Patent Application
20200390526
The present disclosure relates to a method for manufacturing a bone graft composite and a bone graft composite manufactured by the same. More particularly, the present disclosure relates to a method for manufacturing a bone graft composite, which includes forming dentin collagen obtained from human teeth and a growth factor having bone-growth inducing function into a composite, thereby improving alveolar bone regeneration rate, as well as a bone graft composite manufactured by the same.
In the medical field in recent years, regeneration of bone tissue defects due to physical, chemical and burn related bone tissue injuries or disease such as inflammation or tumors is significantly regarded. Osteomyelitis due to external force or secondary infection easily occurs at a bone tissue defect site. In addition, when skin, muscle, bone and nerve tissues, etc. are damaged in multiple ways, it is difficult to regenerate the tissue into normal tissue or a normal organ in each layer of the tissue and, instead, the tissue is replaced with scar tissue, resulting in restriction in mobility and functionality.
Conventionally, in order to solve this problem, by implanting and filling bone tissues in another part of a patient body into the damaged part, however, side effects such as bone defects in other normal parts, restriction in mobility and functionality, etc. were caused.
Further, autologous bone and other bone graft materials considerably absorb bone during a healing period and have deteriorated ability to maintain volume, thus requiring a dense bone graft material. In this regard, it is difficult to penetrate pores in the above materials.
Further, a shielding membrane is used to prevent growth of other tissues before healing the defective bone tissue or invasion of external bacteria into the tissue, or a porous scaffold is used to provide a space in which cells of the damaged bone tissue at the defect site can grow. Further, there is an increasing tendency to use a growth factor that leads stem cells required for healing or regeneration to move toward the defect site through chemotaxis, or to manipulate or cultivate stem cells and then transplant the same at the defect site so as to achieve cell growth.
In connection therewith, International Patent Laid-Open Publication No. WO1993/000050 disclosed a pharmaceutical formulation based on bone morphogenetic protein (BMP) that comprises a polymeric matrix component selected from a group consisting of lactic acid, glycolic acid and a mixture thereof, as well as a protein-sequestering component for bone formation, and has described a technology for growing mesenchymal stem cells into bone tissue by rhBMP-2.
In recent years, the US FDA permits license of products that use rhBMP-2 immersed in a carrier using collagenous fibers of bovine ligament and tendon. However, there are disadvantages in that: (1) carried BMP does not stay in place but flows into the body in a short time, that is, BMP has inferior functions as a carrier; (2) in terms of physical properties, BMP is not rigid as a graft material, that is, the BMP has a loose or spongy fibrous texture; (3) the whole fiber shrinks during bone induction; and (4) the BMP should be added to a fibroid material immediately before surgery.
On this account, bone tissue grafting technologies using human body-derived tooth were proposed and, in this regard, Korean Patent No. 10-1488716 disclosed a kit for regeneration of alveolar bone that uses a growth factor or constructs a growth factor (rhBMP-2) along with a tooth implant material to induce regeneration of alveolar bone.
However, the kit for regenerating alveolar bone uses a tooth implant material after partial demineralization, hence leaving behind other minerals besides an element required for bone formation (collagen).
In addition, the alveolar bone regeneration kit forms a composite by hydrating a tooth implant material in an aqueous solution of growth factor (rhBMP-2) and then coating the surface of tooth powder with the growth factor (rhBMP-2), hence entailing a limitation such as deterioration in ability of transferring the growth factor to a defect site.
The present disclosure has been proposed to overcome the aforementioned problems, and an object of the present disclosure is to provide a bone graft composite with enhanced alveolar bone regeneration by completely demineralizing teeth to obtain high purity dentin collagen and improving an ability to transfer a growth factor to a defect site
In order to solve the above problems, according to an aspect of the present disclosure, there is provided a method for manufacturing a bone graft composite, which includes: pulverizing a tooth to generate tooth powder, and washing and degreasing the tooth powder; completely demineralizing the tooth powder to obtain dentin collagen; preparing a growth factor containing a component to promote growth of human body tissues; and synthesizing a composite by mixing the obtained dentin collagen with the growth factor.
