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Journal of Periodontal Research Oct 2017This systematic review aims to evaluate mesenchymal stem cells (MSC) periodontal regenerative potential in animal models. MEDLINE, EMBASE and LILACS databases were... (Review)
Review
This systematic review aims to evaluate mesenchymal stem cells (MSC) periodontal regenerative potential in animal models. MEDLINE, EMBASE and LILACS databases were searched for quantitative pre-clinical controlled animal model studies that evaluated the effect of local administration of MSC on periodontal regeneration. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. Twenty-two studies met the inclusion criteria. Periodontal defects were surgically created in all studies. In seven studies, periodontal inflammation was experimentally induced following surgical defect creation. Differences in defect morphology were identified among the studies. Autogenous, alogenous and xenogenous MSC were used to promote periodontal regeneration. These included bone marrow-derived MSC, periodontal ligament (PDL)-derived MSC, dental pulp-derived MSC, gingival margin-derived MSC, foreskin-derived induced pluripotent stem cells, adipose tissue-derived MSC, cementum-derived MSC, periapical follicular MSC and alveolar periosteal cells. Meta-analysis was not possible due to heterogeneities in study designs. In most of the studies, local MSC implantation was not associated with adverse effects. The use of bone marrow-derived MSC for periodontal regeneration yielded conflicting results. In contrast, PDL-MSC consistently promoted increased PDL and cementum regeneration. Finally, the adjunct use of MSC improved the regenerative outcomes of periodontal defects treated with membranes or bone substitutes. Despite the quality level of the existing evidence, the current data indicate that the use of MSC may provide beneficial effects on periodontal regeneration. The various degrees of success of MSC in periodontal regeneration are likely to be related to the use of heterogeneous cells. Thus, future studies need to identify phenotypic profiles of highly regenerative MSC populations.
Topics: Animals; Bone Regeneration; Bone Substitutes; Bone Transplantation; Cementogenesis; Databases, Factual; Dental Pulp; Disease Models, Animal; Guided Tissue Regeneration, Periodontal; Humans; Mesenchymal Stem Cells; Meta-Analysis as Topic; Osteogenesis; Periodontal Ligament; Regeneration; Stem Cell Transplantation; Tissue Scaffolds
PubMed: 28394043
DOI: 10.1111/jre.12455 -
Brazilian Dental Journal 2019The aim of presented systematic scoping review was to investigate the actual and future clinical possibilities of regenerative therapies and their ability to regenerate...
The aim of presented systematic scoping review was to investigate the actual and future clinical possibilities of regenerative therapies and their ability to regenerate bone, periodontal and pulp with histological confirmation of the nature of formed tissue. Electronic search was conducted using a combination between Keywords and MeSH terms in PubMed, Scopus, ISI-Web of Science and Cochrane library databases up to January 2016. Two reviewers conducted independently the papers judgment. Screened studies were read following the predetermined inclusion criteria. The included studies were evaluated in accordance with Arksey and O'Malley's modified framework. From 1349 papers, 168 completed inclusion criteria. Several characterized and uncharacterized cells used in Cell Therapy have provided bone regeneration, demonstrating bone gain in quantity and quality, even as accelerators for bone and periodontal regeneration. Synthetic and natural scaffolds presented good cell maintenance, however polyglycolid-polylactid presented faster resorption and consequently poor bone gain. The Growth Factor-Mediated Therapy was able to regenerate bone and all features of a periodontal tissue in bone defects. Teeth submitted to Revascularization presented an increase of length and width of root canal. However, formed tissues not seem able to deposit dentin, characterizing a repaired tissue. Both PRP and PRF presented benefits when applied in regenerative therapies as natural scaffolds. Therefore, most studies that applied regenerative therapies have provided promising results being possible to regenerate bone and periodontal tissue with histological confirmation. However, pulp regeneration was not reported. These results should be interpreted with caution due to the short follow-up periods.
Topics: Bone Regeneration; Dental Pulp; Dentin; Periodontium; Root Canal Therapy
PubMed: 30970065
DOI: 10.1590/0103-6440201902053 -
The Journal of Surgical Research Aug 2023Peripheral nerve injuries have been associated with increased healthcare costs and decreased patients' quality of life. Aging represents one factor that slows the speed... (Review)
Review
INTRODUCTION
Peripheral nerve injuries have been associated with increased healthcare costs and decreased patients' quality of life. Aging represents one factor that slows the speed of peripheral nervous system (PNS) regeneration. Since cellular homeostasis imbalance associated with aging lead to an increased failure in nerve regeneration in mammals of advanced age, this systematic review aims to determine the main molecular and cellular mechanisms involved in peripheral nerve regeneration in aged murine models after a peripheral nerve injuries.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search of 4 databases was conducted in July 2022 for studies comparing the peripheral nerve regeneration capability between young and aged murine models.
