Rainer Lutz
Publications
-
2.92Impact points
Biofunctionalization of the implant surface with different concentrations of a synthetic peptide (P-15).
Clinical oral implants research. 03/2012;
OBJECTIVE: This study aimed at identifying the ideal concentration of a biofunctional surface coating of dental implants with a synthetic peptide (P-15). In a previous study, P-15 was shown to enhance osseointegration parameters. MATERIAL AND METHODS: Implants (modified ANKYLOS(®) A8; FRIADENT Plus(... [more] OBJECTIVE: This study aimed at identifying the ideal concentration of a biofunctional surface coating of dental implants with a synthetic peptide (P-15). In a previous study, P-15 was shown to enhance osseointegration parameters. MATERIAL AND METHODS: Implants (modified ANKYLOS(®) A8; FRIADENT Plus(®) surface) with five different concentrations (0-400 μg/ml) of a P-15 coating as well as uncoated controls were inserted in the frontal bone of 45 adult domestic pigs. The histomorphometric and microradiographic findings for the coated implants were compared to those for the uncoated ones after 7, 14, and 30 days. RESULTS: No significant differences were observed comparing the peri-implant bone density between the coated and uncoated implants The bone-to-implant contact, as the primary histological parameter for osseointegration, showed high rates for all surfaces investigated (between 73.3 ± 17.9% for the control and 81.9 ± 15.2% for P15 20 μg/ml after 30 days). CONCLUSIONS: No significant benefit on osseointegration of a biofunctional P-15 coating of dental implants could be displayed in the present study.
-
2.92Impact points
Histological results after maxillary sinus augmentation with Straumann® BoneCeramic, Bio-Oss®, Puros®, and autologous bone. A randomized controlled clinical trial.
Clinical oral implants research. 02/2012;
OBJECTIVE: This investigation focused on a comparison of clinical and histological characteristics after sinus floor augmentation with biphasic calcium phosphate (BCP, Straumann BoneCeramic(®) ), anorganic bovine bone (ABB, Geistlich Bio-Oss(®) ), mineralized cancellous bone allograft (MCBA, Zimmer ... [more] OBJECTIVE: This investigation focused on a comparison of clinical and histological characteristics after sinus floor augmentation with biphasic calcium phosphate (BCP, Straumann BoneCeramic(®) ), anorganic bovine bone (ABB, Geistlich Bio-Oss(®) ), mineralized cancellous bone allograft (MCBA, Zimmer Puros(®) ), or autologous bone (AB). MATERIALS AND METHODS: Thirty consecutive patients with a posterior edentulous maxillary situation and a vertical bone height less than or equal to 4 mm were included in this study. A two-stage procedure was carried out. After augmentation of the maxillary sinus with ABB, BCP, MCBA, or AB followed by a healing period of 5 months, biopsies were taken with simultaneous implant placement. The samples were analyzed using microradiography and histology. RESULTS: Ninety-four implants were placed in the augmented positions and 53 bone biopsies were taken and evaluated. The bone volume fraction of newly formed bone was measured as 30.28 ± 2.16% for BCP, 24.9 ± 5.67% for ABB, 41.74 ± 2.1% for AB, and 35.41 ± 2.78% for MCBA with significant increases in bone volume of AB vs. BCP and ABB, and MCBA vs. ABB samples. Significantly different residual bone substitute material was measured as 15.8 ± 2.1% in the BCP group and 21.36 ± 4.83% in the ABB group. CONCLUSION: As it provides the highest rate of de novo bone formation, AB can be considered to remain the gold standard in sinus floor augmentation. All tested control materials showed comparable results and are suitable for maxillary sinus augmentation.
-
2.92Impact points
PEG matrix enables cell-mediated local BMP-2 gene delivery and increased bone formation in a porcine critical size defect model of craniofacial bone regeneration.
