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

Mariano Sanz*, Christer Dahlin, Danae Apatzidou, Zvi Artzi, Darko Bozic, Elena Calciolari, Hugo De Bruyn, Henrik Dommisch, Nikos Donos, Peter Eickholz, Jan E. Ellingsen, Håvard J. Haugen, David Herrera, France Lambert, Pierre Layrolle, Eduardo Montero, Kamal Mustafa, Omar Omar, Henning Schliephake

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)82-91
Number of pages10
JournalJournal of Clinical Periodontology
Volume46
Issue numberS21
DOIs
StatePublished - Jun 2019

Keywords

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

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