RESULTS
After the initial search yielded 744 publications, ten articles fulfilled the inclusion criteria. These studies show that age-related changes such as chronic inflammatory state, delayed macrophages' response to injury, dysfunctional Schwann Cells (SCs), and microenvironment alterations cause a reduction in the regenerative capability of the PNS in murine models. Furthermore, identifying altered gene expression patterns of SC after nerve damage can contribute to the understanding of physiological modifications produced by aging.
CONCLUSIONS
The interaction between macrophages and SC plays a crucial role in the nerve regeneration of aged models. Therefore, studies aimed at developing new and promising therapies for nerve regeneration should focus on these cellular groups to enhance the regenerative capabilities of the PNS in elderly populations.
Topics: Humans; Animals; Mice; Aged; Peripheral Nerve Injuries; Quality of Life; Peripheral Nerves; Aging; Nerve Regeneration; Mammals
PubMed: 37060859
DOI: 10.1016/j.jss.2023.03.017 -
Tissue Engineering. Part B, Reviews Feb 2017The growing multidisciplinary field of tissue engineering aims at predictably regenerating, enhancing, or replacing damaged or missing tissues for a variety of... (Review)
Review
The growing multidisciplinary field of tissue engineering aims at predictably regenerating, enhancing, or replacing damaged or missing tissues for a variety of conditions caused by trauma, disease, and old age. One area of research that has gained tremendous awareness in recent years is that of platelet-rich fibrin (PRF), which has been utilized across a wide variety of medical fields for the regeneration of soft tissues. This systematic review gathered all the currently available in vitro, in vivo, and clinical literature utilizing PRF for soft tissue regeneration, augmentation, and/or wound healing. In total, 164 publications met the original search criteria, with a total of 48 publications meeting inclusion criteria (kappa score = 94%). These studies were divided into 7 in vitro, 11 in vivo, and 31 clinical studies. In summary, 6 out of 7 (85.7%) and 11 out of 11 (100%) of the in vitro and in vivo studies, respectively, demonstrated a statistically significant advantage for combining PRF to their regenerative therapies. Out of the remaining 31 clinical studies, a total of 8 reported the effects of PRF in a randomized clinical trial, with 5 additional studies (13 total) reporting appropriate controls. In those clinical studies, 9 out of the 13 studies (69.2%) demonstrated a statistically relevant positive outcome for the primary endpoints measured. In total, 18 studies (58% of clinical studies) reported positive wound-healing events associated with the use of PRF, despite using controls. Furthermore, 27 of the 31 clinical studies (87%) supported the use of PRF for soft tissue regeneration and wound healing for a variety of procedures in medicine and dentistry. In conclusion, the results from the present systematic review highlight the positive effects of PRF on wound healing after regenerative therapy for the management of various soft tissue defects found in medicine and dentistry.
Topics: Blood Platelets; Fibrin; Humans; Regeneration; Tissue Engineering; Wound Healing
PubMed: 27672729
DOI: 10.1089/ten.TEB.2016.0233 -
Clinical Oral Investigations Nov 2015The aim of this systematic review was to assess the study design and reporting of studies on periodontal regeneration, with respect to the effect of the provision of... (Review)
Review
OBJECTIVES
The aim of this systematic review was to assess the study design and reporting of studies on periodontal regeneration, with respect to the effect of the provision of non-surgical periodontal therapy (NSPT) before surgery.
MATERIALS AND METHODS
A systematic search of the literature was conducted for studies on periodontal regeneration on Medline and EMBASE, complemented by a manual search. Initially, 3310 potentially eligible articles were identified.
RESULTS
A total of 293 studies were included in the review. Nearly 10% of studies did not include NSPT in the study protocol before regenerative surgery, while 14% of papers did not report this aspect. Seventy-six percent of studies reported that non-surgical subgingival debridement was performed before periodontal surgery (2 weeks to 6 months before surgery according to the different studies). However, no papers reported clinical and radiographic data before and after NSPT prior to periodontal surgery. Only 45% of papers reported timing of reassessment following NSPT, prior to proceeding with regenerative surgery.
CONCLUSIONS
This review highlights the lack of reporting information on non-surgical periodontal therapy prior to periodontal regenerative surgery, calling for a revision of the current clinical protocols and of the study designs of periodontal regenerative surgery studies.
