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J. Funct. Biomater. 2017, 8(4), 42;

The Effect of RANKL/OPG Balance on Reducing Implant Complications

Doctoral Training Centre—Regenerative Medicine, Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK
Biomaterials and Tissue Engineering Group, School of Dentistry, University of Leeds, Leeds LS2 9JT, UK
Department of Trauma and Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds LS2 9JT, UK
School of Chemical and Process Engineering, University of Leeds, Leeds LS2 9JT, UK
School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK
Author to whom correspondence should be addressed.
Received: 25 August 2017 / Revised: 14 September 2017 / Accepted: 19 September 2017 / Published: 22 September 2017
(This article belongs to the Special Issue Orthopaedic Biomaterials, Implants and Devices)
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Despite the phenomenal success of implants particularly in the realms of dentistry and orthopaedics, there are still challenges to overcome. The failure of implants resulting from infection, prosthetic loosening, and non-union continue to be the most notorious examples. The cascade of fracture healing and bone repair, especially with the presence of an implant, is complex because it involves a multifaceted immune response alongside the intricate process of bone formation and remodelling. Bone loss is a serious clinical problem that is frequently accompanied by chronic inflammation, illustrating that there is a convoluted relationship between inflammation and bone erosion. The effects of pro-inflammatory factors play a significant role in initiating and maintaining osteoclastogenesis that results in bone resorption by osteoclasts. This is because there is a disruption of the relative ratio between Receptor Activator of Nuclear Factor κB-Ligand (RANKL) and osteoprotegerin (OPG), which is central to modulating bone repair and remodelling. This review aims to provide a background to the bone remodelling process, the bone repair cascade post-implantation, and the associated complications. Furthermore, current clinical solutions that can influence bone formation via either internal or extrinsic mechanisms will be described. These efficacious treatments for osteolysis via targeting the RANKL/OPG ratio may be crucial to reducing the incidence of related implant failures in the future. View Full-Text
Keywords: RANKL; OPG; implants; complications; bone loss; bone; bone regeneration RANKL; OPG; implants; complications; bone loss; bone; bone regeneration

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Kapasa, E.R.; Giannoudis, P.V.; Jia, X.; Hatton, P.V.; Yang, X.B. The Effect of RANKL/OPG Balance on Reducing Implant Complications. J. Funct. Biomater. 2017, 8, 42.

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