Randomized clinical trial for the biological evaluation of two nanostructured biphasic calcium phosphate biomaterials as a bone substitute

Uzeda, Marcelo José; Resende, Rodrigo Figueiredo de Brito; Sartoretto, Suelen Cristina; Alves, Adriana Terezinha Neves Novellino; Granjeiro, José Mauro; Calasans-Maia, Mônica Diuana

doi:10.1111/cid.12516

Cited by 31 publications

(40 citation statements)

References 35 publications

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“…Thus, further experimentation is necessary to elucidate this question. Importantly, a recent clinical trial 37 reported histologic results in human extraction sockets grafted with SBC-B comparable to the present data, suggesting similarities in biologic behavior of the biomaterial in extraction socket defects of diferent species.…”

Section: Discussionsupporting

confidence: 87%

“…34 According to manufacturer guidelines, and several other studies using ceramic biomaterials as a bone substitute, their hydration should be done with the patient's blood. [35][36][37][38] However, the availability of blood material in the region to be addressed may not be sufficient to meet the need, especially when large quantities of material is required. In this case, peripheral sources of blood collection may be necessary for the correct hydration of the graft.…”

Section: Introductionmentioning

confidence: 99%

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Effects of methods of hydration of a biphasic ceramic graft on bone regeneration of extraction socket defects

Santos

Santana

Alves

et al. 2018

Journal of Periodontology

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Background Alveolar volumetric changes are inherent to the healing process after tooth extraction and filling of the extraction site with biomaterials can reduce these volumetric changes and provide a more favorable environment for the future prosthetic restoration with implants. Among the biomaterials available, biphasic ceramic compounds have shown promissing clinical results, however, histologic evaluation of bone tissue response to different hydration and incorporation methods are limited. The objective of this study was to comparatively evaluate in vivo the osteoconductive potential of the biphasic ceramic bone substitute (SBC) composed of beta‐tricalcium phosphate and hydroxyapatite after different hydration methodologies in rat extraction sockets. Methods Wistar rats (n = 20) were randomly distributed in two subgroups (G1, G2) according to the hydration methods used. After extraction of the right upper central incisor the alveoli were filled with SBC hydrated by two different methods. Group 1: biomaterial hydrated in blood; Group 2: biomaterial hydrated in physiologic saline. The animals were euthanized after 1 and 6 weeks for removal of the bone blocks containing the biomaterial and were submitted to histologic processing. Five‐μm‐thick demineralized sections of the samples were stained with hematoxylin and eosin (HE) and subjected to histomorphometric analysis. Results Bone formation was limited 7 days after the extraction procedure and increased in both groups between 7 and 42 days from surgery, demonstrating a time dependent increase of bone volume throughtout the experimental period (p < 0.05). Conclusions The hydration of SBC with saline significantly increased new bone formation and reduced connective tissue volume after 42 days demonstrating that hydration method may significantly influence bone healing in such defects, and, thus should be carefully performed.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Effects of methods of hydration of a biphasic ceramic graft on bone regeneration of extraction socket defects

Santos

Santana

Alves

et al. 2018

Journal of Periodontology

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“…These limitations have indicated the necessity for the use of other types of bone substitutes that allow an adequate process of bone tissue formation with reduction of morbidity to the host 8,9 . Among the bone substitute alternatives to autogenous bone graft, osteoconductive biomaterials, such as deproteinized bovine bone (DBB) and biphasic ceramics, which are composed of hydroxyapatite and beta-phosphate tricalcium (HA/TCP), have highly diffused clinical application [8][9][10] . However, the low rate of reabsorption of hydroxyapatite present in both biomaterials implies its complete replacement by bone tissue, and the remnants of these bone substitutes have been observed in the recipient site until the implant placement 9,10 .…”

Section: Introductionmentioning

confidence: 99%

“…Among the bone substitute alternatives to autogenous bone graft, osteoconductive biomaterials, such as deproteinized bovine bone (DBB) and biphasic ceramics, which are composed of hydroxyapatite and beta-phosphate tricalcium (HA/TCP), have highly diffused clinical application [8][9][10] . However, the low rate of reabsorption of hydroxyapatite present in both biomaterials implies its complete replacement by bone tissue, and the remnants of these bone substitutes have been observed in the recipient site until the implant placement 9,10 . In addition, these remaining particles do not participate in the direct osseointegration process of the implants due to the lack of vitality of this tissue 11 .…”

Section: Introductionmentioning

confidence: 99%

Bone repair induced by different bone graft substitutes in critical-sized defects in rat calvaria