CLINICAL RELEVANCE
Periodontal regenerative surgery protocols should take into account the possible effects of non-surgical periodontal therapy in the clinical and radiographic healing of intrabony defects.
Topics: Humans; Periodontal Diseases; Regeneration; Regenerative Medicine
PubMed: 25957601
DOI: 10.1007/s00784-015-1493-5 -
The British Journal of Oral &... Dec 2021Acetylsalicylic acid (ASA) is commonly used as a non-steroidal anti-inflammatory drug that interferes with multiple biological pathways. ASA acts by stimulating... (Meta-Analysis)
Meta-Analysis Review
Acetylsalicylic acid (ASA) is commonly used as a non-steroidal anti-inflammatory drug that interferes with multiple biological pathways. ASA acts by stimulating osteogenesis and inhibiting osteoclastogenesis. Thus, the objective of this study was to perform a systematic review and meta-analysis to evaluate the effectiveness of the use of ASA in the bone regeneration in animal models. This review was structured based on the PRISMA Statement and registered on PROSPERO database according to protocol number #CDR42018111403. The quality of evidence was assessed by using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). With the development of search strategies, we identified studies on the use of ASA from the following databases: 1- Medline (via PubMed); 2 - Web of Science; 3 - Scopus; and 4 - EMBASE. A total of 296 articles were identified and after screening the title, abstract, and full text, only 18 studies were selected for qualitative analysis and 12 were selected for performance of the quantitative analysis (meta-analysis). A meta-analysis of the amount of bone tissue formed showed a significant advantage when ASA was locally used, revealing a mean difference (MD) of 22.75% (95% CI: 15.39-30.12) p < 0.00001. Within the limitations of the available data, the results were promising and showed that ASA can be effective in bone formation in animal models.
Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Bone Regeneration; Bone and Bones; Osteogenesis
PubMed: 34736809
DOI: 10.1016/j.bjoms.2020.08.051 -
Journal of Obstetrics and Gynaecology :... Jul 2022A caesarean section may lead to a defect of the myometrium at the site of the uterine scar. The association with abnormal uterine bleeding or impaired fertility has been...
A caesarean section may lead to a defect of the myometrium at the site of the uterine scar. The association with abnormal uterine bleeding or impaired fertility has been demonstrated. Hysteroscopic remodelling reportedly reduces the symptoms. To review the available literature reporting on hysteroscopic treatment of these defects in symptomatic women with abnormal uterine bleeding or impaired fertility. A systematic search of PubMed and Cochrane databases has been performed until January 2021, including 27 articles. Hysteroscopic remodelling relieved symptoms of abnormal uterine bleeding in 60-100% and 25-100% of women with impaired fertility conceived within the follow up period. No major complications were reported. Hysteroscopic remodelling seems a treatment option in the management of symptomatic caesarean scar defects. Long-term follow-up and larger studies are needed to evaluate the effect on abnormal uterine bleeding as well as on reproductive outcomes.
Topics: Cesarean Section; Cicatrix; Female; Humans; Hysteroscopy; Pregnancy; Uterine Hemorrhage
PubMed: 35014923
DOI: 10.1080/01443615.2021.2003310 -
BMC Oral Health May 2023One of the major clinical challenges of this age could be represented by the possibility to obtain a complete regeneration of infrabony defects. Over the past few years,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
One of the major clinical challenges of this age could be represented by the possibility to obtain a complete regeneration of infrabony defects. Over the past few years, numerous materials and different approaches have been developed to obtain bone and periodontal healing. Among all biomaterials, bioglasses (BG) are one of the most interesting due to their ability to form a highly reactive carbonate hydroxyapatite layer. Our aim was to systematically review the literature on the use and capability of BG for the treatment of periodontal defects and to perform a meta-analysis of their efficacy.
METHODS
A search of MEDLINE/PubMed, Cochrane Library, Embase and DOSS was conducted in March 2021 to identify randomized controlled trials (RCTs) using BG in the treatment of intrabony and furcation defects. Two reviewers selected the articles included in the study considering the inclusion criteria. The outcomes of interest were periodontal and bone regeneration in terms of decrease of probing depth (PD) and gain of clinical attachment level (CAL). A network meta-analysis (NMA) was fitted, according to the graph theory methodology, using a random effect model.
