Amorphous Precursor-Mediated Calcium Phosphate Coatings with Tunable Microstructures for Customized Bone Implants.

Calcium phosphate (CaP) is frequently used as coating for bone implants to promote osseointegration. However, commercial CaP coatings via plasma spraying display similar microstructures, and thus fail to provide specific implants according to different surgical conditions or skeletal bone sites. Herein, inspired by the formation of natural biominerals with various morphologies mediated by amorphous precursors, CaP coatings with tunable microstructures mediated by an amorphous metastable phase are fabricated. The microstructures of the coatings are precisely controlled by both polyaspartic acid and Mg2+ . The cell biological behaviors, including alkaline phosphatase activity, mineralization, and osteogenesis-related genes expression, on the CaP coatings with different microstructures, exhibit significant differences. Furthermore, in vivo experiments demonstrate the osseointegration in different types of rats and bones indeed favors different CaP coatings. This biomimetic strategy can be used to fabricate customized bone implants that can meet the specific requirements of various surgery conditions.

Triggering receptor expressed on myeloid cells-2 stimulates osteoclast differentiation and bone loss in periodontitis.

OBJECTIVE: To investigate the expression of triggering receptor expressed on myeloid cells 2 (TREM-2) in the healthy and diseased tissue, including gingivitis or periodontitis, and then to assess whether it has an impact on the development of periodontitis. METHODS AND MATERIALS: The gingival tissues from healthy controls, gingivitis, and periodontitis underwent hematoxylin-eosin and immunohistochemical staining, and the association of TREM-2 expression or TREM-2+ cell counts with clinical parameters was assessed. An anti-TREM-2 antibody was used to block the osteoclastogenesis in vitro and during the experimental periodontitis by injection into the gingiva. The relative gene expression of TREM-2 in different gingival tissues was analyzed by quantitative PCR. RESULTS: In the gingival tissues of periodontitis, TREM-2 expression and TREM-2+ cell counts were significantly higher than those of gingivitis and healthy controls (p<0.05). In the group of periodontitis showing moderate signs, the gingival tissues displayed significantly lower TREM-2 expression, in contrast with the group with advanced periodontal symptoms (p < 0.05). Consistently, blocking TREM-2 significantly decreased osteoclast formation both in vitro and in vivo (p < 0.05). CONCLUSION: Increased TREM-2 expression and TREM-2+ cells were positively associated with the development of periodontitis. Osteoclast differentiation and stimulating alveolar bone loss were partly relied on TREM-2, which could be a target to be blocked for attenuating osteoclastogenesis in periodontitits.

Tilted implantation technique for edentulous patients.

The tilted implantation technique is characterized by placing the implant at an angle of more than 15° and less than 45° from the horizontal plane. This technique can avoid damaging the maxillary sinus, inferior alveolar nerve, nasal base, and other anatomical structures when the height of the upper and lower jaw available bone is insufficient, to maximize the use of available bone and avoid a large range of bone increment. The tilted implantation technique can reduce the trauma of the surgery, increase the possibility of immediate restoration and shorten the treatment cycle, which has been widely used clinically. In this review, the scope of application, design elements, design scheme and complications of the tilted implantation technique for edentulous patients will be described.

[Criteria for success in dental implants].

With the comprehensive application and development of implant dentistry in recent years, multi-institutional data have supported a large number of clinical research findings. A consensus was gradually reached on the evaluation of the state and effect of implants and types of indicators that were selected after restoration. This study aims to examine the frequently used criteria to define treatment success in implant dentistry.

[Protective effects of hydrogen-rich medium on lipopolysaccharides-induced injury in human periodontal ligament cells].

