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Calcified Tissue International Oct 2017The aim of this study was to evaluate the morphological bone response in animal experiments by applying hydroxyapatite grafts in critical and non-critical size bone... (Review)
Review
The aim of this study was to evaluate the morphological bone response in animal experiments by applying hydroxyapatite grafts in critical and non-critical size bone defects. Current report followed the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Animal experiments were selected by assessing repair of bone defects with hydroxyapatite as bone graft and with blood clot only as control. Eight articles were identified in specialized literature and included in the meta-analysis. Statistical analysis was carried out with a random-effect model (p = 0.05). Subgroup analyses were further performed to investigate bone repair in critical and non-critical bone defects. Comprehensive analysis of bone repair outcome showed a statistically significant difference between hydroxyapatite and blood clot control (p < 0.05). Subgroup analyses showed statistically significant difference for critical bone defects (p < 0.05). No statistically significant difference was reported in non-critical bone defects (p > 0.05). Although animal studies revealed a high risk of bias and results should be interpreted with caution, the literature suggests that non-critical bone defects may heal spontaneously and without the need of a bone graft. Conversely, when critical-size defects are present, the use of hydroxyapatite bone graft improves the bone repair process.
Topics: Animals; Bone Substitutes; Bone Transplantation; Durapatite
PubMed: 28612084
DOI: 10.1007/s00223-017-0294-z -
Materials Science & Engineering. C,... Jul 2017Strategies to achieve dentin remineralization is at present an important target of restorative dentistry. Remineralization of dentin by a bioactive material is complete... (Review)
Review
BACKGROUND AND OBJECTIVES
Strategies to achieve dentin remineralization is at present an important target of restorative dentistry. Remineralization of dentin by a bioactive material is complete only when the tissue regains its functionality. This is achieved when there is adequate apatite formation which most importantly translates into improved mechanical properties of dentin as a result of intrafibrillar mineralization. Bioactive glass (BAG) is a well-known implant material for bone regeneration and is proven to have excellent ability of apatite formation. Hence, recent studies have proposed BAGs as one of the most desired materials for remineralization of dentin. Therefore the aim of this systematic review was to scope the evidence of bioactive glass to remineralize dentin.
METHODS
The following research question was formulated: "Is there strong evidence for bioactive glass to remineralize dentin?" Three databases (Web of science, PubMed and Science direct) were scanned independently following PRISMA guidelines. Inclusion and exclusion criteria were set to identify relevant articles based on title and abstract screening. Finally, potentially relevant articles were downloaded and the full text was scrutinized to select the articles included in this review.
RESULTS
The first phase of search returned 303 articles. A total of 19 papers with full text were scrutinized for inclusion, of which 3 papers were chosen for the final synthesis. All three studies confirm that BAG treatment leads to enhanced apatite formation in dentin. Only 1 of the 3 studies has reported the mechanical properties of dentin after BAG treatment and it revealed that the Young's modulus and flexural bend strength of BAG treated dentin were much lower than natural dentin even though they had similar apatite content.
CONCLUSIONS
This review highlights the importance of assessing the mechanical properties of dentin alongside to the newly formed apatite content in order to prove BAGs efficiency to remineralize this tissue. Though studies have confirmed that BAGs stimulate excellent apatite formation in dentin, it should be concluded that there isn't sufficient evidence for bioactive glass to effectively remineralize this tissue as the mechanical properties of the BAG treated dentin haven't been well explored.
Topics: Apatites; Dental Materials; Dentin; Glass; Humans; Tooth Remineralization
PubMed: 28482504
DOI: 10.1016/j.msec.2017.03.083 -
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 -
The Cochrane Database of Systematic... Nov 2016Anophthalmia is the absence of one or both eyes, and it can be congenital (i.e. a birth defect) or acquired later in life. There are two main types of orbital implant:... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Anophthalmia is the absence of one or both eyes, and it can be congenital (i.e. a birth defect) or acquired later in life. There are two main types of orbital implant: integrated, whereby the implant receives a blood supply from the body that allows for the integration of the prosthesis within the tissue; and non-integrated, where the implant remains separate. Despite the remarkable progress in anophthalmic socket reconstruction and in the development of various types of implants, there are still uncertainties about the real roles of integrated (hydroxyapatite (HA), porous polyethylene (PP), composites) and non-integrated (polymethylmethacrylate (PMMA)/acrylic and silicone) orbital implants in anophthalmic socket treatment.
