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BACKGROUND:Careful regulation of bone immune response during repair of bone scaffold is important for bone regeneration. OBJECTIVE:To review the influence of bone immune response on bone repair and the design of bone tissue engineering scaffold with regulating bone immune function and its application in bone repair. METHODS:Relevant articles published from 1973 to 2023 were retrieved from Science Direct,PubMed,Web of Science,and CNKI databases.English search terms were"osteoimmunology,macrophages,bone repair materials,bone scaffold,bone defects,bone regeneration".Chinese search terms were"bone immunity,macrophages,bone repair material,bone stent,bone defect,bone regeneration".Totally 80 articles of the latest research progress in this field were summarized and analyzed. RESULTS AND CONCLUSION:(1)A detailed review was conducted on the important time points in the origin and development process of bone immunity,and it was explained that macrophages,as important members of the bone immune regulatory system,can be divided into two phenotypes:M1(pro-inflammatory)and M2(anti-inflammatory),and play a key role in different stages of bone regeneration.During the inflammatory phase,M1 type macrophages can activate osteoclasts,initiate tissue repair processes,and participate in the reconstruction of bone microvascular networks.On the other hand,during the bone tissue regeneration process in the later stages of inflammation,sustained high expression of M1 type macrophages can hinder the formation of new bones.During the repair phase,M2 macrophages can secrete osteogenic cytokines,stimulate osteogenic differentiation and mineralization of bone marrow mesenchymal stem cells,and promote bone formation.On the other hand,long-term activation of M2 macrophages can increase the secretion of fibrogenic molecules,leading to excessive formation of scar tissue and delaying the healing process.Therefore,regulating macrophages to undergo phenotype transformation at appropriate stages and constructing an immune microenvironment beneficial for osteogenesis has great significance for bone regeneration.(2)In the process of designing bone scaffolds with bone immune regulation characteristics,the physical and chemical properties such as scaffold roughness,pore structure,stiffness,hydrophilicity,surface charge,and surface functional groups can be changed to affect non-specific protein and cell adhesion,thereby affecting the interaction between bone scaffolds and the immune system.By designing surface functional coatings of bioactive substances such as hydroxyapatite,bioactive glass,metal ions,extracellular matrix,drugs,cytokines,and exosomes,the immune microenvironment can be actively regulated by releasing bioactive substances after implantation into the body,affecting macrophage polarization and crosstalk between macrophages and bone cells,and promoting more M2 polarization of macrophages,so as to build a bone immune microenvironment that is conducive to bone regeneration.(3)Based on the research and development of bone tissue engineering scaffolds,in addition to focusing on the direct regulatory factors of stem cell osteogenic differentiation,this article also proposes that attention should be paid to the management of the immune microenvironment of stem cell differentiation.By regulating the appropriate bone immune microenvironment,more stem cell osteogenic differentiation can be induced;the osteogenic efficiency of the scaffold can be enhanced,and the concept of"bone immune regulatory characteristics"can be condensed;deeply elucidated the multi-directional regulatory role of the bone immune microenvironment and introduced the existing strategies for changing the physicochemical properties and surface functional coating of scaffolds to endow them with bone immune regulatory potential,providing new ideas for guiding the development of a new generation of bone tissue engineering scaffolds with bone immune regulatory characteristics.However,the bone immune microenvironment is a dynamic equilibrium state,and most of the existing regulatory strategies do not consider the dynamic matching of regulation.Therefore,the research and development of intelligent bone immune regulatory scaffolds with efficient and targeted regulation of the immune microenvironment will be a key focus of attention for scholars in future.