Clinical oral implants research. 12/2011;
PURPOSE: This study addressed the suitability of a polyethylene glycol (PEG) matrix as scaffold for cell-mediated local BMP-2 gene transfer in a calvarial critical size defect (CSD) model. MATERIALS AND METHODS: PEG matrix (degradation time 10 days) and PEG membrane (degradation time 120 days) were ... [more] PURPOSE: This study addressed the suitability of a polyethylene glycol (PEG) matrix as scaffold for cell-mediated local BMP-2 gene transfer in a calvarial critical size defect (CSD) model. MATERIALS AND METHODS: PEG matrix (degradation time 10 days) and PEG membrane (degradation time 120 days) were used in the pig calvarial model. Cylindrical (1 × 1 cm) CSD (9 per animal; 20 animals) were filled with: (i) HA/TCP, covered by PEG membrane (group 1); (ii) HA/TCP, mixed with PEG matrix (group 2); and (iii) HA/TCP mixed with BMP-2 transfected osteoblasts and PEG matrix (group 3). BMP-2/4 gene transfer: liposomal in vitro transfection of BMP-2/V5-tag fusion-protein. Quantitative histomorphometry (toluidine blue staining) after 2, 4 and 12 weeks assessed bone formation. Semiquantitative immunohistochemistry estimated the expression of BMP-2 and V5-tag. RESULTS: Group 3 showed significantly higher new bone formation than groups 1, 2 at 4 (P < 0.05) and 12 (P < 0.02) weeks. BMP-2-V5-tag was detected for 4 weeks. BMP-2 expression in group 3 was higher compared to all other groups after 2 and 4 (P < 0.02) weeks. CONCLUSIONS: The PEG matrix serves as scaffold for cell-mediated BMP-2 gene delivery in guided bone regeneration facilitating cell survival and protein synthesis for at least 4 weeks. Local BMP-2 gene delivery by PEG matrix-embedded cells leads to increased bone formation during critical size defect regeneration.
-
2.92Impact points
Osseointegration of SLActive implants in diabetic pigs.
Clinical oral implants research. 11/2011;
OBJECTIVES: Diabetes mellitus is currently classified as a relative contraindication for implant treatment because of microangiopathies with the consequence of impaired bone regeneration and higher rates of implant failure. The study aim was to investigate peri-implant bone formation in a diabetic a... [more] OBJECTIVES: Diabetes mellitus is currently classified as a relative contraindication for implant treatment because of microangiopathies with the consequence of impaired bone regeneration and higher rates of implant failure. The study aim was to investigate peri-implant bone formation in a diabetic animal model in comparison to healthy animals and to evaluate the differences between conventional (SLA(®) ) and modified (SLActive(®) ) titanium implant surfaces on osseointegration. MATERIAL AND METHODS: Each six implants were placed in the calvaria of 11 diabetic and 4 healthy domestic pigs. At 30 and 90 days after implant placement, the bone-to-implant contact (BIC) and bone density (BD) were appraised. Additionally, the expression of the bone-matrix proteins collagen type I and osteocalcin was evaluated at both points in time by using immunohistochemical staining methods. RESULTS: Overall, BIC was reduced in the diabetic group at 30 and 90 days. After 90 days, the SLActive(®) implants showed significantly higher BICs compared with the SLA(®) implants in diabetic animals. Peri-implant BD was higher in the SLActive(®) group at 30 and 90 days in healthy and diabetic animals. Collagen type I protein expression was higher using SLA(®) implants in diabetic pigs at 30 days. Values for osteocalcin expression were not consistent. CONCLUSIONS: The results indicate the negative effect of untreated diabetes mellitus on early osseointegration of dental implants. The modified SLA(®) surface (SLActive(®) ) elicited an accelerated osseointegration of dental implants, suggesting that a better prognosis for implant treatment of diabetic patients is possible.
-
2.92Impact points
Bio-Oss® blocks combined with BMP-2 and VEGF for the regeneration of bony defects and vertical augmentation.
