Purpose: Alveolar bone develops with tooth eruption and is absorbed following tooth extraction. Various ridge preservation techniques have sought to prevent ridge atrophy, with no superior technique evident. Collagen has a long history as a biocompatible material. Its usefulness and safety have been amply verified. The related compound, atelocollagen, is also safe and displays reduced antigenicity since telopeptides are not present. Materials and Methods: The current study evaluated whether the $Rapiderm^{(R)}$ atelocollagen plug (Dalim Tissen, Seoul, Korea) improves tissue healing of extraction sockets and assessed the sequential pattern of bone regeneration using histology and microcomputed tomography in six beagle dogs. To assess the change of extraction socket, hard tissues were examined 2, 4, 6, and 8 weeks after tooth extraction. Result: The experimental groups showed better bone fill with slow remodeling process compared to the control groups although there was no statistical difference between groups. Conclusion: The atelocollagen seems to have a tendency to slow bone remodeling in the early phase of healing period and maintain remodeling capacity until late phase of remodeling. Also, use of atelocollagen increased the bone-to-tissue ratio compared to healing of untreated extraction socket.
Friedmann, Anton;Meskeleviciene, Viktorija;Yildiz, Mehmet Selim;Gotz, Werner;Park, Jung-Chul;Fischer, Kai R.
Journal of Periodontal and Implant Science
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제50권6호
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pp.406-417
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2020
Purpose: This study investigated whether the placement of ribose cross-linked collagen (RCLC) membranes without primary soft tissue closure predictably resulted in sufficient alveolar ridge preservation in contained and non-contained extraction sockets. Methods: Membranes were positioned across extraction sockets, undermining full-thickness flaps, and the gingival margins were fixed by double-interrupted sutures without crossed horizontal mattress sutures for 1 week. In non-contained sockets, a bone substitute was used to support the membrane within the bony envelope. Radiographs and clinical images obtained 4 months later were analyzed by ImageJ software using non-parametric tests. Results: In 18 patients, 20 extraction sockets healed uneventfully and all sites received standard-diameter implants (4.1, 4.8, or 5.0 mm) without additional bone augmentation. Soft tissues and the muco-gingival border were well maintained. A retrospective analysis of X-rays and clinical photographs showed non-significant shrinkage in the vertical and horizontal dimensions (P=0.575 and P=0.444, respectively). The new bone contained vital bone cells embedded in mineralized tissues. Conclusions: Within the limitations of this pilot study, open healing of RCLC membranes may result in sufficient bone volume for implant placement without additional bone augmentation in contained and non-contained extraction sockets.
Nan Zhang;Li Xu;Hao Song;Chunqing Bu;Jie Kang;Chuanchen Zhang;Xiaofei Yang;Fabin Han
International Journal of Stem Cells
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제16권1호
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pp.93-107
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2023
Background and Objectives: Chronic periodontitis can lead to alveolar bone resorption and eventually tooth loss. Stem cells from exfoliated deciduous teeth (SHED) are appropriate bone regeneration seed cells. To track the survival, migration, and differentiation of the transplanted SHED, we used super paramagnetic iron oxide particles (SPIO) Molday ION Rhodamine-B (MIRB) to label and monitor the transplanted cells while repairing periodontal bone defects. Methods and Results: We determined an appropriate dose of MIRB for labeling SHED by examining the growth and osteogenic differentiation of labeled SHED. Finally, SHED was labeled with 25 ㎍ Fe/ml MIRB before being transplanted into rats. Magnetic resonance imaging was used to track SHED survival and migration in vivo due to a low-intensity signal artifact caused by MIRB. HE and immunohistochemical analyses revealed that both MIRB-labeled and unlabeled SHED could promote periodontal bone regeneration. The colocalization of hNUC and MIRB demonstrated that SHED transplanted into rats could survive in vivo. Furthermore, some MIRB-positive cells expressed the osteoblast and osteocyte markers OCN and DMP1, respectively. Enzyme-linked immunosorbent assay revealed that SHED could secrete protein factors, such as IGF-1, OCN, ALP, IL-4, VEGF, and bFGF, which promote bone regeneration. Immunofluorescence staining revealed that the transplanted SHED was surrounded by a large number of host-derived Runx2- and Col II-positive cells that played important roles in the bone healing process. Conclusions: SHED could promote periodontal bone regeneration in rats, and the survival of SHED could be tracked in vivo by labeling them with MIRB. SHED are likely to promote bone healing through both direct differentiation and paracrine mechanisms.