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BACKGROUND:In vitro lymphocyte proliferation test is often used to detect the potential immunogenicity of medical devices,but no detailed extraction conditions and dose are given in the relevant standards. OBJECTIVE:To investigate the effects of different extraction conditions of the test product and different doses of the extract on in vitro human lymphocyte proliferation,and to consider the factors that need to be considered when selecting test conditions for in vitro lymphocyte proliferation test. METHODS:In the experiment,the homogenous bone repair material and heparin-modified intraocular lens were divided into the following 12 groups:(1)Experimental group 1:24-hour complete medium(RPMI modified medium containing 10%fetal bovine serum)extract of 200 μL + lymphocyte suspension of 50 μL;(2)negative control group 1:24-hour complete medium 200 μL + lymphocyte suspension 50 μL;(3)experimental group 2:24-hour complete medium extract 100 μL + lymphocyte suspension 100 μL;(4)negative control group 2:24-hour complete medium 100 μL + lymphocyte suspension 100 μL;(5)experimental group 3:72-hour RPMI modified medium extract(addition of 10%fetal bovine serum before experiment)200 μL + lymphocyte suspension 50 μL;(6)negative control group 3:72-hour RPMI modified medium(addition of 10%fetal bovine serum before experiment)200 μL + lymphocyte suspension 50 μL;(7)experimental group 4:72-hour RPMI modified medium extract(addition of 10%fetal bovine serum before experiment)100 μL + lymphocyte suspension 100 μL;(8)negative control group 4:72-hour RPMI modified medium(addition of 10%fetal bovine serum before experiment)100 μL + lymphocyte suspension 100 μL;(9)positive control group 1:complete medium containing 10 μg/mL plant hemagglutinin-M 200 μL + lymphocyte suspension 50 μL;(10)positive control group 2:complete medium containing 10 μg/mL plant hemagglutinin-M 100 μL + lymphocyte suspension 100 μL;(11)blank control group 1:250 μL complete medium;(12)control group 2:200 μL complete medium.After 3 days of culture,the proliferation of lymphocytes was detected by CCK-8 assay. RESULTS AND CONCLUSION:(1)Under different test conditions,the extracts of the allogeneic bone repair material could enhance the activity of human lymphocytes.Under the condition of 72-hour leaching in RPMI modified medium and the volume ratio of leaching solution and lymphocyte suspension was 4:1,the most significant effect was observed.Heparin-modified intraocular lens extract also had obvious inhibitory effect on lymphocyte activity under this condition;its inhibitory effect on lymphocyte activity may be related to the heparin in the extract.However,the activity of lymphocytes was slightly enhanced by heparin-modified intraocular lens extract under the experimental conditions of complete medium extraction for 24 hours and the volume ratio of extract to lymphocyte suspension was 4:1.(2)Under different extraction conditions and doses,the results of in vitro lymphocyte proliferation test may be quite different.The selection of test conditions should be combined with the clinical application of the product,and the inherent characteristics of the product should also be considered.
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BACKGROUND:Bioactive glass bone repair material has bone-bonding ability,bone induction ability and bone conduction characteristics.However,the performance of bioactive glass does not meet the requirements of clinical application,and the addition of boron is expected to improve the performance of bioactive glass. OBJECTIVE:To study the effect of different contents of B2O3 replacing SiO2 on the mechanical properties and bioactivity of bioactive glass. METHODS:Based on bioactive glass containing phosphorus nitrogen and oxygen(composition:SiO2-CaO-ZnO-Na2O-Si3N4-P2O5),B2O3 was used to partially replace the SiO2.The basic glass containing B2O3 with a mass fraction of 0%(group A),5%(group B),10%(group C),and 15%(group D)was fired using the high-temperature melting method(the total mass fraction of SiO2 and B2O3 in the basic broken glass was 41%).Porous bioactive glass scaffolds were fabricated by the organic foam impregnation method.Uniaxial compression and three-point bending method of universal mechanical testing machine were used to test mechanical properties.Four groups of scaffolds were immersed in simulated body fluids to detect the degradation performance of scaffolds.Scanning electron microscopy was used to observe the morphological changes of scaffolds before and after soaking.X-ray diffraction was used to analyze the phase composition of scaffolds before and after soaking. RESULTS AND CONCLUSION:(1)With the increase of the mass fraction of B2O3,the compressive strength and bending strength of the porous bioactive glass scaffold increased,and there was a significant difference between the compressive strength and bending strength of the four groups(P≤0.05).(2)After soaking in simulated body fluids,the porous bioactive glass scaffolds degraded gradually with the extension of time.At the same soaking time point,the degradation rate of the scaffolds was accelerated with the increase of the mass fraction of B2O3,and the compressive strength and bending strength of the scaffolds in the four groups were significantly different(P≤0.05).(3)Scanning electron microscopy after soaking in simulated body fluids showed that a large number of granular materials were deposited on the surface of group A and group B after soaking for 1 day.After 3 days,the granular materials on the surface fused with each other to form film-like deposits.After 7 days,the films on the surface fused with each other to form pieces,basically covering the entire surface of the specimen.After soaking for 1 day,film-like material deposition was formed on the surface of group C,and after 3 days,the films on the surface were fused into pieces,basically covering the whole surface of the specimen.After soaking for 1 day in group D,flake material covering the whole surface of the specimen could be seen.(4)X-ray diffraction analysis after 1 day of immersion in simulated body fluids showed that the deposits on the surface of the four groups of scaffolds were crystallized hydroxyapatite.(5)B2O3 replacement of SiO2 can enhance the mechanical properties,degradation properties and in vitro mineralization activity of porous bioactive glass scaffolds.