In one embodiment, degreasing the tooth powder may degrease the tooth powder with ethanol for 2 to 12 hours.
In one embodiment, the step for completely demineralizing the tooth powder may include demineralizing degreased tooth powder in a hydrochloric acid solution in the range of 20 times volume of 0.2 to 0.7N for 6 to 12 hours.
In one embodiment, the growth factor may be selected from a group consisting of one or more of those, such as recombinant human bone morphogenetic protein (rhBMP-2), double complex of amino acids to construct BMP, fibroblast growth factor, growth differentiation factor (GDF), transforming growth factor (TGF), platelet-derived growth factor, insulin-like growth factor, epithelial growth factor, keratinocyte growth factor 2 (KGF2), morphogenetic protein 52 (MP52), recombinant proteins thereof, and mixtures thereof.
In one embodiment, the step for synthesizing a composite may include: mixing the obtained dentin collagen and the growth factor; and agitating the mixture of the obtained dentin collagen and the growth factor at 30 to 80 rpm for 3 to 5 minutes. Herein, the dentin collagen and the growth factor in a mixed state are preferably maintained at pH 6.5 to 8.
According to another aspect of the present disclosure, as a solution to overcome the above problem, there is provided a bone graft composite manufactured by the above method.
With the method for manufacturing a bone graft composite and the bone graft composite manufactured thereby according to the present disclosure, the following effects can be accomplished.
First, in a tooth administration group as well as an administration group of a conventional synthetic bone that never regenerates the alveolar bone, bone inducing ability can be maximized to greatly increase an alveolar bone regeneration rate, and perfection and integration of regenerated bone tissues can also be remarkably improved. Further, complete alveolar bone regeneration is possible so as to decrease patient discomfort and, if shape retention is important in a wide range of bone tissue defect sites, side effects due to deformation or contraction of the bone tissue may be reduced.
Second, high purity dentin collagen obtained is synthesized by complete demineralization of a tooth so that undesired reactions induced by other factors during synthesis or transplantation of a bone graft composite, in particular, immune rejection, can be prevented.
Third, unlike the conventional method of coating the surface of tooth powder with a growth factor, a layer filling method of filling a tissue layer of the tooth powder with a growth factor is adopted, thereby improving an ability to transfer a growth factor to a defect site.
Fourth, the bone graft composite consists of the same component called dentin collagen, maintains the original shape even in the body, and thus can have improved bone tissue inducing effects as compared to existing bone graft materials.
Hereinafter, embodiments of the present disclosure will be described in detail with reference to the accompanying drawings so that those skilled in the art can easily implement the present disclosure. However, the description of the present disclosure is merely an example for explanation in terms of configurations and functions, and the scope of the present disclosure should not be construed as being limited by the embodiments described in the text. That is, the embodiments are to be construed as being differently embodied and having various forms, so that the scope of the present disclosure should be understood to include equivalents capable of realizing technical ideas of the invention. Further, the purpose or effects of the present disclosure should not be construed as limiting the scope of the present disclosure, since it does not mean that a specific embodiment should include all or only such effect.
Meanwhile, the meanings of terms described in the present disclosure should be understood as follows.
The terms “first”, “second”, and the like are intended to distinguish one element from another, and the scope to be protected should not be limited by these terms. For example, a first component may be referred to as a second component, and similarly, the second component may also be referred to as the first component.
It is to be understood that, when an element is referred to as being “connected” to another element, it may not only be directly connected to the other element, but also, other elements may be present therebetween. On the other hand, when an element is referred to as being “directly connected” to another element, it should be understood that there are no other elements therebetween. Meanwhile, other expressions describing the relationship between components, such as “between” and “immediately between” or “neighboring” and “directly adjacent to”, should be interpreted as well.
It should be understood that a singular expression also includes multiple expression. Further, the terms “include” and “have” are intended to specify existence of the stated feature, number, step, operation, component, part or a combination thereof, while not precluding possibility of the presence or addition of one or more other features, numbers, steps, operations, components, parts or a combination thereof.
