Shohei Kasugai

Fully functional bioengineered tooth replacement as an organ replacement therapy

Current approaches to the development of regenerative therapies have been influenced by our understanding of embryonic development, stem cell biology, and tissue engineering technology. The ultimate goal of regenerative therapy is to develop fully functioning bioengineered organs which work in cooperation with surrounding tissues to replace organs that were lost or damaged as a result of disease, injury, or aging. Here, we report a successful fully functioning tooth replacement in an adult mouse achieved through the transplantation of bioengineered tooth germ into the alveolar bone in the lost tooth region. We propose this technology as a model for future organ replacement therapies. The bioengineered tooth, which was erupted and occluded, had the correct tooth structure, hardness of mineralized tissues for mastication, and response to noxious stimulations such as mechanical stress and pain in cooperation with other oral and maxillofacial tissues. This study represents a substantial advance and emphasizes the potential for bioengineered organ replacement in future regenerative therapies.

Magnitude and Direction of Mechanical Stress at the Osseointegrated Interface of the Microthread Implant

BACKGROUND The mechanism by which the microthread implant preserves peri-implant crestal bone is not known. The objective of this research is to assess the effect of microthreads on the magnitude and direction of the stress at the bone-implant interface using finite element analysis modeling. METHODS Three-dimensional finite element models representing the microthreaded implant (microthread model) and smooth surface implant (smooth model) installed in the mandibular premolar region were created based on microscopic and computed tomography images. The mesh size was determined based on convergence tests. Average maximum bite force of adults was used with four loading angles on the occlusal surface of the prosthesis. RESULTS Regardless of the loading angle, principal stresses at the bone-implant interface of the microthread model were always perpendicular to the lower flank of each microthread. In the smooth model, stresses were affected by the loading angle and directed obliquely to the smooth interface, resulting in higher shear stress. The interfacial stresses decreased gradually in the apical direction in both models but with wavy pattern in the microthread model and smooth curve for the smooth model. Although peak principal stress values were higher around the microthread implant, peri-implant bone volume exhibiting a high strain level >4,000 μ was smaller around the microthread implant compared to the smooth implant. CONCLUSION Stress-transferring mechanism at the bone-implant interface characterized by the direction and profile of interfacial stresses, which leads to more compressive and less shear stress, may clarify the biomechanical aspect of microthread dental implants.

Molecular and tissue responses in the healing of rat calvarial defects after local application of simvastatin combined with alpha tricalcium phosphate

We have previously reported that healing of rat calvarial defects was enhanced by application of alpha tricalcium phosphate (alphaTCP) combined with simvastatin, a cholesterol synthesis inhibitor. The purpose of the present study was to investigate the cellular and molecular mechanisms in this phenomenon. Rat calvarial defects were grafted with alphaTCP with or without simvastatin or left untreated. Animals were sacrificed on 3, 7, 10, 14, and 21 days postoperatively and histological changes in the defect region were assessed. Gene expression patterns were examined by RT-PCR. Proliferation and migration of osteoprogenitor cells from the dura mater were increased in simvastatin group from day 3 to day 10 (p < 0.01). New bone formation was significantly increased in simvastatin group on day 14 and day 21 (p < 0.01). BMP-2 expression was significantly higher in simvastatin group on day 3 and day 14 (p < 0.05) and maintained until day 21. Increased upregulation of TGF-beta1 was also observed in the simvastatin group on day 7 (p < 0.05) which was maintained until day 14. These findings suggest that the proliferation and recruitment of osteoprogenitor cells were critical steps in early stage of bone healing and that these steps were enhanced by TGF-beta1 and BMP-2, which were stimulated by simvastatin.

Bone augmentation ability of autogenous bone graft particles with different sizes: a histological and micro-computed tomography study.

OBJECTIVES The purpose of this study was to investigate the augmentation process and ability of autogenous bone graft particles of two different sizes in a vertical augmentation chamber. MATERIAL AND METHODS The cranial bones of 24 rabbits were used. Two polytetrafluoroethylene chambers were filled with harvested bone from tibia with small bone (SB; 150-400 microm) and large bone (LB; 1.0-2.0 mm) of the same weight. Animals were sacrificed after 1, 2, 4 and 8 weeks. The samples were analyzed by micro-computed tomography (micro-CT) for quantitative analysis, and embedded in polyester resin as non-decalcified specimens for histological analysis. Total bone volume (TBV), bone height (BH) and distribution of bone structure were calculated by micro-CT. RESULTS Micro-CT evaluation and histology revealed a significant difference between the investigated specimens. TBV and BH of SB decreased to about 50% of the initial situation, and there was a statistically significant difference between 1 and 8 weeks. In contrast, TBV and BH of LB were almost retained at all experimental time points. Significant differences in TBV and BH were also observed between LB and SB at 8 weeks. Bone volume of SB decreased predominantly in the upper half of the chamber at 4 and 8 weeks. In the histological observations, SB showed favorable new bone formation and rapid bone resorption in a time-dependent manner during the entire experimental period. However, LB exhibited favorable morphological stability and continued new bone formation. CONCLUSION SB follows a smooth osteogenic process, whereas it is not effective in volume augmentation. LB is superior to SB in augmentation ability.

