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Calvarial bone regeneration using osteogenin.

This experimental study reports on the application of a partially purified noncollagenous protein extracted from cortical bone to restore craniotomy defects in Papio species (baboon). The partially purified protein (osteogenin) produced significantly more bone formation in calvarial wounds than was found in the untreated controls. There were no adverse tissue reactions from the implanted xenogeneic osteogenin.

Animals↗

Effects of apatite foam combined with platelet-rich plasma on regeneration of bone defects.

The objective of this study was to investigate the regenerative effects of apatite foam (AF) combined with platelet-rich plasma (PRP) on bone defects. Critical-sized defects in the tibia of rats were filled with randomly distributed combinations of AF with and without PRP. The animals were killed after three, six, and 12 weeks, and their tissue responses were histologically examined. At three weeks, we found no significant differences in bone regeneration against control group (21.9 +/- 3.1%) when PRP (20.3 +/- 4.2%) and AF (21.6 +/- 2.9%) were used independently of each other. In contrast, significantly (p<0.01) larger amount of bone (32.3 +/- 6.5%) was formed when the defect was filled with PRP-incorporated AF. At six weeks, both PRP (38.1 +/- 3.2%) and AF (39.6 +/- 7.8%) showed significantly (p<0.05) higher rates of bone regeneration than the control, even though they were used independently. Moreover, the amount of regenerated bone significantly (p<0.01) increased in the defect filled with PRP-incorporated AF (76.1 +/- 8.2%). We concluded, therefore, that the combination of PRP and AF may be useful for the regeneration of defected bone.

Animals↗

Development and cell response of a new biodegradable composite scaffold for guided bone regeneration.

Composites of biodegradable polymers with different calcium phosphate ceramics and glasses, have been developed as scaffolds for applications in bone-tissue engineering. In this work, phosphate glass particles have been incorporated into the polymer, poly(95L/5DL) lactic acid (PLA) and porous structures were elaborated. Their porosity, compressive mechanical properties and biological response were evaluated. Interconnected structures with evenly distributed pores and a porosity as high as 97% were obtained. The incorporation of glass particles into the polymer showed to have a positive effect in the mechanical properties of the foams. Indeed, the compressive modulus increased from 74.5 to 120 KPa and the compressive strength from 17.5 to 20.1 KPa for the PLA and the PLA/glass foams, respectively. The biological response was evaluated by means of the MTT test, the materials resulted to be noncytotoxic.

Absorbable Implants↗

Virus-based gene therapy strategies for bone regeneration.

Gene therapy has emerged as a promising strategy for the repair and regeneration of damaged musculoskeletal tissues. Application of this paradigm to bone healing has shown enhanced efficacy in preclinical animal studies compared to conventional bone grafting approaches. This review discusses current and emerging virus-based genetic engineering strategies for the delivery of therapeutic molecules which promote skeletal regeneration. Viral gene delivery vectors are discussed in the context of bone repair in order to illustrate the challenges and applications of these methods with tissue-specific examples. Moreover the concepts discussed can be broadly applied to promote healing in a wide range of tissues. We also present important considerations involved in the application of these gene therapy techniques to a variety of osteogenic (e.g. bone marrow-derived cells) and non-osteogenic (e.g. fibroblasts and skeletal myoblasts) cell types. Criteria for the selection of regenerative molecules with soluble versus intracellular modes of action and emerging combinatorial approaches are also discussed. Overall, gene transfer technologies have the potential to overcome limitations associated with existing bone grafting approaches and may enable investigators to design therapies which more closely mimic the complex spatial and temporal cascade of proteins involved in endogenous bone development and repair.

Animals↗

Oral rehabilitation using dental implants and guided bone regeneration.

The advent of osseointegrated dental implants focused initially on functional rehabilitation. Interest today centres on aesthetics and the philosophical ideal of replicating nature. Implants can be placed beyond resorbed anatomic limitations where the final prosthesis should be, rather than within the pre-existing resorbed bone. In order to achieve this, the following must be considered: implant positioning, adequate bone support and the overlying soft tissue envelope. Common techniques to modify the surgical environment include different methods of bone grafting and regeneration, ridge expansion and sinus augmentation. With the advent of growth factors like bone-morphogenetic proteins, restoration of bony contours will become more predictable. Soft tissue management techniques include tissue expansion and contouring, gingiva grafts and advancement or rotational flaps. Though some of these procedures can be done concurrently with implant placement, a secondary surgical procedure is often required. Ideal implant positioning involve establishing correct orientation in all dimensions. Due consideration should also be given to occlusion and harmony of the final restoration with the adjacent dentition.

Bone Regeneration↗

Bone regeneration graft materials.

This article focuses on the materials used for the regeneration, rather than repair, of the osseous support needed to anchor both teeth and implants. Once the bone was supportive, but now it is insufficient and must be restored. Specifically, the article examines different materials that aid in regeneration, as well as ones that do not. The pros and cons of osteoinduction and osteoconduction are compared. Autogenous, allographic, alloplastic, and xenographic materials are delineated and their intended purpose is described. These materials build the foundation of osseous support toward a functional future.

Biocompatible Materials↗