All terms used herein have the same meaning as commonly understood by those skilled in the art to which the present disclosure pertains, unless otherwise defined. Commonly used dictionary terms should be interpreted to be consistent with the meanings in the context of the related art, and cannot be interpreted as having ideal or excessively formal meanings unless explicitly defined in the present disclosure.
Hereinafter, a method for manufacturing a bone graft composite (hereinafter referred to as “a composite manufacturing method”) according to an embodiment of the present disclosure will be described with reference to
The composite manufacturing method according to one embodiment of the present disclosure is to improve an alveolar bone regeneration rate by forming a composite of dentin collagen obtained from human teeth and a growth factor having bone inducing function. To this end, the composite manufacturing method may include washing and degreasing tooth powder (S100), completely demineralizing the tooth powder (S200), preparing a growth factor (S300) and completing a composite (S400).
Herein, the above-mentioned dentin collagen refers to a collagen mass of 100% organic material derived from a tooth that could be obtained when the tooth is completely demineralized.
At first, a tooth is pulverized using a grinder to prepare tooth powder, and the tooth powder is washed and degreased using a washing machine (S100).
In one embodiment, the tooth contains collagen and bone morphogenetic protein (“BMP”) consisting of the same components as alveolar bone, and thus includes substantially the same components. Further, the tooth has absorbability involved in bone reconstruction and, preferably, includes micropores formed therein, which collagen fibers of 5 to 200 μm in thickness can penetrate.
In one embodiment, the tooth used herein may be a tooth stored after extraction during dental treatment.
In one embodiment, the tooth used herein may be an autologous tooth that is the patient's own tooth, a homogenous tooth that is another person's tooth, or a heterogeneous tooth that is a tooth of an animal other than a human.
In one embodiment, in step S100 described above, the tooth may be pulverized into powder form using a grinder after removing a defect portion such as tooth decay or inflammation using a cutting tool.
In one embodiment, in step S100 described above, the tooth powder may be frozen with liquid nitrogen at −196° C. or lower for 40 minutes, and then pulverized by a grinder to prepare a powder having an average particle diameter of 50 to 850 μm.
In one embodiment, in step S100 described above, the tooth powder may be washed with distilled water for 40 minutes to remove contaminants and residual soft tissues, followed by degreasing the washed tooth powder in ethanol for 2 to 12 hours.
In one embodiment, in step S100 described above, suspended fat may be removed from the degreased tooth powder using a centrifuge, and the tooth powder may be washed in distilled water for 2 hours using a washing machine.
Next, in step S100 described above, the degreased tooth powder may be completely demineralized (S200).
In one embodiment, in step S200 described above, the degreased tooth powder may be completely demineralized by replacing hydrochloric acid solution in the rage of 20 times volume of 0.2 to 0.7 N for multiple times by 1 hour for 6 to 12 hours until no chemical reaction occurs.
In one embodiment, in step S200 described above, the completely demineralized tooth powder may be sterilized using a hydrogen peroxide solution for 1 hour, washed with distilled water for 2 hours, and then lyophilized. At this time, it is preferable to replace the distilled water used for washing by 30 minutes.
In step S200 described above, the completely demineralized tooth powder is transformed into dentin collagen as described above, and the dentin collagen has a collagen mass form consisting of only collagen.
In the case of tooth powder used for bone growth in the conventional method, organic and inorganic materials are obtained in a ratio by weight of 8.5:1.5 through degreasing and demineralization. On the other hand, dentin collagen obtained according to the above method may include 100% organic component.
When dentin collagen obtained by the above method is introduced into a human body, biocompatibility is excellent and more effective bone growth may be induced.
Next, a growth factor including a bone growth inducing component is prepared (S300).
In one embodiment, in step S300 described above, the growth factor may be selected from a group consisting of one of more of those, such as recombinant human bone morphogenetic protein (rhBMP-2), double complex of amino acids to construct BMP, fibroblast growth factor, growth differentiation factor (GDF), transforming growth factor (TGF), platelet-derived growth factor, insulin-like growth factor, epithelial growth factor, keratinocyte growth factor 2 (KGF2), morphogenetic protein 52 (MP52), recombinant proteins thereof, and mixtures thereof.
