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Objective@# To investigate the osteogenic effect of β-tricalcium phosphate (β-TCP) and bone morphogenetic protein-2 (BMP-2) in the repair of the alveolar cleft.@*Methods @# Fifty-nine patients with unilateral alveolar cleft who visited Capital Medical University School of Stomatology from January 2016 to May 2021 were included. They were divided into three groups according to the different bone repair materials: autologous bone, β-TCP and BMP-2 +β-TCP. The preoperative and postoperative CBCT data of the patients were imported into Mimics 21.0 software. The preoperative volume of the bone defect and the new volume of bone formation were calculated by the three-dimensional reconstruction method. The osteogenesis rate was calculated to evaluate the osteogenesis effect@*Results@#The wounds in the three groups healed well after the operation, without implant material discharge, infection, dehiscence, rejection or other symptoms. Twelve months after the operation, CBCT scanning and three⁃dimensional reconstruction images of the three groups of patients showed the formation of new bone bridges in the alveolar ridge fissure area. The image density of the new bone tissue was not significantly different from that of normal bone tissue, and the continuity of the maxilla was re⁃ stored to varying degrees. The bone rate of autogenous bone was 65.00% ± 16.66%, β⁃ TCP group and BMP⁃2+ β⁃ The bone composition rate of TCP was 69.82% ± 17.60%, 71.35% ± 17.51%, respectively, and there was no significant dif⁃ ference compared with the autogenous bone group (P = 0.382, P = 0.244). The β⁃TCP and BMP⁃2+ β⁃TCP groups had no significant differences in bone rate (P = 0.789). @*Conclusion@#β⁃TCP could be used to replace autologous bone for alveolar cleft repair. The addition of BMP⁃2 to β⁃TCP did not significantly improve the osteogenesis rate.
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Bone defects have always been an important cause of threat to human health, and artificial biomimetic bone repair replacement materials are currently one of the most effective and feasible solution approaches to treat bone damage. To develop artificial bone biomimetic materials, an in vitro biomimetic mineralization system must be constructed first to study in vitro biomimetic mineralization mechanism of natural bone matrix. Collagen is a template for mineralization, and its properties such as crosslinking degree, diameter, osmotic pressure, and surface charge can all directly affect mineralization progress. The biochemical and mechanical environments in which mineralization occurs are also quite distinct in their effects on mineralization process, particularly noncollagenous proteins and fluid shear stress (FSS). FSS is considered to be the main mechanical stimulation of bone tissues in micro-environment, which is of great significance to bone growth, repair and health maintenance. FSS at different levels and loading regimes has significant effects on transformation of amorphous calcium phosphate to bone apatite, self-assembly and directional alignment of collagen fibrils, and formation of hierarchical intrafibrillar mineralization. In this paper, the factors affecting collagen mineralization and their mechanism were summarized, with focus on regulation of FSS on collagen mineralization, and development direction in future was also prospected.
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In the process of repairing of bone defects, bone scaffold materials need to be implanted to restore the corresponding tissue structure at the injury. At present, the repair materials used for bone defects mainly include autogenous bone, allogeneic bone, metal materials, bioceramics, polymer materials and various composite materials. Different materials have demonstrated strong reconstruction ability in bone repair, but the ideal bone implants in the clinic are still yet to be established. Except for autogenous bone, other materials used in bone defect repair are unable to perfectly balance biocompatibility, bone formation, bone conduction and osteoinduction. Combining the latest advances in materials sciences and clinical application, we believe that composite materials supplementedwith Chinese medicine, tissue cells, cytokines, trace elements, etc. and manufactured using advanced technologies such as additive manufacturing technology may have ideal bone repair performance, and may have profound significance in clinical repair of bone defects of special type. This article reviewed to the domestic and foreign literature in recent years, and elaborates the current status of bone defect repair materials in clinical application and basic research in regard to the advantages, clinical options, shortcomings, and how to improve the autogenous bone, allogeneic bone and artificial bone materials, in order to provide a theoretical basis for clinical management of bone defects.
