Uso de los factores de crecimiento presentes en el plasma rico en plaquetas como un tratamiento alternativo de lesiones músculo esqueléticas en animales / Use of growth factors present in platelet-rich plasma as an alternative treatment for musculoskeletal lesions in animals / Uso de fatores de crescimento presentes no plasma rico em plaquetas como tratamento alternativo para lesões musculo esqueléticas em animais

Resumen Se realizó una revisión sistemática del uso de plasma rico en plaquetas (PRP) en animales, seleccionando 105 artículos de referencia, publicados en los últimos 8 años (2012 a 2020) de las revistas Veterinary Medicine International, Scientific Reports, BMC Veterinary Research, Platelets, Biomedicine and Pharmacotherapy entre otras y validadas en las siguientes bases de datos: Pubmed, Web of Science, Sciencedirect, Scielo, Medline, Embase y Scopus. Limitando solo las revistas con altos rankings ayudados con las clasificaciones de revistas por scimago journal. Solo 35 artículos cumplieron los criterios de selección; articulándolo con necesidades actuales en la medicina veterinaria, buscando una nueva biotecnología y proyectándose hacia la medicina regenerativa, basándose en reconstrucción de tejidos vivos para contrarrestar daño o remplazo de función de órganos lesionados. Una de estas herramientas es el plasma rico en plaquetas (PRP) con sus factores de crecimiento (FC) Transformante ß (TGF ß), fibroblástico básico (FGFb), derivado de plaquetas (PDGF), del endotelio vascular (VEGF), tejido conectivo (CTGF) y epidérmico (EGF). Actualmente el (PRP) es un bioestimulante tomado como base por estudios en medicina humana y medicina veterinaria, observando su efectividad en el proceso de consolidación ósea en pacientes clínicos. Se recogieron evidencias científicas presentadas en literatura médica con respecto al PRP como una alternativa de tratamiento en el manejo de fracturas y lesiones músculo esqueléticas, con ello se logra determinar la importancia de la estandarización del procedimiento (PRP) en uso, preparación, almacenamiento y administración.

Abstract A systematic review of platelet-rich plasma (PRP) use in animals was carried out by taking 105 reference articles published during the last 8 years (2012 to 2020) in Veterinary Medicine International, Scientific Reports, BMC Veterinary Research, Platelets, Biomedicine and Pharmacotherapy; they were validated in the following databases: PubMed, Web of Science, ScienceDirect, SciELO, Medline, Embase and Scopus. The search was limited to just journals having a high impact factor; the SCImago journal rank (SJR) indicator (i.e. a sophisticated citation analysis algorithm) was also used. Only 35 of these articles met the selection criteria: i.e. coordinating content with current needs in veterinary medicine, seeking new biotechnological approaches and promoting regenerative medicine based on reconstructing living tissue to counteract damage or replace injured organs' function. One such tool is platelet-rich plasma (PRP) with its derivative growth factors (GF): transforming growth factor-ß (TGF-ß), basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), connective tissue growth factor (CTGF) and epidermal growth factor (EGF). PRP is currently used as a biostimulant, acting as the basis for human and veterinary medicine studies; its effectiveness regarding bone/fracture healing/regeneration in clinical patients has been observed. Scientific evidence in the pertinent medical literature regarding PRP as an alternative treatment for managing fractures and musculoskeletal injuries was collected, thereby determining the importance of standardising the PRP procedure regarding its use, preparation, storage and administration.

Resumo Foi realizada uma revisão sistemática da utilização de plasma rico em plaquetas (PRP) em animais, com 105 artigos de referência, publicados nos últimos 8 anos (2012 a 2020) das revistas Veterinary Medicine International, Scientific Reports, BMC Veterinary Research, Platelets, Biomedicina e Farmacoterapia entre outros e validados nas seguintes bases de dados: Pubmed, Web of Science, Sciencedirect, Scielo, Medline, Embase e Scopus. Limitar apenas os periódicos com classificações altas ajudou com as classificações de periódicos pelo jornal scimago. Dos quais apenas 35 artigos atenderam aos critérios de seleção; articulando-se com as necessidades atuais da medicina veterinária, buscando uma nova biotecnologia e projetando-se na medicina regenerativa, baseada na reconstrução de tecidos vivos para neutralizar danos ou substituição de função de órgãos lesados. Uma dessas ferramentas é o plasma rico em plaquetas (PRP) com seus fatores de crescimento (FC) ß transformador (TGF ß), fibroblasto básico (FGFb), derivado de plaquetas (PDGF), endotelial vascular (VEGF), tecido conjuntivo (CTGF) e epidérmico (EGF). Atualmente (PRP) é um bioestimulante tomado como base para estudos em medicina humana e veterinária, observando sua eficácia no processo de consolidação óssea em pacientes clínicos. Foram coletadas evidências científicas apresentadas na literatura médica a respeito do PRP como alternativa de tratamento no manejo de fraturas e lesões musculoesqueléticas, determinando a importância da padronização do procedimento (PRP) no uso, preparo, armazenamento e administração.