The purpose of this study was to evaluate the adjunctive combined effect of demineralized freeze-dried bone allograft(DFDB) in guided bone regeneration on supra-alveo-lar peri-implant defect. Supra-alveolar perio-implant defects, 3mm in height, each including 4 IMZ titanium plasma-sprayed implants were surgically created in two mongrel dogs. Subsequently, the defects were treated with 1 of the following 3 modalities: Control) no membrane or graft application, Group1) DFDB application, Group2) guided bone regeneration using an expanded polytetra-fluoroethylene membrane, Group3) guided bone regeneration using membrane and DFDB. After a healing period of 12-week, the animals were sacrificed, tissue blocks were harvested and prepared for histological analysis. Histologic examination were as follows; 1. New bon formation was minimal in control and Group 1, but considerable new bone formation was observed in Group 2 and Group 3. 2. There was no osteointegration at the implant-bone interface in the high-polished area of group2 and Group 3. 3. In fluorescent microscopic examination, remodeling of new bone was most active during week 4 and week 8. There was no significant difference in remodeling rate between group 2 and group 3. 4. DFDB particles were observed, invested in a connective tissue matrix. Osteoblast activity in the area was minimal. The results suggest that guided bone regeneration shows promising results in supra-alveolar peri-implant defects during the 12 week healing period although it has a limited potential in promoting alveolar bone regeneration in the high-polished area. There seems to be no significant adjunctive effect when DFDB is combined with GBR.
Purpose: This study evaluated histologically the tissue responses to and the effects of a customized nano-hydroxyapatite (n-HA) block bone graft on periodontal regeneration in a one-wall periodontal-defect model. Methods: A customized block bone for filling in the standardized periodontal defect was fabricated from prefabricated n-HA powders and a polymeric sponge. Bilateral $4{\times}{\times}4{\times}5$ mm (buccolingual width${\times}$mesiodistal width${\times}$depth), one-wall, critical-size intrabony periodontal defects were surgically created at the mandibular second and fourth premolars of five Beagle dogs. In each dog, one defect was filled with block-type HA and the other served as a sham-surgery control. The animals were sacrificed following an 8-week healing interval for clinical and histological evaluations. Results: Although the sites that received an n-HA block showed minimal bone formation, the n-HA block was maintained within the defect with its original hexahedral shape. In addition, only a limited inflammatory reaction was observed at sites that received an n-HA block, which might have been due to the high stability of the customized block bone. Conclusions: In the limitation of this study, customized n-HA block could provide a space for periodontal tissue engineering, with minimal inflammation.
Periodontal disease is one of the major dental diseases. Currently, various methods are used for healing and successful regeneration of periodontal tissue damaged by periodontal disease. The periodontal ligament and alveolar bone have received considerable interest for use in periodontal tissue regeneration and induction. However, as the functions of the factors required for tooth attachment and key regulatory factors for periodontal tissue regeneration in the cementum have recently been identified, interest in cementum formation and regeneration has increased. Dental cementum forms in the late phase of tooth development because of the reciprocal regulatory interaction between cervical loop epithelial cells and surrounding mesenchymal cells, which is regulated by various gene signaling networks. Many attempts have been made to understand the regulatory factors and cellular and molecular mechanisms associated with new cementum formation. In this paper, we reviewed the study outcomes to date on the regulatory factors that induce cementum formation and regeneration, focusing on understanding the roles and functions of Wnt signaling in the regulation of cementum formation. In addition, we aimed to obtain information on the useful reciprocal regulatory factors that mediate cementum formation and regeneration through a series of molecular mechanisms.
Background: Panax ginseng is regarded as one of the best compounds for promoting health, and it has been used traditionally as a medicinal herb. Recently, Korean Red Ginseng (RG) has been shown to protect skin from aging and wrinkling; it can also relieve atopic dermatitis and allergy symptoms. This study aimed to evaluate RG's effects on the regeneration of the full-thickness skin wounds in rat. Methods: Full-thickness skin wounds were generated in rats, and then RG was administered either orally or topically. The wound-healing effects of RG were investigated by assessing wound size, mRNA expression patterns of genes related to wound healing, histological staining, and measurements of lipid, moisture, and elasticity in skin tissues. Results: The wound size was smaller, and tissue regeneration rate was faster in the RG-treated group than that in the control group on days 15 and 20 after initiating treatment. On postoperative day 20, skin lipid and moisture content had increased significantly in the RG-treated group. Significant increases in the gene expression levels of transforming growth $factor-{\beta}1$ and vascular endothelial growth factor were found in the RG group during the early stages of wound healing. Matrix metalloproteinase-1 and matrix metalloproteinase-9 showed significant increases in gene expression levels on day 20. Conclusion: The results suggested that RG may promote healing of full-thickness skin wounds in rats. They also provided basic insights into the effects of RG on skin regeneration, supporting its use as a dressing material for wound treatment and its development as a functional food.
