Bone Engineering Arash Khojasteh, DMD, OMFS Assistant Professor of Oral and Maxillofacial Surgery Shahid Beheshti University of Medical Sciences

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Transcription:

Bone Engineering Arash Khojasteh, DMD, OMFS Assistant Professor of Oral and Maxillofacial Surgery Shahid Beheshti University of Medical Sciences

Tissue Engineering VS Regenerative Medicine Insitu Vs Invitro Osteogenesis

Strategy for Engineered Bone Cells (Osteoblast or Osteoprogenitor) Scaffold ( synthetic or natural) Growth Factor

Dentomaxillofacial Regeneration In situ Osteogenesis Protected Healing Space Inductive agent Transfer In situ Osteogenesis Scaffold

Growth factor Therapy Cell therapy

Maxillary Sinus Augmentation Boyne PJ, Marx RE, Nevins M et al; Int J Periodontics Restorative Dent. 1997;17:11-25

Boyne PJ, Marx RE, Nevins M et al; Int J Periodontics Restorative Dent. 1997;17:11-25

Boyne PJ, Marx RE, Nevins M et al; Int J Periodontics Restorative Dent. 1997;17:11-25

Herford and PJ Boyne

Alan S. Herford. Philip J. Boyne. Rick Rawson. Roland P. Williams J Oral Maxillofac Surg 65:2136-2141, 2007

RhBMP-2 Animal Critical Size defect Study ( Wikesjo) Human studies

Animal Critical Size defect Study RhBMP-2 and ACS Clinical Oral Impl Res 1997;8 367-384

Clinical Oral Impl Res 1997;8 367-384

Protected Bone Healing with DFDBA JOMI 1997; 12: 634-642

Protected Bone Healing with DFDBA JOMI 1997; 12: 634-642

Protected Healing Space Vs Inductive transfer Clinic Oral Impl Res 2004; ; 15: 194-204

Protected Healing Space Vs Indcutive transfer Clinic Oral Impl Res 2004; ; 15: 194-204

Protected Healing Space Vs Indcutive transfer Clinic Oral Impl Res 2004; ; 15: 194-204

Protected Healing Space Vs Inductive agent transfer Clinic Oral Impl Res 2004; 15: 194-204

Simion et al. 2009

Susin et al: J Clin Periodontol 2010; 37: 574 581

Cell therapy Differentiated cell Therapy Mesenchymal Stem Cell Therapy Bone marrow aspirate therapy

Differentiated cell Therapy Spontaneous tooth eruption after alveolar cleft osteoplasty using tissue-engineered bone: a case report Oral Surg Oral Med OralPathol Oral Radiol Endod 2008;105:440-4)

Mesenchymal Stem Cell Therapy Animal Studies Human Studies

Culture

Alizarin Red Staining

RT-PCR

In vitro H&E Staining of Scaffold

Scaffold Selection Accelerated bone regeneration

SEM Analysis. HA/TCP

SEM Analysis: BioOss

Ectopic Bone Formation Investigation Application of mesenchymal stem cells in dog masseter muscle

HA/TCP

BioOss

Ectopic Bone formation in Masseter Muscle Bone Ratio (%) HA/TCP BioOss

MSCs induced bone formation in Bony defects Application of MSCs in 10 mm through and Through Defects in dog mandible

Marrow-derived mesenchymal stem cells-directed bone regeneration in the dog mandible: A comparison between biphasic calcium phosphate and natural bone mineral Jafarian M, Eslaminejad MB, Khojasteh A, Mashhadi Abbas F, Dehghan MM, Hassanizadeh R, Houshmand B. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 May;105(5):e14-24.

Scanning electron microscopy analysis HA/TCP HA/TCP

Scanning electron microscopy analysis

Dr Jafarian, Dr Khojasteh, Dr Hassanzadeh

Mesenchymal stem cells enhance bone regeneration in rat calvarial critical size defects more than platelete-rich plasma Arash Khojasteh, Mohammad reza Baghban Eslaminejad, Hamid Nazarian, Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Sep;106(3):356-62;

MSCs more than PRP

Sinus augmentation using human mesenchymal stem cells loaded into a beta tricalcium phosphate/hydroxyapatite scaffold Shayesteh YS, Khojasteh A, Soleimani M, Alikhasi M, Khoshzaban A, Ahmadbeigi N Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):203-9. Epub 2008 Apr 18.

Secondary repair of alveolar clefts using human mesenchymal stem cells Hossein Behnia, Arash Khojasteh, Masoud Soleimani, Azita Tehranchi, Ahad Khoshzaban, Saeed Hidari Keshel, Reza Atashi, PhD Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009,Aug;106(2):203-9. Epub 2008 Apr 18.

25%-34% Bone fill

Triad of Tissue Engineering JCMF, 2011

Gender Defect Type Age at surgery (Y.O) 3 months postoperative bone volume (%) F Right PMC 13 54.8 F Right PMC 8 50.8 Left PMC 48.3 M Right PMC 9 51.2 10 (Mean) 51.3 (Mean)

J.Oral Implantology 2011

Group 1(Test) Group2 P Value (control) VBL (mm) 2.09 1.03 P<0.05 BF(8 weeks)% 28.5±4.5 4.3%±1.8 P<0.05

Insitu Osteognesis Autogenous bone is the gold standard

Nano scaffolds Nanosilica HA

GEM 21s

ㅢ ML253

ID: ML253 Image analysis(cross-section) 1 2 3 4 5 6 1~2(Top) 3~4(Middle) 5~6(Bottom)

ID: ML253 Region of Interest Top Select area Top Bottom Middle Threshold; New bone area About : 5.6% Bottom Threshold; Total bone area(newbone+bonegraft) About : 27.4% => Bone volume ratio depends on the area(roi). Cross-section image

3D axis Image

Cells (Osteoblast or Osteoprogenitor) Scaffold ( synthetic or natural) Growth Factor

Strategy for Engineered Bone Scaffold Cells Biodynamic Bioreactor Pharmaceutics Clinical Application

Scaffold Key issues Stimulate cell function: bioactive factors on material surface, drug/gene in material compliance/degradation matching

Biodynamic Bioreactor Deliver nutrients and oxygen to maintain cell viability throughout scaffold media in scaffold Perfusion System Goldstein et al Biomaterials 22:1279, 2001

In situ Osteogenesis Protected Healing Space Inductive agent Transfer In situ Osteogenesis Scaffold

Protected Healing Space

Biphasic Synthetic Material As an occlusive resorptive membrane

Dr Jafarian, Dr Khojasteh, Dr Hassanzadeh

Thank you for your Consideration