Mesenchymal Stem Cells and Platelet Gel Improve Bone Deposition within CAD-CAM Custom-Made Ceramic HA Scaffolds for Condyle Substitution

Abstract

Purpose. This study evaluated the efficacy of a regenerative approach using mesenchymal stem cells (MSCs) and CAD-CAM customized pure and porous hydroxyapatite (HA) scaffolds to replace the temporomandibular joint (TMJ) condyle. Methods. Pure HA scaffolds with a 70% total porosity volume were prototyped using CAD-CAM technology to replace the two temporomandibular condyles (left and right) of the same animal. MSCs were derived from the aspirated iliac crest bone marrow, and platelets were obtained from the venous blood of the sheep. Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Sheep were sacrificed 4 months postoperatively. The HA scaffolds were explanted, histological specimens were prepared, and histomorphometric analysis was performed. Results. Analysis of the porosity reduction for apposition of newly formed bone showed a statistically significant difference in bone formation between condyles loaded with MSC and condyles without (P < 0.05). The bone ingrowth (BI) relative values of split-mouth comparison (right versus left side) showed a significant difference between condyles with and without MSCs (P < 0.05). Analysis of the test and control sides in the same animal using a split-mouth study design was performed; the condyle with MSCs showed greater bone formation. Conclusion. The split-mouth design confirmed an increment of bone regeneration into the HA scaffold of up to 797% upon application of MSCs.

Effects of locally administered rhBMP‐2 and bisphosphonate on bone regeneration in the rat fibula

“…Moreover, the use of bisphosphonate as an inducible agent would require cellular‐level studies of the mechanisms of bone formation. Finally, many studies have examined the possibility of using customized scaffold to replace large bone defects (Ciocca et al., ). Thus, in the future, it will be necessary to fabricate customized scaffolds that are porous and absorbable and can provide sufficient control of the release of osteoinductive components using gene therapy, tissue engineering, and 3D bioprinting approaches.…”

Customized hybrid biomimetic hydroxyapatite scaffold for bone tissue regeneration

“…The clinical necessity to substitute the harvesting of a fibula free vascularized flap in human patients for the reconstruction of the mandible after cancer removal, was the motivation of the entire protocol. The first step of this procedure, concerning the customization of the surgical guide and of the bone plate, was studied for human application in the last years by some of the authors and this manuscript describes the future step for constructing and clinically testing of the biochemically engineered scaffold for the substitution of the autologous bone harvesting. In the last two decades several studies described different methodologies to construct scaffold for the bone regenerative medicine of maxillary arches.…”

3D Printing—Encompassing the Facets of Dentistry

“…With the introduction of additive manufacturing, it is possible to generate customized implants and scaffolds for bone and tissue regeneration by using biocompatible materials for orofacial defects (Hixon et al, 2017 ; Tsai et al, 2017 ; Wurm et al, 2017 ). Ranging from calcium phosphate biomaterials in the form of hydroxyapatite, β-tricalcium phosphate to polyglycolic acid and polylactic acid and to scaffolds consisting of bioactive magnesium-calcium silicate/ poly-ε-caprolactone, there has been a rapid advancement in the materials used for bone and tissue grafting regeneration by utilizing additive manufacturing (Saijo et al, 2009 ; Xu et al, 2010 ; Ciocca et al, 2013 ; Tsai et al, 2017 ). With 3D printing it is not only possible to generate tailored scaffolds in the desirable dimensions but also to adjust the properties of these materials with regards to porosity, surface texture, and design.…”