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Objective:To explore the clinical efficacies of root canal filling and repair material(iRoot BP plus)and trioxide condensate(MTA)of root canal repair material,which were used in endodontic revascularization of dental pulp,in treating the apical infection of young permanent teeth.Methods:A total of 40 young patients with apical infection of permanent teeth admitted to the dental department of hospital were selected,and they were divided into an observation group and a control group according to the random number table method,with 20 cases in each group.All patients adopted endodontic revascularization of dental pulp to conduct treatment.The observation group used iRoot BP plus to seal the upper end of the root canal,and the control group used MTA to seal the upper end of the root canal.The clinical efficacy,treatment cycle,frequency of visits,recovery time of chewing and recovery time of apical infection of the two groups of patients were compared.At the same time,the thickness of root canal wall and the root length,as well as the satisfaction of patients for treatment,of the two groups were compared.Results:After endodontic revascularization of dental pulp,the total effective rate of treatment in the observation group was 95%,which was significantly higher than 60%in the control group,and the difference was statistically significant(x2=8.326,P>0.05).Compared with the control group,the treatment cycle,frequency of visits,recovery time of chewing and recovery time of apical infection of the observation group were significantly shortened,and the differences were statistically significant(t=12.492,t=10.424,t=6.524,t=11.907,P<0.05),respectively.After treatment,the length of the root of dental crown and the thickness of root canal wall of the patients in the observation group were respectively longer and better than those in the control group,the differences were statistically significant(t=8.742,t=7.048,P<0.05).The four satisfaction scores of patients in the observation group,which included bite,tooth color,chewing ability and overall aesthetics,were respectively higher than those in the control group,and the differences were statistically significant(t=5.437,t=5.093,t=7.591,t=6.852,P<0.05).Conclusion:iRoot BP plus has more advantages than MTA when the endodontic revascularization of dental pulp is used to treat the apical infection of young permanent teeth,which can more effectively improve the clinical efficacy and treatment satisfaction of patients.