OBJECTIVE: In this study, lipopolysaccharides (LPS) was used to damage human periodontal ligament cells (hPDLCs) and consequently investigate the protective effects of hydrogen on reducing oxidative stress and cell apoptosis rate. METHODS: hPDLCs were isolated, and then cultured with normal medium+1 µg·mL⁻¹ LPS or with hydrogen-rich medium+
1 µg·mL⁻¹ LPS. Cell proliferation activity was assessed using a cell counting kit-8 (CCK-8), and lactic dehydrogenase (LDH) release was also detected. The activities of superoxide dismutase (SOD) and catalase (CAT), and the level of malonaldehyde (MDA) in supernatants were also measured. Cell apoptosis was detected by flow cytometry at 24 h after LPS stimulation. RESULTS: CCK-8 results showed that hydrogen could significantly improve hPDLCs growth and decrease cell apoptosis under LPS stimulation (P<0.05). However, no significant difference in LDH release was found between the two groups. The CAT levels significantly increased at 6 and 12 h in the hydrogen-rich medium as compared with the normal medium group (P<0.05, P<0.01, respectively). However, SOD levels were not significant different at each time point. At 6 h after LPS stimulation, the MDA levels in the cell supernatant of hydrogen-rich medium group were significantly reduced as compared with those in the normal medium group (P<0.05). CONCLUSIONS: The hydrogen-rich medium can effectively improve hPDLCs proliferation activity and antioxidant capacity and reduce apoptosis and oxidative stress under LPS stimulation.

Role of CD133+ cells in tongue squamous carcinomas: Characteristics of 'stemness' in vivo and in vitro.

The objective of the present study was to determine the 'stemness' characteristics of CD133+ cells (harvested from the squamous cell tongue carcinoma Tca-8113 cell line) in vitro and to observe the tumourigenicity of the CD133+ cells in the bodies of NOD/SCID mice. Single cells from the Tca-8113 cell line were observed for multiplication capacity in vitro. The suspending and pelletizing phenomena of Tca-8113 cells in vitro were also observed, and the expression of CD133 in squamous cell carcinoma of the tongue was measured. The CD133+ cells from the Tca-8113 cell line were purified, and their multiplication capacity and differentiation potency were observed. The NOD/SCID mouse model was established, and the tumourigenicity of the CD133+ cells was determined. The Tca-8113 cells were observed to emerge in the form of suspending tumour spheres in squamous cell carcinoma of the tongue. Monoplasts with sustainable multiplication capacity accounted for ~5.32% of the spheres, and 0.95% of the CD133+ cells were expressed in squamous cell carcinoma of the tongue, with stronger multiplication capacity and differentiation potency in vitro. Stronger tumourigenicity was also observed in the bodies of the NOD/SCID mice. CD133- cells exhibited a multiplication capacity to a certain extent. Overall, the CD133+ cells in squamous cell carcinoma of the tongue are characterised by relatively strong tumourigenicity capacity in vivo and in vitro. To a certain extent, these CD133+ cells demonstrate the characteristics of 'stemness'.

BM-MSCs and Bio-Oss complexes enhanced new bone formation during maxillary sinus floor augmentation by promoting differentiation of BM-MSCs.

Bone marrow-derived mesenchymal stem cells (BM-MSCs) have been recognized as a new strategy for maxillary sinus floor elevation. However, little is known concerning the effect of the biomechanical pressure (i.e., sinus pressure, masticatory pressure, and respiration) on the differentiation of BM-MSCs and the formation of new bone during maxillary sinus floor elevation. The differentiation of BM-MSCs into osteoblasts was examined in vitro under cyclic compressive pressure using the Flexcell® pressure system, and by immunohistochemical analysis, qRT-PCR, and Western blot. Micro-CT was used to detect bone formation and allow image reconstruction of the entire maxillary sinus floor elevation area. Differentiation of BM-MSCs into osteoblasts was significantly increased under cyclic compressive pressure. The formation of new bone was enhanced after implantation of the pressured complex of BM-MSCs and Bio-Oss during maxillary sinus floor elevation. The pressured complex of BM-MSCs and Bio-Oss promoted new bone formation and maturation in the rabbit maxillary sinus. Stem cell therapy combined with this tissue engineering technique could be effectively used in maxillary sinus elevation and bone regeneration.

S100A4 upregulation suppresses tissue ossification and enhances matrix degradation in experimental periodontitis models.