Finally, a composite may be synthesized by mixing the dentin collagen obtained from the completely demineralized tooth powder in step S200 and the growth factor prepared in step S300 described above (S400).
In one embodiment, step S400 described above may include a step of mixing the obtained dentin collagen with the growth factor S410, and a step of stirring the obtained growth factor as well as the obtained dentin collagen S420.
In one embodiment, in step 410 described above, it is preferable to maintain pH of the dentin collagen and the growth factor in a mixed state in a range of pH 6.5 to 8.
In one embodiment, in step S420 described above, the mixture of the dentin collagen and growth factor may be stirred using a shaker at 30 to 80 rpm for 3 to 5 minutes.
Unlike the conventional method of coating the surface of tooth powder (=tooth-derived collagen and inorganic material) with the growth factor via the above-described step S420, a layer filling method of filling a tissue layer of dentin collagen with the growth factor rhBMP-2 may be adopted so as to improve an ability to transfer the growth factor to a defect site.
Hereinafter, an embodiment of the method for manufacturing the composite described above will be described with reference to
A tooth was prepared from the patient himself (wisdom tooth, healthy tooth such as premolars extracted for correction purposes), and defects such as tooth decay and inflammation were removed.
The tooth in powder form was frozen using liquid nitrogen at −196° C. or lower for 40 minutes and then pulverized by a grinder to form a powder having an average particle size of 50 to 850 μm as shown in
1. Production of rhBMP-2
(1) Expression and Purification of Human BMP-2 Gene Using E. coli
In order to obtain the human BMP-2 gene, total cellular RNA was extracted from U2OS cells (Life Technologies™, Korea) using Trizol solution (Gibco BRL, USA) in U2OS cells and was subjected to reverse transcription. Polymerase chain reaction (PCR) was performed using 5′-AGAAGAACATATGCAAGCCAAACACAAACAGCGG-3 as a sense primer and 5′-AATTTTACAGCTTCTAGCGACACCCACAACCCT-3′ as an antisense primer with cDNA as a template. The PCR product was isolated and inserted into pGEM-T vector (Promega, USA) and cloned using E. coli (DH5α) (Life Technologies™, Korea).
(2) High-Density Cell Culture
High-density culture was performed in a fermenter (KoBioTec, Korea) using Fatemech et al. technique (Tabandeh F, Shojaosadati S A, Zomorodipour A, et al. Heat-induced production of human growth hormone by high density cultivation of recombinant Escherichia coli. Biotechnol Lett 2004; 26: 245-250. Korz D J, Rinas U, Hellmuth K, Sanders E A, Deckwer W-D. Simple fed-batch technique for high cell density cultivation of Escherichia coli. J of Biotechnology 1995; 39:59-65). A sterile nutrient medium (glucose 33.3 g/L, peptone 10 g/L, yeast extract 5 g/L, MgSO4 1 g/L, CaCl2) 0.048 g/L, ZnSO4 0.0176 g/L, CuSO4 0.008 g/L) was added thereto and cultured for 24 hours with stirring at a stirring speed of 250 rpm.
(3) Protein Purification
The suspension was stored in a cryogenic freezer at −80° C. (Nihon Freezer, Japan). The frozen suspension was thawed at a refrigeration temperature, and the cells were disrupted by pressurization and then centrifuged at 5,500 g and 4° C. for 45 minutes. When the mature rhBMP-2 having undergone a re-denaturalization process has the original tertiary structure, N-terminus has a heparin-binding site.
