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New Materials and Technologies for Guided Tissue Regeneration

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A special issue of Materials (ISSN 1996-1944). This special issue belongs to the section "Biomaterials".

Deadline for manuscript submissions: closed (15 December 2020) | Viewed by 43610

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Prof. Dr. Jamil Awad Shibli

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Department of Periodontology and Oral Implantology, Universidade Guarulhos, Guarulhos, Brazil
Interests: periodontology and oral implantology; mainly peri-implant diseases; guided bone regeneration; laser; PDT; growth factors; implant surface topographies; digital workflow; RCT
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Special Issue Information

Dear Colleagues,

Guided tissue regeneration is a successful procedure employed to increase and/or to create soft and hard tissues for oral and craniomaxillofacial surgery. At present, this biological principle has been improved by the development of several new materials and technologies to reduce the time and increase the efficiency of the regenerative procedure. In addition, local delivery of molecules as growth factors and stem cells combined with new designed and produced scaffolds had expanded the regenerative area, including not only target cells as osteoblasts, but also cells from the periodontal ligament.

This Special Issue aims to explore and share new emerging concepts and technologies in Biomaterials produced by additive manufacturing and other conventional methods applied in several areas.

This Special Issue includes but is not limited to:

Additive manufacturing of bioceramic and polymers;
New concepts of surgical and clinical procedures for bone and soft tissue regeneration;
Long-term follow up studies of different materials used for tissue regeneration;
Local and systemic host conditions that influence guided tissue regeneration;
Complications during healing of surgical regenerative procedures;
Characterization of new developments in both materials and procedures;
Growth factors and blood aggregates for guided tissue regeneration;
New developments of materials applied for craniomaxillofacial and periodontal reconstruction;
New synthetic nanocomposites and nanotubules of carbon;
New materials with nanoscale coating;
Scaffolds for periodontal and peri-implant tissue regeneration.

Prof. Jamil Awad Shibli
Guest Editor

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Keywords

guided tissue regeneration
additive manufacturing
nanoscale materials
periodontal regeneration
periodontitis
peri-implantitis
polymers
carbon
titanium
growth factors
blood aggregates
synthetic scaffolds
diabetes
osteoporosis

Published Papers (10 papers)

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Research

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9 pages, 2338 KiB

Open AccessArticle

Effect of the Pulsed Electromagnetic Field (PEMF) on Dental Implants Stability: A Randomized Controlled Clinical Trial

by Bhukya P. Nayak, Oleg Dolkart, Parth Satwalekar, Yeramala P. Kumar, Anam Chandrasekar, Ophir Fromovich, Elad Yakobson, Shlomo Barak, Ulisses Dayube and Jamil A. Shibli

Materials 2020, 13(7), 1667; https://doi.org/10.3390/ma13071667 - 03 Apr 2020

Cited by 13 | Viewed by 3776

Abstract

A pulsed electromagnetic field (PEMF) has been shown to contribute to heightening bone regeneration in a range of clinical areas, including dentistry. Due to the scarcity of studies using PEMF in oral implantology, the present experiment scrutinized the effect of PEMF can lead to improving the stability of the implant. A total of 19 subjects (40 implants in total) were selected to participate in the current study and were randomly allocated to either the PEMF group or control group. Subjects in the PEMF group received an activated miniaturized electromagnetic device (MED) while the control group received a sham healing cup. Implants stability was assessed by resonance frequency analyses (RFA) via implant stability quotient (ISQ) calculations. RFA were recorded as following: immediately after procedure, and then 2, 4, 6, 8 and 12 weeks later. Radiographic analysis was performed at baseline, 6 and 12 weeks after implant placement. Proinflammatory cytokines were evaluated in peri-implant crevicular fluid (PICF). The PEMF group presented higher ISQ mean values when compared to the control group. The primary stability time frame (the first 2 weeks) MED group depicted an increase in stability of 6.8%, compared to a decrease of 7.6% in the control group related to the baseline. An overall stability increase of 13% was found in MED treated group (p = 0.02), in contrast, the overall stability in the control group decreased by 2% (p = 0.008). TNF-α concentration during first 4 weeks was lower in the MED treated group. The data strongly suggests that MED generated continuing a PEMF may be considered as a new way to stimulate the stability of the implants at the early healing period. Full article

