摘要

Objectives: the following two trendy topics in the field of biostimulators (1) the debate of inflammatory vs. non-inflammatory biostimulators (PLLA-SCA vs. CaHA-R) (2) the factors that affect in vitro studies of PLA and fibroblasts, based on review and comparison of several published studies Introduction: (1) there's been a debate on the mechanism of how biostimulators induces neocollagenesis, with publication indicating that CaHA-R being non-inflammatory and PLLA-SCA being inflammatory, and vice versa. We all agree that too much inflammation is bad, but how do we decide how much is too much? (2) Many factors affect the efficacy of collagen stimulation of in vitro fibroblast culture with PLA, including PLA size/shape/concentration, culture duration, presence of macrophages, senescence of fibroblasts/macrophages. Physicians have to be aware of these factors when interpreting these studies. Materials / method: Review of literature and comparison/analysis Results: (1) There's no definite answer yet as to which biostimulator is more inflammatory, and how much inflammation is too much. The answer probably also depends on the frequency, dosage, and host factors. (2) Small-particle PLA (diameter < 1 um) may also induce transient neocollagensis with the presence of macrophages. (3) It takes time for large-particle PLA (eg,. PLLA-SCA) to affect fibroblasts an cause collagen stimulation (4) senescnet fibroblasts react differently with young fibroblasdts in in-vitro studies Conclusion: More and more biostimulators enter the market, and physicians should be familiar with mechanisms of different products