Effects of cholesterol-bearing pullulan (CHP)-nanogels in combination with prostaglandin E1 on wound healing

The cholesterol-bearing pullulan (CHP)-nanogels are able to trap hydrophobic drugs or proteins inside the nanogels, which is potential in application to drug delivery system and tissue engineering. On the other hand, prostaglandin E1 (PGE1) plays important roles in wound healing and PGE1 ointment has been clinically used to treat chronic skin ulcers and wounds. The purpose of this study is to evaluate effects of CHP nanogels in combination with prostaglandin E1 on wound healing in full thickness skin defect model. A square skin defect (1 x 1 cm(2)) of full thickness was created on the dorsal of Wistar rats. The wound was treated with CHP nanogels without PGE1 (CHP group) or CHP nanogels containing with PGE1 (CHP/PGE1 group) or PGE1 ointment (PGE1 ointment group). In both CHP/PGE1 and PGE1 ointment groups, approximately 6 microg of PGE1 was applied to each wound. In the control group, the wound was untreated. The wound was evaluated in measuring wound area and histologically. In CHP/PGE1 group, the rate of wound size reduction was significantly higher than the ones of other groups. Histologically, CHP/PGE1 promoted neoepithelialization, neovascularization, and wound closure compared to the other treatments. These results suggest that CHP in combination with PGE1 can promote wound healing, which confirms the efficiency of CHP nanogels-based drug delivery system.

Differentiation of Bone Marrow Stromal Cells into Osteoblasts in a Self-assembling Peptide Hydrogel: In Vitro and In Vivo Studies

A prerequisite of tissue engineering approaches with regard to autograft is a suitable scaffold that can harbor cells and signals. Conventionally, such scaffolds have been prepared as 3D scaffolds prefabricated from synthetic or natural biomaterials. RAD16 has been introduced as a new biomaterial, where synthetic peptides self-assemble to form a hydrogel. In this study, RAD16 was examined in terms of osteogenic efficacy and feasibility of ectopic mineralization. Two hundred and seventy-one RAD16 was cocultured with 1 × 106 bone marrow cells from the femurs of 6-week-old Wistar male rats in alpha minimum essential medium supplemented with or without dexamethasone. Second, the same volume of the RAD16 construct hosting the cells with or without hydroxyapatite (HA) particles was treated in the dexamethasone medium as well, prepared in a Teflon tube, and implanted subcutaneously. Cell proliferation was prominent in the RAD16 coculture with dexamethasone at 1 week and significantly decreased by 2 weeks, whereas the other combinations remained or inclined, and their osteogenic differentiation was accelerated up to 2 weeks, as seen in increasing alkaline phosphatase (ALP) activity and mRNAs of ALP, OPN, and OCN. The RAD16 implant prepared with HA particles allowed more osteoblast-like cells and blood cells to grow inside, which was accompanied by elevating OPN gene expression and the stronger peak of VEGF gene expression at 2 weeks. Furthermore, more OPN mRNA signal was detected around the RAD16 containing HA particles by 4 weeks. On the other hand, the RAD16 alone represented lower expression of OPN gene. During the experiment, however, no ectopic mineralization was observed in both groups. Conclusively, it was suggested that the RAD16 showed feasibility of serving as a matrix for osteogenic differentiation of cocultured bone marrow cells in vitro and in vivo. Proceeding of exploration and modification of RAD16 are continuously required for cell-based tissue engineering.

Evaluation of biomimetic scaffold of gelatin–hydroxyapatite crosslink as a novel scaffold for tissue engineering: Biocompatibility evaluation with human PDL fibroblasts, human mesenchymal stromal cells, and primary bone cells