Aroni

Neto

Oliveira

et al. 2019

Rev. odontol. UNESP

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Introduction The use of bone substitutes in grafting procedures as an alternative of the use of autogenous bone graft has been indicated, however, the direct comparison between these biomaterials has been little explored. Objective To evaluate the effect of different osteoconductive bone substitutes on the bone repair in critical-sized defects (CSDs) in rat calvaria. Material and method One CSD with an 8 mm diameter was made in each of the 40 rats used in this study. The animals were randomly allocated into 5 groups (n=8), according to the type of bone substitute used to fill the CSD: COA (Coagulum); AUT (autogenous bone); DBB (deproteinized bovine bone graft); HA/TCP (biphasic ceramic composed of hydroxyapatite and β-phosphate tricalcium); and TCP (β-phosphate tricalcium). A microtomographic analysis was performed to evaluate the remaining defect linear length (DLL) of the CSD and the volume of the mineralized tissues (MT) within the CSD at 3, 7, 15 and 30 days after the surgical procedure. In addition, a histometric analysis was performed to evaluate the composition of the repaired bone tissue (% Bone and % Biomaterial) at the 30-day period. Result It was shown that the COA had the lowest DLL and MT within the CSD. In addition, the COA presented the highest % of bone in CSD. The DBB had a higher MT and a higher % of bone substitute particles in the CSD than the AUT and TCP groups. The DBB and AUT groups presented higher % of bone in the CSD than the TCP group. Conclusion The use of the DBB promoted a better pattern of bone volume gain and formation compared to TCP and HA / TCP but was biologically inferior to the AUT.

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“…These stages guide the osteoblasts to gradually differentiate into osteocytes and facilitate osteogenesis (4); therefore, high bioactivity and biocompatibility, osteoconduction and biodegradability are necessary characteristics in an alternative material that may facilitate bone regeneration (5). In the past three decades, various bone substitutes with high biocompatibility and good osteoconduction have been reported and have been applied to repair bone defects (6)(7)(8)(9); however, insufficient bioactivity of these materials has restricted the repair process (8). Therefore, high biocompatibility, biodegradability and osteogenic potential are considered desirable for bone tissue engineering.…”

Section: Introductionmentioning

confidence: 99%

Water‑soluble nano‑pearl powder promotes MC3T3‑E1 cell differentiation by enhancing autophagy via the MEK/ERK signaling pathway

Cheng

Zhang

2018

Mol Med Report

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Nacre (mother of pearl) is a bioactive material capable of facilitating osteoblast proliferation and differentiation; however, further investigation into the mechanism underlying the effects of nacre on the stimulation of bone differentiation is required. The present study aimed to elucidate the effects of water‑soluble nano‑pearl powder (WSNNP) on osteoblast differentiation and to examine the underlying mechanisms. A MTT assay revealed that WSNNP (10, 25 and 50 µg/ml) may stimulate the viability of preosteoblastic MC3T3‑E1 cells and 50 µg/ml WSNNP exhibited the maximum stimulatory effect. Furthermore, WSNNP significantly enhanced the protein expression levels of differentiation markers, including collagen I, runt‑related transcription factor 2 (RUNX2), secreted phosphoprotein1 (SPP1) and alkaline phosphatase (ALP) in a dose‑dependent manner, which indicated that WSNNP may promote osteoblast differentiation. Subsequently, whether autophagy serves a role in WSNNP‑mediated differentiation of osteoblasts was investigated via western blotting and immunofluorescence. The results of the present study demonstrated that WSNNP treatment significantly evoked the expression of autophagy markers, including microtubule‑associated light chain 3 (LC3)II/I, Beclin1 and autophagy‑related 7 (ATG7), whereas the autophagy inhibitor 3‑methyladenine significantly inhibited WSNNP‑induced osteoblast differentiation. Furthermore, the role of WSNNP on the potential signaling pathways that activate autophagy was investigated. The present study reported that WSNNP may significantly upregulate the mitogen‑activated protein kinase kinase (MEK)/extracellular signal‑regulated kinase (ERK) signaling pathway. Treatment with the MEK inhibitor U0126 significantly inhibited the protein expression levels of WSNNP‑induced differentiation markers, including collagen I, RUNX2, SPP1 and ALP, and autophagy markers, including LC3II/I, Beclin1 and ATG7. Therefore, the findings of the present study suggested that WSNNP may contribute to osteoblast differentiation by enhancing autophagy via the MEK/ERK signaling pathway, thus suggesting a novel direction for optimizing the biological materials in bone implants.

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Randomized clinical trial for the biological evaluation of two nanostructured biphasic calcium phosphate biomaterials as a bone substitute

Abstract: B1 group showed the greatest amount of newly formed bone after 6 months.

Cited by 31 publications

References 35 publications

Effects of methods of hydration of a biphasic ceramic graft on bone regeneration of extraction socket defects

Effects of methods of hydration of a biphasic ceramic graft on bone regeneration of extraction socket defects

Bone repair induced by different bone graft substitutes in critical-sized defects in rat calvaria

Water‑soluble nano‑pearl powder promotes MC3T3‑E1 cell differentiation by enhancing autophagy via the MEK/ERK signaling pathway

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