Subject(s)
Acrylic Resins , Biocompatible Materials , Bone Substitutes , Bone and Bones , Osteogenesis , Tissue Engineering , Tissue ScaffoldsABSTRACT
BACKGROUND: Preliminary study has shown that the composite materials composed of magnesium-based materials and mineralized collagen have a good supporting effect on repairing the critical defects, which can improve the mechanical strength of mineralized collagen and premature collapse during bone healing to some extent. However, magnesium-based metals degrade fast in chloride-containing solutions (including human body fluids or plasma), and the effects of releasing magnesium ions on the proliferation and differentiation of osteoblasts are unknown. OBJECTIVVE: To investigate the effects of magnesium ion combined with mineralized collagen on osteogenic differentiation of mouse preosteoblasts in vitro. METHODS: Mineralized collagen extracts were prepared from complete medium with magnesium ion concentration of 0, 5, 10, and 20 mmol/L. Mouse preosteoblasts were cultured with four mineralized collagen extracts, respectively, which were divided into mineralized collagen group, and 5, 10 and 20 mmol/L Mg2++mineralized collagen groups. The mouse preosteoblasts cultured in complete medium were used as control group. The cell morphology, proliferation, apoptosis, intracellular microfilament actin, and the activity of alkaline phosphatase and expression level of the osteogenic gene Runx2 after osteogenic differentiation were detected. RESULTS AND CONCLUSION: (1) After 24 hours of culture, the cells in the mineralized collagen group, and 5 and 10 mmol/L Mg2++ mineralized collagen groups adhered well, which showed no significant difference from the blank control group, and the elongated spindle cells with many synapses linked to the adjacent cells were observed. The cells in the 20 mmol/L Mg2++mineralized collagen group showed obvious pyknosis. (2) After 1, 3 and 5 days of culture, the cell viability in the 10 mmol/L Mg2++mineralized collagen group was significantly higher than that in the other four groups (P 0.05). The cell viability in the 20 mmol/L Mg2++mineralized collagen group was significantly lower than that in the mineralized collagen group (P < 0.05). (3) After 3 days of culture, DAPI staining showed that 20 mmol/L Mg2++mineralized collagen group had obvious nuclear disintegration, the other four groups had no obvious nuclear disintegration. (4) After 24 hours of culture, phalloidin staining showed that except the blank control and 20 mmol/L Mg2++mineralized collagen groups, the other three groups showed completely extended cell structure, and clear actin microfilaments, especially the 10 mmol/L Mg2++mineralized collagen group. (5) After 7 days of osteogenic differentiation, except for 20 mmol/L Mg2++mineralized collagen group, the activity of alkaline phosphatase and the expression level of Runx2 gene in the other three groups were significantly higher than those in the blank control group (P < 0.05), and those in the 10 mmol/L Mg2++mineralized collagen group was significantly higher than those in the 5 mmol/L Mg2++mineralized collagen and mineralized collagen groups (P < 0.05). (6) These results suggest that the combination of magnesium ion with mineralized collagen should be applied with appropriate concentration range of magnesium ion (≤ 10 mmol/L).
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Objective To evaluate the osteogenesis of rabbit allogeneic tooth derived bone graft material by histological detection ,so as to provide quality and cheap repair materials for the repair of bone defects in dental implants. Methods The bone graft materials were prepared using rab?bits allogeneic extracted teeth. A total of 28 adult Japanese healthy rabbits were selected to establish the cranial defect model with three 8 mm diam?eter holes. The allogenic tooth derived bone graft material were implanted into the experimental group. The artificial bone repair material was used as the control group,and the control group did not receive any implantion. Tetracycline labeling was performed after operation,the specimens were taken at 4,8 and 12 weeks after operation,and then the gross observation,X?ray examination,preparation of hard tissue sections,and HE staining were carried out. Results Histological analysis at 4,8 and 12 weeks after operation showed that there was an increasing trend the new bone for?mation in both experimental group and the control group ,and the experimental group was better;the trabecular bone structure of the blank group was scarce and the change was not obvious. Conclusion Allogenic tooth derived bone graft materials can promote the repair of bone defect ,and the effect is better than that of artificial bone repair materials.
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Objective:To study the efficacy and safety of natural calcined bone repair material(NCBM)in repairing bone defect af-ter tooth extraction.Methods:A randemized,double-blinded,parallel,positive control(Bio-Oss)and multi-center clinical trial was employed.Imaging examination was used as the main efficacy evaluation index,surgical wound healing,rejection reaction,bone me-tabolic changes,bone infection signs were the subordinate efficacy evaluation indexes,the incidence of adverse reactions was observed for safety evaluation.Results:280 cases were included,269 cases completed the trial.In NCBMand Bio-Oss group the effective rate of imaging examination was 93.08% and 93.70%(P >0.05)respectively.The wound healing time of the 2 groups was less than 7 days,no rejection reaction,bone metabolic change and bone infection sign were observed.The incidence of adverse events in NCBM and the Bio-Oss group was 0.72% and 2.14%(P >0.05)respectively.Conclusion:The efficacy and safety between natural cal-cined bone repair material is not inferior to Bio-Oss in repairing bone defect after tooth extraction.