Research

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13 pages, 3056 KiB

Open AccessArticle

Evaluation of Different Autologous Platelet Concentrate Biomaterials: Morphological and Biological Comparisons and Considerations

by Enrico Marchetti, Leonardo Mancini, Sara Bernardi, Serena Bianchi, Loredana Cristiano, Diana Torge, Giuseppe Marzo and Guido Macchiarelli

Materials 2020, 13(10), 2282; https://doi.org/10.3390/ma13102282 - 15 May 2020

Cited by 47 | Viewed by 2586

Abstract

The field of regeneration interventions in oral and maxillofacial surgeries still represents a challenge for researchers and clinicians. Understanding the biological and morphological behaviour of human cells towards the materials used for the regeneration surgeries is key to successfully choosing and applying the [...] Read more.

The field of regeneration interventions in oral and maxillofacial surgeries still represents a challenge for researchers and clinicians. Understanding the biological and morphological behaviour of human cells towards the materials used for the regeneration surgeries is key to successfully choosing and applying the appropriate biomaterials for specific clinical situations. The aim of the study was the biological and morphological evaluation of autologous platelet concentrate materials obtained with different protocols, in culture with human periodontal ligament fibroblasts (HPLF). The study design included the evaluation of Leukocyte-Platelet-Rich-Fibrin (L-PRF), Concentrated Growth Factors (CGF) and autologous platelet gel (APG) in contact with the HPLF cell line after 24 h, 72 h and 7 days of in vitro culture. Cell proliferation and, therefore, viability were evaluated with XTT assays. The morphological response of the cells was evaluated by light microscopy, scanning electron microscopy and confocal microscopy. The XTT assay showed an interesting response in the growth curve. In particular, the material that gave the best results was the CGF. The morphological data supported the XTT assay, showing the best results for the CGF and L-PRF. In conclusion, all the platelet-derived materials stimulated the onset of the growth of the HPLF cell line, making them promising options for periodontal regeneration interventions. Full article

(This article belongs to the Special Issue Biomaterials and Biological Mediators for Periodontal and Bone Regeneration)

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9 pages, 3147 KiB

Open AccessArticle

Effect of Gellan Gum/Tuna Skin Film in Guided Bone Regeneration in Artificial Bone Defect in Rabbit Calvaria

by Seunggon Jung, Hee-Kyun Oh, Myung-Sun Kim, Ki-Young Lee, Hongju Park and Min-Suk Kook

Materials 2020, 13(6), 1318; https://doi.org/10.3390/ma13061318 - 14 Mar 2020

Cited by 8 | Viewed by 2426

Abstract

It is necessary to prevent the invasion of soft tissue into bone defects for successful outcomes in guided bone regeneration (GBR). For this reason, many materials are used as protective barriers to bone defects. In this study, a gellan gum/tuna skin gelatin (GEL/TSG) [...] Read more.

It is necessary to prevent the invasion of soft tissue into bone defects for successful outcomes in guided bone regeneration (GBR). For this reason, many materials are used as protective barriers to bone defects. In this study, a gellan gum/tuna skin gelatin (GEL/TSG) film was prepared, and its effectiveness in bone regeneration was evaluated. The film exhibited average cell viability in vitro. Experimental bone defects were prepared in rabbit calvaria, and a bone graft procedure with beta-tricalcium phosphate was done. The film was used as a membrane of GBR and compared with results using a commercial collagen membrane. Grafted material did not show dispersion outside of bone defects and the film did not collapse into the bone defect. New bone formation was comparable to that using the collagen membrane. These results suggest that the GEL/TSG film could be used as a membrane for GBR. Full article

(This article belongs to the Special Issue Biomaterials and Biological Mediators for Periodontal and Bone Regeneration)

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Review

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32 pages, 630 KiB

Open AccessReview

A Systematic Critical Appraisal of the Methodological Quality of Systematic Reviews on the Effect of Autologous Platelet Concentrates in the Treatment of Periodontal Intraosseous Defects

by Agostino Guida, Gennaro Cecoro, Rosario Rullo, Luigi Laino, Massimo Del Fabbro and Marco Annunziata

Materials 2020, 13(18), 4180; https://doi.org/10.3390/ma13184180 - 20 Sep 2020

Cited by 4 | Viewed by 1780

Abstract

The present study aimed to perform a systematic critical appraisal of the methodological quality of systematic reviews (SRs) on the effect of autologous platelet concentrates (APCs) in the treatment of periodontal intraosseous defects and to provide a synthesis of the main clinical findings [...] Read more.