Clinical oral implants research. 11/2011;
OBJECTIVES: The aim of this study was to evaluate the bone formation rate and osseointegration of Bio-Oss(®) blocks combined with rhBMP-2 and rhVEGF in bony defects and after vertical augmentation. MATERIAL AND METHODS: Bio-Oss(®) blocks plus rhBMP-2 (BMP), Bio-Oss(®) blocks plus rhVEGF (VEGF), or B... [more] OBJECTIVES: The aim of this study was to evaluate the bone formation rate and osseointegration of Bio-Oss(®) blocks combined with rhBMP-2 and rhVEGF in bony defects and after vertical augmentation. MATERIAL AND METHODS: Bio-Oss(®) blocks plus rhBMP-2 (BMP), Bio-Oss(®) blocks plus rhVEGF (VEGF), or Bio-Oss(®) blocks plus rhBMP-2 and rhVEGF (BMPVEGF) were inserted in "critical size defects" (CSD) in the calvariae of adult pigs. Control defects were filled with collagen carrier (Lyostypt(®) ) plus growth factors and untreated Bio-Oss(®) blocks (CO). In a second group, Bio-Oss(®) blocks plus growth factors and untreated Bio-Oss(®) blocks were used for vertical augmentation of the calvariae. In the first group, the investigation time was 30 days, in the second group it was 30 and 60 days. The bone samples were investigated histomorphometrically, and the newly formed bone (BV/TV) was judged by microradiographic investigation. RESULTS: In the CSD model, the newly formed bone in the region of interest was not significantly different within the groups. In the second setting, the inserted bone blocks exhibited sufficient volume stability with increasing bone formation up to 9.33% ± 3.92% for BMP, 10.42% ± 1.81% for BMP/VEGF, 11.01% ± 4.78% for VEGF, and 10.02% ± 5.43% for the control group after 60 days. CONCLUSION: In the chosen setting and time frame, de novo bone formation did not increase with the additional use of growth factors.
-
3.55Impact points
Diabetes mellitus negatively affects peri-implant bone formation in the diabetic domestic pig.
Journal of clinical periodontology. 08/2011; 38(8):771-9.
Diabetes mellitus is classified as a relative contraindication for implant treatment, and higher failure rates have been seen in diabetic patients. The aim of the present study was to investigate the effect of diabetes on peri-implant bone formation in an animal model of human bone repair. Diabetes ... [more] Diabetes mellitus is classified as a relative contraindication for implant treatment, and higher failure rates have been seen in diabetic patients. The aim of the present study was to investigate the effect of diabetes on peri-implant bone formation in an animal model of human bone repair. Diabetes was induced by an intra-venous application of streptozotocin (90 mg/kg) in 15 domestic pigs. Implants were placed after significant histopathological changes in the hard and soft tissues were verified. The bone-implant contact (BIC), peri-implant bone mineral density (BMD), and expression of collagen type-I and osteocalcin proteins were qualitatively evaluated 4 and 12 weeks after implantation. Fifteen animals served as healthy controls. Diabetes caused pathological changes in the soft and hard tissues. The BIC and BMD were significantly reduced in the diabetic group after 4 and 12 weeks. Collagen type-I was increased in the diabetic group at both time points, whereas osteocalcin was reduced in the diabetic group. Poorly controlled diabetes negatively affects peri-implant bone formation and bone mineralization. These findings have to be taken into consideration for diabetic patients with an indication for implant therapy.
-
2.92Impact points
The effect of combined delivery of recombinant human bone morphogenetic protein-2 and recombinant human vascular endothelial growth factor 165 from biomimetic calcium-phosphate-coated implants on osseointegration.
Clinical oral implants research. 03/2011; 22(12):1433-9.
The delivery of growth factors for enhanced osseointegration depends on the effectiveness of the carrier systems at the bone-implant interface. This study evaluated the effect of solo and dual delivery of recombinant human bone morphogenetic protein-2 (rhBMP-2) and recombinant human vascular endothe... [more] The delivery of growth factors for enhanced osseointegration depends on the effectiveness of the carrier systems at the bone-implant interface. This study evaluated the effect of solo and dual delivery of recombinant human bone morphogenetic protein-2 (rhBMP-2) and recombinant human vascular endothelial growth factor (rhVEGF(165) ) from biomimetically octacalcium phosphate-coated implants on osseointegration. Biomimetic implants, bearing either a single growth factor (BMP or VEGF) or their combination (BMP+VEGF), were established, and compared with acid-etched (AE, control) and biomimetic implants without growth factor (CAP). Implants were placed into frontal skulls of nine domestic pigs. The quality of osseointegration was evaluated using microradiographic and histomorphometric analysis of bone formation inside four defined bone chambers of the experimental implant at 1, 2 and 4 weeks. Biomimetic implants, either with or without growth factor, showed enhanced bone volume density (BVD) values after 2 and 4 weeks. This enhancement was significant for the BMP and BMP+VEGF group compared with the control AE group after 2 weeks (P<0.05). All biomimetic calcium-phosphate (Ca-P) coatings exhibited significantly enhanced bone-implant contact (BIC) rates compared with the uncoated control surface after 2 weeks (P<0.05). However, the combined delivery of BMP-2 and VEGF did not significantly enhance BIC at the final observation period. It was concluded that the combined delivery of BMP-2 and VEGF enhances BVD around implants, but not BIC. Therefore, it may be assumed that changes in the surface characteristics should be considered when designing growth factor-delivering surfaces.
