Traditionally, bioactive glasses have been used to fill and restore bone defects. More recently, this category of biomaterials has become an emerging research field for bone tissue engineering applications. Here, we review and discuss current knowledge on porous bone tissue engineering scaffolds on the basis of melt-derived bioactive silicate glass compositions and relevant composite structures. Starting with an excerpt on the history of bioactive glasses, as well as on fundamental requirements for bone tissue engineering scaffolds, a detailed overview on recent developments of bioactive glass and glass-ceramic scaffolds will be given, including a summary of common fabrication methods and a discussion on the microstructural-mechanical properties of scaffolds in relation to human bone (structure-property and structure-function relationship). In addition, ion release effects of bioactive glasses concerning osteogenic and angiogenic responses are addressed. Finally, areas of future research are highlighted in this review.

https://pure.tue.nl/ws/files/3034662/Metis245608.pdf

Bioactive Glass and Glass-Ceramic Scaffolds for Bone Tissue Engineering

Bone substitutes are being increasingly used in surgery as over two millions bone grafting procedures are performed worldwide per year. Autografts still represent the gold standard for bone substitution, though the morbidity and the inherent limited availability are the main limitations. Allografts, i.e. banked bone, are osteoconductive and weakly osteoinductive, though there are still concerns about the residual infective risks, costs and donor availability issues. As an alternative, xenograft substitutes are cheap, but their use provided contrasting results, so far. Ceramic-based synthetic bone substitutes are alternatively based on hydroxyapatite (HA) and tricalcium phosphates, and are widely used in the clinical practice. Indeed, despite being completely resorbable and weaker than cortical bone, they have exhaustively proved to be effective. Biomimetic HAs are the evolution of traditional HA and contains ions (carbonates, Si, Sr, Fl, Mg) that mimic natural HA (biomimetic HA). Injectable cements represent another evolution, enabling mininvasive techniques. Bone morphogenetic proteins (namely BMP2 and 7) are the only bone inducing growth factors approved for human use in spine surgery and for the treatment of tibial nonunion. Demineralized bone matrix and platelet rich plasma did not prove to be effective and their use as bone substitutes remains controversial. Experimental cell-based approaches are considered the best suitable emerging strategies in several regenerative medicine application, including bone regeneration. In some cases, cells have been used as bioactive vehicles delivering osteoinductive genes locally to achieve bone regeneration. In particular, mesenchymal stem cells have been widely exploited for this purpose, being multipotent cells capable of efficient osteogenic potential. Here we intend to review and update the alternative available techniques used for bone fusion, along with some hints on the advancements achieved through the experimental research in this field.

/pdf/bone-substitutes-in-orthopaedic-surgery-from-basic-science-1n4hkut079.pdf

Bone substitutes in orthopaedic surgery: from basic science to clinical practice

It has been suggested that the provision of dental implants can improve the oral function of subjects with severely resorbed mandibles, possibly restoring function to the level experienced by satisfied wearers of conventional complete dentures. Nevertheless, a quantitative comparison has never been made and can be drawn from the literature only with difficulty, since studies differ greatly in methodology. To make such a comparison, we measured bite force and chewing efficiency by using identical methods in subjects with overdentures, complete full dentures, and natural dentitions. Our results indicated that bite forces achieved with overdentures on dental implants were between those achieved with artificial and natural dentitions. Chewing efficiency was significantly greater than that of subjects with full dentures (low mandible), but was still lower than that of subjects with full dentures (high mandible) and overdentures on bare roots. Differences in the height of the mandible revealed significant differences in chewing efficiency between the two full-denture groups. Furthermore, subjects with a shortened dental arch exerted bite forces similar to those of subjects with a complete-natural dentition, but their chewing efficiency was limited due to the reduced occlusal area. For all groups combined, a significant correlation was found between maximum bite force and chewing efficiency. Nearly half of the variation in chewing efficiency was explained by bite force alone.

Biting and Chewing in Overdentures, Full Dentures, and Natural Dentitions

Sol-gel based materials for biomedical applications

https://pure.mpg.de/pubman/item/item_2225903_3/component/file_2261322/2225903.pdf

Calcium phosphates in biomedical applications: materials for the future?

