PDF(Sci-hub)
Abstract：
To review the regenerative technologies used in bone regeneration: bone grafts, barrier membranes, bioactive factors and cell therapies.
Four background review publications served to elaborate this consensus report.
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.
Four background review publications served to elaborate this consensus report.
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.
摘要：
回顾用于骨再生的再生技术：骨移植，屏障膜,生物活性因子和细胞疗法。
四份背景审查出版物用来阐述这份共识报告。
用作骨移植物的生物材料必须满足特定要求：生物相容性，孔隙度,骨传导性,骨诱导性，表面属性,生物降解性，机械性能，血管生成性，处理和制造过程。目前使用的生物材料已经证明了基于满足这些要求的优点和局限性。同样，用于引导骨再生（GBR）的膜必须满足特定的特性和潜在的生物学机制，以提高其临床适用性。临床前和临床研究已经评估了骨形态发生蛋白（主要是BMP-2）和自体血小板浓缩物（APC）在用作生物活性剂以增强骨再生时的附加作用。已经评估了使用细胞疗法增强骨再生的三种主要方法：（a）“最低限度地操纵”整个组织部分；（b）离体扩增的“未定型”干/祖细胞；（c）离体扩增的“定型”骨/骨膜衍生细胞。根据临床试验的证据,细胞移植，最常见的是全骨髓穿刺液（BMA）或骨髓穿刺液浓度（BMAC），与生物材料支架相结合，在鼻窦扩张和水平脊扩张中显示出额外的效果，在牙槽突裂修复中，骨再生与自体骨具有可比性。
四份背景审查出版物用来阐述这份共识报告。
用作骨移植物的生物材料必须满足特定要求：生物相容性，孔隙度,骨传导性,骨诱导性，表面属性,生物降解性，机械性能，血管生成性，处理和制造过程。目前使用的生物材料已经证明了基于满足这些要求的优点和局限性。同样，用于引导骨再生（GBR）的膜必须满足特定的特性和潜在的生物学机制，以提高其临床适用性。临床前和临床研究已经评估了骨形态发生蛋白（主要是BMP-2）和自体血小板浓缩物（APC）在用作生物活性剂以增强骨再生时的附加作用。已经评估了使用细胞疗法增强骨再生的三种主要方法：（a）“最低限度地操纵”整个组织部分；（b）离体扩增的“未定型”干/祖细胞；（c）离体扩增的“定型”骨/骨膜衍生细胞。根据临床试验的证据,细胞移植，最常见的是全骨髓穿刺液（BMA）或骨髓穿刺液浓度（BMAC），与生物材料支架相结合，在鼻窦扩张和水平脊扩张中显示出额外的效果，在牙槽突裂修复中，骨再生与自体骨具有可比性。