(This article belongs to the Special Issue New Materials and Technologies for Guided Tissue Regeneration)

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15 pages, 6274 KiB

Open AccessArticle

Comparison between Plasma Electrolytic Oxidation Coating and Sandblasted Acid-Etched Surface Treatment: Histometric, Tomographic, and Expression Levels of Osteoclastogenic Factors in Osteoporotic Rats

by Gustavo Antonio Correia Momesso, Anderson Maikon de Souza Santos, João Matheus Fonseca e Santos, Nilson Cristino da Cruz, Roberta Okamoto, Valentim Adelino Ricardo Barão, Rafael Shinoske Siroma, Jamil Awad Shibli and Leonardo Perez Faverani

Materials 2020, 13(7), 1604; https://doi.org/10.3390/ma13071604 - 01 Apr 2020

Cited by 17 | Viewed by 2062

Abstract

Plasma electrolytic oxidation (PEO) has been a promising surface coating with better mechanical and antimicrobial parameters comparing to conventional treatment surfaces. This study evaluated the peri-implant bone repair using (PEO) surface coatings compared with sandblasted acid (SLA) treatment. For this purpose, 44 Wistar rats were ovariectomized (OVX-22 animals) or underwent simulated surgery (SS-22 animals) and received implants in the tibia with each of the surface coatings. The peri-implant bone subsequently underwent molecular, microstructural, bone turnover, and histometric analysis. Real-time PCR showed a higher expression of osteoprotegerin (OPG), receptor activator of nuclear kappa-B ligand (RANKL), and osteocalcin (OC) proteins in the SLA/OVX and PEO/SS groups (p < 0.05). Computed microtomography, confocal microscopy, and histometry showed similarity between the PEO and SLA surfaces, with a trend toward the superiority of PEO in OVX animals. Thus, PEO surfaces were shown to be promising for enhancing peri-implant bone repair in ovariectomized rats. Full article

(This article belongs to the Special Issue New Materials and Technologies for Guided Tissue Regeneration)

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12 pages, 2334 KiB

Open AccessArticle

Maintenance of Alveolar Ridge Dimensions Utilizing an Extracted Tooth Dentin Particulate Autograft and Platelet-Rich fibrin: A Retrospective Radiographic Cone-Beam Computed Tomography Study

by Snjezana Pohl, Itzhak Binderman and Jelena Tomac

Materials 2020, 13(5), 1083; https://doi.org/10.3390/ma13051083 - 29 Feb 2020

Cited by 19 | Viewed by 5868

Abstract

This study utilized radiographic comparative analysis in order to evaluate dimensional ridge changes four months after tooth extraction and immediate grafting with mineralized dentin particulate autograft and chopped platelet-rich fibrin. Fifty-eight extraction sockets with up to 2 mm of missing buccal bone in the coronal aspect compared to the lingual bone were included. Graft material was covered with either a platelet-rich fibrin membrane or collagen sponge with no effort to achieve primary closure. The dimensional changes of the ridge were assessed on cone-beam computed tomography (CBCT) images acquired prior to extraction and four months later. The reduction in the buccal bone plate thickness 1 mm, 3 mm, and 5 mm below the buccal crest was −0.87 ± 0.84 mm, −0.60 ± 0.70 mm, and −0.41 ± 0.55 mm, respectively. The mean ridge width changes 1 mm, 3 mm, and 5 mm below the crest were −1.38 ± 1.24 mm, −0.82 ± 1.13 mm, and −0.43 ± 0.89 mm, respectively. The average mid-buccal bone height gain was +1.1%, while the mid-lingual height gain was 5.6%. A mineralized dentin autograft with platelet-rich fibrin is effective in preserving post-extraction alveolar ridge dimensions. Full article

(This article belongs to the Special Issue New Materials and Technologies for Guided Tissue Regeneration)

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15 pages, 4922 KiB

Open AccessFeature PaperArticle

3D Cytocompatible Composites of PCL/Magnetite

by Esperanza Díaz, María Blanca Valle, Sylvie Ribeiro, Senentxu Lanceros-Mendez and José Manuel Barandiarán