Masticatory efficiency, oral function and degree of satisfaction with the treatment received were analysed in a group of fully edentulous patients with severe atrophy of the mandibular bone, rehabilitated with complete removable dentures, before and after anchoring the dentures to osseointegrated implants. Masticatory efficiency increased significantly and chewing cycles increased in amplitude after anchoring the denture. The component of the chewing cycle that most influenced the increase in functional area was the lateral one. A correlation was found between the increase in the lateral component of the chewing cycle and the increased masticatory efficiency achieved with implant-anchored dentures. The degree of satisfaction with their rehabilitation reported by the subjects was correlated neither to increased masticatory efficiency nor to improved oral function.

Implant anchored complete mandibular denture: evaluation of masticatory efficiency, oral function and degree of satisfaction

PURPOSE The aim of this study was to compare the marginal adaptation of metal-ceramic crowns made with 3 different metal substructures MATERIALS AND METHODS Seventy-five gypsum dies were fabricated from a master steel die They were randomly divided into 3 groups of 25 dies each A metal coping was prepared on each die using a different technique for each group: composite alloy, electroforming, and cast high-noble alloy Ceramic was baked on all of the samples following the same protocol and simulating the shape and size of a maxillary central incisor All specimens were evaluated under a stereomicroscope at 200x magnification The marginal gap was measured at 8 different points on each specimen before and after ceramic application and also on the master steel die A total of 3,600 measurements was evaluated The results were statistically elaborated by means of a t test and one-way analysis of variance (ANOVA) RESULTS The ANOVA revealed a significant difference in mean marginal gap before and after ceramic application within each group Electroforming (mean 32 microns) and high-noble alloy (mean 31 microns) showed better marginal fit after ceramic application and on the master steel die compared to composite alloy (mean 68 microns; P < 00001) CONCLUSION Marginal gaps are influenced by the application of ceramic and by the alloy used for the substructure, and the values obtained were within the limits of clinical acceptability (70 microns)

Comparison of marginal fit of 3 different metal-ceramic systems: an in vitro study.

Mandibular bone density, vertebral density and resorption of the edentulous ridge were correlated in a group of 17 partially edentulous subjects.Bone density was quantified by Quantitative Computerized Tomography; resorption was evaluated on panoramic radiographs. Mean bone density in dentate areas was significantly higher than that in edentulous areas; mandibular bone density was not found to relate significantly to vertebral bone density, nor to ridge resorption. In programming osseointegrated implants in the partially edentulous mandible, CT may give a more accurate evaluation of trabecular bone. However, further studies are necessary to clarify its clinical utility.

Bone density in human dentate and edentulous mandibles using computed tomography.

Study Design.A systematic review of scientific literature.Objective.The study aimed to determine whether bone morphogenetic proteins (BMPs) are more effective in treating bone defects than traditional techniques, such as grafting autologous bone.Summary of Background Data.BMPs were used in several h

Bone morphogenetic proteins and bone defects: a systematic review.

Purpose: To evaluate the success rate of immediately loaded conventional implants placed in the premaxilla in association with 2 zygomatic implants. Materials and Methods: All patients included had worn complete maxillary dentures for at least 2 years. They were required to have no severe systemic pathologies and could not be on any drugs. They could not have any oral infection, uncontrolled periodontal disease, sinusitis, parafunctional signs, alteration of the occlusal plane, or smoking habits. They had to be good candidates for the insertion of 4 or 5 traditional implants in the premaxilla and 2 zygomatic implants without guided bone regeneration. Primary stability had to be achieved. Impressions for prosthetic rehabilitation were made during first-stage surgery. Temporary fixed cross-arch prostheses were inserted 12 to 24 hours after surgery. Permanent cross-arch screw-retained prostheses were placed after 6 months. Results: Seven patients met all the inclusion criteria and were enrolled in the study (Caucasian, 4 males and 3 females, mean age 56.8 years). In total, 14 zygomatic and 34 conventional implants were placed. The survival rate for zygomatic and conventional implants and fixed prostheses was 100% after 24 months of functional loading. Conclusion: The preliminary results are encouraging, but the long-term clinical prognosis remains to be determined. (Case Series) INT J ORAL MAXILLOFAC IMPLANTS 2008;23:308‐314

/pdf/immediate-loading-of-maxillary-fixed-prostheses-retained-by-4omfoug33u.pdf

Immediate loading of maxillary fixed prostheses retained by zygomatic and conventional implants: 24-month preliminary data for a series of clinical case reports.

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