The present study aimed to perform a systematic critical appraisal of the methodological quality of systematic reviews (SRs) on the effect of autologous platelet concentrates (APCs) in the treatment of periodontal intraosseous defects and to provide a synthesis of the main clinical findings available. An electronic and hand search was performed up to February 2020; 14 systematic reviews of randomized controlled trials (RCTs), of which 11 were meta-analyses, were included. Only one SR fully satisfied all 11 items of the AMSTAR (“A Measurement Tool to Assess Systematic Reviews”) checklist for methodological quality evaluation, 3 SRs were classified of high quality, 8 of medium quality, and 2 of low quality. There is some evidence on the beneficial additive effect of APCs in the surgical treatment of intraosseous defects when used alone or in combination with bone grafts. APCs did not show any advantage when used together with guided tissue regeneration (GTR) or enamel matrix derivative (EMD). Undertaking SRs which adhere to rigorous standards and protocols is strongly recommended. There are increasing data on the positive adjunctive effect of APCs in the surgical treatment of intraosseous defects but, due to the heterogeneity of the available primary studies, the quality of evidence remains rather low and further long-term well-designed RCTs are encouraged. Full article

(This article belongs to the Special Issue Biomaterials and Biological Mediators for Periodontal and Bone Regeneration)

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15 pages, 665 KiB

Open AccessReview

Platelet-Rich Fibrin in Bone Regenerative Strategies in Orthodontics: A Systematic Review

by Inês Francisco, Maria Helena Fernandes and Francisco Vale

Materials 2020, 13(8), 1866; https://doi.org/10.3390/ma13081866 - 16 Apr 2020

Cited by 18 | Viewed by 3687

Abstract

Preservation of the alveolar bone is a determinant in the outcome of orthodontic treatment. Alveolar bone defects or a decrease of their height and width may occur due to common reasons such as inflammation, tooth extraction, or cleft lip and palate. The aim [...] Read more.

Preservation of the alveolar bone is a determinant in the outcome of orthodontic treatment. Alveolar bone defects or a decrease of their height and width may occur due to common reasons such as inflammation, tooth extraction, or cleft lip and palate. The aim of this systematic review was to investigate and appraise the quality of the most up to date available evidence regarding the applications and effects of platelet-rich fibrin (PRF) in orthodontics. This study was carried out according to preferred reporting items for systematic reviews and meta-analyses guidelines using the following databases: Medline via PubMed, Cochrane Library, Web of Science Core Collection and EMBASE. The qualitative assessment of the included studies was performed using Cochrane Risk of Bias tool and ROBINS-I guidelines. Results: From a total of 489 studies, nine studies were selected. The majority of the included studies demonstrate that autogenous anterior iliac graft with PRF had a higher amount of newly formed bone. Furthermore, this review also suggests that the application of platelet derivatives in the extraction socket can accelerate orthodontic tooth movement. Despite the limitations in the included studies, this systematic review suggested that PRF can improve alveolar cleft reconstruction and orthodontic tooth movement. Full article

(This article belongs to the Special Issue Biomaterials and Biological Mediators for Periodontal and Bone Regeneration)

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16 pages, 1160 KiB

Open AccessReview

Selection of Collagen Membranes for Bone Regeneration: A Literature Review

by Luca Sbricoli, Riccardo Guazzo, Marco Annunziata, Luca Gobbato, Eriberto Bressan and Livia Nastri

Materials 2020, 13(3), 786; https://doi.org/10.3390/ma13030786 - 09 Feb 2020

Cited by 128 | Viewed by 9613

Abstract

Several treatment modalities have been proposed to regenerate bone, including guided bone regeneration (GBR) where barrier membranes play an important role by isolating soft tissue and allowing bone to grow. Not all membranes biologically behave the same way, as they differ from their [...] Read more.

Several treatment modalities have been proposed to regenerate bone, including guided bone regeneration (GBR) where barrier membranes play an important role by isolating soft tissue and allowing bone to grow. Not all membranes biologically behave the same way, as they differ from their origin and structure, with reflections on their mechanical properties and on their clinical performance. Collagen membranes have been widely used in medicine and dentistry, because of their high biocompatibility and capability of promoting wound healing. Recently, collagen membranes have been applied in guided bone regeneration with comparable outcomes to non-resorbable membranes. Aim of this work is to provide a review on the main features, application, outcomes, and clinical employment of the different types of collagen membranes. Comparisons with non-resorbable membranes are clarified, characteristics of cross-linked collagen versus native collagen, use of different grafting materials and need for membrane fixation are explored in order to gain awareness of the indications and limits and to be able to choose the right membrane required by the clinical condition. Full article