Materials 2019, 12(23), 3843; https://doi.org/10.3390/ma12233843 - 21 Nov 2019

Cited by 9 | Viewed by 2319

Abstract

A study of Magnetite (Fe₃O₄) as a suitable matrix for the improved adhesion and proliferation of MC3T3-E1 pre-osteoblast cells in bone regeneration is presented. Biodegradable and magnetic polycaprolactone (PCL)/magnetite (Fe₃O₄) scaffolds, which were fabricated by Thermally Induced Phase Separation, are likewise analyzed. Various techniques are used to investigate in vitro degradation at 37 °C, over 104 weeks, in a phosphate buffered saline (PBS) solution. Magnetic measurements that were performed at physiological temperature (310 K) indicated that degradation neither modified the nature nor the distribution of the magnetite nanoparticles. The coercive field strength of the porous matrices demonstrated ferromagnetic behavior and the probable presence of particle interactions. The added nanoparticles facilitated the absorption of PBS, with no considerable increase in matrix degradation rates, as shown by the Gel Permeation Chromatography (GPC) results for Mw, Mn, and I. There was no collapse of the scaffold structures that maintained their structural integrity. Their suitability for bone regeneration was also supported by the absence of matrix cytotoxicity in assays, even after additions of up to 20% magnetite. Full article

(This article belongs to the Special Issue New Materials and Technologies for Guided Tissue Regeneration)

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14 pages, 14810 KiB

Open AccessFeature PaperArticle

Socket Preservation Using a (Dense) PTFE Barrier with or without Xenograft Material: A Randomized Clinical Trial

by Márcio de Carvalho Formiga, Ulisses Ribeiro Campos Dayube, Cristiane Kern Chiapetti, Daniela de Rossi Figueiredo and Jamil Awad Shibli

Materials 2019, 12(18), 2902; https://doi.org/10.3390/ma12182902 - 08 Sep 2019

Cited by 11 | Viewed by 7392

Abstract

When alveolar preservation procedures are not performed after tooth extraction, aesthetic and functional impairment could occur. Guided bone regeneration using polytetrafluoroethylene (PTFE) membranes has proven to be a simple alternative treatment that results in good maintenance of the alveolar bone for mediate/late implant placement. Therefore, this study compared the effect of alveolar preservation with the use of dense PTFE membranes, with and without xenograft material by Computerized tomography-based body composition (CTBC) analysis, after four months of the socket preservation procedure. A total of 29 teeth indicated for extraction. In the test group, the sockets were filled with bone graft biomaterial and subsequently coated with a dense PTFE membrane. In the control group, the sockets were filled with the blood clots and subsequently coated with a dense PTFE membrane. The results we found on the changes of the bone width and height after the procedures were: buccal plate: control group 0.46 mm, test group 0.91 mm; alveolar height: control group −0.41 mm, test group 0.35 mm; cervical third: control group −0.89 mm, test group −0.11 mm; middle third: control group −0.64, test group −0.50; and apical third: control group 0.09 mm, test group −0.14 mm. The use of a xenograft in conjunction with d-PTFE membranes proved to be superior to the use of the same membrane and blood clot only in regions of the crest, middle third, and alveolar height. Full article

(This article belongs to the Special Issue New Materials and Technologies for Guided Tissue Regeneration)

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15 pages, 11372 KiB

Open AccessArticle

The Effect of the Length and Distribution of Implants for Fixed Prosthetic Reconstructions in the Atrophic Posterior Maxilla: A Finite Element Analysis

by Brunilda Gashi Cenkoglu, Nilufer Bolukbasi Balcioglu, Tayfun Ozdemir and Eitan Mijiritsky

