Biomaterial design strategies to address obstacles in craniomaxillofacial bone repair

Dewey, Maynard M.; Harley, Brendan A.C.

doi:10.1039/d1ra02557k

Cited by 32 publications

(57 citation statements)

References 157 publications

(218 reference statements)

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“…Biodegradable osteosynthesis systems should, preferably, be completely resorbed within 12 months [ 17 ]. However, foreign body reactions to polymeric biodegradable materials remain a major concern, even years after implantation [ 26 ]. Factors that influence foreign-body reactions are implant related (e.g., polymer composition, crystallinity, geometry, and surface topology), recipient related (e.g., blood supply), and plate location related (e.g., epiperiosteal versus subperiosteal) [ 18 , 48 , 49 ].…”

Section: Pre-clinical Evidencementioning

confidence: 99%

“…Short-term foreign body reactions are mainly caused by fast-degrading polymers (e.g., PGA) [ 53 ] while delayed foreign body reactions are often associated with slow-degrading polymers (e.g., PLLA) with high crystallinity and crystalline degradation fragments [ 21 , 54 , 55 ]. Foreign body reactions to polymeric biodegradable materials can occur to particle sizes of <2 µm, even years after the implantation ( Table 2 ) [ 26 ].…”

Section: Pre-clinical Evidencementioning

confidence: 99%

“…These improvements affect the mechanical properties of the system as well as the host response and, in turn, the complications that arise as a result [ 18 , 20 ]. In addition, recent research provides new insights into long-term host response to biodegradable biomaterials [ 18 , 25 , 26 ]. Currently, there is no overview that summarizes and discusses these novel insights to guide clinical usage and future research of these osteosynthesis systems.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances

Gareb¹,

Bakelen²,

Vissink³

et al. 2022

Polymers

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Osteosynthesis systems are used to fixate bone segments in maxillofacial surgery. Titanium osteosynthesis systems are currently the gold standard. However, the disadvantages result in symptomatic removal in up to 40% of cases. Biodegradable osteosynthesis systems, composed of degradable polymers, could reduce the need for removal of osteosynthesis systems while avoiding the aforementioned disadvantages of titanium osteosyntheses. However, disadvantages of biodegradable systems include decreased mechanical properties and possible foreign body reactions. In this review, the literature that focused on the in vitro and in vivo performances of biodegradable and titanium osteosyntheses is discussed. The focus was on factors underlying the favorable clinical outcome of osteosyntheses, including the degradation characteristics of biodegradable osteosyntheses and the host response they elicit. Furthermore, recommendations for clinical usage and future research are given. Based on the available (clinical) evidence, biodegradable copolymeric osteosyntheses are a viable alternative to titanium osteosyntheses when applied to treat maxillofacial trauma, with similar efficacy and significantly lower symptomatic osteosynthesis removal. For orthognathic surgery, biodegradable copolymeric osteosyntheses are a valid alternative to titanium osteosyntheses, but a longer operation time is needed. An osteosynthesis system composed of an amorphous copolymer, preferably using ultrasound welding with well-contoured shapes and sufficient mechanical properties, has the greatest potential as a biocompatible biodegradable copolymeric osteosynthesis system. Future research should focus on surface modifications (e.g., nanogel coatings) and novel biodegradable materials (e.g., magnesium alloys and silk) to address the disadvantages of current osteosynthesis systems.

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Section: Pre-clinical Evidencementioning

confidence: 99%

Section: Pre-clinical Evidencementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances

Gareb¹,

Bakelen²,

Vissink³

et al. 2022

Polymers

View full text Add to dashboard Cite

show abstract

“…Bone decortication and bleeding are caused by the inserted implant triggering intramembranous ossification, a process essential for successful bone remodeling and incorporation, leading to arthrodesis [ 115 , 116 , 117 ]. Implantation of the metal screw is followed by adsorption of a proteinaceous layer [ 118 ] (made of serum molecules, water, and proteins) on the implant surface followed by the formation of a blood clot that recruits inflammatory cells on the side of the instalment and initiates provisional matrix formation [ 119 ].…”