(This article belongs to the Special Issue Biomaterials and Biological Mediators for Periodontal and Bone Regeneration)

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22 pages, 1175 KiB

Open AccessReview

Efficacy of Enamel Derivatives to Improve Keratinized Tissue as Adjunct to Coverage of Gingival Recessions: A Systematic Review and Meta-Analysis

by Nicola Discepoli, Raffaele Mirra and Marco Ferrari

Materials 2019, 12(17), 2790; https://doi.org/10.3390/ma12172790 - 30 Aug 2019

Cited by 8 | Viewed by 2702

Abstract

Background: The systematic review was designed to answer the following focused question: Are enamel matrix derivatives able to improve the quantity of keratinized tissue (KT) around natural dentition in patients with recessions defects after their treatment with periodontal plastic procedures? Methods: Only Randomized [...] Read more.

Background: The systematic review was designed to answer the following focused question: Are enamel matrix derivatives able to improve the quantity of keratinized tissue (KT) around natural dentition in patients with recessions defects after their treatment with periodontal plastic procedures? Methods: Only Randomized Clinical Trials (RCT) in English language evaluating root coverage procedures in combination with enamel matrix derivatives (commercially known as Emdogain^®—EMD), with at least 10 subjects and a minimum duration of six months, were included. The search was applied to PUBMED and SCOPUS and it consists of a combination of MeSH terms and free text words (from January 2000 to June 2019). Risk of bias in individual studies and across studies was also evaluated. Results: After the full text analysis and the exclusion of further 18 articles, 12 articles were finally included. In total 639 recessions were treated (334 tests and 305 control). The recessions defects were classified according to the classification of Miller (Class I, II, III, IV). Only one trial included Miller Class III recessions (7 in total). Enamel matrix derivatives were applied in conjunction with Coronally Advanced Flap (CAF), Coronally Advanced Flap + Sub Epithelial Connective Tissue Graft (CAF + CTG), Semilunar Flap (SF). For the group CAF vs CAF + EMD the mean difference between the keratinized tissue gain in the two procedures was 0.40 mm (95% Confindence Interval Lower/Upper: 0.014–0.81) (p < 0.058); for the comparison CAF + CTG + EMD vs. CAF + CTG the mean difference between the two groups resulted in −0.06 mm (95% Confindence Interval Lower Upper −0.45 to 0.33) (p = 0.7603). Discussion: Randomized clinical trials included medium-low quality evidence. The application of Enamel Matrix Derivatives to surgical procedures aimed to cover gingival recessions does not add robust clinical benefit to conventional plastic procedure alone. Full article

(This article belongs to the Special Issue Biomaterials and Biological Mediators for Periodontal and Bone Regeneration)

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16 pages, 1740 KiB

Open AccessFeature PaperReview

Enamel Matrix Derivative and Autogenous Bone Graft for Periodontal Regeneration of Intrabony Defects in Humans: A Systematic Review and Meta-Analysis

by Marco Annunziata, Angelantonio Piccirillo, Francesco Perillo, Gennaro Cecoro, Livia Nastri and Luigi Guida

Materials 2019, 12(16), 2634; https://doi.org/10.3390/ma12162634 - 19 Aug 2019

Cited by 15 | Viewed by 3718

Abstract

The combination of enamel matrix derivative (EMD) with an autogenous bone graft in periodontal regeneration has been proposed to improve clinical outcomes, especially in case of deep non-contained periodontal defects, with variable results. The aim of the present systematic review and meta-analysis was [...] Read more.

