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Journal of Biomedical Materials... Jan 2023The use of 3D-printed hydroxyapatite (HA) scaffolds for stimulating bone healing has been increasing over the years. Although all the promising effects of these... (Review)
Review
The use of 3D-printed hydroxyapatite (HA) scaffolds for stimulating bone healing has been increasing over the years. Although all the promising effects of these scaffolds, there are still few studies and limited understanding of their interaction with bone tissue and their effects on the process of fracture healing. In this context, this study aimed to perform a systematic literature review examining the effects of different 3D-printed HA scaffolds in bone healing. The search was made according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) orientations and Medical Subject Headings (MeSH) descriptors "3D printing," "bone," "HA," "repair," and "in vivo." Thirty-six articles were retrieved from PubMed and Scopus databases. After eligibility analyses, 20 papers were included (covering the period of 2016 and 2021). Results demonstrated that all the studies included in this review showed positive outcomes, indicating the efficacy of scaffolds treated groups in the in vivo experiments for promoting bone healing in different animal models. In conclusion, 3D-printed HA scaffolds are excellent candidates as bone grafts due to their bioactivity and good bone interaction.
Topics: Animals; Durapatite; Tissue Engineering; Tissue Scaffolds; Bone and Bones; Printing, Three-Dimensional; Bone Regeneration
PubMed: 35906778
DOI: 10.1002/jbm.b.35134 -
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 -
Injury Feb 2010The primary objective of this systematic review of published randomised controlled trials was to evaluate whether there was a clinical benefit in terms of pin loosening... (Review)
Review
OBJECTIVE
The primary objective of this systematic review of published randomised controlled trials was to evaluate whether there was a clinical benefit in terms of pin loosening and pin track infection, or deep infection, associated with hydroxyapatite coating of external fixator pins. The secondary objective was to evaluate whether there was a clinical benefit in terms of loss of alignment or malunion associated with hydroxyapatite coating of external fixator pins.
METHODS
Studies included were identified by a PubMed search for relevant randomised controlled trials on the 20th of December 2007. A systematic review was performed.
RESULTS
All of the studies concluded that there was significantly less pin loosening in the HA-coated groups although the definition of loosening was based on different criteria. However, there was insufficient evidence to properly evaluate the clinical benefit in terms of the numbers needed to treat to avoid premature pin removal. There was also insufficient evidence to evaluate whether any clinical benefit is gained by using HA-coated pins with respect to deep infection and malunion.
CONCLUSION
A well designed large randomised controlled trial is required to determine the numbers needed to treat with HA-coated pins to reduce the incidence of clinically relevant pin loosening, axial deformity and pin track or deep infection.
Topics: Bone Nails; Coated Materials, Biocompatible; Device Removal; Durapatite; External Fixators; Female; Fracture Fixation; Humans; Middle Aged; Prosthesis Failure; Prosthesis-Related Infections; Randomized Controlled Trials as Topic; Torque; Treatment Outcome
PubMed: 19486974
DOI: 10.1016/j.injury.2009.01.001 -
Journal of Dentistry Mar 2019To evaluate the desensitizing effect of nano-hydroxyapatite (n-HAP) on dentine hypersensitivity (DH). (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the desensitizing effect of nano-hydroxyapatite (n-HAP) on dentine hypersensitivity (DH).
SOURCES
Seven electronic databases were searched on April 27, 2018.
STUDY SELECTION
Randomized clinical trials (RCTs) were included based on the PICO strategy: Participants - Humans with DH; Intervention - n-HAP-containing desensitizing; Comparison -n-HAP-free treatments or placebo/negative control; and Outcomes - relief of DH. The risk of bias was classified by the Cochrane guidelines. Five meta-analyses were performed to evaluate the efficacy of n-HAP with regard to pain assessment stimuli (primary outcome); comparison of n-HAP with other treatments or placebo/negative control, and effectiveness of at-home and in-office n-HAP use (secondary outcomes). The quality of the evidence was evaluated using the GRADE.
DATA
Six RCTs with 4 weeks of follow-up were included in the meta-analysis. For the primary outcome, n-HAP showed a better desensitizing effect for evaporative stimuli (SMD -1.09 [-1.24, -0.94], p < 0.00001) and tactile stimuli (SMD -0.93 [-1.42, -0.43]) than other treatments (p = 0.0002). However, there was no difference between n-HAP and other treatments for the cold stimuli (SMD -0.17 [-0.81, 0.48], p = 0.61). In an overall analysis, n-HAP-containing treatment showing the most significant desensitizing effect (SMD -0.93 [-1.19, -0.68], p < 0.00001) with a high quality of evidence for pooled results. In the secondary outcomes, n-HAP showed the best effect in the overall analysis (p < 0.05) with moderate quality evidence.
