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

• Published in: Journal of clinical periodontology Vol. 46; no. S21; pp. 82 - 91
• Main Authors: Sanz, Mariano, Dahlin, Christer, Apatzidou, Danae, Artzi, Zvi, Bozic, Darko, Calciolari, Elena, De Bruyn, Hugo, Dommisch, Henrik, Donos, Nikos, Eickholz, Peter, Ellingsen, Jan E., Haugen, Håvard J., Herrera, David, Lambert, France, Layrolle, Pierre, Montero, Eduardo, Mustafa, Kamal, Omar, Omar, Schliephake, Henning
• Format: Journal Article Web Resource
• Language: English; Norwegian
• Published: United States Blackwell Publishing Ltd 01.06.2019; Wiley; Blackwell
• Subjects: Alveolar bone; Alveolar Ridge Augmentation; Autografts; barrier membrane; bio-absorbable; bioactive agent; Biocompatibility; Biocompatible Materials; Biodegradability; biomaterials; Biomedical materials; bone; Bone biomaterials; Bone growth; Bone marrow; Bone marrow transplantation; Bone morphogenetic proteins; Bone Regeneration; bone replacement graft; Bone Transplantation; cell therapies; Clinical trials; Consensus; Dentisterie & médecine buccale; Dentistry; Dentistry & oral medicine; guided bone regeneration; Guided Tissue Regeneration, Periodontal; Human health sciences; Life Sciences; Mechanical properties; Odontologi; Oral Surgery & Medicine; Osteoconduction; osteoconductive; osteoinductive; Periodontics; Periosteum; Porosity; Progenitor cells; Regeneration; Sciences de la santé humaine; Skin & tissue grafts; Stem cells; Surface properties; bioactive agent; bone replacement graft; bio-absorbable; guided bone regeneration; bone regeneration; osteoconductive; biomaterials; barrier membrane; osteoinductive; cell therapies
• ISSN: 0303-6979; 1600-051X; 1600-051X
• DOI: 10.1111/jcpe.13123

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.