Clinical application of autogenous dentin as a bone graft material / 口腔疾病防治

@#Autogenous dentin is a promising biological material that can be used as a substitute for autologous bone. It has been used in postextraction site preservation, maxillary sinus floor elevation, and alveolar ridge augmentation. The clinical application methods of autologous dentin have showed great diversity without uniform standard. The present article reviewed the clinical application of autogenous dentin to provide new ideas for its future development. The literature review results show that dentin materials require several preparations before transplantation, among which the demineralization is a common chemical processing method. Demineralization can enhance the osteoconductive and osteoinductive properties of dentin, but the complex and time-consuming operation process has limited its application to a certain extent. Partial demineralization may be a more appropriate choice. During transplantation, the morphology of dentin depends on the condition of the bone defect and the surgical method. Granular materials with different diameters are convenient for filling irregular defects. Block materials are conducive to maintaining the space of the reconstruction site. Hollow frame materials are slightly more complicated to process but can combine the advantages of granular and block grafts. In addition to being used alone, dentin can also be transplanted in combination with multiple biological materials. Platelet-rich plasma combined with dentin materials has shown ideal results in clinical studies. Plaster of paris and calcium phosphate ceramics have also been combined with dentin materials in animal experiments. But since they have not been applied in humans, their clinical effects require further research.

Caracterización morfológica y Evaluación clínica de sustitutos óseos de origen porcino de la casa 3Biomat para su aplicación en lesiones óseas bimaxilares / Morphological characterization and clinical evaluation of porcine bone substitutes of the 3Biomat house for its application in bimaxillary bone lesions

Resumen Objetivo. Realizar la caracterización morfológica y la evaluación clínica de sustitutos óseos de origen porcino, como material para la regeneración y reconstrucción de tejido óseo afectado en lesiones óseas bimaxilares. Método. Se analizaron características morfológicas de los materiales para regeneración (dispositivos médicos implantables) Biomec Cx y Biomod, el primero es una membrana acelular de submucosa intestinal y el segundo es sustituto óseo particulado y desmineralizado, ambos de origen porcino, por medio de técnicas de coloración y microscopía, con el objetivo de ver celularidad, organización de las fibras colágenas y tamaños de las partículas. Adicionalmente, se realizó un estudio de tipo comparativo prospectivo, con una muestra intencional de 31 pacientes, en los que se hicieron un total de 83 implantes. Los procedimientos quirúrgicos efectuados fueron: implante pos exodoncia más injerto óseo, implante dental e injerto óseo en el mismo tiempo quirúrgico e injerto óseo con un tiempo de 4 meses de integración para la colocación de implantes dentales. Para la evaluación del efecto regenerativo en los diferentes procedimientos quirúrgicos se interpretaron controles clínicos y radiográficos en los que se miró el comportamiento de la cresta ósea marginal. También se realizaron análisis histológicos de biopsias de tejido óseo regenerado. Resultados. En la caracterización morfológica se encontró que los materiales para regeneración son acelulares. La matriz formada por las fibras de colágeno del sustituto Biomec CX presenta una organización y espacios intersticiales que permiten una buena migración celular. El producto Biomod mostró una densidad y tamaño de partícula adecuada para el proceso regenerativo. En la evaluación clínica, todas las diferencias (mesial y distal) de los meses evaluados en relación con la ganancia de hueso, son estadísticamente significativas; prueba t pareada, p < 0,01 y ANOVA. El aumento promedio en 4 meses fue 0,235mm por mesial (57,3%) y 0,237mm por distal (56,7%). Conclusiones. A partir de los resultados obtenidos tanto en las características morfológicas como en la evaluación clínica de los sustitutos Biomec CX y Biomod, se comprobó que son materiales aptos para su uso en procesos regenerativos en los que se presenten lesiones óseas bimaxilares.