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Objective: Present in?vitro study aimed to evaluate the apical leakage of different bioceramic retrofilling materials with and without smear layer. Materials and Methods: Sixty human single?rooted teeth were decoronated at a standardized root length of 13 mm, chemo?mechanically prepared and obturated. After obturation, root?end resection was done and root?end cavities were prepared using ultrasonic tips. The specimens with prepared retro cavities were randomly assigned into 2 groups (n = 30) based on the smear layer removal protocol used. Each group was further subdivided into 3 subgroups (n = 10) based on the bioceramic retrofilling material MTA (Mineral Trioxide Aggregate; Proroot Dentsply/Tulsa), CEM (Calcium?Enriched Mixture; Bionique Dent, Tehran) and ERRM (EndoSequence® Root Repair Material; Brasseler USA, Savannah, GA). The extension of dye (2% Rhodamine B) penetration was measured in millimetre using a stereomicroscope at 10× zoom. Results were statistically analysed using one?way ANOVA (analysis of variance) test and unpaired Student’s t test. Results: In the presence of smear layer, MTA demonstrated maximum mean apical leakage value (1.70 ± 0.30), followed by CEM (1.40 ± 0.37) and ERRM (1.40 ± 0.23), which was statistically not significant. Without the smear layer, ERRM demonstrated the least mean apical leakage value, which was statistically significant as compared with CEM (P <.05) and MTA ( P <.01). Conclusion(s): All bioceramic retrofilling materials demonstrated apical leakage irrespective of the presence or absence of the smear layer. The presence of a smear layer is beneficial for the sealing ab
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Abstract Differences in liquid-to-powder ratio can affect the properties of calcium silicate-based materials. This study assessed the influence of powder-to-gel ratio on physicochemical properties of NeoMTA Plus. Setting time (minutes), flow (mm and mm²), pH (at different periods), radiopacity (mm Al) and solubility (% mass loss) were evaluated using the consistencies for root repair material (NMTAP-RP; 3 scoops of powder to 2 drops of gel) and root canal sealer (NMTAP-SE; 3 scoops of powder to 3 drops of gel), in comparison to Biodentine cement (BIO) and TotalFill BC sealer (TFBC). Statistical analysis was performed using one-way ANOVA and Tukey tests (α=0.05). BIO had the shortest setting time, followed by NMTAP-RP and NMTAP-SE. TFBC showed the highest setting time and radiopacity. BIO, NMTAP-RP, and NMTAP-SE had similar radiopacity. All materials promoted an alkaline pH. NMTAP-RP/SE presented lower solubility than BIO and TFBC. Regarding the flow, TFBC had the highest values, followed by NMTAP-SE, and NMTAP-RP. BIO had the lowest flow. In conclusion, NMTAP in both powder-to-gel ratios showed high pH and low solubility. The increase in the powder ratio decreased the setting time and flow. These findings are important regarding the proper consistency and work time to clinical application.
Resumen Las diferencias en la proporción líquido/polvo pueden afectar las propiedades de los materiales a base de silicato de calcio. Este estudio evaluó la influencia de la proporción polvo/gel en las propiedades fisicoquímicas del cemento NeoMTA Plus. El tiempo de fraguado (minutos), la fluidez (mm y mm²), el pH (en diferentes períodos), la radiopacidad (mmAl) y la solubilidad (% de pérdida de masa) fueron evaluados utilizando las consistencias para el material de reparación radicular (NMTAP-RP; 3 cucharadas de polvo/2 gotas de gel) y para cemento sellador del conducto radicular (NMTAP-SE; 3 cucharadas de polvo/3 gotas de gel), en comparación con el cemento Biodentine (BIO) y el cemento TotalFill BC (TFBC). El análisis estadístico se realizó utilizando las pruebas ANOVA y Tukey unidireccionales (α=0.05). BIO tuvo el tiempo de fraguado más corto, seguido de NMTAP-RP y NMTAP-SE. TFBC mostró el mayor tiempo de fraguado y radiopacidad. BIO, NMTAP-RP y NMTAP-SE tuvieron una radiopacidad similar. Todos los materiales promovieron un pH alcalino. NMTAP-RP/ SE tuvieron una solubilidad menor que BIO y TFBC. Con respecto a la fluidez, TFBC tuvo los valores más altos, seguido de NMTAP-SE y NMTAP-RP. BIO tuvo la fluidez más baja. En conclusión, NMTAP en la relación polvo/gel mostró un pH alto y una baja solubilidad. El aumento en la proporción de polvo disminuyó el tiempo de fraguado y la fluidez. Estos hallazgos son importantes con respecto a su consistencia y tiempo de trabajo durante la aplicación clínica.