Materials 2019, 12(16), 2556; https://doi.org/10.3390/ma12162556 - 11 Aug 2019

Cited by 13 | Viewed by 3005

Abstract

In this study, different prosthetic designs that could be applied instead of advanced surgical techniques in atrophic maxilla were evaluated with finite element analysis. Atrophic posterior maxilla was modeled using computer tomography images and four models were prepared as follows: Model 1 (M1), two implants supporting a three-unit distal cantilever prosthesis; Model 2 (M2), two implants supporting a three-unit conventional fixed partial denture; Model 3 (M3), three implants supporting three connected crowns; and Model 4 (M4), two implants supporting two connected crowns. Implants 4 mm in width and 8 mm or 13 mm in length were used. A linear three-dimensional finite element programme was used for analysis. The maximum principle stress (tensile) and minimum principle stress (compressive) were used to display stress in cortical and cancellous bones. The von Mises criteria were used to evaluate the stress on the implants. M1 was found to be the most risky model. The short dental arch case (M4) revealed the lowest stresses among the models but is not recommended when one more implant can be placed because of the bending forces that could occur at the mesial implant. In M2 and M3, the distal implants were placed bicortically between the crestal and sinus cortical plates, causing a fall of the stresses because of the bicortical stability of these implants. Full article

(This article belongs to the Special Issue New Materials and Technologies for Guided Tissue Regeneration)

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26 pages, 8855 KiB

Open AccessArticle

Metal Nanoparticles Released from Dental Implant Surfaces: Potential Contribution to Chronic Inflammation and Peri-Implant Bone Loss

by Eriberto Bressan, Letizia Ferroni, Chiara Gardin, Gloria Bellin, Luca Sbricoli, Stefano Sivolella, Giulia Brunello, Devorah Schwartz-Arad, Eitan Mijiritsky, Miguel Penarrocha, David Penarrocha, Cristian Taccioli, Marco Tatullo, Adriano Piattelli and Barbara Zavan

Materials 2019, 12(12), 2036; https://doi.org/10.3390/ma12122036 - 25 Jun 2019

Cited by 101 | Viewed by 6389

Abstract

Peri-implantitis is an inflammatory disease affecting tissues surrounding dental implants. Although it represents a common complication of dental implant treatments, the underlying mechanisms have not yet been fully described. The aim of this study is to identify the role of titanium nanoparticles released form the implants on the chronic inflammation and bone lysis in the surrounding tissue. We analyzed the in vitro effect of titanium (Ti) particle exposure on mesenchymal stem cells (MSCs) and fibroblasts (FU), evaluating cell proliferation by MTT test and the generation of reactive oxygen species (ROS). Subsequently, in vivo analysis of peri-implant Ti particle distribution, histological, and molecular analyses were performed. Ti particles led to a time-dependent decrease in cell viability and increase in ROS production in both MSCs and FU. Tissue analyses revealed presence of oxidative stress, high extracellular and intracellular Ti levels and imbalanced bone turnover. High expression of ZFP467 and the presence of adipose-like tissue suggested dysregulation of the MSC population; alterations in vessel morphology were identified. The results suggest that Ti particles may induce the production of high ROS levels, recruiting abnormal quantity of neutrophils able to produce high level of metalloproteinase. This induces the degradation of collagen fibers. These events may influence MSC commitment, with an imbalance of bone regeneration. Full article

(This article belongs to the Special Issue New Materials and Technologies for Guided Tissue Regeneration)

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10 pages, 1877 KiB

Open AccessArticle

Construction of 3D Cellular Composites with Stem Cells Derived from Adipose Tissue and Endothelial Cells by Use of Optical Tweezers in a Natural Polymer Solution

by Takehiro Yamazaki, Toshifumi Kishimoto, Paweł Leszczyński, Koichiro Sadakane, Takahiro Kenmotsu, Hirofumi Watanabe, Tomohiko Kazama, Taro Matsumoto, Kenichi Yoshikawa and Hiroaki Taniguchi

Materials 2019, 12(11), 1759; https://doi.org/10.3390/ma12111759 - 30 May 2019

Cited by 5 | Viewed by 3108

Abstract

To better understand the regulation and function of cellular interactions, three-dimensional (3D) assemblies of single cells and subsequent functional analysis are gaining popularity in many research fields. While we have developed strategies to build stable cellular structures using optical tweezers in a minimally invasive state, methods for manipulating a wide range of cell types have yet to be established. To mimic organ-like structures, the construction of 3D cellular assemblies with variety of cell types is essential. Our recent studies have shown that the presence of nonspecific soluble polymers in aqueous solution is the key to creating stable 3D cellular assemblies efficiently. The present study further expands on the construction of 3D single cell assemblies using two different cell types. We have successfully generated 3D cellular assemblies, using GFP-labeled adipose tissue-derived stem cells and endothelial cells by using optical tweezers. Our findings will support the development of future applications to further characterize cellular interactions in tissue regeneration. Full article