Abstract Objective. To perform the morphological characterization and clinical evaluation of porcine bone substitutes as a material for the regeneration and reconstruction of affected bone tissue in bimaxillary bone lesions. Method. Morphological characteristics of Biomec Cx and Biomod (implantable medical devices) regeneration materials were analyzed, the first is an acellular membrane of the intestinal submucosa and the second is a particle and demineralized bone substitute, both of porcine origin, by techniques of coloration and microscope with the objective of search the cellularity, organization of collagen fibers and particle sizes. Then a prospective comparative study was conducted with an intentional sample of 31 patients in which a total of 83 implants were made. The surgical procedures were: Post-extraction implant plus bone graft, dental implant- bone graft at the same time and bone graft with a time of 4 months of integration for the placement of dental implants. For the evaluation of the regenerative effect in the different surgical procedure we interpreted clinical and radiographic controls with the behavior of the marginal bone crest. Histological analyzes of biopsies of regenerated bone were also performed. Results. In the morphological characterization it was found that the materials for regeneration are acellular. The matrix formed by the collagen fibers of the substitute Biomec CX presents an organization and interstitial spaces that allow a good cellular migration. The Biomod product showed a density and particle size suitable for the regenerative process. In the clinical evaluation, all the differences (mesial and distal) of the months evaluated in relation to the bone gain, are statistically significant; T-test, p <0.01 and ANOVA. The average increase in 4 months was 0.235mm per mesial (57.3%) and 0.237mm per distal (56.7%). Conclusions. Based on the results obtained both in the morphological characteristics and in the clinical evaluation of the substitutes Biomec CX and Biomod, it was verified that they are suitable materials for use in regenerative processes in which bimaxillary bone lesions are present.

Localized ridge defect augmentation using human pericardium membrane and demineralized bone matrix.

Background: Patient wanted to restore her lost teeth with implants in the lower left first molar and second premolar region. Cone beam computerized tomography (CBCT) revealed inadequate bone width and height around future implant sites. The extraction socket of second premolar area revealed inadequate socket healing with sparse bone fill after 4 months of extraction. Aim: To evaluate the clinical feasibility of using a collagen physical resorbable barrier made of human pericardium (HP) to augment localized alveolar ridge defects for the subsequent placement of dental implants. Materials and Methods: Ridge augmentation was done in the compromised area using Puros® demineralized bone matrix (DBM) Putty with chips and an HP allograft membrane. Horizontal (width) and vertical hard tissue measurements with CBCT were recorded on the day of ridge augmentation surgery, 4 month and 7 months follow‑up. Intra oral periapical taken 1 year after implant installation showed minimal crestal bone loss. Results: Bone volume achieved through guided bone regeneration was a gain of 4.8 mm horizontally (width) and 6.8 mm vertically in the deficient ridge within a period of 7 months following the procedure. Conclusion and Clinical Implications: The results suggested that HP Allograft membrane may be a suitable component for augmentation of localized alveolar ridge defects in conjunction with DBM with bone chips.

Ectopic bone formation in adipose-derived mesenchymal stem cell-seeded osteoinductive calcium phosphate scaffolds / 中国组织工程研究

BACKGROUND:The phenomenon of osteoinduction by biomaterials has been proven in animal experiments. OBJECTIVE:To investigate whether the ability of a biomaterial to initiate bone formation in ectopic implantation sites improves the performance of osteoinductive biomaterial as a scaffold for tissue-engineered bone. METHODS:We compared ectopic bone formation by combining autologous adipose-derived stromal cells with an osteoinductive and a nonosteoinductive biphasic calcium phosphate ceramic to create a tissue engineering construction in the muscle of dogs. Al implants were implanted in the back muscle of 10 adult dogs for 8 weeks and 12 weeks, including osteoinductive biphasic calcium phosphate ceramic+adipose-derived stromal cells (osteoinductive complex group), osteoinductive biphasic calcium phosphate ceramic (osteoinductive broup), nonosteoinductive biphasic calcium phosphate ceramic+adipose-derived stromal cells (nonosteoinductive complex group), and nonosteoinductive biphasic calcium phosphate ceramic (nonosteoinductive group). Micro-CT analysis and histomorphometry were performed to evaluate and quantify ectopic bone formation. RESULTS AND CONCLUSION:Ectopic bone formation was visible in the osteoinductive complex group and osteoinductive group, and the former group was superior to the latter one in quality of new bone (P<0.05). However, there was no ectopic bone formation in the other two groups. Micro-CT results were consistent with the histomorphological detection. These findings indicate that osteoinductive biphasic calcium phosphate ceramic, as a kind of bone tissue engineering scaffold material, has a better osteogenic capacity, while adipose-derived mesenchymal stem cells serve as seed cells to promote the ectopic bone formation.