Section: Biological Response To Metal Implants Used In Lifmentioning

confidence: 99%

Metallic Implants Used in Lumbar Interbody Fusion

et al. 2022

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Over the last decade, pedicle fixation systems have evolved and modifications in spinal fusion techniques have been developed to increase fusion rates and improve clinical outcomes after lumbar interbody fusion (LIF). Regarding materials used for screw and rod manufacturing, metals, especially titanium alloys, are the most popular resources. In the case of pedicle screws, that biomaterial can be also doped with hydroxyapatite, CaP, ECM, or tantalum. Other materials used for rod fabrication include cobalt–chromium alloys and nitinol (nickel–titanium alloy). In terms of mechanical properties, the ideal implant used in LIF should have high tensile and fatigue strength, Young’s modulus similar to that of the bone, and should be 100% resistant to corrosion to avoid mechanical failures. On the other hand, a comprehensive understanding of cellular and molecular pathways is essential to identify preferable characteristics of implanted biomaterial to obtain fusion and avoid implant loosening. Implanted material elicits a biological response driven by immune cells at the site of insertion. These reactions are subdivided into innate (primary cellular response with no previous exposure) and adaptive (a specific type of reaction induced after earlier exposure to the antigen) and are responsible for wound healing, fusion, and also adverse reactions, i.e., hypersensitivity. The main purposes of this literature review are to summarize the physical and mechanical properties of metal alloys used for spinal instrumentation in LIF which include fatigue strength, Young’s modulus, and corrosion resistance. Moreover, we also focused on describing biological response after their implantation into the human body. Our review paper is mainly focused on titanium, cobalt–chromium, nickel–titanium (nitinol), and stainless steel alloys.

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“…Craniomaxillofacial defects arising from tumor, trauma and congenital deformities adversely affect patient's health and their facial aesthetics (1,2). In traditional restorative measures, various shortcomings associated with autologous bone graft, such as secondary operation area and unfavorable repairing results, are often encountered.…”

Section: Introductionmentioning

confidence: 99%

Osteogenically Induced Human Umbilical Cord Mesenchymal Stem Cell-derived Small Extracellular Vesicles Carrying Distinct microRNA Signature Improve Osteoinductivity of Tissue-engineered Bone

Zhou

Rong

et al. 2022

Preprint

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Background: Clinical application of stem cell-based tissue-engineered bone (TEB) has been severely hindered by a low viability of seed cells, slow osteogenesis and biosafety. Mesenchymal stem cells-derived small extracellular vesicles (sEVs) possess similar properties to donor cells and have low immunogenicity, strong stability and favorable biosafety. It’s validated that human umbilical cord mesenchymal stem cells-derived sEVs (hUCMSCs-sEVs) exert therapeutic effects on various diseases. However, little is known whether hUCMSCs-sEVs can effectively be used to construct TEB. This study aimed to investigate whether hUCMSCs-sEVs bore positive effects on bone regeneration and elucidate the underlying mechanisms. Methods: Herein, PM-sEVs and OM-sEVs were separately harvested from proliferation medium (PM) and osteogenic medium (OM) cultured hUCMSCs and identified. The effects of PM-sEVs and OM-sEVs on the bioactivities and osteogenic differentiation of human bone marrow stromal cells (hBMSCs) were evaluated. The differential microRNAs (miRNAs) expressions between PM-sEVs and OM-sEVs were screened by miRNA sequencing. Furthermore, PM-sEVs and OM-sEVs were separately incorporated in tricalcium phosphate (TCP) scaffolds to build TEBs, which were used to repair critical-sized calvarial bone defects of rats. Results: Both PM-sEVs and OM-sEVs had similar morphology, size and expressed specific surface markers of exosomes while didn’t have the surface marker from donor cells. Both PM-sEVs and OM-sEVs could be internalized by hBMSCs, thus significantly promoting the migration, proliferation and osteogenic differentiation of hBMSCs. Remarkably, OM-sEVs outweighed PM-sEVs in accelerating hBMSCs’ migration and osteogenic differentiation. Besides, miRNA sequencing analysis revealed that several differentially expressed miRNAs might be responsible for sEVs’ bioactivities. Furthermore, OM-sEVs could sustainably release from TCP scaffolds, and the resultant TEB had better reparative outcome than that of PM-sEVs group and pure TCP. Conclusion: sEVs isolated from osteogenically induced hUCMSCs (OM-sEVs) could prominently facilitate osteogenic differentiation of hBMSCs by unique miRNAs signature. TEB graft derived from OM-sEVs provided a promising alternative for clinical transplantation.

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Biomaterial design strategies to address obstacles in craniomaxillofacial bone repair

Abstract: There exist many challenges in the process of regenerating craniomaxillofacial bone defects, thus biomaterials must be designed to overcome these.

Cited by 32 publications

References 157 publications

Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances

Titanium or Biodegradable Osteosynthesis in Maxillofacial Surgery? In Vitro and In Vivo Performances

Metallic Implants Used in Lumbar Interbody Fusion

Osteogenically Induced Human Umbilical Cord Mesenchymal Stem Cell-derived Small Extracellular Vesicles Carrying Distinct microRNA Signature Improve Osteoinductivity of Tissue-engineered Bone

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