CONCLUSIONS
The n-HAP-containing treatment showed better clinical performance than other treatments for DH relief. However, long-term follow-up RCTs are required in the future before definitive recommendations can be made.
CLINICAL SIGNIFICANCE
Dentin hypersensitivity is a common global condition and its multifactorial etiology has led to the development of several treatments. The n-HAP-containing treatment showed greater DH relief when compared to other desensitizing agents, placebo or negative control.
Topics: Dentin Desensitizing Agents; Dentin Sensitivity; Durapatite; Humans; Pain Measurement; Treatment Outcome
PubMed: 30611773
DOI: 10.1016/j.jdent.2018.12.014 -
Annals of Plastic Surgery Oct 2023Frontal sinus obliteration is a possible terminus for the management of chronic sinusitis, frontal bone trauma, cancer extirpation, or mucocele. The mucosa of the sinus... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Frontal sinus obliteration is a possible terminus for the management of chronic sinusitis, frontal bone trauma, cancer extirpation, or mucocele. The mucosa of the sinus is stripped and space obliterated with either autogenic, allopathic, or synthetic materials. This study aimed to compare the outcomes of autologous fat and hydroxyapatite cement (HAC) for frontal sinus obliteration.
METHODS
A multidatabase systematic review was conducted to collect outcomes on frontal sinus obliterations with either autologous fat or HAC. Outcomes collected included infection of the frontal sinus or obliteration material, mucocele formation, skin infection at the operative site, hematoma or seroma, cosmetic defect, donor site infection, and need for revision procedure. Prevalence of outcomes was analyzed through meta-analysis of proportions.
RESULTS
Twenty studies were ultimately included in the meta-analysis. Sixteen studies reported outcomes for 667 patients obliterated with autologous fat, and 7 studies reported outcomes for 100 patients obliterated with HAC. Prevalence of infection of the frontal sinus or obliteration material, mucocele formation, skin infection at the operative site, hematoma or seroma, and cosmetic defect did not differ statistically between the cohorts. Donor site infection secondary to fat harvesting for fat obliteration had a prevalence of <0.01. Revision rate was 0.04 (95% confidence interval, 0.01-0.8) for fat obliteration and 0.10 (95% confidence interval, 0.00-0.33) for HAC obliteration.
CONCLUSIONS
No statistically significant differences in the studied outcomes were detected between obliterations with autologous fat and HAC, suggesting that either is equally suitable and may be up to the surgeon's preference.
Topics: Humans; Frontal Sinus; Mucocele; Seroma; Hydroxyapatites
PubMed: 37556560
DOI: 10.1097/SAP.0000000000003581 -
Oral and Maxillofacial Surgery Jun 2017The current systematic review investigated the results of application of some of the most commonly used scaffolds in conjugation with stem cells and growth factors in... (Review)
Review
PURPOSE
The current systematic review investigated the results of application of some of the most commonly used scaffolds in conjugation with stem cells and growth factors in animal and clinical studies.
METHODS
A comprehensive electronic search was conducted according to the PRISMA guidelines in NCBI PMC and PubMed from January 1970 to December 2015 limited to English language publications with available full texts. In vivo studies in relation to "bone healing," "bone regeneration," and at least one of the following items were investigated: allograft, β-tricalcium phosphate, deproteinized bovine bone mineral, hydroxyapetite/tricalcium phosphate, nanohydroxyapatite, and composite scaffolds.
RESULTS
A total of 1252 articles were reviewed, and 46 articles completely fulfilled the inclusion criteria of this study. The highest bone regeneration has been achieved when combination of all three elements, given scaffolds, mesenchymal stem cells, and growth factors, were used. Among studies being reported in this review, bone marrow mesenchymal stem cells are the most studied mesenchymal stem cells, β-tricalcium phosphate is the most frequently used scaffold, and platelet-rich plasma is the most commonly used growth factor.
CONCLUSION
The current review aimed to inform reconstructive surgeons of how combinations of various mesenchymal stem cells, scaffolds, and growth factors enhance bone regeneration. The highest bone regeneration has been achieved when combination of all three elements, given scaffolds, mesenchymal stem cells, and growth factors, were used.