2. Biochemical Properties of Purified rhBMP-2
(1) Purity and Identification Test of rhBMP-2 Stock Solution
As a result of the SDS-PAGE test, as shown in
(2) HPLC (High Performance Liquid Chromatography) Analysis
The purified rhBMP-2 dimer was dissolved in 0.1% TFA (trifluoroacetic acid) at a concentration of 1 μg/μl and subjected to detection and monitoring of protein in each fraction using a C4 reversed-phase HPLC column (4.6 mm×50 mm, 300 Å, 5 μm particle size; GraceVydac, United States). As shown in
3. Production and Purification Results of rhBMP-2 Protein
After dimerization, affinity chromatography was performed in a heparin column (Sigma Dow, Italy). As a result, as shown in
4. Biological Activity of Purified rhBMP-2 (In Vitro Test)
Referring to
A bone graft composite according to the present disclosure in which the rhBMP-2 in Example 2 was filled in a tissue layer of dentin collagen derived from the tooth in Example 1 was prepared.
Hereinafter, for example, the bone graft composite according to the present disclosure, in which the rhBMP-2 in Example 2 was filled into the tissue layer of dentin collagen derived from the tooth in Example 1 will be described.
1 g of completely demineralized dentin collagen was dispensed into a glass vial and capped with a silicone plug. 1 mg of rhBMP-2 was dissolved in a solution consisting of 5 mM glutamic acid, 2.5% by weight (“wt. %”) glycine, 5 mM sodium chloride, 0.015 wt. % of Tween-80 and 0.5 wt. % of D-sorbitol, and the solution was added to the glass vial in which the tooth powder was immersed. The completely demineralized tooth implant material and the vial containing rhBMP-2 were stirred at 4 to 20° C. using a shaker at 30 to 80 rpm for 3 to 5 minutes. The pH was maintained at 6.5 to 8, while rhBMP-2 penetrated into the inner layer of the tooth implant material by adding a physical element using a shaker. Thereafter, the glass vial was placed and maintained in a vacuum freeze dryer at −80° C. for 3 to 6 hours, followed by gradually elevating the temperature to 20° C. to minimize damage to rhBMP-2. The freeze-dried glass vial was sterilized with ethylene oxide.
Six athymic mice (average weight: 15 to 20 g) were used. The animals were divided into three groups (1, 2 and 4 weeks), and each group was divided into two subgroups: a tooth administration group and a growth factor administration group. The tooth administration group is an experimental group in which only dentin collagen was administered, and the growth factor administration group is a control group in which a composite of dentin collagen and growth factor rhBMP-2 was administered. Six athymic mice were fed with free access to food and water under a mean ambient temperature condition of 22° C. and at a 12-hour shading cycle. Pentobarbital sodium (tranquilizer) was administered intraperitoneally and an operation site was disinfected and isolated to perform general anesthesia. A thigh portion was incised to form subcutaneous pockets on both sides and grafts of the growth factor administration group (0.03 g of dentin collagen, 0.2 mg/ml, 5.0 μg of rhBMP-2) were used, wherein the control group was applied to the left side while the experimental group was applied to the right side.
In the growth factor administration group, 0.03 mg of tissue layer of dentin collagen in the bone graft composite in Example 3 was filled with 0.2 ml of aqueous solution of rhBMP-2. In the control group, only 0.03 mg of dentin collagen without the growth factor was inserted and then the incision was sutured with a nylon suture. In order to protect the wound from infection, antibiotic ointment (Daewoong Pharm, Korea) was used throughout the study.
Soft tissue biopsies containing dentin collagen and the growth factor rhBMP-2 in the subcutaneous pocket were obtained from the athymic mice at 1, 2 and 4 weeks after insertion. A total of 12 biopsies was fixed in 10% formalin for 24 hours. After complete demineralization in Calci-Clear Rapid (National Diagnostics, Atlanta, Ga.) for 12 hours, the specimens were washed with distilled water. The specimens were then treated by a Hypercentre XP tissue processor (Shandon, UK), submerged in paraffin, and cut to 4 to 5 μm thickness. The divided specimens were observed using an optical microscope after hematoxylin and eosin staining. Images were captured using a Magna Fire digital camera system (Optronics, Goleta, Calif.).
However, it was found that the actual alveolar bone in a magnified image of the specimen after 1 week is produced in a completely different manner. That is, in the growth factor administration group, the regenerated bone is larger than the original tooth particle, whereas the tooth administration group showed a part of the alveolar bone to be regenerated on only the left side.