AIM: S100A4, also known as fibroblast-specific protein 1 or metastasin 1, is not only highly expressed in growth-stimulated cultured cells and metastatic tumor cells, but also in the periodontal ligament. The aim of this study was to investigate the roles of S100A4 in the pathogenesis of periodontitis and its regulatory mechanisms in inflammatory milieu. METHODS: Experimental periodontitis was induced in rats by submarginal silk ligatures. TRAP activity and S100A4 expression in periodontal ligaments were examined using immunohistochemistry and immunofluorescence methods. IL-1ß-treated human periodontal ligament cells (hPDLCs) were used as in vitro model of experimental periodontitis. S100A4 mRNA and protein were assessed using qRT-PCR and Western blot, respectively. hPDLCs were transfected with either S100A4 overexpression plasmids or shRNAs plasmids. The mineralization in hPDLCs was evaluated with a 12-d osteogenic induction assay, and the expression of ALP, OCN, MMP-2 and MMP-13 was analyzed by qRT-PCR. RESULTS: In the periodontal ligaments of rats with experimental periodontitis, TRAP activity and S100A4 protein staining were considerably more intense compared with those in the control rats. Treatment of hPDLCs with IL-1ß (10, 50 and 100 ng/mL) dose-dependently increased the mRNA and protein levels of S100A4. Transfection with shRNAs markedly increased mineralized nodule formation and the osteogenic-related markers ALP and OCN levels in hPDLCs, whereas the overexpression of S100A4 significantly reduced mineralized nodule formation, and increased the matrix degradation enzymes MMP-2 and MMP-13 levels in hPDLCs. CONCLUSION: S100A4 is upregulated in the experimental rat periodontitis and in IL-1ß-treated hPDLCs, where S100A4 suppresses osteogenic differentiation and enhances matrix degradation. Thus, S100A4 is a potential target for the treatment of periodontitis.

Comparison of tissue-engineered bone from different stem cell sources for maxillary sinus floor augmentation: a study in a canine model.

PURPOSE: To compare the potential of tissue-engineered bone derived from different stem cell sources for canine maxillary sinus augmentation. MATERIALS AND METHODS: Bilateral maxillary sinus floor augmentations were performed in 6 beagles and were randomly repaired with 3 graft types: Bio-Oss granules alone (n = 4; group A), a complex of osteoblasts derived from bone marrow mesenchymal stem cells (BMMSCs) and Bio-Oss (n = 4; group B), and a complex of osteoblasts derived from periodontal ligament stem cells (PDLSCs) and Bio-Oss (n = 4; group C). After 12 weeks, fluorescent labeling, maxillofacial computed tomography, scanning electron microscopy, and histologic and histomorphometric analyses were used to evaluate new bone deposition, mineralization, and remodeling in the augmented area. RESULTS: The osteogenic capacity was greater in groups B and C than in group A. The level tended to be higher in group C than in group B; however, the difference was not statistically significant. CONCLUSIONS: Seeding of PDLSCs or BMMSCs onto Bio-Oss can promote bone formation and mineralization and maintain the maximum volume of the augmented maxillary sinus. These tissue-engineered bone complexes might be a good option for augmentation of the maxillary sinus in edentulous patients.

Periodontal ligament versus bone marrow mesenchymal stem cells in combination with Bio-Oss scaffolds for ectopic and in situ bone formation: A comparative study in the rat.

The aim of this study was to compare the osteogenic effects of periodontal ligament stem cells (PDLSCs) versus bone marrow mesenchymal stem cells (BMMSCs) in combination with Bio-Oss scaffolds on subcutaneous and critical-size defects in the immunodeficient rat calvarium. PDLSCs and BMMSCs were obtained from the same canine donor. Twenty-four rats were randomly assigned to one of four experimental groups (n = 6 each): group A (no-graft negative control), group B (Bio-Oss positive control), group C (BMMSC/Bio-Oss test group), and group D (PDLSC/Bio-Oss test group). Eight weeks post-transplantation, ectopic and in situ bone regeneration was evaluated by micro-computed tomography (µ-CT), histology, histomorphometry, and immunohistochemistry. The stem cell/Bio-Oss constructs were significantly superior to the controls in terms of their ability to promote osteogenesis (p < 0.01), while the PDLSC/Bio-Oss construct tended to be superior to the BMMSC/Bio-Oss construct. Thus, engineered stem cell/Bio-Oss complexes can successfully reconstruct critical-size defects in rats, and PDLSCs and BMMSCs are both suitable as seed cells.