Topics: Allografts; Animals; Biocompatible Materials; Bone Regeneration; Calcification, Physiologic; Calcium Phosphates; Humans; Hydroxyapatites; Intercellular Signaling Peptides and Proteins; Nanostructures; Stem Cell Transplantation; Tissue Engineering; Tissue Scaffolds; Vascularized Composite Allotransplantation
PubMed: 28194530
DOI: 10.1007/s10006-017-0608-3 -
Journal of Biomedical Materials... Jul 2022Apart from osseointegration, the stability and long-term survival of percutaneous titanium implants is also strongly dependent on a qualitative soft-tissue integration... (Review)
Review
Apart from osseointegration, the stability and long-term survival of percutaneous titanium implants is also strongly dependent on a qualitative soft-tissue integration in the transcutaneous region. A firm connective tissue seal is needed to minimize soft-tissue dehiscence and epithelial downgrowth. It is well-known that the implant surface plays a key role in controlling the biological response of the surrounding keratinized tissue and several coating systems have been suggested to enhance the soft-tissue cell interactions. Although some promising results have been obtained in vitro, their clinical significance can be debated. Therefore, the purpose of this systematic review is to gain more insight into the effect of such coatings on the interface formed with keratinized soft-tissue in vivo. A comprehensive search was undertaken in March 2021. Relevant electronic databases were consulted to identify appropriate studies using a set of search strings. In total, 12 out of 4971 publications were included in this review. The reported coating systems were assigned to several subgroups according to their characteristics: metallic, ceramic and composite. Notwithstanding the differences in study characteristics (animal model, implantation period, reported outcomes), it was noticed that several coatings improve the soft-tissue integration as compared to pristine titanium. Porous titanium coatings having only limited pore sizes (<250 μm) do not support dermal fibroblast tissue attachment. Yet, larger pores (>700 μm) allow extensive vascularized soft-tissue infiltration, thereby supporting cell attachment. Nanostructured ceramic coatings are found to reduce the inflammatory response in favor of the formation of cell adhesive structures, that is, hemidesmosomes. Biomolecule coatings seem of particular interest to stimulate the soft-tissue behavior provided that a durable fixation to the implant surface can be ensured. In this respect, fibroblast growth factor-2 entrapped in a biomimetic apatite coating instigates a close to natural soft-tissue attachment with epidermal collagen fibers attaching almost perpendicular to the implant surface. However, several studies had limitations with respect to coating characterization and detailed soft-tissue analysis, small sample size and short implantation periods. To date, robust and long-term in vivo studies are still lacking. Further investigation is required before a clear consensus on the optimal coating system allowing enhancing the soft-tissue seal around percutaneous titanium implants can be reached.
Topics: Animals; Coated Materials, Biocompatible; Osseointegration; Porosity; Prostheses and Implants; Surface Properties; Titanium
PubMed: 35103386
DOI: 10.1002/jbm.b.35025 -
Journal of Plastic, Reconstructive &... May 2024Facial aging has long been an area of focus in esthetic surgery. It is the consequence of physiologic and environmental factors, with a trend toward non-surgical... (Review)
Review
INTRODUCTION
Facial aging has long been an area of focus in esthetic surgery. It is the consequence of physiologic and environmental factors, with a trend toward non-surgical modalities. Although volume augmentation has long been a focus of non-surgical facial rejuvenation, there is emerging interest in the use of biostimulators to induce physiologic changes in the skin. This article aimed to provide an overview of this class of therapies.
METHODS
A systematic review regarding the clinical use of biostimulatory agents including platelet-rich plasma (PRP), platelet-rich fibrin (PRF), poly-L-lactic acid (PLLA) and calcium hydroxylapatite (CaHA) in facial rejuvenation was performed using PubMed databases. The protocol was developed following the preferred reporting for items for systematic reviews-protocols guidelines. Included studies matched predetermined criteria according to the employed intervention and outcomes.
RESULTS
The systematic review was performed in September 2023, with the primary search yielding 464 articles. Abstract review resulted in 73 articles of potential relevance. Comprehensive review of the articles and manual reference checks were performed, independently, by 2 authors. This yielded a total of 45 articles that met the inclusion criteria.
CONCLUSIONS
There is an increasing role for non-surgical modalities in facial rejuvenation. Biostimulatory agents may be used as an alternative, or act as an adjunct, to other non-surgical modalities. These agents induce physiologic changes that mitigate facial aging. There is limited, quantifiable data, which fully illustrate the effect in these products. Although these agents are known to illicit inflammatory changes, more controlled studies are needed to better elucidate the biostimulatory capacity of such non-surgical treatments.