-
2.92Impact points
Biofunctionalization of titanium implants with a biomimetic active peptide (P-15) promotes early osseointegration.
Clinical oral implants research. 07/2010; 21(7):726-34.
The early stages of peri-implant bone formation play an essential role in the osseointegration and long-term success of dental implants. By incorporating bioactive coatings, this biofunctionalization of implant surfaces may enhance the attachment of the implant to the surrounding bone and stimulate ... [more] The early stages of peri-implant bone formation play an essential role in the osseointegration and long-term success of dental implants. By incorporating bioactive coatings, this biofunctionalization of implant surfaces may enhance the attachment of the implant to the surrounding bone and stimulate bone regeneration. To demonstrate faster osseointegration, the surfaces of dental implants were grit-blasted and acid-etched. They were then coated with hydroxyapatite (HA) and experimental implants were further coated with a biomimetic active peptide (P-15) in one of two concentrations. These biofunctionalized samples and controls with no peptide were placed in the forehead region of 12 adult pigs. Six animals were evaluated for a period of 14 or 30 days. Histomorphometric analysis demonstrated that the implants with the high concentration of P-15 had significantly higher percentage of bone-to-implant contact (BIC) at 14 (P=0.018) and 30 (P=0.015) days compared with the other groups. Both concentrations of P-15 showed increased peri-implant bone density compared to the control group at 30 days. Biofunctionalization of the implant surface with a biomimetic active peptide leads to significantly increased BIC rates at 14 and 30 days and higher peri-implant bone density at 30 days.
-
1.50Impact points
Preclinical animal model for de novo bone formation in human maxillary sinus.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 10/2009; 108(3):e37-44.
OBJECTIVES: Up to now the effect of bone-substitute materials on de novo bone formation has been tested in a variety of preclinical animal models. We hypothesized that there is no significant difference in bone regeneration after application of autogenous bone (AB) and bone substitutes in a porcine ... [more] OBJECTIVES: Up to now the effect of bone-substitute materials on de novo bone formation has been tested in a variety of preclinical animal models. We hypothesized that there is no significant difference in bone regeneration after application of autogenous bone (AB) and bone substitutes in a porcine calvarial monocortical defect model and in human maxillary sinus. STUDY DESIGN: Twenty-four weeks after application of ss-tricalcium phosphate (betaTCP), hydroxyapatite (HA), and AB in each of 3 defects on the sculls of 6 adult pigs (N = 54) and the application in 44 sinus floor elevations (11x betaTCP, 6x HA and 24x AB) in 41 patients, bone regeneration rates where compared microradiographically. Wilcoxon rank-sum test was used for statistical analysis. RESULTS: Comparing the human with the animal specimens microradiographically, no significant difference of the mineralization rate could be found. CONCLUSION: The chosen porcine model is a valuable method for preclinical testing of bone-substitute materials in maxillofacial surgery.
-
2.82Impact points
In vivo performance of selective electron beam-melted Ti-6Al-4V structures.
