calcium phosphate allowed newly formed bone after maxillary sinus augmentation.

Cited by 30 publications

References 35 publications

The use of injectable sonication-induced silk hydrogel for VEGF165 and BMP-2 delivery for elevation of the maxillary sinus floor

The use of injectable sonication-induced silk hydrogel for VEGF165 and BMP-2 delivery for elevation of the maxillary sinus floor

Implant stability in the posterior maxilla: a controlled clinical trial

Primary Human Alveolar Bone Cells Isolated from Tissue Samples Acquired at Periodontal Surgeries Exhibit Sustained Proliferation and Retain Osteogenic Phenotype during In Vitro Expansion

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