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J Clin Periodontol. 2019 Jun;46 Suppl 21:82-91. doi: 10.1111/jcpe.13123.

Biomaterials and regenerative technologies used in bone regeneration in the craniomaxillofacial region: Consensus report of group 2 of the 15th European Workshop on Periodontology on Bone Regeneration.

Author information

1
Department of Dental Clinical Specialties and ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.
2
Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
3
Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
4
Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
5
Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
6
Centre for Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK.
7
Department Periodontology & Implantology, College of Dental Science, Radboud University Medical Center, Nijmegen, The Netherlands.
8
Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany.
9
Department of Periodontology, Johann Wolfgang Goethe-University, Frankfurt, Germany.
10
Department of Prosthetics an Oral Function, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
11
Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
12
Dental Biomaterials Research Unit (d-BRU), Department of Periodontology and Oral Surgery, University of Liège (ULiège), ULiège, Belgium.
13
Inserm, U791, Laboratory for Osteoarticular and Dental Tissue Engineering, Faculty of Dental Surgery, University of Nantes, Nantes Cedex 1, France.
14
Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Bergen, Norway.
15
Department of Oral and Maxillofacial Surgery, George-Augusta-University, Gottingen, Germany.

Abstract

BACKGROUND AND AIMS:

To review the regenerative technologies used in bone regeneration: bone grafts, barrier membranes, bioactive factors and cell therapies.

MATERIAL AND METHODS:

Four background review publications served to elaborate this consensus report.

RESULTS AND CONCLUSIONS:

Biomaterials used as bone grafts must meet specific requirements: biocompatibility, porosity, osteoconductivity, osteoinductivity, surface properties, biodegradability, mechanical properties, angiogenicity, handling and manufacturing processes. Currently used biomaterials have demonstrated advantages and limitations based on the fulfilment of these requirements. Similarly, membranes for guided bone regeneration (GBR) must fulfil specific properties and potential biological mechanisms to improve their clinical applicability. Pre-clinical and clinical studies have evaluated the added effect of bone morphogenetic proteins (mainly BMP-2) and autologous platelet concentrates (APCs) when used as bioactive agents to enhance bone regeneration. Three main approaches using cell therapies to enhance bone regeneration have been evaluated: (a) "minimally manipulated" whole tissue fractions; (b) ex vivo expanded "uncommitted" stem/progenitor cells; and (c) ex vivo expanded "committed" bone-/periosteum-derived cells. Based on the evidence from clinical trials, transplantation of cells, most commonly whole bone marrow aspirates (BMA) or bone marrow aspirate concentrations (BMAC), in combination with biomaterial scaffolds has demonstrated an additional effect in sinus augmentation and horizontal ridge augmentation, and comparable bone regeneration to autogenous bone in alveolar cleft repair.

KEYWORDS:

barrier membrane; bio-absorbable; bioactive agent; biomaterials; bone regeneration; bone replacement graft; cell therapies; guided bone regeneration; osteoconductive; osteoinductive

PMID:
31215114
DOI:
10.1111/jcpe.13123

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