Journal of biomedical materials research. Part A. 02/2009;
Highly porous titanium structures are widely used for maxillofacial and orthopedic surgery because of their excellent mechanical properties similar to those of human bone and their facilitation of bone ingrowth. In contrast to common methods, the generation of porous titaniumproducts by selective el... [more] Highly porous titanium structures are widely used for maxillofacial and orthopedic surgery because of their excellent mechanical properties similar to those of human bone and their facilitation of bone ingrowth. In contrast to common methods, the generation of porous titaniumproducts by selective electron beam melting (SEBM), an additive manufacturing technology, overcomes difficulties concerning the extreme chemical affinity of liquid titanium to atmospheric gases which consequently leads to strongly reduced ductility of the metal. The purpose of this study was to assess the suitability of a smooth compact and a porous Ti-6Al-4V structure directly produced by the SEBM process as scaffolds for bone formation. SEBM-processed titanium implants were placed into defects in the frontal skull of 15 domestic pigs. To evaluate the direct contact between bone and implant surfaces and to assess the ingrowth of osseous tissue into the porous structure, microradiographs and histomorphometric analyses were performed 14, 30, and 60 days after surgery. Bone ingrowth increased significantly during the period of this study. After 14 days the most outer regions of the implants were already filled with newly formed bone tissue (around 14%). After 30 days the bone volume inside the implants reached almost 30% and after 60 days abundant bone formation inside the implants attained 46%. During the study only scarce bone-implant contact was found around all implants, which did not exceed 9% around compact specimens and 6% around porous specimens after 60 days. This work demonstrates that highly porous titanium implants with excellent interconnectivity manufactured using the SEBM method are suitable scaffolds for bone ingrowth. This technique is a good candidate for orthopedic and maxillofacial applications. (c) 2009 Wiley Periodicals, Inc. J Biomed Mater Res, 2009.
-
2.19Impact points
In vivo evaluation of anodic TiO(2) nanotubes: An experimental study in the pig.
Journal of biomedical materials research. Part B, Applied biomaterials. 10/2008;
Because of their ability to mimic the dimensions of constituent components of natural bone and the possibility to serve as a gene and drug-delivery carrier, nanotubes seem to be a promising coating for medical implants. Aim of this study was to investigate the effects of a TiO(2) nanotube structured... [more] Because of their ability to mimic the dimensions of constituent components of natural bone and the possibility to serve as a gene and drug-delivery carrier, nanotubes seem to be a promising coating for medical implants. Aim of this study was to investigate the effects of a TiO(2) nanotube structured surface on periimplant bone formation in vivo when compared with an untreated standard titanium surface. Twenty-five titanium implants covered with an ordered TiO(2) nanotube layer with an individual tube diameter of 30 nm and 25 commercially pure titanium (cp-Ti) implants were placed in the frontal skull of 25 domestic pigs. To evaluate the effects of the nanotube structured implants on the periimplant bone formation, bone-implant contact (BIC), and immunohistochemistry analysis were performed at day 3, 7, 14, 30, and 90. Evaluating immunohistochemistry, a significantly higher collagen type- I expression occurred at day 7 (p = 0.003), day 14 (p = 0.016), and day 30 (p = 0.044), for the nanostructured implants in comparison with the control group. It could be found that a nanotube structured implant surface with a diameter of 30 nm does influence bone formation and bone development by enhancing osteoblast function. SEM evaluation of the specimen surfaces revealed that the nanotube coatings do resist shearing forces that evoked by implant insertion. Because of their simple, low cost, flexible manufacturing and the possibility for the usage as drug or growth factor delivery system, nanotubes seem to be a promising method for future medical implant coatings. (c) 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2008.
-
2.92Impact points
Bone regeneration after topical BMP-2-gene delivery in circumferential peri-implant bone defects.
Clinical oral implants research. 07/2008; 19(6):590-9.
OBJECTIVES: The aims of this study were to evaluate the rate of bone formation and osseointegration after topical gene delivery with a liposomal vector system carrying bone morphogenetic protein (BMP)-2 cDNA in combination with a collagen carrier and autologous bone as a carrier in freshly created p... [more] OBJECTIVES: The aims of this study were to evaluate the rate of bone formation and osseointegration after topical gene delivery with a liposomal vector system carrying bone morphogenetic protein (BMP)-2 cDNA in combination with a collagen carrier and autologous bone as a carrier in freshly created peri-implant bone defects. MATERIALS AND METHODS: Eight domestic pigs received nine calvariae defects each (10 x 7 mm). A dental implant was inserted into the centre of each defect. In the test groups, the remaining space was filled with the liposomal vector/BMP-2 complex combined with a collagen carrier (n=18) or an autologous bone graft (n=18). Control groups were collagen only (n=18) and autologous bone graft only (n=18). RESULTS: There was a significant difference in mineralisation rate in the BMP-2/bone graft (29.9%+/- 4.8 and 68.3%+/- 7.2) and bone graft only (22.6%+/- 2.6 and 49.4%+/- 13.9) groups after 7 and 28 days. Mineralisation values were also significantly higher in the BMP-2/collagen group (21.2%+/- 16.2 and 53.1%+/- 12.5) compared with the collagen-only group (8.2%+/- 7 and 41%+/- 8.1) in two different regions after 28 days. Also the bone-to-implant contact was significantly increased in the BMP-2/bone graft group after 28 days and in the BMP-2/collagen group after 7 and 28 days compared with their control groups. CONCLUSIONS: The results of this study show a significantly positive effect of liposomal vector/BMP-2 on bone regeneration and osseointegration in bony circumferential peri-implant defects.