The combination of enamel matrix derivative (EMD) with an autogenous bone graft in periodontal regeneration has been proposed to improve clinical outcomes, especially in case of deep non-contained periodontal defects, with variable results. The aim of the present systematic review and meta-analysis was to assess the efficacy of EMD in combination with autogenous bone graft compared with the use of EMD alone for the regeneration of periodontal intrabony defects. A literature search in PubMed and in the Cochrane Central Register of Controlled Trials was carried out on February 2019 using an ad-hoc search string created by two independent and calibrated reviewers. All randomized controlled trials (RCTs) comparing a combination of EMD and autogenous bone graft with EMD alone for the treatment of periodontal intrabony defects were included. Studies involving other graft materials were excluded. The requested follow-up was at least 6 months. There was no restriction on age or number of patients. Standard difference in means between test and control groups as well as relative forest plots were calculated for clinical attachment level gain (CALgain), probing depth reduction (PDred), and gingival recession increase (RECinc). Three RCTs reporting on 79 patients and 98 intrabony defects were selected for the analysis. Statistical heterogeneity was detected as significantly high in the analysis of PDred and RECinc (I² = 85.28%, p = 0.001; I² = 73.95%, p = 0.022, respectively), but not in the analysis of CALgain (I² = 59.30%, p = 0.086). Standard difference in means (SDM) for CALgain between test and control groups amounted to −0.34 mm (95% CI −0.77 to 0.09; p = 0.12). SDM for PDred amounted to −0.43 mm (95% CI −0.86 to 0.01; p = 0.06). SDM for RECinc amounted to 0.12 mm (95% CI −0.30 to 0.55. p = 0.57). Within their limits, the obtained results indicate that the combination of enamel matrix derivative and autogenous bone graft may result in non-significant additional clinical improvements in terms of CALgain, PDred, and RECinc compared with those obtained with EMD alone. Several factors, including the surgical protocol used (e.g. supracrestal soft tissue preservation techniques) could have masked the potential additional benefit of the combined approach. Further well-designed randomized controlled trials, with well-defined selection criteria and operative protocols, are needed to draw more definite conclusions. Full article

(This article belongs to the Special Issue Biomaterials and Biological Mediators for Periodontal and Bone Regeneration)

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20 pages, 5791 KiB

Open AccessFeature PaperReview

New Perspectives in the Use of Biomaterials for Periodontal Regeneration

by Federico Ausenda, Giulio Rasperini, Raffaele Acunzo, Angelina Gorbunkova and Giorgio Pagni

Materials 2019, 12(13), 2197; https://doi.org/10.3390/ma12132197 - 08 Jul 2019

Cited by 41 | Viewed by 10252

Abstract

Periodontitis is a disease with a high prevalence among adults. If not treated, it can lead to loss of teeth. Periodontal therapy aims at maintaining patient’s teeth through infection control and correction of non-maintainable anatomies including—when possible—regeneration of lost periodontal tissues. The biological [...] Read more.

Periodontitis is a disease with a high prevalence among adults. If not treated, it can lead to loss of teeth. Periodontal therapy aims at maintaining patient’s teeth through infection control and correction of non-maintainable anatomies including—when possible—regeneration of lost periodontal tissues. The biological regenerative potential of the periodontium is high, and several biomaterials can be utilized to improve the outcome of periodontal therapy. Use of different natural and synthetic materials in the periodontal field has been studied for many years. The main materials used today in periodontology analyzed in this review are: Resorbable and non-resorbable barrier membranes; autogenous, allogeneic, xenogeneic, and alloplastic bone substitutes; biological agents, such as amelogenins; platelet-derived growth factor; bone morphogenic proteins; rh fibroblast growth factor 2; teriparatide hormone; platelet concentrates; and 3D scaffolds. With the development of new surgical techniques some concepts on periodontal regeneration that were strictly applied in the past seem to be not so critical today. This can have an impact on the materials that are needed when attempting to regenerate lost periodontal structures. This review aims at presenting a rationale behind the use of biomaterials in modern periodontal regeneration Full article

(This article belongs to the Special Issue Biomaterials and Biological Mediators for Periodontal and Bone Regeneration)

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25 pages, 2727 KiB

Open AccessReview

Fabrication of Scaffolds for Bone-Tissue Regeneration

by Petra Chocholata, Vlastimil Kulda and Vaclav Babuska

Materials 2019, 12(4), 568; https://doi.org/10.3390/ma12040568 - 14 Feb 2019

Cited by 381 | Viewed by 15809

Abstract

The present article describes the state of the art in the rapidly developing field of bone tissue engineering, where many disciplines, such as material science, mechanical engineering, clinical medicine and genetics, are interconnected. The main objective is to restore and improve the function [...] Read more.

The present article describes the state of the art in the rapidly developing field of bone tissue engineering, where many disciplines, such as material science, mechanical engineering, clinical medicine and genetics, are interconnected. The main objective is to restore and improve the function of bone tissue by scaffolds, providing a suitable environment for tissue regeneration and repair. Strategies and materials used in oral regenerative therapies correspond to techniques generally used in bone tissue engineering. Researchers are focusing on developing and improving new materials to imitate the native biological neighborhood as authentically as possible. The most promising is a combination of cells and matrices (scaffolds) that can be fabricated from different kinds of materials. This review summarizes currently available materials and manufacturing technologies of scaffolds for bone-tissue regeneration. Full article

(This article belongs to the Special Issue Biomaterials and Biological Mediators for Periodontal and Bone Regeneration)

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