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Calcarea Silicata/análisis , Química Física , Cemento DentalRESUMEN
BACKGROUND: With the improvement in medical level, the clinical demand for bone repair materials is gradually Increasing, and the requirements are also getting more and more. OBJECTIVE: To review the related research progress In the field of bone repair materials In recent years, to analyze the advantages and disadvantages of different materials, and to guide future development In this research field. METHODS: A computer-based online search of CNKI, Wanfang, PubMed, Web of Science databases was performed to retrieve papers published during 1950-2019 with the search terms “tissue engineering, bone repair material, bone defect, natural bone material, bone graft replacement material, traditional Chinese medicine” in Chinese and English. A total of over 900 papers were retrieved, and 68 of them were included In the final analysis. RESULTS AND CONCLUSION: In recent year, with the flourish development of bone tissue engineering, the research of bone tissue repair materials is in the ascendant. In addition to optimizing natural bone, a variety of bone graft substitute materials have been developed, for example, natural macromolecule materials, synthetic macromolecule materials, biomedical ceramics materials, biomedical metal materials, etc., but these materials have different properties. Although there are many bone repair materials at present, the Ideal bone repair materials are few. Therefore, bone tissue repair and bone remodeling is still one of the urgent orthopedic problems to be solved In the clinic. In addition, the traditional Chinese medicine for bone repair, such as pyritum combined with modern bone repair materials, can effectively avoid some of the drawbacks of the current bone repair materials, thereby effectively treating bone defect diseases. This deserves In-depth investigation In the field of bone repair.
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Autologous breast reconstruction after radical resection of breast cancer has been widely used in clinic.Some surgical methods of autologous breast reconstruction may cause abdominal wall defect to a certain extent.The abdominal wall defect leads to the loss of normal function,which leads to a series of serious pathophysiological changes.At present,transverse rectus abdominis myocutaneous flap(TRAM) and deep inferior epigastric artery perforator flap(DIEP) are commonly used for breast reconstruction.According to the different types of abdominal wall defect after breast autoreconstruction for breast cancer surgery,the corresponding surgical repair scheme should be formulated on the basis of strictly following the basic principles of abdominal wall repair.At the same time,appropriate materials for repairing abdominal wall defect are selected according to the different extent of abdominal wall defect.The posterior sheath and peritoneum of rectus abdominis are usually intact after breast reconstruction,and the anterior sheath of rectus abdominis may be retained.The different layers of abdominal wall can be repaired by surgical methods,and the application of repair materials is emphasized.
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Objective To verify the feasibility of applying hydrothermal synthesis for preparing oyster hydroxyapatite(HA) and to develop a preparation method of oyster HA porous material for bone repair.Methods Hydrothermal synthesis was applied for preparing oyster HA,and the reaction condition was 220 ℃ for 6 h.Then,the prepared oyster HA was used as the raw material for porous scaffold preparation by sponge-soaking and sintering,successively.The porosity and compressive strength of the scaffold were adjusted by controlling the soaking time and absorbed HA slurry of the sponges.Results Hydrothermal synthesis was an effective method for preparing oyster HA.When the volume of the sponge cube was 1 cm3,the material absorbed by one to three times sponge-soaking were 0.184 8 g,0.318 1 g and 0.426 1 g,respectively,the corresponding porosity were 91.5％,82.9％ and 78.5％,and the compressive strength were 1.06 MPa,3.99 MPa and 8.49 MPa.Conclusion The oyster shell powder can be effectively converted into HA under the hydrothermal reaction condition of 220 ℃ for 6 h.The preparation of HA porous bone repair material by sponge-soaking method can obtain ideal porosity and mechanical strength.However,in this preparation process,the number of sponge-soaking and the weight of the absorbed HA slurry should be exactly controlled in order to obtain desired properties.
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Abstract The aim of this study was to evaluate in vitro the cytotoxicity on human periodontal ligament fibroblasts of three root-end filling materials: MTA Angelus(r), EndoSequence Root Repair Material Putty(r) and Super EBA(r). A primary culture of human periodontal ligament fibroblasts was previously obtained in order to evaluate the cytotoxicity of the three extracts from the root-end filling materials after 2 and 7 days of setting. Serial dilutions of these extracts (1:1, 1:2, 1:4 and 1:8) were evaluated at 1, 3 and 7 days using the methyl-thiazol-tetrazolium (MTT) colorimetric assay. Cell viability was evaluated as percentage of the negative control group, which represented 100% cell viability. Statistical analyses were done with t-test, ANOVA and Kruskal-Wallis test at a significance level of 5%. It was found that the main difference among root-end filling materials was in the higher dilutions (p<0.05), but there was a similar behavior in lower dilutions (p>0.05). Cell viability of MTA Angelus(r) was superior for 2-day setting (p<0.05), compared with the other two root-end fillings. There were no statistically significant differences between 7-day set MTA Angelus(r) and EndoSequence Root Repair Material Putty(r). Super EBA(r) showed the lowest percentage of cell viability at higher dilutions (p<0.05). Therefore, MTA Angelus(r) and EndoSequence Root Repair Material Putty(r) were less cytotoxic in the highest dilution (1:1) compared with Super EBA(r).
