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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(s) -
Sanz Mariano,
Dahlin Christer,
Apatzidou Danae,
Artzi Zvi,
Bozic Darko,
Calciolari Elena,
De Bruyn Hugo,
Dommisch Henrik,
Donos Nikos,
Eickholz Peter,
Ellingsen Jan E.,
Haugen Håvard J.,
Herrera David,
Lambert France,
Layrolle Pierre,
Montero Eduardo,
Mustafa Kamal,
Omar Omar,
Schliephake Henning
Publication year - 2019
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.13123
Subject(s) - regeneration (biology) , medicine , biomedical engineering , ex vivo , tissue engineering , periodontology , bone healing , stem cell , biomaterial , dentistry , surgery , in vivo , microbiology and biotechnology , biology
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 ( APC s) 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.