Hypoxia-inducible factor-1α overexpression indicates poor clinical outcomes in tongue squamous cell carcinoma.

The aim of the present study was to investigate the expression of hypoxia-inducible factor-1α (HIF-1α) in tongue squamous cell carcinoma (TSCC) and to assess its possible impact on prognosis. A total of 49 tumor samples and 15 adjacent non-tumor samples from 49 patients treated between January 2000 and December 2005 at the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Tongji University (Shanghai, China) were obtained for investigation with immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). The expression of HIF-1α was detected in 87.76% (43/49) of the TSCC samples and in 33.33% (5/15) of the adjacent non-tumor tissues. The expression of vascular endothelial growth factor (VEGF) was also observed in 83.67% (41/49) of the TSCC samples and in only 20% (3/15) of the adjacent non-tumor samples at a low level. RT-PCR revealed that the mRNA expression of HIF-1α and VEGF was present in the tumor tissues; however, it was barely detected in the corresponding adjacent normal tissues. The overexpression of HIF-1α was significantly associated with T classification (P=0.01), lymphatic metastasis (P=0.05) and histological differentiation (P<0.001). Furthermore, HIF-1α overexpression was significantly associated with poor overall (P=0.001) and disease-free survival rates (P=0.01), independent of T stage and lymphatic metastasis. The Cox proportional hazards regression model demonstrated that the level of HIF-1α expression may be an independent prognostic factor for TSCC. HIF-1α overexpression was observed in TSCC and its overexpression suggests a poor prognosis. HIF-1α may be a molecular marker for predicting the prognosis of TSCC.

Treatment of postburn anteriorly located neck contractures with local flaps.

OBJECTIVE: The objective of this study was to summarize our experience of using local flaps for the reconstruction of neck defects after cervical contractures release, particularly of using the extended deltopectoral flaps whose distal margin was beyond the anterior axillary line even reaching dorsalis for reconstruction of anterior neck scar contractures in a single-stage procedure. METHODS: From 1987 to 2008, neck scar contractures were reconstructed using various local flaps in 68 patients with postburn anteriorly located neck contractures. The local flaps used consisted of 36 deltopectoral flaps, 6 extended deltopectoral flaps, 4 free scapular flaps, 8 neck-shoulder flaps, and 14 Z-plasties. The distal end of extended deltopectoral flaps was transferred as microvascular-free flap provided by the posterior circumflex humeral artery, but the proximal end as pedicle flap supplied by the anterior perforating branches of internal mammary artery. Other flaps were elevated conventionally as described previously in the articles. RESULTS: Of 68 patients, there were 59 cases (86.8%) whose release of the contractures was excellent. For 51 patients, the whole process of treatment was finished only in a single-stage procedure. We used extended deltopectoral flap, which was developed from our own anatomic studies and from previous reports in the literature, in 6 patients. This new flap extends the volume of the original deltopectoral flap, from 22 to 32 cm in length and 10 to 22 cm in width (at the apex). Postoperatively, all flaps survived completely. Patients were satisfied with their results. The follow-up period ranged 1 to 10 years; no obvious recontractures have been noted. There were no severe donor-site complications. CONCLUSIONS: The local flap with matching texture, color, elasticity, and pliability is still the best choice for reconstruction of postburn anteriorly located neck contractures. The extended deltopectoral flap has been used successfully to yield satisfactory outcomes for the scar contractures in the anterior neck and should be conserved as a selective method for reconstructive surgeons.

Effects of trichostatin A on HIF-1α and VEGF expression in human tongue squamous cell carcinoma cells in vitro.