-
2.82Impact points
Effects of bioactive glass and beta-TCP containing three-dimensional laser sintered polyetheretherketone composites on osteoblasts in vitro.
Journal of biomedical materials research. Part A. 02/2008;
Because of their excellent physical properties nonresorbable thermoplastic polymers have become more important for the field of reconstructive surgery. Aim of the present study was to investigate the effects of laser sintered polyetheretherketone (PEEK) with incorporated osteoconductive and bioactiv... [more] Because of their excellent physical properties nonresorbable thermoplastic polymers have become more important for the field of reconstructive surgery. Aim of the present study was to investigate the effects of laser sintered polyetheretherketone (PEEK) with incorporated osteoconductive and bioactive bone substitution materials on osteoblasts in vitro. Human osteoblasts (hFOB 1.19) were seeded onto laser sintered PEEK samples containing nano-sized carbon black, beta-tricalciumphosphate (beta-TCP), and bioactive glass 45S5. Osteoblasts were investigated for cell viability, cell proliferation and cell morphology. A constant proliferation of osteoblasts could be observed on all samples with the highest values for bioactive glass containing samples at day 7 (OD 1.76 +/- 0.22) and day 14 (OD 3.75 +/- 0.31) and lowest values for beta-TCP containing probes throughout the study compared with the PEEK pure control group. Highest cell viability was observed for Bioglass containing probes (95.5 +/- 3.32)% whereas osteoblasts seeded on beta-TCP containing probes showed reduced viability (84.4 +/- 4.32)%. Laser sintered PEEK implants seem to be attractive candidates for use as bone substitutes for reconstructive surgery because of their biocompatibility, individual shape, and the possibility of compounding bioinert polymer powder with osteoconductive and bioactive materials which might benefit bone formation in vivo. (c) 2008 Wiley Periodicals, Inc. J Biomed Mater Res, 2008.
-
7.88Impact points
The effect on bone regeneration of a liposomal vector to deliver BMP-2 gene to bone grafts in peri-implant bone defects.
Biomaterials. 07/2007; 28(17):2772-82.
Successful bone-implant osseointegration in large peri-implant bone defects is often difficult, even through autologous bone grafting. Recently, cell-mediated regional gene therapy was introduced to deliver potent morphogens or growth factors in regenerative medicine. We applied liposomal vectors ca... [more] Successful bone-implant osseointegration in large peri-implant bone defects is often difficult, even through autologous bone grafting. Recently, cell-mediated regional gene therapy was introduced to deliver potent morphogens or growth factors in regenerative medicine. We applied liposomal vectors carrying bone morphogenetic protein (BMP)-2 cDNA directly into freshly created peri-implant bone defects on pig calvariae, with or without autologous bone graft. The BMP-2 gene was efficiently introduced into immigrating cells and trabecular cells lining the marginal bone surrounding the bony defect. After 1 week, abundant BMP-2 protein was detected throughout the peri-implant bone defect by immunohistochemistry. At 4 weeks, BMP-producing cells were still present in the defect and peri-implant area, which significantly enhanced new bone formation, compared with the control groups. Interestingly within a week of BMP-2 gene delivery with bone grafts, most osteoblastic cells lining the grafted bone chips also produced BMP-2. Particulated bone was immediately reorganized into newly formed trabecular bone. Grafted bone without BMP-2 gene delivery was still scattered and new bone matrix formation was not detected until 4 weeks after bone grafting. In conclusion, direct application of the BMP-2 gene using a liposomal vector enhanced bone regeneration in a bony defect and gene delivery combined with bone graft could induce a rapid osseointegration of the bone-implant interface at earlier stage.
Following (1)
-
Emeka Nkenke
Friedrich-Alexander Universität Erlangen-Nürnberg
