Journal of Oral Implantology September 2012 - (Page 538)

LITERATURE REVIEW Cell Culture–Based Tissue Engineering as an Alternative to Bone Grafts in Implant Dentistry: A Literature Review Daniel Goncalves Boeckel, DDS, MSc1* ¸ Rosemary Sadami Arai Shinkai, DDS, PhD2 ´ Marcio Lima Grossi, DDS, PhD2 Eduardo Rolim Teixeira, DDS, PhD2 Several biomaterials and techniques for bone grafting have been described in the literature for atresic bone tissue replacement caused by edentulism, surgical resectioning, and traumas. A new technique involves tissue engineering, a promising option to replace bone tissue and solve problems associated with morbidity of autogenous grafting. This literature review aims to describe tissue-engineering techniques using ex vivo cell culture as an alternative to repair bone maxillary atresias and discuss the concepts and potentials of bone regeneration through cell culture techniques as an option for restorative maxillofacial surgery. Key Words: tissue engineering, bone transplantation, bone regeneration, stem cells INTRODUCTION ore than 2.2 million bone graft procedures are performed annually in dentistry, neurosurgery, and orthopedics.1 The popularity of dental implants has generated an even higher demand for dentoalveolar bone reconstruction.2 There are 4 functional principles that characterize the biology of biomaterials applied for bone grafting. These are osteointegration, which is the ability of the bone tissue to directly adhere to the surface of the implant biomaterial without forming a fibrous interface; osteoconduction, which is the ability to support and guide bone growth on the surface of the grafted material; osteoinduction, which is the capacity to induce mesenchymal stem cells to differentiate into osteoblasts in the region of interest; and osteogenesis, meaning the capacity to form new bone tissue through the cells present at the grafting material.3,4 One prerequisite for oral rehabilitation in os1 2 M Private practice, Brazil. Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Brazil. * Corresponding author, e-mail: DOI: 10.1563/AAID-JOI-D-11-00197 teointegration is the presence of a remnant alveolar process, which may allow the installation of dental implants aimed to withstand a functional prosthesis over a long period of time.5,6 For this reason, various biomaterials have been tested and suggested as alternatives for bone reconstruction in the dental literature. These graft materials could be divided by their origin as autogenous, allogeneic, xenografts, or synthetic.1,2,4 Autogenous grafts have the best clinical response in terms of newly formed bone tissue because they come from the same individual and therefore present properties such as osteogenesis, osteoinduction, and osteointegration.3 Osteoprogenitor cells present in the autogenous grafts may promote new bone tissue formation, as marrow elements may facilitate the combination with osteoinductive proteins and osteogenic cells and also help to establish local vascular support.1,4,7,8 Despite a positive clinical response, autogenous grafts have limitations on their clinical use because of factors such as donor site morbidity and the amount of available material.9,10 In addition, the literature has shown that 8% to 20% of surgeries involving autogenous grafts are associated with postoperative complications, including hematomas, blood loss, nerve and vessel injury, infections, bone 538 Vol. XXXVIII /Special Issue No. One /2012

Table of Contents for the Digital Edition of Journal of Oral Implantology September 2012

American Academy of Implant Dentistry Foundation Supports Basic and Clinical Research
Evaluation of 3- to 8-Year Treatment Outcomes and Success Rates With 6 Implant Brands in Partially Edentulous Patients
Histometric Analysis of Bone Repair in Bone-Implant Interface Using a Polylactic/ Polyglycolic Acid Copolymer Associated With Implants in Rabbit Tibia
Fold-Over Flap Technique for Developing the Facial Gingival Contour: A Case Report
Rehabilitation of the Atrophic Posterior Maxilla With Pterygoid Implants: A Review
Immediate Loading of Maxillary and Mandibular Implant-Supported Fixed Complete Dentures: A 1- to 10-Year Retrospective Study
Immediate Loading of Single Post-Extractive Implants in the Anterior Maxilla: 12-Month Results From a Multicenter Clinical Study
Immediate Implants After Enucleation of an Odontogenic Keratocyst: An Early Return to Function
Effects of Different Abutment Connection Designs on the Stress Distribution Around Five Different Implants: A 3-Dimensional Finite Element Analysis
Implant-Prosthetic Rehabilitation of a Patient with Nonsyndromic Oligodontia: A Clinical Report
Planning for Immediate Loading of Implant-Supported Prostheses: Literature Review
Development of a Rat Model of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)
Anorganic Bovine-Derived Hydroxyapatite vs β-Tricalcium Phosphate in Sinus Augmentation: A Comparative Histomorphometric Study
Peripheral Giant Cell Granuloma Associated With Dental Implants: Clinical Case and Literature Review
Bilateral Vertical Ridge Augmentation With Block Grafts and Guided Bone Regeneration in the Posterior Mandible: A Case Report
Cell Culture–Based Tissue Engineering as an Alternative to Bone Grafts in Implant Dentistry: A Literature Review

Journal of Oral Implantology September 2012