Resumo O objetivo deste trabalho foi avaliar in vitro a citotoxicidade em fibroblastos do ligamento periodontal humano de três cimentos de retrobturação: MTA Angelus(r), EndoSequence Root Repair Material Putty(r) e Super EBA(r). Uma cultura de fibroblastos primários do ligamento periodontal humano foi obtida anteriormente a fim de avaliar a citotoxicidade dos três extratos dos cimentos de retrobturação após 2 e 7 dias de endurecimento. As diluições em série destes extratos (1:1, 1:2, 1:4 e 1:8) foram avaliados em 1, 3 e 7 dias empregando o ensaio colorimétrico metil-tiazol-tetrazólio (MTT). A viabilidade celular foi calculada em base da porcentagem do grupo de controle negativo, que representou 100% de viabilidade de células. As análises estatísticas foram realizadas com o teste t, ANOVA e teste de Kruskal-Wallis a um nível de significância de 5%. Verificou-se que a principal diferença entre os cimentos de retrobturação estava nas diluições mais elevadas (p<0,05) e houve um comportamento semelhante nas diluições mais baixas (p>0,05). A viabilidade celular dos fibroblastos do ligamento periodontal humano foi superior para MTA Angelus(r) de 2 dias de endurecimento (p<0,05), em comparação com os outros materiais de retrobturação. Não houve diferença significante entre MTA Angelus(r) e EndoSequence Root Repair Material Putty(r) de 7 dias de endurecimento. Super EBA(r) mostrou a menor percentagem da viabilidade celular nas diluições mais altas (p<0,05). Portanto, os cimentos de retrobturação MTA Angelus(r) e EndoSequence Root Repair Material Putty(r) foram menos citotóxicos na diluição mais alta (1:1) em comparação com Super EBA(r).
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Humanos , Ligamento Periodontal/patología , Materiales de Obturación del Conducto Radicular , Células Cultivadas , Técnicas In VitroRESUMEN
Mesenteric lymphangiomas, which involve near total mesentery, are extremely rare. A mesenteric lymphangioma should be treated through excision because they can cause invasion of vital structures, bleeding, or infection. After excision of a huge mesenteric lymphangioma, internal herniation may occur through a large mesenteric defect leading to intestinal volvulus, obstruction, and other life-threatening circumstances. We report a case in which a biologic collagen implant (Permacol) was used for mesenteric defect repair after excision of a huge mesenteric lymphangioma. The implant did not cause any symptoms or complications during follow-up for 4 years. When encountering large defects of mesentery, closure with implant can be a feasible choice, and Permacol could be a possible implant for closing the defect.
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Niño , Humanos , Colágeno , Estudios de Seguimiento , Hemorragia , Vólvulo Intestinal , Linfangioma , MesenterioRESUMEN
Objective To study the biomechanical effect from different prosthetic materials used on unilateral maxillary defect repair by three dimensional finite element (FE) analysis method. Methods The maxillary unilateral defect model was reconstructed by medical image processing software MIMICS. The prosthesis was generated by mirroring technology. After processing, the FE unilateral maxillary defect model and healthy maxillary model were established to simulate stress distributions on the maxilla during occlusion. Results The maximum stress on maxilla using different repair materials was always found concentrated on the edge of maxilla connected with zygoma (the positions attaching zygolabialis and levator anguli oris). The minimum stress of from the maxilla edge on the repair side was 8.471 MPa by using tricalcium phosphate (TCP) composite. The maximum stress from the maxilla edge on the repair side was 17.55 MPa by using hydroxyapatite (HA) material. Conclusions Different repair materials had no significant effect on natural side of the maxilla after restoration, while a greater impact of force status on the repair side was found. The elastic modulus of different repair materials can be used as a basis for maxilla restoration in clinic.