Orthopaedic applications of bone graft & graft substitutes: a review.

Treatment of delayed union, malunion, and nonunion is a challenge to the orthopaedic surgeons in veterinary and human fields. Apart from restoration of alignment and stable fixation, in many cases adjunctive measures such as bone-grafting or use of bone-graft substitutes are of paramount importance. Bone-graft materials usually have one or more components: an osteoconductive matrix, which acts as scaffold to new bone growth; osteoinductive proteins, which support mitogenesis of undifferentiated cells; and osteogenic cells, which are capable of forming bone in the appropriate environment. Autologous bone remains the “gold standard” for stimulating bone repair and regeneration, but its availability may be limited and the procedure to harvest the material is associated with complications. Bone-graft substitutes can either substitute autologous bone graft or expand an existing amount of autologous bone graft. We review the currently available bone graft and graft substitutes for the novel therapeutic approaches in clinical setting of orthopaedic surgery.

Guided Haversian remodeling in acute bone trauma in rabbit ribia and mandible / 中华急诊医学杂志

Objective To search a better novae biomaterial applied to guide bone regeneration for promoting the healing of acute bone trauma by the experimental study of Haversian remodeling.Method Circular bone defects of 5mm diameter were created in tibias and the corners of mandibles in 36 rabbits.The defects were covered with calcium alginate film (CAF) in the experimental group, collagen membrane (CM)and no membrane (blank) in the control groups respectively. Healing conditions were analyzed using gross inspection, and histological and immunohistochemical studies after 1, 2, 4, 6 and 8 weeks respectively.Results The experimental group appeared more and earlier Haversian remodeling with osteoinductive factors leading to better bone regeneration. The control groups showed more macrophages with CM absorbed slowly, weak and delayed Haversian remodeling, and less osteoinductive factors ( P ＜ 0.05) in the early stage.Conclusions Calcium alginate film, as a relatively cheaper biomaterial, provided better effect than the collagen membrane on guided bone regeneration, because of its better Haversian remodeling and more content of osteoinductive factors shown in this experiment.

Comparison of osteoinductive activity of three types of bone graft materials / 中国矫形外科杂志

[Objective]To compare the osteoinductive activity of calcium sulfate(CS),allogenetic demineralized bone materials(ADBM) and heterogenetic demineralized bone materials(HDBM) by observing their efficiency in inducing bone formation.[Method]CS,ADBM and HDBM were transplanted into thigh muscle pouches of mice.Thirty-six mature Sprague-Dawly mice were divided into 2 groups at random.CS was transplanted into the left(group A 1,n=9) and ADBM into the right(group A2,n=9) thigh muscle pouches.HDBM was transplanted into the left thigh muscle pouches(group B 1,n=9) and the right sites were taken as blank controls(group B2,n=9).Experiments were done to induce ectopic bone formation.At 2,4,6 weeks postoperatively,specimen were collected to evaluate gross and tissue structures and biochemical tests for alkaline phosphatase(ALP) and Ca2+ so that osteoinductive activities of different bone graft materials could be assessed.[Result]At 2 weeks postoperativly,ADBM and HDBM were wrapped up by fibrous tissues and stromal cells gathering around the DBM slices.At 4 weeks postoperativly,formation of cartilage and osteoblasts were observed,and at 6 weeks,materials like cartilage matrix were observed to grow.The concentration of ALP and Ca2+ in study groups was higher than that of control group,which meant that 2 types of DBM had osteogenic potential and that the differences of osteogenetie potential in ADBM and HDBM relied on the donors,whereas CS could be degraded and absorbed fast with light inflammatory reaction and no ectopic bone formation was observed in CS graft.[Conclusion]Both ADBM and HDBM have osteoinductive potential.ADBM is better in inducing ectopic bone formation than HDBM.Differences in donors and preparation of ADBM and HDBM have impacts on their abilities of inducing ectopic bone formation.CS is good at biocompatibility and could be used as bulking agents to repair bone defects.