Topics: Humans; Rejuvenation; Skin Aging; Cosmetic Techniques; Face; Polyesters; Durapatite; Platelet-Rich Plasma
PubMed: 38518624
DOI: 10.1016/j.bjps.2024.02.069 -
European Review For Medical and... Jul 2022Synthetic hydroxyapatite (HA) and its related materials have made great progress in basic research and clinical application in spinal repair and reconstruction. However,... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Synthetic hydroxyapatite (HA) and its related materials have made great progress in basic research and clinical application in spinal repair and reconstruction. However, the effect of HA and its composites used in spinal fusion still remained controversial. This meta-analysis aimed at evaluating the efficacy and safety of HA compared with autologous bone.
MATERIALS AND METHODS
A systematic search in PubMed, MEDLINE, China National Knowledge Internet, EMBASE, and the Cochrane Library was conducted for relevant studies from inception until May 2021. Studies investigating the application of HA and its related composites in spinal fusion were selected for analysis.
RESULTS
The operation time of patients treated with artificial bone containing HA was less than that of patients with autologous bone (p = 0.02). The amount of operative blood loss in patients in the HA group was less than that in the autograft group (p = 0.007). Patients treated with autologous bone got a more significant advantage in fusion rate at 6 months (p = 0.009). Nevertheless, there was no significant difference in the fusion rate between patients in the two groups at 12 months or no less than 24 months postoperatively (p = 0.24; p = 0.87). Compared to the autograft group, the HA group significantly decreased postoperative adverse events (p = 0.03). Furthermore, there was no significant difference in the Oswestry Disability Index (p = 1.00) nor the Visual Analogue Scale score (p = 0.94) between the two groups.
CONCLUSIONS
This meta-analysis suggests that the clinical application of HA and its related composite materials in spinal reconstruction is comparable to that of autologous bone, with satisfactory efficacy and safety.
Topics: Bone Transplantation; Durapatite; Humans; Lumbar Vertebrae; Spinal Fusion; Spine; Treatment Outcome
PubMed: 35856351
DOI: 10.26355/eurrev_202207_29183 -
Operative Dentistry Sep 2021Functional acidic monomers are able to chemically interact with hydroxyapatite, and this bond appears to be very stable. Therefore, this aspect of the 10-MDP molecule... (Meta-Analysis)
Meta-Analysis
Does Addition of 10-MDP Monomer in Self-etch Adhesive Systems Improve the Clinical Performance of Noncarious Cervical Lesion Restorations? A Systematic Review and Meta-analysis.
BACKGROUND
Functional acidic monomers are able to chemically interact with hydroxyapatite, and this bond appears to be very stable. Therefore, this aspect of the 10-MDP molecule made it attractive and added to self-etch adhesives.
OBJECTIVES
The objective of this Systematic Review (SR) and Meta-analysis (MA) was to determine whether systems with the 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) functional monomer in their formula showed better clinical performance in restorations placed in noncarious cervical lesions (NCCL) when compared to systems without it. The PROSPERO registration number of the MA is CRD42016050538.
DATA AND SOURCES
An e-search was conducted through MEDLINE via PubMed, Cochrane Library, Scopus, Web of Science, OpenGrey, Clinical Trials, Current Controlled Trials, and EU Clinical Trials Register, and a search through the references of included studies was also performed. Randomized Controlled Clinical Trials, in which the effectiveness of self-etch adhesive systems, with or without the 10-MDP functional monomer for NCCL, was discussed, were included. Risk of bias was performed according to the Cochrane Collaboration tool, and the certainty of evidence was evaluated through GRADE.
STUDY SELECTION
The data were grouped, heterogeneity (I2) was tested, and after duplicate removal, 4208 manuscripts were retrieved. From these, 11 studies were included in the qualitative analysis (risk of bias), with nine classified as low risk and two unclear. GRADE analysis detected moderate-to-high certainty of evidence, so the quantitative synthesis [Meta-analysis (MA)] was performed including the 11 studies.
RESULTS AND CONCLUSION
There were no statistical differences in the clinical performance of restorations conducted using "with or without 10-MDP" adhesive types, for all evaluated criteria (p=0.05), with heterogeneity ranging from 0% to 53%. Thus, the presence of 10-MDP functional monomer did not influence the clinical performance of restorations placed in NCCL.
Topics: Dental Cements; Dental Restoration, Permanent; Durapatite; Methacrylates
PubMed: 35486508
DOI: 10.2341/20-053-LIT