In Situ Printing of Polylactic Acid/Nanoceramic Filaments for the Repair of Bone Defects Using a Portable 3D Device.

In situ 3D printing is attractive for the direct repair of bone defects in underdeveloped countries and in emergency situations. So far, the lack of an interesting method to produce filament using FDA-approved biopolymers and nanoceramics combined with a portable strategy limits the use of in situ 3D printing. Herein, we investigated the osseointegration of new nanocomposite filaments based on polylactic acid (PLA), laponite (Lap), and hydroxyapatite (Hap) printed directly at the site of the bone defect in rats using a portable 3D printer. The filaments were produced using a single-screw extruder (L/D = 26), without the addition of solvents that can promote the toxicity of the materials. In vitro performance was evaluated in the cell differentiation process with mesenchymal stem cells (MSC) by an alkaline phosphatase activity test and visualization of mineralization nodules; a cell viability test and total protein dosage were performed to evaluate cytotoxicity. For the in vivo analysis, the PLA/Lap composite filaments with a diameter of 1.75 mm were printed directly into bone defects of Wistar rats using a commercially available portable 3D printer. Based on the in vitro and in vivo results, the in situ 3D printing technique followed by rapid cooling proved to be promising for bone tissue engineering. The absence of fibrous encapsulation and inflammatory processes became a good indicator of effectiveness in terms of biocompatibility parameters and bone tissue formation, and the use of the portable 3D printer showed a significant advantage in the application of this material by in situ printing.

The incidence of osteoradionecrosis of the jaws in oral cavity cancer patients treated with intensity-modulated radiotherapy: a systematic review and meta-analysis.

OBJECTIVE: A systematic review with meta-analysis was conducted to define the incidence of osteoradionecrosis (ORN) in patients with oral cavity cancer (OCC) treated with intensity-modulated radiotherapy (IMRT), and to identify the risk factors influencing its development. STUDY DESIGN: Six databases were searched systematically. A meta-analysis was performed to determine overall, spontaneous, and dental extraction-attributed incidences of ORN. The Grading of Recommendations Assessment, Development, and Evaluation tool evaluated evidence certainty. RESULTS: Out of 11 eligible studies, 6 underwent meta-analysis for the overall aggregated ORN incidence in OCC patients receiving IMRT, resulting in an incidence rate of 8% (95% CI: 6%-11%). Regarding development reasons, 2 studies were assessed, revealing an incidence of 36% (95% CI: 1%-98%) for spontaneous ORN, and 17% (95% CI: 5%-44%) ensued from dental extraction exclusively pre-RT. All rates had very low certainty of evidence. Factors significantly correlated with ORN development included postoperative RT use (78%), employment of therapeutic doses above 50 Gy, and mandibular involvement (80.5%). CONCLUSION: The findings suggest that IMRT alone is not sufficient to decrease ORN rates in OCC patients, underscoring the importance of precisely identifying the involved risk factors. However, further detailed primary studies will be necessary.

The Local Release of Teriparatide Incorporated in 45S5 Bioglass Promotes a Beneficial Effect on Osteogenic Cells and Bone Repair in Calvarial Defects in Ovariectomized Rats.

With the increase in the population's life expectancy, there has also been an increase in the rate of osteoporosis, which has expanded the search for strategies to regenerate bone tissue. The ultrasonic sonochemical technique was chosen for the functionalization of the 45S5 bioglass. The samples after the sonochemical process were divided into (a) functionalized bioglass (BG) and (b) functionalized bioglass with 10% teriparatide (BGT). Isolated mesenchymal cells (hMSC) from femurs of ovariectomized rats were differentiated into osteoblasts and submitted to in vitro tests. Bilateral ovariectomy (OVX) and sham ovariectomy (Sham) surgeries were performed in fifty-five female Wistar rats. After a period of 60 days, critical bone defects of 5.0 mm were created in the calvaria of these animals. For biomechanical evaluation, critical bone defects of 3.0 mm were performed in the tibias of some of these rats. The groups were divided into the clot (control) group, the BG group, and the BGT group. After the sonochemical process, the samples showed modified chemical topographic and morphological characteristics, indicating that the surface was chemically altered by the functionalization of the particles. The cell environment was conducive to cell adhesion and differentiation, and the BG and BGT groups did not show cytotoxicity. In addition, the experimental groups exhibited characteristics of new bone formation with the presence of bone tissue in both periods, with the BGT group and the OVX group statistically differing from the other groups (p < 0.05) in both periods. Local treatment with the drug teriparatide in ovariectomized animals promoted positive effects on bone tissue, and longitudinal studies should be carried out to provide additional information on the biological performance of the mutual action between the bioglass and the release of the drug teriparatide.