Referring to the photograph of the specimens after 2 weeks, it could be seen that the growth factor administration group (4 weeks later) achieved regeneration. On the other hand, a part of the tooth in Example 1 which is the tooth administration group (4 weeks later) was still observed, indicating that an alveolar bone regeneration rate is lower than that of the bone graft composite according to the present disclosure.
Finally, in the photographs of the specimens after 4 weeks, cartilage formation was demonstrated, which is evidence of bone induction. More particularly, similar to the growth factor administration group, the tooth administration group at the left side also exhibited cartilage. Further, tooth particles were never observed in the growth factor administration group. These results indicate that the cartilage was completely restored in addition to alveolar bone regeneration.
Referring to
As a result of
Dentin collagen in
In
The collected tooth was stored in 75% alcohol, stored in a refrigerator or freezer and sent for treatment to a clean room of Korea Tooth Bank Co. Ltd. The soft tissues remaining in the clean room were removed, and the tooth was crushed into particles of 50 to 850 μm in diameter, washed, degreased, desalted and lyophilized as previously reported. After sterilization with ethylene oxide, tooth powder was stored at room temperature for clinical use. The growth factor administration group was prepared by adding 5.0 μg of rhBMP-2 (Cowellmedi, Busan, Korea) to 0.03 g of tooth powder (0.2 mg/ml rhBMP-2 concentration). The mixture was deeply frozen at −70° C. and placed in a freeze-dried glass vial, followed by fixing the same in a freeze dryer (ILShin Lab, Seoul, Korea).
Surgery was performed under local anesthesia with 2% lidocaine HCl containing epinephrine. After incision and flap opening, tooth powder or a composite synthesized from dentin collagen and growth factor rhBMP-2 was used for supplement. Patients were instructed to take oral antibiotics (625 mg, amoxicillin and clavulanate, Augmentin, Ilseong Pharmaceutical, Seoul) 3 times a day for 5 days after rinsing the mouth twice a day with 0.1% chlorhexidine solution. At the 7th day of observation, calm healing was observed in all areas. Patients with signs of inflammation, infection or graft rejection were not reported.
The graft site was re-incised at the end of 3 months for the mandible and at 6 months for the maxillary in order to collect tissues (Trephine drill: 3.0 mm outer diameter and 2.3 mm inner diameter, Dentium, Seoul, Korea). Each sample was prepared to include both newly formed bone and implanted dentin particles. There were no wound complications such as hematoma, wound dehiscence, postoperative fever, and hemorrhage.
The tissue harvested by the trephine drill was processed for histological assessment. Two sections containing entire defect were selected and stained with hematoxylin and eosin. Digital images were obtained, and (1) a ratio of newly formed bone site, (2) an area ratio of dentin base material residue, and (3) a ratio of soft tissue component area proportional to the total area were determined using test tubes with unknown types of graft materials.
Referring to
Referring to
Such a bone graft composite as described above may induce rapid regeneration of alveolar bone to thus greatly reduce patient discomfort and achieve additional effects such as prevention of infection caused by long-term regeneration, thereby being very useful in the field of medical care.
As described above, the embodiments of the present disclosure are not limited to the above-described apparatuses and/or methods, but may also be implemented by a program for realizing functions corresponding to the configuration in the embodiments of the present disclosure or a recording medium on which the program is recorded. Further, these embodiments can be easily implemented by those skilled in the art from the embodiments described above.
While the present disclosure has been particularly illustrated and described with reference to exemplary embodiments thereof, it is to be understood that the invention is not limited to the disclosed exemplary embodiments. Instead, various modifications and improvements based on the fundamental concept of the present disclosure defined by the appended claims are also possible by those skilled in the art and would fall within the scope of the present disclosure to be protected.
Although this invention has been described in specific detail with reference to the disclosed embodiments, it will be understood that many various and modifications may be effected within the spirit and scope of the invention as described in the appended claims.
| Number | Date | Country | Kind |
|---|---|---|---|
| 10-2017-0151599 | Nov 2017 | KR | national |
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/KR2018/002067 | 2/20/2018 | WO | 00 |
