Small-sized granules of biphasic bone substitutes support fast implant bed vascularization

Barbeck, Mike; Dard, Michel; Kokkinopoulou, Maria; Markl, Jürgen; Booms, Patrick; Sader, RA; Kirkpatrick, Charles James; Ghanaati, Shahram

doi:10.1080/21592535.2015.1056943

Cited by 51 publications

(103 citation statements)

References 63 publications

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“…The morphology of the granules may have influenced the induction of MNGCs and their polarization. This statement is supported by previous in vivo studies that revealed a high number of MNGCs in small sized granules of bone substitute materials compared to the large sized granules . In addition, the here investigated biomaterials were evaluated using scanning electron microscopy in a previous study .…”

Section: Discussionsupporting

confidence: 77%

Biomaterial‐induced multinucleated giant cells express proinflammatory signaling molecules: A histological study in humans

Zhang

Al‐Maawi

Wang

et al. 2018

J Biomedical Materials Res

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The biomaterials physicochemical characteristics influence their cellular reaction, degradation and regenerative capacities. Macrophages and multinucleated giant cells (MNGCs) are observed in the augmentation area of biomaterials. This study, for the first time, evaluated the polarization pattern of macrophages and MNGCs in response to two different bone substitute materials (synthetic bone substitute material [SBSM] = NanoBone vs. xenogeneic bone substitute material [XBSM] = Bio‐Oss) in human bone biopsies compared to non‐augmented bone (control). Histomorphometrical analysis of the polarization in proinflammatory (M1) and anti‐inflammatory (M2) cells was performed using different immunohistochemical markers: CD‐68 = macrophages; CCR‐7 and Cox‐2 (M1) and CD‐206 and CD‐163 (M2) and tartrate‐resistant acid phosphatase (TRAP). The macrophage polarization pattern in SBSM showed a significantly higher number of M1 cells than did XBSM and non‐augmented bone. XBSM induced a significantly higher number of CD‐206‐positive macrophages than SBSM did. No significant difference was found between XBSM and the non‐augmented bone. MNGCs expressed CD‐68 and TRAP. In both test‐groups, MNGCs showed a high proinflammatory character (CCR‐7 and Cox‐2‐positive) and their number in the SBSM group was significantly higher than that of XBSM. The tissue distribution showed a significantly low percentage of the remaining biomaterial in SBSM compared to XBSM. Within the limitations of this study, these findings show that MNGCs exhibit a rather proinflammatory character and lead to biomaterial degradation, once they are induced in a high number. The premature degradation of bone substitute materials is compensated with a high percentage of connective tissue and not new bone formation. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 780–790, 2019.

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Section: Discussionsupporting

confidence: 77%

Biomaterial‐induced multinucleated giant cells express proinflammatory signaling molecules: A histological study in humans

Zhang

Al‐Maawi

Wang

et al. 2018

J Biomedical Materials Res

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“…In the past few decades it has been repeatedly shown that multinucleated giant cells (MNGCs) are involved in the tissue reaction to numerous biomaterials, including the majority of bone substitutes . Based on the knowledge gained from autologous bone grafts it has manifoldly been supposed that these MNGCs are osteoclasts or so‐called “osteoclast‐like cells” and appear to be involved in the processes of “physiological” bone turnover during defect repair .…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, other results indicate that material‐induced MNGCs are involved in the inflammatory reaction cascade called “foreign body reaction to biomaterials” and, thus, MNGCs have been attributed to the foreign body giant cell (FBGC) type . Although it has been shown that some similarities exist between osteoclasts and biomaterial‐adherent MNGCs, it has been shown that the latter cell type did not exhibit essential characteristics of osteoclasts, such as a ruffled cell border and the induction of other molecules such as interleukin‐4 and −13 (IL‐4/‐13).…”