Biomimetic gelatin (gel)–hydroxyapatite (HA) composites have been prepared for studying hard tissue engineering scaffolds. However, the biocompatibility test of this form of material using these three cell types, which are periodontal ligament (PDL) fibroblast cells, human mesenchymal stromal cells (HMSc) and primary cells from human hip bone (HBc) has never been evaluated. The objective of this article is to prepare and evaluate the biocompatibility of gel–HA crosslinked scaffold for tissue engineering. Two different scaffolds were prepared: preparation (1), 2.5% gel/2.5% HA; preparation (2), 2.5% gel/5% HA. Three cell types including PDL, HMSc, and HBc were used. Assessment of biocompatibility and osteoblastic cellular responses was evaluated using a three-dimensional cell culture method and scanning electron microscopy (SEM). From SEM, it was observed that scaffold (1) exhibits stable porous formation with well-blended and dispersed HA powder. All three cell types were able to proliferate in both scaffolds. The HMSc and HBc got attached to the scaffolds to a significantly higher degree and subsequently proliferated more than PDL. The alkaline phosphatase (ALP) activities of HMSc and HBc were stronger when cultured in scaffold (S1) than (S2). It was seen that the two scaffold preparations show good biocompatibility with all three cell types tested. The better cellular responses with scaffold (S1) than (S2) might be due to the different structural and morphological characteristics, that is, scaffold (S1) retained more small-sized apatite crystals and a better developed pore configuration than scaffold (S2). Based on these findings, the biomimetically synthesized composite scaffolds have the potential to be used in hard tissue regeneration and tissue engineering fields.

Exploitation of a novel polysaccharide nanogel cross-linking membrane for guided bone regeneration (GBR).

Cholesterol‐bearing pullulan (CHP) nanogel is a synthetic degradable biomaterial for drug delivery with high biocompatibility. Guided bone regeneration (GBR) is a bone augmentation technique in which a membrane is used to create and keep a secluded regenerative space. The purpose of the present study was to evaluate the effects of the novel CHP nanogel membrane in GBR. Thirty‐six adult Wistar rats were used and bilaterally symmetrical full‐thickness parietal bone defects of 5 mm diameter were created with a bone trephine burr. Each defect was covered with the collagen membrane or the CHP nanogel membrane or untreated without any membrane. The animals were sacrificed at 2, 4 and 8 weeks and analysed radiologically and histologically. Furthermore, after incubating human serum with CHP nanogel or collagen, the amount of PDGF in the serum was measured using ELISA. New bone formation in terms of bone volume was higher in the nanogel group than in the control or collagen groups at 2 and 4 weeks. At 8 weeks, both membrane groups showed higher bone volumes than the control group. Notably, the newly‐formed bone in the bone defect in the nanogel group was uniform and histologically indistinguishable from the original bone, whereas in the collagen group the new bone showed an irregular structure that was completely different from the original bone. After incubating with CHP nanogel, the amount of PDGF in the serum decreased significantly. CHP nanogel GBR membrane favourably stimulated bone regeneration, in which a unique characteristic of CHP nanogel, the storage of endogenous growth factors, was likely implicated. Copyright

Molecular and cell biological properties of mouse osteogenic mesenchymal progenitor cells, Kusa

A cell line of murine osteogenic progenitor cells, Kusa, was established from femoral bone marrow stromal cells with other types of mesenchymal progenitor cells. We characterized two sublines of Kusa (Kusa-A1 and Kusa-O) from several aspects, including the use of an expression profiling system, a cDNA microarray. The original Kusa subline (Kusa-A1) had high alkaline phosphatase activity and high accumulation of calcium deposits in a condition inducing mineralization, with ascorbic acid and β-glycerophosphate. Kusa-O, a low osteogenic subline of Kusa, had high alkaline phosphatase activity but slow accumulation of calcium deposits even in the inducing condition. These two Kusa sublines differed in the expression of the osteogenic marker genes, osteocalcin and osteopontin, during mineralization. A type of cDNA microarray revealed marked downregulation of gene expression in the inducing condition in both Kusa-A1 and Kusa-O. Another type of high-throughput microarray was performed to examine the difference in gene expression patterns between Kusa-A1 and Kusa-O. By this analysis, periostin, which would be involved in a stage of osteogenesis, was low in Kusa-A1. On the contrary, Myocyte enhancer factor 2C (MEF2C), a myogenic transcriptional factor, was high in Kusa-A1, although no expression of any other myogenic genes was shown.

Factors related to prosthetic restoration in patients with shortened dental arches: a multicentre study

The aim of this study was to identify the factors related to prosthetic restoration in patients with shortened dental arches (SDA). SDA patients with 2-12 missing occlusal units were consecutively enrolled from seven university-based dental hospitals in Japan. Of the 145 subjects (mean age; 63·4 years), 41% chose no treatment and 59% sought to replace their edentulous spaces with removable partial dentures or implant-supported fixed partial dentures. Restoration decisions were related to tooth loss patterns. Only 3% of subjects missing just second molar(s) sought to receive prosthetic treatment, while the percentage increased to 58% in subjects who were missing first and second molars and 93% in subjects missing premolar(s). Logistic regression analyses found that young age, increased number of missing occlusal units, asymmetric arch and presence of chewing complaint were significant predictors for prosthetic restoration (P<0·05). Increased number of missing occlusal units and asymmetric arch were significant predictors for the presence of chewing complaint (P<0·05). These results suggest that perceived impairment of chewing ability owing to missing occlusal units is a critical factor for prosthetic restoration in SDA patients.