RESULTS
Through the digital search, 46 citations were identified. After duplicate removal and screening process, 20 articles were included. All RCTs were retrieved and rated following the Risk of bias 2 scale, revealing several potential sources of bias. The meta-analysis focused on the evaluation at 6 months, with 12 eligible articles for PD and 10 for CAL. As regards the PD at 6 months, AUTOGENOUS CORTICAL BONE, BIOGLASS and PLATELET RICH FIBRIN were more efficacious than open flap debridement alone, with a statistically significant standardized mean difference (SMD) equal to -1.57, -1.06 and - 2.89, respectively. As to CAL at 6 months, the effect of BIOGLASS is reduced and no longer significant (SMD = -0.19, p-value = 0.4) and curiously PLATELET RICH FIBRIN was more efficacious than OFD (SMD =-4.13, p-value < 0.001) in CAL gain, but in indirect evidence.
CONCLUSIONS
The present review partially supports the clinical efficacy of BG in periodontal regeneration treatments for periodontal purposes. Indeed, the SMD of 0.5 to 1 in PD and CAL obtained with BG compared to OFD alone seem clinically insignificant even if it is statistically significant. Heterogeneity sources related to periodontal surgery are multiple, difficult to assess and likely hamper a quantitative assessment of BG efficacy.
Topics: Humans; Biocompatible Materials; Bone Regeneration; Dental Care; Durapatite; Furcation Defects
PubMed: 37158885
DOI: 10.1186/s12903-023-02898-z -
European Archives of... Feb 2022Platelet-rich fibrin (PRF) results in satisfactory wound healing. This analysis focuses on assessing the effectiveness of PRF in the treatment of tympanic membrane (TM)... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Platelet-rich fibrin (PRF) results in satisfactory wound healing. This analysis focuses on assessing the effectiveness of PRF in the treatment of tympanic membrane (TM) perforations.
MATERIALS AND METHODS
The literature was searched using PubMed, Embase, Cochrane Library and Web of Science databases from inception to February 28th, 2021. The following healing and hearing outcomes were measured: closure rate, pre-and postoperative auditory results, and incidence of postoperative infections. Data were pooled and expressed as the odds ratio (OR).
RESULTS
Ten studies were eligible for qualitative review, and seven of them were included for the final quantitative comparison. The OR for the closure rate of acute perforations was 4.30 (95% CI 1.35-13.70, I = 0%), and the OR in the chronic subgroup was 5.42 (95% CI 2.57-11.43, I = 0%). The total OR value for the completed closure rate was 5.10 (95% CI 2.72-9.54, I = 0%), indicating that the utilization of PRF can enhance the closure of both acute and chronic perforations. The qualitative review did not find improved hearing results with the use of PRF. In addition to promoting closure, PRF can reduce the incidence of infections (OR = 0.14). The sensitivity analysis did not change the final results, and there was no publication bias in this analysis.
CONCLUSION
PRF can increase the closure rate of acute perforations, enhance the survival rate of autografts in TM surgeries and reduce the incidence of infections. However, the literature indicates that PRF does not influence the hearing outcomes. This study shows that PRF is an effective agent for TM regeneration.
Topics: Humans; Platelet-Rich Fibrin; Tympanic Membrane; Tympanic Membrane Perforation; Wound Healing
PubMed: 34086080
DOI: 10.1007/s00405-021-06915-1 -
Journal of Nanobiotechnology Dec 2022Critical-sized bone defects are always difficult to treat, and they are associated with a significant burden of disease in clinical practice. In recent decades, due to... (Meta-Analysis)
Meta-Analysis Review
Critical-sized bone defects are always difficult to treat, and they are associated with a significant burden of disease in clinical practice. In recent decades, due to the fast development of biomaterials and tissue engineering, many bioinspired materials have been developed to treat large bone defects. Due to the excellent osteoblastic ability of black phosphorous (BP), many BP-based biomaterials have been developed to treat bone defects. Therefore, there are abundant studies as well as a tremendous amount of research data. It is urgent to conduct evidence-based research to translate these research data and results into validated scientific evidence. Therefore, in our present study, a qualitative systematic review and a quantitative meta-analysis were performed. Eighteen studies were included in a systematic review, while twelve studies were included in the meta-analysis. Our results showed that the overall quality of experimental methods and reports of biomaterials studies was still low, which needs to be improved in future studies. Besides, we also proved the excellent osteoblastic ability of BP-based biomaterials. But we did not find a significant effect of near-infrared (NIR) laser in BP-based biomaterials for treating bone defects. However, the quality of the evidence presented by included studies was very low. Therefore, to accelerate the clinical translation of BP-based biomaterials, it is urgent to improve the quality of the study method and reporting in future animal studies. More evidence-based studies should be conducted to enhance the quality and clinical translation of BP-based biomaterials.
Topics: Animals; Biocompatible Materials; Phosphorus; Bone Regeneration; Tissue Engineering
PubMed: 36496422
DOI: 10.1186/s12951-022-01735-9