Section: Introductionmentioning

confidence: 99%

“…Although it has been shown that some similarities exist between osteoclasts and biomaterial‐adherent MNGCs, it has been shown that the latter cell type did not exhibit essential characteristics of osteoclasts, such as a ruffled cell border and the induction of other molecules such as interleukin‐4 and −13 (IL‐4/‐13). Furthermore, numerous studies have shown that TRAP‐expressing MNGCs also become induced after the implantation of bone substitutes as well as different other classes of biomaterials in ectopic tissues and not only within the microenvironment of bone tissue (Fig. ) …”

Section: Introductionmentioning

confidence: 99%

“… Furthermore, numerous studies have shown that TRAP‐expressing MNGCs also become induced after the implantation of bone substitutes as well as different other classes of biomaterials in ectopic tissues and not only within the microenvironment of bone tissue (Fig. ) .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multinucleated giant cells in the implant bed of bone substitutes are foreign body giant cells—New insights into the material‐mediated healing process

Barbeck

Booms

Unger

et al. 2017

J Biomedical Materials Res

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In addition to macrophages, multinucleated giant cells (MNGCs) are involved in the tissue reaction to a variety of biomaterials. Especially in the case of bone substitute materials it has been assumed that the MNGCs are osteoclasts, based on the chemical and physical similarity of many materials to the calcified matrix and the bony environment in which they are used. However, many studies indicate that these cells belong to the cell line of the foreign body giant cells (FBGCs), which are of "inflammatory origin", although they have been shown to possess both a pro- and also anti-inflammatory phenotype. Moreover, no information is available about their role in the tissue reaction to bone substitute materials. The present study was conducted to analyze the origin of MNGCs in the implant beds of a synthetic and a xenogeneic bone substitute and focused on the application of immunohistochemical methods. Two antibodies against integrin molecules specific for osteoclasts (β-3 integrin) or FBGCs (β-2 integrin) were used to distinguish both giant cell types. The results of the present study indicate that the MNGCs induced by both kinds of bone substitutes are FBGCs, as they express only β-2 integrin in contrast to the osteoclasts outside of the immediate implantation areas, which only demonstrate β-3 integrin expression. These data give new insight into the tissue reaction to both xenogeneic and synthetic bone substitutes. Based on this new knowledge further research concerning the proteomic profile of the FBGCs especially based on the different physicochemical properties of bone substitutes is necessary. This may show that specific characteristics of bone substitutes may exhibit a substantial influence on the regeneration process via the expression of anti-inflammatory molecules by FBGCs. Based on this information it may be possible to formulate and choose bone substitutes that can guide the process of bone tissue regeneration on the molecular level. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1105-1111, 2017.

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Monocyte preseeding leads to an increased implant bed vascularization of biphasic calcium phosphate bone substitutes via vessel maturation

Barbeck

Unger

Booms

et al. 2016

J. Biomed. Mater. Res.

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The present study analyzes the influence of the addition of monocytes to a biphasic bone substitute with two granule sizes (400-700 μm and 500-1000 μm). The majority of the added monocytes was detectable as mononuclear cells, while also low amounts of (chimeric) multinucleated giant cells (MNGCs) were found. No increase in the total number of MNGCs was established, but a significantly increased percent vascularization. Altogether, the results show that the added monocytes become involved in the tissue response to a biomaterial without marked changes in the overall reaction. Monocyte addition enables an increased implant bed vascularization especially via induction of vessel maturation and, thus intervenes positively in the healing reaction to a biomaterial. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2928-2935, 2016.

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Small-sized granules of biphasic bone substitutes support fast implant bed vascularization

Cited by 51 publications

References 63 publications

Biomaterial‐induced multinucleated giant cells express proinflammatory signaling molecules: A histological study in humans

Biomaterial‐induced multinucleated giant cells express proinflammatory signaling molecules: A histological study in humans

Multinucleated giant cells in the implant bed of bone substitutes are foreign body giant cells—New insights into the material‐mediated healing process

Monocyte preseeding leads to an increased implant bed vascularization of biphasic calcium phosphate bone substitutes via vessel maturation

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