title: Synthetic bone substitute engineered with amniotic epithelial cells enhances bone regeneration after maxillary sinus augmentation.
abstract: BACKGROUND
  Evidence has been provided that a cell-based therapy combined with the use of bioactive materials may significantly improve bone regeneration prior to dental implant, although the identification of an ideal source of progenitor/stem cells remains to be determined.
  
  
  OBJECTIVE
  In the present research, the bone regenerative property of an emerging source of progenitor cells, the amniotic epithelial cells (AEC), loaded on a calcium-phosphate synthetic bone substitute, made by direct rapid prototyping (rPT) technique, was evaluated in an animal study.
  
  
  METHODS
  Two blocks of synthetic bone substitute (∼0.14 cm(3)), alone or engineered with 1×10(6) ovine AEC (oAEC), were grafted bilaterally into maxillary sinuses of six adult sheep, an animal model chosen for its high translational value in dentistry. The sheep were then randomly divided into two groups and sacrificed at 45 and 90 days post implantation (p.i.). Tissue regeneration was evaluated in the sinus explants by micro-computer tomography (micro-CT), morphological, morphometric and biochemical analyses.
  
  
  CONCLUSIONS
  The obtained data suggest that scaffold integration and bone deposition are positively influenced by allotransplantated oAEC. Sinus explants derived from sheep grafted with oAEC engineered scaffolds displayed a reduced fibrotic reaction, a limited inflammatory response and an accelerated process of angiogenesis. In addition, the presence of oAEC significantly stimulated osteogenesis either by enhancing bone deposition or making more extent the foci of bone nucleation. Besides the modulatory role played by oAEC in the crucial events successfully guiding tissue regeneration (angiogenesis, vascular endothelial growth factor expression and inflammation), data provided herein show that oAEC were also able to directly participate in the process of bone deposition, as suggested by the presence of oAEC entrapped within the newly deposited osteoid matrix and by their ability to switch-on the expression of a specific bone-related protein (osteocalcin, OCN) when transplanted into host tissues.
authors.affiliation: Department of Comparative Biomedical Science, University of Teramo, Teramo, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Barboni
authors.forename: Carlo
authors.initials: C
authors.lastname: Mangano
authors.forename: Luca
authors.initials: L
authors.lastname: Valbonetti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Marruchella
authors.forename: Paolo
authors.initials: P
authors.lastname: Berardinelli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Martelli
authors.forename: Aurelio
authors.initials: A
authors.lastname: Muttini
authors.forename: Annunziata
authors.initials: A
authors.lastname: Mauro
authors.forename: Rossella
authors.initials: R
authors.lastname: Bedini
authors.forename: Maura
authors.initials: M
authors.lastname: Turriani
authors.forename: Raffaella
authors.initials: R
authors.lastname: Pecci
authors.forename: Delia
authors.initials: D
authors.lastname: Nardinocchi
authors.forename: Vincenzo Luca
authors.initials: VL
authors.lastname: Zizzari
authors.forename: Stefano
authors.initials: S
authors.lastname: Tetè
authors.forename: Adriano
authors.initials: A
authors.lastname: Piattelli
authors.forename: Mauro
authors.initials: M
authors.lastname: Mattioli
mesh_terms: D000653:Amniotic Fluid / Q000166:cytology*; D000818:Animals; D001861:Bone Regeneration; D018786:Bone Substitutes; D002478:Cells, Cultured; D004847:Epithelial Cells / Q000378:metabolism / Q000637:transplantation*; D015870:Gene Expression; D008437:Maxilla / Q000502:physiology / Q000601:surgery; D008443:Maxillary Sinus / Q000098:blood supply / Q000601:surgery*; D034561:Sheep, Domestic; D023822:Tissue Engineering; D054457:Tissue Scaffolds; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000378:metabolism; D055114:X-Ray Microtomography
chemical_list: D018786:Bone Substitutes; D042461:Vascular Endothelial Growth Factor A