OBJECTIVES
To assess the effects of integrated versus non-integrated orbital implants for treating anophthalmic sockets.
SEARCH METHODS
We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2016), Embase (January 1980 to August 2016), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to August 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 8 August 2016.
SELECTION CRITERIA
Randomised controlled trials (RCTs) and quasi-RCTs of integrated and non-integrated orbital implants for treating anophthalmic sockets.
DATA COLLECTION AND ANALYSIS
Two authors independently selected relevant trials, assessed methodological quality and extracted data.
MAIN RESULTS
We included three studies with a total of 284 participants (250 included in analysis). The studies were conducted in India, Iran and the Netherlands. The three studies were clinically heterogenous, comparing different materials and using different surgical techniques. None of the included studies used a peg (i.e. a fixing pin used to connect the implant to the prosthesis). In general the trials were poorly reported, and we judged them to be at unclear risk of bias.One trial compared HA using traditional enucleation versus alloplastic implantation using evisceration (N = 100). This trial was probably not masked. The second trial compared PP with scleral cap enucleation versus PMMA with either myoconjunctival or traditional enucleation (N = 150). Although participants were not masked, outcome assessors were. The last trial compared HA and acrylic using the enucleation technique (N = 34) but did not report comparative effectiveness data.In the trial comparing HA versus alloplastic implantation, there was no evidence of any difference between the two groups with respect to the proportion of successful procedures at one year (risk ratio (RR) 1.02, 95% confidence interval (CI) 0.95 to 1.09, N = 100, low-certainty evidence). People receiving HA had slightly worse horizontal implant mobility compared to the alloplastic group (mean difference (MD) -3.35 mm, 95% CI -4.08 to -2.62, very low-certainty evidence) and slightly worse vertical implant motility (MD -2.76 mm, 95% CI -3.45 to -2.07, very low-certainty evidence). As different techniques were used - enucleation versus evisceration - it is not clear whether these differences in implant motility can be attributed solely to the type of material. Investigators did not report adverse events.In the trial comparing PP versus PMMA, there was no evidence of any difference between the two groups with respect to the proportion of successful procedures at one year (RR 0.92, 95% CI 0.84 to 1.01, N = 150, low-certainty evidence). There was very low-certainty evidence of a difference in horizontal implant motility depending on whether PP was compared to PMMA with traditional enucleation (MD 1.96 mm, 95% CI 1.01 to 2.91) or PMMA with myoconjunctival enucleation (-0.57 mm, 95% CI -1.63 to 0.49). Similarly, for vertical implant motility, there was very low-certainty evidence of a difference in the comparison of PP to PMMA traditional (MD 3.12 mm 95% CI 2.36 to 3.88) but no evidence of a difference when comparing PP to PMMA myoconjunctival (MD -0.20 mm 95% CI -1.28 to 0.88). Four people in the PP group (total N = 50) experienced adverse events (i.e. exposures) compared to 6/100 in the PMMA groups (RR 17.82, 95% CI 0.98 to 324.67, N = 150, very low-certainty evidence).None of the studies reported socket sphere size, cosmetic effect or quality of life measures.
AUTHORS' CONCLUSIONS
Current very low-certainty evidence from three small published randomised controlled trials did not provide sufficient evidence to assess the effect of integrated and non-integrated material orbital implants for treating anophthalmic sockets. This review underlines the need to conduct further well-designed trials in this field.
Topics: Anophthalmos; Durapatite; Eye Enucleation; Eye Evisceration; Humans; Orbital Implants; Polyethylene; Polymethyl Methacrylate; Prosthesis Design; Prosthesis Implantation; Randomized Controlled Trials as Topic
PubMed: 27820878
DOI: 10.1002/14651858.CD010293.pub2 -
Aesthetic Surgery Journal Jun 2016Despite its increasing usage of facial applications, there is a paucity of objective data regarding calcium hydroxylapatite (CaHA). (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Despite its increasing usage of facial applications, there is a paucity of objective data regarding calcium hydroxylapatite (CaHA).
OBJECTIVES
To systematically evaluate the complications from CaHA injection for facial soft tissue augmentation.
METHODS
Published studies on CaHA injection for facial soft tissue enhancement were identified through searches of the PubMed, EMBASE, and Cochrane Controlled Trial databases. Only randomized, controlled trials comparing CaHA injection to either placebo or an active comparator for facial cosmetic use were included. The outcome measures were the count (n) and frequency (%) of each complication, including edema (swelling), erythema (redness), ecchymosis (bruising), pain, pruritus (itching), hematomas, nodules, and extrusions.