Although the main purpose of periodontal treatment to regenerate is the complete regeneration of periodontal tissue due to periodontal disease, most of the treatment cannot meet such purpose because healing by long epithelial junction. Therefore, diverse materials of resorbable and non-resorbable have been used to regenerate the periodontal tissue. Due to high risk of exposure and necessity of secondary surgical procedure when using non-resorbable membrane, guided tissue regeneration using the resorbable membrane has gain popularity, recently. However, present resorbable membrane has the disadvantage of not having sufficient time to regenerate date to the difference of resorption rate according to surgical site. Meanwhile, other than the structure stability and facile manipulation, acellular dermal matrix has been reported to be a possible scaffold for cellular proliferation due to rapid revascularization and favorable physical properties for cellular attachment and proliferation. The purpose of this study is to estimate the influence of acellular dermal matrix on periodontal ligament, cementum and alveolar bone when acellular dermal matrix is implanted to 1-wall alveolar bone defect. 4 dogs of 12 to 16 month old irrelevant to sex , which below 15Kg of body weight, has been used in this study. ADM has been used for the material of guided tissue regeneration. The 3rd premolar of the lower jaw was extracted bilaterally and awaited for self-healing. subsequently buccal and lingual flap was elevated to form one wall intrabony defect with the depth and width of 4mm on the distal surface of 2nd premolar and the mesial surface of 4th premolar. After the removal of periodontal ligament by root planing. notch was formed on the basal position. Following the root surface treatment, while the control group had the flap sutured without any treatment on surgically induced intrabony defect. Following the root surface treatment, the flap of intrabony defect was sutured with the ADM inserted while the control group sutured without any insertion. The histologic specimen was observed after 4 and 8 weeks of treatment. The control group was partially regenerated by periodontal ligament, new cementum and new alveolar bone. the level of regeneration is not reached on the previous formed notch. but, experimental group was fully regenerated by functionally oriented periodontal ligament fiber. new cementum and new alveolar bone. In conclusion, we think that ADM seems to be used by scaffold for periodontal ligament cells and the matrix is expected to use on guided tissue regeneration.
The stimulatory effect of recombinant human basic fibroblast growth factor (bFGF) on wound healing was evaluated in healing-impaired animal models. Full-thickness wounds were made in prednisolone-treated mice, streptozotocin (STZ)-induced diabetic rats and mitomycin C (MMC)-treated rats. Saline or bFGF at a dose of 1, 5, or $25\mu\textrm{g}$ per wound was applied to the open wound once a day for three to five days. The degree of wound healing was assessed using wound size and histological parameters such as degree of epidermal and dermal regeneration. Local application of bFGF accelerated wound closure significantly in a dose-dependent manner in all healing-impaired wounds (p<0.05). The wound healing effect of bFGF was further confirmed by histological examination in MMC-treated rats. Epidermal and dermal regeneration were enhanced in bFGF-treated wounds with a dose-related response. Dermal regeneration parameters such as collagen matrix formation and angiogenesis were significantly increased in $5\mu\textrm{g}$, or $\25mu\textrm{g}$ of bFGF-treated wounds when compared to saline-treated wounds (p<0.05). pectin immunostaining on day 8 for vascular endothelium showed an increased number of neovessels in bFGF-treated wounds. These results suggest that topical application of bFGF has beneficial effects on wound healing by angiogenesis and granulation tissue formation in healing-impaired wounds.
Lim, Hyun-Chang;Paeng, Kyeong-Won;Kim, Myong Ji;Jung, Ronald E.;Hammerle, Christoph HF.;Jung, Ui-Won;Thoma, Daniel S.
Journal of Periodontal and Implant Science
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제52권2호
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pp.170-180
/
2022
Purpose: This study was conducted to assess the effect of hard and/or soft tissue grafting on immediate implants in a preclinical model. Methods: In 5 mongrel dogs, the distal roots of P2 and P3 were extracted from the maxilla (4 sites in each animal), and immediate implant placement was performed. Each site was randomly assigned to 1 of the following 4 groups: i) gap filling with guided bone regeneration (the GBR group), ii) subepithelial connective tissue grafting (the SCTG group), iii) GBR and SCTG (the GBR/SCTG group), and iv) no further treatment (control). Non-submerged healing was provided for 4 months. Histological and histomorphometric analyses were performed. Results: Peri-implant tissue height and thickness favored the SCTG group (height of periimplant mucosa: 1.14 mm; tissue thickness at the implant shoulder and ±1 mm from the shoulder: 1.14 mm, 0.78 mm, and 1.57 mm, respectively; median value) over the other groups. Bone grafting was not effective at the level of the implant shoulder and on the coronal level of the shoulder. In addition, simultaneous soft and hard tissue augmentation (the GBR/SCTG group) led to a less favorable tissue contour compared to GBR or SCTG alone (height of periimplant mucosa: 3.06 mm; thickness of peri-implant mucosa at the implant shoulder and ±1 mm from the shoulder: 0.72 mm, 0.3 mm, and 1.09 mm, respectively). Conclusion: SCTG tended to have positive effects on the thickness and height of the periimplant mucosa in immediate implant placement. However, simultaneous soft and hard tissue augmentation might not allow a satisfactory tissue contour in cases where the relationship between implant position and neighboring bone housing is unfavorable.
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