Hypoxia is an essential feature of the microenvironment of solid tumors, which regulates a variety of transcription factors including hypoxia-inducible factor-1α (HIF-1α). HIF-1α overexpression enhances tumor angiogenesis via upregulation of vascular endothelial growth factor (VEGF) and some other hypoxia-inducible angiogenic factors, which lead to a more aggressive tumor phenotype, tumor metastasis and resistance to radiation and chemotherapy. In this study, we found that a histone deacetylase (HDAC) inhibitor, trichostatin A (TSA), inhibited cell proliferation and invasion, blocked the cell cycle, and induced cell apoptosis in a dose- and time-dependent manner in the human tongue squamous cell carcinoma (TSCC) SCC-6 cell line in vitro. Furthermore, TSA reduced both basal levels and hypoxia-induced HIF-1α protein accumulation but not HIF-1α mRNA levels, and both protein and mRNA levels of VEGF expression. These results showed that TSA had a potent anticancer activity on TSCC cells, suggesting that TSA could be a promising drug targeting tumor angiogenesis via inhibition of HIF-1α and VEGF expression in the development of an effective chemopreventive and anticancer agent on human TSCCs.

[Biological characteristics of CD133+ subpopulation in tongue squamous cell carcinoma Tca8113 cell line].

OBJECTIVE: To detect the expression of CD133 in human tongue squamous cell carcinoma Tea8113 cell line and observe proliferation ability of CD133 groups in vitro. METHODS: Limiting dilution assay was employed to observe the proliferating character of Tca8113 single cell in vitro. The ability of growing as cancer spheroids was observed with ultra-low attachment plates. The flow cytometry was used to detect the expression of putative tumor-initiating cell marker CD133 in human tongue squamous cell carcinoma Tca8113 cell line. The selective technique of immunomagnetic beads was applied to purify CD133 tumor cells, CD133 tumor cells were cultured and their ability of proliferation were observed in vitro. RESULTS: After 12 days, the result of single cell culture in vitro revealed that about 5.23% of cultured Tca8113 cells possessed the capacity of continue proliferation. The cells line fromed floating clusters with one week of passaging cells into non-adherent plates. Approximately 0.95% of cells in Tca8113 cell line expressed CD133. Compared with CD133- cells and control Tca8113 cells, CD133+ cells demonstrated increased proliferation capacity. The proportion of CD133 cells decreased in culture as days passed. The percentage of CD133+ cells decreased from 92.45% to 1.62% in twelve days' culture. CONCLUSION: Tumor stem cells have the character of heterogenity and lower proportion of CD133 but higher ability of proliferation, and the diferentiation in human tongue squamous cell carcinoma Tca8113 cell line in vitro, CD133 may be one of makers for tumor-initiating cell of human tongue squamous cell carcinoma Tca8113 cell line.

Expression, localisation and synthesis of versican by the enamel organ of developing mouse molar tooth germ: an in vivo and in vitro study.

OBJECTIVE: Versican is a large, aggregating chondroitin sulphate proteoglycan. In dental tissue, versican expression occurs primarily in mesenchymal tissue but rarely in epithelial tissue. We investigated the expression, localisation and synthesis of versican in the enamel organ of the developing tooth germ. DESIGN: To elucidate versican localisation in vivo, in situ hybridisation and immunohistochemistry were conducted in foetal ICR mice at E11.5-E18.5. Epithelium and mesenchyme from the lower first molars at E16.0 were enzymatically separated and versican mRNA expression was investigated by semi-quantitative RT-PCR. Organ culture of the separated samples combined with metabolic labelling with [(35)S], followed by gel filtration, was performed to analyse secreted proteoglycans. RESULTS: Versican mRNA was first expressed in the thickened dental epithelium at E12.0 and continued to be expressed in the enamel organ until the bell stage. Versican immunostaining was detected in the stellate reticulum areas from the bud stage to the apposition stage. The enamel organ at E16.0 expressed versican mRNA at a level comparable to that in dental mesenchyme. Furthermore, when compared to dental mesenchyme, about 1/2-3/4 of the [(35)S]-labelled versican-like large proteoglycan was synthesised and released into tissue explants by the enamel organ. CONCLUSIONS: The dental epithelium of developing tooth germ is able to synthesise significant amounts of versican.