RESULTS
Four studies on nasolabial fold (NLF) injection of CaHA consisting of two subgroups were included: (i) a CaHA-lidocaine vs CaHA subgroup and (ii) a CaHA vs hyaluronic acid (HA) subgroup. The addition of lidocaine to CaHA therapy displayed no significant effect on edema (RR (95% CI): 1.07 (0.94-1.21), P = .311), erythema (RR (95% CI): 0.91 (0.66-1.24), P = .544), ecchymosis (RR (95% CI): 1.04 (0.71-1.52), P = .843), pain (RR (95% CI): 0.88 (0.58-1.33), P = .553), or pruritus (RR (95% CI): 0.82 (0.45-1.50), P = .515). There was no significant difference between CaHA vs HA for hematomas (RR (95% CI): 0.24 (0.01-4.31), P = .332) or nodules (RR (95% CI): 0.18 (0.01-6.62), P = .353). There was no significant publication bias detected in either subgroup (Begg's test P > 0.05).
CONCLUSIONS
These findings support the addition of lidocaine to NLF injection of CaHA and suggest an equivalence between CaHA and HA with respect to hematoma and nodule formation. LEVEL OF EVIDENCE 2: Risk.
Topics: Anesthetics, Local; Biocompatible Materials; Cosmetic Techniques; Durapatite; Humans; Injections; Lidocaine; Nasolabial Fold; Pain; Randomized Controlled Trials as Topic; Skin Aging
PubMed: 27178901
DOI: 10.1093/asj/sjv206 -
Journal of Cranio-maxillo-facial... Apr 2016To delineate the best procedures for increasing osseointegration in cranio-maxillo-facial surgery using nano-sized calcium phosphate coatings on titanium patient... (Review)
Review
OBJECTIVE
To delineate the best procedures for increasing osseointegration in cranio-maxillo-facial surgery using nano-sized calcium phosphate coatings on titanium patient specific implants.
MATERIALS AND METHODS
A multi-database single-reviewer systematic literature review was conducted.
RESULTS
Twenty-eight papers consisting of twenty-five animal studies and three human studies met the selection criteria. The results of existing literature suggest that titanium implants coated with nano calcium phosphate and hydroxyapatite improves osseointegration and implant fixation. However, not all coating techniques enhance biofunctionalization. Factors including implant microroughness, coating thickness, calcium phosphate solubility, and nanotopography contribute significantly to biofunctionalization. Nonetheless, additional data derived from clinical studies are needed to support this statement, as well as the possible influence of routine autoclaving procedures.
Topics: Animals; Calcium Phosphates; Coated Materials, Biocompatible; Dental Implantation, Endosseous; Dental Implants; Durapatite; Humans; Nanoparticles; Osseointegration; Surface Properties; Titanium
PubMed: 26857757
DOI: 10.1016/j.jcms.2015.12.004 -
International Journal of Molecular... Mar 2015This study aimed to review the laboratory methods on biomimetic remineralization of demineralized human dentine. A systematic search of the publications in the PubMed,... (Review)
Review
This study aimed to review the laboratory methods on biomimetic remineralization of demineralized human dentine. A systematic search of the publications in the PubMed, TRIP, and Web of Science databases was performed. Titles and abstracts of initially identified publications were screened. Clinical trials, reviews, non-English articles, resin-dentine interface studies, hybrid layer studies, hybrid scaffolds studies, and irrelevant studies were excluded. The remaining papers were retrieved with full texts. Manual screening was conducted on the bibliographies of remaining papers to identify relevant articles. A total of 716 studies were found, and 690 were excluded after initial screening. Two articles were identified from the bibliographies of the remaining papers. After retrieving the full text, 23 were included in this systematic review. Sixteen studies used analogues to mimic the functions of non-collagenous proteins in biomineralization of dentine, and four studies used bioactive materials to induce apatite formation on demineralized dentine surface. One study used zinc as a bioactive element, one study used polydopamine, and another study constructed an agarose hydrogel system for biomimetic mineralization of dentine. Many studies reported success in biomimetic mineralization of dentine, including the use of non-collagenous protein analogues, bioactive materials, or elements and agarose hydrogel system.
Topics: Acrylic Resins; Biocompatible Materials; Biomimetic Materials; Biomimetics; Calcium Phosphates; Dental Cements; Dentin; Humans; Tooth Remineralization
PubMed: 25739078
DOI: 10.3390/ijms16034615