(This article belongs to the Special Issue New Materials and Technologies for Guided Tissue Regeneration)

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Review

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10 pages, 2369 KiB

Open AccessReview

Adipose Tissue-Derived Stem Cells: The Biologic Basis and Future Directions for Tissue Engineering

by Diana Aparecida Dias Câmara, Jamil Awad Shibli, Eduardo Alexandre Müller, Paulo Luiz De-Sá-Junior, Allan Saj Porcacchia, Alberto Blay and Nelson Foresto Lizier

Materials 2020, 13(14), 3210; https://doi.org/10.3390/ma13143210 - 18 Jul 2020

Cited by 26 | Viewed by 3478

Abstract

Mesenchymal stem cells (MSCs) have been isolated from a variety of tissues using different methods. Active research have confirmed that the most accessible site to collect them is the adipose tissue; which has a significantly higher concentration of MSCs. Moreover; harvesting from adipose tissue is less invasive; there are no ethical limitations and a lower risk of severe complications. These adipose-derived stem cells (ASCs) are also able to increase at higher rates and showing telomerase activity, which acts by maintaining the DNA stability during cell divisions. Adipose-derived stem cells secret molecules that show important function in other cells vitality and mechanisms associated with the immune system, central nervous system, the heart and several muscles. They release cytokines involved in pro/anti-inflammatory, angiogenic and hematopoietic processes. Adipose-derived stem cells also have immunosuppressive properties and have been reported to be “immune privileged” since they show negative or low expression of human leukocyte antigens. Translational medicine and basic research projects can take advantage of bioprinting. This technology allows precise control for both scaffolds and cells. The properties of cell adhesion, migration, maturation, proliferation, mimicry of cell microenvironment, and differentiation should be promoted by the printed biomaterial used in tissue engineering. Self-renewal and potency are presented by MSCs, which implies in an open-source for 3D bioprinting and regenerative medicine. Considering these features and necessities, ASCs can be applied in the designing of tissue engineering products. Understanding the heterogeneity of ASCs and optimizing their properties can contribute to making the best therapeutic use of these cells and opening new paths to make tissue engineering even more useful. Full article

(This article belongs to the Special Issue New Materials and Technologies for Guided Tissue Regeneration)

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10 pages, 3657 KiB

Open AccessCase Report

A Modified Ridge Splitting Technique Using Autogenous Bone Blocks—A Case Series

by Dorottya Pénzes, Fanni Simon, Eitan Mijiritsky, Orsolya Németh and Márton Kivovics

Materials 2020, 13(18), 4036; https://doi.org/10.3390/ma13184036 - 11 Sep 2020

Cited by 4 | Viewed by 4945

Abstract

Background: Alveolar atrophy following tooth loss is a common limitation of rehabilitation with dental implant born prostheses. Ridge splitting is a well-documented surgical method to restore the width of the alveolar ridge prior to implant placement. The aim of this case series is to present a novel approach to ridge expansion using only autogenous bone blocks. Methods: Patients with Kennedy Class I. and II. mandibles with insufficient bone width were included in this study. Ridge splitting was carried out with the use of a piezoelectric surgery device by preparing osteotomies and after mobilization of the buccal cortical by placing an autologous bone block harvested from the retromolar region as a spacer between the buccal and lingual cortical plates. Block-grafts were stabilized by osteosynthesis screws. Implant placement was carried out after a 3-month healing period. A total of 13 implants were placed in seven augmented sites of six patients. Results: Upon re-entry, all sites healed uneventfully. Mean ridge width gain was 2.86 mm, range: 2.0–5.0 mm. Conclusions: Clinical results of our study show that the modified ridge splitting technique is a safe and predictable method to restore width of the alveolar ridge prior to implant placement. Full article

(This article belongs to the Special Issue New Materials and Technologies for Guided Tissue Regeneration)

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